Abstract
This chapter presents a case study highlighting development of a Web-based wiki-driven collaboration portal that is being used by a distributed group of community health organizations engaged in developing a strategic implementation plan for health information technology (HIT) at the point of care. The transdisciplinary approach to software development incorporates the perspectives, skill-set, and interests of a diverse group of stakeholders, including staff from the community health organizations, academic researchers, and software developers. The case study describes a select set of the challenges and strategies that have emerged in the planning and development process, including issues surrounding communication, training and development, and infrastructure. Prospects for future development are also explored.
TopIntroduction
Internet or web-based communications platforms may greatly expand the reach and scope of collaborative projects. Most businesses and organizations currently grapple with an inefficient, often linear fashion of editing shared plans and documents via word processing software and email. This process does not typically permit users to simultaneously see and make changes in a fashion that is transparent and modifiable, and depends on the next person in the email chain to respond in a timely fashion. Often this does not represent the best overall workflow for a given process. Conversely, web-based collaboration portals, wikis, and other groupware (Schrum & Lamb, 1996; Pereira & Soares, 2007) technologies allow for shared development, editing, and distribution of materials among various stakeholders. These products are intuitive, and user-friendly, and permit non-technical users to edit or upload documents and other multimedia files by simple interfaces. Many are inexpensive, easy to set up, and support integration with other interactive web 2.0 technologies such as blogs, RSS feeds, internet calendaring, email integration, and user defined metadata tagging for easy retrieval. The combination of ease-of-use and intuitive features have pushed wikis to the forefront of collaborative groupware options. In fact, one limitation of many products is their ease of use, which can create increased risks for vandalism to the system (Gonzalez-Reinhart, 2005). Nevertheless, when correctly set up and managed, wikis have the potential to enable collaborative learning communities that use advanced knowledge management and distributed learning strategies (Boulos, Maramba & Wheeler, 2006).
The ability of wiki technology to support collaboration in a distributed network holds great promise in the field of health care. Health care organizations must work constantly to improve quality and service delivery in a system that is increasingly dispersed and complex. In this environment, tools that foster collaboration and partnership are essential. Unfortunately, health care providers in low-resource environments may be hesitant to adopt novel technologies (Fiscella & Geiger, 2006; Shields, Shin, Leu, Levy, Betancourt, Hawkins & Proser, 2007). Barriers often include lack of familiarity with information technology (IT) applications, cost, differences in language and context of communication, limitations in end user ability to adapt to technology, and variations in the infrastructure necessary for end users to engage in IT-enabled collaboration (Chaisson, Reddy, Kaplan & Davidson, 2006).
The challenges of using collaborative IT tools, including wikis, in health care settings may also be related to the unique requirements of health care from both legal and usability perspectives. On the legal side, federal Health Insurance Portability Accountability Act (HIPAA)1 requirements in the United States call for stringent security features in the use, transmission, and sharing of information; wikis and communications portals must be able to meet these standards. From a usability perspective, health care is a highly specialized industry. The context of the health care environment necessitates easy-to-use graphical user interfaces for non-expert users, the ability to alert end users for new content in an appropriate manner, and seamless integration of the product into workflow of the busy medical office environment.
Key Terms in this Chapter
webDAV: Web-based Distributed Authoring and Versioning, or WebDAV, is a set of extensions to the Hypertext Transfer Protocol (HTTP) that allows users to collaboratively edit and manage files on remote World Wide Web servers.
Axon Collaboration Portal 2.0: A wiki-driven portal capable of WYSIWYG content creation, document publishing, and document distribution developed by Serebrum Corporation that uses a robust role-based access control security model to enable easy and secure collaboration among project team members.
Transdisciplinary: A process that melds varying backgrounds and perspectives of stakeholders, resulting in unified concepts, ideas and approaches to an identified problem or issue.
role based access control (RBAC): A policy neutral and flexible access control approach to restricting system access to authorized users
Portal: A Web site that offers a range of resources, such as e-mail, chat boards, search engines, content and online shopping.
Groupware: Software that supports multiple users working on related tasks in local and remote networks. Also called “collaborative software,” groupware is an evolving concept that is more than just multiuser software which allows access to the same data but also provides a mechanism that helps users coordinate and keep track of ongoing projects together.
community health organization: A non-profit health care organization which administers and coordinates the delivery of health care services to people living in a designated community or neighborhood.
HIPAA (Health Insurance Portability and Accountability Act of 1996): A federal law (Public Law 104-191) intended to improve the portability of health insurance and simplify health care administration. HIPAA sets standards for electronic transmission of claims-related information and for ensuring the security and privacy of all individually identifiable health information.
Health Information Technology (HIT): The application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use.
Wiki: A website or similar online resource which allows users to add and edit topic-based content collectively with simple formatting rules and without extensive knowledge of programming or HTML.