Using System Analysis and Personas for e-Health Interaction Design

Today, designers obtain more central roles in product and service development (Perks, Cooper, & Jones, 2005). They have to deal with increasingly complicated problems, like integrating the needs of various stakeholders while taking care about social, ethical and ecological consequences of their designs. To deal with this demanding design situation, they need to apply new methods to organize the available information and to negotiate the stakeholder’s perspectives. This paper describes how systems analysis supports the design process in a complex environment. In a case study, we demonstrate how this method enables designers to describe user requirements for complex design environments while considering the perspectives of various stakeholders. We present a design research project applying cybernetic systems analysis using the software ''System-Tools'' (Vester, 2002). Results from the analysis were taken to inform the design of an electronic patient record (EPR), considering the particularities of the German health care system. Based on the analysis, we developed a set of requirements for every stakeholder group, detailing the patients' perspective with persona descriptions. We then picked a main persona as reference for the EPR design. We describe the resulting design sketch and discuss the value of cybernetic systems analysis as a tool to deal with complex social environments. The result shows how the method helps designers to structure and organize information about the context and identify fruitful intervention opportunities for design. Keywords: E-Health; System Analysis, Cybernetics; Personas.</p

Benefits of and barriers to involving users in medical device technology development and evaluation

Objectives: This study investigated the benefits of, and barriers to user involvement in medical device technology development and evaluation. Methods: A structured review of published literature in peer-reviewed journals. Results: This review revealed that the main benefits of user involvement were an increased access to user needs, experiences and ideas; improvements in medical device designs and user interfaces; and an increase in the functionality, usability and quality of the devices. On the other hand, resource issues, particularly those of time and money were found the key impediments to involving users in the development and evaluation of medical device technologies. This study has categorised both the benefits and barriers to user involvement also. Conclusions: The involvement of users in MDTD&E requires resources, which are limited; however, it is essential from both users and manufacturers perspectives

Exploiting the potential of large databases of electronic health records for research using rapid search algorithms and an intuitive query interface.

Objective: UK primary care databases, which contain diagnostic, demographic and prescribing information for millions of patients geographically representative of the UK, represent a significant resource for health services and clinical research. They can be used to identify patients with a specified disease or condition (phenotyping) and to investigate patterns of diagnosis and symptoms. Currently, extracting such information manually is time-consuming and requires considerable expertise. In order to exploit more fully the potential of these large and complex databases, our interdisciplinary team developed generic methods allowing access to different types of user. Materials and methods: Using the Clinical Practice Research Datalink database, we have developed an online user-focused system (TrialViz), which enables users interactively to select suitable medical general practices based on two criteria: suitability of the patient base for the intended study (phenotyping) and measures of data quality. Results: An end-to-end system, underpinned by an innovative search algorithm, allows the user to extract information in near real-time via an intuitive query interface and to explore this information using interactive visualization tools. A usability evaluation of this system produced positive results. Discussion: We present the challenges and results in the development of TrialViz and our plans for its extension for wider applications of clinical research. Conclusions: Our fast search algorithms and simple query algorithms represent a significant advance for users of clinical research databases

Interdisciplinary design of a pervasive fall handling system

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Summarisation and visualisation of e-Health data repositories

At the centre of the Clinical e-Science Framework (CLEF) project is a repository of well organised, detailed clinical histories, encoded as data that will be available for use in clinical care and in-silico medical experiments. We describe a system that we have developed as part of the CLEF project, to perform the task of generating a diverse range of textual and graphical summaries of a patient’s clinical history from a data-encoded model, a chronicle, representing the record of the patient’s medical history. Although the focus of our current work is on cancer patients, the approach we describe is generalisable to a wide range of medical areas

Contribution of the voluntary sector to mental health crisis care in England: protocol for a multimethod study.

Introduction - Timely access to the right kind of support for people experiencing a mental health crisis can be problematic. The voluntary sector (VS) plays a key role in providing support and enabling access, but there is a knowledge gap concerning its contribution and interface with public services in mental health crisis care. Methods and analysis - This study aims to address this. The study has three empirical elements: (1) a national survey of voluntary sector organisations (VSOs) in England and national stakeholder interviews to develop a typology of organisations and interventions provided by VSOs; (2) detailed mapping of VS services in two regions through interviews and extending the national survey; (3) four case studies, identified from the regional mapping, of VS mental health crisis services and their interface with National Health Service (NHS) and local authority services, at both a system and individual level. Data collection will involve interviews with commissioners; VSO and NHS or local authority providers; and focus groups with people who have experience of VSO crisis support, both service users and carers; and mapping the crisis trajectory of 10 service users in each study site through narrative interviews with service users and informal carers to understand the experience of VSO crisis care and its impact. Ethics and dissemination - The University of Birmingham Humanities and Social Sciences Ethical Review Committee granted ethical approval (reference ERN_16-1183) for the national and regional elements of the study. Ethical review by the Health Research Authority will be required for the case study research once the sites have been identified from the first two elements of the study. A range of methods including a policy seminar, publication in academic journals and a tool kit for commissioners and practitioners will be produced to maximise the impact of the findings on policy and practice

Transitions of care from child and adolescent mental health services to adult mental health services (TRACK Study) : a study of protocols in Greater London

Background: Although young people's transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) in England is a significant health issue for service users, commissioners and providers, there is little evidence available to guide service development. The TRACK study aims to identify factors which facilitate or impede effective transition from CAHMS to AMHS. This paper presents findings from a survey of transition protocols in Greater London. Methods: A questionnaire survey (Jan-April 2005) of Greater London CAMHS to identify transition protocols and collect data on team size, structure, transition protocols, population served and referral rates to AMHS. Identified transition protocols were subjected to content analysis. Results: Forty two of the 65 teams contacted (65%) responded to the survey. Teams varied in type (generic/targeted/in-patient), catchment area (locality-based, wider or national) and transition boundaries with AMHS. Estimated annual average number of cases considered suitable for transfer to AMHS, per CAMHS team (mean 12.3, range 0–70, SD 14.5, n = 37) was greater than the annual average number of cases actually accepted by AMHS (mean 8.3, range 0–50, SD 9.5, n = 33). In April 2005, there were 13 active and 2 draft protocols in Greater London. Protocols were largely similar in stated aims and policies, but differed in key procedural details, such as joint working between CAHMS and AMHS and whether protocols were shared at Trust or locality level. While the centrality of service users' involvement in the transition process was identified, no protocol specified how users should be prepared for transition. A major omission from protocols was procedures to ensure continuity of care for patients not accepted by AMHS. Conclusion: At least 13 transition protocols were in operation in Greater London in April 2005. Not all protocols meet all requirements set by government policy. Variation in protocol-sharing organisational units and transition process suggest that practice may vary. There is discontinuity of care provision for some patients who 'graduate' from CAMHS services but are not accepted by adult services