University of Twente Student Theses


Mixed methods approach to evaluate the usage of personal health records in chronic care

Taken, Marloes (2017) Mixed methods approach to evaluate the usage of personal health records in chronic care.

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Abstract:Background: Nowadays, eHealth is expected to play an important role in supporting patients with chronic conditions in their self-management. However, in recent evaluations only the effects of eHealth technologies are measured by performing RCTs. Consequently, it remains unknown why these effects occur and what are the reasons behind the use an non-use of eHealth technologies. Therefore, there is a need for eHealth evaluations that goes beyond measuring the effects. The eCCM which is a framework for developing effective eHealth solution for chronic care is expected to support these evaluations. Objective: The aims of this study is to evaluate how PHRs for the chronic conditions: T2DM, COPD and CHF are used to support self-management for patients and the daily care routines for healthcare professionals and to come up with recommendations to make the PHRs for chronic conditions more persuasive. Methods: A mixed methods design was used to combine quantitative and qualitative research methods. The quantitative research data (log data) were used to gain more understanding of the usage of PHRs and to identify predictors for long-term usage. By using qualitative data from different sources (e.g. usability tests, interviews etc.) it was possible to identify the experiences of the potential end users and their healthcare professionals about the usage and implementation of the e-Vita platform. Subsequently, the qualitative data enabled the researchers to investigate to what extent the PHRs fits the components of the eCCM. Results: A fast declining trend is shown for the amount of sessions that is performed on the PHRs. However, patients with more sessions more intensively used the different feature which especially applies for the PHRs were intended usage is pursued. Besides, it was found that the feedback loop presented in the eCCM, required for interactions between the healthcare professionals and patients to provide tailored self-management solutions was completely lacking in the studied PHRs. Additionally, is was found that those who visited all main features of a PHR have a higher probably to become long-term users. Conclusion: Equal usage patterns are shown for the PHRs. Besides, it can be concluded that a holistic and ‘agile science’ approach to evaluate the components of the PHRs with the end users continuously and as early in the development process on is lacking. For the evaluations of PHRs it can be concluded that a mixed methods approach contributed positively to investigating the usage. Furthermore, placing the PHR in the eCCM is of great value to take into account the context of the technology and to identify which components needed improvements to make PHRs more persuasive. However, future studies should focus on how the eCCM can be expanded to fit the transmural care setting.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:70 social sciences in general
Programme:Health Sciences MSc (66851)
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