Summary
Objectives: The aim of this paper is to examine the adequacy of the concept of Physician Order
Entry (POE) as a model for clinical systems, and to suggest an alternative understanding
of the order creation and communication process.
Methods: The study is based on an interpretative analysis of POE as a model for clinical systems
and the results of our recent fieldwork.
Results: Observations from our recent fieldwork suggest that orders, like patient care in
general, emerge from interactions among patients, physicians, nurses, family members,
and others, employing a variety of technologies and information resources in the process.
Orders as we have observed them originate, are negotiated, and are carried out in
a dynamically evolving group with fluctuating membership and shifting role responsibilities.
Furthermore, orders by themselves represent only a partial picture of what is done
for the patient.
Conclusion: We argue that information systems are more likely to be helpful if they accommodate
and facilitate POE as a multidisciplinary collaboration effort and fit better into
the larger system of patient care.
Keywords
Computerized physician order entry (CPOE) - human computer interaction - social informatics
- distributed cognition
