Collaboration between Healthcare Providers through ICT “The Social Requirements of Health 2.0 applications” - Pieter Duysburgh - eHealth conference Istanbul 23-25/09/2009

Introduction 2

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Outline 1.The project: Share4Health 2.Health User-Centered design 4.Characteristics of collaboration in healthcare 5.Social requirements of health The next step 4

Outline 1.The project: Share4Health 2.Health User-centered design 4.Characteristics of collaboration in healthcare 5.Social requirements of health The next step 5

1. The project: Share4Health IBBT Project (Interdisciplinary Institute for Broadband Technology)  Both industrial and academic partners  Multidisciplinary research teams 6

1. The project: Share4Health 7 Create a platform for sharing information between physicians and pharmacists Provide extra services on top of that platform Medication record Patient summary Patient consent Decision support Health 2.0 functionalities

8 XDS Radiologist XDS reposi tory GP XDS reposi tory Patient XDS reposi tory Pharmacist XDS reposi tory Hospital XDS reposi tory Home Care XDS reposi tory XDS registry authorizat ion documen t metadata request token grant token deny XDS principle: Based on a central registry of metadata, distributed information can be accessed Security can be enforced by an external agent

1. Share4Health Challenge: When we take the Share4Health platform as a given, what health 2.0 applications can then be developed? Approach: User-centered design Method: literature research, discourse analysis, expert interviews 9

2. Health The project: Share4Health 2.Health User-centered design 4.Characteristics of collaboration in healthcare 5.Social requirements of health The next step 10

2. Health 2.0 What is Health 2.0? 11 Patientslikeme.com Sermo.com MyMedLab.com DocCheck Hello Health Google Health Healtheva Ozmosis DoctorWorld.NET Microsoft HealthVault

2. Health 2.0: functionality oriented 12

2. Health 2.0: efficiency oriented  Efficiency oriented 13

2. Health 2.0: grassroot oriented 14

Social networking Participation Openness Collaboration Collaborative filtering processes 2. Health 2.0  5 elements of Günter Eysenbach:  Social networking  Participation  Openness  Collaboration  Collaborative filtering processes 15

3. User-centered design 1.The project: Share4Health 2.Health User-centered design 4.Characteristics of collaboration in healthcare 5.Social requirements of health The next step 16

3. User-centered design “the design tradition that refers to the user to drive, inspire and inform the design development process” (E. Sanders & P.J. Stappers, 2008) 17

3. User-centered design  Iterative process: 18 Socio-technical situation Social and technical requirements Social and technical recommendations Social and technical choice

3. User-centered design: social requirements Social requirements are the users’ needs related to the use of an application in interaction with others. As health 2.0 applications have collaboration as a central characteristic, social requirements become very relevant in the creation process. 19

3. User-centered design: CSCW research CSCW (Computer-Supported Cooperative Work) research Challenges to CSCW or groupware: 20 Translate these findings to a healthcare context Understanding (the exceptions in) workflow Awareness of other users Importance of incentives Critical mass Difficulty of the adoption process Disruption of social processes Differing goals, knowledge, meanings and histories Visibility of communication exchange

4. Characteristics of collaboration in healthcare 1.The project: Share4Health 2.Health User-Centered design 4.Characteristics of collaboration in healthcare 5.Social requirements of health The next step 21

4. Characteristics of collaboration in healthcare Professional status: the ‘art’ of being a healthcare professional 22

4. Characteristics of collaboration in healthcare Patient centeredness 23

4. Characteristics of collaboration in healthcare Ambiguity in medicine 24

4. Characteristics of collaboration in healthcare Complex organization of healthcare 25

5. Social requirements of health 2.0 apps 1.The project: Share4Health 2.Health User-Centered design 4.Characteristics of collaboration in healthcare 5.Social requirements of health The next step 26

5. The social requirements of health 2.0 apps 27 Professional status Professional status Ambiguity in medicine Ambiguity in medicine Patient centeredness Patient centeredness Complexity of healthcare Complexity of healthcare Supported autonomy Supported autonomy Fluid collaboration Fluid collaboration Rationale in context Rationale in context

6. The next step 1.The project: Share4Health 2.Health User-Centered design 4.Characteristics of collaboration in healthcare 5.Social requirements of health The next step 28

6. The next step 29 Sota on web 2.0 and mash-up technology + Social requirements The multidisciplinary team worked on 6 scenarios After two sesions with lead users of healthcare IT, the most favourable scenario was retained

All medication records of a patient (EPR, google health, etc): Drug A Drug B All medication records of a patient (EPR, google health, etc): Drug A Drug B 6. The next step: conceptual medication interaction scenario 30 Patient drug C Drug A + Drug C

7. Conclusions  Social requirements are elementary as health 2.0 applications have collaboration as a central characteristic  The 3 social requirements presented here (supported autonomy, rationale in context, and fluid collaboration) are generic and will have to be further specified when the functionalities of the application and the main users are known. 31

Thank you 32