Healthcare professionals as customers: A service perspective on Portuguese primary care health information systems

Health information systems are becoming ubiquitous throughout healthcare delivery processes. Governments, enticed by the potential for improved patient care and cost reduction, are pushing for more integrated IT systems in healthcare. However, the successful adoption of these systems depends on the value they create as a service for healthcare professionals and how they support their activities. Following a call for more multidisciplinary research in health information systems and increased end-user participation in HIS development, this study presents a service perspective that considers users of health information systems (HIS) as active partners and co-creators of value, instead of passive recipients of the functionalities brought by these IT systems. From a service perspective we frame healthcare professionals as customers of HIS, and analyze how they can better support healthcare provision. We present an in-depth study of primary care professionals experience with the HIS of the Portuguese National Health Service. Experience was systematized using Customer Experience Modeling, a method that takes into account the holistic nature of experience. Results portray and evaluate HIS according to professionals´ experience requirements. They also show a fragmented reality where HIS usefulness is being hampered by integration and performance issues. HIS design guidelines are also posited.