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Developing Ideas for Future Electronic Patient Record Systems through Drama Improvisation

Creating useful and useable clinical IT systems for Health Care Organizations (HCOs) is not an easy task. The introduction of Electronic Patient Records (EPRs) creates new possibilities for data gathering, manipulation and use, which are not possible with traditional Paper Based Systems. With this huge number of possibilities it is important to focus on health care workers’ real information need in their daily work. Health care workers base their work on knowledge gained through experience and concrete patient information, and clinical IT systems should be able to support this work. Many traditional software engineering methods designed for finding out what the users needs are one-directional: Software developers interview users, software developers observe users, and users deliver requirements to software developers. However, health care workers complex knowledge work is not easy to capture with available methodologies. If users are not aware of why they work in particular way, they will have difficulties articulating their real information needs. There is therefore a need for methods where software developers and users can collaborate and create a common understanding of both problems and possible solutions. After discussing some of the problems associated with more traditional approaches to user participation in the software development process, we will describe our initial efforts to introduce drama and role-play as a technique to document health care workers’ information needs, and to come up with ideas about how an IT system can help them in their daily work. By acting out realistic situations from their own work life six nurses were able to contribute with ideas about how an EPR system could be useful to them, and what features it should contain. Finally, we discuss some limitations of this method, and provide some ideas about how this method can be further elaborated to be more useful in the software development process.