Challenges of Evaluation in Biomedical Informatics - Evaluation Methods in Biomedical Informatics - page 4

FIGURE 1.1. Actors involved in health care delivery and regulation.

Every evaluation study should be motivated by one or more of these
factors; otherwise, it risks being what has been called a “triple blind study,”
in which neither evaluators, participants, nor readers of the report can
fathom why it was done. † Awareness of the major reason for conducting an
evaluation often helps frame the major questions to be addressed and
avoids any disappointment that may result if the focus of the study is mis-
directed. We return in Chapter 3 to the problem of deciding how much to
emphasize each of the many questions that arise in most evaluation studies.

Who Is Involved in Evaluation and Why?

We have already mentioned the range of perspectives in biomedical infor-
matics, from the technical to the organizational. With specific regard to the
clinical domain, Figure 1.1 shows some of the actors involved in paying for
(solid arrows) and regulating (shaded arrows) the healthcare process. Any
of these actors may be affected by a biomedical information resource, and
each may have a unique view of what constitutes benefit. More specifically,
in a typical clinical information resource project, the key “stakeholders” are
the developer, the user, the patients whose management may be affected,
and the person responsible for purchasing and maintaining the information
resource. Each of these individuals or groups may have different questions