Meeting patients' needs with patient information systems: potential benefits of qualitative research methods

This article reports on our pilot evaluation of an electronic patient information system for children with amblyopia and their parents. The aim was to investigate whether the information system would be able to improve the quality of care, as indicated by an improvement in the effectiveness and efficiency of care, and in an increase in patient satisfaction. In the pilot evaluation, we used qualitative research methods, exploring the impact of the information system on children and their parents, with the aim to find suitable indicators for a potential further, quantitative study. Yet we found that the system was little used and had marginal effects on the quality of care for children with amblyopia and their parents. It appeared that the main problem underlying this patient information system was that the needs of those people who actually would be using the system had never really been investigated. The designers had built their assumptions about these needs into the system. These appeared to be mistaken at so many levels that the system could not become a success. As a result of this pilot evaluation, the patient information project was thoroughly transformed. This study makes clear that a thorough exploration of user needs before building the system, using qualitative research methods, may be crucial because it can prevent mismatches and maximizes the chance that the eventual information system meets its most important aim: to enhance patient empowerment and improve the quality of care.

[1]  Anselm L. Strauss,et al.  Qualitative Analysis For Social Scientists , 1987 .

[2]  C. H. Kriebel.  Management information systems , 1970, ACM '70.

[3]  Terry Winograd,et al.  Bringing Design to Software , 1996 .

[4]  Anthony J. Zawilski,et al.  The health care professional's workstation: its functional components and user impact , 1992 .

[5]  Chris Sauer,et al.  Why information systems fail: a case study approach , 1993 .

[6]  P Flatley Brennan,et al.  Patient-centered Information Systems , 2000, Yearbook of Medical Informatics.

[7]  Graham Button,et al.  Published in: Technology in Working Order: Studies of Work, Interaction, and Technology, , 2022 .

[8]  Charles P. Friedman,et al.  Evaluation Methods in Medical Informatics , 1997, Computers and Medicine.

[9]  Costas Pappas,et al.  Medical informatics Europe '97 , 1996 .

[10]  G Eysenbach,et al.  Labeling and Filtering of Medical Information on the Internet , 1999, Methods of Information in Medicine.

[11]  Morten Kyng,et al.  Design at Work , 1992 .

[12]  C Appleby.  Net gain or net loss? Health care consumers become Internet savvy. , 1999, Trustee : the journal for hospital governing boards.

[13]  B. Kaplan,et al.  Objectification and negotiation in interpreting clinical images: implications for computer-based patient records , 1995, Artif. Intell. Medicine.

[14]  Marion J. Ball,et al.  Aspects of the Computer-based Patient Record , 1992, Computers in Health Care.

[15]  D. Gustafson,et al.  Impact of a patient-centered, computer-based health information/support system. , 1999, American journal of preventive medicine.

[16]  Martyn Hammersley,et al.  Ethnography : Principles in Practice , 1983 .

[17]  M. Lynne Markus,et al.  Learning from adopters' experiences with ERP: problems encountered and success achieved , 2000, J. Inf. Technol..

[18]  Holly Jimison,et al.  Health care providers and purchasers and evaluation of interactive health communication applications , 1999 .

[19]  Patricia Flatley Brennan,et al.  Review: Improving Health Care by Understanding Patient Preferences: The Role of Computer Technology , 1998, J. Am. Medical Informatics Assoc..

[20]  Diana E. Forsythe,et al.  Using ethnography in the design of an explanation system , 1995 .

[21]  D H Gustafson,et al.  Consumers and evaluation of interactive health communication applications. The Science Panel on Interactive Communication and Health. , 1999, American journal of preventive medicine.

[22]  M. Collen.  A History of Medical Informatics in the United States, 1950 to 1990 , 1995 .

[23]  J Henderson,et al.  Developers and evaluation of interactive health communication applications. The Science Panel on Interactive Communications and Health. , 1999, American journal of preventive medicine.

[24]  Kenneth C. Laudon,et al.  Management Information Systems: New Approaches to Organization and Technology , 1997 .

[25]  Marc Berg,et al.  Patient care information systems and health care work: a sociotechnical approach , 1999, Int. J. Medical Informatics.

[26]  Niek Klazinga,et al.  Quality management of medical specialist care in the Netherlands : an explorative study of its nature and development , 1996 .

[27]  Paul C. Tang,et al.  Informing patients: a guide for providing patient health information. , 1998, Journal of the American Medical Informatics Association : JAMIA.

[28]  J. Mattison,et al.  Naming Notes: Transitions from Free Text to Structured Entry , 1995, Methods of Information in Medicine.