title: Challenges to physicians' use of a wireless alert pager.
abstract: Pagers, personal data assistants (PDAs) and other devices that have wireless connectivity are becoming a popular method for delivering patient related information to medical decision makers. Although medical informatics research has emphasized the design, and implementation of pagers as event notification mechanisms, researchers have not paid as much attention to how this technology impacts medical work. We present a case study of physicians in a Surgical Intensive Care Unit (SICU) using wireless alert pagers. The pagers provide a variety of alphanumeric clinical alert messages and are widely used by SICU physicians. However, the use of the pagers has created unanticipated challenges to the physicians' traditional work practices. These challenges include: (1) flattening of hierarchical workflows, (2) coping with information overload and missing context, and (3) lack of feedback. These challenges are tied to both the specific technical design of the system and the traditional structure of medical work.
authors.affiliation: School Management and Information Systems, University of Missouri, Rolla, USA.
authors.forename: Madhu C
authors.initials: MC
authors.lastname: Reddy
authors.forename: Wanda
authors.initials: W
authors.lastname: Pratt
authors.forename: David W
authors.initials: DW
authors.lastname: McDonald
authors.forename: M Michael
authors.initials: MM
authors.lastname: Shabot
mesh_terms: D001291:Attitude of Health Personnel; D006747:Hospital Communication Systems / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration; D007400:Interprofessional Relations; D007407:Interviews as Topic; D024802:Nurse's Role; D019370:Observation; D015279:Organizational Culture; D010820:Physicians; D017010:Reminder Systems / Q000295:instrumentation; D013685:Telecommunications / Q000295:instrumentation* / Q000706:statistics & numerical data