The everyday ethics of field work research with vulnerable patients.

Patients are increasingly involved in health informatics research. Researchers are always aware of the ethical dimensions of their research, but studies in the field with patients--especially among the frail, elderly, cognitively impaired--present specific additional 'everyday moral dilemmas'. Reflecting on experiences of a hospital study of patients with dementia, this paper draws attention on the type and constant presence of this situated ethics, the immediacy of decision-making, and the importance of everyday ethics for health informatics

The Challenges of and Solutions for Combining Cocreation and Agile in the Development of Health Information Technologies

Background: Involving users has become a prominent principle in the development of Health Information Technologies (HIT) and has led to an uprise in agile and cocreation methods. Previous literature shows how the two can be combined in one method, but also suggest that using such a method may come with challenges, for which a solution is unclear.Purpose: To identify the challenges of using a method that combines agile and cocreation, provide solutions for these challenges, and evaluate its usage. Methods and Materials: The setting for this research was the Agile Cocreation of Robots for Aging (ACCRA) project. The research consisted of three phases: 1) evaluating the Agile Cocreation method to identify challenges in its usage, by analysing documents from the project (e-mails, meeting notes), 2) solving the challenges to improve the method, by designing solutions in a co-creation session; and 3) evaluating the usage of the improved version via a survey among engineers and user researchers involved in the project.Results: We identified three main challenges and developed three solutions, which were used in the next phase of the project. First, to engage all stakeholders in cocreation, we implemented more fun and playful materials. Second, to bridge the differences between engineers and user researchers we invested in face-to-face meetings. Third, to manage knowledge in the project we intensified our meeting schedule too weekly meetings. In the quantitative evaluation of the improved cocreation method, the engineers and user researchers were positive about the agile cocreation method and about our improvements.Conclusion: When developing HIT, a method that combines agile and cocreation is useful because it helps to identify user needs and to translate these needs into technology. To identify the needs of these users and other stakeholders it is important to involve them as active partners in cocreation using fun and playful materials. Engineers and user researchers should bridge their differences and meet face-to-face as much as possible

Development of a Healthy Eating and Lifestyle Program (HELP) Online Website for Filipinos: A Case Report

Background and Purpose: Non-communicable diseases (NCDs) are a major public health problem in the Philippines and around the world. Preventive measures to reduce its continuous rise require improvement in the health system. Utilization of information and communication technology-(ICT)-based tools will allow dissemination of evidenced-based information in the population. This case report contains the description of the development process of a Web-based nutrition Website. Case Description: ICT-based tools were explored as means of communicating nutrition information to the public because of the increasing access and usage of the Internet among Filipinos. An iterative process with five major phases were followed in the development. Outcome: The Website HELP Online can be accessed through (http://i.fnri.dost.gov.ph/helponline). There is integration of two modules: one for the general public and the other for registered nutritionist dietitians (RND) of the Food and Nutrition Research Institute (FNRI). The first module contained the nutrition counseling platform that connects and records all interactions of online and walk-in clients with their RNDs. The second module contained nutrition calculators, a health tracker, and nutrition education materials. Discussion: The developed HELP Online Website was used for online users to easily access nutrition information and services offered by Department of Science and Technology (DOST)-FNRI. The user-centered design focus in combination with a responsive Web platform resulted in improved user satisfaction. In terms of content, use of the current and accepted scientific information translated to simpler and easier messages were found to be more effective among the target group. Although many issues exist with the continuous use of ICT-based tools, the main purpose is to improve the delivery of evidence-based information to the public

Design for Transfer:figural transfer through metaphorical recontextualization in Games for Health

Why are serious games often less attractive to play? How is it possible that since the 70's it has seldom been possible to design really good and attractive Games for Health (G4H)? And why isn't serious gaming an essential part of our medical curricula, knowing that it is a learning tool with enormous potential? This dissertation shows that G4Hs are almost always simulations of reality, in which an attempt is made to approach a certain degree of similarity with professional practice. Yet games do not always have to be literal representations of reality. By linking an educational theory about figural transfer that has fallen into oblivion to the manifestations of serious games, this research argues for a 'design for transfer-rationale' with which different, and perhaps even better, serious games can be designed. This way of thinking requires a design research approach, necessary to recontextualize existing insights in a research-based manner towards new game contexts. This dissertation also makes concrete recommendations regarding educational innovation, the need for design-oriented research, and the importance of good design in Health

Design for Mobile Mental Health:An Exploratory Review

A large number of mobile mental health apps are available to the public but current knowledge about requirements of designing such solutions is scarce, especially from sociotechnical and user centred points of view. Due to the significant role of mobile apps in the mental health service models, identifying the design requirements of mobile mental health solutions is crucial. Some of those requirements have been addressed individually in the literature, but there are few research studies that show a comprehensive picture of this domain. This exploratory review aims to facilitate such holistic understanding. The main search keywords of the review were identified in a cross-disciplinary requirements workshop. The search was started by finding some core references in the healthcare databases. A wider range of references then has been explored using a snowball method. Findings showed that there is a good understanding of individual design requirements in current literature but there are few examples of implementing a combination of different design requirements in real world products. The design processes specifically developed for mobile mental health apps are also rare. Most studies on operational mobile mental health apps address major mental health issues while prevention and wellbeing areas are underdeveloped. In conclusion, the main recommendations for designing future mobile mental health solutions include: moving towards sociotechnical and open design strategies, understanding and creating shared value, recognizing all dimensions of efficacy, bridging design and medical research and development, and considering an ecosystem perspective

User-centred Design and Evaluation of Health Information Technology

Doktorgradsavhandling i informasjons- og kommunikasjonsteknologi, Fakultet for teknologi og naturvitenskap, Universitetet i AgderHealth information technologies play an important role in exchange of information and coordination of continuity of care in health care services. This thesis explores the approach of user-centred design and evaluation in the development of health information technology, with the main research focus on end-user involvement. A study on user-centred design and evaluation in the externally funded research projects United4Health and eHealth- extended Care Coordination was conducted. In addition, the internal project Visually impaired users touching the screen - A user evaluation evaluated visually impaired users using mobile technology. In the EU project United4Health, a collaborative telemedicine system for remote monitoring of chronic obstructive pulmonary disease patients was developed. The regional project eHealth- extended Care Coordination addressed the information flow within inter-municipal health care teams to build a collaborative information system that facilitated coordination between municipalities. In both projects, end-users were involved in workshops in an early design phase and participated in usability evaluations during the iterative development. A mixed methods research approach including observations, semi-structured interviews and a questionnaire was used for data collection in the user-centred design process. The data analysis was based on a qualitative content analysis from a human-computer interaction perspective. This thesis also addresses the topic of the usability evaluation of health information technology from the perspective of the technical infrastructure necessary for optimisation of data collection and retrospective analysis of data. In this regard, a usability evaluation of a mobile touchscreen together with visually impaired users was made. The results from the user-centred design and evaluation research are presented in this dissertation through a collection of 9 scientific published papers in international peer-reviewed journals and conference proceedings. This study contributes to the knowledge of user-centred design in several ways. Firstly, this thesis provides an understanding on how to actively and efficiently involve users in design and development of health information technology by conducting empirical research. Secondly, it contributes to the knowledge on how to run usability evaluations of health information technology in high fidelity laboratory settings, health care environment and patients’ homes. Thirdly, it provides recommendations for a technical infrastructure in order to optimise the outcome of usability evaluations. The Norwegian Social Science Data Services approved the studies presented here