Challenges to Patient Experience: Documenting Evidence-Based Practice in the Family Health Center

摘要

In the clinical setting, documenting evidence-based decision making is, increasingly, an important and time-consuming part of work. In the abstract, few health and medical professionals doubt the value of evidence-based medicine and practice. Evidence-based medicine and practice as a concept is well-researched, documented in health and medical literature, and has gained wide acceptance among researchers and practitioners alike. There are significant financial incentives for implementing evidence-based practice models. However, there are also challenges to implementation. During the clinical patient encounter, the need to attend to the knowledge work of documenting evidence-based decisions can distract if not disrupt work. There is understandably considerable resistance to new technology among providers in mission-driven clinics when the need to document evidence causes profound changes in work practice and, just as importantly, changes in the way they identify as being a healthcare provider. In this article, we draw on a user experience research project of evidence-based practice in a mission-driven organization, a family medicine clinic. Our experience design research is a response to adaptive challenges in these healthcare providers' work lives. We document design challenges posed by technologies implemented to align work practice with evidence and to produce a record of evidence-based decisions, with particular emphasis on electronic medical records. We discuss three themes drawn from this research and the implications of these for UX researchers and practitioners.