I agree. A hospital information system or other medical information system must conform to the individual institution in order to effectively facilitate the operation of that organization and the more effectively that it does its job, the more strongly it will modify the operation and the culture and character of that organization over time. This bi-directional adaptation necessarily takes time and thought and ongoing development of both the software and organization.
Adrian Midgley wrote: >> when the authors were not also the system developers, less than >> half of the systems showed an improvement. In fact, "grading oneself" >> was the only factor that was consistently associated with good >> evaluations." > >Now I interpret this and the next quote differently. > > >> No matter how much they may try to be objective, the very process of >> development and refinement has created in them hidden assumptions about >> "the way things work" > >I suspect that if the people using the system are not (strongly >influential in) developing it, it does not improve their performance. > >and... > >I think that as one develops (or perhaps extensively configures) >software, in one's practice, the assumptions including values that one >works on in clinical practice and administration are built into it, and >feed back in their turn, in that sometimes choices in software objectify >a choice between potential ways to do something, codify a practice, >treat a condition. > >Thus the system shrinks and stretches onto the users like a pair of >jeans in a bath. > >Later, it doesn't fit anyone else quite so well. > >-- >Adrian Midgley FLOSS regularly > > --------------------------------------- Jim Self Systems Architect, Lead Developer VMTH Computer Services, UC Davis (http://www.vmth.ucdavis.edu/us/jaself)
