TY - JOUR
T1 - Development process of a mobile electronic medical record for nurses
T2 - A single case study
AU - Vossebeld, Danielle M.
AU - Puik, Erik C.N.
AU - Jaspers, Joris E.N.
AU - Schuurmans, Marieke J.
N1 - Funding Information:
The principal author thanks the HU University for Applied Sciences Utrecht for funding her PhD candidacy at the University Medical Center. Special thanks are also due to the MEMR project manager and to the nurses and nurse managers at the case study hospital, for the open sharing of information.
Publisher Copyright:
© 2019 The Author(s).
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2019/1/14
Y1 - 2019/1/14
N2 - Background: With the growing shortage of nurses, labor-saving technology has become more important. In health care practice, however, the fit with innovations is not easy. The aim of this study is to analyze the development of a mobile input device for electronic medical records (MEMR), a potentially labor-saving application supported by nurses, that failed to meet the needs of nurses after development. Method: In a case study, we used an axiomatic design framework as an evaluation tool to visualize the mismatches between customer needs and the design parameters of the MEMR, and trace these mismatches back to (preliminary) decisions in the development process. We applied a mixed-method research design that consisted of analyzing of 118 external and internal files and working documents, 29 interviews and shorter inquiries, a user test, and an observation of use. By factoring and grouping the findings, we analyzed the relevant categories of mismatches. Results: The involvement of nurses during the development was extensive, but not all feedback was, or could not be, used effectively to improve the MEMR. The mismatches with the most impact were found to be: (1) suboptimal supportive technology, (2) limited functionality of the app and input device, and (3) disruption of nurses' workflow. Most mismatches were known by the IT department when the MEMR was offered to the units as a product. Development of the MEMR came to a halt because of limited use. Conclusion: Choices for design parameters, made during the development of labor-saving technology for nurses, may conflict with the customer needs of nurses. Even though the causes of mismatches were mentioned by the IT department, the nurse managers acquired the MEMR based on the idea behind the app. The effects of the chosen design parameters should not only be compared to the customer needs, but also be assessed with nurses and nurse managers for the expected effect on the workflow.
AB - Background: With the growing shortage of nurses, labor-saving technology has become more important. In health care practice, however, the fit with innovations is not easy. The aim of this study is to analyze the development of a mobile input device for electronic medical records (MEMR), a potentially labor-saving application supported by nurses, that failed to meet the needs of nurses after development. Method: In a case study, we used an axiomatic design framework as an evaluation tool to visualize the mismatches between customer needs and the design parameters of the MEMR, and trace these mismatches back to (preliminary) decisions in the development process. We applied a mixed-method research design that consisted of analyzing of 118 external and internal files and working documents, 29 interviews and shorter inquiries, a user test, and an observation of use. By factoring and grouping the findings, we analyzed the relevant categories of mismatches. Results: The involvement of nurses during the development was extensive, but not all feedback was, or could not be, used effectively to improve the MEMR. The mismatches with the most impact were found to be: (1) suboptimal supportive technology, (2) limited functionality of the app and input device, and (3) disruption of nurses' workflow. Most mismatches were known by the IT department when the MEMR was offered to the units as a product. Development of the MEMR came to a halt because of limited use. Conclusion: Choices for design parameters, made during the development of labor-saving technology for nurses, may conflict with the customer needs of nurses. Even though the causes of mismatches were mentioned by the IT department, the nurse managers acquired the MEMR based on the idea behind the app. The effects of the chosen design parameters should not only be compared to the customer needs, but also be assessed with nurses and nurse managers for the expected effect on the workflow.
KW - Axiomatic design
KW - Customer needs
KW - Health information system
KW - mHealth
KW - Mobile application
KW - Mobile EMR
KW - Nurses
KW - Product development process
KW - Humans
KW - Nursing Staff, Hospital
KW - Mobile Applications
KW - Telemedicine
KW - Adult
KW - Medical Informatics Applications
KW - Electronic Health Records
KW - Software Design
UR - http://www.scopus.com/inward/record.url?scp=85059953114&partnerID=8YFLogxK
U2 - 10.1186/s12911-018-0726-3
DO - 10.1186/s12911-018-0726-3
M3 - Article
C2 - 30642324
AN - SCOPUS:85059953114
SN - 1472-6947
VL - 19
JO - BMC Medical Informatics and Decision Making
JF - BMC Medical Informatics and Decision Making
IS - 1
M1 - 11
ER -