Order creation and communication in healthcare

Methods Inf Med. 2003;42(4):376-84.


Objectives: The aim of this paper is to examine the adequacy of the concept of Physician Order Entry (POE) as a model for clinical systems, and to suggest an alternative understanding of the order creation and communication process.

Methods: The study is based on an interpretative analysis of POE as a model for clinical systems and the results of our recent fieldwork.

Results: Observations from our recent fieldwork suggest that orders, like patient care in general, emerge from interactions among patients, physicians, nurses, family members, and others, employing a variety of technologies and information resources in the process. Orders as we have observed them originate, are negotiated, and are carried out in a dynamically evolving group with fluctuating membership and shifting role responsibilities. Furthermore, orders by themselves represent only a partial picture of what is done for the patient.

Conclusion: We argue that information systems are more likely to be helpful if they accommodate and facilitate POE as a multidisciplinary collaboration effort and fit better into the larger system of patient care.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Cognition
  • Decision Support Systems, Clinical*
  • Hospital Information Systems*
  • Humans
  • Interdisciplinary Communication*
  • Language
  • Medical Records Systems, Computerized*
  • Models, Organizational
  • Program Development
  • United States
  • User-Computer Interface