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Evaluating Health Information Systems Using Ontologies
Blekinge Institute of Technology, Faculty of Engineering, Department of Health. (Applied Health Technology)ORCID iD: 0000-0002-0316-548X
Blekinge Institute of Technology, Faculty of Engineering, Department of Health. (Applied Health Technology)ORCID iD: 0000-0001-9870-8477
Blekinge Institute of Technology, Faculty of Engineering, Department of Mechanical Engineering. (Product Development Research Lab)ORCID iD: 0000-0002-9662-4576
Blekinge Institute of Technology, Faculty of Computing, Department of Software Engineering. University of Applied Sciences and Arts Northwestern Switzerland. (Software Engineering Research Laboratory)ORCID iD: 0000-0001-7368-4448
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2016 (English)In: JMIR Medical Informatics, ISSN 2291-9694, Vol. 4, no 2, article id e20Article in journal (Refereed) Published
Abstract [en]

Background: There are several frameworks that attempt to address the challenges of evaluation of health information systems by offering models, methods, and guidelines about what to evaluate, how to evaluate, and how to report the evaluation results. Model-based evaluation frameworks usually suggest universally applicable evaluation aspects but do not consider case-specific aspects. On the other hand, evaluation frameworks that are case specific, by eliciting user requirements, limit their output to the evaluation aspects suggested by the users in the early phases of system development. In addition, these case-specific approaches extract different sets of evaluation aspects from each case, making it challenging to collectively compare, unify, or aggregate the evaluation of a set of heterogeneous health information systems.

Objectives: The aim of this paper is to find a method capable of suggesting evaluation aspects for a set of one or more health information systems—whether similar or heterogeneous—by organizing, unifying, and aggregating the quality attributes extracted from those systems and from an external evaluation framework.

Methods: On the basis of the available literature in semantic networks and ontologies, a method (called Unified eValuation using Ontology; UVON) was developed that can organize, unify, and aggregate the quality attributes of several health information systems into a tree-style ontology structure. The method was extended to integrate its generated ontology with the evaluation aspects suggested by model-based evaluation frameworks. An approach was developed to extract evaluation aspects from the ontology that also considers evaluation case practicalities such as the maximum number of evaluation aspects to be measured or their required degree of specificity. The method was applied and tested in Future Internet Social and Technological Alignment Research (FI-STAR), a project of 7 cloud-based eHealth applications that were developed and deployed across European Union countries.

Results: The relevance of the evaluation aspects created by the UVON method for the FI-STAR project was validated by the corresponding stakeholders of each case. These evaluation aspects were extracted from a UVON-generated ontology structure that reflects both the internally declared required quality attributes in the 7 eHealth applications of the FI-STAR project and the evaluation aspects recommended by the Model for ASsessment of Telemedicine applications (MAST) evaluation framework. The extracted evaluation aspects were used to create questionnaires (for the corresponding patients and health professionals) to evaluate each individual case and the whole of the FI-STAR project.

Conclusions: The UVON method can provide a relevant set of evaluation aspects for a heterogeneous set of health information systems by organizing, unifying, and aggregating the quality attributes through ontological structures. Those quality attributes can be either suggested by evaluation models or elicited from the stakeholders of those systems in the form of system requirements. The method continues to be systematic, context sensitive, and relevant across a heterogeneous set of health information systems.

Place, publisher, year, edition, pages
JMIR Publications , 2016. Vol. 4, no 2, article id e20
Keywords [en]
health information systems; ontologies; evaluation; technology assessment; biomedical
National Category
Information Systems
Identifiers
URN: urn:nbn:se:bth-12114DOI: 10.2196/medinform.5185ISI: 000387986800010OAI: oai:DiVA.org:bth-12114DiVA, id: diva2:938404
Funder
EU, FP7, Seventh Framework Programme, 604691Available from: 2016-06-16 Created: 2016-06-16 Last updated: 2019-10-29Bibliographically approved
In thesis
1. Evaluating Success Factors of Health Information Systems
Open this publication in new window or tab >>Evaluating Success Factors of Health Information Systems
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Health information systems are our technological response to the growing demand for health care. However, their success in their mission can be challenging due to the complexity of evaluating technological interventions in health care. In the series of studies compiled in this dissertation, we looked at the evaluation of these systems. We focused on the evaluation of factors that lead to success, where success is indicated by user satisfaction and can be induced by both intervention-specific and individual-specific factors.

Study 1 developed a method, called UVON, to elicit and organise the user-demanded qualities in the outcomes of the health information system intervention. Through the application of the UVON method in the FI-STAR project, an EU project which developed and deployed seven e-health applications in seven member countries, ten categories of quality and their subcategories were identified. These qualities formed two questionnaires, specific to the patient and health professional users. Through the questionnaires, the patients and health-professionals users evaluated and graded both the occurrence of those demanded qualities in the project outcomes and their general satisfaction.

Study 2 analysed the survey results to find out which of those ten qualities have the highest impact on satisfaction or can predict it better. Two partial least squares structural equation modelling (PLS-SEM) models were constructed, for the patient and health professionals, based on the Unified eValuation using ONtology (UVON) and survey outputs. The models showed that effectiveness is an important quality in creating satisfaction for both user groups. Besides, affordability for the health professionals and efficiency plus safety for the patients were the most influential. A satisfaction index is also introduced for simple and fast inferring of the changes in the outcome qualities.

Study 5 recruited outputs and learnings from studies 1 and 2 to design a system that partially automates the process of evaluating success factors in health information systems, making it continuous and real-time, and replacing hard-to-run surveys with automatically captured indicators and analytics.

Study 3 focused on individual-specific factors in using health information systems, particularly the technophilia personality trait. A short six-items instrument, called TechPH, was designed to measure technophilia in users, tuned for older users. The study recruited empirical data from the Swedish National Study on Aging and Care (SNAC) project. Two factors, labelled techAnxiety and techEnthusiams, are identified by the factor analysis method. A TechPH score was introduced as a scalar measurement of technophilia.

Study 4 elicited and discussed the ethical challenges of evaluating and researching health information systems. Both a scoping review and a novel systematic postulation approach were recruited to identify twenty ethical challenges. The identified ethical challenges were discussed and mapped into a three-dimensional space of evaluation stages, demanded qualities, and major involving entities (stakeholder and artefacts), which fosters further postulation of ethical challenges.

Place, publisher, year, edition, pages
Karlskrona: Blekinge Tekniska Högskola, 2019. p. 340
Series
Blekinge Institute of Technology Doctoral Dissertation Series, ISSN 1653-2090 ; 14
Keywords
Health Information Systems, Health Information Technology, Health Informatics, eHealth, Digital Health, Evaluation, Information Systems Evaluation, Health Technology Assessment, User Satisfaction, Technophilia, Evaluation and Research Ethics, System Design
National Category
Other Electrical Engineering, Electronic Engineering, Information Engineering
Identifiers
urn:nbn:se:bth-18799 (URN)978-91-7295-387-1 (ISBN)
Public defence
2019-12-17, J1640, Campus Gräsvik, Karlskrona, 14:00 (English)
Opponent
Supervisors
Available from: 2019-10-29 Created: 2019-10-29 Last updated: 2019-12-06Bibliographically approved

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Eivazzadeh, ShahryarAnderberg, PeterLarsson, TobiasFricker, SamuelBerglund, Johan

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