"Succesful eHealth depends on focus on user and context"

Photo: Pills on top of a smartphone

A new eHealth application provides carers with on-site support on how antibiotics can be administered; ©panthermedia.net/ viperagp

Human-centered design can greatly stimulate the improvement of safe patient care through technology. This is Jobke Wentzel's conclusion, who just obtained her doctoral degree at the Faculty of Behavioural, Management & Social Sciences (BMS) of the University of Twente.

For her doctoral thesis ‘Keeping an eye on the context: Participatory development of eHealth to support clinical practice’ she researched in which way eHealth solutions can contribute to increasing the quality of the work of healthcare professionals such as nurses: more efficient and safer patient care. The research is part of EurSafety Health-net, a German-Dutch collaboration to achieve better and safer care.

For her research Wentzel has recorded the information requirement of care providers when administering antibiotics in hospitals. As part of this Wentzel recorded the moment on which a decision is made and which information is required in order to encourage safe and appropriate use of antibiotics. On the basis of these findings technology has been developed in which the information requirements and work processes are key. The eHealth application, specifically built for this project, provides on-site support on how antibiotics can be administered. This application meets a need that can barely be met through the existing protocols, because they do not take the care provider as starting point, but the medication.

"We determine that improvement of patient safety can be achieved through proper collaboration and information exchange between care providers, patients and other stakeholders," says Wentzel. "In this, technology plays a supporting role. The people who perform or are affected by the care processes concerned have to occupy centre stage in order to achieve enduring change. Already during the development of MRSA-net (as part of the preceding project of the same name) the importance of focusing on the user became clear. In the current research, within the EurSafety Health-net project, we have added that an eye for the environment, relevant stakeholders included, is also a part of this."

During her research Wentzel observed a mismatch in the availability and accessibility of bed-side information for the nurses. "They had to rely on a protocol system that was not user friendly and which did not determine the user's needs as most important." Because the app improved the accessibility of the information, many nurses preferred to use the app over the traditional sources of information. The log data showed a connection between moments of use and moments of antibiotics administration in the care process, such as increased use of the app at the times of the medication rounds. This indicates actual implementation in the care process.

The implementation of the app made it clear that proper consultation about responsibilities for certain tasks, such as monitoring and signaling of sub-optimal treatment and changing policy in a timely fashion, is necessary. It addition, it was apparently unclear who should be responsible for keeping information up to date and matching information to the needs of the users. This lack of clarity was not easy to solve. Organizational changes in systems and skills surrounding eHealth are necessary in order to ensure that the added value of ICT in products, services and processes is truly utilized. The Persuasive Health Technology research group, where Wentzel obtains her doctoral degree, provides a context-directed and user-centered approach to eHealth with the CeHRes Roadmap, supervised by Prof. Van Gemert-Pijnen.

MEDICA-tradefair.com; Source: University of Twente

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