Incompatible Images

This chapter investigates asthmatics’ reasons for not adopting an e-health system for asthma selfmanagement. An understanding of these reasons is particularly relevant, because clinical evidence indicates that, if used, such systems lead to better asthma management. The investigated asthma system is, however, based on a taken-for-granted image of asthmatics as, per se, striving to be symptom-free. This image is incompatible with interviewed asthmatics’ day-to-day performances of their asthma, and renders invisible (a) that their asthma performances emphasize an economy of good passages and of feeling capable, (b) that they achieve the objective of feeling capable in quite different ways, and (c) that feeling capable does not per se equal being symptom-free all the time. To attain long-term use of self-management systems and other patient-centred e-health systems, such systems must acknowledge and link into the manifold performances that comprise users’ ways of living with their disease.

Using Interaction Design to Improve Usability of a PHR User Interface Based on Visual Elements

This chapter presents a case study of using interaction design methods for exploring and testing usability and user experience of a Personal Health Record (PHR) user interface based on visual and graphical elements. To identify problems and improve the design of PHR user interface we conducted two taskoriented usability testing based on the think-aloud technique for observing users during their interaction with a high-fidelity PHR prototype, and questionnaires and semistructured interviews for measuring user satisfaction. Our study demonstrates that a user-centered approach to interaction design involving the final users in an iterative design-evaluation process is important for exploring innovative user interfaces and for identification of problems in the early stages of the development cycle of a PHR.

E-Health Marketing

In this chapter, we review key concepts, using the marketing mix framework, to identify the needs of healthcare consumers, and the tools and services that can fulfill these needs. Unlike traditional healthcare delivery, patient-centered e-health (PCEH) involves the consumer as a partner and has a number of marketing implications. A more informed understanding of PCEH will help practitioners and researchers to formulate marketing strategies that improve healthcare outcomes and are acceptable to patients.

Assessing a Patient-Centered E-Health Approach to Chronic Disease Self-Management

This chapter explores how in developing patient-centred e-health systems it is possible to accommodate heterogeneous characteristics of end-users and their diverse health and care contexts. It concurs with conventional sociotechnical design paradigms that argue systems must be easy to use, fulfill a perceived need, and present a clear value proposition to ensure successful adoption and utilisation by patients. The chapter also highlights the need for awareness of a number of key challenges relating to emerging discourses on ‘empowering patients’ and ‘e-health’. The implications of these challenges for the development of a truly patient-centred e-health approach are explored in a detailed case study. This chapter contributes to research focused on supporting patients to become genuine co-participants in their own care, health and well-being. However, it also acknowledges that part of the challenge of achieving this goal requires a focus on assisting clinicians to learn to respond to this shift in the autonomy of decision- making

Connecting with Ourselves and Others Online

In this chapter, we look at some fundamental aspects of communicating about ourselves and our health through technology. In particular, we examine how the social psychological theories of self-presentation and self-regulation might be applied to online health-communication. It is argued that the specific qualities of text-based communication might have unique benefits for health-communication through the interplay between the writing process and the concerns posed by health-issues. An understanding of how psychological processes are connected with online health communication is believed to be fundamental in understanding trends within self-help and user-driven health communication, and to predict possible outcomes of such behavior. Also, this knowledge might inform the design and development of patient-centered solutions for health-communication and heath-service delivery.

Exploring the Technology Adoption Needs of Patients Using E-Health

An extended version of the technology acceptance model (TAM) is applied to study hospital Web sites, one specific area of e-health. In a review of literature, five significant factors from TAM research are identified that are logically related to e-health sites from the user’s perspective: usefulness, ease of use, trust, privacy, and personalization. All five factors emerged in the data analysis of 30 participants using a hospital Web site. We discuss the implications of this study for guiding development of effective patient-centered e-health.

Perceptions of E-Health in Rural Communities

This chapter is drawn from a comprehensive study that examined the effect Human-Computer Interaction usability factors had on rural residents’ perception of trust in e-health services. Written comments provided by participants were examined to develop a qualitative assessment of dimensions that are important to rural residents’ perceptions of e-health. Identification of these dimensions will aid e-health system designers and administrators in creating better e-health applications.

Healthcare Quality and Cost Transparency Using Web-Based Tools

This chapter explores the use of Web sites to provide patients with understandable information about the quality and price of healthcare (healthcare transparency). Our first objective is to discuss patients’ perceptions of empowerment and need for quality and cost information when choosing medical providers and facilities for healthcare procedures. To meet this objective, we address issues of patient awareness of sources of healthcare quality and cost information, perceived responsibility for managing healthcare costs, and knowledge of appropriate actions to exercise choice of providers. Our second objective is to investigate the potential of Web-based tools, which provide healthcare quality and cost information, to facilitate patients’ decision-making processes regarding choice of provider for healthcare services, particularly common outpatient procedures. To meet this second objective, we use insights from usercentered design procedures (e.g., focus groups and in-depth interviews) associated with the development of a healthcare transparency Web-based tool.

Involving Patients and the Public in E-Health Research

This chapter deals with the principles and practice of patient and public involvement in e-health research, and discusses some of the issues raised. In the first part of this chapter, we discuss the problems of defining an “e-health consumer,” and discuss why, how and when to involve consumers in e-health research. We also set out principles to guide effective consumer involvement, and the benefits that this can bring in the e-health arena. In the second part of this chapter, we describe how consumers were successfully involved, through a variety of methods, in the development and evaluation of an Internet-based intervention to aid diabetes self-management. Patient and public involvement in research is not the same as undertaking research on patients or the public. It is about understanding, incorporating and benefiting from the relevant consumer perspective, at various levels, throughout the stages of a project.

Patient-Centered E-Health Design

This chapter introduces a series of techniques and tools useful for developing patient-centered e-health. As information technology (IT) is revolutionizing health care delivery, a wide range of personal health information management tools have become available to the patients. The variety and quality of information delivered by these tools will determine how useful consumers find them. Equally important is how the information is delivered. To create quality e-health, designers must attend to the needs and wants of users by engaging them in the design and testing processes. User-centered design (UCD) is a formal approach to ensuring that new products address the needs, wants, skills, and preferences of the user throughout the tool’s development. UCD is a design and evaluation process which pays special attention to the intended users, what they will do with the product, where they will use it, and what features they consider essential. This iterative approach ensures that users’ needs and wants are met and ultimately increases the likelihood users will accept the final product. This chapter focuses on UCD methods and techniques, giving examples of how to use them and when.