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

Human factors in mental healthcare : A work system analysis of a community-based program for older adults with depression and dementia

Mental healthcare is a critical but largely unexplored application domain for human factors/ergonomics. This paper reports on a work system evaluation of a home-based dementia and depression care program for older adults, the Aging Brain Care program. The Workflow Elements Model was used to guide data collection and analysis of 59 h of observation, supplemented by key informant input. We identified four actors, 37 artifacts across seven types, ten action categories, and ten outcomes including improved health and safety. Five themes emerged regarding barriers and facilitators to care delivery in the program: the centrality of relationship building; the use of adaptive workarounds; performance of duplicate work; travel and scheduling challenges; and communication-related factors. Findings offer new insight into how mental healthcare services are delivered in a community-based program and key work-related factors shaping program outcomes

Macroergonomic factors in the patient work system: examining the context of patients with chronic illness

Human factors/ergonomics recognises work as embedded in and shaped by levels of social, physical and organisational context. This study investigates the contextual or macroergonomic factors present in the health-related work performed by patients. We performed a secondary content analysis of findings from three studies of the work of chronically ill patients and their informal caregivers. Our resulting consolidated macroergonomic patient work system model identified 17 factors across physical, social and organisational domains and household and community levels. These factors are illustrated with examples from the three studies and discussed as having positive, negative or varying effects on health and health behaviour. We present three brief case studies to illustrate how macroergonomic factors combine across domains and levels to shape performance in expected and unexpected ways. Findings demonstrate not only the importance of context for patients\u27 health-related activities but also specific factors to consider in future research, design and policy efforts. Practitioner Summary: Health-related activities of patients are embedded in and shaped by levels of social, physical and organisational context. This paper combined findings from three studies to specify 17 contextual or macroergonomic factors in home-and community-based work systems of chronically ill patients. These factors have research, design and policy implications

A framework to extract biomedical knowledge from gluten-related tweets: the case of dietary concerns in digital era

Journal pre proofBig data importance and potential are becoming more and more relevant nowadays, enhanced by the explosive growth of information volume that is being generated on the Internet in the last years. In this sense, many experts agree that social media networks are one of the internet areas with higher growth in recent years and one of the fields that are expected to have a more significant increment in the coming years. Similarly, social media sites are quickly becoming one of the most popular platforms to discuss health issues and exchange social support with others. In this context, this work presents a new methodology to process, classify, visualise and analyse the big data knowledge produced by the sociome on social media platforms. This work proposes a methodology that combines natural language processing techniques, ontology-based named entity recognition methods, machine learning algorithms and graph mining techniques to: (i) reduce the irrelevant messages by identifying and focusing the analysis only on individuals and patient experiences from the public discussion; (ii) reduce the lexical noise produced by the different ways in how users express themselves through the use of domain ontologies; (iii) infer the demographic data of the individuals through the combined analysis of textual, geographical and visual profile information; (iv) perform a community detection and evaluate the health topic study combining the semantic processing of the public discourse with knowledge graph representation techniques; and (v) gain information about the shared resources combining the social media statistics with the semantical analysis of the web contents. The practical relevance of the proposed methodology has been proven in the study of 1.1 million unique messages from more than 400,000 distinct users related to one of the most popular dietary fads that evolve into a multibillion-dollar industry, i.e., gluten-free food. Besides, this work analysed one of the least research fields studied on Twitter concerning public health (i.e., the allergies or immunology diseases as celiac disease), discovering a wide range of health-related conclusions.SING group thanks CITI (Centro de Investigacion, Transferencia e Innovacion) from the University of Vigo for hosting its IT infrastructure. This work was supported by: the Associate Laboratory for Green Chemistry-LAQV, which is financed by national funds from and the Portuguese Foundation for Science and Technology (FCT) under the scope of the strategic funding of [UIDB/50006/2020] and [UIDB/04469/2020] units, and BioTecNorte operation [NORTE010145FEDER000004] funded by the European Regional Development Fund under the scope of Norte2020Programa Operacional Regional do Norte, the Xunta de Galicia (Centro singular de investigacion de Galicia accreditation 2019-2022) and the European Union (European Regional Development Fund - ERDF)- Ref. [ED431G2019/06] , and Conselleria de Educacion, Universidades e Formacion Profesional (Xunta de Galicia) under the scope of the strategic funding of [ED431C2018/55GRC] Competitive Reference Group. The authors also acknowledge the post-doctoral fellowship [ED481B2019032] of Martin PerezPerez, funded by the Xunta de Galicia. Funding for open access charge: Universidade de Vigo/CISUGinfo:eu-repo/semantics/publishedVersio

Healthcare service innovation based on information technology: The role of social values alignment

The electronic personal health record (ePHR) is an information technology (IT) de- signed for patients’ empowerment in health self-management. Its actual implementation remains less than expected due to two main barriers that must be addressed by ePHRs’ providers: lack of trust in providers with regards to data privacy and lack of flexibility of the tool. In this study, we suggest that to potentially overcome these two challenges, ePHRs could be provided by health cooperatives (co-ops) in collaboration with open source devel- opment communities that share similar values. Based on the concept of social alignment that focuses on values, we explore the potential social bi-alignments between the values underlying the mission of health co-ops and the purpose of ePHRs, and between the founda- tional values of health co-ops and open source development communities. We also explore the effect of such potential social values alignments on health co-ops’ interest in innovat- ing with an ePHR-based service. To achieve our research objectives, 17 interviews were conducted in health co-ops in Quebec, a province of Canada where the network of health co-ops is particularly active. Our findings show that the concept of social values alignment is useful in the context of ePHR-based service innovation in health co-ops. However, our data analysis shows that social values alignment is not sufficient for healthcare service innovation to happen. Indeed, our findings lead us toward the concept of organizational readiness to better understand what is required to increase the likelihood of ePHR-based service innovation in health co-ops. This study culminates with the undertaking of theo- retical development where we propose a conceptual model of IT-based service innovation in healthcare organizations by expanding on our findings and on insights from the liter- ature

O papel de enfermeiro em tempo de internet : orientação e avaliação de informação em saúde

Orientadora: Profª Drª Verônica de Azevedo MazzaDissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação Mestrado Profissional em Enfermagem. Defesa: Curitiba, 27/09/2017Inclui referências : f.123-151Resumo: O progresso das Tecnologias da Informação e Comunicação possibilitou o acesso a informações em saúde e a ferramentas de suporte on-line. Considerando os riscos a que o conteúdo informacional on-line de baixa qualidade pode expor os pacientes, é imprescindível que os profissionais de saúde incorporem em sua prática profissional a avaliação da qualidade das informações on-line sobre saúde. Objetivou-se apreender a percepção dos enfermeiros sobre as potencialidades e fragilidades do uso das informações de sites sobre Transplante de Células-Tronco Hematopoiéticas no cuidado e elaborar um instrumento para avaliação da qualidade dessas informações. Trata-se de uma pesquisa de intervenção, de caráter exploratório e baseada em método misto quali-quantitativo. A abordagem qualitativa foi realizada por meio de entrevistas semiestruturadas. Para a abordagem quantitativa utilizou-se a aplicação do instrumento de avaliação de sites desenvolvido coletivamente pelos participantes. Participaram deste estudo 23 enfermeiros, com experiência em Serviço de Transplante de Medula Óssea, lotados na Unidade de Hematologia, Hemoterapia e Oncologia, entre outras unidades do hospital. A coleta de dados ocorreu entre novembro de 2016 e fevereiro de 2017, em duas etapas: na primeira, foram realizadas entrevistas semiestruturadas e, na segunda etapa, atividades on-line de intervenção por meio da elaboração coletiva de um instrumento de avaliação da qualidade da informação de sites brasileiros com essa temática, e aplicação desta ferramenta na avaliação de dois sites. As entrevistas foram transcritas e analisadas com o auxílio do software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires, emergindo desta análise quatro classes, intituladas: Percepção do enfermeiro sobre suas competências nas orientações a pacientes e familiares com perfil de busca de informações em sites sobre saúde; Das limitações existentes às possibilidades de melhorar a prática sobre a qualidade das informações on-line sobre saúde; A Internet como uma possibilidade na ampliação da rede de apoio social; Potencialidades e fragilidades das informações on-line sobre saúde. Para análise dos dados quantitativos da aplicação do instrumento, foram realizados o cálculo da amplitude do intervalo de classes, o intervalo de pontuação para classes, a interpretação de planilhas e representações gráficas. As atividades on-line de intervenção realizadas mostraram-se eficazes para a elaboração e aplicação de um instrumento de avaliação da qualidade da informação de sites, produto desta pesquisa. Na percepção dos participantes, as informações on-line sobre saúde possuem tanto fragilidades quanto potencialidades. Identificou-se a existência de uma lacuna na formação e prática dos enfermeiros em algumas habilidades de Informática em Enfermagem, pois apesar de demonstrarem conhecimento para avaliação da qualidade das informações on-line sobre saúde, não realizam a translação do mesmo para sua prática profissional. Considera-se importante refletir sobre a necessidade de investimentos na formação e capacitação dos enfermeiros para superar suas limitações e incorporar as informações on-line aos cuidados de Enfermagem para possibilitar uma assistência centrada nas necessidades dos pacientes e familiares com esse perfil de busca e utilização de informações. Palavras-chave: Internet. Informação de Saúde ao Consumidor. Informática em Enfermagem. Competência informacional.Abstract: The advances in Information and Communication Technologies (ICTs) enabled the access to health information and online support tools. Considering the hazards that low-quality online informative content may expose patients, it is essential that healthcare professionals include quality evaluation on online health information in their professional practice. It aimed to apprehend nurses' perception about the potentialities and weaknesses in the use of informative sites on Hematopoietic Stem Cells Transplantation for caring, and elaborate an instrument for the quality evaluation of such information. It was an exploratory, intervention research study, grounded in a mixed quali-quantitative method. The qualitative approach was held by means of semi-structured interviews. For the quantitative approach, the application of a site evaluation instrument was used, jointly developed by the participants. Twenty-three (23) experienced nurses in Hematopoietic Stem Cells Transplantation Service, who worked at the Hematology, Hemotherapy and Oncology Unit, among other hospital units, participated in the study. Data collection was carried out between November, 2016 and February, 2017, entailing two steps: in the first one, semi-structured interviews were held, and in the second one, online intervention activities were carried out by means of the joint elaboration of a quality evaluation instrument of Brazilian sites on the theme, and application of the tool in two sites. The interviews were transcribed and analyzed by means of the Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires® (IRAMUTEQ) software, emerging four classes from that analysis, as follows: Nurses' perceptions on their competencies in guiding patients and family members who have the profile of searching for information on health sites; From the existing limitations to the possibilities of improving the practice on online quality health information; Internet as a possibility to expand the social support network; Potentialities and weaknesses of online health information. For the analysis of the quantitative data in the instrument application, class width calculation, class score intervals, spreadsheet interpretation and graphic representations were carried out. The online intervention activities, which were carried out, proved effective for the elaboration and application of a quality evaluation instrument of informative sites, by-product of this study. In the participants' perception, online health information may feature as many weaknesses as potentialities. A gap in nurses' education and practice was evidenced towards some nursing Informatics skills, once they show knowledge on quality evaluation of online health information, however, the participants do not transport it to their professional practice. It is important to consider investments in nurses' education and qualification, so that they can overcome their limitations and incorporate online information to Nursing care, thus enabling care centered on the needs of patients and their families with that profile of information search and use. Key words: Internet. Health Information to Users. Nursing Informatics. Informative Competency

Reflection and personal health informatics for people living with HIV

Recent advances in medicine mean that millions of people who are living with the Human Immunodeficiency Virus (HIV) can expect to live normal life spans. However, HIV, the medication prescribed to control the virus, and living with a stigmatized disease, are each associated with a wide array of negative impacts on the body and mind, and these present a challenge in an individual’s ability to self-manage their health information. A key aspect of self-management is self-understanding, and Personal Health Informatics (PHI) has the potential to help those living with HIV in understanding their health through reflection. However, there is little indication of the needs of people living with HIV and how PHI systems can best support them in reflecting on their health information. In order to fill this gap, this thesis aims to answer the overall research question: How can Personal Health Informatics systems support people living with HIV in reflecting on their personal health information? Answering this research question was approached in four parts: • The development of a synthesized model of the process of PHI, as means of understanding the context of PHI. • Interviews with HIV+ individuals were conducted to understand where there were opportunities for supporting reflection. • An analysis of an online forum was conducted to determine what people living with HIV were trying to reflect upon, what health information was being asked about, and how the community attempts to support them in reflecting on their health. • Two visual prototypes were designed to simulate community-aided reflection and support people living with HIV in reflecting on their personal health information. These were used during a user study to understand how reflection occurred. My research is the first to explore how to support HIV+ people in reflecting on their personal health information. The main contribution of this research is a detailed understanding of how PHI systems can support people living with HIV in reflecting on their health information. This main contribution is comprised of four smaller ones: • A six-stage process model of Personal Health Informatics • A detailed understanding of how people living with HIV currently track and reflect on their personal health information, and design implications for PHI systems to support them in reflection • An empirical understanding of community-aided reflection as it occurs in an online forum, alongside the identification of five common questions that people living with HIV seek help in online forums for reflecting upon, the information asked about, and how the community attempts to address the questions • A detailed depiction of how reflection occurs when using a prototype designed to simulate community-aided reflectio