JunHua Li

Health Care Provider Adoption of eHealth: Systematic Literature Review

Background eHealth is an application of information and communication technologies across the whole range of functions that affect health. The benefits of eHealth (eg, improvement of health care operational efficiency and quality of patient care) have previously been documented in the literature. Health care providers (eg, medical doctors) are the key driving force in pushing eHealth initiatives. Without their acceptance and actual use, those eHealth benefits would be unlikely to be reaped. Objective To identify and synthesize influential factors to health care providers’ acceptance of various eHealth systems. Methods This systematic literature review was conducted in four steps. The first two steps facilitated the location and identification of relevant articles. The third step extracted key information from those articles including the studies’ characteristics and results. In the last step, identified factors were analyzed and grouped in accordance with the Unified Theory of Acceptance and Use of Technology (UTAUT). Results This study included 93 papers that have studied health care providers’ acceptance of eHealth. From these papers, 40 factors were identified and grouped into 7 clusters: (1) health care provider characteristics, (2) medical practice characteristics, (3) voluntariness of use, (4) performance expectancy, (5) effort expectancy, (6) social influence, and (7) facilitating or inhibiting conditions. Conclusions The grouping results demonstrated that the UTAUT model is useful for organizing the literature but has its limitations. Due to the complex contextual dynamics of health care settings, our work suggested that there would be potential to extend theories on information technology adoption, which is of great benefit to readers interested in learning more on the topic. Practically, these findings may help health care decision makers proactively introduce interventions to encourage acceptance of eHealth and may also assist health policy makers refine relevant policies to promote the eHealth innovation.

mHealth for Influenza Pandemic Surveillance in Developing Countries

Influenza pandemics caused millions of deaths and massive economic losses worldwide in the last century. The impact of any future pandemic is likely to be greatest in developing countries as a result of their limited surveillance and healthcare resources. eHealth facilitates the detection and reporting of potential pandemic strains by using digital data transmitted, sorted and retrieved electronically both at the local site and at a distance. The implementation of eHealth is resource costly but developing countries have limited financial and technical resources. This adversely affects access to eHealth applications. Mobile communication technologies hold great promise in improving access to and affordability of eHealth services even to the poorest areas. This paper illustrates how a mobile phone SMS-based application can be applied to mHealth, potentially facilitating influenza pandemic surveillance in developing countries.

A framework for assessing ICT preparedness for e-health implementations

Electronic health (e-health) is probably one of the most significant contributions of Information Communication Technology (ICT) in present daypsilas healthcare. ICT efficiently bridges healthcare sector and technology for e-health implementation, which is a costly affair due to involvement of considerable amount of planning and investment. Preparedness, on the other hand can be defined as a state of readiness prior taking any action and applicable for implementing any e-health project. Study of preparedness essentially i) renders insight to the existing resources, ii) specifies the requirements for successful implementation of a project, and iii) helps set up strategies for the said implementation. Preparedness may be assessed at various levels of e-health implementations, such as ICT, Application, Service, Process and Government or Organizational levels. The present work focuses at the very initial level i.e. ICT and proposes an ICT-preparedness-framework for e-health implementation. The proposed ICT-preparedness framework is a conceptual one and is based on two different applications - A) connected graph-based approach to capture and in turn quantify some of the ICT constructs (Hardware, Connectivity, Software and Skills) and their respective indicators and B) a fuzzy set-based technique to assess the preparedness levels of these constructs. Finally the framework is discussed with an e-health scenario on Tele-cardiology.

Emerging ICT implementation issues in aged care.

BACKGROUND Demand for aged care services continues to soar as a result of an aging population. This increasing demand requires more residential aged care facilities and healthcare workforce. One recommended solution is to keep older people in their homes longer and support their independent life through the use of information and communication technologies (ICT). However, the aged care sector is still in the early stages of adopting ICT. OBJECTIVE The aim of this study was to identify the key issues that affect the adoption of ICT in the aged care sector. METHODS A systematic literature review was undertaken and involved four steps. The first two steps aimed to identify and select relevant articles. Data was then extracted from the selected articles and identified issues were analyzed and grouped into three major categories. RESULTS ICT adoption issues were categorized into different perspectives, representing older people, health professionals and management. Our findings showed that all three groups were mostly concerned with issues around behavior, cost and lack of technical skills. DISCUSSION AND CONCLUSIONS Findings reported in this study will help decision makers at aged care settings to systematically understand issues related to ICT adoption and thus proactively introduce interventions to improve use of ICT in this sector. On the basis of our findings, we suggest future research focus on the examination of aged care workflow and assessment of return on ICT investment.

A functional specification for mobile eHealth (mHealth) Systems

The declining cognitive and motor abilities has become a major problem in the health care of the elderly, often leading to potentially fatal falls. Current rehabilitation strategies to address this issue include routine physiotherapy which is often dull and boring for the patient, leading to poor adherence. In recent years, the use of video games in physical therapy has reportedly had a positive affect on rehabilitation strategies. We propose using a modified version of a music video game, Dance Dance Revolution (DDR), to motivate the elderly and increase adherence to rehabilitation. We also present the design of a mobile monitoring system which allows the health professional to monitor the patients progress.

mHealth for the control of TB/HIV in developing countries

mHealth (healthcare using mobile communication technologies) is being strengthened as a new tool to tackle the global crisis in inadequate workforce and patient monitoring, especially in resource-limited settings. High numbers of people living with TB/HIV fail treatment and develop resistance because they cannot maintain a high degree of adherence to their medication regimens. This paper illustrates how a simple and inexpensive SMS-based mHealth application can be used to facilitate the TB/HIV treatment.

e-Health preparedness assessment in the context of an influenza pandemic: a qualitative study in China

Objective To assess the preparedness status of a hospital in Beijing, China for implementation of an e-Health system in the context of a pandemic response. Design This research project used qualitative methods and involved two phases: (1) group interviews were conducted with key stakeholders to examine how the surveillance system worked with information and communication technology (ICT) support in Beijing, the results of which provided background information for a case study at the second phase and (2) individual interviews were conducted in order to gather a rich data set in relation to e-Health preparedness at the selected hospital. Setting In phase 1, group interviews were conducted at Centres for Disease Prevention and Control (CDC) in Beijing. In phase 2, individual interviews were performed at a secondary hospital selected for the case study. Participants In phase 1, three group interviews were undertaken with 12 key stakeholders (public health/medical practitioners from the Beijing city CDC, two district CDCs and a tertiary hospital) who were involved in the 2009 influenza A (H1N1) pandemic response in Beijing. In phase 2, individual interviews were conducted with 23 participants (including physicians across medical departments, an IT manager and a general administrative officer). Primary and secondary measures For the case study, five areas were examined to assess the hospitals preparedness for implementation of an e-Health system in the context of a pandemic response: (1) motivational forces for change; (2) healthcare providers’ exposure to e-Health; (3) technological preparedness; (4) organisational non-technical ability to support a clinical ICT innovation and (5) sociocultural issues at the organisation in association with e-Health implementation and a pandemic response. Results This article reports a small subset of the case study results from which major issues were identified under three main themes in relation to the hospitals preparedness. These issues include a poor sharing of patient health records, prescription errors, unavailability of software tools to assist physicians in answering patient questions, physicians’ concerns about the reliability of ICT and the high monetary cost of e-health implementation and uncertainty over return on investment, and their dissatisfaction with the software in use. Conclusions Prior to the implementation of e-Health, planning must be undertaken to ensure the smooth introduction of the system. The assessment of organisational preparedness is an important step in this planning process. On the basis of a case study, deficient areas of organisational preparedness were identified for the prospective implementation of electronic health records. Accordingly, we suggested possible solutions for the areas in need of improvement to facilitate e-Health implementations success.

Applications of E-Health for pandemic management

During the last century, influenza pandemics caused hundreds of thousands of deaths, millions of hospitalizations, social disruption, and massive economic losses worldwide. With the increase in global transport and communications, as well as urbanization and overcrowding conditions, any novel influenza strain would be likely to spread quickly, and as a result the impact of an influenza pandemic can be even more formidable. E-Health holds great promise in mitigating the impact of a pandemic. This paper discusses the use of E-Health for public health surveillance, and pandemic outbreak investigation and response and also illustrates the idea through a systematic development of a cooperative application of mobile phones (mHealth) for this purpose.

An approach for E-Health system assessment & specification

One of the key benefits of E-Health systems is in the digitization of data, which allows electronic digital transmission, sorting, retrieval and other manipulations. E-Health directly supports healthcare prevention, patient diagnosis and patient management and care, both at the local site and at a distance. This study proposes an approach for the assessment and requirement specification of E-Health systems. We view assessment as a tool for developing requirements specifications as well as continuous assessment of the system.

Evaluation of caBIG® caTissue Software

Tissue banks collect, preserve and harvest human/non-human tissues for health related research or education. Usually, the banks maintain the associated data in Microsoft Excel or Access. There are limitations when the data need to be share by multiple stakeholders. This paper evaluates an open source bio specimen data management system (caTissue) and discusses some of the key features.