A sociotechnical systems approach toward tailored design for personal health information management

We used a sociotechnical systems approach—which conceptualizes a system of interacting people, technologies, and tasks, to identify individual differences in personal health information management (PHIM) that can inform the design of patient-friendly environments, tools, and technologies. We conducted a secondary thematic analysis of data collected as part of a parent project, vizHOME. The goal of vizHOME was to improve health and health outcomes through identifying key features in the environment that will inform the design of consumer health information technology HIT. We analyzed interview data collected from 20 individuals with diabetes. We found seven dimensions of PHIM: (1) level of privacy preferred for PHIM; (2) amount of engagement in PHIM; (3) extent of guidance preferred for PHIM; (4) level of documentation preferred for PHIM; (5) degree of physical distribution of PHIM; (6) amount of flexibility in PHIM routine; and (7) use of external cues to manage PHIM. Our results suggest that each dimension exists as a continuum, which are anchored from low to high. Exploring the interaction between PHIM and the sociotechnical system in which PHIM is performed revealed key dimensions of PHIM as well as individual differences in those PHIM dimensions. Identification of individual differences in PHIM can support the creation of human-centered design considerations for tailored environments, products, processes, and technologies that support PHIM. Future research will seek to validate PHIM dimensions in a larger population and develop a PHIM-typing measure to identify PHIM types toward tailoring processes, products, and to individual needs in context. Experience Framework This article is associated with the Innovation & Technology lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this len

Ideas and Enhancements Related to Mobile Applications to Support Type 1 Diabetes

Background: Mobile devices have become increasingly important to young people who now use them to access a wide variety of health-related information. Research and policy related to the integration of health information and support with this technology do not effectively consider the viewpoint of a younger patient. Views of young people with type 1 diabetes are vital in developing quality services and improving their own health-related quality of life (HRQOL), yet research on their lifestyle and use of Web and mobile technology to support their condition and in non–health-related areas is sparse. Objective: To develop insight into young people with type 1 diabetes and their current use of Web and mobile technology and its potential impact on HRQOL. This can be achieved by constructing an in-depth picture of their day-to-day experiences from qualitative interviewing and exploring how they make use of technology in their lives and in relation to their condition and treatment. The goal was then to build something to help them, using the researcher’s technical expertise and seeking users’ opinions during the design and build, utilizing sociotechnical design principles. Methods: Data were collected by semistructured, in-depth qualitative interviews (N=9) of young people with type 1 diabetes aged 18-21. Interviews were transcribed and loaded onto NVivo for theme identification. Data analysis was undertaken during initial interviews (n=4) to locate potential ideas and enhancements for technical development. Latter interviews (n=5) assisted in the iterative sociotechnical design process of the development and provided additional developmental ideas. Results: Six themes were identified providing an understanding of how participants lived with and experienced their condition and how they used technology. Four technological suggestions for improvement were taken forward for prototyping. One prototype was developed as a clinically approved app. A number of ideas for new mobile apps and enhancements to currently existing apps that did not satisfactorily cater to this age group’s requirements for use in terms of design and functionality were suggested by interviewees but were not prototyped. Conclusions: This paper outlines the nonprototyped suggestions from interviewees and argues that young people with type 1 diabetes have a key role to play in the design and implementation of new technology to support them and improve HRQOL. It is vital to include and reflect on their suggestions as they have a radically different view of technology than either their parents or practitioners. We need to consider the relationship to technology that young people with type 1 diabetes have, and then reflect on how this might make a difference to them and when it might not be a suitable mechanism to use

We are bitter, but we are better off: Case study of the implementation of an electronic health record system into a mental health hospital in England

In contrast to the acute hospital sector, there have been relatively few implementations of integrated electronic health record (EHR) systems into specialist mental health settings. The National Programme for Information Technology (NPfIT) in England was the most expensive IT-based transformation of public services ever undertaken, which aimed amongst other things, to implement integrated EHR systems into mental health hospitals. This paper describes the arrival, the process of implementation, stakeholders' experiences and the local consequences of the implementation of an EHR system into a mental health hospital

Consumer Health Informatics: Empowering Healthy-Lifestyle-Seekers Through mHealth

People are at risk from noncommunicable diseases (NCD) and poor health habits, with interventions like medications and surgery carrying further risk of adverse effects. This paper addresses ways people are increasingly moving to healthy living medicine (HLM) to mitigate such health threats. HLM-seekers increasingly leverage mobile technologies that enable control of personal health information, collaboration with clinicians/other agents to establish healthy living practices. For example, outcomes from consumer health informatics research include empowering users to take charge of their health through active participation in decision-making about healthcare delivery. Because the success of health technology depends on its alignment/integration with a person's sociotechnical system, we introduce SEIPS 2.0 as a useful conceptual model and analytic tool. SEIPS 2.0 approaches human work (i.e., life's effortful activities) within the complexity of the design and implementation of mHealth technologies and their potential to emerge as consumer-facing NLM products that support NCDs like diabetes

"There are too many, but never enough": qualitative case study investigating routine coding of clinical information in depression.

We sought to understand how clinical information relating to the management of depression is routinely coded in different clinical settings and the perspectives of and implications for different stakeholders with a view to understanding how these may be aligned

Кибербезопасность в образовательных сетях

The paper discusses the possible impact of digital space on a human, as well as human-related directions in cyber-security analysis in the education: levels of cyber-security, social engineering role in cyber-security of education, “cognitive vaccination”. “A Human” is considered in general meaning, mainly as a learner. The analysis is provided on the basis of experience of hybrid war in Ukraine that have demonstrated the change of the target of military operations from military personnel and critical infrastructure to a human in general. Young people are the vulnerable group that can be the main goal of cognitive operations in long-term perspective, and they are the weakest link of the System.У статті обговорюється можливий вплив цифрового простору на людину, а також пов'язані з людиною напрямки кібербезпеки в освіті: рівні кібербезпеки, роль соціального інжинірингу в кібербезпеці освіти, «когнітивна вакцинація». «Людина» розглядається в загальному значенні, головним чином як та, що навчається. Аналіз надається на основі досвіду гібридної війни в Україні, яка продемонструвала зміну цілей військових операцій з військовослужбовців та критичної інфраструктури на людину загалом. Молодь - це вразлива група, яка може бути основною метою таких операцій в довгостроковій перспективі, і вони є найслабшою ланкою системи.В документе обсуждается возможное влияние цифрового пространства на человека, а также связанные с ним направления в анализе кибербезопасности в образовании: уровни кибербезопасности, роль социальной инженерии в кибербезопасности образования, «когнитивная вакцинация». «Человек» рассматривается в общем смысле, в основном как ученик. Анализ представлен на основе опыта гибридной войны в Украине, которая продемонстрировала изменение цели военных действий с военного персонала и критической инфраструктуры на человека в целом. Молодые люди являются уязвимой группой, которая может быть главной целью когнитивных операций в долгосрочной перспективе, и они являются самым слабым звеном Систем

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

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 analyses England’s health policy between 1989 and 2013 and reviews literature on PCC and IT. 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 due to 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 should be identified and designed into IT-enabled services rather than simply added on afterwards

The transformative capacity of new technologies. How innovations affect sectoral change: Conceptual considerations

Following up on recent debates about sectoral systems of innovation and production, the paper introduces a heuristic framework for analyzing and explaining distinct patterns of technology-based sectoral change. The concept is based on two interrelated influencing factors. The first is the sectoral-specific transformative capacity of new technologies themselves, that is, their substantial or incremental impact on socioeconomic and institutional change in a given sectoral system. The second is the sectoral adaptability of socioeconomic structures, institutions, and actors confronted with the opportunities presented by new technologies. The first factor the sectoral transformative capacity of new technologies enables us to identify the technology-driven pressure to change and adjust the structural and institutional architectures of the sectoral system. The second, complementary factor sectoral adaptability helps us to discern the distinct social patterns of anticipating and absorbing this technology-based pressure. The specific interplay between the two influencing factors creates distinguishable modes of sectoral transformation, ranging from anticipative and smooth adjustments to reactive and crisis-ridden patterns of change. Even processes of radical sectoral change continue over longer periods of mismatch, characterized by a cumulation of numerous and mostly gradual organizational, structural, and institutional transformations. --

Addressing the Quality and Safety Gap Part I: Case Studies in Transforming Hospital Nursing and Building Cultures of Safety

Presents case studies of strategies four healthcare systems and a state government are using to address underlying causes in flawed systems: strengthening care processes, optimizing staffing, and promoting safe work habits. Lists policy recommendations

The ethics of digital well-being: a multidisciplinary perspective

This chapter serves as an introduction to the edited collection of the same name, which includes chapters that explore digital well-being from a range of disciplinary perspectives, including philosophy, psychology, economics, health care, and education. The purpose of this introductory chapter is to provide a short primer on the different disciplinary approaches to the study of well-being. To supplement this primer, we also invited key experts from several disciplines—philosophy, psychology, public policy, and health care—to share their thoughts on what they believe are the most important open questions and ethical issues for the multi-disciplinary study of digital well-being. We also introduce and discuss several themes that we believe will be fundamental to the ongoing study of digital well-being: digital gratitude, automated interventions, and sustainable co-well-being