Ethnography

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Ethnography

Executive Summary of HIDA Evaluation of HIS by Ethnographic and Human Factors Engineering

In order to improve the implementation process of HIS, HIDA will be employing extensive ethnographic and workflow analysis prior to rollout of any HIS product by our clients. Recent literature(1) suggests that such an analysis may contribute greatly to improved success of such rollouts.

The ethnographic analysis is a qualitative research method focusing on close field observation of sociocultural phenomena.

History: In the past, ethnography has been used in cultural anthropology to look at the everyday behaviors of groups with a common culture, beginning with such social scientists as Malinowski or Mead in the early 1920’s.

In this case, we will be looking at the hospital settings where the HIS will be deployed. The analysis will involve direct(participant) observations of all physician, nursing , pharmacy, ancillary personnel, dietary, housekeeping and administrative personnel and anyone else involved in the day-to-day operations of each area of the hospital, on a shiftwide basis. In addition, key representatives of each group identified by the ethnographer will be interviewed for a more thorough understanding of current work interactions with others on the team, and how HIS could enhance that interaction.

A workflow analysis will be constructed based on the observations and interviews of the ethnographic analysis. The effort to enhance this workflow with HIS will be evaluated first by storyboard prior to HIS rollout, with an attempt to modify HIS to fit to personnel workflow.

Advantages: Long term observation of the various areas of the hospital areas in which the HIS is to be deployed should give HIDA distinct advantages in understanding the workflow of the personnel to be using the HIS, their interactions, and well as ways in which the user/tool dyad can be enhanced.

Shortcomings: The shortcomings of participant observation can involve some ethical dilemmas (relationships that can influence research findings, perceptions of the researcher that can influence findings,etc)(2)

Examples in Medical Informatics: Work of the POET group at OHSU: http://www.ohsu.edu/academic/dmice/research/cpoe/index.php

Bibliography: 1. Chan,W, “Increasing the success of physician order entry through human factors engineering,” J of Healthcare Information Management 2002, 16(1):71-9.

2. Fine, G. A. , “Ten lies of ethnography”, Journal of Contemporary Ethnography, 1993, 22, p. 267-294. Sandy Mendel [Category: BMI560-W-08]