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Logo of bmcmidmBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Medical Informatics and Decision Making
 
BMC Med Inform Decis Mak. 2012; 12: 68.
Published online Jul 12, 2012. doi:  10.1186/1472-6947-12-68
PMCID: PMC3407796
An empirically-derived approach for investigating Health Information Technology: the Elementally Entangled Organisational Communication (EEOC) framework
Andrew Georgiou,corresponding author1 Johanna I Westbrook,1 and Jeffrey Braithwaite2
1Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, University of New South Wales, Sydney, Australia, 2052
2Centre for Clinical Governance Research in Health, Australian Institute of Health Innovation, Faculty of Medicine, University of New South Wales, Sydney, Australia, 2052
corresponding authorCorresponding author.
Andrew Georgiou: a.georgiou/at/unsw.edu.au; Johanna I Westbrook: j.westbrook/at/unsw.edu.au; Jeffrey Braithwaite: j.braithwaite/at/unsw.edu.au
Received February 17, 2012; Accepted July 12, 2012.
Abstract
Background
The purpose of this paper is to illustrate the Elementally Entangled Organisational Communication (EEOC) framework by drawing on a set of three case studies which assessed the impact of new Health Information Technology (HIT) on a pathology service. The EEOC framework was empirically developed as a tool to tackle organisational communication challenges in the implementation and evaluation of health information systems.
Methods
The framework was synthesised from multiple research studies undertaken across a major metropolitan hospital pathology service during the period 2005 to 2008. These studies evaluated the impact of new HIT systems in pathology departments (Laboratory Information System) and an Emergency Department (Computerised Provider Order Entry) located in Sydney, Australia.
Results
Key dimensions of EEOC are illustrated by the following case studies: 1) the communication infrastructure between the Blood Bank and the ward for the coordination and distribution of blood products; 2) the organisational environment in the Clinical Chemistry and Haematology departments and their attempts to organise, plan and control the processing of laboratory specimens; and 3) the temporal make up of the organisation as revealed in changes to the way the Central Specimen Reception allocated, sequenced and synchronised work tasks.
Conclusions
The case studies not only highlight the pre-existing communication architecture within the organisation but also the constitutive role communication plays in the way organisations go about addressing their requirements. HIT implementation involves a mutual transformation of the organisation and the technology. This is a vital consideration because of the dangers associated with poor organisational planning and implementation of HIT, and the potential for unintended adverse consequences, workarounds and risks to the quality and safety of patient care. The EEOC framework aims to account for the complex range of contextual factors and triggers that play a role in the success or otherwise of new HITs, and in the realisation of their innovation potential.
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