A Case Study on the Hospital Information Systems Usability

병원정보시스템 사용성에 대한 실증연구

  • Park, Chan-Seok (A Medical Information Center of the Chungnam National University Hospital) ;
  • Lee, Hyen-Uoo (Graduate School of MIS, Chungbuk National University) ;
  • Koh, Seok-Ha (Graduate School of MIS, Chungbuk National University)
  • 박찬석 (충남대학교병원 의료정보실) ;
  • 이현우 (충북대학교 경영정보학) ;
  • 고석하 (충북대학교 경영정보학과)
  • Published : 2008.12.31

Abstract

This study is a development of quality scale and a measurement of quality levels for the Hospital Information System(HIS) used in the hospital industry. This study is to provide decision-making guidelines for hospital managers, system analysts, and software designers, and to provide feedback for the users' information needs. The target people of the study were medical doctors, nurses, pharmacists, and clerical staff. The service contexts of usability were diagnosis/treatment, nursing, medicine preparation, and treatment fee receipt/claim. The quality factors were the efficiency, effectiveness, and satisfaction of IS09241-11. This study shows that the current domestic HISs are mostly based on patient diagnosis/treatment and treatment fee accounting, and that other quality scales are necessary according to different job categories, specializations, positions, and service domains. Especially, the low quality of HIS was found in the abnormal service processing, information sharing by outside institutions, and standardization. It may be added that the HIS should be improved and developed in these respects.

본 연구는 병원산업에서 사용하는 병원정보시스템에 대한 품질 척도의 개발과 품질 수준 측정을 실시한 실증연구이다. 연구목적은 병원정보시스템을 위한 품질 측정 척도의 개발과 경향을 파악하여 병원경영자, 시스템 분석가와 소프트웨어 설계자들에게 의사결정을 위한 가이드라인 제공과 사용자들의 정보욕구에 대한 피드백을 제공하는데 있다. 연구대상은 의사, 간호사, 약사와 원무행정으로 하였고, 업무맥락은 환자진료, 환자간호, 약품 조제/제제, 진료비 수납/청구로 선정하였으며 품질 속성은 ISO9241-11의 효율성, 효과성, 만족성으로 분류하였다. 연구결과 국내 병원정보시스템은 환자진료와 진료비 계산 중심으로 구축되어 있다는 것을 알 수 있었고 직종, 전공, 직위와 업무 범위에 따라 각각 다른 품질 척도가 필요하다는 것이 밝혀졌다. 특히 병원정보시스템의 품질이 매우 낮은 분야는 비정상적인 업무처리와 외부 기관의 정보 공유 및 표준화로 밝혀졌다. 이것은 앞으로 병원정보시스템 품질을 개선해야하고 발전시켜야 할 부분이라고 할 수 있다.

Keywords

References

  1. 고석하, 비즈니스시스템 분석 및 설계, 대영사, 2003
  2. 고석하, 소프트웨어 프로젝트 관리, 생능출판사, 2007
  3. 김성언, 강동진, "경쟁우위 전략에 따른 병원정보스템 구조가 시스템 수행성과에 미치는 영향", Journal of Business Research Korea Association, 제14권, 제2호, 1999, pp. 197-216
  4. 김창엽, 강길원, 이진석, 김병익, 김용익, 신영수, "국내 병원정보시스템의 도입 현황", 대한의료정보학회지, 제5권, 제1호, 1999a, pp. 27-34
  5. 김창엽, 강길원, 황지인, 하범만, 김병익, 깅용익, 신영수, "처방 전달체계 도입에 따른 사용자의 업무형태변화와 만족도 및 적응도 조사", 대한의료정보학회지, 제5권, 제1호, 1999b, pp. 51-66
  6. 박창례, 최성녀, "병원정보시스템의 최종사용자 만족에 대한 사례연구", 강릉대학교 산경론집, 1998, pp. 124-136
  7. 박찬석, 고석하, "종합병원 구성원들의 정보욕구에 의한 분류", Journal of Information Technology Application and Management, 제10권, 제2호, 2003, pp. 44-57
  8. 박찬석, 고석하, "병원정보시스템 품질 척도의 제안", Information System Review, 제10권, 제2호, 2007, pp. 169-186
  9. 박찬석, 박길하, 김석훈, 고석하, "병원정보시스템 품질 척도의 제안: C 대학병원 사례연구", 한국지식정보기술학회지, 제2권 제2호, 2007, pp. 70-83
  10. 유해영, 소프트웨어 공학, 사이텍미디어, 1998
  11. 조현, 양진선, 이인희, 이현경, 이용철, 한창훈, 임정도, "병원정보시스템 도입후 업무만족도에 영향을 미치는 요인에 관한 연구", 대한의료정보학회지, 제5권, 제1호, 1999, pp. 37-49
  12. 충남대학교병원, 충남대학교병원 업무분장규정, 충남대학교병원 규정집, 2006, pp. 302-335
  13. 채서일, 마케팅방법론, 제3판, 학현사, 2006
  14. Aarts, J., J. Ash and M. Berg, "Extending the Understanding of Computerized Physician Order Entry: Implications for Professional Collaboration Workflow and Quality of Care", International journal of Medical Informatics article in press, 2006, pp. 23-36
  15. Abraham, J., R. Feldman and C. Carlin, "Understanding Employee Awareness of Health Care Quality Information: How can Employers Benefit?", Health Services Research, Vol.36, No.6, 2004, pp. 1799-1817
  16. Ammenwerth, E., J. Brender, P. Nykanen, H. U. Prokosch, M. Rigby and J. Tamlmon, "Visions and strategies to improve evaluation of health information systems Reflections and lessons based on the HIS-EVAL workshop in Innsbruck", International Journal of Medical Informatics, Vol.73, No.1, 2004, pp. 479-491 https://doi.org/10.1016/j.ijmedinf.2004.04.004
  17. Borst, F., R. Appel, R. Baud, Y. Ligier and J. R. Scherrer, "Happy Birthday DIOGENE: A Hospital Information System Born 20 Years Ago", International Journal of Medical Informatics, Vol.54, No.2, 1999, pp. 157-167 https://doi.org/10.1016/S1386-5056(99)00004-0
  18. Carroll, C., P. Marsden, P. Soden, E. Naylor, J. New and T. Dornan, "Involving Users in the Design and Usability Evaluation of a Clinical Decision Support System", Journal of Computer Methods and Programs in Biomedicine, Vol.32, No.1, 2002, pp. 123-135
  19. Cooper, D. and P. S. Schindler, Business Research Methods, Published by McGraw-Hill Higher Educaton Companies Inc, New York, NY, 2003
  20. Folmer, E. and J. Bosch, "Architecting for Usability: A Survey", The Journal of Systems and Software, Vol.70, No.2, 2004, pp. 61-78 https://doi.org/10.1016/S0164-1212(02)00159-0
  21. Forsstrom, J. J. and M. Rigby, "Considerations on the Quality of Medical Software and Information Services", International Journal of Medical Informatics, Vol.56, No.1, 1999, pp. 169-176 https://doi.org/10.1016/S1386-5056(99)00044-1
  22. Gremy, F., J. M. Fessler and M. Bonnin, "Information Systems Evaluation and Subjectivity", International Journal of Medical Informatics, Vol.56, No.1, 1999, pp. 13-23 https://doi.org/10.1016/S1386-5056(99)00034-9
  23. Hanmer, L., "Criteria for Evaluation of District Health Information Systems", International Journal of Medical Informatics, Vol.56, No.1, 1996, pp. 161-168 https://doi.org/10.1016/S1386-5056(99)00046-5
  24. Haux, H., "Health Information Systems-Past, Present, Future", International Journal of Medical Informatics, Vol.75, No.2, 2006, pp. 268-281 https://doi.org/10.1016/j.ijmedinf.2005.08.002
  25. Hellens, L. A., "Information Systems Quality versus Software Quality a Discussion from a Managerial, an Organisational and an Engineering Viewpoint", Information and Software Technology, Vol.39, No.2, 1997, pp. 801-808 https://doi.org/10.1016/S0950-5849(97)00038-4
  26. Hyatt, L. E. and L. H. Rosenberg, "Software Metrics Program for Risk Assessment", Acta Astronautica, Vol.40, No.2. 1997, pp. 223-233 https://doi.org/10.1016/S0094-5765(97)00148-3
  27. ISO/IEC9126, Information Technology-Software Quality Characteristics and Metrics part 1-part 3, 1997
  28. ISO9241-11, Guidance on Usability, 2005. (http://www.iso.org/iso/en.catalogue detail?csnumber=16883)
  29. Jaana, M., M. M. Ward, G. Pare and D. S. Wakefield, "Clinical Information Technology in Hospitals: A Comparison between the State of Iowa and two Provinces in Canada", International Journal of Medical Informatics, Vol.74, No.3, 2005, pp. 719-731 https://doi.org/10.1016/j.ijmedinf.2005.05.009
  30. Johnson, C. M., T. R. Johnson and J. Zhang, "A User-Centered Framework for Redesigning Health Care Interfaces", Journal of BioMedical Informatics, Vol.38, No.1, 2005, pp. 75-87 https://doi.org/10.1016/j.jbi.2004.11.005
  31. Kushniruk, A., "Evaluation in the Design of Health Information Systems: Application of Approaches Emerging from Usability Engineering", Computers in Biology and Medicine, Vol.32, No.2, 2002, pp. 141-149 https://doi.org/10.1016/S0010-4825(02)00011-2
  32. Rath, S., C. Heuer, W. Alle, A. Bach, B. Bischoff and M. M. Bonsanto, "Integration of Generic Indicators for Quality Management in Hospital Information Systems", International Journal of Medical Informatics, Vol.55, No.1, 1999, pp. 79-188
  33. Salmela, H., "From Information Systems Quality to Sustainable Business Quality", Information and Software Technology, Vol.39, No.3, 1997, pp. 819-825 https://doi.org/10.1016/S0950-5849(97)00040-2
  34. Southon, G., "IT, Change and Evaluation: An Overview of the Role of Evaluation in Health Services", International Journal of Medical Informatics, Vol.56, No.1, 1999, pp. 125-133 https://doi.org/10.1016/S1386-5056(99)00043-X
  35. Staccini, P., M. Joubert, J. F. Quaranta, D. Fieschi and M. Fieschi, "Modelling Health Care Processes for Eliciting User Requirements: A Way to Link a Quality Paradigm and Clinical Information System Design" International Journal of Medical Informatics, Vol.64, No.1, 2001, pp. 129-142 https://doi.org/10.1016/S1386-5056(01)00203-9
  36. Stockman, S. G., A. R. Todd and G. A. Robinson, "A Framework for Software Quality Measurement", IEEE Journal on Selected Areas In Communications, Vol.8, No.2, 1990, pp. 224-234 https://doi.org/10.1109/49.46876
  37. Wyatt, J. C. and S. M. Wyatt, "When and How to Evaluate Health Information Systems?", International Journal of Medical Informatics, Vol.69, No.2, 2003, pp. 251-259 https://doi.org/10.1016/S1386-5056(02)00108-9
  38. Zhang, J., T. J. Johnson, V. L. Patel, D. P. Paige and T. Kubose, "Using Usability Heuristics to Evaluate Patient Safety of Medical Devices", Journal of BioMedical Informatics, Vol.29, No.1, 2003, pp. 23-30