No Wrong Door: Designing Health Information Technology to Support Interprofessional Collaboration Around Child Development Work
Mikles, Sean Patrick
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Child development refers to children gaining the skills they need to succeed in life, consisting of abilities in overlapping domains such as speech, motor, social, and cognition. Developmental disabilities are chronic delays in gaining such skills, and if they are not addressed in a timely manner, a child can experience negative outcomes throughout their life. Responsibilities for identifying and treating developmental delays and disabilities are spread across many stakeholders in the community, including not only parents but an interprofessional collection of service providers such as pediatricians, early educators, childcare providers, providers of home visiting services, and community groups. Regardless of who is involved in a child’s care, there must be “no wrong door” into the ecosystem of development support services. Unfortunately, these stakeholders operate in silos, resulting in a fractured system of services that parents struggle to navigate. This often leads to delays in the receipt of necessary services and uncoordinated care. Various researchers and policy leaders, such as the American Academy of Pediatrics, have suggested that health information technology (HIT) could be an important tool to help stakeholders collaborate in a child’s care management. Current biomedical informatics literature, however, provides little practical guidance on how to design HIT systems to support such interprofessional collaboration. This dissertation presents four studies that aim to address this design gap by drawing upon the extensive body of literature on collaborative practice and the user-centered design framework. These studies demonstrate the use of qualitative methods in conjunction with theoretical concepts to assess the needs of a heterogeneous collection of stakeholders in regard to collaborative work with the goal of deriving design implications for future creators of collaborative HIT systems. The first study demonstrates the utility of using concepts from collaboration literature to uncover actionable design implications for collaborative systems using previously collected interview data from an interprofessional collection of stakeholders. The second and third studies utilize the methods of the first study to explore interprofessional work processes and interprofessional trust, respectively, with original interview data. Building upon the third study, the last study provides practical guidance for designing interprofessional collaborative systems to support the creation of trust between stakeholders of heterogeneous backgrounds. This is achieved through eliciting the information that people use to judge trustworthiness, and then creating and testing prototype webpages listing the noted information. This research will provide concrete methodological guidance for designers of future systems to support collaborative work, as well as provide concrete design implications for such systems.