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Volume 75, Issue 12, Pages 829-839 (December 2006)


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The usability axiom of medical information systems

Stefan V. PantaziCorresponding Author Informationemail address, Andre Kushniruk, Jochen R. Moehr

Received 16 June 2005; received in revised form 20 November 2005; accepted 24 May 2006.

Abstract 

Introduction

In this article we begin by connecting the concept of simplicity of user interfaces of information systems with that of usability, and the concept of complexity of the problem-solving in information systems with the concept of usefulness. We continue by stating “the usability axiom” of medical information technology: information systems must be, at the same time, usable and useful. We then try to show why, given existing technology, the axiom is a paradox and we continue with analysing and reformulating it several times, from more fundamental information processing perspectives.

Discussion

We underline the importance of the concept of representation and demonstrate the need for context-dependent representations. By means of thought experiments and examples, we advocate the need for context-dependent information processing and argue for the relevance of algorithmic information theory and case-based reasoning in this context. Further, we introduce the notion of concept spaces and offer a pragmatic perspective on context-dependent representations. We conclude that the efficient management of concept spaces may help with the solution to the medical information technology paradox. Finally, we propose a view of informatics centred on the concepts of context-dependent information processing and management of concept spaces that aligns well with existing knowledge centric definitions of informatics in general and medical informatics in particular. In effect, our view extends M. Musen's proposal and proposes a definition of Medical Informatics as context-dependent medical information processing.

Summary

The axiom that medical information systems must be, at the same time, useful and usable, is a paradox and its investigation by means of examples and thought experiments leads to the recognition of the crucial importance of context-dependent information processing. On the premise that context-dependent information processing equates to knowledge processing, this view defines Medical Informatics as a context-dependent medical information processing which aligns well with existing knowledge centric definitions of our field.

School of Health Information Science, University of Victoria, BC, Canada

Corresponding Author InformationCorresponding author at: School of Health Information Science, University of Victoria, HSD Building, Room A202, Victoria, BC, Canada V8W 3P5. Tel.: +1 250 472 4300; fax: +1 250 472 4751.

PII: S1386-5056(06)00154-7

doi:10.1016/j.ijmedinf.2006.05.039


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