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Time Does Not Heal Usability Issues!: Results from a Longitudinal Evaluation of a Health IT Deployment Performed at Three Swedish Hospital Units
Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction.
2012 (English)In: OzCHI '12 Proceedings of the 24th Australian Computer-Human Interaction Conference, New York, NY, USA: ACM Press, 2012, 273-280 p.Conference paper (Refereed)
Abstract [en]

This paper presents a longitudinal evaluation of user adoption during a Patient Administrative System (PAS) deployment. The research was performed at three units within a Swedish university hospital. Both qualitative and quantitative methods have been used to gather data before, during and up to two years after the deployment. The results show that all users experienced usability problems. After two years of usage the system was still not considered to be as supportive as the old system. The users that were required to use the system felt unsure and stressed about whether all information was consulted or not. The users that were less dependent on the system solved the problems by not doing the tasks; instead they let the clerks continue to do the PAS tasks as they did before the deployment. The results indicate that time will not heal usability problems; instead they need to be addressed in other ways.

Place, publisher, year, edition, pages
New York, NY, USA: ACM Press, 2012. 273-280 p.
Keyword [en]
EPR, deployment, ehealth, evaluation, implementation, organisational change, sociotechnical systems, usability, user adoption
National Category
Human Computer Interaction
Research subject
Medical Informatics; Human-Computer Interaction
URN: urn:nbn:se:uu:diva-188363DOI: 10.1145/2414536.2414582ISBN: 978-1-4503-1438-1OAI: oai:DiVA.org:uu-188363DiVA: diva2:589145
24rd Australian Computer-Human Interaction Conference
Available from: 2013-01-17 Created: 2012-12-16 Last updated: 2013-04-29Bibliographically approved
In thesis
1. Evolving Systems – Engaged Users: Key Principles for Improving Region-wide Health IT Adoption
Open this publication in new window or tab >>Evolving Systems – Engaged Users: Key Principles for Improving Region-wide Health IT Adoption
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Many countries have formulated their eHealth visions and billions of dollars have been spent on supporting the eHealth development throughout the world. An important part of the development is the electronic patient record (EPR). To enable sharing and increase cooperation between care providers, most Swedish county councils have decided to use a region-wide EPR. The health professionals often experience numerous problems and consider the region-wide EPR to be too generic and require them to tailor their practices instead of the system evolving towards supporting their needs.

The aim of the PhD research is to gain knowledge of adoption when deploying and using region-wide health IT systems. This is accomplished by studying, analysing and reflecting upon what region-wide health IT systems are and how professionals use them in their practice. In the research a grounded theory method has been used, which means that the empirical data, not theories and hypotheses, have driven the research process. The data-gathering methods have been interviews, observations, participating in meetings, questionnaires, seminars and conducting literature reviews.

In order to be able to improve the adoption, a set of four key principles has been identified: (1) Evolving systems-Engaged users, (2) Treat IT deployment and usage as part of organisational development, (3) Identify, respect and support differences, and (4) Identify what must be customised and what can be centralised.

These four principles challenge the traditional way of developing enterprise-wide IT and emphasise the importance that users must engage in the development, procurement and deployment process to identify their similar and unique needs and procedures. It is crucial that both the similarities and uniqueness are respected and supported. The similarities can be supported by a centralised, standardised solution, while uniqueness requires a customised solution. In order to accomplish that, the IT deployment and usage needs to be treated as an important part of the on-going organisational development, and the IT systems must evolve, i.e., be continuously developed in order to engage the users to participate. 

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2013. 85 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Science and Technology, ISSN 1651-6214 ; 1030
HCI, eHealth, EPR, sociotechnical systems, enterprise-wide systems, deployment, change management, usability, health care
National Category
Human Computer Interaction
Research subject
Computer Science with specialization in Human-Computer Interaction
urn:nbn:se:uu:diva-196510 (URN)978-91-554-8623-5 (ISBN)
Public defence
2013-05-24, Auditorium Minus, Museum Gustavianum, Akademigatan 3, Uppsala, 13:30 (Swedish)
Available from: 2013-05-02 Created: 2013-03-11 Last updated: 2014-07-21Bibliographically approved

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