Skip to main content
SpringerLink
Log in

The Role of Patients in Designing Health Information Systems: The Case of Applying Simulation Techniques to Design an Electronic Patient Record (EPR) Interface

  • Published:
Health Care Management Science Aims and scope Submit manuscript

Abstract

One overall objective of Electronic Patient Records (EPRs) is to improve patient education and to enhance the patient experience through the use of information technology (IT) so as to facilitate the sharing of information between providers and their patients. The research project reported on herein took place at University Health Network (UHN) in Toronto (Canada), which is a large academic health science center with multiple hospital sites in the city. As a first step in this process, we examined the literature to investigate the human factors issues related to healthcare as well as other settings. Subsequently, we interviewed a number of interested stakeholders from two groups: the physicians (both family and attending) and the patients themselves. Finally, using a simulation environment, we explored the content that UHN lung-transplant patients would be interested in having within their own EPRs. In this paper, we report on the research, the methodology and the findings pertaining to the both the content and the design of an electronic patient record.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. P.B. Elberg, Electronic patient records and innovation in health care services, International Journal of Medical Informatics 64(2–3) (2001) 201–205.

    Google Scholar 

  2. C. Lovis, R.H. Baud and J.R. Scherrer, Internet integrated in the daily medical practice within an electronic patient record, Comput. Biol. Med. 28(5) (1998) 567–579.

    Google Scholar 

  3. S.E. Ross and C.T. Lin, The effects of promoting patient access to medical records: A review, J. Am. Med. Inform. Assoc. 10(2) (2003) 129–138.

    Google Scholar 

  4. U. Tachinardi, M. de SaRebelo, P.P. de Magalhaes Oliveira, Jr. and P.E. Pilon, Real time information from bedside monitors as part of a web-based patient record, in: Proc. AMIA Symposium (2001) pp. 691–695.

  5. A. van’t Riet, M. Berg, F. Hiddema and K. Sol, Meeting patients’ needs with patient information systems: Potential benefits of qualitative research methods, International Journal of Medical Informatics 64(1) (2001) 1–14.

    Google Scholar 

  6. A.F. Jerant and D.B. Hill, Does the use of electronic medical records improve surrogate patient outcomes in outpatient settings? Journal of Family Practice 49 (2000) 349–357.

    Google Scholar 

  7. H. Barki and J. Hartwick, Rethinking the concept of user involvement, MIS Quarterly 13(1) (1989) 53–63.

    Google Scholar 

  8. H. Barki and J. Hartwick, Measuring user participation, user involvement, and user attitude, MIS Quarterly 18(1) (1994) 59–82.

    Google Scholar 

  9. J.J. Baroudi, M.H. Olson and B. Ives, An empirical study of the impact of user involvement on system usage and information satisfaction, Communications of the ACM 29(3) (1986) 232–238.

    Google Scholar 

  10. W.J. Doll and G. Torkzadeh, A congruence construct of user involvement, Decision Sciences 22(2) (1991) 443–453.

    Google Scholar 

  11. C.R. Franz and D. Robey, Organizational context, user involvement, and the usefulness of information systems, Decision Sciences 17(4) (1986) 329–356.

    Google Scholar 

  12. H.L. Gibson, Determining user involvement, Journal of System Management (August 1977) 20–22.

  13. D.L. Goodhue, Understanding user evaluations of information systems, Management Science 41(12) (1995) 1827–1844.

    Google Scholar 

  14. J. Hartwick and H. Barki, Explaining the role of user participation in information system use, Management Science 40(4) (1994) 440–465.

    Article  Google Scholar 

  15. B. Ives and M. Olson, User involvement and MIS success: A review of research, Management Science 30(5) (1984) 586–603.

    Google Scholar 

  16. J.D. McKeen, T. Guimaraes and J.C. Wetherbe, The relationship between user participation and user satisfaction: An investigation of four contingency factors, MIS Quarterly 18(4) (1994) 427–451.

    Google Scholar 

  17. D. Robey and D.L. Farrow, User involvement in information system development: A conflict model and empirical test, Management Science 28(1) (1982) 73–85.

    Google Scholar 

  18. J. Rockart and A. Crescenzi, Engaging top management in information technology, Sloan Management Review 25 (1984) 3–16.

    Google Scholar 

  19. I. Iakovidis, Towards personal health record: Current situation, obstacles and trends in implementation of electronic healthcare record in Europe, International Journal of Medical Informatics 52(1–3) (1998) 105–115.

    Google Scholar 

  20. K. Walsh-Burke and C. Marcusen, Self-advocacy training for cancer survivors: The cancer survival toolbox, Cancer Practice 7(6) (1999) 297–301.

    Google Scholar 

  21. P.C. Tang and C. Newcomb, Informing patients: A guide for providing patient health information, J. Am. Med. Inform. Assoc. 5(6) (1998) 563–570.

    Google Scholar 

  22. H. Eliasoph, e-Health consumer: A diminishing tolerance of hospitals, Hospital Quarterly (Winter 2000/2001) 30–34.

  23. M.J. Barry, D.C. Cherkin, Y. Chang, F.J. Fowler and S. Skates, A randomized trial of a multimedia shared decision-making program for men facing a treatment decision for benign prostatic hyperplasia, Disease Management and Clinical Outcomes 1(1) (1997) 5–14.

    Google Scholar 

  24. S. Molenaar, M.A. Sprangers, E.J. Rutgers, E.J. Luiten, J. Mulder, P.M. Bossuyt , Decision support for patients with early-stage breast cancer: Effects of an interactive breast cancer CDROM on treatment decision, satisfaction, and quality of life, Journal of Clinical Oncology 19(6) (2001) 1676.

    Google Scholar 

  25. V.J. Strecher, T. Greenwood, C. Wang and D. Dumont, Interactive multimedia and risk communication, J. Natl. Cancer. Inst. Monograph 25 (1999) 134–139.

    Google Scholar 

  26. J.J. Cimino, V.L. Patel and A.W. Kushniruk, What do patients do with access to their medical records? Medinfo 10(Pt. 2) (2001) 1440–1444.

    Google Scholar 

  27. J.J.Cimino, J.Li, E.A.Mendonca, S.Sengupta, V.L.Patel and A.W.Kushniruk, An evaluation of patient access to their electronic medical records via the World Wide Web, in: Proc. AMIA Symposium (2000) pp. 151–155.

  28. A.W. Kushniruk, C. Patel, V.L. Patel and J.J. Cimino, ‘Televaluation’ of clinical information systems: An integrative approach to assessing Web-based systems, International Journal of Medical Informatics 61(1) (2001) 45–70.

    Google Scholar 

  29. T. Ferguson, Health online and the empowered medical consumer, Journal on Quality Improvement 23(5) (1997) 55–70.

    Google Scholar 

  30. M.J. Ball and J. Lillis, E-health: Transforming the physician/patient relationship, International Journal of Medical Informatics 61(1) (2001) 1–10.

    Google Scholar 

  31. K.J. Leonard and W. Winkelman, Developing electronic patient records: Employing interactive methods to ensure patient involvement, in: Proceedings from the 28th Meeting of the European Working Group on Operational Research Applied to Health Services (ORAHS), Rio de Janeiro, Brazil (July–August 2002) pp. 225–239.

  32. M. Baldry, C. Cheal, B. Fisher, M. Gillett and V. Huet, Giving patients their own records in general practice: Experience of patients and staff, Br. Med. J. (Clin. Res. Ed.) 292(6520) (1986) 596–598.

    Article  Google Scholar 

  33. D.L. Bronson and K. O’Meara, The impact of shared medical records on smoking awareness and behavior in ambulatory care, J. Gen. Intern. Med. 1(1) (1986) 34–37.

    Google Scholar 

  34. C.M. Ruland and S. Bakken, Representing patient preference-related concepts for inclusion in electronic health records, J. Biomed. Inform. 34(6) (2001) 415–422.

    Google Scholar 

  35. D.L. Bronson, A.S. Rubin and H.M. Tufo, Patient education through record sharing, QRB Qual. Rev. Bull. 4(12) (1978) 2–4.

    Google Scholar 

  36. R.C. Maly, L.B. Bourque and R.F. Engelhardt, A randomized controlled trial of facilitating information giving to patients with chronic medical conditions: Effects on outcomes of care, J. Fam. Pract. 48(5) (1999) 356–363.

    Google Scholar 

  37. M. Berg, C. Langenberg, I. van der Berg and J. Kwakkernaat, Considerations for sociotechnical design: Experiences with an electronic patient record in a clinical context, International Journal of Medical Informatics 52(1–3) (1998) 243–251.

    Google Scholar 

  38. V.L. Patel, A.W. Kushniruk, S. Yang and J.F. Yale, Impact of a computer-based patient record system on data collection, knowledge organization, and reasoning, J. Am. Med. Inform. Assoc. 7(6) (2000) 569–585.

    Google Scholar 

  39. W.W. Stead and N.M. Lorenzi, Health informatics: Linking investment to value, J. Am. Med. Inform. Assoc. 6(5) (1999) 341–348.

    Google Scholar 

  40. D.R. Dixon, The behavioral side of information technology, International Journal of Medical Informatics 56 (1999) 117–123.

    Google Scholar 

  41. K.J. Leonard, Information systems for healthcare: Why we have not had more success – the top 15 reasons, Healthcare Management Forum 13(3) (2000) 45–51.

    Article  Google Scholar 

  42. N.M. Lorenzi and T. Riley, Organizational Aspects of Health Informatics: Managing Technological Change (Springer, New York, 1995) p. 224.

    Google Scholar 

  43. M. Ruffin, Digital Doctors (Hillsboro Printing Company, Florida, 1998) 189 pp.

    Google Scholar 

  44. N.W. Treister, Physician acceptance of new medical information systems: The field of dreams, Physician Executive 24(3) (May–June, 1998) 20–24.

    Google Scholar 

  45. L.P. Drazen , Patient Care Information Systems: Successful Design and Implementation (Springer, New York, 1995) 32 pp.

    Google Scholar 

  46. A. Kreider and N. Haselton, The Systems Challenge (American Hospital Publishing, Chicago, 1997) 95 pp.

    Google Scholar 

  47. L.L. Weed, Knowledge Coupling: New Premises and New Tools for Medical Care and Education (Springer, New York, 1991) pp. 109–111.

    Google Scholar 

  48. S.T. Liaw, A.J. Radford and I. Maddocks, The impact of a computer generated patient held health record, Aust. Fam. Physician 27(Suppl. 1) (1998) S39–S43.

    Google Scholar 

  49. D. Masys, D. Baker, A. Butros and K.E. Cowles, Giving patients access to their medical records via the Internet: The PCASSO experience, J. Am. Med. Inform. Assoc. 9(2) (2002) 181–191.

    Google Scholar 

  50. A.J. Osheroff et al., Computers in clinical practice: Managing patients, information, and communication, American College of Physicians (1995) 94–99.

  51. E.M. Rogers, Diffusion of Innovations, 5th Ed. (The Free Press, New York, 1995).

    Google Scholar 

  52. P.G.W. Keen, Information systems and organizational change, Communications of the ACM 14(1) (1981) 24–33.

    Google Scholar 

  53. J.C.J. Chang, Business environment, user involvement, and information systems success: A case study, Inaugural America Conference of the Association for Information System (1995), http:hsb.baylor.edu/ramsower/acis/papers/changj.htm

  54. S.T. Young and J.S. Chang, Implementation of a patient-centred and physician-oriented healthcare information system, Medical Informatics 22(3) (1997) 207–214.

    Google Scholar 

  55. S.C. Porter and I.S. Kohane, Optimal data entry by patients: Effects of interface structure and design, Medinfo 10(Pt. 1) (2001) 141–145.

    Google Scholar 

  56. H.B. Jamison and P.P. Sher, Consumer health informatics: Health information technology for consumers, Journal of the American Society for Information Science 46(10) (1995) 783–790.

    Google Scholar 

  57. S.E. Ross, M.A. Earnest, C. Lin and L. Wittevrongel, Providing patients access to online medical records: A comparison of physician and patient expectations, in: 25th Annual Meeting, Society of General Internal Medicine (May 2–4, 2002).

Download references

Author information

Authors and Affiliations

  1. Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, M5S 1A8, Canada

    Kevin J. Leonard

  2. Research Scientist, Center for Global eHealth Innovation, Toronto General Hospital, University Health Network, Toronto, ON, Canada

    Kevin J. Leonard

Authors
  1. Kevin J. Leonard
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kevin J. Leonard.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Leonard, K.J. The Role of Patients in Designing Health Information Systems: The Case of Applying Simulation Techniques to Design an Electronic Patient Record (EPR) Interface. Health Care Manage Sci 7, 275–284 (2004). https://doi.org/10.1007/s10729-004-7536-0

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10729-004-7536-0

Keywords

Search

Navigation