Kenton T. Unruh

Personal health information management

Integrating personal health information helps people manage their lives and actively participate in their own health care.

Catalyzing social support for breast cancer patients

Social support is a critical, yet underutilized resource when undergoing cancer care. Underutilization occurs in two conditions: (a) when patients fail to seek out information, material assistance, and emotional support from family and friends or (b) when family and friends fail to meet the individualized needs and preferences of patients. Social networks are most effective when kept up to date on the patients status, yet updating everyone takes effort that patients cannot always put in. To improve this situation, we describe the results of our participatory design activities with breast cancer patients. During this process, we uncovered the information a social network needs to stay informed as well as a host of barriers to social support that technology could help break down. Our resulting prototype, built using Facebook Connect, includes explicit features to reduce these barriers and thus, promote the healthy outcomes associated with strong social support.

Patients as actors: The patient's role in detecting, preventing, and recovering from medical errors

PURPOSE Patients have the most to gain from reducing medical errors; yet, little research has been done to investigate the role they could or already do play in detecting and preventing errors in their own health care. The purpose of this study is to examine patients role in detecting, preventing, and recovering from medical errors in outpatient oncology. METHODS In this paper, we use cognitive work analysis and Rasmussens taxonomy of human performance to describe five cases of medical errors that occurred in an outpatient, cancer-care setting. We detail the role of the patient in each case, and analyze each role using constructs from previous studies of human behavior and errors. RESULTS Observational data indicates that patients engage in a range of tasks that identify, prevent, and recover from medical errors in outpatient cancer care. The results of this study point to the importance of considering patients and their work in both the design of patient-care information systems and the structure of clinical-care environments that enable safe and effective health care.

Information Communities: Characteristics Gleaned from Studies of Three Online Networks

Digital network infrastructures such as community networks have heralded powerful new ways for enhancing peoples quality of life. We argue that the Internet has further facilitated the creation of information communities: constituencies united by a common interest in building and increasing access to sets of dynamic, linked, and varying information resources. Using data from a two-year study of three community networks, we describe five defining characteristics of effective information communities: (1) emphasis on collaboration among diverse information providers, (2) capacity to form around peoples needs to access and use information, (3) capacity to exploit the information sharing qualities of emerging technologies, (4) ability to transcend barriers to information-sharing, and (5) capacity to foster social connectedness.

Impact of a Telehealth Program That Delivers Remote Consultation and Longitudinal Mentorship to Community HIV Providers

Longitudinal mentoring and consultation via real-time interactive video increased community provider HIV knowledge and confidence, while decreasing professional isolation. ECHO telementoring effectively delivers clinical education and support and has potential to increase HIV care capacity across broad geographic regions.

Towards effective evaluation of digital community information systems

Digital Community Information Systems (CIS) are increasing in both size and scale. These systems help people obtain community information (CI) for the myriad situations that arise in everyday life. As these systems migrate to the online environment, increasing complexities and scale provide the impetus for improvements in system design. System re-design, however, relies on the effective evaluation of digital CIS. Despite the plethora of evaluation frameworks from the systems, organizational, and information retrieval fields, minimal research has directly addressed the issue of digital CIS evaluation. Following a selective review of digital CIS and evaluation approaches, a layered evaluation framework is proposed to guide the evaluation of digital CIS.

Creating a National HIV Curriculum

In recent years, the HIV care provider workforce has not kept pace with an expanding HIV epidemic. To effectively address this HIV workforce shortage, a multipronged approach is needed that includes high-quality, easily accessible, up-to-date HIV education for trainees and practicing providers. Toward this objective, the University of Washington, in collaboration with the AIDS Education and Training Center National Coordinating Resource Center, is developing a modular, dynamic curriculum that addresses the entire spectrum of the HIV care continuum. Herein, we outline the general principles, content, organization, and features of this federally funded National HIV Curriculum, which allows for longitudinal, active, self-directed learning, as well as real-time evaluation, tracking, and feedback at the individual and group level. The online curriculum, which is in development, will provide a free, comprehensive, interactive HIV training and resource tool that can support national efforts to expand and strengthen the United States HIV clinical care workforce.

Evaluation of digital community information systems

Community information systems provide a critical link between local resources and residents. While online versions of these systems have potential benefits, a systematic evaluation framework is needed to analyze and document realized impacts. Based on data from a nation-wide study of digital community information systems, an evaluation framework is proposed.