شناسایی مسائل پیش روی توسعه سیستم پایش از راه دور بیماران و ارائه راهکار از دیدگاه کاربران: کاربرد روش‌شناسی سیستم‌های نرم

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری مدیریت فناوری اطلاعات، دانشکده مدیریت و حسابداری، دانشگاه شهید بهشتی، تهران، ایران.

2 استادیار، گروه مدیریت صنعتی و فناوری اطلاعات، دانشکده مدیریت و حسابداری، دانشگاه شهید بهشتی، تهران، ایران.

3 استاد، گروه مدیریت صنعتی و فناوری اطلاعات، دانشکده مدیریت و حسابداری، دانشگاه شهید بهشتی، تهران، ایران.

10.48308/jimp.14.2.9

چکیده

مقدمه و اهداف: به‌طورکلی سیستم‌های سلامت از راه دور و به‌تبع آن سیستم پایش از راه دور بیماران از زمان معرفی تاکنون همواره با مشکلاتی در خصوص پذیرش این سیستم‌ها از طرف کاربران مواجه بوده‌اند. تعدد و تعارض در دیدگاه‌ها، نیازمندی‌ها و نگرانی‌های کاربران نسبت به تغییر در نحوه ارائه خدمات سلامت، طراحی این سیستم‌ها را با وضعیتی پیچیده روبه‌رو می‌کند که می‌توان آن را به‌عنوان مسئله نرم تعریف کرد. در این شرایط طراحی این سیستم‌ها‌ نیازمند رویکردی برای درک مسائل و پیچیدگی‌ها و دستیابی به راه‌حلی مطلوب و ممکن با توجه به شرایط اجتماعی و فرهنگی محیط اجرا ‌است. هدف این پژوهش استفاده از چارچوب تغییریافته روش‌شناسی سیستم‌های نرم به‌عنوان یک روش ساختاریافته برای مقابله با مسائل نرم در مواجهه با پیچیدگی‌های طراحی و پیاده‌سازی سیستم‌ پایش از راه دور بیماران از دیدگاه عوامل انسانی ‌است.
 روش‌ها: در این پژوهش یک رویکرد ترکیبی شامل روش‌شناسی سیستم‌های نرم برای شناسایی مسائل، تعریف نیازمندی‌ها و اقدامات به همراه چارچوب NASSS به‌عنوان یک لنز نظری برای هدایت تفکر شرکت‌کنندگان معرفی شده است که از این‌ رویکرد در توسعه سیستم پایش از راه دور بیماران با تمرکز بر پذیرش سیستم استفاده شده است. در این مطالعه اقداماتی شامل انجام مصاحبه، ترسیم تصویر غنی، تحلیل محتوای دیدگاه‌ها و شناسایی مسائل در فاز یافتن و تعریف ریشه‌ای، تحلیل CATWOE و ارائه مدل‌های مفهومی در فاز مدل‌سازی انجام شد. در ادامه در فازهای مباحثه و تعریف بر اساس دو مدل مفهومی از دیدگاه پزشکان و بیماران، اقدامات مطلوب و ممکن تعریف شدند.
یافته‌ها: در پژوهش حاضر، مصاحبه‌هایی نیمه­ساختاریافته بر اساس حوزه‌های چارچوب NASSS با 15 نفر از پزشکان و 13 نفر از بیماران به‌صورت انفرادی و در گروه‌های دو و سه نفره به‌عنوان کاربر نهایی سیستم پایش از راه دور بیماران صورت گرفت. در ادامه نتایج مصاحبه‌ها تحلیل شد و دیدگاه‌های شرکت‌کنندگان در چهار مسئله نیازمندی‌های فرایند پایش از راه دور، اعتماد به سیستم، مقرون‌به‌صرفه­بودن آن و اجرای سیستم پایش از راه دور در ساختار و رویه‌های جاری بیمارستان دسته‌بندی شد؛ سپس در فاز مدل‌سازی برای درک بهتر مسائل از دیدگاه شرکت‌کنندگان در فرایند مصاحبه، تعاریف ریشه‌ای از طریق فرمول PQR ایجاد و با استفاده از تحلیل CATWOE غنی شده و مدل‌های مفهومی از مسائل بر اساس دیدگاه بیماران و پزشکان ارائه شد. در پایان پس از انجام فازهای مباحثه و تعریف، اقدامات مطلوب و ممکن برای توسعه سیستم پایش از راه دور بیماران به‌عنوان پاسخ به هر یک از نگرانی‌ها و نیازمندی‌های شرکت‌کنندگان در پژوهش، بر اساس ماهیت اقدامات در چهار بُعد ویژگی‌های موردانتظار از سیستم، فرایندهای اجرایی، قوانین و دستورالعمل‌های موردنیاز و همچنین سیاست‌گذاری‌های موردنیاز تعریف شد.
 نتیجه‌گیری: نتایج این پژوهش نشان داد که روش‌شناسی سیستم‌های نرم با درک دیدگاه‌های عوامل انسانی و شناسایی و مفهوم‌سازی مسائل و پیچیدگی‌های جنبه‌های مختلف سیستم‌ پایش از راه دور بیماران و تعریف اقدامات مرتبط موردتوافق می‌تواند به توسعه‌دهندگان سیستم، مجریان و سیاست‌گذاران نظام سلامت در شناخت نیازمندی‌ها و فرایندهای موردتوافق کاربران بالقوه سیستم‌ پیش از طراحی و پیاده‌سازی آن کمک شایانی کند و موجب کاهش مقاومت و افزایش پایبندی در کاربران شود.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Identifying the Problems Facing the Development of Patient Telemonitoring Systems and Providing Solutions from Users' Perspectives: Application of Soft Systems Methodology

نویسندگان [English]

  • Omid Shafaghsorkh 1
  • Ashkan Ayough 2
  • Akbar Alem Tabriz 3
1 Ph.D Candidate, Department of Industrial Management and Information Technology, Faculty of Management & Accounting, Shahid Beheshti University, Tehran, Iran.
2 Assistant Professor, Department of Industrial Management and Information Technology, Faculty of Management & Accounting, Shahid Beheshti University, Tehran, Iran.
3 Professor, Department of Industrial Management and Information Technology, Faculty of Management & Accounting, Shahid Beheshti University, Tehran, Iran.
چکیده [English]

Introduction: Telehealth systems, including patient telemonitoring systems, have consistently faced challenges in user adoption since their introduction. The diversity and conflicts in users' views, needs, and concerns about changes in health service delivery create a complex situation, which can be defined as a "soft problem." Designing these systems requires an approach to understand the issues and complexities and achieve feasible solutions considering the social and cultural conditions of the implementation environment. This research aims to use the modified soft systems methodology framework as a structured method to tackle these soft problems in the design and implementation of patient telemonitoring systems from the perspective of human factors.
Methods: This research employs a hybrid approach, incorporating soft systems methodology to identify problems, define requirements, and determine actions, alongside the NASSS framework as a theoretical lens to guide participants' views. This approach was used to develop the patient telemonitoring system with a focus on system adoption. The study involved conducting interviews, drawing rich pictures, analyzing users' views, identifying problems during the finding phase, and performing root definition, CATWOE analysis, and presenting conceptual models in the modeling phase. During the discussion and definition phases, based on conceptual models from physicians' and patients' perspectives, desirable and feasible actions were defined.
Results and discussion: Semi-structured interviews were conducted with 15 physicians and 13 patients, individually and in groups of two and three, as end-users of the patient telemonitoring system. The interview results were analyzed, and participants' views were categorized into four issues: telemonitoring process requirements, trust in the system, cost-effectiveness, and the implementation of the telemonitoring system within the current hospital structure and procedures. In the modeling phase, root definitions were created using the PQR formula and enriched with CATWOE analysis. Conceptual models of the problems were then presented based on patients' and physicians' perspectives. Finally, after the discussion and definition phases, desirable and feasible actions for developing the patient telemonitoring system were defined in four dimensions: expected system features, executive processes, required rules and instructions, and necessary policies.
Conclusions: The results show that soft systems methodology, by understanding human factors' perspectives and identifying and conceptualizing the problems and complexities of various aspects of the patient telemonitoring system, can significantly aid system developers, implementers, and health system policymakers. It helps them understand the requirements and agreed processes of potential users before design and implementation, reducing resistance and increasing user adherence.

کلیدواژه‌ها [English]

  • Telehealth Systems
  • Patient Telemonitoring System
  • Soft Systems Methodology
  • System Design
  • System Adoption

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