Applying User Input to the Design and Testing of an Electronic Behavioral Health Information System for Wraparound Care Coordination.
Applying User Input to the Design and Testing of an Electronic Behavioral Health Information System for Wraparound Care Coordination.
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DOI：
10.1007/s10488-015-0658-5
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发表时间：
2016-05
期刊：
影响因子：
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通讯作者：
Lyon AR
中科院分区：
文献类型：
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作者：
Bruns EJ;Hyde KL;Sather A;Hook AN;Lyon AR
卫生信息技术（HIT）和对有复杂需求的个人的护理协调是提高卫生保健质量的高度优先事项。然而，关于如何最好地设计电子健康记录系统和相关技术以促进行为健康护理协调模型的实施，或者如何最好地将用户输入应用于设计和测试过程，几乎没有经验指导。在本文中，我们描述了一个迭代开发过程，该过程在多个点上结合了用户/利益相关者的观点，并产生了一个电子行为健康信息系统（EBHIS），该系统专门针对患有严重情绪和行为障碍的青少年的综合护理协调模型。首先，我们回顾了关于EBHIS如何提高用于通知开发的概括的效率和结果的基础HIT研究。在描述了用于封装的原型EBHIS的基本原理和功能之后，我们描述了一系列六个小型研究的方法和结果，这些研究为系统开发提供了四个阶段的信息——预开发、开发、初始用户测试和商业化——并讨论了这些结果如何为系统设计和改进提供了信息。最后，我们提出了接下来的步骤，传播的挑战，并为其他旨在发展专门的行为健康HIT的人提供指导。研究小组的经验加强了EBHIS提供的机会，以改善有复杂需求人群的护理协调，同时也指出了实施此类技术需要克服的一系列障碍和挑战。
Health information technology (HIT) and care coordination for individuals with complex needs are high priorities for quality improvement in health care. However, there is little empirical guidance about how best to design electronic health record systems and related technologies to facilitate implementation of care coordination models in behavioral health, or how best to apply user input to the design and testing process. In this paper, we describe an iterative development process that incorporated user/stakeholder perspectives at multiple points and resulted in an electronic behavioral health information system (EBHIS) specific to the wraparound care coordination model for youth with serious emotional and behavioral disorders. First, we review foundational HIT research on how EBHIS can enhance efficiency and outcomes of wraparound that was used to inform development. After describing the rationale for and functions of a prototype EBHIS for wraparound, we describe methods and results for a series of six small studies that informed system development across four phases of effort – predevelopment, development, initial user testing, and commercialization – and discuss how these results informed system design and refinement. Finally, we present next steps, challenges to dissemination, and guidance for others aiming to develop specialized behavioral health HIT. The research team's experiences reinforce the opportunity presented by EBHIS to improve care coordination for populations with complex needs, while also pointing to a litany of barriers and challenges to be overcome to implement such technologies.