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DESIGNING INTERACTIONS 113 Figure 6.5 There is a continuum of common ground between agents that defines how much of the interaction can be modelled formally ahead of time, and how much needs to be left informal until the time of the interaction. Computational systems work well when substantial modelling can occur ahead of time, whilst communication systems can be used when agents are unable to reliably model their interactions ahead of time. While we cannot predict every specific interaction that will occur in the real work environment, the design process can model the typical interaction space within which any new system will be introduced. The interaction space can be modelled to include the most important interactions that will be competing with the new designed interaction. Within the overall interaction space, the communication space forms a subset containing interactions that are informal person-to-person exchanges. We can also conceive of an information space, which by corollary contains those formally structured interactions that typically rely on information models and computational systems. We saw earlier that the notions of the communication space and information space are probably driven by a dichotomy in communication and information technologies, and that at a more abstract level, they actually are not separate spaces but form different ends of a continuum of explicit task modelling. To construct the interaction space, we start with a general description of an interaction between two agents, which may either be human, or computational. An agent typically has a number of tasks that need to be carried out, and a pool of resources available to accomplish those tasks. An interaction occurs between two agents when one agent creates and then communicates a message to another, to accomplish a particular task. A mediated interaction occurs when a communication channel intermediates between agents by bearing the messages between them. For example, e-mail can be used to mediate an interaction between two individuals, just as can an electronic medical record, which is as much a service to communicate messages between clinical staff, as it is an archival information repository.
114 STARTING POINTS The first step in modelling the interaction space surrounding a new interaction we wish to design is to note which other agents will be local to the new interaction, and then to examine the likely effects of any interactions they might have on the new interaction. By doing so we enhance the chance that new interactions will succeed when they are eventually introduced into the intended interaction space. In general terms the impact of one interaction on another may be to (Figure 6.6): ■ ■ ■ Compete with another interaction as a direct substitute. For example, a user could use an on-line database to seek information, or instead, use the telephone to call a colleague to ask for the same information. The human—human interaction mediated by the telephone competes with the database to meet the user’s information needs. Compete with another interaction for the resources of an agent. An agent has limited resources and if they are expended on one interaction they may not be available to another. For example, an information system may be well received in ‘in vitro’ laboratory tests, but when placed in a work environment we may find the users have insufficient time to use the system, because of competing tasks. The new system is then ‘rejected’ not because it does not do what was intended, but because the impact of the real-world interaction space on its intended users was not modelled. Concurrent interactions can also subvert the execution of a designed interaction. For example, a user may be interrupted in the workplace and take up a new task, and not log off the information system they were using, causing a potential breach of security. Create new information transfer pathways, through a combination of interactions. Each interaction connects agents, and each new interaction enables novel conversations between agents. If these combinations are not factored into system design, then the introduction of a system may produce unexpected results. For example, consider the interaction between a human agent and an electronic patient record system or EPR. Computational agents that might co-exist with the EPR could include other applications like e-mail or a word-processor. If the design process fails to include these additional computational agents, then unintended interactions made possible via these other agents may subvert the original EPR design. For example, it may be possible for a user to copy a section of text from the medical record to a wordprocessor, where it can be edited, and then re-inserted into the EPR. However, since this interaction with the word-processor is not part of the original design scope, it may introduce problems. A user could inadvertently paste the text into the record of a different patient, and no formal mechanism would be in place to prevent this context-switch error. Similarly, text might be copied from an EPR that has been designed with powerful security features to prevent unauthorized access, and then copied into an e-mail message, which is insecure. In both cases, the co-existence of an unmodelled additional computational agent introduces interactions beyond the scope of the original
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Health Information Management In al
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Health Information Management Integ
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Contents List of illustrations vii
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Illustrations FIGURES 3.1 Medicatio
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Contributors Marc Berg is a physici
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Series preface In almost all Wester
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Acknowledgements I would like to th
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Chapter 1 Introduction In all Weste
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INTRODUCTION 3 touch upon the deplo
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INTRODUCTION 5 can draw upon to mai
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INTRODUCTION 7 Physician Order Entr
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Part I Starting points Understandin
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WAITING FOR GODOT 11 KEY TERMS ■
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WAITING FOR GODOT 13 Netherlands an
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WAITING FOR GODOT 15 facts to show
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WAITING FOR GODOT 17 (Lewinski-Corw
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WAITING FOR GODOT 19 In most cases,
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WAITING FOR GODOT 21 (Anonymous 191
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WAITING FOR GODOT 23 Because of the
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WAITING FOR GODOT 25 they simply sa
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WAITING FOR GODOT 27 expected. Stil
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WAITING FOR GODOT 29 organize their
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WAITING FOR GODOT 31 performance in
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WAITING FOR GODOT 33 different HIS
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WAITING FOR GODOT 35 CONCLUSION: TH
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WAITING FOR GODOT 37 assumption tha
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WAITING FOR GODOT 39 Anonymous (191
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WAITING FOR GODOT 41 Berg, M. (1997
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Chapter 3 Health care work and pati
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HEALTH CARE WORK AND INFORMATION SY
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Page 78 and 79: THE CONTEXTUAL NATURE OF INFORMATIO
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Page 96 and 97: STARTING POINTS 81 ‘gender, race,
Page 98 and 99: STARTING POINTS 83 Now, imagine an
Page 100 and 101: STARTING POINTS 85 organization,
Page 102 and 103: STARTING POINTS 87 Figure 5.2 Incre
Page 104 and 105: STARTING POINTS 89 already overflow
Page 106 and 107: STARTING POINTS 91 responsibilities
Page 108 and 109: STARTING POINTS 93 answer the quest
Page 110 and 111: STARTING POINTS 95 Kohn, L.T., J.M.
Page 112 and 113: Chapter 6 Designing interactions En
Page 114 and 115: DESIGNING INTERACTIONS 99 the way t
Page 116 and 117: DESIGNING INTERACTIONS 101 1 Identi
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Page 120 and 121: DESIGNING INTERACTIONS 105 communic
Page 122 and 123: DESIGNING INTERACTIONS 107 Figure 6
Page 124 and 125: DESIGNING INTERACTIONS 109 ■ Figu
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Page 130 and 131: DESIGNING INTERACTIONS 115 Figure 6
Page 132 and 133: DESIGNING INTERACTIONS 117 Covell D
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Page 136 and 137: INFORMATION STRATEGY: AN INTRODUCTI
Page 152 and 153: Chapter 8 Developing the informatio
Page 154 and 155: STRATEGY, IMPLEMENTATION AND EVALUA
Page 172 and 173: Guidelines for information system d
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STRATEGY, IMPLEMENTATION AND EVALUA
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Chapter 9 Implementing information
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IMPLEMENTING INFORMATION SYSTEMS 16
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Chapter 10 Project management of in
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Index accumulation 53-4, 61, 73-4,
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INDEX 223 contingent and emergent c
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INDEX 225 satisfaction 176 patient
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INDEX 227 support 164 technology de
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