Abstract
BackgroundInformation and communication sources in the healthcare sector are replaced with new eHealth technologies. This has led to problems arising from the lack of awareness of the importance of end-user involvement in eHealth development and of the difficulties caused by using traditional summative evaluation methods. The Constructive eHealth evaluation method (CeHEM) provides a solution to these problems by offering an evaluation framework for supporting and facilitating end-user involvement during all phases of eHealth development. The aim of this paper is to support this process by sharing experiences of the eHealth evaluation method used in the introduction of electronic health records (EHR) in the North Denmark Region of Denmark. It is the first time the fully developed method and the experiences on using the CeHEM in all five phases of a full lifecycle framework is presented.MethodsA case study evaluation of the EHR development process in the North Denmark Region was conducted from 2004 to 2010. The population consisted of clinicians, IT professionals, administrators, and vendors. The study involved 4 hospitals in the region. Data were collected using questionnaires, observations, interviews, and insight gathered from relevant documents.ResultsThe evaluation showed a need for a) Early involvement of clinicians, b) The best possible representation of clinicians, and c) Workload reduction for those involved. The consequences of not providing this were a lack of ownership of decisions and negative attitudes towards the clinical benefits related to these decisions.Further, the result disclosed that by following the above recommendations, and by providing feedback to the 4 actor groups, the physicians’ involvement was improved. As a result they took ownership of decisions and gained a positive attitude to the clinical benefits.ConclusionsThe CeHEM has proven successful in formative evaluation of EHR development and can point at important issues that need to be taken care of by management. The method provides a framework that takes care of feedback and learning during eHealth development. It can thus support successful eHealth development in a broader context while building on a well-known success factor: end-user involvement in eHealth development.
Highlights
Information and communication sources in the healthcare sector are replaced with new eHealth technologies
This paper presents for the first time the fully developed method and the experiences on using the Constructive eHealth evaluation method during all five phases of the method
The results and the discussion provided for Phases 1 and 2 focus on the actions taken during these phases, as compared to the recommendations in the Constructive eHealth evaluation method (CeHEM)
Summary
Information and communication sources in the healthcare sector are replaced with new eHealth technologies This has led to problems arising from the lack of awareness of the importance of end-user involvement in eHealth development and of the difficulties caused by using traditional summative evaluation methods. Enduser involvement in design and implementation is an example of an important organizational issue that requires special attention for a successful outcome [2, 3, 6, 8,9,10,11,12] Experience has shown such involvement to be a precondition for achieving the positive clinical benefits of new eHealth technologies [1, 10, 13], as well as joint ownership [11, 12, 14,15,16] - both well-known success factors in eHealth development. Experience shows that, to achieve the success factors mentioned above, the involvement must be at the first, more comprehensive, end of the scale: end-users must be involved at the earliest possible stage as their ability to influence decisions already taken gradually decreases as the development process progresses [15, 22,23,24,25]
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