Using Activity Theory and Task Structure Charts to Model Patient-Introduced Online Health Information into the Family Physician/Patient Examination Process

  • Beth EllingtonEmail author
Conference paper
Part of the Advances in Intelligent Systems and Computing book series (AISC, volume 1130)


This research study was undertaken to gain a richer understanding of the use of patient-introduced online health information during the physician/patient examination and communication process. Utilizing qualitative data obtained from ten family physician interviews and workflow modeling of the data using activity diagrams and task structure charts, this study uncovered the frequency of patient-introduced online health information, physician suggested online resources, use of email for physician/patient communication, use of electronic medical records, along with tasks involved and methods used by the physicians to work the online health information into the physician/patient examination and knowledge transfer process.


Patient-introduced online health information Physician productivity Work flow modeling Engström’s Activity Theory 


  1. 1.
    Aarts, J., van der Sijs, H.: CPOE, alerts and workflow: taking stock of ten years research at Erasmus MC. Stud. Health Technol. Inform. 148, 165–169 (2009)Google Scholar
  2. 2.
    Ahern, D.: Challenges and opportunities of eHealth research. Am. J. Prev. Med. 32, 75–85 (2007)CrossRefGoogle Scholar
  3. 3.
    Ahluwalia, S., Murry, E., Stevenson, F., Kerr, C., Burns, J.: ‘A heartbeat moment’: qualitative study of GP views of patients bringing health information from the internet to a consultation. Br. J. Gen. Pract. 60, 88–94 (2010)CrossRefGoogle Scholar
  4. 4.
    Ahmad, F., Hudak, P., Bercovitz, K., Hollenberg, E., Levinson, W.: Are physicians ready for patients with Internet-based health information? J. Med. Internet Res. 8, e22 (2006)CrossRefGoogle Scholar
  5. 5.
    Babbie, E.: The Practice of Social Research. Thomson Wadsworth, Belmont (2007)Google Scholar
  6. 6.
    Ball, M., Lillis, J.: E-health: transforming the physician/patient relationship. Int. J. Med. Inform. 61, 1–10 (2001)CrossRefGoogle Scholar
  7. 7.
    Blumenthal, D.: Implementation of the federal health information technology initiative. N. Engl. J. Med. 365, 2426–2431 (2011)CrossRefGoogle Scholar
  8. 8.
    Brann, M., Anderson, J.: E-Medicine and health care consumers: recognizing current problems and possible resolutions for a safer environment. Health Care Anal. 10, 403–415 (2002)CrossRefGoogle Scholar
  9. 9.
    Brooks, L., Griffin, T.: Is it time for a new practice environment? An operational look at your practice. J. Med. Pract. Manag. 25, 307–310 (2010)Google Scholar
  10. 10.
    Centers for Disease Control and Prevention: Health Literacy (2011). Accessed 9 Oct 2011
  11. 11.
    Dugdale, D., Epstein, R., Pantilat, S.: Time and the patient-physician relationship. J. Gen. Intern. Med. 14, S34–S40 (1999)CrossRefGoogle Scholar
  12. 12.
    Elcin, M., Odabasi, O., Gokler, B., Sayek, I., Akova, M., Kiper, N.: Developing and evaluating professionalism. Med. Teach. 28, 36–39 (2006)CrossRefGoogle Scholar
  13. 13.
    Elkin, N.: How America Searches: Health and Wellness. iCrossing, Inc., pp. 1–17 (2008)Google Scholar
  14. 14.
    Engeström, Y.: Learning by Expanding: An Activity-Theoretical Approach to Developmental Research. Orienta-Konsultit, Helsinki (1987)Google Scholar
  15. 15.
    Engeström, Y.: Activity theory as a framework for analyzing and redesigning work. Ergonomics 43(7), 960–974 (2000)CrossRefGoogle Scholar
  16. 16.
    Eudy, K.: Google second only to doctors as source of health information. Capstrat and Public Policy Polling (2010). Accessed 31 May 2010
  17. 17.
    Fowler, F.J.: Survey Research Methods. Sage, Los Angeles (2009)Google Scholar
  18. 18.
    Fox, S., Rainie, L.: The online health care revolution: how the Web helps Americans take better care of themselves. Pew Internet & American Life Project (2000). Accessed 30 Nov 2008
  19. 19.
    Freed, G., Stockman, J.: Oversimplifying primary care supply and shortages. J. Am. Med. Assoc. 301, 1920–1922 (2009)CrossRefGoogle Scholar
  20. 20.
    Keselman, A., Logan, R., Smith, C., Leroy, G., Zeng-Treitler, Q.: Developing informatics tools and strategies for consumer-centered health communication. J. Am. Med. Inform. Assoc. 15, 473–483 (2008)CrossRefGoogle Scholar
  21. 21.
    Kim, K., Kim, S.: Physicians’ perception of the effects of Internet health information on the doctor-patient relationship. Inform. Health Soc. Care 34, 136–148 (2009)CrossRefGoogle Scholar
  22. 22.
    Kreuter, M., McClure, S.: The role of culture in health communication. Annu. Rev. Public Health 25, 439–455 (2004)CrossRefGoogle Scholar
  23. 23.
    NC Medical Board (North Carolina Medical Board) (2011). Accessed 19 Nov 2011
  24. 24.
    Preece, J., Rogers, Y., Sharp, H.: Interaction Design: Beyond Human-Computer Interaction. Wiley, New York (2002)Google Scholar
  25. 25.
    Rauh, S., Wadsworth, E., Weeks, W., Weinstein, J.: The savings illusion – why clinical quality improvement fails to deliver bottom – line results. N. Engl. J. Med. e48, 1–3 (2011)Google Scholar
  26. 26.
    Stevenson, W.: Operations Management. McGraw-Hill, Boston (2012)Google Scholar
  27. 27.
    Trist, E., Murray, H.: Historical overview. In: The Social Engagement of Social Science: A Tavistock Anthology. University of Pennsylvania Press, Philadelphia, pp. 1–34 (1990)Google Scholar
  28. 28.
    U. S. Department of Health and Human Services: National Plan to Improve Health Literacy (2010). Accessed 9 Oct 2011
  29. 29.
    Wensing, M., Wollershiem, H., Grol, R.: Organizational interventions to implement improvements in patient care: a structured review of reviews. Implement. Sci. 1, 2 (2006)CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Appalachian State UniversityBooneUSA

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