Leonor Teixeira

User-centered requirements engineering in health information systems

The use of sophisticated information and communication technologies (ICTs) in the health care domain is a way to improve the quality of services. However, there are also hazards associated with the introduction of ICTs in this domain and a great number of projects have failed due to the lack of systematic consideration of human and other non-technology issues throughout the design or implementation process, particularly in the requirements engineering process. This paper presents the methodological approach followed in the design process of a web-based information system (WbIS) for managing the clinical information in hemophilia care, which integrates the values and practices of user-centered design (UCD) activities into the principles of software engineering, particularly in the phase of requirements engineering (RE). This process followed a paradigm that combines a grounded theory for data collection with an evolutionary design based on constant development and refinement of the generic domain model using three well-known methodological approaches: (a) object-oriented system analysis; (b) task analysis; and, (c) prototyping, in a triangulation work. This approach seems to be a good solution for the requirements engineering process in this particular case of the health care domain, since the inherent weaknesses of individual methods are reduced, and emergent requirements are easier to elicit. Moreover, the requirements triangulation matrix gives the opportunity to look across the results of all used methods and decide what requirements are critical for the system success.

Using Task Analysis to Improve the Requirements Elicitation in Health Information System

This paper describes the application of task analysis within the design process of a Web-based information system for managing clinical information in hemophilia care, in order to improve the requirements elicitation and, consequently, to validate the domain model obtained in a previous phase of the design process (system analysis). The use of task analysis in this case proved to be a practical and efficient way to improve the requirements engineering process by involving users in the design process.

Web-enabled registry of inherited bleeding disorders in Portugal: conditions and perception of the patients

Summary.  Local and national haemophilia registries are powerful instruments to support the healthcare and researchers and improve the communication between Comprehensive Haemophilia Diagnostic and Treatment Centres (HTCs) and patients. Hemo@care is an example of a Local Haemophilia Registry Systems (LHR_Sys) based on the Web, developed in collaboration with a HTC located in Portugal, to support the haemophilia treatments registry, collect and manage the clinical information and provide mechanisms to control the clotting factor concentrates (CFC) stock. To extend this solution (the hemo@care) to other Portuguese HTCs and consequently to meet the preconditions to create a National Haemophilia Registry Systems (NHR_Sys), a study based on a questionnaire was carried out at nationwide. This study aims to assess the conditions and motivations of people with haemophilia (PWH) geographically scattered throughout the country, to use a potential Web‐enabled registry with the purpose of replacing the traditional paper‐diaries, to understand their judgment about a potential NHR_Sys currently non‐existent in Portugal, and at the same time, to characterize demographically and pathologically those people at the nationwide. The results based on the analysis of 168 responses (response rate of 31%) confirmed the high prevalence of the disease in haemophilia A (75%) compared with haemophilia B (11.3%) and a large incidence in the severe levels, or the existence of people with mild severity without diagnosis and treatment. Furthermore, the results also revealed the need, conditions and motivation for using a registry system by PWH; thus it is deemed to justify the extension of the hemo@care to other HTCs in Portugal and consequently to create the NHR_Sys.

Requirements Engineering Using Mockups and Prototyping Tools: Developing a Healthcare Web-Application

Healthcare web-application development teams involve non-computer experts working (clinicians) on the requirements specification that is later processed by software engineers/analysts (conceptual model) and coded by software programmers (software project). The management of this process, which involves different levels of abstraction and professionals with different backgrounds, is often complex. As such, mediators and facilitator’s mechanisms for the requirements-gathering process and information transfer are needed. The main purpose of this work is to minimize the problems associated with this complex process, supporting the requirements engineering process of a healthcare web-application in a rapid prototyping model. The results proved that a rapid and functional prototyping model can improve the effectiveness of the requirement elicitation of any software development.

Modeling a Web-based Information System for managing clinical information in hemophilia care.

Nowadays, information systems combined with the Internet, have a significant role in data storage, as in the efficiency and promptness of data transfer and can offer a large contribute in managing and manipulating the information resulting from treatment and attendance of chronic patients, as hemophiliacs. On the other hand, the Internet also created the opportunity of patients to insert data concerning home treatments. This paper briefly describes the modeling process of a Web-based information system to help the management of inherited bleeding disorders integrating, diffusing and archiving large sets of information from heterogeneous sources in scope of the hemophilia care at the Hematology Service of Coimbra Hospital Center, in Portugal

Using participatory design in a health information system

This article describes the experience of developing an interactive Health Information System (iHIS) currently under test in a hospital, which benefited from the practices of the User-Centred Design (UCD), in a Participatory Design (PD) approach. Techniques from the Human-Computer Interaction (HCI) and/or Usability Engineering (UE), combined with traditional Software Engineering (SE), allowed an effective and usable solution from the users point of view. The good results usually achieved with this approach were confirmed. Despite these good results, we deem that if there is not some control of the procedure by the project manager, it may be difficult to end the requirement analysis, since requirement reformulation is fostered.

Portuguese Haemophilia Registry. Set of variables for a computerized solution.

National Patient Registries (NPR) have an important role in the management of haemophilia and other inherited bleeding disorders, representing powerful instruments to support healthcare and research. Computer software to assist the NPR is crucial, as it facilitates the introduction of the data from a national universe that will be centralized and merged into a unique location, thus ensuring a greater reliability and accuracy of the collected data, avoiding duplication of patients. In Portugal, despite the efforts and recognition of the need of a NPR, just recently the protocol for the establishment of the computer software to support the Portuguese National Registry of Haemophilia and other Congenital Coagulopathies (PorR H&CC) was approved. This paper aims to present this newly developed computerized solution, as well as to report the main variables and information that will be available. The development of this application, which includes a set of socio-demographic, clinical and treatment data, was based on the principles of WFH, and the database that supports the NPR, with anonymized data, is operated and maintained in accordance with the Data Protection Law. Currently, the first data are available on the application. Our focus now is to ensure more registries and continuous data entry in order to have complete information on the characterization of the haemophilia patient population in Portugal.

A Preliminary Usability Evaluation of Hemo@Care: A Web-Based Application for Managing Clinical Information in Hemophilia Care

In this work, an overall description of the methods used and the results obtained in the on-going evaluation of hemo@care is presented. To help understanding the methods and results, we first give an overview of the main functionalities of hemo@care , which is a web application to manage the clinical information in hemophilia care, developed to be used by hematologists, nursing staff and patients suffering from hemophilia. Following we described the methods used in this particular evaluation, and finally we present the main results and general conclusions of these preliminary usability evaluation.

Destination management systems: creation of value for visitors of tourism destinations

Considering the important role of information and communication technologies (ICTs) in tourism, a growing number of destination management organisations (DMOs) have been adopting more complex destination web-applications/websites to tourism destinations – destination management systems (DMSs). However, the concept of DMS is far from being consensual. The present study aims to clarify the concept of DMS by identifying the main differences between DMS and other DMO web-applications/websites regarding functionalities targeted at potential visitors of destinations. This study is carried out based on a comparison between DMS-specific and DMS-non-specific sources (papers and book chapters). The results suggest that the major difference between DMS and more traditional DMO websites relies in the transaction dimension. While DMS-non-specific reviewed sources tend to focus more on informational functionalities, DMS-specific studies clearly highlight transaction tools. The study highlights the need to develop DMS including a more varied range of transactional and communication/relationship functionalities.

Improving the management of chronic diseases using web-based technologies: an application in hemophilia care

Modern methods of information and communication that use web technologies provide an opportunity to facilitate closer communication between patients and healthcare providers, allowing a joint management of chronic diseases. This paper describes a web-based technological solution to support the management of inherited bleeding disorders integrating, diffusing and archiving large sets of data relating to the clinical practice of hemophilia care, more specifically the clinical practice at the Hematology Service of Coimbra Hospital Center (a Hemophilia Treatment Center located in Portugal).