Development process of a mobile electronic medical record for nurses: a single case study

Abstract 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 po...

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Main Authors: Danielle M. Vossebeld, Erik C. N. Puik, Joris E. N. Jaspers, Marieke J. Schuurmans
Format: Article
Language:English
Published: BMC 2019-01-01
Series:BMC Medical Informatics and Decision Making
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12911-018-0726-3
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author Danielle M. Vossebeld
Erik C. N. Puik
Joris E. N. Jaspers
Marieke J. Schuurmans
author_facet Danielle M. Vossebeld
Erik C. N. Puik
Joris E. N. Jaspers
Marieke J. Schuurmans
author_sort Danielle M. Vossebeld
collection DOAJ
description Abstract 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.
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spelling doaj.art-5b3a50a056294189beaf812f0efe11b92022-12-21T18:36:55ZengBMCBMC Medical Informatics and Decision Making1472-69472019-01-0119111210.1186/s12911-018-0726-3Development process of a mobile electronic medical record for nurses: a single case studyDanielle M. Vossebeld0Erik C. N. Puik1Joris E. N. Jaspers2Marieke J. Schuurmans3Research Centre for Healthy and Sustainable Living, HU University of Applied Sciences UtrechtResearch Centre for Healthy and Sustainable Living, HU University of Applied Sciences UtrechtDepartment of Medical Technology & Clinical Physics, University Medical Center UtrechtJulius Center, University Medical Center UtrechtAbstract 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.http://link.springer.com/article/10.1186/s12911-018-0726-3Mobile EMRmHealthHealth information systemMobile applicationAxiomatic designProduct development process
spellingShingle Danielle M. Vossebeld
Erik C. N. Puik
Joris E. N. Jaspers
Marieke J. Schuurmans
Development process of a mobile electronic medical record for nurses: a single case study
BMC Medical Informatics and Decision Making
Mobile EMR
mHealth
Health information system
Mobile application
Axiomatic design
Product development process
title Development process of a mobile electronic medical record for nurses: a single case study
title_full Development process of a mobile electronic medical record for nurses: a single case study
title_fullStr Development process of a mobile electronic medical record for nurses: a single case study
title_full_unstemmed Development process of a mobile electronic medical record for nurses: a single case study
title_short Development process of a mobile electronic medical record for nurses: a single case study
title_sort development process of a mobile electronic medical record for nurses a single case study
topic Mobile EMR
mHealth
Health information system
Mobile application
Axiomatic design
Product development process
url http://link.springer.com/article/10.1186/s12911-018-0726-3
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AT mariekejschuurmans developmentprocessofamobileelectronicmedicalrecordfornursesasinglecasestudy