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Marcilly R, Lesselroth B, Guerlinger S, Pigot A, Schiro J, Pelayo S. Active Involvement of End-Users in an EHR Procurement Process: a Usability Walkthrough Feasibility Case Study. J Gen Intern Med 2023; 38:974-981. [PMID: 37798578 PMCID: PMC10593645 DOI: 10.1007/s11606-023-08277-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 06/13/2023] [Indexed: 10/07/2023]
Affiliation(s)
- Romaric Marcilly
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille, F-59000, France.
- Inserm, CIC-IT 1403, F-59000, Lille, France.
| | - Blake Lesselroth
- School of Health Information Science, University of Victoria, Victoria, Canada
- University of Oklahoma-Tulsa, School of Community Medicine, Tulsa, USA
| | - Sandra Guerlinger
- Inserm, CIC-IT 1403, F-59000, Lille, France
- CHU de Lille, Direction des Ressources Numériques, Lille, France
| | - Annick Pigot
- Lille Catholic Hospitals, Information Department, Lille, F-59160, France
| | - Jessica Schiro
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille, F-59000, France
- Inserm, CIC-IT 1403, F-59000, Lille, France
| | - Sylvia Pelayo
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille, F-59000, France
- Inserm, CIC-IT 1403, F-59000, Lille, France
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Lesselroth B, Church VL, Adams K, Mixon A, Richmond-Aylor A, Glasscock N, Wiedrick J. Interprofessional survey on medication reconciliation activities in the US Department of Veterans' Affairs: development and validation of an Implementation Readiness Questionnaire. BMJ Open Qual 2022; 11:bmjoq-2021-001750. [PMID: 36229073 PMCID: PMC9562315 DOI: 10.1136/bmjoq-2021-001750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Medication reconciliation (MR) can detect medication history discrepancies at interfaces-in-care and help avoid downstream adverse drug events. However, organisations have struggled to implement high-quality MR programmes. The literature has identified systems barriers, including technology capabilities and data interoperability. However, organisational culture as a root cause has been underexplored. OBJECTIVES Our objectives were to develop an implementation readiness questionnaire and measure staff attitudes towards MR across a healthcare enterprise. METHODS We developed and distributed a questionnaire to 170 Veterans' Health Affairs (VHA) sites using Research Electronic Data Capture (REDCap) software. The questionnaire contained 21 Likert-scale items that measured three constructs, such as: (1) the extent that clinicians valued MR; (2) perceptions of workflow compatibility and (3) perceptions concerning organisational climate of implementation. RESULTS 8704 clinicians and staff responded to our questionnaire (142 of 170 VHA facilities). Most staff believed reconciling medications can improve medication safety (approximately 90% agreed it was 'important'). However, most (approximately 90%) also expressed concerns about changes to their workflow. One-third of respondents prioritised other duties over MR and reported barriers associated with implementation climate. Only 47% of respondents agreed they had enough resources to address discrepancies when identified. INTERPRETATION Our findings indicate that an MR readiness assessment can forecast challenges and inform development of a context-sensitive implementation bundle. Clinicians surveyed struggled with resources, technology challenges and implementation climate. A strong campaign should include clear leadership messaging, credible champions and resources to overcome technical challenges. CONCLUSIONS This manuscript provides a method to conduct a readiness assessment and highlights the importance of organisational culture in an MR campaign. The data can help assess site or network readiness for an MR change management programme.
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Affiliation(s)
- Blake Lesselroth
- Department of Medical Informatics, The University of Oklahoma-Tulsa, Tulsa, Oklahoma, USA,School of Health Information Science, University of Victoria, Victoria, British Columbia, Canada
| | - Victoria Lee Church
- US Department of Veterans Affairs, Office of Nursing Services, Washington, DC, USA
| | - Kathleen Adams
- US Department of Veterans Affairs, Office of Human Factors Engineering, Washington, DC, USA
| | - Amanda Mixon
- School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Amy Richmond-Aylor
- Office of Specialty Care Services, Veterans Health Administration, Washington, DC, USA
| | - Naomi Glasscock
- Specialty Care Services, Prescription Drug Monitoring Program, Veterans Health Administration, Washington, DC, USA
| | - Jack Wiedrick
- Biostatistics & Design Program, Oregon Health & Science University, Portland, Oregon, USA
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Abstract
Understanding the factors affecting the use of healthcare technologies is a crucial topic that has been extensively studied, specifically during the last decade. These factors were studied using different technology acceptance models and theories. However, a systematic review that offers extensive understanding into what affects healthcare technologies and services and covers distinctive trends in large-scale research remains lacking. Therefore, this review aims to systematically review the articles published on technology acceptance in healthcare. From a yield of 1768 studies collected, 142 empirical studies have met the eligibility criteria and were extensively analyzed. The key findings confirmed that TAM and UTAUT are the most prevailing models in explaining what affects the acceptance of various healthcare technologies through different user groups, settings, and countries. Apart from the core constructs of TAM and UTAUT, the results showed that anxiety, computer self-efficacy, innovativeness, and trust are the most influential factors affecting various healthcare technologies. The results also revealed that Taiwan and the USA are leading the research of technology acceptance in healthcare, with a remarkable increase in studies focusing on telemedicine and electronic medical records solutions. This review is believed to enhance our understanding through a number of theoretical contributions and practical implications by unveiling the full potential of technology acceptance in healthcare and opening the door for further research opportunities.
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Hassandoust F, Akhlaghpour S, Johnston AC. Individuals' privacy concerns and adoption of contact tracing mobile applications in a pandemic: A situational privacy calculus perspective. J Am Med Inform Assoc 2021; 28:463-471. [PMID: 33164077 DOI: 10.1093/jamia/ocaa240] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/25/2020] [Accepted: 09/12/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The study sought to develop and empirically validate an integrative situational privacy calculus model for explaining potential users' privacy concerns and intention to install a contact tracing mobile application (CTMA). MATERIALS AND METHODS A survey instrument was developed based on the extant literature in 2 research streams of technology adoption and privacy calculus. Survey participants (N = 853) were recruited from all 50 U.S. states. Partial least squares structural equation modeling was used to validate and test the model. RESULTS Individuals' intention to install a CTMA is influenced by their risk beliefs, perceived individual and societal benefits to public health, privacy concerns, privacy protection initiatives (legal and technical protection), and technology features (anonymity and use of less sensitive data). We found only indirect relationships between trust in public health authorities and intention to install CTMA. Sex, education, media exposure, and past invasion of privacy did not have a significant relationship either, but interestingly, older people were slightly more inclined than younger people to install a CTMA. DISCUSSION Our survey results confirm the initial concerns about the potentially low adoption rates of CTMA. Our model provides public health agencies with a validated list of factors influencing individuals' privacy concerns and beliefs, enabling them to systematically take actions to address these identified issues, and increase CTMA adoption. CONCLUSIONS Developing CTMAs and increasing their adoption is an ongoing challenge for public health systems and policymakers. This research provides an evidence-based and situation-specific model for a better understanding of this theoretically and pragmatically important phenomenon.
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Affiliation(s)
- Farkhondeh Hassandoust
- Business Information Systems department, Auckland University of Technology, Auckland, New Zealand
| | - Saeed Akhlaghpour
- UQ Business School, The University of Queensland, Brisbane, Australia
| | - Allen C Johnston
- Department of Information Systems, Statistics and Management Science, Culverhouse College of Business, University of Alabama, Tuscaloosa, USA
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Xu X, Griva K, Koh M, Lum E, Tan WS, Thng S, Car J. Creating a Smartphone App for Caregivers of Children With Atopic Dermatitis With Caregivers, Health Care Professionals, and Digital Health Experts: Participatory Co-Design. JMIR Mhealth Uhealth 2020; 8:e16898. [PMID: 33118949 PMCID: PMC7661237 DOI: 10.2196/16898] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 03/26/2020] [Accepted: 06/03/2020] [Indexed: 01/27/2023] Open
Abstract
Background Smartphone apps could support patients and caregivers in disease self-management. However, as patients’ experiences and needs might not always align with clinical judgments, the eliciting and engaging of perspectives of all stakeholders in the smartphone app design process is of paramount importance. Objective The aims of this study are to better understand the needs of and challenges facing caregivers and health care professionals (HCPs) who care for children with atopic dermatitis (AD) and to explore the desirable features and content of a smartphone app that would support AD self-management. Methods This study adopted a qualitative participatory co-design methodology involving 3 focus group discussions: workshop one focused on caregivers; workshop two engaged with HCPs; and in the last workshop, caregivers and digital health experts were asked to design the wireframe prototype. The participants completed a sociodemographic questionnaire, a technology acceptance questionnaire, and a workshop evaluation form. Results Twelve caregivers participated in the first workshop, and 10 HCPs participated in the second workshop. Eight caregivers and 4 digital health experts attended the third workshop. Three superordinate themes that reflected caregivers’ and HCPs’ challenges and needs were identified: empowerment by education, confusion over treatment, and emotional impact. Workshop participants also raised a series of suggestions on the features and contents of the AD self-management app, which informed the last co-design workshop, and described their needs and challenges. In the last workshop, the participants developed a wireframe prototype of the app following the identified requirements and recommendations. Conclusions The co-design approach was found to be a successful way of engaging with the participants, as it allowed them to express their creativity and helped us to articulate the root of the clinical problems. The co-design workshop was successful in creating and generating new ideas and solutions for smartphone app development.
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Affiliation(s)
- Xiaomeng Xu
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Konstadina Griva
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Mark Koh
- Dermatology Service, KK Women's and Children's Hospital, Singapore, Singapore
| | - Elaine Lum
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Woan Shin Tan
- Health Services and Outcomes Research Department, National Healthcare Group, Singapore, Singapore.,Geriatric Education and Research Institute, Singapore, Singapore
| | - Steven Thng
- Skin Research Institute of Singapore, Singapore, Singapore
| | - Josip Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
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van Velsen L, Evers M, Bara CD, Op den Akker H, Boerema S, Hermens H. Understanding the Acceptance of an eHealth Technology in the Early Stages of Development: An End-User Walkthrough Approach and Two Case Studies. JMIR Form Res 2018; 2:e10474. [PMID: 30684434 PMCID: PMC6334698 DOI: 10.2196/10474] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 04/23/2018] [Accepted: 04/24/2018] [Indexed: 11/20/2022] Open
Abstract
Background Studies that focus on the acceptance of an electronic health (eHealth) technology generally make use of surveys. However, results of such studies hold little value for a redesign, as they focus only on quantifying end-user appreciation of general factors (eg, perceived usefulness). Objective We present a method for understanding end-user acceptance of an eHealth technology, early in the development process: The eHealth End-User Walkthrough. Methods During a walkthrough, a participant is guided by using the technology via a scenario, a persona, and a low-fidelity protoype. A participant is questioned about factors that may affect acceptance during and after the demonstration. We show the value of the method via two case studies. Results During the case studies, participants commented on whether they intend to use a technology and why they would (not) use its main features. They also provided redesign advice or input for additional functions. Finally, the sessions provide guidance for the generation of business models and implementation plans. Conclusions The eHealth End-User Walkthrough can aid design teams in understanding the acceptance of their eHealth application in a very early stage of the design process. Consequently, it can prevent a mismatch between technology and end-users’ needs, wishes and context.
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Affiliation(s)
- Lex van Velsen
- Telemedicine Cluster, Roessingh Research and Development, Enschede, Netherlands.,Biomedical Signals and Systems Group, University of Twente, Enschede, Netherlands
| | - Mirka Evers
- Telemedicine Cluster, Roessingh Research and Development, Enschede, Netherlands
| | - Cristian-Dan Bara
- Telemedicine Cluster, Roessingh Research and Development, Enschede, Netherlands
| | - Harm Op den Akker
- Telemedicine Cluster, Roessingh Research and Development, Enschede, Netherlands.,Biomedical Signals and Systems Group, University of Twente, Enschede, Netherlands
| | - Simone Boerema
- Telemedicine Cluster, Roessingh Research and Development, Enschede, Netherlands
| | - Hermie Hermens
- Telemedicine Cluster, Roessingh Research and Development, Enschede, Netherlands.,Biomedical Signals and Systems Group, University of Twente, Enschede, Netherlands
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Pelayo S, Santos R. Human Factors and Organizational Issues in 2015: The Increasing Complexity of the Healthcare Domain Calls for More Comprehensive Approaches. Yearb Med Inform 2016:126-129. [PMID: 27830240 DOI: 10.15265/iy-2016-043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To summarize significant research contributions on human factors and organizational issues in medical informatics published in 2015. METHODS An extensive search using PubMed/Medline and Web of Science® was conducted to identify the scientific contributions published in 2015 that address human factors and organizational issues in medical informatics. The selection process comprised three steps: (i) 15 candidate best papers were first selected by the two section editors, (ii) external reviewers from internationally renowned research teams reviewed each candidate best paper, and (iii) the final selection of five best papers was conducted by the editorial board of the Yearbook. RESULTS Noteworthy papers in 2015 emphasize the increasing complexity of the healthcare environment. They call for more comprehensive approaches and evaluation studies. All provide a real added-value in this direction. CONCLUSION There is no more need to promote the contribution of human factors and ergonomics (HFE) approaches to health IT-related risks and patient safety. However, there is still a need for research on HFE methods to adapt health information technology tools to the complexity of the healthcare domain.
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Affiliation(s)
- S Pelayo
- S. Pelayo, INSERM CIC-IT 1403 Evalab, CHU Lille, UDSL EA 2694, Lille University, F-59000, Lille, France, E-mail:
| | - R Santos
- R. Santos, HOSPITAL DA LUZ - LEARNING HEALTH, R. Carlos Alberto da Mota Pinto, 17-9º, 1070-313 Lisboa, Portugal, E-mail:
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