Qualitative evaluation of health information exchange efforts
Joan S. Ash , Kenneth P. Guappone Department of Medical Informatics and Clinical Epidemiology, School of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA
Because most health information exchange (HIE) initiatives are as yet immature, qualitative evaluation is recommended so that what is learned through evaluation can be immediately applied to assist in HIE development efforts. As new and undeveloped as some of these entities are, the evaluation need not wait until some future end point when objective outcomes can be clearly measured, qualitative research which can inform the process of HIE organizational development, should be conducted so that lessons can be learned along the way as it provides optimal course corrections.
Qualitative methods
The qualitative methods are primarily language based, with data in the form of words rather than numbers. They take into consideration the larger context of a human situation, so often they are used at the site of activity, in the field.
Because, for these questions, the answers may vary over time, an evaluation plan would be longitudinally. Each step, from idea generation, to design, to data gathering, to analysis, to interpretation, will likely be done more than once, so the design plan is generally iterative and flexible rather than tightly pre-configured because as new discoveries emerge, the plan may need modification and redefinition to allow the collection of the richest data possible.
As in any project, the design for evaluation begins with articulating exactly what it is you want to know. And what are the essential and specific questions you need to have answered about the barriers and facilitators to the HIE development and needs, expectations, motivations of the many different stakeholders and questions like these
An initial assessment must be done early in the HIE development process could yield critical information about whether different entities are ready for this effort. Some possible foci for this initial assessment might include the plan and planning process, cultural foundation, clinician involvement, clinician satisfaction and workflow assessment.
Qualitative research methods are considered subjective in that they can assess how people make sense of things—how they view the world, inductive as they are oriented to discovery and exploration and contextual because of its naturalistic approach and providing rich details of findings. In the opposite quantitative research methods are considered objective, deductive and generalized because of its nature which is in most cases numeric. However, the two approaches can be combined as they can effectively complement each other.
Then we will take a look at some useful methods such as interviewing which is ideal to exploring HIE stakeholder perception ,focus groups or group interviews which provides different type of information than that which a single individual can provide and observation which is non-invasive, so that busy subjects are not inconvenienced. Typical daily tasks can be watched in context, and observational data can confirm or disconfirm what people tell you during interviews.
Mostafa Elhefnawy
