Norm Archer

Personal health records: a scoping review

Electronic personal health record systems (PHRs) support patient centered healthcare by making medical records and other relevant information accessible to patients, thus assisting patients in health self-management. We reviewed the literature on PHRs including design, functionality, implementation, applications, outcomes, and benefits. We found that, because primary care physicians play a key role in patient health, PHRs are likely to be linked to physician electronic medical record systems, so PHR adoption is dependent on growth in electronic medical record adoption. Many PHR systems are physician-oriented, and do not include patient-oriented functionalities. These must be provided to support self-management and disease prevention if improvements in health outcomes are to be expected. Differences in patient motivation to use PHRs exist, but an overall low adoption rate is to be expected, except for the disabled, chronically ill, or caregivers for the elderly. Finally, trials of PHR effectiveness and sustainability for patient self-management are needed.

Barriers to the adoption of online supply chain solutions in small and medium enterprises

Purpose – The objective of this paper is to identify and measure the perceived importance of barriers in the SME community to the adoption of internet business procurement and supply chain solutions.Design/methodology/approach – This was a telephone survey of a sample of 173 Canadian small and medium‐sized enterprises (SMEs), stratified by size of company (small and medium) and according to whether they were distributors, retailers or manufacturers. The data were analyzed statistically through an analysis of variance approach.Findings – Few differences were found between SME internet adopters and non‐adopters. There is a need for education for all SME management on the benefits and drawbacks to using e‐business solutions. Inter‐organizational information systems that are required to link supply chain partners can be a serious barrier to online solutions. There is a significant dependency among supply chain partners in decisions on adopting online links. Flexibility, agility and ability of SMEs can help th...

Factors of adoption of mobile information technology by homecare nurses: a technology acceptance model 2 approach.

Pervasive healthcare support through mobile information technology solutions is playing an increasing role in the attempt to improve healthcare and reduce costs. Despite the apparent attractiveness, many mobile applications have failed or have not been implemented as predicted. Among factors possibly leading to such outcomes, technology adoption is a key problem. This must be investigated early in the development process because healthcare is a particularly sensitive area with vital social implications. Moreover, it is important to investigate technology acceptance using the support of scientific tools validated for relevant information systems research. This article presents an empirical study based on the Technology Acceptance Model 2 in mobile homecare nursing. The study elicited the perceptions of 91 Canadian nurses who used personal digital assistants for 1 month in their daily activities. A partial least squares modeling data analysis revealed that nurses perception of usefulness is the main factor in the adoption of mobile technology, having subjective norm and image within the organization as significant antecedents. Overall, this study was the first attempt at investigating scientifically, through a pertinent information systems research model, user adoption of mobile systems by homecare nursing personnel.

Driving Forces for M-Commerce Success

Is m-commerce just an extension or a subset of e-commerce? Will it turn out to be just more hype? In this paper we discuss the realities of m-commerce and the major differences between mobile commerce and Internet-based e-commerce. Based on this understanding, we identify key factors that must be taken into consideration in order to design valuable m-commerce applications. We emphasize that the success of m-commerce relies on the synergy of three driving forces: technology innovation, evolution of a new value chain, and active customer demand.

Examining Adoption Behavior of Mobile Government

M-government (MG), as a subset of E-government (EG), has expedited the dynamic nature of EG and also created certain channels which either are not available or would be problematic for EG. This has resulted in offering more dynamic and versatile methods for citizens to access certain government services. The objective of the current study is to address and posit the factors which can contribute to an understanding of citizen intention to adopt MG services. A model was used to capture citizen behavior in MG service adoption, and the results from this model are contrasted with adoption behavior for EG from a similar study. To that end, we have developed and validated a model entitled “citizen adoption behavior of MG” (CAB-MG).

Electronic Personal Health Record Systems: A Brief Review of Privacy, Security, and Architectural Issues

Electronic personal health records (PHRs) are beginning to receive widespread attention as a tool for consumers. Such systems may be used by individuals to input data and to access information from a variety of sources (e.g. family physicians), thus improving their understanding of the state of their health and helping to manage their own healthcare better. The main source of information for PHRs is normally the patient’s physician, supplemented by patient input and other sources of information such as prescriptions and lab test results, as well as institutional inputs from hospitals and other facilities. The architecture of such a system must be such that patients can access all the useful information that is relevant to their medical history in a form that is understandable to them, while at the same time protecting against unauthorized access. This paper addresses design and architectural issues of PHR systems, and focuses on privacy and security issues which must be addressed carefully if PHRs are to become generally acceptable to consumers.

A comparison of physician pre-adoption and adoption views on electronic health records in Canadian medical practices.

Background There is a major campaign involving large expenditures of public money to increase the adoption rate of electronic health record (EHR) systems in Canada. To maximize the chances of success in this effort, physician views on EHRs must be addressed, since user perceptions are key to successful implementation of technology innovations. Objective We propose a theoretical model comprising behavioral factors either favoring or against EHR adoption and use in Canadian medical practices, from the physicians’ point of view. EHR perceptions of physicians already using EHR systems are compared with those not using one, through the lens of this model. Methods We conducted an online cross-sectional survey in both English and French among medical practitioners across Canada. Data were collected both from physicians using EHRs and those not using EHRs, and analyzed with structural equation modeling (SEM) techniques. Results We collected 119 responses from EHR users and 100 from nonusers, resulting in 2 valid samples of 102 and 83 participants, respectively. The theoretical adoption model explained 55.8% of the variance in behavioral intention to continue using EHRs for physicians already using them, and 66.8% of the variance in nonuser intention to adopt such systems. Perception of ease of use was found to be the strongest motivator for EHR users (total effect .525), while perceptions of usefulness and of ease of use were the key determinants for nonusers (total effect .538 and .519, respectively) to adopt the system. Users see perceived overall risk associated with EHR adoption as a major obstacle (total effect –.371), while nonusers perceive risk only as a weak indirect demotivator. Of the 13 paths of the SEM model, 5 showed significant differences between the 2 samples (at the .05 level): general doubts about using the system (P = .02), the necessity for the system to be relevant for their job (P < .001), and the necessity for the system to be useful (P = .049) are more important for EHR nonusers than for users, while perceptions of overall obstacles to adoption (P = .03) and system ease of use (P = .042) count more for EHR users than for nonusers. Conclusions Relatively few differences in perceptions about EHR system adoption and use exist between physicians already using such systems and those not yet using the systems. To maximize the chances of success for new EHR implementations from a behavioral point of view, general doubts about the rationale for such systems must be mitigated through improving design, stressing how EHRs are relevant to physician jobs, and providing substantiating evidence that EHRs are easier to use and more effective than nonusers might expect.

Developing fundamental capabilities for successful e-government implementation

Several researchers address the failure of e-government (EG) in developing countries. Researchers studying the failure of information and communication technology (ICT) and EG systems reveal that the initiative, strategy, and adoption criteria of ICT in developing countries do not follow the same track as in developed countries. The failure to manage ICT and adopt EG systems arises from two points – the government itself and the citizens. The objective of this study is to identify the determinants and critical factors that contribute to government development of fundamental capabilities to adopt and manage ICT and successfully implement EG systems. This research study, applying qualitative methodology in a developing country, identifies the fundamental capabilities required to implement EG in developing countries, and the critical factors required to develop the capabilities necessary to adopt ICT and implement EG.

RFID Implementation Issues in China: Shanghai Port Case Study

ABSTRACT Radio Frequency Identification (RFID), which is an automated identification technology, has received widespread attention due to its adoption by Wal-Mart and its top 100 suppliers. As the cost of this new technology falls, it is being implemented by a variety of industries around the world, to take advantage of its improvements in supply chain efficiency and visibility. This paper briefly introduces a number of RFID trials that have been conducted in China. In particular, a case involving an RFID application in Shanghai Port container vehicle management is discussed in detail, to demonstrate the critical implementation issues facing Chinese adopters in terms of the use of RFID technology.

Online self-management interventions for chronically ill patients: cognitive impairment and technology issues.

INTRODUCTION As the fraction of the population with chronic diseases continues to grow, methods and/or technologies must be found to help the chronically ill to take more responsibility to self-manage their illnesses. Internet based and/or mobile support for disease self-management interventions have often proved effective, but patients with chronic illnesses may have co-occurring cognitive impairment, making it more difficult for them to cope with technologies. Many older patients are also not familiar with technologies or they may have cognitive disabilities or dementia that reduce their ability to self-manage their healthcare. On-line solutions to the needs of chronically ill patients must be investigated and acted upon with care in an integrated manner, since resources invested in these solutions will be lost if patients do not adopt and continue to use them successfully. OBJECTIVES To review the capabilities of online and mobile support for self-management of chronic illnesses, and the impacts that age and disease-related issues have on these interventions, including cognitive impairment and lack of access or familiarity with Internet or mobile technologies. METHODS This study includes a review of the co-occurrence of cognitive impairment with chronic diseases, and discusses how cognitive impairment, dyadic caregiver patient support, patient efficacy with technology, and smart home technologies can impact the effectiveness and sustainability of online support for disease self-management. RESULTS Disease self-management interventions (SMIs) using online patient centered support can often enable patients to manage their own chronic illnesses. However, our findings show that cognitive impairment often co-occurs in patients with chronic disease. This, along with age-related increases in multiple chronic illnesses and lack of technology efficacy, can be obstacles to Internet and mobile support for chronic disease self-management. CONCLUSION Patients with chronic diseases may have greater than expected difficulties in using Internet and mobile technologies for disease self-management, often due to cognitive impairment or unfamiliarity with technology. Approaches to dealing with such barriers include suitable integration of solutions involving patient-caregiver dyads, better design of online applications, careful attention to technology adoption and sustainability, and smart home technologies.