Chapter 4 of our textbook compares positivist, interpretive, critical, feminist, and postmodern approaches to research. Subjectivity and objectivity on the part of the researcher is discussed in relation to these methodologies. In my research project, I have become familiar with several models of electronic personal health records. The first demo I saw showed many online screens where the user must enter a large quantity of family medical history, and continually update the website. At that time, I immediately rejected the design as being overburdensome, requiring too much data entry, and not being very useful for consumers. After reading this chapter, I realize that I was not making an objective observation, but was putting my value-judgment onto the product. In fact, because I have an extremely busy schedule, without the time to gather family medical record detail, even though I know it is an important task, I was projecting this negative reaction to all users. Perhaps someone else, perhaps a retired person, with more free time would find this activity valuable and the software extremely useful. Having always considered myself an objective person, I started to judge myself harshly on this. Then I read in the chapter that for critical social science (CSS) being objective is not being value free; it means a non-distorted picture of reality with the goal of making social change. Then I talked to other people who also don’t like the idea of a large amount of data entry. They feel it is the physician’s responsibility to provide the data and to monitor it. However, one of the people I talked to with this attitude began to have a major health problem. So I realized that people can’t solely rely on physicians whether they like data entry or not, and that perhaps my role as a researcher is to take a CSS viewpoint and try to find a design that is a compromise and brings about a change needed for technology acceptance, use, acceptance for responsibility over one’s own health, hopefully resulting in better societal health.
My topic is very complex and to narrow it down to a manageable level, I will first do a literature review and then focus on reviewing features of existing “tethered” vs. “untethered” products. A “tethered” electronic personal health record is initiated and owned by an entity such as a hospital or health insurance plan which allows the patient access via a “portal.” These vary in patient access levels, but most of them offer limited patient input. The patient may be able to enter emergency contacts, allergies, make appointments, or fill pharmacy prescritions, but these things are optional and the lab or xray reports and medical records content is populated by the entity-owner. The “untethered” products are the opposite; the patient is the purchaser and owner of the free-standing or online software, with some offering limited connectivity to physicians’ records. I am going to try to take a CSS approach to this review.
