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On development of information systems with GIS functionality in public health informatics: a requirements engineering approach
Linköping University, Department of Computer and Information Science. Linköping University, The Institute of Technology.
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Public health informatics has in recent years emerged as a field of its own from medical informatics. Since public health informatics is newly established and also new to public health professionals, previous research in the field is relatively scarce. Even if the overlap with medical informatics is large, there are differences between the two fields. Public health is, for example, more theoretical and more multi-professional than most clinical fields and the focus is on populations rather than individuals. These characteristics result in a complex setting for development of information systems. To our knowledge there exist few systems that support the collaborative process that constitutes the foundation of public health programs. Moreover, most applications that do support public health practitioners are small-scale, developed for a specific purpose and have not gained any wider recognition.

The main objective of this thesis is to explore a novel approach to identifying the requirements for information system support with geographical information system (GIS) functionality in public health informatics. The work is based on four case studies that are used to provide the foundation for the development of an initial system design. In the first study, problems that public health practitioners experience in their daily work were explored. The outcome of the study was in terms of descriptions of critical activities. In the second study, the use case map notation was exploited for modeling the process of public health programs. The study provides a contextual description of the refinement of data to information that could constitute a basis for both political and practical decision in complex inter-organizational public health programs. In the third study, ethical conflicts that arose when sharing geographically referenced data in public health programs were analyzed to find out how these affect the design of information systems. The results pointed out issues that have to be considered when developing public health information systems. In the fourth study, the use of information systems with GIS functionality in WHO Safe Communities in Sweden and the need for improvements were explored. The study resulted in identification of particular needs concerning information system support among public health practitioners.

From these studies, general knowledge about the issues public health practitioners experience in daily practice was gained and the requirements identified were used as a starting-point for the design of information systems for Motala WHO Safe Community.

The main contributions of the thesis involve two areas: public health informatics and requirements engineering. First, a novel approach to system development in public health informatics is presented. Second, the application of use case maps as a tool for requirements engineering in complex settings such as public health programs is presented. Third, the introduction of requirements engineering in public health informatics has been exemplified. The contributions of the thesis should enhance the possibility to perform more adequate requirements engineering in the field of public health informatics. As a result, it should be possible to develop information systems that better meet the needs in the field of public health. Hence, it contributes to making the public health programs more effective, which in the long run will improve public health. 

Place, publisher, year, edition, pages
Linköping: Linköpings universitet , 2003. , 86 p.
Series
Linköping Studies in Science and Technology. Dissertations, ISSN 0345-7524 ; 823
National Category
Computer Science
Identifiers
URN: urn:nbn:se:liu:diva-35572Local ID: 27654ISBN: 91-7373-656-2 (print)OAI: oai:DiVA.org:liu-35572DiVA: diva2:256420
Public defence
2003-06-05, Estraden, Hus E, Linköpings Universitet, Linköping, 09:00 (Swedish)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2013-01-08
List of papers
1. Using the critical incident technique to define a minimal data set for requirements elicitation in public health
Open this publication in new window or tab >>Using the critical incident technique to define a minimal data set for requirements elicitation in public health
2002 (English)In: International Journal of Medical Informatics, ISSN 1386-5056, E-ISSN 1872-8243, Vol. 68, no 1-3, 165-174 p.Article in journal (Refereed) Published
Abstract [en]

The introduction of computer-based information systems (ISs) in public health provides enhanced possibilities for service improvements and hence also for improvement of the population's health. Not least, new communication systems can help in the socialization and integration process needed between the different professions and geographical regions. Therefore, development of ISs that truly support public health practices require that technical, cognitive, and social issues be taken into consideration. A notable problem is to capture ‘voices’ of all potential users, i.e., the viewpoints of different public health practitioners. Failing to capture these voices will result in inefficient or even useless systems. The aim of this study is to develop a minimal data set for capturing users' voices on problems experienced by public health professionals in their daily work and opinions about how these problems can be solved. The issues of concern thus captured can be used both as the basis for formulating the requirements of ISs for public health professionals and to create an understanding of the use context. Further, the data can help in directing the design to the features most important for the users.

Keyword
Critical incident technique, Information systems design, Public health, Public health informatics, Requirements engineering
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-46775 (URN)10.1016/S1386-5056(02)00074-6 (DOI)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-13
2. Requirements Engineering for inter-organizational health information systems with functions for spatial analyses: modeling a WHO safe community applying Use Case Maps
Open this publication in new window or tab >>Requirements Engineering for inter-organizational health information systems with functions for spatial analyses: modeling a WHO safe community applying Use Case Maps
2002 (English)In: Methods of Information in Medicine, ISSN 0026-1270, Vol. 41, no 4, 299-304 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: To evaluate Use Case Maps (UCMs) as a technique for Requirements Engineering (RE) in the development of information systems with functions for spatial analyses in inter-organizational public health settings.

Methods: In this study, Participatory Action Research (PAR) is used to explore the UCM notation for requirements elicitation and to gather the opinions of the users. The Delphi technique is used to reach consensus in the construction of UCMs.

Results: The results show that UCMs can provide a visualization of the system's functionality and in combination with PAR provide a sound basis for gathering requirements in inter-organizational settings. UCMs were found to represent a suitable level for describing the organization and the dynamic flux of information including spatial resolution to all stakeholders. Moreover, by using PAR, the voices of the users and their tacit knowledge is intercepted. Further, UCMs are found useful in generating intuitive requirements by the creation of use cases.

Conclusions: With UCMs and PAR it is possible to study the effects of design changes in the general information display and the spatial resolution in the same context. Both requirements on the information system in general and the functions for spatial analyses are possible to elicit when identifying the different responsibilities and the demands on spatial resolution associated to the actions of each administrative unit. However, the development process of UCM is not well documented and needs further investigation and formulation of guidelines.

Keyword
health informatics, public health, system development, requirements engineering (RE), case study methods
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-48753 (URN)12425241 (PubMedID)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-12
3. Ethical issues in public health informatics: implications for system design when sharing geographic information
Open this publication in new window or tab >>Ethical issues in public health informatics: implications for system design when sharing geographic information
2002 (English)In: Journal of Biomedical Informatics, ISSN 1532-0464, E-ISSN 1532-0480, Vol. 35, no 3, 178-185 p.Article in journal (Refereed) Published
Abstract [en]

Public health programs today constitute a multi-professional inter-organizational environment, where both health service and other organizations are involved. Developing information systems, including the IT security measures needed to suit this complex context, is a challenge. To ensure that all involved organizations work together towards a common goal, i.e., promotion of health, an intuitive strategy would be to share information freely in these programs. However, in practice it is seldom possible to realize this ideal scenario. One reason may be that ethical issues are often ignored in the system development process. This investigation uses case study methods to explore ethical obstacles originating in the shared use of geographic health information in public health programs and how this affects the design of information systems. Concerns involving confidentiality caused by geographically referenced health information and influences of professional and organizational codes are discussed. The experience presented shows that disregard of ethical issues can result in a prolonged development process for public health information systems. Finally, a theoretical model of design issues based on the case study results is presented.

Keyword
Confidentiality, Geographical information systems (GIS), Health informatics, IT security, Privacy, Public health, Requirements engineering (RE), Systems development
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-46991 (URN)10.1016/S1532-0464(02)00527-0 (DOI)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-13
4. Prerequisites to use information system as support in Public Health Programs: an initial requirements elicitation and analysis for WHO safe sommunities
Open this publication in new window or tab >>Prerequisites to use information system as support in Public Health Programs: an initial requirements elicitation and analysis for WHO safe sommunities
(English)Manuscript (preprint) (Other academic)
Abstract [en]

The public health context constitutes a heterogeneous environment and presents a complex task for system developers. In this study, the requirements elicitation and analysis of prerequisites for using information systems (ISs) in public health programs is investigated. Special interest is also paid to geographical information system (GIS) functionality. The specific objective of this study is to explore the need for support of ISs and GISs that exists in WHO Safe Communities in Sweden. To elicit the requirements, a questionnaire based on the critical incident technique (CIT) was used. By using CIT, it is possible to focus the development on the problems experienced by the users. Moreover, it covers both technical and social requirements. Thereafter a voice of the customer table is used to transform the needs to technical requirements. The study results in recommendations for ISs development with GIS functionality for public health practitioners.

National Category
Engineering and Technology
Identifiers
urn:nbn:se:liu:diva-86940 (URN)
Available from: 2013-01-08 Created: 2013-01-08 Last updated: 2013-09-05
5. Design of information systems for Public Health Programs: the case of Motala WHO safe community
Open this publication in new window or tab >>Design of information systems for Public Health Programs: the case of Motala WHO safe community
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Objectives: In public health only a fraction of the potential that information systems (ISs) and geographical information systems (GISs) provides has been used. Public-health programs are executed in complex environments, and are characterized by being multi-professional and inter-organizational. Hence, there is a need for extensive studies of how ISs should be con figured to truly support public health practitioners. The objective of this study is to explore how information technology, including GIS functionality, should be configured to support practitioners in community-based public health programs.

Measurements: The critical incident technique, interviews, the voice of the customer table, and use case maps were used for data collection.

Results: Communication and a clearinghouse with contact persons were identified as key features and support for creating both official and unofficial contact networks is provided. The design has a module-based architecture, including an extendable easy-to-use module with GIS functionality.

Conclusions: To support both individuals and heterogonous teams in complex public health programs, a module-based architecture is proposed. Hence, the system can be tailor-made to support individuals in their specific tasks and at their specific skill level.

Keyword
Public health, Requirements engineering, Prototypes, Information systems development, Safe community, GIS
National Category
Engineering and Technology
Identifiers
urn:nbn:se:liu:diva-86942 (URN)
Available from: 2013-01-08 Created: 2013-01-08 Last updated: 2013-09-05

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