Yvonne O’ Connor

First impressions are lasting impressions: intention to participate in mobile health projects within developing countries

Abstract With healthcare infrastructure and health services remaining inadequate in many countries, numerous mobile health (mHealth) development studies have been reported, especially in low- and middle-income countries. This reflects a broad recognition that mobile technologies can play an important role in the provision of healthcare services at the regional, community and individual levels. However, implementing large-scale mHealth programmes has proven difficult; hence the use of mHealth pilots or feasibility studies as precursors to full rollouts. Existing literature reports that social, cultural, economic, political, technological and institutional factors influence the successful implementation of mHealth artefacts, yet there remains a dearth of research investigating individuals’ intention to participate in mHealth feasibility projects. Typically, mHealth projects involve a number of key stakeholders, ranging from direct stakeholders (such as healthcare workers who use the applications) to indirect stakeholders (such as the patients themselves who are not direct users of the technologies). Through the lens of impression management and self-determination theories, this study examines the extent to which an indirect user’s first impression, i.e. their initial encounter with the project and the project team on the ground, influences their decision to engage with an mHealth pilot project. Findings indicate that initial impressions formulated by indirect users impact their intention to participate in larger scale mHealth implementations. Through these early impressions participants formulate their perceptions about the project, and this directly influences their decision to engage. Furthermore, an individual’s first impressions can influence other potential participants’ decision to participate, especially in the context of the healthcare worker–patient relationship. The paper concludes that understanding indirect users’ expectations regarding the role of mHealth in addressing societal problems is essential to the success of wider mHealth projects in developing countries.

Examining the infusion of mobile technology by healthcare practitioners in a hospital setting

While mobile Health (mHealth) holds much potential, the infusion of mHealth is still in its infancy and has yet to achieve sufficient attention in the Information Systems field. As a result, the objective of this paper is to identify the (a) determinants for successful infusion of mHealth by healthcare practitioners and (b) benefits healthcare practitioners perceive from infusing mHealth. A sequential mixed methods approach (case study and survey) is employed to achieve this objective. The study contributes to IS theory and practice by: (1) developing a model with six determinants (Availability, Self-Efficacy, Time-Criticality, Habit, Technology Trust, and Task Behaviour) and three individual performance-related benefits associated with mHealth infusion (Effectiveness, Efficiency, and Learning), (2) exploring undocumented determinants and relationships, (3) identifying conditions that both healthcare practitioners and organisations can employ to assist with mHealth infusion and (4) informing healthcare organisations and vendors as to the performance of mHealth in post-adoptive scenarios.

Sociocultural and Technological Barriers Across all Phases of Implementation for mobile Health in Developing Countries

Abstract In recent years, scholars are realizing the importance of examining mobile health (mHealth) implementation in developing countries. A vast array of research exists that focuses on barriers of mHealth adoption in such domains. However, the majority of these papers embrace the concept of adoption to cover the entire process of implementation. This chapter acknowledges that various phases of implementation exist. As a result, the researchers identify potential barriers for each phase of mHealth implementation in developing countries. By examining extant literature, this study reveals that various sociocultural and technological factors across individuals and organizations collectively can hinder mHealth implementation in developing regions. Extant research indicates that the focus of mHealth in these constituencies, a nascent area of research, places too much emphasis on the benefits associated with mHealth implementation. Subsequently, this chapter endeavors to outline the barriers that should assist with overcoming common obstacles in the successful implementation of mHealth initiatives in developing countries.

Supporting LIFE: Mobile Health Application for Classifying, Treating and Monitoring Disease Outbreaks of Sick Children in Developing Countries

This paper presents the Supporting LIFE L ow cost I ntervention F or dis E ase control project. Supporting LIFE applies a novel combination of Android based smartphone technology, patient vital sign sensors and expert decision support systems to assist Community Health Workers in resource-poor settings in their assessment, classification and treatment of seriously ill children, more specifically children from 2 months to 5 years of age. The application digitises widely accepted WHO/UNICEF paper based guidelines known as Community Case Management. The project also facilitates for disease monitoring and surveillance via a reporting website.

Developing eXtensible mHealth Solutions for Low Resource Settings

Over the last ten years there has been a proliferation of mHealth solutions to support patient diagnosis and treatment. Coupled with this, increased attention and resources have been attributed to the development of technologies to improve patient health care outcomes in low resource settings. Most significantly, it is the development of highly extensible, portable and scalable technologies which have received the most attention. As part of an mHealth intervention in Malawi Africa, an agnostic clinical guideline decision-support rule engine has been developed which uses classification and treatment rules for assessing a sick child defined in XML; namely, Integrated Management of Childhood Illness (IMCI) and Community Case Management (CCM). Using a two-phased approach, 1) the rules underpinning the cloud-based mobile eCCM application were devised based on the widely accepted WHO/UNICEF paper based guidelines and 2) subsequently validated and extended through a user workshop conducted in Malawi, Africa.

Citizen participation in decision-making: can one make a difference?

Abstract Big Data promises benefits for society as well as business. Do policy makers know how best to use this scale of data driven decision-making in an effective way for citizens? Citizen participation is portrayed in literature as a key component in policy decision-making. Yet, this decision-making process to date is often driven by other stakeholders such as scientific experts, academic institutions, national and international governing bodies, to name but a few. Furthermore, there is scant literature on the best way to create policy for new technology, taking into consideration the voice of the citizen. The prevailing question, therefore, is what extent does citizen participation in decision-making make a difference to shaping policy for technology? Our paper explores an experimental method for citizens to make a difference to European policy decision-making on the future of technology and the impact on society. Employing a case study of Irish citizens as part of the CIMULACT (Citizen and Multi-Actor Consultation on Horizon 2020) project this paper reports a new methodology for gathering citizens’ perspectives on future decision-making policies on technology. The findings reveal key advantages and disadvantages to this methodology. This paper makes a number of contributions to both the academic and practitioner communities.

Examining Contextual Factors and Individual Value Dimensions of Healthcare Providers Intention to Adopt Electronic Health Technologies in Developing Countries

Despite substantial research on electronic health (e-Health) adoption, there still exist vast differences between resource-rich and resource-poor populations regarding Information Technology adoption. To help bridge the technological gulf between developed and developing countries, this research-in-progress paper examines healthcare providers’ intention to adopt e-health technologies from two perspectives 1) contextual factors (i.e. specific to developing world settings) and 2) individual value dimensions (i.e. cultural, utilitarian, social and personal). The primary output of this paper is a theoretical model merging both the contextual factors and value dimensions; this forms a strong baseline to examine and help ensure the successful adoption of e-Health technologies within developing countries. Future research will be performed to validate the model developed in this paper, with a specific focus on mobile Health in Malawi, Africa.

Understanding community health workers’ intentions to participate in mHealth studies within developing countries

ABSTRACT In relation to mobile health (mHealth) initiatives, early engagement by potential end users has been established to have a positive impact both in the medium- to long-term adoption of the solution. However, there remains a paucity of research which focuses on participant recruitment for mHealth initiatives in developing countries. The objective of this paper, therefore, is to examine community health workers’ (CHWs’) intentions to participate in a mHealth pilot study in Malawi, Africa. A conceptual model with three characteristics is derived from the existing literature which may influence a CHW’s intentions: namely, (1) participant, (2) pilot study, and (3) social and contextual characteristics. A paper-based survey of CHWs was employed to examine the model, analysed using the partial least squares method of structural equation modelling. This study reveals that participant and pilot study characteristics primarily influence the decision-making process of CHWs when considering their participation in pilot studies. Health policy-makers and professionals should focus on reducing uncertainty by promoting the importance of the study at individual and societal levels and ensuring that potential end users are competent interacting and using mHealth.

Stakeholders perspectives on paper-based and electronic clinical decision support systems in Malawi Africa

Abstract The objective of this paper is to explore the perceptions of key stakeholders involved and/or affected by existing paper-based decision support guidelines (known as Community Case Management (CCM)) and a proposed digitised mobile clinical decision support system (CDSS) of CCM in rural settings of Malawi, Africa. Data was collected using field notes and semi-structured interviews with 17 key stakeholders (i.e. clinical, technical, development aid support (NGO), government and community health workers both in Malawi, Europe and USA). Stakeholders provide a rich insight into the variety of both perceived benefits and challenges of the existing guidelines and the proposed electronic CDSS. It was found that all stakeholders believe that the CDSS will improve adherence to guidelines and subsequently result in better care for children. It is further envisioned that the time needed for administration with the current paper-based approach could be reduced using electronic, as opposed to manual, collation and sending of records. This paper acts to underpin the rationale and motivation for the development and rollout of an electronic CDSS to support community health workers in their assessment, classification and treatment of young children in rural settings in Malawi, Africa.

Starting With Small Health Data Opportunities For Mhealth In Africa

The need to obtain data to understand effective and available child mortality-reducing control measures in rural areas of developing countries is great. Evidence shows that this challenge can potentially be overcome with the increased availability of Information and Communication Technology (ICT) to support the data/information/ knowledge needs of healthcare delivery services in low resource settings. Recognising the benefits of ICT and the need for improvements in the Nigerian health sector, this paper outlines the plans for the technical feasibility assessment of the IMPACT (usIng Mobile Phones for Assessing, Classifying and Treating sick children) smartphone application to capture, store and analyse of child health assessment data. IMPACT is a secure, scalable, user friendly mobile health (mHealth) innovation that is being developed to support ‘small data’ capabilities within the context of healthcare in the community in Enugu State, Nigeria, Africa. Notwithstanding the heightened focus on ‘big data’ in health, this research is interested in investigating the opportunities associated with doing ‘small healthcare data’ well, with the long term view of building to the big data scenario for healthcare in the community in Enugu. This paper outlines the plan for the IMPACT project considering the implications for health data, knowledge management in healthcare and the big data opportunities to support disease surveillance, healthcare delivery and resourcing and healthcare practitioner education.