Information technology and hospice palliative care: social, cultural, ethical and technical implications in a rural setting

OBJECTIVE: There is a need to better understand the specific settings in which health information technology (HIT) is used and implemented. Factors that will determine the successful implementation of HIT are context-specific and often reside not at the technical level but rather at the process and people level. This paper provides the results of a needs assessment for HIT to support hospice palliative care (HPC) delivery in rural settings. METHODS: Roundtable discussions using the nominal group technique were done to identify priority issues regarding HIT usage to support rural HPC delivery. Qualitative content analysis was then used to identify sociotechnical themes from the roundtable data. RESULTS: Twenty priority issues were identified at the roundtable session. Content analysis grouped the priority issues into one central theme and five supporting themes to form a sociotechnical framework for patient-centered care in rural settings. CONCLUSION: There are several sociotechnical themes and associated issues that need to be considered prior to implementing HIT in rural HPC settings. Proactive evaluation of these issues can enhance HIT implementation and also help to make ethical aspects of HIT design more explicit.