Characterizing the use of health care services delivered via computer networks.
Characterizing the use of health care services delivered via computer networks.
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描述通过计算机网络提供的医疗保健服务的使用情况。
DOI：
10.1136/jamia.1995.95338869
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
Brennan,PF
中科院分区：
文献类型：
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作者：
Brennan,PF
目的：评价人员必须制定方法，以描述快速增长的将患者与卫生服务联系起来的电子网络的使用情况。在本文中，提出了4-S框架来描述通过计算机网络提供的卫生服务的使用情况。4-S框架的效用是通过一项已完成的随机现场实验得出的数据来说明的，该实验中，47名阿尔茨海默病患者的护理人员访问了ComputerLink，这是一个特殊的计算机网络，为阿尔茨海默病患者的居家护理人员提供信息、交流和决策支持。设计：人机交互理论从行为角度描述了通过计算机网络提供的卫生服务的使用。4-S框架结合了基于用户（主体）行为的视角：对整个系统的访问和使用、特定服务的使用、单个会话中的行为以及持久的行为特征。4-S框架是在对使用ComputerLink的3800多个数据进行的二次分析中进行测试的。测量：使用从ComputerLink评估中获得的数据实例化了4-S框架。获得了三种类型的辅助数据。访问计算机网络的被动监视器提供定量信息，例如访问发生的时间，访问的持续时间和使用的服务顺序。全文信息可从公共信息发布中获得。在实验结束时，用户通过自我报告获得对使用情况的主观评价。结果：4-S框架的组成部分适合表征阿尔茨海默病护理人员使用ComputerLink的操作方面。通过4-S框架的应用，出现了对定量使用和定性使用的理解（例如，洞察到特定服务的不同使用）。结论：4-S框架提供了一种机制，将各种使用措施结合成一个连贯的整体。该框架促进了对使用情况的精确描述，从而促进了对通过计算机网络提供的保健服务的评价。它适用于评估用户满意度、测量需求解决方案和确定选定的临床结果。
Objective: Evaluators must develop methods to characterize the use of the rapidly proliferating electronic networks that link patients with health services. In this article the 4-S framework is proposed for characterizing the use of health services delivered via computer networks. The utility of the 4-S framework is illustrated using data derived from a completed, randomized field experiment in which 47 caregivers of persons who had Alzheimer's disease accessed ComputerLink, a special computer network providing information, communication, and decision support to homebound caregivers of persons who have Alzheimer's disease.Design: Human-computer interaction theories characterize the use of health services delivered via computer networks in behavioral terms. The 4-S framework incorporates perspectives based on user (subject) behavior: access to and use of the total system, use of specific services, behavior within single sessions, and enduring behavioral characteristics. The 4-S framework was tested in a secondary analysis of data from over 3,800 uses of ComputerLink.Measurement: The 4-S framework was instantiated using data obtained from the ComputerLink evaluation. Three types of secondary data were obtained. A passive monitor of access to the computer network provided quantitative information, such as time of day when access occurred, duration of access, and sequence of services used. Full-text messages were available from the public message postings. Subjective appraisal of use was obtained from self-reporting by users at the end of the experiment.Results: The components of the 4-S framework were suitable to characterize operational aspects of ComputerLink use by Alzheimer's disease caregivers. Through application of the 4-S framework, an understanding of both quantitative use and qualitative use emerged (e.g., insight was gained into the differential use of specific services).Conclusions: The 4-S framework provided a mechanism for combining various measures of use into a coherent whole. The framework promotes a precise characterization of use and thereby facilitates evaluation of health services delivered via computer networks. It is suitable for evaluation of user satisfaction, measurement of needs resolution, and ascertainment of selected clinical outcomes.