By examining the major components and interdependencies of the home health care delivery system, a human factors perspective offers insights into ways that safety and quality can be compromised and can help pave the way for new modes of thinking in home health care policy.
Consumer health IT application design would benefit from the use of human factors and ergonomics design and evaluation methods. Considering the context in which home-based consumer health IT applications are used will likely affect the ability of these applications to positively impact the quality, safety and efficiency of patient care.
Personal health records (PHRs), centralized places for people to electronically store and organize their health information, can benefit both patients and doctors. This qualitative study of health insurers' PHRs for enrollees reveals potential benefits and challenges. Insurers' ability to put claims-based data into the PHR offers an advantage. However, consumers are concerned about sharing personal health information with insurers and about Internet security. Physicians question (1) the validity of claims data in making treatment decisions and (2) whether accessing these PHRs is worth the disruptions to their workflow. This paper offers possible solutions that may lead to more widespread adoption of insurer PHRs. [Health Affairs 28, no. 2 (2009): 377-389; 10.1377/hlthaff.28.2.377] A p e r s o na l h e a lt h r e c o r d (PHR) is a centralized place for people to electronically store and organize their personal health information, separate from electronic or paper medical records maintained by their health care providers. Many envision patients' control over PHR content and access, portability, and the capability to maintain a lifelong patient history as essential components of a valuable PHR.1 Others argue that PHRs' value will be realized with applications that expand patients' use of stored information to actively manage their care. Many advocates believe that PHRs have the potential to revolutionize health care and improve quality by engaging patients in their care, improving patient-clinician communication, and, ultimately, improving health outcomes and reducing costs.
CHI designers can employ the use case-based evaluation approach to assess the fit of a CHI intervention with patients' health work, in the context of their daily activities and environment, which would be difficult or impossible to evaluate by laboratory-based studies.
Objective: Achieving optimal health outcomes requires that consumers maintain myriad health data and understand how to utilize appropriate health information management applications. This case study investigated four families' health information management tasks in their homes. Participants: Four different families participated in the study: a single parent household; two nuclear family households; and an extended family household. Methods: A work system model known as the balance model was used as a guiding framework for data collection. Data collection consisted of three stages: (1) primary health information manager interviews; (2) family interviews; and (3) task observations. Results: Overall, families reported 69 unique health information management tasks that took place in nine different locations, using 22 different information storage artifacts. Frequently occurring tasks related to health management or health coordination were conducted in public spaces. Less frequent or more time-consuming tasks, such as researching a health concern or storing medical history, were performed in private spaces such as bedrooms or studies. Conclusions: Similarities across households suggest potential foundational design elements that consumer health information technology application designers need to balance with tailored interventions to successfully support variations in individuals' health information management needs.
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