Projects

Co-Evolving Roles and Technologies in the NHS: Barrier and Forces for Changes

Aims

New information technologies, such as the National Electronic Library for Health (NeLH), are rapidly being introduced in the UK National Health Service, forcing working practices to adapt. This, in turn, causes changes in roles, relationships and expectations. For example, patients gathering information about their conditions from the world wide web challenge the expertise of their general practitioners, changing the doctor-patient relationship. Similarly, traditional authority roles are challenged by junior hospital staff accessing information that their senior colleagues may have neither the time nor skills to. The traditional academic / research role of the clinical librarian is, in turn, being challenged to change into that of a knowledge broker to support day-to-day clinical decisions.

• The focus of the proposed research is on understanding the forces for, barriers against, and effects of change, as information systems such as digital libraries are introduced in clincial settings.
• Looking at the strong forces for change, such as the perceived potential of new technologies to support clincial practice, government pressures towards professional accountability (including a focus on evidence-based medicine and clinical governance) and pressure from well-informed patitents Within clinical professions, however, there is often resistance to change, resulting in misfits between individuals´ value and the expectations of others. Thus, internal forces are creating dynamics for change, which may reinforce or oppose external forces for change.

Methodology

The project will apply qualitative research methods including observation, in-depth interviews and focus groups, using Grounded Theory Analysis techniques to develop a well-founded account of changes and their interrelationships, for a range of user groups and within a variety of clinical settings. User groups will include patients and their representatives, clinicians and other healthcare professionals (such as librarians and IT staff); settings will include primary care and hospitals, urban (including a teaching hospital) and rural. The project will take place over three years.

Keywords

healthcare IT; digital; socio-technical systems; organisational change; NeLH; human-computer interaction

Publications

Adams, A., Blandford, A. & Lunt, P. (2005). Social Empowerment and Exclusion: A Case Study on Digital Libraries. In ACM Transactions on CHI. 12.2. 174-200. (pdf)

Adams, A., & Blandford, A. (in preparation) The Developing Role of Digital Library Intermediaries. To be submitted to JASIST. Full draft exists.

Adams, A., Blandford, A. & Attfield S. (2005). Implementing Digital Resources for Clinicians' and Patients' Varying Needs. In Medical Informatics and the Internet in Medicine. 30(2) 107-122. (Special issue on BCS Healthcare Computing 2005) (pdf)

Adams , A. & Kostkova (2004) Healthcare Digital Libraries Workshop – ECDL 2004, 16 September 2004 . Workshop report in Dlib Magazine. October 2004. Available from http://www.dlib.org/dlib/october04/adams/10adams.html

Adams, A., Blandford, A., Budd, D. & Bailey, N. (2005). Organisational Communication and Awareness: A Novel Solution. Health Informatics Journal 11: 163 - 178. (pdf)

Adams, A. & Blandford, A. (2005). Digital Libraries' support for the user's Information Journey. In Proc. JCDL 2005. 160-169. (pdf)

Adams, A. & Blandford, A. (2005). Bridging the Gap Between Organisational and User Perspectives of Security in the Clinical Domain. In International Journal of Human-Computer Studies. 63. 175 - 202. (pdf)

Adams, A. (2005). The Impact of Authentication on Health Digital Resources. Proc. Workshop on Healthcare Digital Libraries. 22 September 2005 , Vienna . (pdf)

Adams, A., Attfield, S. & Blandford, A. (2004). Have Digital Resources Taken a Wrong Turn on the Health Information Journey? In Proc. Healthcare Digital Libraries Workshop (at ECDL 2004). (pdf)

Adams, A. & Blandford, A. (2003). An Outreach Librarian Project’s Impact Upon Successful Digital Library Uptake. Proc. Workshop on Healthcare Digital Libraries. 21 August 2003 , Trondheim . (pdf)

Attfield, S., Adams, A. & Blandford, A. (forthcoming) Patient Info rmation Needs: Before and After Doctor Consultations. To appear in Health Info rmatics Journal Extended version of a paper (pdf) presented at the Proc. Workshop on Healthcare Digital Libraries. 22 September 2005 , Vienna . (pdf)

Attfield, S., Adams, A. & Blandford, A. (2004) Effective ways to use non-personal information in healthcare: report from a workshop held at University College London 15-16 April 2004. Healthcare Libraries Group Newsletter. 21(3). September 2004. 16-17.

Broome, C. & Adams, A. (2005) What gets missed when deploying new technologies in A&Es. Medical Informatics and the Internet in Medicine. 30(2) 83-87. (Special issue on BCS Healthcare Computing 2005).

Buchanan, G., Jung, D., Hinze, A. & Adams, A. (2005) Health Service DL Alerting: Users, Requirements and Design. Proc. Workshop on Healthcare Digital Libraries. 22 September 2005 , Vienna .

Fields, B., Adams, A. & Kostkova (2003). Healthcare Digital Libraries workshop – ECDL 2003, 21 August 2003 . Workshop report in Dlib Magazine. September 2003. Available from http://www.dlib.org/dlib/september03/09contents.html

Fleet, L. & Blandford, A. (2005). Requirements of Time Management Tools for Outpatient Physiotherapy Practice. Health Informatics Journal 11: 179 - 199. (pdf)

Murphy, J & Adams, A (2005) Demonstrating the Benefits of User Education: the Case for IT Skills and Info rmation Literacy. In Health Info rmation and Libraries Journal, special issue from presentations at the Royal Society of Medicine. 22(s1). 45-58