Thinking out loud and e-health for coordinated care: lessons from user requirements gathering in the 4C project

e-Health is a core part of Australia’s strategy to address rising costs and changing demands for healthcare services. That over $1bn has been spent and only 6% of Australians registered to the personally controlled electronic health record suggests user challenges remain. Evidence confirms the benefits from involving users in systems development there is a need for examples of how to engage effectively in healthcare settings. This research describes the use of an agile development methodology combined with the ‘Thinking Out Loud’ technique to deliver a solution that exceeded user requirements in supporting a new model of care. The 4C project solution proposed to connect Aged Care institutions with general practices, hospitals and specialist services in Tasmania’s north-west region. It was underpinned by a design incorporating three spheres of participation. As a trial project for the PCEHR it remains unclear why lessons learned appear not to have been deployed more explicitly in the national roll-out.