Trust in technology-mediated collaborative health encounters: Constructing trust in passive user interactions with technologies

Montague, Enid; Asan, Onur

doi:10.1080/00140139.2012.663002

Cited by 25 publications

(17 citation statements)

References 19 publications

(21 reference statements)

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“…In this way, our concept with its underlying statements contributes to a new understanding of eHealth literacy. The concept also includes subjects previously identified to be essential to ensure usage of health technology [ 35 , 36 ], that is, trust that is embedded in the domains “4. Access to technologies that work” and “7.…”

Section: Discussionmentioning

confidence: 99%

Enhancing the Effectiveness of Consumer-Focused Health Information Technology Systems Through eHealth Literacy: A Framework for Understanding Users' Needs

Kayser

Kushniruk²,

Osborne³

et al. 2015

JMIR Human Factors

144

109

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BackgroundeHealth systems and applications are increasingly focused on supporting consumers to directly engage with and use health care services. Involving end users in the design of these systems is critical to ensure a generation of usable and effective eHealth products and systems. Often the end users engaged for these participatory design processes are not actual representatives of the general population, and developers may have limited understanding about how well they might represent the full range of intended users of the eHealth products. As a consequence, resulting information technology (IT) designs may not accommodate the needs, skills, cognitive capacities, and/or contexts of use of the intended broader population of health consumers. This may result in challenges for consumers who use the health IT systems, and could lead to limitations in adoption if the diversity of user attributes has not been adequately considered by health IT designers.ObjectiveThe objective of this paper is to propose how users’ needs and competences can be taken into account when designing new information and communications technology solutions in health care by expanding the user-task-context matrix model with the domains of a new concept of eHealth literacy.MethodsThis approach expands an existing method for supporting health IT system development, which advocates use of a three-dimensional user-task-context matrix to comprehensively identify the users of health IT systems, and what their needs and requirements are under differing contexts of use. The extension of this model involved including knowledge about users’ competences within the seven domains of eHealth literacy, which had been identified based on systematic engagement with computer scientists, academics, health professionals, and patients recruited from various patient organizations and primary care. A concept map was constructed based on a structured brainstorm procedure, card sorting, and computational analysis.ResultsThe new eHealth literacy concept (based on 7 domains) was incorporated as a key factor in expanding the user-task-context matrix to describe and qualify user requirements and understanding related to eHealth literacy. This resulted in an expanded framework and a five-step process, which can support health IT designers in understanding and more accurately addressing end-users’ needs, capabilities, and contexts to improve effectiveness and broader applicability of consumer-focused health IT systems. It is anticipated that the framework will also be useful for policy makers involved in the planning, procuring, and funding of eHealth infrastructure, applications, and services.ConclusionsDeveloping effective eHealth products requires complete understanding of the end-users’ needs from multiple perspectives. In this paper, we have proposed and detailed a framework for modeling users’ needs for designing eHealth systems that merges prior work in development of a user-task-context matrix with the emerging area of eHealth literacy. This framework is intende...

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Section: Discussionmentioning

confidence: 99%

Enhancing the Effectiveness of Consumer-Focused Health Information Technology Systems Through eHealth Literacy: A Framework for Understanding Users' Needs

Kayser

Kushniruk²,

Osborne³

et al. 2015

JMIR Human Factors

144

109

View full text Add to dashboard Cite

show abstract

“…Furthermore, one of the reasons for high ratings might be that an overarching trust in a physician might be associated with patients’ trust and satisfaction in the physician's EHR use regardless of interaction style. A previous study also indicated that patient trust in physicians influences patients’ perceptions of physicians’ technology use (Montague & Asan, 2012). Another reason might be that patients mostly see only their physicians and assume their physicians’ interaction with the EHR is the ideal one, since they do not have a chance to compare with other physicians’ interaction styles.…”

Section: Discussionmentioning

confidence: 94%

“…ease of use and interaction style). These cues influence the patient’s perceptions of the work system as a whole and of individual system elements (Montague & Asan, 2012). The provider’s use of technology can also affect communicative behaviors.…”

Section: Introductionmentioning

confidence: 99%

Physician interactions with electronic health records in primary care

Asan

Montague

2012

Health Systems

Self Cite

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Objective It is essential to design technologies and systems that promote appropriate interactions between physicians and patients. This study explored how physicians interact with Electronic Health Records (EHRs) to understand the qualities of the interaction between the physician and the EHR that may contribute to positive physician-patient interactions. Study Design Video-taped observations of 100 medical consultations were used to evaluate interaction patterns between physicians and EHRs. Quantified observational methods were used to contribute to ecological validity. Methods Ten primary care physicians and 100 patients from five clinics participated in the study. Clinical encounters were recorded with video cameras and coded using a validated objective coding methodology in order to examine how physicians interact with electronic health records. Results Three distinct styles were identified that characterize physician interactions with the EHR: technology-centered, human-centered, and mixed. Physicians who used a technology-centered style spent more time typing and gazing at the computer during the visit. Physicians who used a mixed style shifted their attention and body language between their patients and the technology throughout the visit. Physicians who used the human-centered style spent the least amount of time typing and focused more on the patient. Conclusion A variety of EHR interaction styles may be effective in facilitating patient-centered care. However, potential drawbacks of each style exist and are discussed. Future research on this topic and design strategies for effective health information technology in primary care are also discussed.

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“…A study by Montague et al (2012) classified HCP behavior while using the EHR as technology-centered vs. human-centered and found that those who demonstrated human-centered behaviors had more positive verbal and non-verbal communication with patients compared with those who were focused more on typing and gazing at the computer. Poor communication between HCP and patients can also affect rapport, patient satisfaction, adherence to treatment, clinical outcomes, and patient trust (Shachak, Hadas-Dayagi, Ziv, & Reis, 2009;Tabler et al, 2014), highlighting the importance and need for solutions to preserve the connection that patients need with their providers.…”

Section: Acknowledgmentsmentioning

confidence: 99%

“…A strength from the analysis showed despite patients' concerns with security and privacy, patient's perceived quality of care fosters trust and builds the patientprovider relationship. The population may be willing to accept greater privacy risks as a trade-off for greater quality of care (Walker et al, 2017).Another study byMontague and Asan (2012) also investigated patient trust in health technology and the relationship with care providers. Data was collected from a Trust in Medical Technology instrument.…”

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confidence: 99%

Patient Perceptions of Google Glass in the Outpatient Dermatology Setting

Odenheimer

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PATIENT PERCEPTIONS OF GOOGLE GLASS IN THE OUTPATIENT DERMATOLOGY SETTING Background: The ubiquitous use of electronic health record (EHRs) during medical office visits using a computer monitor and keyboard can be distracting and disrupt patient-healthcare provider (HCP) non-verbal eye contact cues, which are integral to effective communication. Provider use of a remote medical scribe with face-mounted eyeglass technology, such as Google Glass (GG), may preserve patient-HCP communication in the healthcare setting by allowing providers to access other parts of the patient's EHR (e.g. laboratory results, current medications, immunization records) all while maintaining direct eye contact with their patients. The medical scribe is able to chart patient encounters in real-time working on or off site, documenting the visit directly into the EHR and freeing the HCP to focus only on the patient.Objective: The purpose of this study was to examine patient perceptions of their interaction with a HCP who used GG with a remote medical scribe during office visits. Additionally, the author sought to identify any associations between patient privacy and trust in their HCP when GG is used in the medical office setting.Methods: For this descriptive, cross-sectional study, a convenience sample of patients was recruited from an outpatient dermatology clinic in Northern California. Participants provided demographic data and completed a 12-item questionnaire to assess their familiarity, comfort, privacy, and perceptions following routine office visits with a HCP where GG was used to document the clinical encounter. Data were analyzed using appropriate descriptive and inferential statistics. Results:Over half (59.4%, n = 102) of the 170 study participants were female, Caucasian (60%, n = 102), Asian (24.1%, n = 41), college-educated (89%, n = 151), and ranged between 18 and 90 years of age (M = 50.5, SD = 17.4). The majority of participants (69.4%, n = 118) were familiar with GG, not concerned with a privacy issues (77.6%, n = 132), and stated the use of GG did not affect their trust in the HCP (81.8%, n = 139). Moreover, participants comfortable with the use of GG were less likely to be concerned about privacy (p < .001) andparticipants who trusted their HCP were less likely to be concerned about them using GG (p < .009). Almost one third (29%, n = 49) stated they would likely adopt technology early on and 87% (n = 148) preferred their HCP use GG if it delivered better care. Conclusions:Study findings support the use of GG for outpatient dermatology visits. Future research should explore the use of GG in other areas of healthcare and strive to include a diverse socioeconomic patient population in study samples.

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Trust in technology-mediated collaborative health encounters: Constructing trust in passive user interactions with technologies

Cited by 25 publications

References 19 publications

Enhancing the Effectiveness of Consumer-Focused Health Information Technology Systems Through eHealth Literacy: A Framework for Understanding Users' Needs

Enhancing the Effectiveness of Consumer-Focused Health Information Technology Systems Through eHealth Literacy: A Framework for Understanding Users' Needs

Physician interactions with electronic health records in primary care

Patient Perceptions of Google Glass in the Outpatient Dermatology Setting

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