Lisette Van Gemert, University of Twente, Enschede, Netherlands Nicol Nijland*, university of twente, enschede, Netherlands Track: Research Presentation Topic: Web 2.0 approaches for behaviour change, public health and biosurveillance Presentation Type: Oral presentation Submission Type: Single Presentation Building: MECC Room: Auditorium 2 Date: 2010-11-29 11:00 AM – 12:30 PM Last modified: 2010-11-03

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Today’s healthcare system faces problems such as aging, a growth in multimorbidity, a serious decrease in the number of available personnel, and a limited budget. Technology could contribute to the solution of these problems by supporting a better balance between self-care and professional care. Current demands by ‘e-patients’ to manage their own health and well-being may be met by technological interventions.

From systematic reviews and empirical-based studies, we know that the uptake of technology in daily practice is rather low. The low uptake of eHealth technologies (eHTs) is caused by an expert–driven developmental process that produces technology which fails to meet users’ needs and disregards social-cultural habits and the complexity of healthcare. It is also caused by the classic behavioral theories and medical models that underpin these eHealth technologies, neglecting the complex interdependencies between technology, care, context and communication that influence the uptake of eHealth technologies.

We believe that a holistic view on supporting healthcare via technology is needed to ensure that eHts are used and that they are effective. A holistic view on eHTs considers human characteristics (eg, biological, psychological), socio-economical and cultural environments, and technology (design, usability) as indistinguishable connected to each other. The development of eHts involves much more than simply designing or engineering a good ‘thing’ or tool. Rather, it is about creating an infrastructure for knowledge dissemination, communication and the organization of healthcare. In fact, creating a new technology works as a catalyst for innovating healthcare, since the development of technology induces clarification of how the process of healthcare delivery and reimbursement runs, who the key actors are, and how payment is organized. Developers should be aware of the interaction between technology, people (patients, citizens, healthcare professionals) and their social-cultural environment e.g. the healthcare organization. Without addressing the need for a total fit between people, technology and the healthcare organization in the development process, eHts run the risk of being ineffective in promoting healthier living.

To develop technology that is meaningful for all the stakeholders involved (like patients, healthcare professionals, financers, government) and that fits into the healthcare system, the participation of stakeholders is essential for specifying the values, critical design issues and resources (skills, capacities, etc.) that are at stake.
Stakeholder engagement within the development of eHts will often imply changes not only in the technological development process, but also in organizational, institutional, research and development cultures as well as individual mindsets. Therefore we need a holistic view on eHts to develop technology that is human-centered and that has value for all the stakeholders involved.