BMC Med Inform Decis Mak - Methods to identify, study and understand end-user participation in HIT development.

Tópicos

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Resumo

CKGROUND: Experience has shown that for new health-information-technology (HIT) to be suc-cessful clinicians must obtain positive clinical benefits as a result of its implementation and joint-ownership of the decisions made during the development process. A prerequisite for achieving both success criteria is real end-user-participation. Experience has also shown that further research into developing improved methods to collect more detailed information on social groups participating in HIT development is needed in order to support, facilitate and improve real end-user participation.METHODS: A case study of an EHR planning-process in a Danish county from October 2003 until April 2006 was conducted using process-analysis. Three social groups (physicians, IT-professionals and administrators) were identified and studied in the local, present perspective. In order to understand the interactions between the three groups, the national, historic perspective was included through a literature-study. Data were collected through observations, interviews, insight gathered from documents and relevant literature.RESULTS: In the local, present perspective, the administrator's strategy for the EHR planning process meant that there was no clinical workload-reduction. This was seen as one of the main barriers to the physicians to achieving real influence. In the national, historic perspective, physicians and administrators have had/have different perceptions of the purpose of the patient record and they have both struggled to influence this definition. To date, the administrators have won the battle. This explains the conditions made available for the physicians' participation in this case, which led to their role being reduced to that of clinical consultants--rather than real participants.CONCLUSION: In HIT-development the interests of and the balance of power between the different social groups involved are decisive in determining whether or not the end-users become real participants in the development process. Real end-user-participation is essential for the successful outcome of the process. By combining and developing existing theories and methods, this paper presents an improved method to collect more detailed information on social groups participating in HIT-development and their interaction during the development. This allows HIT management to explore new avenues during the HIT development process in order to support, facilitate and improve real end-user participation.

Resumo Limpo

ckground experi shown new healthinformationtechnolog hit success clinician must obtain posit clinic benefit result implement jointownership decis made develop process prerequisit achiev success criteria real enduserparticip experi also shown research develop improv method collect detail inform social group particip hit develop need order support facilit improv real endus participationmethod case studi ehr planningprocess danish counti octob april conduct use processanalysi three social group physician itprofession administr identifi studi local present perspect order understand interact three group nation histor perspect includ literaturestudi data collect observ interview insight gather document relev literatureresult local present perspect administr strategi ehr plan process meant clinic workloadreduct seen one main barrier physician achiev real influenc nation histor perspect physician administr hadhav differ percept purpos patient record struggl influenc definit date administr won battl explain condit made avail physician particip case led role reduc clinic consultantsrath real participantsconclus hitdevelop interest balanc power differ social group involv decis determin whether endus becom real particip develop process real enduserparticip essenti success outcom process combin develop exist theori method paper present improv method collect detail inform social group particip hitdevelop interact develop allow hit manag explor new avenu hit develop process order support facilit improv real endus particip

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