Victoria E. Slinde Bang and Stig Grube Jakobsen: Secundary application of EPR for scientific work in an educational and research institution: A field study at the Dental Schoool in Copenhagen with a view to determining the preconditons of an implementation. Master Thesis in Danish [Sekundær anvendelse af EPJ til videnskabeligt og forskningsrelateret arbejde på en uddannelses- og forskningsinstitution - en forundersøgelse på Tandlægeskolen i København med henblik på afdækning af forudsætningerne for en realisering], IT University of Copenhagen, September 2005.
The following report concludes and documents a study at the Copenhagen School of Dentistry aimed at setting the stage for future utilization of information in an electronic patient record in relation to secondary purposes such as scientific research work. The purpose of this study is to assure the required level of quality of the data in the electronic patient record, which is deemed necessary to perform such activities, through analysis of aspects of the domain of work, the working arrangement(s), the organisational culture, and norms etc., and to propose guidelines for the design and realisation of the identified level of quality - both at the technical level as well as the organisational level.
The conducted study follows an empirical approach, based on nineteen on location-interviews, representing the domain of work as widely as possible. Besides these interviews there have been a pre-investigation - containing five interviews, in-situ interviews, and participation in a workshop - narrowing down the characteristics of the problem at hand. Finally, the project group has had a first-hands experience with a related system in G6teborg, Sweden including an interview with a leading system developer attached to the ongoing development of a system called MedView. The resulting insight into the domain of work has demonstrated a rather complex domain due to the fact that it is concerned with a cross-functional educational and research agenda within a highly specialized academic profession.
The conducted study is further shaped and supplemented by a theoretical approach centred around issues of CSCW, with a focus on temporally and spatially distributed knowledge workers, and their means of cooperation and articulation. This has led to a focus on how to distribute knowledge through the electronic patient record, which, in this context, is considered to be a semantic extension of the clinical information traditionally contained in patient records of various kinds. This demand for knowledge distribution, i.e. semantically enriched
clinical information, correlates with the heterogeneous aspect of the domain of work, which is causing certain cognitive as well as organisational barriers with respect to realizing the full potential of an inter-disciplinary secondary utilization of data stored in the electronic patient record system. The study points to the necessity of implementing metadata as a means of supplying actors with semantic insight into the specific context of data, thereby, allowing them to judge the appropriateness of these data in relation to the work at hand. The study further indicates variability in the specific needs for information in relation to the various tasks conducted in the domain of work, making the need for facilitating insight through the use of metadata evident. The need for organisational change is also identified as a critical condition for the realisation of the technological change due to the characteristics of the existing work practice and the organisational culture and norms.