Health@HomeThe Work of Health Information Management in the Household (HIMH): Implications for Consumer Health Informatics (CHI) Innovations
- Affiliations of the authors: School of Nursing (AM, PFB) and College of Engineering (PFB), University of Wisconsin–Madison, Madison, WI; InterMedia, University of Oslo, Oslo, Norway (AM)
- Correspondence and reprints: Anne Moen, RN, PhD, InterMedia, University of Oslo, P.O. Box 1161, Blindern, N-0318 Oslo, Norway; e-mail: <anne.moen{at}intermedia.uio.no>
- Received 2 December 2004
- Accepted 25 May 2005
Abstract
Objective Contemporary health care places enormous health information management demands on laypeople. Insights into their skills and habits complements current developments in consumer health innovations, including personal health records. Using a five-element human factors model of work, health information management in the household (HIMH) is characterized by the tasks completed by individuals within household organizations, using certain tools and technologies in a given physical environment.
Design We conducted a descriptive-exploratory study of the work of HIMH, involving 49 community-dwelling volunteers from a rural Midwestern community.
Measurements During in-person interviews, we collected data using semistructured questionnaires and photographs of artifacts used for HIMH.
Results The work of HIMH is largely the responsibility of a single individual, primarily engaged in the tasks of acquiring, managing, and organizing a diverse set of health information. Paper-based tools are most common, and residents develop strategies for storing information in the household environment aligned with anticipated use. Affiliative relationships, e.g., parent-child or spousal, within the household serve as the organization that gives rise to health information management practices. Synthesis of these findings led to identification of several storage strategies employed in HIMH. These strategies are labeled “just-in-time,” “just-because,” “just-in-case,” and “just-at-hand,” reflecting location of the artifacts of health information and anticipated urgency in the need to retrieve it.
Conclusion Laypeople develop and employ robust, complex strategies for managing health information in the home. Capitalizing on these strategies will complement and extend current consumer health innovations to provide functional support to people who face increasing demands to manage personal health information.
Footnotes
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The study Advanced Technologies for Health@Home is funded through a grant from the Intel Corporation to the University of Wisconsin-Madison (Dr. Brennan, Principal Investigator). We acknowledge contributions from Chris Brunnette, MS, past project manager, research assistants Jared Wickus, MS, and Teresa Zayas-Cabán, MS, PhD, who did most of the home visits, and collaboration with the Dodge-Jefferson Community, as well as support from the Health Systems Lab at UW-Madison. Dr. Moen was supported by a grant from the US-Norway Fulbright Association and a postdoctoral fellowship from the Norwegian Research Council, and PFB is supported by the Moehlman Bascom Fund, University of Wisconsin–Madison.
