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Elicitation and prioritization of requirements for electronic health records for oncology in low resource settings: A concept mapping study.
International Journal of Medical Informatics ( IF 3.7 ) Pub Date : 2019-12-17 , DOI: 10.1016/j.ijmedinf.2019.104055
Johnblack K Kabukye 1 , Nicolet de Keizer 2 , Ronald Cornet 2
Affiliation  

BACKGROUND Understanding functional and non-functional requirements is essential to successfully implement electronic medical record (EMR) systems. Actual requirements will be different for different contexts. OBJECTIVE To elicit and prioritize requirements for implementing EMRs in oncology in low and middle income countries (LMICs), and to relate these to requirements from high-income countries. PARTICIPANTS AND SETTING Cancer care stakeholders including oncologists, general doctors, nurses, biostatisticians, information technologists, from different LMICs, were involved. METHODS Concept mapping was used. Statements of requirements were obtained during focus group discussions (FGDs) and interviews. Using surveys, the requirements were clustered and ranked on importance and feasibility. Data were analyzed in SPSS using agglomerative hierarchical clustering and multidimensional scaling, to create cluster maps and go-zone maps reflecting the relationships between the requirements and their prioritization. RESULTS Four FGD sessions, with twenty participants, were conducted. In addition, six participants were interviewed. Twenty-two participants clustered the requirements and sixty-three participants ranked them on importance and feasibility. One hundred and sixty requirement statements were generated which were reduced to sixty-four after de-duplication and merging. Nine clusters were obtained encompassing the following domains, in order of importance: Security, Conducive organization, Management/Governance, General EMR functionalities, Computer infrastructure, Data management, Usability, Oncology decision support, and Ancillary requirements. On ranking, the requirements scored between 3.74 and 4.80 on importance, and between 3.55 and 4.46 on feasibility, on a 5-point Likert scale. We generated concept maps for use when communicating with stakeholders. CONCLUSION For oncology EMRs in LMICs, requirements overlap those from high-income countries, but generic EMR functionalities, Infrastructural and organizational requirements are still considered priority in LMICs compared to oncology-specific requirements or advanced EMR features e.g. computerized decision support or interoperability. Concept mapping is a fast and cost-effective method for eliciting and prioritizing EMR requirements in a user-centered manner.

中文翻译:

在资源匮乏的情况下,对肿瘤电子病历电子病历要求的启发和优先级排序:概念图研究。

背景技术了解功能和非功能需求对于成功实施电子病历(EMR)系统至关重要。实际要求因环境而异。目的得出中低收入国家(LMIC)在肿瘤学中实施EMR的要求并对其进行优先排序,并将其与高收入国家的要求联系起来。参与者和背景涉及不同LMIC的癌症护理利益相关者,包括肿瘤学家,普通医生,护士,生物统计学家,信息技术专家。方法使用概念图。在焦点小组讨论和访谈中获得了要求的陈述。使用调查,对需求进行了聚类,并对重要性和可行性进行了排名。使用聚集的层次聚类和多维标度在SPSS中对数据进行了分析,以创建反映需求及其优先级之间关系的聚类图和区域图。结果进行了四场FGD会议,有20位参与者。此外,还采访了六名参与者。22位参与者对需求进行了聚类,63位参与者对重要性和可行性进行了排名。生成了160条需求语句,在重复数据删除和合并后减少到64条。按照重要性顺序,获得了九个集群,包括以下领域:安全性,有益的组织,管理/治理,常规EMR功能,计算机基础设施,数据管理,可用性,肿瘤学决策支持,和辅助要求。在排名上,要求的重要性得分在3.74和4.80之间,而可行性在3.55和4.46之间,满分为5分。我们生成了概念图,供与利益相关者沟通时使用。结论对于LMIC中的肿瘤EMR,要求与高收入国家的要求重叠,但是与肿瘤特定要求或高级EMR功能(例如计算机决策支持或互操作性)相比,LMIC中的通用EMR功能,基础设施和组织要求仍被视为优先事项。概念映射是一种以用户为中心的方式来引发EMR需求并确定其优先级的快速且经济高效的方法。在5点李克特量表上。我们生成了概念图,供与利益相关者沟通时使用。结论对于LMIC中的肿瘤EMR,要求与高收入国家的要求重叠,但是与肿瘤特定要求或高级EMR功能(例如计算机决策支持或互操作性)相比,LMIC中的通用EMR功能,基础设施和组织要求仍被视为优先事项。概念映射是一种以用户为中心的方式来引发EMR需求并确定其优先级的快速且经济高效的方法。在5点李克特量表上。我们生成了概念图,供与利益相关者沟通时使用。结论对于LMIC中的肿瘤EMR,要求与高收入国家的要求重叠,但是与肿瘤特定要求或高级EMR功能(例如计算机决策支持或互操作性)相比,LMIC中的通用EMR功能,基础设施和组织要求仍被视为优先事项。概念映射是一种以用户为中心的方式来引发EMR需求并确定其优先级的快速且经济高效的方法。与肿瘤学特定要求或高级EMR功能(例如计算机决策支持或互操作性)相比,基础设施和组织要求仍被视为LMIC中的优先事项。概念映射是一种以用户为中心的方式来引发EMR需求并确定其优先级的快速且经济高效的方法。与特定于肿瘤学的要求或高级EMR功能(例如计算机决策支持或互操作性)相比,基础设施和组织要求仍被认为是LMIC中的优先事项。概念映射是一种以用户为中心的方式来引发EMR需求并确定其优先级的快速且经济高效的方法。
更新日期:2020-01-04
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