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understanding healthcare professionals and the system in which they work. The tools of
RHC, while still in early stages of development, have potential to complement other
determinant frameworks such as computational simulation modelling (e.g. system
dynamic modeling,[16-18] discrete event modelling[19, 20] and agent based
modelling[21, 22]). This chapter presents two aspects of RHC applicable to
interventions in health informatics: understanding how normal variation in everyday
work can affect design and implementation of sustainable digital health systems, and
designing information systems to cope with unexpected events.
2. Applications of Resilient Health Care in health informatics
2.1. Identifying and understanding variability in everyday work
The importance of considering wanted and unwanted variation in everyday work
when designing sustainable digital health systems is illustrated through a case study of
the implementation of an Australia-wide video consultation and triage service
supporting expecting parents and parents, families and carers of young children.
Established in 2010, the telehealth service consists of a national helpline, video and
website service sponsored by the Australian government. Telephone consultation and
triage services are commonly used to deliver health advice worldwide. In Australia,
availability of high-speed internet services in remote areas is driving a move from
telephone to video telehealth services for healthcare providers; however, providers are
unfamiliar with how to introduce and operate a video service. When designing a new
system of work, it is important to take into consideration how day-to-day work is
currently carried out, in order to improve uptake and reduce workarounds when the
system is implemented.[23] A useful tool for understanding variation in everyday work,
including how that variation in combination with multiple interacting activities can
affect outcomes, is the Functional Resonance Analysis Method (FRAM).[24]
The FRAM supports modelling complex socio-technical systems and is developed
by determining the activities or functions that make up a process, and how they are
coupled. Depending on the problem to be solved or question to be answered, the
process can be modelled broadly, or at a more detailed level. For example, if we
wanted to model the processes involved in using an automatic teller machine (ATM),
we might break the process broadly into activities of (1) insert card, (2) enter PIN, (3)
enter withdrawal amount, and (4) take money and card. However, if we were interested
in specific detail such as the usability of the ATM screen, we might expand step (3) to
include additional steps for select savings account, check account balance, enter
withdrawal amount, request receipt, and so on. The data for developing a FRAM model
can be obtained through a number of methods, including ethnography, interviews,
documented processes, and so on. Each function is then described in terms of six
aspects (see Figure 1):
R.Clay-WilliamsandJ.Braithwaite /ResilientHealthCare 137
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Buch Applied Interdisciplinary Theory in Health Informatics - Knowledge Base for Practitioners"
Applied Interdisciplinary Theory in Health Informatics
Knowledge Base for Practitioners
- Titel
- Applied Interdisciplinary Theory in Health Informatics
- Untertitel
- Knowledge Base for Practitioners
- Autoren
- Philip Scott
- Nicolette de Keizer
- Andrew Georgiou
- Verlag
- IOS Press BV
- Ort
- Amsterdam
- Datum
- 2019
- Sprache
- englisch
- Lizenz
- CC BY-NC 4.0
- ISBN
- 978-1-61499-991-1
- Abmessungen
- 16.0 x 24.0 cm
- Seiten
- 242
- Kategorie
- Informatik