title: Pathways Home: comparing voluntary IT and non-IT users participating in a mentored self-management project.
abstract: This research paper examines the challenges in the development and adoption of an electronic patient diary within the Pathways Home for Respiratory Illness Project. This project supported community-based patients suffering from chronic obstructive pulmonary disease (COPD) to achieve increased levels of self-management and self-efficacy using electronic-monitoring techniques and mentoring by community health nurses. Participants had the option of voluntarily adopting an electronic patient diary to support their self-monitoring, which provided patients, nurses and clinicians with access to symptom and psycho-social data. This aimed to improve the identification, comprehension and initiation of early action in relation to alterations in their conditions. The paper presents data on technology adoption, electronic diary usage and, self-reported data quality, as well as examining the impact of the technology on hospitalisations (frequency and duration). The participants who chose to use the online patient diary continued their involvement with the project for the entire trial period (85% vs 54% completion). Participants were more likely to maintain use of the online patient diary than the paper diary. Both the groups experienced a positive improvement in their self-efficacy to self-manage their condition scores. The data highlight the problems implicit in some of the assumptions underpinning existing information systems models, especially in evaluating impact and the end-points presumed to be relevant in systems development life cycles.
authors.affiliation: eHealth Services Research Group, School of Computing & Information Systems, University of Tasmania, Hpbart, Tasmania. Elizabeth.Cummings@utas.edu.au
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Cummings
authors.forename: Andrew
authors.initials: A
authors.lastname: Robinson
authors.forename: Helen Courtney
authors.initials: HC
authors.lastname: Pratt
authors.forename: Helen
authors.initials: H
authors.lastname: Cameron-Tucker
authors.forename: Richard
authors.initials: R
authors.lastname: Wood-Baker
authors.forename: E Haydn
authors.initials: EH
authors.lastname: Walters
authors.forename: Paul
authors.initials: P
authors.lastname: Turner
mesh_terms: D006801:Humans; D008499:Medical Records / Q000706:statistics & numerical data*; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D010358:Patient Participation / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D012648:Self Care / Q000706:statistics & numerical data*; D013648:Tasmania / Q000453:epidemiology