11 research outputs found
Mutual Learning during Post-implementation. A study of designing a maternal and child health application in rural Tanzania
Cooperation between users and designers requires mutual learning about the information system to be developed, and research has provided guidelines and techniques for how to achieve it. However, for designers working in contexts where they experience a wide knowledge gap between themselves and prospective users, attaining mutual learning (ML) in these settings can be challenging. This study demonstrates an action research project carried out at a rural clinic in Tanzania to develop and implement an electronic medical record system. In that setting, techniques such as hands-on training, prompted reflections and extensive support after implementation helped the nurses (system users) to learn how to use the system. Similarly, these techniques helped the designers to learn about the clinical work. Large parts of the ML therefore took place during and after the system implementation when there was a real system to mutually learn from
Travelling an unfamiliar road: Implications for the entry of design practitioners into healthcare
This thesis reflects on the User Experience design practice employed for the HealthMap project to create online interactive self-management plans for people with HIV. It traces the development of collaborative design understanding within the multidisciplinary team and identifies key elements in the development of a healthcare IT design practice that lay the foundation for an emerging Community of Practice for Healthcare Experience Designers
Sotsiotehniline lÀhenemine tehnoloogilistes juurutustes Oà Monier lahenduste nÀitel
KĂ€esoleva bakalaureusetöö eesmĂ€rk on konkreetse juhtumianalĂŒĂŒsi pĂ”hjal hinnata, kuidas
sobitub ettevÔttesisese infotehnoloogilise rakenduse arendus ja disain sotsiaalinformaatika
teooria ning kitsamalt sotsiotehnilise lÀhenemise konteksti, kui rakenduse arendamisel ei ole
nimetatud paradigmasid arvestatud. Sotsiotehnilise lÀhenemismudeli kohaselt tuleb IT-rakenduse
arenduse puhul asetada sĂŒsteemi tehniline ja sotsiaalne kontekst vĂ”rdsetele positsioonidele.
Sotsiotehniline lÀhenemine ei ole tehnoloogiakeskne vaid arvestab ka keskkonnaga, kuhu
sĂŒsteem asetub, nt sĂŒsteemi lĂ”ppkasutaja ja muude sidusgruppidega, tööpraktikate ja
organisatsiooni strateegiatega.
Töö uurimisobjektiks on katusekive ning âpaigaldustarvikuid tootvas ettevĂ”ttes OĂ Monier
juurutatud materjalide tuvastamiseks ja laotoimingute registreerimiseks mÔeldud laolahenduse
pilootprojekt. Lisaks OĂ Monierile on juurutusprotsessiga seotud osapooled AS ID-Balti, kui
laolahenduse tarkvara ja kasutajaliidese arendaja ning seadmete tarnija ja BT Consult GmbH, kui
lahenduse majandustarkvara tugi ja liidestaja. OĂ Monier on osa Monier Grupi seitsmest riigist
koosnevast PĂ”hjamaade ja Baltikumi Ă€riĂŒksusest. Lahenduse pilootprojekt juurutati OĂ Monieri
Kiiul asuvas laos. Organisatsiooni strateegiline plaan nÀgi ette, et pilootprojekti Ônnestumise
korral vÀetakse lahendus kasutusele kÔikides regiooni ladudes. Töö uurimustulemuste eesmÀrgiks ei ole hinnangute andmine uurimisobjektile ning selle
projektikĂ€sitlusele, vaid analĂŒĂŒsida seda, kas ja millisel mÀÀral ettevĂ”ttesisese infotehnoloogilise
lahenduse arendusprotsess antud juhtumi pÔhjal kattub sotsiaalinformaatika lÀhenemismudeliga.
Töö pĂ”hilisteks uurimiskĂŒsimusteks olid lahenduse juurutusprotsessi ning juhtumi sotsiotehnilise
konstruktsiooni vaheliste peamiste sarnasuste ning erinevuste leidmine ning nende mÔjude
hindamine projekti lÔpptulemusele.
JuhtumianalĂŒĂŒsiks oli töö autoril kasutada lahenduse arenduse projektdokumentatsioon.
TĂ€iendavate uurimisandmete kogumiseks kasutas autor semistruktureeritud intervjuusid ning
kirjalikke avatud kĂŒsimustega ankeete. Uurimisandmete kogumiseks on kĂŒsitletud kĂ”iki projekti
seotud osapooli ja vĂ”tmeisikuid. Projekti analĂŒĂŒsi tulemuste vĂ”rdlemise aluseks sotsiotehnilise
lĂ€henemismudeliga oli autori poolt projektile loodud sotsiotehniline konstruktsioon. LĂ”ppjĂ€relduse objektiivsuse tagamiseks on leitud erinevustele kĂŒsitud kommentaarid Monieri
laolahenduse arenduse projektijuhilt.
Uurimistulemusest selgus, et töös vaadeldud IT-rakenduse arendusprotsess pigem kattus
sotsiaalinformaatika ning sotsiotehnilise paradigmadega. Kuigi pĂŒstitatud eesmĂ€rgis olid Ă€rilised,
siis uue laolahenduse kaardistamisel ja disainimisel lÀhtuti peamiselt organisatsiooni
standardsetest tööprotsessidest ning sellest, et uus laolahendus oleks kasutaja jaoks vÔimalikult
kergesti omandatav, lihtne ja mugav kasutada ning, et selle kasutamine hÀiriks vÔimalikult vÀhe
tema pĂ”hitööd. Projekti arendusse olid kaasatud kasutajad, mitte kĂŒll pĂ€ris laotöötajate vaid
laojuhatajate tasemel, kuid Monieri töökorraldus on ĂŒlesehitatud sellisena, et laojuhatajad
teostavad samuti vajadusel kÔiki jooksvaid laotoiminguid. SeetÔttu kÀsitles Monier neid antud
projekti raames lÔppkasutajana.
Peamised erinevused ilmnesid uue lahenduse arendusprotsessi arvestamisel organisatsiooni
olemasoleva tehnoloogilise infrastruktuuriga. Arenduse kÀigus tekkis mitmeid probleeme uue
lahenduse liidestamisel olemasoleva majandustarkvaraga ning projektimeeskond ei olnud
informeeritud kÔikidest Monieri projektiga seotud IT-otsustest. Antud asjaolude tÔttu tekkis
projekti arenduse kÀigus vÀiksemaid tÔrkeid, mis pÔhjustasid seisakuid projekti ajagraafikus ning
lĂŒkkasid edasi lahenduse lĂ”plikku kasutuselevĂ”ttu. Lisaks ei ole Monieril vĂ€lja töötatud
lahenduse lĂ”plik tugistruktuur. Autor on juhtumi analĂŒĂŒsi tulemusena toonud vĂ€lja ka mĂ”ned soovitused analoogsete arenduste
juurutusprotsessi edukaks planeerimiseks ja lÀbiviimiseks, mis on esitatud kÀesoleva töö
jÀrelduste ja diskussiooni osas.
Töö kokkuvÔttena vÔib öelda, et Monieril laolahenduse arenduse projektijuhtimine kattus
mitmetes olulistes punktides sotsiotehnilise paradigma vaadetega IT-arendustele. Suuri
pÔhimÔttelisi erinevusi lÀhenemiste vahel autor ei tuvastanud. Leitud erinevused olid eeskÀtt
vĂ€iksemates detailides. Uurimustulemused ei andnud ĂŒhest vastust sellele, palju nendest
erinevustest oleks olnud vÔimalik juurutusprotsessi tÀpsema planeerimisega Àra hoida
Implication des utilisateurs dans le dĂ©veloppement des innovations mĂ©dicales : une analyse sociotechnique de la collaboration et de ses enjeux pour lâorganisation des soins
Les changements technologiques ont des effets structurants sur lâorganisation des soins dans notre systĂšme de santĂ©. Les professionnels de la santĂ© et les patients â les principaux utilisateurs des innovations mĂ©dicales â sont des acteurs clĂ©s dans les trajectoires suivies par les nouvelles technologies en santĂ©. Pour dĂ©velopper des technologies mĂ©dicales plus efficaces, sĂ©curitaires et conviviales, plusieurs proposent dâintensifier la collaboration entre les utilisateurs et les dĂ©veloppeurs. Cette recherche sâintĂ©resse Ă cette prĂ©misse sur la participation des utilisateurs dans les processus dâinnovation mĂ©dicale. L'objectif gĂ©nĂ©ral de cette recherche est de mieux comprendre la collaboration entre les utilisateurs et les dĂ©veloppeurs impliquĂ©s dans la transformation des innovations mĂ©dicales. Adoptant un cadre dâanalyse sociotechnique, cette thĂšse par articles sâarticule autour de trois objectifs : 1) dĂ©crire comment la littĂ©rature scientifique dĂ©finit les objectifs, les mĂ©thodes et les enjeux de lâengagement des utilisateurs dans le dĂ©veloppement des innovations mĂ©dicales; 2) analyser les perspectives dâutilisateurs et de dĂ©veloppeurs de technologies mĂ©dicales quant Ă leur collaboration dans le processus dâinnovation; et 3) analyser comment sont mobilisĂ©s, en pratique, des utilisateurs dans le dĂ©veloppement dâune innovation mĂ©dicale. Le premier objectif sâappuie sur une synthĂšse structurĂ©e des Ă©crits scientifiques (n=101) portant sur le phĂ©nomĂšne de la participation des utilisateurs dans les processus dâinnovation mĂ©dicale. Cette synthĂšse a dĂ©gagĂ© les mĂ©thodes appliquĂ©es ou proposĂ©es pour faire participer les utilisateurs, les arguments normatifs vĂ©hiculĂ©s ainsi que les principaux enjeux soulevĂ©s. Le deuxiĂšme objectif repose sur lâanalyse de trois groupes de discussion dĂ©libĂ©ratifs et d'une plĂ©niĂšre impliquant des utilisateurs et des dĂ©veloppeurs (n=19) de technologies mĂ©dicales. Lâanalyse a permis dâexaminer leurs perspectives Ă l'Ă©gard de diverses approches de collaboration dans les processus d'innovation. Le troisiĂšme objectif implique lâĂ©tude dâune innovation en Ă©lectrophysiologie lors de la phase de recherche clinique. Cette Ă©tude de cas unique s'appuie sur une analyse qualitative d'Ă©tudes cliniques (n=57) et des Ă©ditoriaux et synthĂšses de connaissances dans des revues mĂ©dicales spĂ©cialisĂ©es (n=15) couvrant une pĂ©riode de dix ans (1999 Ă 2008) ainsi que des entrevues semi-dirigĂ©es avec des acteurs clĂ©s impliquĂ©s dans le processus dâinnovation (n=3). Cette Ă©tude a permis de mieux comprendre comment des utilisateurs donne un sens, sâapproprient et lĂ©gitiment une innovation mĂ©dicale en contexte de recherche clinique. La contribution gĂ©nĂ©rale de cette thĂšse consiste en une meilleure comprĂ©hension de lâapport des utilisateurs dans les processus dâinnovation mĂ©dicale et de sa capacitĂ© Ă aligner plus efficacement le dĂ©veloppement technologique avec les objectifs du systĂšme de santĂ©.Technological changes have major effects on health care organization. Health professionals and patients â the main users of medical innovations â are key actors in the ongoing development and refinement of new medical technologies. To develop more efficient, safe and user-friendly medical technologies, many propose enhancing collaboration between technology users and developers. This research investigates the premise of involving users in the medical innovation process. The main objective of this research is to better understand the collaboration between users and developers involved in the transformation of medical innovations. Adopting a sociotechnical approach, this thesis by article has three objectives: 1) Describe how the literature defines the objectives, methods and issues of engaging users in the development of medical innovations; 2) Analyze the perspectives of users and developers of medical technologies with regards to their collaboration in the innovation process; and 3) Analyze how users are mobilized in practice in the development of medical innovation. The first objective is addressed by a narrative synthesis of the scientific literature (n=101) on user involvement in the medical innovation process. This synthesis has identified the methods used or proposed, normative arguments conveyed, and the main issues raised by involving users. Analysis of data from three deliberative focus groups and a plenary involving users and developers (n=19) of medical technology were employed to address the second objective. The analysis details their perspectives on various modes of collaboration in the innovation process. The third objective involves a case study of an innovation in electrophysiology at the clinical research phase. This case study is based on a qualitative analysis of clinical studies (n=57), editorials and reviews in medical journals (n=15) covering a ten year period (1999-2008) and semi-structured interviews with key actors involved in the innovation process (n=3). This study provides insight into how users make sense of, appropriate and legitimize medical innovation in the context of clinical research. The overall contribution of this thesis is a better understanding of user involvement in the medical innovation process and how to more effectively align technological development with the objectives of the health system
Front-Line Physicians' Satisfaction with Information Systems in Hospitals
Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.Peer reviewe
Development of an online self-management intervention for adults with type 2 diabetes (HeLP-Diabetes)
Background: The prevalence of type 2 diabetes is increasing and estimates suggest that by 2030 nearly 1 in 10 adults worldwide will be living with this condition. 10% of the NHS budget is spent on treating diabetes and related complications like heart attacks, strokes and blindness. Improving self-management in people living with type 2 diabetes is crucial in reducing the morbidity and mortality associated with this disease. Uptake of group-based self-management training is low and there is an urgent need for evidence based and effective alternatives. Computer-based interventions have the potential to provide cost-effective self-management training and improve outcomes for people with type 2 diabetes. The eHealth Unit was awarded a 5 year NIHR Programme grant for Applied Research to develop, evaluate and implement an online self-management intervention for adults with type 2 diabetes. This thesis describes my contribution towards developing the intervention. Aims/objectives: To describe the development of an online self-management intervention for adults with type 2 diabetes. Methods: The intervention development process was modelled on the MRC guidelines for developing complex interventions. This started with a systematic review of the literature on computer-based self-management interventions for adults with type 2 diabetes. Suitable theories to underpin the intervention were identified and used to construct a logic model to describe the potential mode of action. Qualitative work with people living with type 2 diabetes and health professionals was used to explore patient and professional defined wants and needs from such interventions. This data was then synthesized to inform the development of a theory-based online intervention called HeLP-Diabetes, designed to improve self-management in people living with type 2 diabetes. Conclusions: The synthesis of previous evidence with new qualitative data from patients and health professionals has helped to create a unique online intervention that will hopefully help bridge current gaps in the delivery of self-management training and improve outcomes for people with type 2 diabetes