Modeling Patient Treatment With Medical Records: An Abstraction Hierarchy to Understand User Competencies and Needs
Modeling Patient Treatment With Medical Records: An Abstraction Hierarchy to Understand User Competencies and Needs
复制标题
使用医疗记录对患者治疗进行建模：了解用户能力和需求的抽象层次结构
作者：
J. St;C. Burns
医疗保健是一个复杂的社会技术系统。患者治疗正在不断发展，需要结合技术的使用和新的以患者为中心的治疗模式。认知工作分析（CWA）是理解复杂系统的有效框架，工作域分析（WDA）有助于理解复杂生态。虽然CWA以前的应用程序已经描述了病人的治疗，由于其工作范围，病人以前被描述为生物医学机器，而不是参与自己护理的病人演员。目的建立一个抽象的层次结构，将患者描述为具有复杂社会价值观和优先权的人。这有助于更好地理解现代护理方法中的治疗。本研究的目的是进行WDA，以代表具有医疗记录的患者的治疗。方法通过对书面文本的分析和与主题专家的合作，开发了该模型。我们的WDA通过其功能目的，抽象功能，广义功能，物理功能和物理形式来表示生态。结果与其他工作领域模型相比，该模型能够清晰地表达医疗、患者教育和有限卫生保健资源之间的微妙平衡。分析中的概念与其他WDA的建模选择相似，但将它们组合为全面、系统和上下文概述。该模型有助于了解用户的能力和需求。未来的模型可以被开发为模拟患者的域，并使探索的共享决策（SDM）的范例。结论我们的工作域模型将治疗目标、决策约束和任务工作流联系起来。这个模型可以被那些希望使用生态界面设计（EID）来改进系统的系统开发人员使用。我们的层次结构是未来可以探索新治疗模式的第一个。未来的层次结构可以将患者建模为控制器，并且可能对移动的应用程序开发有用。
Background Health care is a complex sociotechnical system. Patient treatment is evolving and needs to incorporate the use of technology and new patient-centered treatment paradigms. Cognitive work analysis (CWA) is an effective framework for understanding complex systems, and work domain analysis (WDA) is useful for understanding complex ecologies. Although previous applications of CWA have described patient treatment, due to their scope of work patients were previously characterized as biomedical machines, rather than patient actors involved in their own care. Objective An abstraction hierarchy that characterizes patients as beings with complex social values and priorities is needed. This can help better understand treatment in a modern approach to care. The purpose of this study was to perform a WDA to represent the treatment of patients with medical records. Methods The methods to develop this model included the analysis of written texts and collaboration with subject matter experts. Our WDA represents the ecology through its functional purposes, abstract functions, generalized functions, physical functions, and physical forms. Results Compared with other work domain models, this model is able to articulate the nuanced balance between medical treatment, patient education, and limited health care resources. Concepts in the analysis were similar to the modeling choices of other WDAs but combined them in as a comprehensive, systematic, and contextual overview. The model is helpful to understand user competencies and needs. Future models could be developed to model the patient’s domain and enable the exploration of the shared decision-making (SDM) paradigm. Conclusion Our work domain model links treatment goals, decision-making constraints, and task workflows. This model can be used by system developers who would like to use ecological interface design (EID) to improve systems. Our hierarchy is the first in a future set that could explore new treatment paradigms. Future hierarchies could model the patient as a controller and could be useful for mobile app development.