A Chronic Wound Healing Information Technology System: Design, Testing, and Evaluation in Clinic

Abstract

In the UK, chronic wound healing is an area of specialist clinical medicine that operates within the framework of the National Health Service. It has been the basis for the design, testing and evaluation of a prototype system of information and communication technology (ICT), specifically adapted to the domain. Different wound healing clinics were examined using a combination of 'hard' and 'soft' methods to allow a richer perspective of the activity and gain a deeper understanding of the human activity, its relation to the working information system, the existing information technology (IT), and the potential of a comprehensive IT system to manipulate live data in clinic. Clinicians and administration staff were included in all aspects of the process to enhance the design lifecycle and the understanding of the process. An observe, report, plan and act (ORPA) cycle, based on the dictates of action research, was established to accomplish the design and testing of a system that clinicians were comfortable enough with to consider its use in clinic. Three different strategies were applied to evaluate its use in participating clinics. Cultural historical activity theory was used as the main framework to analyse the activity system, and to interpret the clinicians and the systems performance, as well as their evaluation of the experience. Activity breakdown areas are suggested and reasons for them are considered in the light of wound care workers feedback, and the researcher's observations, notes, and analysis.