A participatory approach to designing and enhancing integrated health information technology systems for veterans: protocol.
A participatory approach to designing and enhancing integrated health information technology systems for veterans: protocol.
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DOI：
10.2196/resprot.3815
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发表时间：
2015-02-27
影响因子：
1.7
通讯作者：
Martin TL
中科院分区：
文献类型：
--
作者：
Haun JN;Nazi KM;Chavez M;Lind JD;Antinori N;Gosline RM;Martin TL
退伍军人事务部（VA）开发了健康信息技术（HIT）和资源，以改善退伍军人获得医疗保健计划和服务的机会，并支持以患者为中心的医疗保健提供方法。为了提高退伍军人对医疗信息系统的访问和有意义的使用，有必要了解他们与各种医疗信息系统资源交互的偏好，以完成与健康管理相关的任务和交换信息。本文的目的是描述一种新的协议：(1)开发HIT数字健康矩阵模型；(2)运用两两比较层次分析法，了解退伍军人使用电子健康资源完成健康管理相关任务的方式和原因；(3)开发可视化建模仿真，描述退伍军人使用VA HIT管理健康状况和交换健康信息的偏好。该研究使用参与式研究方法来了解退伍军人如何在给定的环境中使用VA HIT来完成健康管理任务，以及他们将来如何与HIT界面（例如，外观，感觉和功能）进行交互。本研究包括两轮退伍军人焦点小组自我调查和视觉建模模拟技术。本研究亦将召集专家小组，协助建立VA HIT数位健康矩阵模型，让专家小组成员和资深参与者都能完成层次分析法，两两比较，以评估电子健康资源在一系列健康管理任务中的适用性。该协议描述了迭代、参与式和以患者为中心的过程：(1)开发VA HIT数字健康矩阵模型，该模型概述了退伍军人可用的当前VA面向患者的平台，描述了它们的特征和相关使用背景；(2)基于退伍军人的直接反馈，开发可视化模型仿真，以描述患者的偏好，以增强面向VA患者的平台的同步、集成和标准化。焦点小组主题包括使用电子卫生资源的当前用途、偏好、促进因素和障碍；VA HIT的同步、集成和标准化建议；以及对VA系统内数据共享和授权的偏好。这项工作强调了促进和抑制当前VA HIT使用的实用、技术和个人因素，并为集成系统的重新设计提供了信息。数字健康矩阵模型和可视化建模仿真利用退伍军人偏好和经验的知识，直接告知VA HIT的增强功能，并提供更全面和集成的用户体验。这些努力旨在支持VA HIT的采用和持续使用，以直接符合退伍军人偏好的方式支持患者自我管理和临床护理协调。
The Department of Veterans Affairs (VA) has developed health information technologies (HIT) and resources to improve veteran access to health care programs and services, and to support a patient-centered approach to health care delivery. To improve VA HIT access and meaningful use by veterans, it is necessary to understand their preferences for interacting with various HIT resources to accomplish health management related tasks and to exchange information. The objective of this paper was to describe a novel protocol for: (1) developing a HIT Digital Health Matrix Model; (2) conducting an Analytic Hierarchy Process called pairwise comparison to understand how and why veterans want to use electronic health resources to complete tasks related to health management; and (3) developing visual modeling simulations that depict veterans’ preferences for using VA HIT to manage their health conditions and exchange health information. The study uses participatory research methods to understand how veterans prefer to use VA HIT to accomplish health management tasks within a given context, and how they would like to interact with HIT interfaces (eg, look, feel, and function) in the future. This study includes two rounds of veteran focus groups with self-administered surveys and visual modeling simulation techniques. This study will also convene an expert panel to assist in the development of a VA HIT Digital Health Matrix Model, so that both expert panel members and veteran participants can complete an Analytic Hierarchy Process, pairwise comparisons to evaluate and rank the applicability of electronic health resources for a series of health management tasks. This protocol describes the iterative, participatory, and patient-centered process for: (1) developing a VA HIT Digital Health Matrix Model that outlines current VA patient-facing platforms available to veterans, describing their features and relevant contexts for use; and (2) developing visual model simulations based on direct veteran feedback that depict patient preferences for enhancing the synchronization, integration, and standardization of VA patient-facing platforms. Focus group topics include current uses, preferences, facilitators, and barriers to using electronic health resources; recommendations for synchronizing, integrating, and standardizing VA HIT; and preferences on data sharing and delegation within the VA system. This work highlights the practical, technological, and personal factors that facilitate and inhibit use of current VA HIT, and informs an integrated system redesign. The Digital Health Matrix Model and visual modeling simulations use knowledge of veteran preferences and experiences to directly inform enhancements to VA HIT and provide a more holistic and integrated user experience. These efforts are designed to support the adoption and sustained use of VA HIT to support patient self-management and clinical care coordination in ways that are directly aligned with veteran preferences.