Narrative
analysis of mivia
IS 356 E-Gov00
Presented by Angela Chen
Introduction
The migrant workers often find it difficult to access health care, and even when they are successful, the care they receive is sporadic and fragmented as they move form job to job and community to community. Due to this nature, migrant workers fall into the categories of vulnerable and underserved group. In order to minimize the barriers that underserved populations continues to face in accessing or using of health information, the Informatics has been identified a critical role in designing a health system that produces care that is safe, effective, patient centered, timely, and efficient, as well as a strategy for reducing health disparities in underserved populations.
Background
MiVIA,
which means 00y way00in Spanish, is an electronic Personal Health
Record designed for the migrant and seasonal workers in Sonoma, California.
in 2002 under the collaboration of Vineyard Worker Services, Saint Joseph
Health System-Sonoma Country, and Community Health Resource & Development
Center. The following video will give you a comprehensive understanding
about MiVIA program.
What
is narrative interview?
According to Jovchelovitch and Bauer, narrative interview is described as a qualitative research method used to stimulate interviewees or study participants to express their experiences and view of the topic being studied through telling stories or narratives. It is believed that the perspective of the interviewee is best revealed in stories where the informant is using his or her own spontaneous language in the narration of events. Therefore, the interviewees will not be restrained by a specific form of answers but an open-end story he/her wants to talk about.
Click to listen Jessica00
Interview: And we came
to realize that the patients we were enrolling didn00 have education
on the computer or the internet. So we start thinking maybe we
need to go a little bit further, for the user actually to be able to
use it.00/b>
(Interview:
From the doc00 point of view, is filling out patients00information
on MiVIA web a burden or are they all for it?) 00ah, when we
first started it was a burden, we have to write down the charts and
we have to go ahead and input into the computer. You know it was
not really having it until we started calling people and doing little
survey, you know, asking 00re you using it? How often or how are you
comfortable using it and etc?00nbsp; And it was until I brought the
numbers back to the physicians we are worked with and they were really
surprised that how many people were actually using it.00/b>
5.
Challenges/recommendation
Two main
challenges:
00t is hard to promote the MiVIA program to the clinics or physicians,00nbsp;
00acking
of funds, computer equipment and human resources to support the program.00/b>
Recommendations
(Please see the file for the complete recommendations.)
The number of enrollment of the MiVIA program is a decisive factor for the physicians/clinics to adopt MiVIA program. Showing good numbers worth more than a thousand words. Thus, it is recommended that a comprehensive statistics/survey of MiVIA usage be conducted to serve this purpose. Further, providing physicians statistical benefits of adopting MiVIA, such as improving accuracy of information across the continuum of care, saving redundant paperwork, shortening the wait for obtaining patient00 lab result and etc, to physician/clinics will certainly increase physicians00 interest.
Recommendations
(Con00)
Saint Joseph hospital is the only hospital offering community service as well as a catholic organization, MiVIA program should utilize the 00rand identity/trust00 to promote the program.
00ustomer perceived value00is an important concept from marketing perspective. MiVIA card turns out surprisely to be a big hit by serving as an ID card due to most of the migrant workers can not obtain formal ID cards for their illegal immigrant status. Follow this logic, MiVIA program will be prevailing if MiVIA card or online health record system is designed to suit users00extra needs. For instance, according to the cases told by VWS workers, the migrant workers are mostly young, single male. A lot of them have sexual transmitted disease issue that they are unwilling to share or disclose with. Therefore, if MiVIA online system supports a search function for the non-disclosable diseases in Spanish version as a side benefit besides storing personal health record, the potential clients may be increased as they perceive more values from the system.
6. Coda
While Jessica was asked
what her day is alike when she is with the mobile clinic, she described
how she outreached and enrolled the patients as telling her everyday
story. From that, I thoroughly agree that story telling approach
gives me a deeper understanding of interviewee00 perspectives.
For instance, she would be able to open up and disclose more details
about how she has to train the patients to use computer from scratch
to the point they can use the MiVIA program without her help.
Without narrative interview, I would not know what difficulties she
needs to go through and how much effort she needs to put on the training
session in such detail. As stories went along, Jessica further
shared her grandma00 case with MiVIA program. Those details
definitely will not be presented or disclosed in the context of true/false
or Likert-scale survey.
Coda (Con00)
When carrying out the
analysis of data from narrative interview, I use Labov00 structural
approach with some modifications to identify the story components and
select illustrative quotes which highlight any significant parts of
the narratives. Using this structure allows me to understand the
MiVIA program at complete angles.
Various stories led me
to a deeper, thorough understanding of the mindset of the MiVIA users.
Those insights are derived from the richer data- narrative interview,
and they enable us to evaluate the MiVIA program comprehensively.
While governmental agencies,
medical centers or health organizations are taking steps to empower
citizen to access the health care information and communication and
evaluating the effects of information technology used on health, this
MiVIA program could be a pilot project to assess the electronic health
system used by underserved populations.
Evaluation
and Extension
In order to ensure we
achieve our learning object, you should be able to answer the following
questions. (Please answer them in the short essay format. )
What the values/benefit of the MiVIA program perceived from the users?
Please describe what the training session is alike?
List few sales pitches for promoting MiVIA program.
Narrative interview is particular useful for what kind of study and why?
websites
MiVIA
https://www.mivia.org/About_Us.aspx#intro
https://www.followmezone.net/viahomepage/sign_up_2.shtml
Narratives
http://web.cgu.edu/faculty/wickera/working.htm
http://www2.chass.ncsu.edu/garson/pa765/narrativ.htm
