A Realist Evaluation of the usability of the Welsh Community Care Information System (WCCIS) in a South Wales Valley
Objective – The focus of this study is to investigate the usability of an integrated health and social care information system (Welsh Community Care Information System - WCCIS) in a South Wales Valley. The evaluation adopts a realist approach to examine whether WCCIS is usable for the end practitioners, how is it usable and for whom and under what circumstances?" (Pawson, 2006). Methods– The thesis is structured using the Rameses II reporting standards for realist evaluations, (Wong et al, 2016). This study adopted four cycles of data collection; realistic synthesis, document collection, two focus groups and one semi structured interview. There were fifteen participants, all of the participants worked in the same geographical area in the South Wales valley and within the health and social care profession. The participants were from diverse roles and included social workers, community psychiatric nurse, administrator and a health board project manager.The framework used for analysis was Wong and Papoutsi (2016). Throughout each data cycle the development of context, mechanism, and outcome (CMO) configuration in relation to the programme theories were continuously developed including their influence to the usability of WCCIS. Results – The results revealed issues in regards to integration, implementation process, training and the usability of WCCIS. All participants envisaged the potential for WCCIS when the ‘teething problems’ have been resolved. The participants considered the process of implementation being a phased approach and not all organisations going live at the same time to have acted as a hindrance to implementation due to still having to access multiple systems to retrieve information. Other examples including the referral process, the inability to email one another within the system, the lack of training and the lack of involvement in implementation and design of WCCIS, affected participant usability. The practitioners were grateful for such functions including the spell check and the copy and paste but recommended further improvements in relation to the technical issues for full usability within the everyday role. To summarise the findings of this evaluation the core factors effecting the participant usability of WCCIS was primarily due to the input the practitioners had in the development of WCCIS, which the evaluation revealed to be minimal. The training the practitioners received did not meet their needs to use the system effectively and have resorted to learning the system over time. Conclusion – This study demonstrates the need for integration between the health and social care sector, to which WCCIS is aiming to achieve. The focus of this study was to investigate the usability of WCCIS in a South Wales Valley. Practitioners within this study can envisage the potential of WCCIS but they currently do not experience the benefits of WCCIS as there is still issues within the system affecting the practitioner’s usability. Overall, at the time writing this evaluation WCCIS does not reach the potential in terms of usability that the practitioners need it to for them to be able to achieve their day-to-day tasks with ease. The researcher has provided a learning log in the recommendation section that focuses on the lessons learnt in this South Wales valley and the recommended improvements to be made to increase the usability of WCCIS for the end users in other geographical localities.
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