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DESIGNING HEALTH CARE THAT WORKS

DESIGNING HEALTHCARE THAT WORKS: A SOCIO-TECHNICAL APPROACH

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Contents

List of Contributors

Biography of Authors

Introduction

Reference

Further Reading

1 - Socio-technical Design for the Care of People With Spinal Cord Injuries

1. INTRODUCTION

2. SPINAL CORD INJURY

3. SCENARIO

4. SCILLS, THE SPINAL CORD INJURY LIVING AND LEARNING SYSTEM

4.1 Prior Work

5. SYSTEM DESCRIPTION

6. FORMATIVE EVALUATION

6.1 Examination of Activities

6.1.1 Bladder and Bowel Functions

6.1.2 Hydration

6.1.3 Pressure Sores

6.1.4 Other Activities

6.1.5 The Social Context of Care

7. TECHNICAL LESSONS

8. REFLECTIONS ON SOCIO-TECHNICAL DESIGN

Acknowledgments

References

2 - Design Principles for Supporting Patient-Centered Journeys

1. INTRODUCTION: HEALTH CARE AS A JOURNEY

2. BACKGROUND: PERSONAL HEALTH MANAGEMENT CHALLENGES DURING CANCER CARE

3. CASE STUDY: THE BREAST CANCER JOURNEY

3.1 Understanding Navigation Practices

3.2 Assessing Survivors’ Journey Reflections

3.3 My Journey Compass: Pilot Study of a Flexible and Mobile Personal Health Technology

3.3.1 My Journey Compass Design

3.3.2 Health Care System Partnership

3.3.3 Participant Recruitment

3.3.4 Creating an Education Navigator Position

3.3.5 My Journey Compass Deployment

4. LESSONS LEARNED: SUPPORTING HEALTH CARE JOURNEYS

4.1 Understand the Role of Privacy

4.2 Place Patients in Control

4.3 Amplify Existing People Practices

4.4 Provide Holistic Support: Supporting Life Goals Not Health care Goals

4.5 Design for User’s Changing Needs

5. FUTURE WORK

6. CONCLUSION

References

3 - Supporting Collaboration to Preserve the Quality of Life of Patients at Home—A Design Case Study

1. INTRODUCTION

2. BACKGROUND: SUPPORTING COLLABORATION IN HOME CARE

3. THE CASE

3.1 Context: Home Care in France

3.2 E-maison Médicale—A Local Initiative for Home Care

4. METHOD

4.1 Data Collection

4.2 Data Analysis Approach

5. RESULTS OF THE EMPIRICAL ANALYSIS OF PRACTICES

5.1 The Liaison Notebook as a Coordinative Artifact

5.2 Addressing the Multiple Dimensions of Home Care

5.3 Articulating Different Collaboration Rhythms

5.4 Challenges of the Actual Practices

6. DESIGN AND EVALUATION OF THE CARE APPLICATION

6.1 Design Principles

6.1.1 Enabling a Discussion-Based Documentation

6.1.2 Offering Tagging Possibility for Documented Information

6.1.3 Tracking the Challenging Issues in a Patient’s Trajectory

6.2 The CARE Application

6.2.1 Enabling a Discussion-Based Documentation

6.2.2 Offering Tagging Possibility for Documented Information

6.2.3 Tracking the Challenging Issues in a Patient’s Trajectory

7. CARE PILOT STUDY

7.1 Finding Candidates and Inclusion Criteria

7.2 Rolling out CARE

7.3 Follow-up and Data Collection

8. LESSONS LEARNED

8.1 Flexibility to Accommodate Different Values

8.2 Building Trust

8.3 Open Sharing

8.4 Notes on the Implementation and the Training

9. CONCLUSION

References

4 - A Community Health Orientation for Wellness Technology Design & Delivery

1. INTRODUCTION

2. PHI RESEARCH IN COMMUNITY-BASED ORGANIZATIONS

3. CASE STUDY

3.1 Formative Research

3.2 Spaceship Launch

3.3 Evaluation Study

4. FINDINGS

4.1 Family and Organizational Values: Concordance and Dissonance

4.2 Physical Affordances

4.3 Operational Factors

5. DISCUSSION

5.1 The Value of a Community-Based Approach for Addressing Issues of Health Equity

5.2 Untapped Potential: Leveraging CBPR Models of Neighborhood Health Promotion

6. CONCLUSION

Acknowledgments

References

5 - Socio-technical Betwixtness: Design Rationales for Health Care IT

1. INTRODUCTION

2. A SHORT HISTORICAL BRIEF ON RATIONALES BEHIND THE DESIGN OF WORK, TECHNOLOGY, AND ORGANIZATIONS

3. A FOUNDATIONAL MODEL FOR ELECTRONIC HEALTH RECORDS

4. EMPOWERING AND MANAGING DISTRIBUTED WORK: IT FOR HOSPITAL PORTERS

5. DISCUSSION: ON THE BETWIXNESS OF DESIGN IN HEALTH CARE

6. CENTRAL POINTS

Acknowledgments

References

6 - Stakeholders as Mindful Designers: Adjusting Capabilities Rather Than Needs in Computer-Supported Daily Workforce Planning

1. INTRODUCTION

2. DESCRIPTION AND COURSE OF STUDY

2.1 Project Setup

2.2 Executing the Project

3. LEARNINGS FOR SOCIO-TECHNICAL DESIGN

3.1 Challenge 1: Dealing With Formal Positions (and Hierarchies)

3.2 Challenge 2: Ensuring Willingness to Use New Technology and Actively Participate in Evaluation

3.3 Challenge 3: Effective Sharing—Articulation, Documentation, and Conveying Process Models Through Technological Artifacts

4. CONCLUSION

References

7 - Dashboard Design for Improved Team Situation Awareness in Time-Critical Medical Work: Challenges and Lessons Learned

1. INTRODUCTION

2. BACKGROUND: DOMAIN OVERVIEW AND APPROACHES TO DASHBOARD DESIGN

2.1 Clinical Dashboards and Approaches to Design

3. TRU-BOARD DESIGN GOALS AND DISPLAY FEATURES

3.1 Providing Basic Overview of the Resuscitation Progress and Facilitating Periodic Process Summaries

3.2 Reducing Redundant Communication

4. TRU-BOARD DESIGN AND EVALUATION PROCESS

4.1 Research Setting

4.2 Participants

4.3 Methods

4.3.1 Participatory Design Workshops

4.3.2 Simulated Resuscitation in the Trauma Room

4.3.3 Video Review of Live Resuscitation Events

4.3.4 Video Review Sessions With Interviews

4.3.5 Concluding Focus Group

4.3.6 Data Analysis

4.4 Summary of the Design Process and Outcomes

5. SOCIO-TECHNICAL CHALLENGES IN DESIGNING DASHBOARDS FOR SAFETY-CRITICAL MEDICAL WORK

5.1 Challenges in Measuring Display Effects on Team Performance

5.2 Challenges to the Real-World Display Deployment and User Adoption

6. CONCLUSION AND FUTURE WORK

Acknowledgments

References

8 - The Recording and Reuse of Psychosocial Information in Care

1. INTRODUCTION

2. LITERATURE REVIEW

3. ABOUT THE STUDY

3.1 Participants

3.2 Data and Data Collection

4. DOCTORS’ WORK

4.1 Information Acquiring and Assembling

5. DOCUMENTING HEALTH CARE INFORMATION

5.1 Psychosocial Information, but Only in “Talk”

5.2 Psychosocial Information in the Record, but When?

5.3 Detailing Psychosocial Information in the Record

6. DISCUSSION

7. DESIGN IMPLICATIONS

8. CONCLUSION

Acknowledgments

References

9 - Challenges for Socio-technical Design in Health Care: Lessons Learned From Designing Reflection Support

1. INTRODUCTION: DESIGNING SUPPORT FOR COLLABORATIVE REFLECTION IN HEALTH CARE

2. BACKGROUND: SUPPORTING REFLECTIVE LEARNING IN HEALTH CARE

3. THE TALKREFLECTION APP TO SUPPORT REFLECTION AT WORK

4. DESIGN PROCESS AND RESULTS

4.1 Methodology

4.2 Step 1: Ethnography and Interviews to Explore the Domain

4.3 Step 2: Participatory Design Workshops and Prototyping

4.4 Step 3: Evaluation in Practice

5. REFLECTIONS: SOCIO-TECHNICAL DESIGN CHALLENGES IN HEALTH CARE

5.1 Challenge 1: Dealing With Inherent Hierarchy Structures and the Role of Superiors

5.2 Challenge 2: Low Willingness to Use New Technology for Communication Purposes; Low Expectation of Benefits From Employing th...

5.3 Challenge 3: Dealing With Little Support for Appropriate Technical Infrastructure, Especially for Nonmedical Tasks

5.4 Challenge 4: Dealing With Unstructured, Spontaneous Processes Driven by External Factors Versus Meaningful and Planned Integ...

5.5 Challenge 5: Dealing With Privacy, Liability, and Security With Respect to Data Handling

6. CONCLUSION

Acknowledgments

References

10 - Double-Loop Health Technology: Enabling Socio-technical Design of Personal Health Technology in Clinical Practice

1. INTRODUCTION

2. BACKGROUND: PERSONAL HEALTH TECHNOLOGY

3. CASE: DESIGNING FOR DOUBLE-LOOP TREATMENT IN MENTAL HEALTH

3.1 Design Process

3.2 Smartphone Application

3.3 Clinical Portal

3.4 Clinical Implementation

4. LESSONS LEARNED

4.1 Using Personal Health Technology

4.2 Reorganizing Socio-technical Systems

4.3 Socio-technical Scalability of Personal Health Technology

4.4 Socio-technical Integration of Personal Health Technology

5. CONCLUSION

Acknowledgments

References

11 - Designing Health Care That Works—Socio-technical Conclusions

1. THE EXTENDED VIEW OF A SOCIO-TECHNICAL PERSPECTIVE

1.1 Increased Scope of Social Interaction

1.2 Motivation, Values, and Interests for Health care

1.3 Time, Dynamic Constellations, Processes, and Places

1.4 Dealing With Data

1.5 Extended Scope of Technology

2. CONSEQUENCES FOR DESIGN

2.1 Focus on Interests and Values

2.2 Process- and Time-Orientation

2.3 Complexity and Agility

2.4 Participation

3. METHODS THAT ARE APPLIED

3.1 Empirical Work

3.2 Methods to Support Design

4. CHALLENGES AND PROBLEMS

4.1 Dealing With Health care Data

4.2 Trust

4.3 Complexity and Limited Perspectives

4.4 Lack of Willingness

4.5 The Evidence Problem

5. HOW TO DEAL WITH THE PROBLEMS

5.1 How to Increase Motivation

5.2 Improving the Quality of Data Handling

5.3 Control and Flexibility

5.4 Facilitation and Improved Quality of Communication

5.5 Providing Evidence

6. SUMMARY AND FUTURE WORK

Index

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