Development process of a mobile electronic medical record for nurses: a single case study.

Area of Science:

• Health Informatics
• Human-Computer Interaction
• Nursing Technology

Background:

• The increasing demand for labor-saving technology in nursing is driven by staff shortages.
• Integrating new innovations into healthcare practice presents significant challenges.
• This study examines the development of a mobile input device for electronic medical records (MEMR) that ultimately failed to meet nursing staff needs.

Purpose of the Study:

• To analyze the development process of a mobile input device for electronic medical records (MEMR).
• To identify and understand the mismatches between nursing staff needs and the MEMR's design parameters.
• To trace these mismatches back to decisions made during the MEMR development.

Main Methods:

• A case study approach was employed using an axiomatic design framework for evaluation.
• A mixed-method research design included analysis of 118 documents, 29 interviews, a user test, and observation.
• Findings were categorized to analyze key mismatches between user needs and system design.

Main Results:

• Extensive nurse involvement did not fully translate into effective improvements for the MEMR.
• Significant mismatches included suboptimal supportive technology, limited app/device functionality, and workflow disruption.
• Many identified mismatches were known by the IT department prior to product rollout, leading to limited use and halted development.

Conclusions:

• Design parameter choices in labor-saving healthcare technology can conflict with end-user needs.
• Despite IT awareness of issues, nurse managers adopted the MEMR based on its concept.
• Assessing the impact of design choices on workflow with both nurses and nurse managers is crucial for successful technology implementation.