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Current approaches to health IT research and development emphasize the valuable role of users. However, differences amongst users, in how they are defined, involved and interact with health IT under conditions of varying complexity has received limited attention. Failure to acknowledge these differences makes assessments of the quality, reliability and transferability of results problematic. More importantly, as e-health systems are increasingly opened up to use by health consumers the implications of differences in the context of system use for patient safety require closer investigation. To support the safety of e-Health systems, it is essential that where users are involved we can more accurately differentiate between types of users and their contexts of use and how these factors interact with usability and the risk of unintended consequences from such systems. This paper presents an extended three dimensional user-task-context matrix for considering who users of healthcare applications are, their needs and their requirements under differing contexts of use.
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