title: Copability, coping, and learning as focal concepts in the evaluation of computerised diabetes disease management.
abstract: BACKGROUND
  Within diabetes care, the majority of health decisions are in the hands of the patient. Therefore, the concepts of disease management and self-care represent inescapable challenges for both patient and healthcare professionals, entailing a considerable amount of learning. Thus, a computerised diabetes disease management systems (CDDM) is to be seen not merely as tools for the medical treatment, but also as pedagogical tools to enhance patient competence.
  
  
  OBJECTIVE
  The unfortunate lack of success for most knowledge-based systems might be related to the problem of finding an adequate way of evaluating the systems from their development through the implementation phase to the daily clinical practice. The following presents the initial methodological considerations for evaluating the usefulness of a CDDM system called DiasNet, which is being implemented as a learning tool for patients. The evaluation of usefulness of a CDDM, we claim, entails clinical assessment taking into account the challenges and pitfalls in diabetes disease management.
  
  
  RESULTS
  Drawing on activity theory, we suggest the concept of copability as a supplement to 'usability' and 'utility' when determining 'usefulness'. We maintain that it is necessary to ask how well the user copes with the new situation using the system. As ways to measure copability of DiasNet the concepts of coping and learning are discussed, as well as ways this methodology might inform systems development, implementation, and daily clinical practice.
authors.affiliation: Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark. eb@hst.auc.dk
authors.forename: Egil
authors.initials: E
authors.lastname: Boisen
authors.forename: Ann
authors.initials: A
authors.lastname: Bygholm
authors.forename: David
authors.initials: D
authors.lastname: Cavan
authors.forename: Ole K
authors.initials: OK
authors.lastname: Hejlesen
mesh_terms: D000223:Adaptation, Psychological; D003658:Decision Making, Computer-Assisted; D020000:Decision Support Systems, Clinical; D003920:Diabetes Mellitus / Q000628:therapy*; D019468:Disease Management; D006801:Humans; D007256:Information Systems; D007858:Learning; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D012648:Self Care