Practice-centred evaluation and the privileging of care in health information technology evaluation

Darking, Mary; Anson, Rachel; Bravo, Ferdinand; Davis, Julie M.; Flowers, Steve; Gillingham, Emma L.; Goldberg, Lawrence; Helliwell, Paul; Henwood, Flis; Hudson, Claire; Latimer, Simon; Lowes, P.; Stirling, Ian

doi:10.1186/1472-6963-14-243

Cited by 14 publications

(12 citation statements)

References 31 publications

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“…More research conducted with patients, not just about patients is needed. Some work has already been done in this area (Hogarth et al, 2010;Davies et al, 2011;Darking et al, 2014) but the challenge for the IS community is to consider how those local experiences can inform national initiatives.…”

Section: Discussionmentioning

confidence: 99%

Transforming healthcare: policy discourses of IT and patient-centred care

Klecuń

2016

European Journal of Information Systems

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Information Technology (IT) is increasingly seen in policy and academic literature as key to the modernization of healthcare provision and to making healthcare patient-centred. However, the concept of Patient-Centred Care (PCC) and the role of IT in the transformation of healthcare are not straightforward. Their meanings need unpacking in order to reveal assumptions behind different visions and their implications for IT-enabled healthcare transformation. To this end, this paper reviews literature on PCC and IT and analyses England's health policy between 1989 and 2013. English policy has set out to transform healthcare from organization-centric to patient-centred and has placed IT as central to this process. This policy vision is based on contested conceptualizations of PCC. IT implementation is problematic and this is at least partly because of the underpinning goals and visions of healthcare policy. If this misalignment is not addressed then producing technologically superior systems, or better IT implementation strategies, is unlikely to result in widespread and substantial changes to the way healthcare is delivered and experienced. For IT to support a healthcare service that is truly patient-centred, patients' needs and wants need to be identified and designed into IT-enabled services rather than simply added on afterwards.

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Section: Discussionmentioning

confidence: 99%

Transforming healthcare: policy discourses of IT and patient-centred care

Klecuń

2016

European Journal of Information Systems

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“…Participation is considered a key principle for designing health interventions and technologies in ways that are accessible and meaningful to people in different life situations [23,29,30]. In this section, we compare the outcomes of our co-design process with the results of previous studies that involved PLWH in the design of HIV apps and highlight how co-design findings can inform mHealth developments.…”

Section: Discussionmentioning

confidence: 99%

Development of an mHealth platform for HIV Care: Gathering User Perspectives Through Co-Design Workshops and Interviews

Marent¹,

Henwood²,

Darking³

2018

JMIR Mhealth Uhealth

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BackgroundDespite advances in testing and treatment, HIV incidence rates within European countries are at best stable or else increasing. mHealth technology has been advocated to increase quality and cost-effectiveness of health services while dealing with growing patient numbers. However, studies suggested that mHealth apps are rarely adopted and often considered to be of low quality by users. Only a few studies (conducted in the United States) have involved people living with HIV (PLWH) in the design of mHealth.ObjectiveThe goal of this study was to facilitate a co-design process among PLWH and clinicians across 5 clinical sites in the European Union to inform the development of an mHealth platform to be integrated into clinical care pathways. We aimed to (1) elicit experiences of living with HIV and of working in HIV care, (2) identify mHealth functionalities that are considered useful for HIV care, and (3) identify potential benefits as well as concerns about mHealth.MethodsBetween January and June 2016, 14 co-design workshops and 22 semistructured interviews were conducted, involving 97 PLWH and 63 clinicians. Data were analyzed thematically and iteratively, drawing on grounded theory techniques.ResultsFindings were established into 3 thematic clusters: (1) approaching the mHealth platform, (2) imagining the mHealth platform, and (3) anticipating the mHealth platform’s implications. Co-design participants approached the mHealth platform with pre-existing concerns arising from their experiences of receiving or providing care. PLWH particularly addressed issues of stigma and questioned how mHealth could enable them to manage their HIV. Clinicians problematized the compatibility of mHealth with existing information technology systems and questioned which patients should be targeted by mHealth. Imagining the potential of mHealth for HIV care, co-design participants suggested medical functionalities (accessing test results, managing medicines and appointments, and digital communication channels), social functionalities (peer support network, international travel, etc), and general features (security and privacy, credibility, language, etc). Co-design participants also anticipated potential implications of mHealth for self-management and the provision of care.ConclusionsOur approach to co-design enabled us to facilitate early engagement in the mHealth platform, enabling patient and clinician feedback to become embedded in the development process at a preprototype phase. Although the technologies in question were not yet present, understanding how users approach, imagine, and anticipate technology formed an important source of knowledge and proved highly significant within the technology design and development process.

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“…Participation is considered a key principle for designing health interventions and technologies in ways that are accessible and meaningful for people in different life situations [28][29][30]. In this section we compare the outcomes of our co-design process with the results of previous studies that involved PLWH in the design of HIV apps and highlight how co-design findings informed the development of the EmERGE mHealth platform.…”

Section: Discussion Implications and Comparison With Prior Workmentioning

confidence: 99%