The Language Action Perspective, 1999 59 An Empirical Study of Multidisciplinary Communication in Healthcare using a Language-Action Perspective Mareike Schoop Department of Computer Science, Informatik V – Information Systems, Aachen University of Technology, Germany Abstract Good communication is the basis for effective cooperation. An area where cooperation is essential is multidisciplinary healthcare. In this paper we will present a research project that aims at promoting effective multidisciplinary communication in a healthcare environment. We will answer the question of whether empirical modelling of the communication and cooperation patterns can be done based on a Language-Action Perspective and whether a Language-Action Perspective can be the basis for designing computer systems supporting multidisciplinary communication and cooperation in healthcare. An emphasis will be on the discussion of the Language-Action paradigm for the present work in the context of existing critiques. 1 Introduction In recent years there has been a move towards more cooperation in healthcare. A more holistic approach to patient care is now taken. Patient care is no longer solely medical care but involves input from healthcare professionals coming from several disciplines [14]. Today, it is not permitted to discharge a patient from hospital simply on the grounds that his or her medical treatment has finished. Nursing or social needs have also to be met before a patient can be allowed home. As is to be expected, the areas of healthcare that see the greatest changes towards truly shared patient care are the ones where professionals from different disciplines have a large impact on the shared task of improving a patient's state of health. For example, Geriatrics is a highly cooperative area. The different needs of elderly people can only be met by the interaction of professionals from several disciplines. Thus, the cooperation between professionals from many different disciplines is necessary to achieve the task of effective patient care. However, the reality is sometimes different: professionals do not always understand each other and cooperation does not always work. Healthcare professionals have particular interests concerning the patients that are determined by their professional role. For example, a doctor is interested in a patient's present medical complaints whereas a nurse needs to find out the care needs; a physiotherapist is interested in a patient's state of mobility, and an occupational therapist assesses a patient's needs concerning daily living in order to ensure a maximal safe level of independence. According to their different interests and tasks, the professionals will notice different things when looking at the same patient and, therefore, will talk about different aspects of patient care. These differences in viewpoints can make communication between healthcare professionals difficult [16]. If communication problems exist then they often lead to difficulties in cooperation because professionals cannot cooperate if they do not understand each other. Cooperative documentation systems (CDSs) have been developed to support multidisciplinary communication and cooperation in healthcare. CDSs are information systems containing multidisciplinary documents. They aim to support a cooperative plan of care by providing a medium for information exchange between different professional groups such as doctors, nurses, physiotherapists. The whole process from admission to discharge is documented there and a CDS acts, therefore, as a medium of written multidisciplinary communication [17]. The aim of the present work is to improve cooperation between different professional groups in healthcare, especially cooperation between doctors and nurses by means of information technology. As will become clear later, the focus is on improving multidisciplinary communication through CDSs. In order to find out about cooperation and communication patterns and existing communication problems in healthcare, a multidisciplinary healthcare environment was selected and ethnographic studies were conducted there. At the end of the ethnographic studies a list of key issues was elaborated that it was felt should be considered for introducing computer-based systems for supporting cooperative work in such an environment. These key findings will be introduced in section 2. These findings prompted us to look at theories of communication as a theoretical basis for a new and more theoretically rigorous approach to the design of CDSs. The present work is based on the so-called Language-Action Perspective (LAP) which has developed into a new paradigm in the field of information systems. The basic assumptions underlying this paradigm will be introduced in section 3. After classifying common communication problems, the general requirements for a (computer-based) CDS were considered. Section 4 will present a number of conceptual categories that were felt need to be