{"id":"https://openalex.org/W4225002659","doi":"https://doi.org/10.1177/00187208221087013","title":"Workarounds in the Shadow System: An Ethnographic Study of Requirements for Documentation and Cooperation in a Clinical Advisory Center","display_name":"Workarounds in the Shadow System: An Ethnographic Study of Requirements for Documentation and Cooperation in a Clinical Advisory Center","publication_year":2022,"publication_date":"2022-04-26","ids":{"openalex":"https://openalex.org/W4225002659","doi":"https://doi.org/10.1177/00187208221087013","pmid":"https://pubmed.ncbi.nlm.nih.gov/35471848"},"language":"en","primary_location":{"id":"doi:10.1177/00187208221087013","is_oa":true,"landing_page_url":"https://doi.org/10.1177/00187208221087013","pdf_url":"https://journals.sagepub.com/doi/pdf/10.1177/00187208221087013?download=true","source":{"id":"https://openalex.org/S83386566","display_name":"Human Factors The Journal of the Human Factors and Ergonomics Society","issn_l":"0018-7208","issn":["0018-7208","1547-8181"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310320017","host_organization_name":"SAGE Publishing","host_organization_lineage":["https://openalex.org/P4310320017"],"host_organization_lineage_names":["SAGE Publishing"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Human Factors: The Journal of the Human Factors and Ergonomics Society","raw_type":"journal-article"},"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"bronze","oa_url":"https://journals.sagepub.com/doi/pdf/10.1177/00187208221087013?download=true","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5070873247","display_name":"Frauke M\u00f6rike","orcid":"https://orcid.org/0000-0001-6452-3853"},"institutions":[{"id":"https://openalex.org/I4577782","display_name":"Technische Universit\u00e4t Berlin","ror":"https://ror.org/03v4gjf40","country_code":"DE","type":"education","lineage":["https://openalex.org/I4577782"]}],"countries":["DE"],"is_corresponding":true,"raw_author_name":"Frauke M\u00f6rike","raw_affiliation_strings":["Technische Universit\u00e4t Berlin, Department of Psychology and Ergonomics (IPA), Division of Ergonomics, Berlin, Germany"],"raw_orcid":"https://orcid.org/0000-0001-6452-3853","affiliations":[{"raw_affiliation_string":"Technische Universit\u00e4t Berlin, Department of Psychology and Ergonomics (IPA), Division of Ergonomics, Berlin, Germany","institution_ids":["https://openalex.org/I4577782"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5066247090","display_name":"Hannah Lucia Spiehl","orcid":null},"institutions":[{"id":"https://openalex.org/I4577782","display_name":"Technische Universit\u00e4t Berlin","ror":"https://ror.org/03v4gjf40","country_code":"DE","type":"education","lineage":["https://openalex.org/I4577782"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"Hannah L. Spiehl","raw_affiliation_strings":["Technische Universit\u00e4t Berlin, Department of Psychology and Ergonomics (IPA), Division of Ergonomics, Berlin, Germany"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Technische Universit\u00e4t Berlin, Department of Psychology and Ergonomics (IPA), Division of Ergonomics, Berlin, Germany","institution_ids":["https://openalex.org/I4577782"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5049204500","display_name":"Markus A. Feufel","orcid":"https://orcid.org/0000-0003-0563-8831"},"institutions":[{"id":"https://openalex.org/I4577782","display_name":"Technische Universit\u00e4t Berlin","ror":"https://ror.org/03v4gjf40","country_code":"DE","type":"education","lineage":["https://openalex.org/I4577782"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"Markus A. Feufel","raw_affiliation_strings":["Technische Universit\u00e4t Berlin, Department of Psychology and Ergonomics (IPA), Division of Ergonomics, Berlin, Germany"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Technische Universit\u00e4t Berlin, Department of Psychology and Ergonomics (IPA), Division of Ergonomics, Berlin, Germany","institution_ids":["https://openalex.org/I4577782"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5070873247"],"corresponding_institution_ids":["https://openalex.org/I4577782"],"apc_list":{"value":1500,"currency":"USD","value_usd":1500},"apc_paid":null,"fwci":3.4805,"has_fulltext":true,"cited_by_count":21,"citation_normalized_percentile":{"value":0.93331042,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":89,"max":99},"biblio":{"volume":"66","issue":"3","first_page":"636","last_page":"646"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.49889999628067017,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.49889999628067017,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11024","display_name":"Information Systems Theories and Implementation","score":0.3330000042915344,"subfield":{"id":"https://openalex.org/subfields/3312","display_name":"Sociology and Political Science"},"field":{"id":"https://openalex.org/fields/33","display_name":"Social Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T13248","display_name":"Healthcare Technology and Patient Monitoring","score":0.015799999237060547,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/workaround","display_name":"Workaround","score":0.9436584115028381},{"id":"https://openalex.org/keywords/documentation","display_name":"Documentation","score":0.829414963722229},{"id":"https://openalex.org/keywords/center","display_name":"Center (category theory)","score":0.6582233905792236},{"id":"https://openalex.org/keywords/shadow","display_name":"Shadow (psychology)","score":0.5804461240768433},{"id":"https://openalex.org/keywords/ethnography","display_name":"Ethnography","score":0.45062097907066345},{"id":"https://openalex.org/keywords/advisory-committee","display_name":"Advisory committee","score":0.42462611198425293},{"id":"https://openalex.org/keywords/library-science","display_name":"Library science","score":0.3361852765083313},{"id":"https://openalex.org/keywords/computer-science","display_name":"Computer science","score":0.2641507089138031},{"id":"https://openalex.org/keywords/geography","display_name":"Geography","score":0.2578524947166443},{"id":"https://openalex.org/keywords/psychology","display_name":"Psychology","score":0.227877676486969},{"id":"https://openalex.org/keywords/political-science","display_name":"Political science","score":0.22001135349273682},{"id":"https://openalex.org/keywords/archaeology","display_name":"Archaeology","score":0.18502551317214966},{"id":"https://openalex.org/keywords/public-administration","display_name":"Public administration","score":0.1489865481853485},{"id":"https://openalex.org/keywords/operating-system","display_name":"Operating system","score":0.06446695327758789}],"concepts":[{"id":"https://openalex.org/C194541083","wikidata":"https://www.wikidata.org/wiki/Q457174","display_name":"Workaround","level":2,"score":0.9436584115028381},{"id":"https://openalex.org/C56666940","wikidata":"https://www.wikidata.org/wiki/Q788790","display_name":"Documentation","level":2,"score":0.829414963722229},{"id":"https://openalex.org/C2779463800","wikidata":"https://www.wikidata.org/wiki/Q5062222","display_name":"Center (category theory)","level":2,"score":0.6582233905792236},{"id":"https://openalex.org/C117797892","wikidata":"https://www.wikidata.org/wiki/Q286363","display_name":"Shadow (psychology)","level":2,"score":0.5804461240768433},{"id":"https://openalex.org/C179454799","wikidata":"https://www.wikidata.org/wiki/Q132151","display_name":"Ethnography","level":2,"score":0.45062097907066345},{"id":"https://openalex.org/C3017489713","wikidata":"https://www.wikidata.org/wiki/Q4686866","display_name":"Advisory committee","level":2,"score":0.42462611198425293},{"id":"https://openalex.org/C161191863","wikidata":"https://www.wikidata.org/wiki/Q199655","display_name":"Library science","level":1,"score":0.3361852765083313},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.2641507089138031},{"id":"https://openalex.org/C205649164","wikidata":"https://www.wikidata.org/wiki/Q1071","display_name":"Geography","level":0,"score":0.2578524947166443},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.227877676486969},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.22001135349273682},{"id":"https://openalex.org/C166957645","wikidata":"https://www.wikidata.org/wiki/Q23498","display_name":"Archaeology","level":1,"score":0.18502551317214966},{"id":"https://openalex.org/C3116431","wikidata":"https://www.wikidata.org/wiki/Q31728","display_name":"Public administration","level":1,"score":0.1489865481853485},{"id":"https://openalex.org/C111919701","wikidata":"https://www.wikidata.org/wiki/Q9135","display_name":"Operating system","level":1,"score":0.06446695327758789},{"id":"https://openalex.org/C8010536","wikidata":"https://www.wikidata.org/wiki/Q160398","display_name":"Crystallography","level":1,"score":0.0},{"id":"https://openalex.org/C185592680","wikidata":"https://www.wikidata.org/wiki/Q2329","display_name":"Chemistry","level":0,"score":0.0},{"id":"https://openalex.org/C542102704","wikidata":"https://www.wikidata.org/wiki/Q183257","display_name":"Psychotherapist","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D004282","descriptor_name":"Documentation","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":true},{"descriptor_ui":"D004282","descriptor_name":"Documentation","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":true},{"descriptor_ui":"D004282","descriptor_name":"Documentation","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":true},{"descriptor_ui":"D004282","descriptor_name":"Documentation","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D057188","descriptor_name":"Workflow","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D057188","descriptor_name":"Workflow","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D057188","descriptor_name":"Workflow","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D057188","descriptor_name":"Workflow","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.1177/00187208221087013","is_oa":true,"landing_page_url":"https://doi.org/10.1177/00187208221087013","pdf_url":"https://journals.sagepub.com/doi/pdf/10.1177/00187208221087013?download=true","source":{"id":"https://openalex.org/S83386566","display_name":"Human Factors The Journal of the Human Factors and Ergonomics Society","issn_l":"0018-7208","issn":["0018-7208","1547-8181"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310320017","host_organization_name":"SAGE Publishing","host_organization_lineage":["https://openalex.org/P4310320017"],"host_organization_lineage_names":["SAGE Publishing"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Human Factors: The Journal of the Human Factors and Ergonomics Society","raw_type":"journal-article"},{"id":"pmid:35471848","is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/35471848","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Human factors","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.1177/00187208221087013","is_oa":true,"landing_page_url":"https://doi.org/10.1177/00187208221087013","pdf_url":"https://journals.sagepub.com/doi/pdf/10.1177/00187208221087013?download=true","source":{"id":"https://openalex.org/S83386566","display_name":"Human Factors The Journal of the Human Factors and Ergonomics Society","issn_l":"0018-7208","issn":["0018-7208","1547-8181"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310320017","host_organization_name":"SAGE Publishing","host_organization_lineage":["https://openalex.org/P4310320017"],"host_organization_lineage_names":["SAGE Publishing"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Human Factors: The Journal of the Human Factors and Ergonomics Society","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/9","score":0.4399999976158142,"display_name":"Industry, innovation and infrastructure"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4225002659.pdf","grobid_xml":"https://content.openalex.org/works/W4225002659.grobid-xml"},"referenced_works_count":59,"referenced_works":["https://openalex.org/W113095850","https://openalex.org/W115219466","https://openalex.org/W609221474","https://openalex.org/W781881025","https://openalex.org/W1604945007","https://openalex.org/W1931861466","https://openalex.org/W1949232578","https://openalex.org/W1964029476","https://openalex.org/W1965892145","https://openalex.org/W1967661036","https://openalex.org/W1971670344","https://openalex.org/W1982052445","https://openalex.org/W1996062335","https://openalex.org/W1996444345","https://openalex.org/W2000352018","https://openalex.org/W2006285022","https://openalex.org/W2040155823","https://openalex.org/W2057400909","https://openalex.org/W2061288902","https://openalex.org/W2066416113","https://openalex.org/W2069703836","https://openalex.org/W2075891523","https://openalex.org/W2084275349","https://openalex.org/W2092352362","https://openalex.org/W2095118384","https://openalex.org/W2100305148","https://openalex.org/W2112293711","https://openalex.org/W2119313576","https://openalex.org/W2155152688","https://openalex.org/W2158226816","https://openalex.org/W2158656770","https://openalex.org/W2171820918","https://openalex.org/W2172024658","https://openalex.org/W2398855771","https://openalex.org/W2615403700","https://openalex.org/W2616630680","https://openalex.org/W2738464573","https://openalex.org/W2739904528","https://openalex.org/W2763507114","https://openalex.org/W2783929168","https://openalex.org/W2790212925","https://openalex.org/W2791110983","https://openalex.org/W2798625560","https://openalex.org/W2840913647","https://openalex.org/W2888806592","https://openalex.org/W2913317404","https://openalex.org/W2952090161","https://openalex.org/W2974702374","https://openalex.org/W2991247213","https://openalex.org/W2996494834","https://openalex.org/W3010117219","https://openalex.org/W3083528746","https://openalex.org/W3090922250","https://openalex.org/W3164196770","https://openalex.org/W4200526545","https://openalex.org/W4244021162","https://openalex.org/W4246467737","https://openalex.org/W4298269205","https://openalex.org/W6605264872"],"related_works":["https://openalex.org/W4381612620","https://openalex.org/W2950380533","https://openalex.org/W2998499456","https://openalex.org/W2893207040","https://openalex.org/W1840516357","https://openalex.org/W3127868735","https://openalex.org/W2753986652","https://openalex.org/W4387616455","https://openalex.org/W971576836","https://openalex.org/W4391423632"],"abstract_inverted_index":{"OBJECTIVE:":[0],"Hospital":[1],"information":[2,23,117,146],"systems":[3,57,134,171],"(HIS)":[4],"are":[5,28,46,89,135],"meant":[6],"to":[7,20,38,102,155,158,195,206],"manage":[8],"complex":[9],"work":[10,151],"processes":[11],"across":[12,137],"healthcare":[13],"organizations.":[14],"We":[15],"describe":[16],"limitations":[17],"of":[18,51,61,124,181,201],"HIS":[19,108,194],"address":[21,156],"local":[22,189],"requirements":[24,183],"and":[25,55,73,78,82,93,115,131,141,149,153,169,199],"how":[26,154],"they":[27],"circumvented":[29],"at":[30],"different":[31,59,138],"organizational":[32,139],"levels.":[33],"Results":[34],"can":[35],"be":[36],"used":[37,120],"better":[39],"support":[40,103,196],"collaboration":[41],"in":[42,63,105,193],"socio-technical":[43,65],"systems.":[44],"BACKGROUND:":[45],"conceptualized":[47],"as":[48,98,122],"the":[49,107],"entirety":[50],"all":[52,113],"(in)formal":[53],"digital":[54],"analog":[56],"connecting":[58],"communities":[60],"practice":[62],"a":[64,94,99,177],"system.":[66],"METHODS:":[67],"An":[68,162],"ethnographic":[69],"study":[70],"with":[71],"observations":[72],"semi-structured":[74],"interviews":[75],"was":[76],"conducted":[77],"analyzed":[79],"through":[80],"categorization":[81],"iterative":[83],"coding.":[84],"RESULTS:":[85],"Several":[86],"digital-analog":[87],"workarounds":[88],"employed":[90],"for":[91],"documentation":[92],"shared":[95],"server":[96],"functions":[97],"shadow":[100,170],"system":[101,160,174],"workflows":[104],"ways":[106],"cannot.":[109],"For":[110],"collaborative":[111],"documentation,":[112],"(official":[114],"informal)":[116],"sources":[118],"were":[119],"simultaneously":[121],"part":[123],"an":[125],"interconnected":[126,136],"boundary":[127,166],"infrastructure.":[128],"CONCLUSION:":[129],"Formal":[130],"informal":[132],"IT":[133,182],"levels":[140],"provide":[142],"insights":[143],"into":[144],"unmet":[145],"requirements,":[147],"effective":[148],"problematic":[150],"practices,":[152],"them":[157],"improve":[159],"functioning.":[161],"integrated":[163],"perspective":[164],"on":[165],"infrastructures,":[167],"workarounds,":[168],"may":[172],"advance":[173],"analysis,":[175],"providing":[176],"more":[178],"comprehensive":[179],"picture":[180],"than":[184],"any":[185],"concept":[186],"alone.":[187],"APPLICATION:":[188],"needs.":[190],"Customized":[191],"interfaces":[192],"search,":[197],"access,":[198],"exchange":[200],"relevant":[202],"data":[203],"might":[204],"help":[205],"mitigate":[207],"current":[208],"shortcomings.":[209]},"counts_by_year":[{"year":2026,"cited_by_count":7},{"year":2025,"cited_by_count":3},{"year":2024,"cited_by_count":7},{"year":2023,"cited_by_count":3},{"year":2022,"cited_by_count":1}],"updated_date":"2026-08-21T09:56:20.448147","created_date":"2025-10-10T00:00:00"}
