The pilot implementation is analyzed, and the lessons learned are discussed in relation to usability engineering in general.
TopOrganization Background
This section introduces the chapter and describes the experiences of the IT vendor CSC Scandihealth in working with pilot implementation on the basis of effects-driven IT development and the EHR client, a large hospital complex located in a European region, the Hospital for short.
A pilot implementation is defined as: “a field test of a properly engineered, yet unfinished system, in its intended environment, using real data and aiming – through real-use experience – to explore the value of the system, improve or assess its design, and reduce implementation risk.” (Hertzum, Bansler, Havn, & Simonsen, 2012). Pilot implementations are field trials and in that sense constitute a continuation of prototype evaluations into the field. In this chapter, we describe a case where the preparations were carried out before a pilot implementation included using workshops with mock-ups as well as several versions of prototypes. The pilot implementation was supported by so-called ‘effects-driven IT development’ (Hertzum & Simonsen, 2011) by which the desired effects of using the system were specified, used as specifications for the mock-ups and prototypes, and finally measured as part of a formative usability evaluation based on the system used during actual work as part of the pilot implementation. In the following, we outline the strategies of both the vendor and client and the circumstances making the pilot implementation and effects-driven IT development relevant. We set the stage and describe the effects specified to produce the input to the succeeding usability evaluation. Then, we describe the case and the pilot implementation including planning and design, technical configuration, organizational adaption, use of the system, and the learning that took place. We conclude the chapter by discussing challenges, solutions, and recommendations.
Organizational Facts and Strategy: CSC Scandihealth
CSC Scandihealth is a company within the Computer Sciences Corporation and is part of its global healthcare Vertical, which specializes in delivering IT to public and private healthcare providers. CSC Scandihealth (in the following referred to as CSC, for short) employs 375 healthcare IT specialists in Denmark with an annual turnover of USD78 million.
The CSC's mission is to “deliver a solution to the client,” rather than “delivering a product to the client.” This marks a decisive shift in attitude towards the vendor-client relationship in CSC. To achieve this goal, the company and its employees must engage in various processes that must be aligned with the clinical work the solutions are to support. The increase in intimacy with the client’s core business and the need of establishing technology consistent with individual healthcare providers is stated by CSC’s CEO Freddy Lykke:
The vision we have is that the healthcare community is increasingly integrated into the various sections of society, coming closer and closer together, and our mission is that we [CSC] can help to make the linkage of the Healthcare community (Barlach & Simonsen, 2011).
Freddy Lykke elaborates how this vision can be implemented through a bottom-up approach:
The bottom-up approach is basically another way of saying that it is the clinicians themselves that are to define how their work processes are to be supported, rather than we [CSC] come with a system where we have defined how we think the workflow should be at the various hospitals and their wards. We present a system that allows the clinicians to dynamically describe how the system should work in their specific situations (Barlach & Simonsen, 2011).