Knowledge of how to design digital systems that are ergonomically sound, high in usability, and optimized for the user, context, and task has existed for some time. Despite this, there are still too many examples of new digital health care systems that are poorly designed and that could negatively affect both the work environment of health care staff and patient safety. This could be because of a gap between the theoretical knowledge of design and ergonomics and the practical implementation of this knowledge in procuring and developing digital health care systems. Furthermore, discussions of digitalization are often at a general level and risk neglecting the nature of direct interaction with the digital system. This is problematic since it is at this detailed level that work environment and patient safety issues materialize in practice. In this paper, we illustrate such issues with two scenarios concerned with contemporary electronic health care records, based on field studies in two health care settings. We argue that current methods and tools for designing and evaluating digital systems in health care must cater both to the holistic level and to the details of interaction and ergonomics. It must also be acknowledged that health care professionals are neither designers nor engineers, so expectations of them during the development of digital systems must be realistic. We suggest three paths toward a more sustainable digital work environment in health care: (1) better tools for evaluating the digital work environment in the field; (2) generic formulations of qualitative requirements related to usability and for adaptation to the user, context, and task, to be used in procurement; and (3) the introduction of digital ergonomics as an embracing concept capturing several of the ergonomic challenges (including physical, cognitive, and organizational aspects) involved in implementing and using digital systems.

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中文翻译：

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为什么数字医疗保健系统的设计仍然很差，为什么医疗保健实践不要求更多？实现可持续数字工作环境的三种途径

关于如何设计符合人体工程学、可用性高并针对用户、上下文和任务进行优化的数字系统的知识已经存在一段时间了。尽管如此，仍然有太多新数字医疗保健系统设计不佳的例子，它们可能对医疗保健人员的工作环境和患者安全产生负面影响。这可能是因为设计和人体工程学的理论知识与这些知识在采购和开发数字医疗保健系统中的实际实施之间存在差距。此外，对数字化的讨论往往是笼统的，可能会忽视与数字系统直接交互的性质。这是有问题的，因为工作环境和患者安全问题正是在这个详细级别在实践中体现出来的。在本文中，我们基于在两个医疗保健环境中的实地研究，通过与当代电子医疗保健记录相关的两个场景来说明这些问题。我们认为，当前用于设计和评估医疗保健数字系统的方法和工具必须满足整体水平以及交互和人体工程学的细节。还必须承认，医疗保健专业人员既不是设计师也不是工程师，因此在数字系统开发过程中对他们的期望必须切合实际。我们建议通过三种途径打造更可持续的医疗保健数字工作环境：(1) 更好的评估该领域数字工作环境的工具；(2) 采购中使用的与可用性和适应用户、环境和任务相关的定性要求的通用表述；

这只是摘要。阅读 JMIR 网站上的完整文章。JMIR 是互联网时代电子健康和医疗保健领域领先的开放获取期刊。