We spoke with Dr. Ramesh Farzanfar, the Principal Investigator on the project entitled Development of a Longitudinal Qualitative Methods Manual and Quantitative Instrument for Evaluating Use of Multi-Contact eHealth Technologies by Patients and Consumers at Boston Medical Center.

Q: What is unique and/or innovative about your study?
Our evaluation study is based on exploring the patterns of utilization among eHealth users. “Use” is a critical factor of success in the adoption or diffusion of an innovation, particularly innovations based on science and technology. Many applications of eHealth technologies involve discretionary use by patients and other consumers over extended periods of time. Consequently, adherence of the users to the program schedule is required to achieve the targeted effect and/or its maintenance. There is some evidence that some eHealth technologies fail as a result of nonuse or underutilization. We believe our study’s focus on the issue of “use” makes it distinct and ultimately useful to both designers and consumers.

Q: How is your project progressing so far?
We have completed recruitment of the 80 participants in our first evaluation study and have already detected different patterns of use among the users. We are now in the process of conducting our qualitative in-depth interviews. Also, we have almost completed the first draft of our Procedures’ Manual.

Q: What prompted you to explore this research?
I have worked in a medical informatics environment for almost 10 years. During these years, we have conducted several clinical trials of our automated intervention. The fact that some users do not adhere to the prescribed guidelines for system utilization has been a source of intellectual curiosity and a concern to me. We have observed varying patterns of use ranging from complete adherence to nonuse. I was looking for an opportunity to explore this phenomenon further and the Health e-Technologies initiative provided that opportunity.

Q: How would a typical end-user utilize the final product/results of your research?
Our study will develop a quantitative instrument for investigators who work in eHealth to explore the question of “adherence to program utilization.” The study will also develop a Procedures’ Manual to enable those who are new to qualitative research to conduct qualitative evaluations to explore users’ experience. A qualitative evaluation will also help generate items for a quantitative measurement instrument. Both of these products should assist investigators in their evaluations to explore how they can improve and enhance utilization.

Q: What are the greatest challenges in eHealth and more specifically, your project?
I believe that the most important challenges to eHealth are:
· Making eHealth accessible to all citizens (equity).
· Ensuring data privacy.
· Translating the results of eHealth research to marketable and useful products.
· Translating the results of eHealth research to reliable and effective services.
· Overcoming citizens’ resistance to support and manage their own health through eHealth.

A challenge to the project is a possible resistance to qualitative evaluation approaches by the designers or developers who have a “positivist” orientation.

Q: In what ways would you like to see eHealth evolve?
I would like to see eHealth evolve so that it could eradicate barriers to the distribution of modern scientifically-based medicine across the world.

Q: How do you stay informed of advances and innovations in eHealth?
I stay informed through the Internet, eHealth journals and books, conferences and workshops as well as exchanges with colleagues and friends.

Many thanks to Ramesh for her time and insight!

Come back soon – in our next edition we’ll hear from Dr. Kate Lorig of Stanford University.