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A generic model of clinical practice.

H J Tange1, J L G Dietz, A Hasman

  • 1Department of Medical Informatics, Maastricht University, Maastricht. tange@mi.unimaas.nl

Methods of Information in Medicine
|July 23, 2003
PubMed
Summary

A new generic model for clinical practice, based on conversation theory, can guide the design of electronic patient record (EPR) systems for shared care. This model defines four actors and their interactions to represent clinical activities.

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Area of Science:

  • Health Informatics
  • Clinical Informatics
  • Healthcare Management

Background:

  • Shared-care initiatives require robust electronic patient record (EPR) systems.
  • Lack of practical experience necessitates theoretical models for EPR design in shared care.
  • Existing models of individual clinical practice offer limited scope for collaborative settings.

Purpose of the Study:

  • To review and integrate elements from existing individual clinical practice models.
  • To present a generic model of clinical practice applicable to both individual and collaborative settings.
  • To provide a theoretical foundation for designing EPR systems in shared care environments.

Main Methods:

  • Application of conversation-for-action theory principles.

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  • Utilization of the DEMO method for modeling information generation through conversations.
  • Defining actors as roles, irrespective of whether they are played by single or multiple individuals.

    • Main Results:

    • Clinical practice is conceptualized through four distinct actors: service provider, problem solver, coordinator, and worker, each representing a level of clinical responsibility.
    • Information within the patient record is generated through conversations between pairs of these actors.
    • Connecting these conversations creates a process view, offering meta-information on the rationale of clinical practice, suitable for EPR extension.

    Conclusions:

    • The developed generic model demonstrates potential for encompassing all professional activities in clinical practice.
    • Further validation is required to confirm the model's comprehensive applicability.
    • While providing a theoretical basis for shared-care EPR systems, successful implementation necessitates considerations beyond the theoretical model itself.