A Methodology for Development of Clinical Performance Monitoring Applications

Clinical performance monitoring applications enable performance management of care processes in clinical settings. Although information technology has been advocated as a solution to support the provision of better care, the development of clinical performance monitoring applications is often a non-trivial task. A high rate of failure in IT healthcare project implementations has been reported in the literature due to the disconnect between clinicians and the development team. Furthermore, challenges inherent to the configuration of the healthcare system add to the complexity of developments. Often data sources are not adequately structured or cannot be accessed in a timely fashion; processes are uncoordinated or ill-defined; a plethora of information technologies across different healthcare organizations make interoperability problematic; and there are concerns related to privacy and security. Getting the right information to measure the achievement of the right goals at the right time for the right people is the main task to address when developing clinical performance monitoring applications. In this thesis we propose a development methodology that combines technical and managerial aspects of application development following a user-centered approach. It involves the engagement of stakeholders and users throughout in a three phase iterative process of modeling, implementation and evaluation to ensure user acceptance and adoption of applications when deployed. In particular, our focus is on the development of mobile clinical performance monitoring applications, where raw data about clinical problems are logged by healthcare providers and then transformed into meaningful reports that will support decision-making. The development methodology is evaluated using a case study of a Resident Practice Profile (RPP) application that was developed by a team lead by Dr. Gary Viner from the University of Ottawa medical school