james milewski mentor: yunan chen, assistant professor informatics consumer health informatics and...

JAMES MILEWSKIMENTOR: YUNAN CHEN, ASSISTANT PROFESSOR

INFORMATICS

Consumer health informatics and chronic illness: gathering requirements in context for a personal health information management

system

Personal Health Information ManagementPHIM

Why we engage in PHIM

PHIM Challenge Mediums + Distributed Sources

+ Demands of Health Care System = Work

Health Information at Home

Spheres of Influence on PHIM

Consumer Health Informatics:Approaching PHIM in the Home

Medical Informatics/Consumer Health Informatics CHI: Reaching the patient through computers

and telecommunication systems (Eysenback 2000)

Sociotechnical approach to explore interwoven networks of people, tools, routines, sources, and responsibilities of the patient

Previous Works

The concept of work in the home (Corbin 1985)

Privacy of Health: The consumer’s perspective. (Bartolo 2004)

The Work of Health Information Management in the Household (Moen 2005)

Information Work in the Chronic Experience (Souden 2008)

Why Diabetes?

Chronic Illness : 78% of health care expenditure (Holman 2005)

Previous work focused on diabetes Personal understandings of illness among people who

have type 2 diabetes (Hornsten et al 2004) Harnessing the potential of the Internet to

promote chronic illness self management: diabetes as an example of how well we are doing (Bull et al 2005)

Health communication and knowledge construction (Ginman et al 2003)

Purpose

Understand the in-home PHIM process of type 2 diabetes patients and their support group

TransitionsTechnologiesChallenges of managingHow info seeking and tech use change over

time

Methodology

Qualitative study based on in-depth interviews Participant Recruitment In-home session collecting data from

questionnaire, photos, and interviews

Questionnaire DataSources of Diabetes

Information

12 Patients with a mean of 11.5 years as a diabetic

Understanding of diabetes and its treatment

PATIENTS WERE ASKED TO RANK THE FOLLOWING AREAS WITH 1 BEING THE MOST DIFFICULT

Most Difficult Part of Managing Your Diabetes

Technology: “We’re you busy yesterday?” Technology: “We’re you busy yesterday?” Durable Media Durable Media

37 Photos

Transcription Coding

Using Grounded Theory: Independent coders sift, chart, and sort material according to key issues and themes until a consensus is reached for the codes.

Rely Eager Redundant Info

Don’t Track Memory Transit

Attitude Challenges Regimen

Q: Do you take info between doctors?I: No. (3, 22)

Transit

I always feel unfortunate that they don’t have a database that the doctors could feed it in, the web or something. (3, 27)

Eager

I just leave, ah, it in my blood monitor. I have never charted it (3, 99)

Rely

Preliminary Results and Implications

Patients with type 2 diabetes and their support networks Shift away from paper-based media to various

technologies Rely on IT-enabled diabetes management Eager for new technologies to augment the home-

based PHIM process

PHIM system adoption factors Perceived usefulness and the perceived ease of use

across the span of the disease

What’s next?

Cont’d gathering data: recruit 5 more participants

Extracting software requirements and use case scenarios

Prototype implementation and testing