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Design and introduction of an electronic patient record: how to involve users?
1Institute of Health Policy and Management, Erasmus University Medical Center Rotterdam, P.O. Box 1738 3000 DR Rotterdam, The Netherlands. Getrouw@bmg.eur.nl
Objectives:
Two forms of participatory design (PD) - management-dominated and end-users focused - are described in the design and introduction of an electronic patient record (EPR) for a mental health care centre.
Methods:
Qualitative research methods were used to achieve a 'fine-grained' insight into the EPR development process and its impacts. These methods included interviews, document study and observation of project group meetings.
Results:
Management-dominated PD is highly structured, led by managers and centred around rationalisation of work. End-user focused PD is more bottom-up oriented. Central in this approach are users' working patterns and user needs. In the case described, both forms actually lead to a poorly functioning EPR. It is explained why these results could be expected.
Conclusion:
Our findings suggest not to reject PD, but to find a more appropriate balance between the two forms of PD.