Activity‐Driven Needs Analysis and Modeling in healthcare information systems development

Healthcare is networked, multiprofessional and cooperative work where information systems are used as means to manipulate, store and share critical and sensitive information within the work tasks of the different professionals. The changes in information systems cause changes in the work practices as well. It is important to understand the work activities where the information system will be embedded. However, the traditional information systems development (ISD) approaches are technically oriented instead of work oriented. Especially the starting point of any development project is often fuzzy and without methodologies and guidance. The research objective is to provide theoretically based, practically adaptive methods for the early phases of work oriented ISD in user organizations.Activity‐Driven Needs Analysis and Modeling was studied and developed as an integral part of larger research of Activity‐Driven (AD) ISD approach. The previous research results utilizing Activity Theory and Developmental Work Research in ISD were taken as materials to be tested and developed further in iterative research cycles. Participatory action research, case study, and constructive analysis were the main forms of the research. The empirical studies were carried on in healthcare organizations in Finland, China and Mozambique. Empirical data were gathered from the participating organizations e.g. by group and individual interviews, workshops and brainstorming sessions. Multiprofessional and multidisciplinary research groups, including “lay” healthcare professionals, have been involved to the research.The research produced knowledge about the nature of ISD in the participating organizations and methodological knowledge for supporting the starting point situations. Activity‐Driven Needs Analysis and Modeling was developed and tested; and related to mainstream methodologies, e.g. process modeling. The results of this research mainly focused on improving the applicability of the approach and the means for analysis and modeling. Specifically, the results show that the ADNA and AD Modeling fit for the starting point analysis in healthcare organizations: capturing the essence of the work activities and the information needs of the different actors within work activities, including the need for information sharing between the individuals and work activities

Depicting the Landscape around Information Flows: Methodological Propositions

Developers of software applications entering new markets want to know: “Where are our users (more formally, which actors in which organizations will benefit from using our products)? Where do they need our products (more formally, in which processes will the actors benefit from using the products)? Where are our customers (more formally, who has the authority to decide on introducing the products into the processes)?” Similarly, Information Systems researchers starting to study a phenomenon in a context new to them need to understand the broad socio-political and organizational landscape around the actual object of research. This is particularly important when the same phenomenon is being studied in different countries – if differences in the broader context are not recognized, it is impossible to compare the results. Most Information Systems theories, methods and textbooks are developed in the “North” (North America, Europe, Australia), in wealthy societies and mainly in the context of big private business – although often considered “universal”. Practitioners, educators and researchers in the South work in contexts that can be very different from the “universal” in terms of economy, political structures, cultures, infrastructures, education, etc. They need to be able to identify and understand the differences and similarities between the “universal” and their actual context

Where does the interaction break down? The stakeholder map of health IT systems development and use in Finland

Prior research shows that clinical users’ experience of healthcare IT systems in Finland is poor. Research shows further that physicians are highly critical of the perceived lack of user participation in systems development, but developers of the same systems argue that they do work with users and are highly interested in their views. This study aimed at mapping the stakeholders involved in the user–developer interaction network, in order to identify the spots where the interaction breaks down. A method for depicting the healthcare landscape was adapted for depicting the healthcare IT systems development landscape. Experts selected through purposive sampling were interviewed to identify stakeholders and problems. Content analysis was used to categorise problems into development spots. A stakeholder map was drawn, consisting of 22 organization types, nine activities within them, and two groups of individuals. Seven development spots were identified, within and between the healthcare provider and the software provider but also related to other stakeholders. A significantly larger number of stakeholders are involved in healthcare IT system development than what was initially evident. They all influence the end-user experience in some way. It is not only the software product itself (whether with good or bad usability), but also several other factors that may affect user experience. Further research can now focus on what can be done and by whom to address the development spots