Infinicare framework for integrated understanding of health-related activities in clinical and daily-living contexts

Abstract Clinical and consumer health informatics interventions promise to transform health care, yielding higher quality, more accessible care at a lower cost. However, the potential of these interventions cannot be achieved if they are developed and rolled out in a disconnected way: clinic-based systems typically do not interface with home-based systems that capture patient-generated health-related data. The fragmentation between these interventions severely limits the benefits of all interventions; given that health care is a continuum between clinical and daily-living settings. We introduce the Infinicare framework, which posits that clinical health-related activities “shape” daily-living-based health-related activities and, conversely, that daily-living-based health-related activities “inform” activities in clinics. Non-alignment of activities across these diverse contexts yields systemic gaps. Workflow studies that capture health-related activities and characterise gaps between clinical and daily-living contexts can inform the design and implementation of gap-filling, collaborative health information technologies. To inform these technologies, workflow studies should be patient-oriented, include both clinical and daily-living settings and subsume both process and structure variables. Novel methodologies are needed to effectively and efficiently capture health-related activities across both clinical and daily-living settings and their contexts. Guidelines for applying these recommendations in developing collaborative health information technologies are provided.

[1]  D. Makuc,et al.  Health, United States, 2009; with special feature on medical technology , 2010 .

[2]  James J. Cimino,et al.  Understanding workflow in telehealth video visits: Observations from the IDEATel project , 2009, J. Biomed. Informatics.

[3]  N. Campos,et al.  Context is Everything: Measuring Institutional Change in Transition Economies , 1999 .

[4]  Kevin B. Johnson,et al.  Bridging Organizational Divides in Health Care: An Ecological View of Health Information Exchange , 2013, JMIR medical informatics.

[5]  Pascale Carayon,et al.  Handbook of human factors and ergonomics in health care and patient safety , 2006 .

[6]  John S. Pruitt,et al.  The Persona Lifecycle: Keeping People in Mind Throughout Product Design , 2006 .

[7]  Urmimala Sarkar,et al.  Care partners and online patient portals. , 2014, JAMA.

[8]  William S. Yancy,et al.  Nutrition Therapy Recommendations for the Management of Adults With Diabetes , 2013, Diabetes Care.

[9]  Molla S. Donaldson,et al.  The Urgent Need to Improve Health Care Quality: Consensus Statement , 1998 .

[10]  Sarah J. Flynn,et al.  Facilitators and barriers to hypertension self-management in urban African Americans: perspectives of patients and family members , 2013, Patient preference and adherence.

[11]  Alastair Baker,et al.  Crossing the Quality Chasm: A New Health System for the 21st Century , 2001, BMJ : British Medical Journal.

[12]  T. Macculloch Context is everything , 2008, Issues in mental health nursing.

[13]  Rupa S. Valdez,et al.  Macroergonomic factors in the patient work system: examining the context of patients with chronic illness , 2017, Ergonomics.

[14]  Kim M. Unertl,et al.  Traversing the many paths of workflow research: developing a conceptual framework of workflow terminology through a systematic literature review , 2010, J. Am. Medical Informatics Assoc..

[15]  Paul Dourish,et al.  What we talk about when we talk about context , 2004, Personal and Ubiquitous Computing.

[16]  Patricia Flatley Brennan,et al.  Using iPod touch journals to capture patients' health information communication practices , 2013, AMIA.

[17]  Steven R. Simon,et al.  Research Paper: Physicians' Use of Key Functions in Electronic Health Records from 2005 to 2007: A Statewide Survey , 2009, J. Am. Medical Informatics Assoc..

[18]  J. Nagelkerk,et al.  Perceived barriers and effective strategies to diabetes self-management. , 2006, Journal of advanced nursing.

[19]  S. Trottier,et al.  Prediction of adherence to antiretroviral therapy: A one-year longitudinal study , 2005, AIDS care.

[20]  Shirley Gregor,et al.  The Nature of Theory in Information Systems , 2006, MIS Q..

[21]  Murray Sinclair,et al.  The analysis of organisational processes , 2005 .

[22]  Tiffany C. Veinot,et al.  Transforming consumer health informatics through a patient work framework: connecting patients to context , 2015, J. Am. Medical Informatics Assoc..

[23]  F. Spikmans,et al.  Why do diabetic patients not attend appointments with their dietitian? , 2003, Journal of human nutrition and dietetics : the official journal of the British Dietetic Association.

[24]  Michelle C. McKinley,et al.  Diet and physical activity in the self-management of type 2 diabetes: barriers and facilitators identified by patients and health professionals , 2012, Primary Health Care Research & Development.

[25]  Stephen Downs,et al.  Project HealthDesign: Rethinking the power and potential of personal health records , 2010, J. Biomed. Informatics.

[26]  Salvatore T. March,et al.  Design and natural science research on information technology , 1995, Decis. Support Syst..

[27]  B. Karsh,et al.  A human factors engineering paradigm for patient safety: designing to support the performance of the healthcare professional , 2006, Quality and Safety in Health Care.

[28]  J. Sallis,et al.  Ecological models of health behavior. , 2008 .

[29]  Kim M. Unertl,et al.  Research Paper: Describing and Modeling Workflow and Information Flow in Chronic Disease Care , 2009, J. Am. Medical Informatics Assoc..

[30]  M. Gulliford,et al.  Patients’ perceptions and experiences of ‘continuity of care’ in diabetes , 2006, Health expectations : an international journal of public participation in health care and health policy.

[31]  P. Dieppe,et al.  Individualisation of drug treatments for patients with long-term conditions: a review of concepts , 2014, BMJ Open.

[32]  Alan R. Hevner,et al.  Design Science in Information Systems Research , 2004, MIS Q..

[33]  Wanda Pratt,et al.  Understanding patients' health and technology attitudes for tailoring self-management interventions , 2015, AMIA.

[34]  M. Benningfield,et al.  SBIRT (Screening Brief Intervention and Referral to Treatment) - A Primary Care Tool to Assess for Substance Use Disorder , 2016 .

[35]  Pascale Carayon,et al.  Human factors of complex sociotechnical systems. , 2006, Applied ergonomics.

[36]  Ursula Faber,et al.  Requirements Engineering A Good Practice Guide , 2016 .

[37]  Suzanne Bakken,et al.  Review of health information technology usability study methodologies , 2011, J. Am. Medical Informatics Assoc..

[38]  Pascale Carayon,et al.  Evaluation of Nurse Interaction With Bar Code Medication Administration Technology in the Work Environment , 2007 .

[39]  Behavioral Domains,et al.  Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2 , 2015 .

[40]  Michael Seid,et al.  Coproduction of healthcare service , 2015, BMJ Quality & Safety.

[41]  Jeanne Keruly,et al.  Is the quality of the patient-provider relationship associated with better adherence and health outcomes for patients with HIV? , 2006, Journal of general internal medicine.

[42]  Sabine Koch,et al.  Home telehealth - Current state and future trends , 2006, Int. J. Medical Informatics.

[43]  Patricia Flatley Brennan,et al.  Observing health in everyday living: ODLs and thecare-between-the-care , 2014, Personal and Ubiquitous Computing.

[44]  Alan R. Hevner,et al.  The Three Cycle View of Design Science , 2007, Scand. J. Inf. Syst..

[45]  David W. Bates,et al.  White Paper: Personal Health Records: Definitions, Benefits, and Strategies for Overcoming Barriers to Adoption , 2006, J. Am. Medical Informatics Assoc..

[46]  Glyn Elwyn,et al.  Interprofessionalism and shared decision-making in primary care: a stepwise approach towards a new model , 2010, Journal of interprofessional care.

[47]  Peter Hoonakker,et al.  Human Factors Analysis of Workow in Health Information Technology Implementation , 2016 .

[48]  Sandra K. Garrett,et al.  A process centered analysis of medication administration: Identifying current methods and potential for improvement , 2011 .

[49]  Kim M. Unertl,et al.  Clinical Workflow Analysis, Process Redesign, and Quality Improvement , 2016 .

[50]  et al.,et al.  How is the electronic health record being used? Use of EHR data to assess physician-level variability in technology use , 2014, J. Am. Medical Informatics Assoc..

[51]  Stephen D. Persell,et al.  Contextual Errors and Failures in Individualizing Patient Care , 2010, Annals of Internal Medicine.

[52]  P. Carayon,et al.  Work system design for patient safety: the SEIPS model , 2006, Quality and Safety in Health Care.

[53]  J. Sweeney,et al.  Patient and family engagement: a framework for understanding the elements and developing interventions and policies. , 2013, Health affairs.

[54]  A. Localio,et al.  Role of computerized physician order entry systems in facilitating medication errors. , 2005, JAMA.

[55]  M. Gilbert,et al.  Personal health records as portal to the electronic medical record , 2014, Journal of Neuro-Oncology.

[56]  M. Naylor,et al.  Transitional Care of Older Adults Hospitalized with Heart Failure: A Randomized, Controlled Trial , 2004, Journal of the American Geriatrics Society.

[57]  Jean Nagelkerk PhD Aprn Bc,et al.  Perceived barriers and effective strategies to diabetes self-management , 2006 .

[58]  Toomas Timpka,et al.  Research Paper: Participatory Design of Information Systems in Health Care , 1998, J. Am. Medical Informatics Assoc..

[59]  Mark S. Ackerman,et al.  Designing for Lived Health: A Practice-Based Approach for Person-Centered Health Information Technologies , 2015, Designing Socially Embedded Technologies in the Real-World.

[60]  Tiffany C. Veinot,et al.  Technical infrastructure implications of the patient work framework , 2015, J. Am. Medical Informatics Assoc..

[61]  David W. Leebron Linkages , 2002, American Journal of International Law.

[62]  Richard J Holden,et al.  The patient work system: an analysis of self-care performance barriers among elderly heart failure patients and their informal caregivers. , 2015, Applied ergonomics.

[63]  Ben-Tzion Karsh,et al.  Clinical Practice Improvement and Redesign : How Change in Workflow Can Be Supported by Clinical Decision Support , 2009 .

[64]  Rupa S. Valdez,et al.  Human Factors and Ergonomics in Home Care , 2016 .

[65]  Madhu C. Reddy,et al.  Challenges to inter-departmental coordination of patient transfers: A workflow perspective , 2010, Int. J. Medical Informatics.

[66]  J. Gruman,et al.  From patient education to patient engagement: implications for the field of patient education. , 2010, Patient education and counseling.

[67]  M. Barry,et al.  Shared decision making--pinnacle of patient-centered care. , 2012, The New England journal of medicine.

[68]  Sam Sheps,et al.  Continuity of care for children with complex chronic health conditions: parents' perspectives , 2009, BMC health services research.

[69]  Jason Weiss,et al.  A Workflow Framework for Health Management in Daily Living Settings , 2016, Nursing Informatics.

[70]  Patricia Flatley Brennan,et al.  Revisiting sociotechnical systems in a case of unreported use of health information exchange system in three hospital emergency departments. , 2013, Journal of evaluation in clinical practice.

[71]  Ming-Lu Wu,et al.  Quality function deployment: A literature review , 2002, Eur. J. Oper. Res..

[72]  B. J. Fogg Healthy Living with Persuasive Technologies : Framework , Issues , and Challenges , 2009 .

[73]  P. Carayon,et al.  SEIPS 2.0: a human factors framework for studying and improving the work of healthcare professionals and patients , 2013, Ergonomics.

[74]  Jenna L. Marquard,et al.  Overcoming challenges integrating patient-generated data into the clinical EHR: Lessons from the CONtrolling Disease Using Inexpensive IT - Hypertension in Diabetes (CONDUIT-HID) Project , 2013, Int. J. Medical Informatics.

[75]  E H Wagner,et al.  Quality improvement in chronic illness care: a collaborative approach. , 2001, The Joint Commission journal on quality improvement.

[76]  N. Gale,et al.  Using the framework method for the analysis of qualitative data in multi-disciplinary health research , 2013, BMC Medical Research Methodology.

[77]  Andrew Robinson,et al.  Uncovering the Limits of Patient-Centeredness: Implementing a Self-Management Trial for Chronic Illness , 2005, Qualitative health research.

[78]  Volker Wulf,et al.  Designing Socially Embedded Technologies in the Real-World , 2015, Computer Supported Cooperative Work.

[79]  G. V. van Servellen,et al.  Individual and system level factors associated with treatment nonadherence in human immunodeficiency virus-infected men and women. , 2002, AIDS patient care and STDs.

[80]  Jos Aarts,et al.  Patient-centered care requires a patient-oriented workflow model. , 2013, Journal of the American Medical Informatics Association : JAMIA.

[81]  Alison B. Evert,et al.  Nutrition Therapy Recommendations for the Management of Adults With Diabetes , 2013, Diabetes Care.