Ching-Ping Lin

Computer Physician Order Entry (CPOE) systems have been shown to save time, streamline processes and reduce medication prescribing errors and adverse drug events. However, CPOE remains a poorly adopted technology in most United States hospitals. Clinical work is known to be interruptive, multitasking, collaborative and distributed yet current CPOE systems emphasize linear, normative and solitary work. To study this work-technology disconnect, I performed a qualitative field study that included document collection, observations and interviews of pediatric inpatient physicians working in teams. I identified emerging physician work themes through inductive analysis. I systematically characterized the larger contexts in which ordering occurs by deductively analyzing these data using Cognitive Work Analysis (CWA) - a holistic systems analysis framework that characterizes work by identifying constraints on work at multiple levels from the work environment to the worker. Through these combined results, I identified and will present design implications for future CPOE systems that can support flexibility, cooperation and adaptation to unanticipated work situations before they become sources of medical errors.