Research

Thesis Defense by Fenne Verhoeven MSc October 2^nd 2009

“When staff handle Staph - User-driven versus expert-driven communication of infection control guidelines”

Health care-associated infections cause thousands of preventable deaths each year. Therefore, it is crucial that health care workers (HCWs) adhere to infection control guidelines. Although most HCWs are aware of the rationale for guidelines, adherence is generally poor which might be caused by the guidelines’ expert-driven character. Where as traditionally, paper-based guidelines have a strong focus on scientific validation, regulation, and legislation, HCWs’ information need is rather action-oriented.

Based on extensive user-centred research involving HCWs, a website is developed that presents evidence-based guidelines as answers to questions that reflect HCWs’ practical informational needs. The guidelines are presented in multimodality in an action-oriented manner with links to additional resources, tables, figures, and videos next to an advanced question-answering system that enables HCWs to search for information using their own language. Evaluation studies showed that the website outperformed the traditional, paper-based guidelines with regard to efficiency (four minutes faster), effectiveness (40% more successfully) and user satisfaction.

The website appeared to ‘empower’ HCWs since it allowed them to take decisions for daily work practice, and thereby reduced infection control professionals’ workload. The website (www.mrsa-net.nl) has an average of 500 unique daily users and is ranked highly in Google (second/third position after entering MRSA).

This thesis provides the methodological steps and design principles necessary to communicate user-driven guidelines via a website suggesting how to optimally implement this website in daily work practice in order to enhance effective and efficient risk and crisis communication. Methicillin Resistant Staphylococcus aureus (also known as “hospital bacteria”) served as a case study for this thesis’s research, but the thesis might serve as a manual for the communication of guidelines regarding all types of infectious diseases, such as Mexican flu (new influenza A (H1N1)).

Promoter of this thesis is Prof. Dr. Michaël Steehouder, assistent-promotor is Dr. Lisette van Gemert-Pijnen

Date: Friday, October 2^nd 2009

Time: 14.45-16.00h

Place: University of Twente, Building Spiegel, room 2.

Research report on mobile technology national health portal kiesBeter.nl

The national health portal kiesBeter.nl is a project at RIVM. From this project an assignment was received to study KiesBeter’s prospects for mobile services. The final report was delivered to RIVM in time last August.

Several comparable mobile services have been investigated, with special attention to usability, informational and technological conditions. A literature review revealed that only a few national health portals worldwide use the M-channel. A ‘mobile website’ is available in 27% of the national health portals. A ‘mobile website’ of KiesBeter.nl however would be a temporary solution, because of the rapid developments in mobile technology.

KiesBeter.nl meets most of the requirements of the MWBP of the W3C. The website is being viewed ever more from mobile phones. The mobile services that could complement the services and objectives of KiesBeter are a text messaging service (sms) and Layar. The user of these services can search for the nearest health professionals like general practitioner, dentist or hospital. The information suits the development of a query ‘on the move’, is short and snappy, and provides no redundant information. More research is needed to identify the lead users - who best predict the success of a service - and the specific usability and information requirements that vary per service.

Research report on usability study kiesBeter.nl for chronic patients

The national health portal kiesBeter.nl is a project of RIVM commissioned by the Ministry Of Health. From this project an assignment was received to study the portal’s opportunities to specific improvements for patients with chronic diseases. The final report was delivered last August.

A study was done with respect to the usability of kiesBeter.nl with patients with asthma, diabetes, and osteoarthritis and their fellows. Participants (n=21) completed several information-seeking assignments on the kiesBeter website, while thinking aloud. They were also interviewed.

Their comments and their actions on the computer were recorded and analyzed. This resulted in a list of recommendations to improve the kiesBeter website for use by chronic patients. The recommendations concern layout/design, navigation, content, reliability and empowerment (perceived help in dealing with the disease). Many recommendations may also be helpful for improving the website for the general public.

As a whole, the website is often appreciated. Participants award it on average with a 7 (1-10 scale). They feel the website looks good and provides understandable and reliable information. However, they often experience problems with finding information, caused by pages that are crammed full with links or buttons having the same name, and inconsistent navigation methods across the website. Empowerment is mostly judged negatively. Most participants think the website can not help them get more control over their disease or acquire more disease-related knowledge etc. This is primarily caused by the limited disease-related information on the website as most information was already known by the participants.

Collaboration Waterloo University, Canada

The University of Waterloo (UW) and the University of Twente (UT) will sign a ‘Letter of Intent’ to embed already existing working relations and to establish their intention to expand scientific cooperation and exchange. University of Waterloo and UT are both young, ambitious research universities. In the future this intention will be enhanced into a university-wide strategic alliance.

The Center develops a professional relationship in the field of eHealth, health informatics and disease management with the Waterloo Institute for Health Informatics Research (WIHIR). During a work visit in September the Letter will be signed by the Board of UW. Nienke Nijhof, a PhD student on dementia and domotica will participate in the exchange program.

Conference Digital World 2010: eTELEMED, February 2010

February 10-15, 2010 the International Academy, Research and Industry Association (IARIA) organize its annual international conference ‘Digital World 2010’ in St. Maarten (Netherlands Antilles).

Digital World is an umbrella concept entailing eight sub-conferences in the field of advanced technology, science and society. One of them is eTELEMED, the second international conference on eHealth, Telemedicine, and Social Medicine.

As members of eTELEMED’s Advisory Committee, the centre has proposed a ‘workshop’ which in fact is a mini-conference. Subject is ‘Business Modeling for the Next Generation of Telemedicine Systems and Services’. See for details and Call for Papers: http://www.iaria.org/conferences2010/BUSMMed.html

To us business modeling is an enormously important and promising concept for health care innovation in our countries. We invite you to participate in eTELEMED in general and the workshop in particular. Subscribe here.

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<< IGS Home Newsletter IGS eHealth and Disease Management About Research Organisation Symposia Search	Research Thesis Defense by Fenne Verhoeven MSc October 2^nd 2009 “When staff handle Staph - User-driven versus expert-driven communication of infection control guidelines” Health care-associated infections cause thousands of preventable deaths each year. Therefore, it is crucial that health care workers (HCWs) adhere to infection control guidelines. Although most HCWs are aware of the rationale for guidelines, adherence is generally poor which might be caused by the guidelines’ expert-driven character. Where as traditionally, paper-based guidelines have a strong focus on scientific validation, regulation, and legislation, HCWs’ information need is rather action-oriented. Based on extensive user-centred research involving HCWs, a website is developed that presents evidence-based guidelines as answers to questions that reflect HCWs’ practical informational needs. The guidelines are presented in multimodality in an action-oriented manner with links to additional resources, tables, figures, and videos next to an advanced question-answering system that enables HCWs to search for information using their own language. Evaluation studies showed that the website outperformed the traditional, paper-based guidelines with regard to efficiency (four minutes faster), effectiveness (40% more successfully) and user satisfaction. The website appeared to ‘empower’ HCWs since it allowed them to take decisions for daily work practice, and thereby reduced infection control professionals’ workload. The website (www.mrsa-net.nl) has an average of 500 unique daily users and is ranked highly in Google (second/third position after entering MRSA). This thesis provides the methodological steps and design principles necessary to communicate user-driven guidelines via a website suggesting how to optimally implement this website in daily work practice in order to enhance effective and efficient risk and crisis communication. Methicillin Resistant Staphylococcus aureus (also known as “hospital bacteria”) served as a case study for this thesis’s research, but the thesis might serve as a manual for the communication of guidelines regarding all types of infectious diseases, such as Mexican flu (new influenza A (H1N1)). Promoter of this thesis is Prof. Dr. Michaël Steehouder, assistent-promotor is Dr. Lisette van Gemert-Pijnen Date: Friday, October 2^nd 2009 Time: 14.45-16.00h Place: University of Twente, Building Spiegel, room 2. Research report on mobile technology national health portal kiesBeter.nl The national health portal kiesBeter.nl is a project at RIVM. From this project an assignment was received to study KiesBeter’s prospects for mobile services. The final report was delivered to RIVM in time last August. Several comparable mobile services have been investigated, with special attention to usability, informational and technological conditions. A literature review revealed that only a few national health portals worldwide use the M-channel. A ‘mobile website’ is available in 27% of the national health portals. A ‘mobile website’ of KiesBeter.nl however would be a temporary solution, because of the rapid developments in mobile technology. KiesBeter.nl meets most of the requirements of the MWBP of the W3C. The website is being viewed ever more from mobile phones. The mobile services that could complement the services and objectives of KiesBeter are a text messaging service (sms) and Layar. The user of these services can search for the nearest health professionals like general practitioner, dentist or hospital. The information suits the development of a query ‘on the move’, is short and snappy, and provides no redundant information. More research is needed to identify the lead users - who best predict the success of a service - and the specific usability and information requirements that vary per service. Research report on usability study kiesBeter.nl for chronic patients The national health portal kiesBeter.nl is a project of RIVM commissioned by the Ministry Of Health. From this project an assignment was received to study the portal’s opportunities to specific improvements for patients with chronic diseases. The final report was delivered last August. A study was done with respect to the usability of kiesBeter.nl with patients with asthma, diabetes, and osteoarthritis and their fellows. Participants (n=21) completed several information-seeking assignments on the kiesBeter website, while thinking aloud. They were also interviewed. Their comments and their actions on the computer were recorded and analyzed. This resulted in a list of recommendations to improve the kiesBeter website for use by chronic patients. The recommendations concern layout/design, navigation, content, reliability and empowerment (perceived help in dealing with the disease). Many recommendations may also be helpful for improving the website for the general public. As a whole, the website is often appreciated. Participants award it on average with a 7 (1-10 scale). They feel the website looks good and provides understandable and reliable information. However, they often experience problems with finding information, caused by pages that are crammed full with links or buttons having the same name, and inconsistent navigation methods across the website. Empowerment is mostly judged negatively. Most participants think the website can not help them get more control over their disease or acquire more disease-related knowledge etc. This is primarily caused by the limited disease-related information on the website as most information was already known by the participants. Collaboration Waterloo University, Canada The University of Waterloo (UW) and the University of Twente (UT) will sign a ‘Letter of Intent’ to embed already existing working relations and to establish their intention to expand scientific cooperation and exchange. University of Waterloo and UT are both young, ambitious research universities. In the future this intention will be enhanced into a university-wide strategic alliance. The Center develops a professional relationship in the field of eHealth, health informatics and disease management with the Waterloo Institute for Health Informatics Research (WIHIR). During a work visit in September the Letter will be signed by the Board of UW. Nienke Nijhof, a PhD student on dementia and domotica will participate in the exchange program. Conference Digital World 2010: eTELEMED, February 2010 February 10-15, 2010 the International Academy, Research and Industry Association (IARIA) organize its annual international conference ‘Digital World 2010’ in St. Maarten (Netherlands Antilles). Digital World is an umbrella concept entailing eight sub-conferences in the field of advanced technology, science and society. One of them is eTELEMED, the second international conference on eHealth, Telemedicine, and Social Medicine. As members of eTELEMED’s Advisory Committee, the centre has proposed a ‘workshop’ which in fact is a mini-conference. Subject is ‘Business Modeling for the Next Generation of Telemedicine Systems and Services’. See for details and Call for Papers: http://www.iaria.org/conferences2010/BUSMMed.html To us business modeling is an enormously important and promising concept for health care innovation in our countries. We invite you to participate in eTELEMED in general and the workshop in particular. Subscribe here.