The book presents a user-oriented methodology for formative (technology) assessment at the development of medical IT-based solutions throughout a system's life-cycle, i.e. from the conception of an idea to disposal of the materialized solution. The methodology developed was tested in a full scale prospective application. Three basic cognitions underpin the entire work: 1) the users of the medical application domain are responsible (and liable) for the level of quality of their service provision within the Healthcare scenario; 2) users are experts at their work (the Healthcare service), and the IT-professionals are not; and 3) introduction of a non-trivial IT-based solution implies re-engineering of the business of the organization into which it is introduced.
The present monograph is a slightly edited version of a European Doctorate Thesis, defended on the 28th of February 1997 at the Faculty of Technology & Science of Aalborg University, Denmark.
The study was supported by a number of financial sources. Initially, it was funded by a set of European R&D projects, which were all partly funded by the EU Commission: KAVAS (A1021), KAVAS-2 (A2019), and ISAR (A2052) AIM Projects, COMAG-BME Concertation Project and ATIM Accompanying Measure. The Danish Research Council for Technology & Science kindly provided a grant that enabled the follow-up case study within the ISAR Project and its synthesis. Finally, Virtual Centre for Health Informatics at Aalborg University provided the funding for the editing. The work was accomplished during three employments, which together provided the remaining funding for the project activities: Computer Resources International A/S, Medical Informatics Laboratory ApS and Aalborg University, Institute of Electronic Systems. The author sincerely thanks the decision makers behind these financial sources.
Particularly the following are thanked for their support and contributions: CHRU de Lille (France) for the hospitality when staying repeatedly in Lille to carry out the case study, and for the ongoing assistance and constructive feed-back; Aalborg University, Department of Medical Informatics and Image Analysis (Denmark), for encouraging me to do the concluding part of the work and for providing me with the facilities for it; and the KAVAS Consortia for inspiring brainstorming sessions and academic debates on the topic.
Personal thanks are given to Marie Catherine Beuscart-Zéphir for opening my eyes to cognitive aspects of IT-systems and for our academic debates on the contents and role of User Requirements in particular; to Rory O'Moore as the leading figure at the development of KAVAS's Evaluation Methodology and for his inspiring engagement in and synthesis of the never ending brainstorming related to it; to Jan Talmon for our academic debates on the Quality Assessment Framework, which inspired me to refine the formalism upon which this work is founded; to my supervisor Stig Kjær Andersen for his ongoing support and constructive feed-back and for pointing out the problems in my writing style; to Torben and Marion Rügge for the final linguistic revision; and to my husband Peter McNair for our ongoing academic debates and for never ceasing to believe in my capability to accomplish this study.
Last, but certainly not least I wish to express my gratitude towards the Adjudication Committee for their valuable and constructive comments and criticism: Professor Jan van Bemmel from Erasmus University Rotterdam, Professor Jean-Raoul Scherrer from University Hospital Geneva, Professor Rory O'Moore from St. James Hospital, Dublin, and Associate Professor Jan Stage from the Department of Computer Science at Aalborg University.
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