A declarative model of clinical information systems integration in intensive care

Munir, SK

Abstract

The findings of this multi-site study emphasise the importance of Organisational
Culture for integrating clinical information systems into intensive care units. A novel
model, the Iterative Systems Integration Model, has two principle components, these
being Organisational Culture and the Actual Usefulness of the clinical information
system. The model is derived from empirical data collected in four intensive care sites
in England and Denmark, with one site being used to validate the model. The model
highlights clinical information systems as directly affecting the work processes of the
sites investigated, which in turn affect the Organisational Culture and Actual Usefulness
of the clinical information system used, and these features affect clinical information
system integration. This forms an iterative process of change as clinical information
systems are introduced and integrated.
Intensive care units are complex organisations, with complex needs and work
processes. The impact of clinical information systems on these work processes is
investigated in this thesis using Role Activity Diagrams. These diagrams are analysed to
show that although clinical work processes are consistent at each site, the information
processes differ. Intensive care information processes are found to have the potential to
be much simplified with the introduction of seamless clinical information systems.
Qualitative data collectio n methods were deployed, i. e., observations,
interviews, and shadowing of clinical staff, together with a questionnaire at each site for
further validation. Data were analysed using grounded theory to extract salient
variables, which informed the development of the model. These factors were indicative
of the Organisational Culture of the sites investigated and the Actual Useftilness of the
clinical information systems being used.
It was posited that clinical information systems that reconcile expectations of
both hospital management and clinical staff - and that have the potential to adapt to
their organisational environment - have a greater chance of surviving in complex
environments such as intensive care. Despite decades of Health Infon-flatics, no such
systems exist in their entirety; this research shows that 'ancient problems' of clinical
information systems integration are still prevalent, and presents the Iterative Systems
Integration Model, the application of which may assist with the integration of clinical
information systems in intensive care.

Citation

Munir, S. A declarative model of clinical information systems integration in intensive care. (Thesis). University of Salford, UK

• Thesis Type: Thesis
• Deposit Date: Jun 23, 2009
• Publicly Available Date: Jun 23, 2009
• Additional Information: Additional Information : PhD supervisor: Professor Stephen Kay
• Award Date: Jan 1, 2004