Abstract
BackgroundThe use of electronic health (eHealth) technologies in practice often is lower than expected, mostly because there is no optimal fit among a technology, the characteristics of prospective users, and their context. To improve this fit, a thorough systematic development process is recommended. However, more knowledge about suitable development methods is necessary to create a tool kit that guides researchers in choosing development methods that are appropriate for their context and users. In addition, there is a need for reflection on the existing frameworks for eHealth development to be able to constantly improve them.ObjectiveThe two main objectives of this case study were to present and reflect on the (1) methods used in the development process of a virtual reality application for forensic mental health care and (2) development model that was used: the CeHRes Roadmap (the Centre for eHealth Research Roadmap).MethodsIn the development process, multiple methods were used to operationalize the first 2 phases of the CeHRes Roadmap: the contextual inquiry and value specification. To summarize the most relevant information for the goals of this study, the following information was extracted per method: (1) research goal, (2) explanation of the method used, (3) main results, (4) main conclusions, and (5) lessons learned about the method.ResultsInformation on 10 methods used is presented in a structured manner. These 10 methods were stakeholder identification, project team composition, focus groups, literature study, semistructured interviews, idea generation with scenarios, Web-based questionnaire, value specification, idea generation with prototyping, and a second round of interviews. The lessons learned showed that although each method added new insights to the development process, not every method appeared to be the most appropriate for each research goal.ConclusionsReflection on the methods used pointed out that brief methods with concrete examples or scenarios fit the forensic psychiatric patients the best, among other things, because of difficulties with abstract reasoning and low motivation to invest much time in participating in research. Formulating clear research questions based on a model’s underlying principles and composing a multidisciplinary project team with prospective end users appeared to be important in this study. The research questions supported the project team in keeping the complex development processes structured and prevented tunnel vision. With regard to the CeHRes Roadmap, continuous stakeholder involvement and formative evaluations were evaluated as strong points. A suggestion to further improve the Roadmap is to explicitly integrate the use of domain-specific theories and models. To create a tool kit with a broad range of methods for eHealth development and further improve development models, studies that report and reflect on development processes in a consistent and structured manner are needed.
Highlights
Electronic health—a technology to support health, well-being, and health care—can offer many benefits, such as increased quality of care, accessible health care, and increased self-management [1]
With regard to the Centre for eHealth Research eHealth (CeHRes) Roadmap, continuous stakeholder involvement and formative evaluations were evaluated as strong points
To support researchers in operationalizing development models, we propose that a general tool kit with a broad range of eHealth development methods might be developed
Summary
Electronic health (eHealth)—a technology to support health, well-being, and health care—can offer many benefits, such as increased quality of care, accessible health care, and increased self-management [1]. Examples are the CeHRes Roadmap (the Centre for eHealth Research Roadmap) [9], the person-based approach [10], the accelerated creation-to-sustainment model [11], intervention mapping [12], the persuasive system design model [13], and the agile science approach [14] Most of these models and approaches do not offer concrete prescriptions for ready-to-use research methods that fit specific contexts and people. Such a tool kit can provide an overview of broad-range development methods and guidelines on when and how to apply them In this way, it can support researchers in choosing appropriate methods for the context and end users with which they are working and different phases of their development process. There is a need for reflection on the existing frameworks for eHealth development to be able to constantly improve them
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