The integration of hospital information systems through user centred design.

The development of computer systems in UK hospitals has in recent years been focused on the provision of hospital-wide information systems, known as Hospital Information Support Systems (HISS). This development has been motivated by National Health Service reforms and a realisation that earlier fragmented systems were not meeting the requirements of clinical and nursing staff in the most effective way. Such systems were often developed by external, centralised agencies using systems analysis techniques appropriate to the development of information systems in product orientated organisations. However, the hospital ward, an environment existing at the 'sharp end' of health care, in which many diverse and non-computer related activities take place, presents the system designer with many of the classic problems with which the discipline of Human Computer Interaction (HCI) is concerned. Although a HISS has the potential to improve both the work conditions of clinical staff and the delivery of health care, this may be impeded by many of the common obstacles associated with the introduction of a large and complex computer system into a work environment where tasks are ill defined.

This thesis reports on a project that is based upon the application of HCI methods to the health care environment and their contribution to the solution of the problems that such an environment presents. Requirements for the users' interface to the potential HISS are derived using a task analytic approach, involving Task Analysis for Knowledge Descriptions (TAKD). A prototype system has been designed and subsequently evaluated in a hospital ward. The contribution of TAKD to the design and its further applicability to the environment are assessed.

The research represents an original application of a formal task analysis method to the design of ward based computer systems, and as such makes a valuable contribution to the areas of medical informatics and HCI. It shows that TAKD has real but limited applicability in this sphere, in that its use can lead to the design of more usable interfaces, while there is a need to combine it with methods aimed at broader systems design if these benefits are to accrue in the development of a HISS. The potential for the integration of task analysis with Design Rationale methods is also demonstrated.