Design and introduction of an electronic patient record: how to involve users?
OBJECTIVE
Two forms of participatory design (PD) - management-dominated and end-users focused - are described in the design and introduction of an electronic patient record (EPR) for a mental health care centre.


METHODS
Qualitative research methods were used to achieve a 'fine-grained' insight into the EPR development process and its impacts. These methods included interviews, document study and observation of project group meetings.


RESULTS
Management-dominated PD is highly structured, led by managers and centred around rationalisation of work. End-user focused PD is more bottom-up oriented. Central in this approach are users' working patterns and user needs. In the case described, both forms actually lead to a poorly functioning EPR. It is explained why these results could be expected.


CONCLUSIONS
Our findings suggest not to reject PD, but to find a more appropriate balance between the two forms of PD.
Faber
M G
MG
Institute of Health Policy and Management, Erasmus University Medical Center Rotterdam, P.O. Box 1738 3000 DR Rotterdam, The Netherlands. Getrouw@bmg.eur.nl
D003155:Community Mental Health Centers; D003299:Cooperative Behavior; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D006778:Hospitals, Psychiatric; D006801:Humans; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D008605:Mental Health Services / Q000458:organization & administration*; D009426:Netherlands; D009936:Organizational Innovation; D016730:Program Development; D012985:Software Design; D019037:Urban Health Services