Methods to identify, study and understand end-user participation in HIT development

Area of Science:

• Health Informatics
• Human-Computer Interaction
• Sociology of Technology

Background:

• Successful health-information-technology (HIT) implementation hinges on clinicians gaining tangible clinical benefits and co-owning development decisions.
• Achieving these success factors necessitates genuine end-user participation in the HIT development process.
• Improved methods are needed to gather detailed information on social groups involved in HIT development to enhance participation.

Purpose of the Study:

• To analyze the dynamics of end-user participation in a health-information-technology (HIT) planning process.
• To investigate the influence of social group interactions and power balances on end-user involvement in HIT development.
• To present an improved method for collecting data on social groups and their interactions during HIT development.

Main Methods:

• A case study utilizing process-analysis of an Electronic Health Record (EHR) planning process in a Danish county (2003-2006).
• Inclusion of three key social groups: physicians, IT professionals, and administrators.
• Integration of national, historic literature review with local, present-day observations, interviews, and document analysis.

Main Results:

• Administrator strategies in the EHR planning process led to a lack of clinical workload reduction, a barrier to physician influence.
• Divergent historical and present perceptions between physicians and administrators regarding the patient record's purpose created power imbalances.
• Physicians' roles were diminished to clinical consultants rather than active participants due to these power dynamics.

Conclusions:

• The balance of power and interests among social groups in HIT development critically determines the extent of end-user participation.
• Genuine end-user participation is indispensable for the successful outcome of HIT development projects.
• An improved data collection method is proposed to better understand social group interactions, enabling HIT management to foster greater end-user involvement.