Enhancing the effectiveness of consumer-focused health information technology systems through eHealth literacy: a framework for understanding users' needs
Kayser, Lars, Kushniruk, Andre, Osborne, Richard H., Norgaard, Ole and Turner, Paul 2015, Enhancing the effectiveness of consumer-focused health information technology systems through eHealth literacy: a framework for understanding users' needs, JMIR human factors, vol. 2, no. 1, pp. 1-14, doi: 10.2196/humanfactors.3696.
Background: eHealth systems and applications are increasingly focused on supporting consumers to directly engage with anduse health care services. Involving end users in the design of these systems is critical to ensure a generation of usable and effectiveeHealth products and systems. Often the end users engaged for these participatory design processes are not actual representativesof the general population, and developers may have limited understanding about how well they might represent the full range ofintended users of the eHealth products. As a consequence, resulting information technology (IT) designs may not accommodatethe needs, skills, cognitive capacities, and/or contexts of use of the intended broader population of health consumers. This mayresult in challenges for consumers who use the health IT systems, and could lead to limitations in adoption if the diversity of userattributes has not been adequately considered by health IT designers.Objective: The objective of this paper is to propose how users’needs and competences can be taken into account when designingnew information and communications technology solutions in health care by expanding the user-task-context matrix model withthe domains of a new concept of eHealth literacy.Methods: This approach expands an existing method for supporting health IT system development, which advocates use of athree-dimensional user-task-context matrix to comprehensively identify the users of health IT systems, and what their needs andrequirements are under differing contexts of use. The extension of this model involved including knowledge about users’competences within the seven domains of eHealth literacy, which had been identified based on systematic engagement withcomputer scientists, academics, health professionals, and patients recruited from various patient organizations and primary care.A concept map was constructed based on a structured brainstorm procedure, card sorting, and computational analysis.Results: The new eHealth literacy concept (based on 7 domains) was incorporated as a key factor in expanding theuser-task-context matrix to describe and qualify user requirements and understanding related to eHealth literacy. This resultedin an expanded framework and a five-step process, which can support health IT designers in understanding and more accuratelyaddressing end-users’ needs, capabilities, and contexts to improve effectiveness and broader applicability of consumer-focusedhealth IT systems. It is anticipated that the framework will also be useful for policy makers involved in the planning, procuring,and funding of eHealth infrastructure, applications, and services.Conclusions: Developing effective eHealth products requires complete understanding of the end-users’ needs from multipleperspectives. In this paper, we have proposed and detailed a framework for modeling users’ needs for designing eHealth systemsthat merges prior work in development of a user-task-context matrix with the emerging area of eHealth literacy. This framework is intended to be used to guide design of eHealth technologies and to make requirements explicitly related to eHealth literacy,enabling a generation of well-targeted, fit-for-purpose, equitable, and effective products and systems.
Field of Research
111711 Health Information Systems (incl Surveillance)
Socio Economic Objective
920299 Health and Support Services not elsewhere classified
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