Understanding clinical work practices for cross-boundary decision support in e-health

Area of Science:

• Health Informatics
• Clinical Practice Research
• Human-Computer Interaction

Background:

• Integrated healthcare information systems aim for cross-organizational decision support.
• Effective decision support requires understanding local clinical practices, clinician capabilities, workplace context, and patient needs.
• Adapting knowledge for cross-boundary decision support is a significant challenge in e-health.

Purpose of the Study:

• To investigate clinical practices across different geographical regions (UK, UAE, Nigeria).
• To identify factors influencing variations in clinical practices.
• To propose design guidelines for enterprise information systems supporting cross-boundary e-health decision support.

Main Methods:

• User-centered study involving clinicians from the UK, UAE, and Nigeria.
• Analysis of clinical practices within their real-world contexts.
• Identification of ontological, stereotypical, and situated practices.

Main Results:

• Clinical practices differ significantly across geographical work settings.
• Differences are moderated by adherence to best practice guidelines and patient-centered care needs.
• Awareness of specific practice types (ontological, stereotypical, situated) is crucial for knowledge adaptation.

Conclusions:

• Local work contexts significantly shape clinical practices.
• A practice-centered approach is essential for effective cross-boundary e-health decision support.
• The proposed CaDHealth framework offers a model for developing adaptive enterprise information systems.