HERO (Healthcare Electronic Records in Organisations)

NHS的一项重大创新是全电子病历（EPR），允许数据传输（例如在全科诊所和药房或医院之间），并提供自动提示，以确保医生或护士记得做正确的测试并提供正确的治疗（循证实践）。但医疗工作是复杂的，EPR并不完全适合医生、护士和管理人员的工作方式。这项研究大量借鉴了美国组织科学家最近的理论和方法论见解，重新审视了EPR的真正用途。我们不把它看作是关于病人知识的容器，而是把EPR看作是围绕病人疾病发展轨迹的协作工作实践的组织者。换句话说，EPR告诉众多的卫生专业人员，行政人员和管理人员他们必须在何时和以何种顺序（以及患者必须在哪里）做什么，以确保提供适当的一揽子护理。我们将使用多方法，多地点的案例研究方法（基于尹的工作）来研究这些工作实践以及EPR如何增强，发展和威胁它们。研究的目标是产生一个务实的模式，支持NHS组织实施EPR和类似的复杂技术。

A major innovation in the NHS is a fully electronic patient record (EPR) that allows data to be transferred (e.g. between general practice and pharmacies or hospitals), and which also provide automatic prompts to make sure the doctor or nurse remembers to do the right tests and provide the right treatment (evidence based practice). But medical work is complex, and the EPR does not fit seamlessly into the way doctors, nurses and managers tend to go about their business. This study, which draws heavily on recent theoretical and methodological insights from organisational scientists in the USA, takes a new look at what the EPR is really for. Instead of considering it as a container for knowledge about the patient, we view the EPR as an ORGANISER for collaborative work practices around the patient s unfolding illness trajectory. In other words, the EPR tells the numerous health professionals, administrators and managers what they have to do when and in what order (and where the patient has to be), to ensure that an appropriate package of care is delivered. We will use a multi-method, multi-site case study approach (based on the work of Yin) to study these work practices and how the EPR enhances, develops, and threatens them. The goal of the research is to produce a pragmatic model for supporting NHS organisations in implementing the EPR and comparable complex technologies.