The hospital organization, containing a variety of clinical providers and supporting departments, is a complex service delivery system. This system requires a taxonomy of clinical documentation between the different clinicians and services for patient care coordination and billing justification. Our project, MD:Notes (where MD stands for "multiple device") is about the design of a new application for physicians to enter progress notes, one component of all clinical documentation. This paper focuses on the user-centered research conducted at Highland and San Francisco General Hospital around the physicians, the primary stakeholders of the application. Our research demonstrates that a lack of mobility, difficult entry, transcription lag time and a lack of mandate to switch completely over to the electronic format is causing breakdowns that lead to poor service quality. While the design of the application is focused around the physicians, considerations must also be made to the secondary stakeholders, who are concerned with cost, reports for auditing and interoperability. Addressing the goals of all those in the service chain will lead to an application with a higher level of potential adoption.

This PATH Research Report covers the (Vehicle-Infrastructure Integration) VII California Development and Deployment (Task Order6217) efforts beginning in 2008 and concluding June 30, 2009. This is a successor to the report for TO 5217and reports theapplications-oriented research subsequent to that work.

The report is organized by a synopsis of the background and reasons for the VII California project, then it summarizes some of the antecedent (TO 5217) work: the "Innovative Mobility Showcase" (2005), which established the architecture and, importantly the applications (curve overspeed warning, probe messaging)) and the underlying testbed and enablers (High Accuracy National Differential GPS).