Samenvatting
Samenvatting EHealth Research Theory and Development - Digital health communication (800872-M-6)
- Instelling
- Tilburg University (UVT)
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eHealth research, theory anddevelopment
Summary
Chapter 7 - holistic development of eHealth technology
The CeHRes roadmap provides guidelines for a holistic development approach of eHealth
technology.
Holism is a central construct with regard to eHealth development. It means that constructs such
as technology, people and context are all interrelated and interdependent and are all part of one
whole instead of separate elements. A development process that creates a good fit between
these technological, human and contextual factors will increase the chances of an intervention
reaching its goals.
Existing approaches such as participatory development, human-centered design, business
modeling and persuasive technology can be combined into a frame word that supports the
development of such an eHealth technology.
eHealth development
- Is a participatory development process
- Creates new infrastructures for improving health care, health an dwell-being
- Is intertwined with implementation
- Coupled with persuasive design
- Requires continuous evaluation cycles
The CeHRes roadmap serves as a guideline for eHealth development, implementation and
evaluation.
,Can be used for new technologie that are developed from scratch but also to improve existing
technologies or even the critical analysis of an already conducted development process.
This approach does not take into account that behavior is influenced at multiple levels. This
complexity of behavior requires interactive, evidence based strategies that acknowledge these
interrelations and focus on an optimized fit between individuals, context and interventions.
Agile science enables rapid iteration and improvement of systems before they are widely
implemented. Such an approach considers the interrelationship between context, people and
technology better than a rigid, sequential apprade. The CeHRes roadmap provides a framework
to guide a multidisciplinary development through this process.
Multidisciplinary development team had to operationalize these interactive phases to direct and
manage the development process. Ideally, a development team should consist of two kinds of
people
- Professionals focused on the development, implementation and evaluation of the
technology, such as designers, technicians, business experts, project managers and
researchers.
- People whose involvement ensures that the technology fits with the target population
and its context, such as patients or healthcare professionals that will use the technology
to improve their health or to make their tasks more efficient.
Five phases and formative evaluation cycles
- Description of the phase: in this section a brief description of the phase, its background
and its relation with the entire development process is provided.
- Objectives: this paragraph briefly states the objectives of that phase, which logically
arise from the description of the phase.
- Concepts, methods and activities: this paragraph is structured by the previously stated
objectives. For each objective, relevant concepts, methods and or activities are
described to give an idea of how the objectives of the phase can be reached. Concepts
can be models, theories or approaches. They have to be understood to get a good idea
of the rationale behind the methods and activities that can be used.
- Outcomes: thai section explains what kind of outcomes a phase should have and how
these outcomes are related to previous and following phases.
- Case study: when necessary, case studies are presented at the end of a phase to further
illustrate it. These case studies are derived from practice and based on research of the
center for eHealth and wellbeing research.
Contextual inquiry
Helps the development team to get a grasp of the intended context through the use of multiple
methods. The outcomes of the contextual inquiry serves as a basis for the rest of the
development process. Assist in keeping focus on the people and their environment.
Several main objectives:
, 1) The relevant stakeholders: anyone who affects or is affected by a potential eHealth
technology has to be identified
Literature scan/review - expert recommendations - snowball sampling with stakeholders
-> might be necessary to narrow down and select the key stakeholders.
2) The identified stakeholders have to be analyzed: it should be clear what the task and
roles of the stakeholders are in order to identify the key stakeholders.
Key stakeholders should be actively involved in the development process. Different ways to
conduct a stakeholder analysis: stakeholder salience (mapping stakeholders based on their
power, legitimacy and urgency) or stakeholder visualization in a stakeholder map (figure 7.2).
3) The current situation and its weak and strong points have to be describes in order to find
out if and in what way an eHealth technology can contribute to the current situation
Frequently used methods:
- Desk research
- Systematic literature review
- Focus groups
- Interviews
- Observation
The main outcome of the contextual inquiry: should be an overview of the current situation; the
rules, regulations and ethical issues of the context; and possibilities and conditions for the use
of technology.
Value specification
The value specification phase elaborates on the issues (problem or points for improvement) that
were identified in the contextual inquiry. A proper value specification assists in finding out what
kind of goals the technology should reach according to the stakeholders and what should be
done to reach these according to stakeholders and what should be done to reach these goals. It
also forces the development team to be precise.
To achieve the fit between context and technology some questions can be asked
- What exactly should be improved or supported by means of an eHealth technology?
- What should its main goals be, according to the involved stakeholders?
-> These so-called values can differ per key stakeholder, so it is up to the development team to
prioritize them and make decisions on how to cope with conflicting values.
A business model describes how the organization involved in eHealth development creates,
delivers and captures value. Can be used to deliberate, plan and operationalize the
implementation of eHealth by means of discussing the added value of an eHealth technology
and what resources are required for the actualization of these values in practice.
Objectives of the value specification
1) The values from all involved key stakeholders have to be identified and should be clear
what the added value should be.
interviews/ focus groups/ observations
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