Design and evaluation in eHealth: challenges and implications for an interdisciplinary field - PubMed (original) (raw)

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Design and evaluation in eHealth: challenges and implications for an interdisciplinary field

Claudia Pagliari. J Med Internet Res. 2007.

Abstract

Much has been written about insufficient user involvement in the design of eHealth applications, the lack of evidence demonstrating impact, and the difficulties these bring for adoption. Part of the problem lies in the differing languages, cultures, motives, and operational constraints of producers and evaluators of eHealth systems and services. This paper reflects on the benefits of and barriers to interdisciplinary collaboration in eHealth, focusing particularly on the relationship between software developers and health services researchers. It argues that the common pattern of silo or parallel working may be ameliorated by developing mutual awareness and respect for each others' methods, epistemologies, and contextual drivers and by recognizing and harnessing potential synergies. Similarities and differences between models and techniques used in both communities are highlighted in order to illustrate the potential for integrated approaches and the strengths of unique paradigms. By sharing information about our research approaches and seeking to actively collaborate in the process of design and evaluation, the aim of achieving technologies that are truly user-informed, fit for context, high quality, and of demonstrated value is more likely to be realized. This may involve embracing new ways of working jointly that are unfamiliar to the stakeholders involved and that challenge disciplinary conventions. It also has policy implications for agencies commissioning research and development in this area.

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Conflict of interest statement

None declared.

Figures

Figure 1

Figure 1

The increasing breadth and complexity of eHealth in terms of the stakeholders, technologies, objectives and disciplines involved

Figure 2

Figure 2

Key software lifecycle models: Waterfall [25], Spiral [26], Star [27] model

Figure 3

Figure 3

ISO 13407 standard for human-centered design processes for interactive systems

Figure 4a

Figure 4a

Sequential stages in evaluation of complex interventions (after [33]). Similar steps are used in the evaluation of new drugs, from initial preclinical research through to postmarketing surveillance.

Figure 4b

Figure 4b

Iterative view of complex intervention evaluation (after [33]). This recognizes that results from individual phases may prompt revisions and repetition.

Figure 5

Figure 5

The Action Research Spiral (after [34])

Figure 6

Figure 6

The “Plan-Do-Study-Act” process improvement cycle of total quality management (after [35])

Figure 7

Figure 7

An idealized framework for evaluating emergent eHealth resources at different stages of development and implementation

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