In the Training section:
Training
Training Workshop Content
Part 1: Introduction
[c.10 mins]
i. Read out the workshop aim, objectives and structure. [ TRAINER ]
ii. Explain that e-health is part of e-government. [ TRAINER ]
Other Possible Activities:
- If trainees may be unsure what e-government is, read out an e-government definition: see eGovernment Definition page (note broad definition). Then get the group to discuss or debate the definition of e-government and its relation to e-health. [ TRAINER & GROUP ]
Part 2: Understanding eHealth Projects
i. Explain that the whole notion of 'e-health' is still challenged. This part of the workshop looks at the reasons why one would (and might not) proceed with e-health projects. [ TRAINER ]
Other Possible Activities:
- For both of the sub-parts listed here - 2a and 2b - if trainees have a fair bit of experience on e-health projects, you can reverse the suggested order of activity within each sub-part. This means first getting the group to reflect on their experience in order to list the benefits (2a) or costs/downsides (2b) of e-health projects. Only then do they read the relevant Web site pages, compare those with the lists the group has prepared, and draw any additional conclusions. [ TRAINEES & GROUP ]
Part 2a: What benefit from e-health?
[c.35 mins]
i. Get trainees to read through the checklist of potential benefits on the Benefits/Costs of Public Sector Health IS Projects page . [ TRAINEES ]
ii. In pairs, small groups or plenary, get trainees to use their reading plus their own experience to summarise the key benefits that they feel e-health projects should produce in their particular part of the public sector health system. [ GROUP ]
Other Possible Activities:
- If trainees need additional real-world evidence about the benefits of e-health, they can read through and then discuss the 'Impact' sections in one or more of the seven main cases listed on the eHealth Cases page. [ TRAINEES & GROUP ]
Part 2b: Why think twice about e-health?
[c.50 mins]
i. Get trainees to read about the informal, personal benefits that e-health projects can deliver, on the Benefits/Costs of Public Sector Health IS Projects page . [ TRAINEES ]
ii. Get trainees to read about both the costs and downsides of e-health projects, on the Benefits/Costs of Public Sector Health IS Projects page . [ TRAINEES ]
iii. In pairs, small groups or plenary, get trainees to use their reading plus their own experience to summarise the key costs and the key downsides that they feel e-health projects in their particular part of the public sector health system are likely to produce. [ GROUP ]
iv. Now get the group to compare their list of likely costs and downsides versus their list of likely benefits. They can see if one side of the 'equation' outweighs the other, or if they seem fairly even. What does the group conclude about the likely progress and outcome of e-health? [ GROUP ]
Other Possible Activities:
- If trainees need additional real-world evidence about the costs of e-health, they can read through and then discuss the 'Impact' sections in one or more of the seven main cases listed on the eHealth Cases page. [ TRAINEES & GROUP ]
Part 3: Understanding eHealth Project Success and Failure
[c.75 mins]
i. Review the workshop findings to date (these are likely to be: that e-health projects are useful but that they face some challenges). The next step, then, is to find out why some e-health projects do deliver their benefits, but others don't. [ TRAINER ]
ii. Explain that there is no agreement about why e-health projects succeed or fail: different people give different explanations. Here, the group will look at one possible explanation for success/failure. But that explanation might not be relevant to everyone's situation. Rather than treat it as 'the truth', better to see it as a starting point for thinking and planning. [ TRAINER ]
iii. Get trainees to read through the Design-Reality Gap Model page. [ TRAINEES ]
iv. In pairs or small groups, get trainees to provide examples of design-reality gaps from their own experience. For experience of successful e-health projects, do they find that there are mainly small gaps between design and reality? For experience of unsuccessful e-health projects, do they find that are mainly large gaps between design and reality? Are there other dimensions that are missing from the ITPOSMO checklist? [ GROUP ]
v. Discuss the match or mismatch between the ideas of the model, and the experience of the trainees. What does the group conclude about design-reality gaps: is this an idea that is relevant and useful in its current form, or one that needs to be modified to make it relevant and useful (if so, how), or is it simply not relevant or useful in any form (if the latter, then later design-reality gap activities can be ignored)? [ GROUP ]
Other Possible Activities:
- If trainees have limited experience, they can spend more time reading and/or discussing the linked case study example on Computerising a Central Asian Epidemiology Service . [ TRAINEES/GROUP ]
- If trainees need additional confidence in handling design-reality gaps, identify a single e-health case study (for example, you could choose one of the cases from the eHealth Cases page). Then get trainees in small groups to identify the dimensions and size of design-reality gaps in the chosen case (note, unless the case is particularly detailed, trainees may be unable to identify all seven ITPOSMO dimensions). Discuss whether the overall size of gap relates to the reported outcome (success or failure) of the case. [ GROUP ]
Part 4: Practical Techniques for eHealth Projects
i. Explain that many - likely most - e-health projects are failures of some kind, and that trainees need to take account of this in their work. With that in mind, the workshop now moves on to look at some practical techniques trainees can use when involved with e-health projects that are planned or that are in the middle of being implemented. [ TRAINER ]
ii. Explain to the trainees that there are no panaceas to guard against e-health failure. If there were, then failure would have been banished long ago. Instead, there are just some ideas that some people may find feasible and effective (but some people may not). [ TRAINER ]
Part 4a: Assessing the risks of e-health project failure
[c.120 mins]
i. Get trainees to read through the Design-Reality Gap Risk Assessment page, including the worked example. [ TRAINEES ]
ii. Get trainees to work in pairs or small groups on a real-world e-health project that is planned or being implemented. Ideally, they should use a single real-world case with which all the group is familiar (e.g. one on which they are all currently employed). Alternatively, a text-based case must be prepared by the trainer: one of the Web site cases (such cases 1 or 2 on the eHealth Cases page- both listed as "too early to evaluate") could be used as the basis for this. The trainees' task is - taking each of the ITPOSMO dimensions in turn - to identify organisational reality at present; to identify the design assumptions/requirements; and then to give a 0-10 rating for the design-reality gap on that dimension. A table or diagram, like those used in the worked example on the Web page, should be used to present the individual dimension gaps. The gaps for all the individual dimensions should be totalled, and compared to the results table on the Design-Reality Gap Risk Assessment page. On this basis, the group should draw conclusions about the likelihood of success or failure, and about the main sources of risk to the project. [ GROUP ]
iii. Get the groups to reflect on the approach they have just used, and then discuss questions such as: Was this a relevant and useful approach to assess the risks of e-health project failure? What were its strong and weak points? How would we do it differently next time? [ GROUP ]
Other Possible Activities:
- If trainees need to think more about adapting design-reality techniques to their particular situation, get the groups to discuss in turn each of the 'Variations' listed on the Design-Reality Gap Risk Assessment page.. It can be particularly valuable to consider the drivers behind e-health projects that may offset some of the risks. The groups should draw up an action plan for modifying the design-reality gap technique in practice. [ GROUP ]
Part 4b: Reducing the risks of e-health project failure
[c.100 mins]
i. Get trainees to read through the Design-Reality Gap Closure page, including the related case example. [ TRAINEES ]
ii. Assuming that the group activity for Part 4a identified some potential sources of risk, get trainees to continue working in their existing groups on the same case. Based on their earlier identification of main sources (dimensions) of risk, the group should now make an action plan that directly addresses those dimensions through design-reality gap reduction. The plan should identify key generic and specific actions to take in order to reduce project risk and increase the likelihood of success. The group must show that any suggested actions are both desirable and feasible. [ GROUP ]
iii. Get the groups to reflect on the approach they have just used, and then discuss questions such as: Was this a relevant and useful approach to reduce the risks of e-health project failure? What were its strong and weak points? How would we do it differently next time? [ GROUP ]
Part 5: Action Plans
[c.25 mins]
i. Get trainees to write down three key learning points from this workshop (i.e. the three most important things they feel they have learned from the workshop) and three key action points (i.e. three actions they wish to take on their return to the workplace as a result of undertaking this training). [ GROUP ]
ii. Summarise some of the overall issues that have emerged from the workshop, and identify any "next steps". [ TRAINER ]
Other Possible Activities:
- If trainees need to get feedback on their personal action points, get trainees to share and discuss learning and action points with one other person and/or get trainees to share and discuss learning and action points in a plenary report-back. [ GROUP ]
- If generic or group action points need to be identified, get trainees to discuss further training or other generic action needs arising from the training workshop. [ GROUP ]
- If this training workshop needs to be evaluated, get trainees to fill in (and possibly discuss) an evaluation form. A simple evaluation form asks just four questions: "What was good about this workshop, that we should retain if we repeat the workshop?"; "What was not so good about this workshop, that we should change if we repeat the workshop?"; "What was missing from this workshop, that we should add if we repeat the workshop?"; "Any other comments?". [ GROUP ]