The desktop, or the top of the desk? The relative usefulness of household features for personal health information management.

Sixty percent of the US population manages at least one chronic illness. For these patients, personal health information management (PHIM) is an integral part of daily life, and largely occurs within the home. However, the way in which the home supports PHIM has not been systematically investigated.

Home is where the head is: a distributed cognition account of personal health information management in the home among those with chronic illness.

Managing chronic illness requires personal health information management (PHIM) to be performed by lay individuals. Paramount to understanding the PHIM process is understanding the sociotechnical system in which it frequently occurs: the home environment. We combined distributed cognition theory and the patient work system model to investigate how characteristics of the home interact with the cognitive work of PHIM.

Health@Home Moves All About the House!

It is now well recognized that patients play an important and active role in self-care and disease management, and many of these activities happen in their homes. Information technologies to support such care might be better used if they were designed taking into account the physical context of the home and the health information management needs of the residents. We conducted home-based interviews of 20 adults including an extensive analysis of their personal health information management (PHIM) tasks.

SafeHOME: Promoting Safe Transitions to the Home.

This paper introduces the SafeHome Simulator system, a set of immersive Virtual Reality Training tools and display systems to train patients in safe discharge procedures in captured environments of their actual houses. The aim is to lower patient readmission by significantly improving discharge planning and training. The SafeHOME Simulator is a project currently under review.

vizHOME--A context-based home assessment: Preliminary implications for informatics.

The rapid migration of health care from the institution to the home presents a plethora of consumer health technology options.. The fit of these technologies to the users' actual task performance and environment remains to be explored.

Virtualizing living and working spaces: Proof of concept for a biomedical space-replication methodology.

The physical spaces within which the work of health occurs - the home, the intensive care unit, the emergency room, even the bedroom - influence the manner in which behaviors unfold, and may contribute to efficacy and effectiveness of health interventions. Yet the study of such complex workspaces is difficult. Health care environments are complex, chaotic workspaces that do not lend themselves to the typical assessment approaches used in other industrial settings.

Project HealthDesign: a preliminary program-level report.

Advancements in the health information technology that brought personal health records to individuals have opened the door to new insights concerning the cues people use to monitor health in their everyday lives. In order to evaluate the impact of capturing, storing, and integrating these observations of daily living (ODLs) into the clinical care process, Project HealthDesign selected five teams to create and analyze mobile health applications with ODLs in mind. These teams targeted underserved, minority populations with at least two chronic conditions.

Observations of daily living: putting the "personal" in personal health records.

Keeping individuals aware of their own health is a global challenge in health care. Observations of Daily Living (ODLs), cues to health that are derived from and personally meaningful to an individual, provide a detailed picture of one's experience of health. Project HealthDesign, an 8-year initiative of the Robert Wood Johnson Foundation, is investigating ODLs and devising innovative ways of tracking them through personal health record deployment in diverse communities and health care settings.

Technology-enhanced practice for patients with chronic cardiac disease: home implementation and evaluation.

Objective: This 3-year field experiment engaged 60 nurses and 282 patients in the design and evaluation of an innovative home-care nursing model, referred to as technology-enhanced practice (TEP).

Methods: Nurses using TEP augmented the usual care with a web-based resource (HeartCareII) that provided patients with self-management information, self-monitoring tools, and messaging services.

Results: Patients exposed to TEP demonstrated better quality of life and self-management of chronic heart disease during the first 4 weeks, and were no more likely than patients in usual care to make unplanned visits to a clinician or hospital.

Project HealthDesign: rethinking the power and potential of personal health records.

Project HealthDesign, a multi-year, multi-site project sponsored by the Robert Wood Johnson Foundation with additional support from the California HealthCare Foundation, is designed to stimulate innovation in personal health records (PHRs). Project HealthDesign teams employed user-centered design processes to create designs and prototypes of computer-based applications to support and enhance human health for a wide range of patients, from children with chronic health conditions to elders transitioning from hospital to home. A program design philosophy encouraged designers to envision PHRs as a suite of personal health information management tools, or applications, separate from, but drawing upon, personal health data from a variety of sources.

Human factors and ergonomics in home care: Current concerns and future considerations for health information technology.

Sicker patients with greater care needs are being discharged to their homes to assume responsibility for their own care with fewer nurses available to aid them. This situation brings with it a host of human factors and ergonomic (HFE) concerns, both for the home care nurse and the home dwelling patient, that can affect quality of care and patient safety. Many of these concerns are related to the critical home care tasks of information access, communication, and patient self-monitoring and self-management.

Project HealthDesign: enhancing action through information.

Project HealthDesign is a country-wide initiative in the United States designed to stimulate innovation in personal health records (PHRs). Nine grantee teams engaged in an 18-month long design and prototyping process. Two teams addressed the needs of children and adolescents; three created novel approaches to help adults prevent or manage metabolic syndrome; three groups employed interface innovations to assist patients with chronic care management and one team devised a novel calendaring system to assist patients undergoing complex medical/surgical treatments to integrate care processes into their daily lives.

HeartCareII: patients' use of a home care web resource.

In a six-month randomized field experiment our team evaluated the impact of a technology-enhanced practice (TEP) model compared to the usual care delivered by home care nurses. Research staff provided computers and technical assistance; home care visit nurses trained patients in the use of the components of the HeartCareII website most relevant to their care needs. The purpose of this paper is to explore participant exposure to the web-based HeartCareII resources, the technical core of the TEP.

Project HealthDesign: stimulating the next generation of personal health records.

Project HealthDesign is a national program designed to rethink the power and potential of personal health to rethink the power and potential of personal health records. It intends to stimulate development of new personal health management tools by harnessing the content of the personal health record and making advice, recommendations, and data-tracking tools available to lay people. The program goals include creating a set of prototype personal health records applications, deriving the core functions needed to support interoperable 'plug-and-play' resources for managing health challenges, and addressing the ethical, legal, and social issues that confront the development of computer tools to promote health actions.

HeartCareII: home care support for patients with chronic cardiac disease.

Systematic engagement of patients in disease management requires design and deployment of innovative technologies that complement and extend professional nursing services. We describe here a model of nursing practice that capitalizes on a web-based resource (HeartCareII) to support patient self-management, symptom interpretation, and self-monitoring. Research staff provided computers and technical assistance; visit nurses trained patients in the components of the HeartCareII Website most relevant to their care needs.

Development of an instrument to measure technology acceptance among homecare patients with heart disease.

To monitor the experience of participants in a field evaluation of a home care Web support service we developed a survey to measure patient technology acceptance. Predictors of the acceptance model were selected from the technology acceptance literature. Cognitive interviewing was used to improve the validity of the survey items.

Designing study nurses' training to enhance research integrity: a macroergonomic approach.

Successful field evaluation of informatics initiatives designed to create technology-enhanced professional practice relies on adequate training of experimental participants. However, such training presents design, implementation and evaluation challenges. A macroergonomic approach, focusing on an organizational view of people, technology, task and environment interactions in work systems, provides a framework for training that allows anticipation and compensation for challenges.

Creating technology-enhanced practice: A university-home care-corporate alliance.

Insuring full benefit of consumer health informatics innovations requires integrating the technology into nursing practice, yet many valuable innovations are developed in research projects and never reach full integration. To avoid this outcome, a team of researchers partnered with a home care agency's staff and patients and their corporate parent's Information Systems and Research group to create a Technology-Enhanced Practice (TEP) designed to enhance care of home bound patients and their family care givers. The technology core of TEP, the HeartCare2 web site, was built in a collaborative process and deployed within the existing patient portal of the clinical partner.

Designing a technology enhanced practice for home nursing care of patients with congestive heart failure.

This paper describes the process we used to design the HeartCare website to support Technology Enhanced Practice (TEP) for home care nurses engaged in providing care for patients with Congestive Heart Failure (CHF). Composed of communication, information, and self-monitoring functions, the HeartCare website is aimed at supporting best practice nursing care for these patients. Its unique focus is professional practice, thus the scope of this project is greater and more abstract than those focusing on a task or set of activities.

Design and testing of an interactive smoking cessation intervention for inner-city women.

The purpose of this study was to design and test the usability of a computer-mediated smoking cessation program for inner-city women. Design and content were developed consistent with principles of user-centered design. Formative and summative evaluation strategies were utilized in its testing.

Usability testing and outcomes of an interactive computer program to promote smoking cessation in low income women.

The purpose of this study was to develop and test an interactive computer-mediated smoking cessation program for inner-city women. A non-probability sample of 100 women who receive care at an inner-city community health center in Indianapolis participated in the usability study. Women completed the computer program in the clinic following baseline data collection.