Westbrook, JI and Braithwaite, J and Georgiou, A and Ampt, A and Creswick, N and Coiera, E and Iedema, R, Multimethod Evaluation of Information and Communication Technologies in Health in the Context of Wicked Problems and Sociotechnical Theory, American Medical Informatics Association. Journal, 14, (6) pp. 746-755. ISSN 1067-5027 (2007) [Refereed Article]
OBJECTIVE: Few research designs look at the deep structure of complex social systems. We report the design and implementation of a multimethod evaluation model to assess the impact of computerized order entry systems on both the technical and social systems within a health care organization.
DESIGN: We designed a multimethod evaluation model informed by sociotechnical theory and an appreciation of the nature of wicked problems. We mobilized this model to assess the impact of an electronic medication management system via a three-year program of research at a major academic hospital.
MEASUREMENTS: Model components include measurements relating to three dimensions of system impact: safety and quality, organizational culture, and work and communication patterns.
RESULTS: Application of the evaluation model required the development and testing of purpose-built measurement tools such as software to collect multidimensional work measurement data. The model applied established research methods including medication error audits and social network analysis. Design features of these tools and techniques are described, along with the practical challenges of their implementation. The distinctiveness of doing research within a unique paradigm of complex systems, explicating the wickedness and the dimensionality of sociotechnical theory, is articulated.
CONCLUSION: Designing an effective evaluation model requires a deep understanding of the nature and complexity of the problems that information technology interventions in health care are trying to address. Adopting a sociotechnical perspective for model generation improves our ability to develop evaluation models that are adaptive and sensitive to the characteristics of wicked problems and provides a strong theoretical basis from which to analyze and interpret findings.
|Item Type:||Refereed Article|
|Research Division:||Language, Communication and Culture|
|Research Group:||Other language, communication and culture|
|Research Field:||Other language, communication and culture not elsewhere classified|
|Objective Division:||Expanding Knowledge|
|Objective Group:||Expanding knowledge|
|Objective Field:||Expanding knowledge in language, communication and culture|
|UTAS Author:||Iedema, R (Professor Rick Iedema)|
|Web of Science® Times Cited:||99|
|Deposited By:||Health Sciences B|
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