Akzeptanz und Usability sind Evidenz
Forderung:
Akzeptanz und Usability, d. h. die einfache Bedienbarkeit digitaler Anwendungen im Gesundheitswesen sollten als wissenschaftlicher Nachweis für eine sinnvolle Nutzung anerkannt und deshalb anhand eines standardisierten Vorgehens evaluiert werden. Dasselbe gilt für die subjektive Wahrnehmung der Nützlichkeit.
Rationale:
Neben klinischer Wirksamkeit sind auch Akzeptanz oder Wahrnehmung der Nützlichkeit und einfachen Bedienbarkeit durch die Endnutzerinnen, also Patientinnen oder Leistungserbringerinnen, wichtige Treiber für eine langfristige Nutzung von Telemedizin-Anwendungen (Harst et al., 2019). Darin unterscheiden sie sich zumindest in Teilen von pharmakologischen Interventionen, obwohl auch hier mangelnde Bereitschaft zur regelmäßigen Einnahme die Wirksamkeit schmälert. Daher fordern wir, dass sowohl die Gestaltung und Bedienbarkeit (sog. Usability) einer Anwendung als auch die Präferenzen von Patientinnen und Leistungserbringerinnen bereits in der Entwicklungsphase erhoben, d. h. als Evidenz für eine nachhaltig erfolgreiche Implementierung verstanden werden sollen (Årsand und Demiris, 2008). Verschiedenste Faktoren beeinflussen dabei die Akzeptanz und Usability digitaler Anwendungen im Gesundheitswesen und können durch explizite Adressierung deren langfristige Nutzung positiv beeinflussen (siehe Abbildung).
Akzeptanzfaktoren für digitale Anwendungen im Gesundheitswesen. Erweiterung der Unified Theory of Acceptance and Use of Technology 2 nach Otto und Harst (2019)
Was daraus folgt:
Es bedarf eines standardisierten nutzerzentrierten Entwicklungsprozesses für digitale Anwendungen im Gesundheitswesen, der mit bestehenden ISO-Normen wie der ISO 9241 („Ergonomics of humansystem interaction“) konform ist. Teil dieses Prozesses sollte eine kontinuierliche Evaluation der Akzeptanz und Usability einer Anwendung sein.
Warnung:
Umständliche Bedienung und Funktionalitäten, die nicht den Präferenzen der Nutzerinnen entsprechen, wirken in der Bewertung der Wirksamkeit insb. von Telemedizin-Anwendungen als Störfaktoren. Wenn eine Anwendung nicht genutzt wird, weil sie den Erwartungen der Nutzerinnen nicht entspricht, wird sie als unwirksam erscheinen, obwohl sie evidenzbasierte Interventionen enthält.
Literaturverzeichnis
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