| A trip to the hospital can result in a large amount of information to be recorded and maintained. Health information systems, specifically electronic health records (EHRs), allow multiple stakeholders to document important information, as well as to collaborate and share with others. The healthcare ecosystem is comprised of many people, such as the patient, a primary clinician, and many specialist clinicians or a caregiver. Each stakeholder often documents a health record separately. For example, the primary clinician of a patient may have a certain record while the patients may be recording their health information by themselves. Likewise, a specialist clinician may be recording a patient's information in a health record entirely separate from the records of the patient's primary clinician. This can create a disconnect between both sets of records, potentially missing vital health information. Therefore, it is important for health information systems to provide the ability to share and collaborate among the stakeholders.;There are a variety of different health information systems that are available to both patients and clinicians. For example, personal health records (PHRs) are electronic health records that allow the patient to be the primary caretaker of the record. These have enormous potential to improve both documentation of health information and patient care. However, the adoption of this system has been relatively slow among both patients and clinicians. In contrast, one electronic health record that has been more widely accepted than PHRs is the electronic medical record (EMR), which consists of only clinician-generated data and labs. Although many hospitals have already adopted an EMR system, there are still a number of barriers and challenges that EMR systems face.;This thesis presents data from three case studies that explore two aspects: (1) the different barriers and challenges that limit the adoption of these health information systems; (2) problems with how different stakeholders such as clinicians, patients, and caregivers collaborate with the data generated from these health information systems. The results in this thesis have shown that patient-originated data needs to be clinically relevant. Therefore, users and clinicians should be constantly sharing the information and using that information to collaborate in order to verify the relevancy of these data. Similarly, the lack of adoption may in part be due to these challenges in the usability of the systems but also in the misunderstandings of the context of use by systems designers, in which users indicated the necessity to bridge the "cultural" divide between a variety of users, such as the healthcare provider and the developer. |
