Design Of Health Information Systems Research Articles

Usability evaluation of emergency information systems in educational hospitals in Kerman, Iran

BackgroundSmart and practical health information systems and applications with fewer errors are crucial for healthcare facilities. One method that ensures the proper design of health information systems (HIS) and applications is usability evaluation.ObjectiveThis study aimed to evaluate the usability of the emergency information systems used at the emergency departments of four educational hospitals in Kerman, Iran.MethodThis study was conducted in two phases. In the first phase, the information systems' errors and shortages were identified using a semi-structured questionnaire by users (nurses and the IT staff). In the second phase, based on the results of the first phase, two questionnaires were designed for each group of users to their opinions about the usability of the emergency information systems.ResultsThe average score of “reducing and facilitating user’s daily activities” was significantly different among hospitals (p = 0.03). Shahid Beheshti Hospital obtained the lowest usability score (17.5), and Afzalipour Hospital received the highest usability score (21.75). Moreover, the average score in “use of the HIS” for nurses and IT staff was 2.93 and 3.54 on a scale of 5, respectively.ConclusionUsability evaluation of health information systems is essential to ensure that these systems provide sufficient and accurate information and requirements for users and health care providers. Also, modifying health information systems based on the user views and expectations improves the quality of the system and user-system Interaction.

Special Section on Inclusive Digital Health: Notable Papers on Addressing Bias, Equity, and Literacy to Strengthen Health Systems.

To summarize significant research contributions on addressing bias, equity, and literacy in health delivery systems published in 2021. An extensive search using PubMed and Scopus was conducted to identify peer-reviewed articles published in 2021 that examined ways that informatics methods, approaches, and tools could address bias, equity, and literacy in health systems and care delivery processes. The selection process comprised three steps: (1) 15 candidate best papers were first selected by the two section editors; (2) external reviewers from internationally renowned research teams reviewed each candidate best paper; and (3) the final selection of three best papers was conducted by the editorial committee of the Yearbook. Selected best papers represent studies that characterized significant challenges facing biomedical informatics with respect to equity and practices that support equity and literacy in the design of health information systems. Selected papers represent the full spectrum of this year's yearbook theme. In general, papers identified in the search fell into one of the following categories: (1) descriptive accounts of algorithmic bias in medical software or machine learning approaches; (2) enabling health information systems to appropriately encode for gender identity and sex; (3) approaches to support health literacy among individuals who interact with information systems and mobile applications; and (4) approaches to engage diverse populations in the use of health information systems and the biomedical informatics workforce CONCLUSIONS: : Although the selected papers are notable, our collective efforts as a biomedical informatics community to address equity, literacy, and bias remain nascent. More work is needed to ensure health information systems are just in their use of advanced computing approaches and all persons have equal access to health care and informatics tools.

Effect of mobile application user interface improvements on minimum expected home visit coverage by community health workers in Mali: a randomised controlled trial

BackgroundProactive community case management (ProCCM) has shown promise to advance goals of universal health coverage (UHC). ProCCM community health workers (CHWs) face operational challenges when pursuing their goal of visiting...

An investigation of task characteristics and users’ evaluation of interaction design in different online health information systems

This paper addresses the importance of improving users’ satisfaction and efficiency for obtaining health information through health information systems. In order to understand how task characteristics, such as type, complexity, and difficulty, affect user interaction with online health information systems in China, this paper investigates if and how various types of task and information systems lead to different user experience, and, how tasks affect users’ evaluation of the interaction design of specific systems. A user experiment was carried out with 24 participants completing two types of tasks with two levels of complexity on three popular health information systems in China. The two types of tasks comprise a high objective complexity task and a medium complexity task. The three selected health systems include the 39 Health Website, Quick Doctors, and Good Doctor Online. Both quantitative and qualitative data were analyzed. The results indicate that the difference of both tasks and systems affect users’ judgment concerning task difficulty and complexity, as well as users’ evaluation of the interaction design of the systems. In order to better assist users with obtaining health information, this paper provides suggestions for improving the interaction design of health information systems from four aspects: website structure and information organization, webpage display, usability, and system performance. The limitations and future work are also discussed.

Perancangan Sistem Informasi Catatan Kesehatan Ibu Hamil dan Ibu Bersalin Berbasis SMS Notifikasi

The maternal health record is a record that contains the development of the fetus and the pregnant health record as well, this note is very important as a reference when a pregnant woman will give birth so that in addition to this note is given to the patient (pregnant women) midwife and gynecologist place control should also have this health record. Patients also often forget to bring even forget to put or keep this health notebook so forget the date of return control that has been written on the note note. Patients should not forget the date of re-control and not be empty of health record book then made the design of health information system for pregnant mother and mother-based sms notification with the aim can be a reminder of date of control visit for pregnant mother and reminded of date of estimated delivery. Methods of data collection is done by direct observation, interview and literature study. System design using UML modeling language. The result of this research is the design of information system of maternity health record and maternity based on sms notification with purpose as reminder of date of control visit for pregnant mother and reminder of estimated date of labor and assist in better management of maternal and maternal health record.

Institutionalizing Information Systems for Universal Health Coverage in Primary Healthcare and the Need for New Forms of Institutional Work

Today, many countries around the world focus on ensuring that all people can access health services of sufficient quality without experiencing financial hardship (i.e., universal health coverage). To measure progress towards this goal, countries need to build robust health information systems. Because countries need to root universal health coverage in primary healthcare, they also needs to sensitively anchor health information systems that support universal health coverage in existing routine health information systems. However, doing so involves significant challenges, which we study via empirically analyzing an Indian state's effort to implement a universal health coverage health information system in primary healthcare. Using a theoretical lens informed by institutional theory, we seek to answer the question: “What is required to develop institutions that support the use of new technologies and associated work processes that universal health coverage entails?”. We identify the contradictions that emerge when new systems clash with existing ones, and we discuss what implications such contradictions have in terms of system design, work processes, and institutions. We contribute to the literature by explaining inherent complexities in universal health coverage health information system design and implementation and providing system design guidelines.

Research gaps in routine health information system design barriers to data quality and use in low- and middle-income countries: A literature review.

Despite the potential impact of health information system (HIS) design barriers on health data quality and use and, ultimately, health outcomes in low- and middle-income countries (LMICs), no comprehensive literature review has been conducted to study them in this context. We therefore conducted a formal literature review to understand system design barriers to data quality and use in LMICs and to identify any major research gaps related understanding how system design affects data use. We conducted an electronic search across 4 scientific databases-PubMed, Web of Science, Embase, and Global Health-and consulted a data use expert. Following a systematic inclusion and exclusion process, 316 publications (316 abstracts and 18 full papers) were included in the review. We found a paucity of scientific publications that explicitly describe system design factors that hamper data quality or data use for decision making. Although user involvement, work flow, human-computer interactions, and user experience are critical aspects of system design, our findings suggest that these issues are not discussed or conceptualized in the literature. Findings also showed that individual training efforts focus primarily on imparting data analysis skills. The adverse impact of HIS design barriers on data integrity and health system performance may be even bigger in LMICs than elsewhere, leading to errors in population health management and clinical care. We argue for integrating systems thinking into HIS strengthening efforts to reduce the HIS design-user reality gap.

Application of triangulation approach in requirements engineering process: A study in analysis and design of the pediatrics epilepsy information system

: Introduction: Requirements Engineering process is a crucial phase in software development. In order to achieve a successful design of health information systems (HISs), applying the best methodologies is essential. Therefore, the aim of the present study was to design pediatrics Epilepsy Information System (EPIS) as well as the use of triangulation approach in elicitation and validation of epilepsy information system requirements in its engineering process. Methods: This applied study was carried out in Bandar Abbas pediatric hospital. Triangulation approach based on three different analyses and validation methods in requirements engineering process was applied. To do the triangulation work, as well as designing a usable system, according to the most common User Centered Design (UCD) methods, we use three well-known methodological approaches in UCD: (a) Object-Oriented System Analysis (OOSA); (b) Hierarchical Task Analysis; and, (c) Prototyping. The results of each of these methods were analyzed by selected clinical staff, iterative cycle in models design also continued until lack of need for new changes. Then final results were presented in a general category in the form of triangulation matrix. Results: 55 high-level requirements with minimum information items to store information of hospitalized epileptic patients obtained from multiple methods. The greatest requirements (84%) were identified or validated in the OOSA step, some requirements (13%) have been identified only in the design and evaluation of prototype. Conclusion: Triangulation approach helped us in confirmation of findings, and finally enhance the credibility of the study. Health informatics specialists should try to use of multiple methods in the early phases of systems design that lead to a rich and comprehensive picture of HIS requirements.

Health information systems´ usability-related use errors in patient safety incidents

Health information systems contain usability issues that cause use errors, which may pose a risk to patient safety. The aim of this study was to identify what kind of usability issues in information systems cause use errors that lead to patient safety incidents. Patient safety incidents reported into an incident reporting system in a Finnish hospital district during the year 2014 (n=2500) were analyzed from the perspectives of usability and use errors. An inductive content analysis was carried out in order to gather information about the usability issues that may have led to a use error, thus causing patient safety incidents. The results showed that the main usability issues are the distribution of information into multiple views, identification problems with the selected patient, and basic daily tasks' reliance on users' memory. The results show that the relationship between usability, use errors, and patient safety should be understood and considered in the health information system design.

Using a contextualized sensemaking model for interaction design: A case study of tumor contouring

Sensemaking theories help designers understand the cognitive processes of a user when he/she performs a complicated task. This paper introduces a two-step approach of incorporating sensemaking support within the design of health information systems by: (1) modeling the sensemaking process of physicians while performing a task, and (2) identifying software interaction design requirements that support sensemaking based on this model. The two-step approach is presented based on a case study of the tumor contouring clinical task for radiotherapy planning. In the first step of the approach, a contextualized sensemaking model was developed to describe the sensemaking process based on the goal, the workflow and the context of the task. In the second step, based on a research software prototype, an experiment was conducted where three contouring tasks were performed by eight physicians respectively. Four types of navigation interactions and five types of interaction sequence patterns were identified by analyzing the gathered interaction log data from those twenty-four cases. Further in-depth study on each of the navigation interactions and interaction sequence patterns in relation to the contextualized sensemaking model revealed five main areas for design improvements to increase sensemaking support. Outcomes of the case study indicate that the proposed two-step approach was beneficial for gaining a deeper understanding of the sensemaking process during the task, as well as for identifying design requirements for better sensemaking support.

Design of Health Information Systems

Design of Health Information Systems

Participatory Design, User Involvement and Health IT Evaluation.

End user involvement and input into the design and evaluation of information systems has been recognized as being a critical success factor in the adoption of information systems. Nowhere is this need more critical than in the design of health information systems. Consistent with evidence from the general software engineering literature, the degree of user input into design of complex systems has been identified as one of the most important factors in the success or failure of complex information systems. The participatory approach goes beyond user-centered design and co-operative design approaches to include end users as more active participants in design ideas and decision making. Proponents of participatory approaches argue for greater end user participation in both design and evaluative processes. Evidence regarding the effectiveness of increased user involvement in design is explored in this contribution in the context of health IT. The contribution will discuss several approaches to including users in design and evaluation. Challenges in IT evaluation during participatory design will be described and explored along with several case studies.

Online HIV prevention information

Purpose – Two research questions are addressed: what are black female college students’ perceptions of current messages present on web sites about HIV/AIDS awareness and prevention?; and what messages do black female college students find culturally relevant to them, and why? Results indicate that these women perceive several communication barriers including lack of trust and unfamiliarity with information sources, stigma ascribed to HIV, as well as misconceptions and traditional values held by some in the black community and health institutions. HIV prevention messages are perceived as relevant if they exhibit qualities including interactive features. The paper aims to discuss these issues. Design/methodology/approach – To understand black collegiate women as health information seekers, it is important to engage paradigms that allow researchers to make sense of how group members construct their content needs, what helps shape this construction, and the meaning derived from the consumption of the information, focus groups are an effective qualitative method for enabling collective discussion and interaction between research participants that facilitates the exploration of under-researched topics like HIV prevention as well as the language commonly used by respondents to describe HIV from a socio-cultural perspective. The research team conducted three focus groups to appraise current black female college students’ attitudes and perceptions of messages presented on HIV/AIDS prevention and awareness web sites Findings – HIV prevention messages are perceived as relevant if they exhibit qualities including interactive features, practical advice using non-technical vocabulary, content authored and disseminated by familiar and trustworthy individuals and institutions, and risk related to individual behaviors rather than the demographic group. Implications of the findings and suggestions for future research on the design of health information systems are provided. Research limitations/implications – This research is based on a small sample size based on one region of the USA. Practical implications – Health communication materials should also provide strategies for dispelling myths, and combating feelings of stigma, and mistrust. In addition, practical advice such as questions to ask physicians may help to produce positive and desirable outcomes as black women seek services from the healthcare system. The message itself must take into account a number of factors include short and simple messages, clean web pages, navigation structures that make information easy to find, comprehensive information all found in a single web site, and interactive features to facilitate discussion and sharing. In particular, with social media, women can also play a role in the creation and dissemination of health messages in multiple modalities including text, spoken word, still and moving images, and music. Social implications – “A major component of preventive health practice is the availability and provision of information regarding risks to health and promotional measures for enhancing the health status among this population” (Gollop, 1997, p. 142). However, as Dervin (2005) cautions, while information is necessary, it is insufficient to encourage behavior change. To combat the health disparities that differentially impact African-American women requires expertize and understanding from multiple perspectives. By providing insight into how black collegiate women perceive HIV prevention information needs, the women in the focus groups lend a necessary voice in the effort toward healthy equity through the creation of effective health interventions that will appeal to them. Originality/value – The author seeks to create an online and socially connected experience characteristic of ongoing user input and active engagement in content development which targets the population. From a human-computer interaction viewpoint, the authors are seeking to avoid design divorced from context and meaning. In developing such an experience, the authors will need to triangulate the roles of culture, context, and design to reduce the content divide, yet amplify the notion of participatory web. Participatory web embodies a social justice movement to build web content from voices typically dampened in the discourse. It (re)shapes meaning, identity, and ecologies in the process of foci on particular social, health, and political causes (e.g. HIV/AIDS). Giving black women ownership over the creation of health information on the internet may improve the ability to provide targeted HIV prevention content that is culturally salient and more effective in reducing HIV infections in this community.

Understanding the role of social media in online health: A global perspective on online social support

Around the globe, people are increasingly using social media for the provision of online social support. Online social support may be especially relevant for parents who have children that are afflicted with rare chronic diseases such as MECP2 Duplication Syndrome. Despite increasing evidence that online social support enhances a person’s psychological well-being, there is little research that seeks to understand how and why various forms of social media facilitate social support. This study develops a theoretical framework from the existing psychosocial and media theories that describes the relationship between social media and social support. This paper concludes with implications for health information systems design.

Capturing Information Needs of Care Providers to Support Knowledge Sharing and Distributed Decision Making

This paper reports on work carried out to elicit information needs at a trans-disciplinary, nurse-managed health care clinic that serves a medically disadvantaged urban population. The trans-disciplinary model provides a "one-stop shop" for patients who can receive a wide range of services beyond traditional primary care. However, this model of health care presents knowledge sharing challenges because little is known about how data collected from the non-traditional services can be integrated into the traditional electronic medical record (EMR) and shared with other care providers. There is also little known about how health information technology (HIT) can be used to support the workflow in such a practice. The objective of this case study was to identify the information needs of care providers in order to inform the design of HIT to support knowledge sharing and distributed decision making. A participatory design approach is presented as a successful technique to specify requirements for HIT applications that can support a trans-disciplinary model of care. Using this design approach, the researchers identified the information needs of care providers working at the clinic and suggested HIT improvements to integrate non-traditional information into the EMR. These modifications allow knowledge sharing among care providers and support better health decisions. We have identified information needs of care providers as they are relevant to the design of health information systems. As new technology is designed and integrated into various workflows it is clear that understanding information needs is crucial to acceptance of that technology.

A model of awareness to enhance our understanding of interprofessional collaborative care delivery and health information system design to support it

BackgroundAs more healthcare delivery is provided by collaborative teams there is a need for enhanced design of health information systems (HISs) to support collaborative care delivery. The purpose of this study was to develop a model of the different types of awareness that exist in interprofessional collaborative care (ICC) delivery to inform HIS design to support ICC. MethodsQualitative data collection and analysis was done. The data sources consisted of 90h of non-participant observations and 30 interviews with nurses, physicians, medical residents, volunteers, and personal support workers. ResultsMany of the macro-level ICC activities (e.g. morning rounds, shift change) were constituted by micro-level activities that involved different types of awareness. We identified four primary types of ICC awareness: patient, team member, decision making, and environment. Each type of awareness is discussed and supported by study data. We also discuss implication of our findings for enhanced design of existing HISs as well as providing insight on how HISs could be better designed to support ICC awareness. ConclusionAwareness is a complex yet crucial piece of successful ICC. The information sources that provided and supported ICC awareness were varied. The different types of awareness from the model can help us understand the explicit details of how care providers communicate and exchange information with one another. Increased understanding of ICC awareness can assist with the design and evaluation of HISs to support collaborative activities.

Towards an Integrative Cognitive-Socio-Technical Approach in Health Informatics: Analyzing Technology-Induced Error Involving Health Information Systems to Improve Patient Safety

The purpose of this paper is to argue for an integration of cognitive and socio-technical approaches to assessing the impact of health information systems. Historically, health informatics research has examined the cognitive and socio-technical aspects of health information systems separately. In this paper we argue that evaluations of health information systems should consider aspects related to cognition as well as socio-technical aspects including impact on workflow (i.e. an integrated view). Using examples from the study of technology-induced error in healthcare, we argue for the use of simulations to evaluate the cognitive-socio-technical impacts of health information technology [36]. Implications of clinical simulations and analysis of cognitive-social-technical impacts are discussed within the context of the system development life cycle to improve health information system design, implementation and evaluation.

A four stage approach for ontology-based health information system design

To describe and illustrate a four stage methodological approach to capture user knowledge in a biomedical domain area, use that knowledge to design an ontology, and then implement and evaluate the ontology as a health information system (HIS). A hybrid participatory design-grounded theory (GT-PD) method was used to obtain data and code them for ontology development. Prototyping was used to implement the ontology as a computer-based tool. Usability testing evaluated the computer-based tool. An empirically derived domain ontology and set of three problem-solving approaches were developed as a formalized model of the concepts and categories from the GT coding. The ontology and problem-solving approaches were used to design and implement a HIS that tested favorably in usability testing. The four stage approach illustrated in this paper is useful for designing and implementing an ontology as the basis for a HIS. The approach extends existing ontology development methodologies by providing an empirical basis for theory incorporated into ontology design.

Towards Shared Situational Awareness and Actionable Knowledge - An Enhanced, Human-Centered Paradigm for Public Health Information System Design

Technology has exerted an increasingly dominant influence on the ways and means that objectives of informatics projects are pursued and has extended the capabilities of informatics systems in general. However, literature examining the importance of human links between situational awareness-related processes and decision-making capabilities remains relatively sparse. Substantial knowledge gaps exist in information system implementation between technology and public health surveillance. The purpose of this article is to present an enhanced conceptual framework, built upon innovative perspectives of a human-centered paradigm of implementation, to enable and enhance human-centric decision-making. To clarify this concept, we employ a case of situational awareness in the setting of a recent command post exercise in order to illustrate core concepts and practices. We divide the framework into methods, tools, and goals to broaden the context of discussion, and conclude with lessons learned from this field operation exercise. The present study could be of value to military commanders, policy leaders, and analysts across multiple disciplines, such as in the public health, counterinsurgency, and bioterrorism surveillance communities.

Health information systems design to support a nursing model of care: opportunities and challenges.

The design and implementation of health information systems (HISs) in team-based settings is complex owing to the multiple users with different perspectives who interact with the system. We argue that such perspectives must be understood prior to designing and implementing HISs. One specific type of team-based model is a nursing care model. In such a model, care is provided through an interdisciplinary team that is lead by the nursing staff. We analyze a nursing-based model of care according to the context of the organization, clinical unit, and individual as defined by the Contextual Implementation Model [1]. We then discuss how the nursing model will be affected by automation using different HISs.