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J Am Med Inform Assoc 1997;4:94-101 doi:10.1136/jamia.1997.0040094
  • Focus on People and Organization Issues
  • Review

Addressing Organizational Issues into the Evaluation of Medical Systems

  1. Bonnie Kaplan
  1. Affiliation of the author: Quinnipiac College, Hamden, CT; Institute of Living, Hartford, CT
  1. Correspondence and reprint requests to: Bonnie Kaplan, PhD, Director, Medical Information Systems Program, Associate Professor, Computer Science/Information Systems, Quinnipiac College, Hamden, CT 06518.E-mail: bkaplan{at}yalevm.cis.yale.edu
  • Received 2 October 1996
  • Accepted 21 November 1996

Abstract

New system design and evaluation methodologies are being developed to address social, organizational, political, and other non-technological issues in medical informatics. This paper describes a social interactionist framework for researching these kinds of organizational issues, based on research within medical informatics and other disciplines over the past 20 years. It discusses how effective evaluation strategies may be undertaken to address organizational issues concerning computer information systems in medicine and health care. The paper begins with a theoretical framework for evaluation. It then describes the 4Cs of evaluation: communication, care, control, and context. Five methodological guidelines are given for conducting comprehensive evaluations that address these 4Cs. An example of an evaluation research design that fits the guidelines and was used in an evaluation of an on-line clinical imaging system is discussed. Results of the evaluation study illustrate how this approach addresses organizational concerns and the 4Cs.

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