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Sociotechnical Challenges of Developing an Interoperable Personal Health Record: Lessons Learned
Gregory L Gaskin1, Christopher A Longhurst, Rebecca Slayton
1Program in Science, Technology and Society, School of Humanities and Sciences, Stanford University, Stanford, CA.
Applied Clinical Informatics
|October 18, 2011
Summary
Developing interoperable Personal Health Records (PHRs) involves complex sociotechnical challenges. Addressing issues in teamwork, goals, user conception, and vendor coordination is crucial for successful PHR implementation.
Area of Science:
- Health Informatics
- Sociotechnical Systems Analysis
- Healthcare Management
Background:
- Interoperable Personal Health Records (PHRs) offer potential benefits for healthcare delivery.
- Developing and implementing commercial PHRs in hospitals presents significant sociotechnical challenges.
Purpose of the Study:
- To analyze sociotechnical issues in developing an interoperable commercial PHR within a hospital.
- To establish guidelines for future PHR implementations based on lessons learned.
Main Methods:
- Qualitative study using observational research and semi-structured interviews over 28 weeks.
- Grounded theory approach applied to analyze field notes and interview transcripts from 8 hospital team members.
- Data collection focused on the development and adaptation of a vendor-based PHR.
Main Results:
- Multidisciplinary teamwork facilitated identification of essential PHR features.
- Divergent goals for the PHR were present within the hospital team.
- Differing organizational views on end-users between hospital and software company impacted expectations.
- Coordination and accountability issues between hospital and software vendor led to delays and strained relationships.
Conclusions:
- The development of commercial interoperable PHRs is an inherently sociotechnical process.
- Complex issues and barriers exist in designing and developing PHR systems.
- Recommendations are provided to guide future PHR development and implementation.
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