ArticleApplied clinical informatics2022
Understanding the Digital Disruption of Health Care: An Ethnographic Study of Real-Time Multidisciplinary Clinical Behavior in a New Digital Hospital.
Article in Applied clinical informatics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Impact of Digital Hospitals on Patient and Clinician Experience: Systematic Review and Qualitative Evidence Synthesis.Journal of medical Internet research · 2024Pooled it
- Trial
- Barriers and Facilitators to Electronic Health Record Documentation Compliance in Multidisciplinary Hospital Settings: A Scoping Review.Journal of multidisciplinary healthcare · 2026Review
- Streamlining a Patchwork - Exploring the Challenges of Digital Transformation in Pathology: Ethnographic Study.Journal of medical Internet research · 2025Article
- Barriers to and Facilitators of Technology Adoption in Emergency Departments: A Comprehensive Review.International journal of environmental research and public health · 2025Review
- Artificial intelligence after the bedside: co-design of AI-based clinical informatics workflows to routinely analyse patient-reported experience measures in hospitals.BMJ health & care informatics · 2024Article
- Patterns and Perceptions of Standard Order Set Use Among Physicians Working Within a Multihospital System: Mixed Methods Study.JMIR formative research · 2024Article
- The impact of transition to a digital hospital on medication errors (TIME study).NPJ digital medicine · 2023Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUnderstanding electronic medical record (EMR) implementation in digital hospitals has focused on retrospective "work as imagined" experiences of multidisciplinary clinicians, rather than "work as done" behaviors. Our research question was "what is the behavior of multidisciplinary clinicians during the transition to a new digital hospital?"
objectivesThe aim of the study is to: (1) Observe clinical behavior of multidisciplinary clinicians in a new digital hospital using ethnography. (2) Develop a thematic framework of clinical behavior in a new digital hospital.
methodsThe setting was the go-live of a greenfield 182-bed digital specialist public hospital in Queensland, Australia. Participants were multidisciplinary clinicians (allied health, nursing, medical, and pharmacy). Clinical ethnographic observations were conducted between March and April 2021 (approximately 1 month post-EMR implementation). Observers shadowed clinicians in real-time performing a diverse range of routine clinical activities and recorded any clinical behavior related to interaction with the digital hospital. Data were analyzed in two phases: (1) content analysis using machine learning (Leximancer v4.5); (2) researcher-led interpretation of the text analytics to generate contextual meaning and finalize themes.
resultsA total of 55 multidisciplinary clinicians (41.8% allied health, 23.6% nursing, 20% medical, 14.6% pharmacy) were observed across 58 hours and 99 individual patient encounters. Five themes were derived: (1) Workflows for clinical documentation; (2) Navigating a digital hospital; (3) Digital efficiencies; (4) Digital challenges; (5) Patient experience. There was no observed harm attributable to the digital transition. Clinicians primarily used blended digital and paper workflows to achieve clinical goals. The EMR was generally used seamlessly. New digital workflows affected clinical productivity and caused frustration. Digitization enabled multitasking, clinical opportunism, and benefits to patient safety; however, clinicians were hesitant to trust digital information.
conclusionThis study improves our real-time understanding of the digital disruption of health care and can guide clinicians, managers, and health services toward digital transformation strategies based upon "work as done."
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