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Scenarios to capture work processes in shared homecare-From analysis to application
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Centre for eHealth.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Centre for eHealth.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Centre for eHealth.
2010 (English)In: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 79, no 6, E126-E134 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Shared homecare is increasingly common, and in order to develop ICT that support such complex cooperative and interdisciplinary work it is crucial to obtain an understanding of work processes at the clinical level before the development is initiated. It is also crucial, but difficult, to correctly transfer this insight to the development team. METHOD: User-centered scenario building in interdisciplinary working groups is applied for capturing cooperative work routines, information demands, and other central preconditions in shared homecare. RESULTS: Use of scenarios for analysis of cooperative work and as information carrier is described via a case from the multi-disciplinary OLD@HOME project. Both current and future work scenarios were elicited. To illustrate the process of transforming scenarios into more technical descriptions (use cases), and finally into an application, examples showing the transparency in resulting use cases and in the implemented system are provided. CONCLUSION: In this case study, scenarios proved to be useful not only in initial system development phases but throughout the entire development process, improving accessibility and assessment of end user needs. For the development team, scenarios assisted in solving usability issues, and served as a basis for describing use cases and for further system development. More importantly, the shared care scenarios ensured the provision of different perspectives on common work processes, which are often neglected in conventional requirements specifications. This also improved understanding between different clinical groups and between clinicians and developers.

Place, publisher, year, edition, pages
2010. Vol. 79, no 6, E126-E134 p.
Keyword [en]
Interdisciplinary communication, Integrated health care systems, Software design, Nursing records, Medical records, Home care services
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-97968DOI: 10.1016/j.ijmedinf.2008.07.007ISI: 000278192800014PubMedID: 18762445OAI: oai:DiVA.org:uu-97968DiVA: diva2:173108
Available from: 2009-01-23 Created: 2009-01-23 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Sharing is Caring: Integrating Health Information Systems to Support Patient-Centred Shared Homecare
Open this publication in new window or tab >>Sharing is Caring: Integrating Health Information Systems to Support Patient-Centred Shared Homecare
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In the light of an ageing society with shrinking economic resources, deinstitutionalization of elderly care is a general trend. As a result, homecare is increasing, and increasingly shared between different health and social care organizations. To provide a holistic overview about the patient care process, i.e. to be patient-centred, shared homecare needs to be integrated. This requires improved support for information sharing and cooperation between different actors, such as care professionals, patients and their relatives.

The research objectives of this thesis are therefore to study information and communication needs for patient-centered shared homecare, to explore how integrated information and communication technology (ICT) can support information sharing, and to analyze how current standards for continuity of care and semantic interoperability meet requirements of patient-centered shared homecare.

An action research approach, characterized by an iterative cycle, an emphasis on change and close collaboration with practitioners, patients and their relatives, was used. Studying one specific homecare setting closely, intersection points between involved actors and specific needs for information sharing were identified and described as shared information objects. An integration architecture making shared information objects available through integration of existing systems was designed and implemented. Mobile virtual health record (VHR) applications thereby enable a seamless flow of information between involved actors. These applications were tested and validated in the OLD@HOME-project. Moreover, the underlying information model for a shared care plan was mapped against current standards. Some important discrepancies were identified between these results and current standards for continuity of care, stressing the importance of evaluating standardized models against requirements of evolving healthcare contexts.

In conclusion, this thesis gives important insights into the needs and requirements of shared homecare, enabling a shift towards patient-centered homecare through mobile access to aggregated information from current feeder systems and documentation at the point of need.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2009. 98 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 414
Keyword
health informatics, user-centred design, integrated health information systems, homecare services, cooperative work, health informatics standardization
National Category
Biomedical Laboratory Science/Technology
Identifiers
urn:nbn:se:uu:diva-9527 (URN)978-91-554-7390-7 (ISBN)
Public defence
2009-02-13, Auditorium Minus, Gustavianum, Akademigatan 3, Uppsala, 09:15
Opponent
Supervisors
Available from: 2009-01-23 Created: 2009-01-23Bibliographically approved

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