Evaluating healthcare information systems through an “enterprise” perspective

National waiting time monitoring in oral healthcare - The role of triage dental nurses

OBJECTIVES

Our study analyzed dental nurses' use and use behavior determinants of electronic patient IS modules in telephone triage. The modules were implemented in public oral healthcare organizations' patient ISs to digitalize the national waiting time monitoring system.

METHODS

For the cross-sectional survey, we collected data from dental nurses using convenience sampling and applied a modified UTAUT as the theoretical framework.

RESULTS

The results indicate that using the module for different purposes varied, and the nurses used it sparsely in recording data for monitoring national waiting times. Using the module was laborious, and triage work was busy.

CONCLUSION

Dental nurses' low system usage resulted in poor-quality data for waiting time monitoring. As healthcare data is increasingly used for purposes other than clinical decision making, we must ensure that healthcare professionals performing clinical tasks perceive data recording for non-clinical purposes as meaningful and have time for proper data entry.

The Impact of Information and Communication Technologies (ICTs) on Health Outcomes: A Mediating Effect Analysis Based on Cross-National Panel Data

When ICTs (Information and Communications Technologies) are combined with healthcare, they can make a key contribution to gradually improve national health outcomes. The global outbreak of COVID-19 in 2020 further highlighted the important role of e-Health and m-Health service modes. This research structures a mediated effect model to explore dynamic relationships between ICT factors, ICT impacts, and national health outcomes, among which ICT factors are independent variables; ICT impacts are mediating variables, and national health outcome indicators selected from United Nations Millennium Development Goals (MDGs) and World Development Indicators are dependent variables. The fixed effect model is used to process a set of 141 countries’ panel data from 2012 to 2016 from World Bank and World Economic Forum, while the classical three-step test method and Sobel test combined with fixed effects are used to test the mediated effects of the panel data. The results show that there are significant associations between ICT factors and national health outcome indicators, while only some of the partial mediated effects are proved. ICT environment and ICT usage can influence both the under-five mortality rate and adolescent fertility rate via ICT social impact. However, the mediated effect of ICT social impact on maternal mortality ratio and life expectancy at birth has not been confirmed. Meanwhile, the mediated effect of ICT economic impact has not been proven. This research is an interdisciplinary research in the field of information and communication technology and public health and reveals the path and mechanism whereby ICT factors improve national health outcomes, which can help global policymakers drive the next phase of the implementation of the Sustainable Development Goals (SDGs) and continue to improve the overall health at the national level.

Ambient Assisted Living: Identifying New Challenges and Needs for Digital Technologies and Service Innovation

Background : The ambient assisted living (AAL) market is rapidly becoming fundamental to the delivery of health and social care services for the elderly. Worldwide many different steps have been taken to increase the engagement of older adults with these technologies. Much of this work has focused on the development of novel digital services that increase wellbeing or tackle social challenges.

Aim : The aim of the study was to identify and describe the demands for AAL-services from the perspective of older adults. We also examine the challenges and needs of the ambient assisted living market using a needs based approach.

Method : An exploratory case study was conducted with an aim to capture information about older adults’ demands for AAL services. A survey was used to collect the data. The survey study respondents validated the results.

Results : The results of the study indicate that the area of AAL needs be studied from a multiple-sided market perspective. Our research suggests there is a need to describe and understand the factors that facilitate or constrain the implementation of services with focus on health and social care. There is also a need to describe and analyze the relationship between policy and practice and its effects on the AAL market. It is necessary to capture expressed demand, to identify market challenges at the macro level and to be able to understand how services should operate and serve older adults in practice. Such research is critical to the development of guidance for policy makers, suppliers and service providers.

Discussion : Older adults are asking for intelligent, assistive living solutions that help them to continue to live independent lives and remain socially included in their networks, associations, and communities. The elderly need services that stimulate and maintain their physical and intellectual capital. The development of innovative AAL environments is, however, a complex social process that involves the use and delivery of innovative ICT–based services. The implementation and use of AAL to support older adults involve service providers and elderly consumers.

Conclusions : The results of the study may be of interest to policy makers, entrepreneurs, technology suppliers, service providers and health and social care organizations, who are willing to innovate and influence the development of the AAL market through their choices and decisions.

A literature review for large-scale health information system project planning, implementation and evaluation

Information technology is perceived as a potential panacea for healthcare organisations to manage pressure to improve services in the face of increased demand. However, the implementation and evaluation of health information systems (HIS) is plagued with problems and implementation shortcomings and failures are rife. HIS implementation is complex and relies on organisational, structural, technological, and human factors to be successful. It also requires reflective, nuanced, multidimensional evaluation to provide ongoing feedback to ensure success. This article provides a comprehensive review of the literature about evaluating and implementing HIS, detailing the challenges and recommendations for both evaluators and healthcare organisations. The factors that inhibit or promote successful HIS implementation are identified and effective evaluation strategies are described with the goal of informing teams evaluating complex HIS.

Anticipating mismatches of HIT investments: Developing a viability-fit model for e-health services

OBJECTIVES

Albeit massive investments in the recent years, the impact of health information technology (HIT) has been controversial and strongly disputed by both research and practice. While many studies are concerned with the development of new or the refinement of existing measurement models for assessing the impact of HIT adoption (ex post), this study presents an initial attempt to better understand the factors affecting viability and fit of HIT and thereby underscores the importance of also having instruments for managing expectations (ex ante).

METHODS

We extend prior research by undertaking a more granular investigation into the theoretical assumptions of viability and fit constructs. In doing so, we use a mixed-methods approach, conducting qualitative focus group discussions and a quantitative field study to improve and validate a viability-fit measurement instrument.

RESULTS

Our findings suggest two issues for research and practice. First, the results indicate that different stakeholders perceive HIT viability and fit of the same e-health services very unequally. Second, the analysis also demonstrates that there can be a great discrepancy between the organizational viability and individual fit of a particular e-health service.

CONCLUSION

The findings of this study have a number of important implications such as for health policy making, HIT portfolios, and stakeholder communication.

Examining the pre-adoption stages of healthcare IT: A case study of vital signs monitoring systems

Pervasive healthcare systems can reduce the costs and improve the quality of healthcare. However, insufficient care in managing the process before the organizational decision to adopt information technology (IT) can result in poor outcomes. With most previous research focusing on IT adoption, this paper develops a multi-stage theoretical framework for the pre-adoption phase of healthcare IT to address this practical challenge and gap in the literature. With a priori concepts identified from previous multi-stage models, our framework was developed by analyzing two cases of the introduction of vital signs monitoring systems in hospitals to identify the important stages and influencing factors for healthcare IT pre-adoption.

Exploring the Relationship between ICTs and Public Health at Country Level

The authors use a health analytics approach to investigate the relationship between information and communication technology (ICT) and public health at a country level. The research uses the ICT factors of accessibility, usage, quality, affordability, trade, and applications, as well as the public delivery indicators of adolescent fertility rate, child immunization for DPT, child immunization for measles, tuberculosis detection rate, life expectancy, adult female mortality rate, and adult male mortality rate. ICT data was collected from the International Telecommunication Union ICT Indicator database. The public health data was collected from the World Bank website. Results of the analytics indicate that ICT factors are positively associated with some public health indicators. Nearly all of the ICT factors are positively associated with the public health indicators of immunization rates, TB detection rates, and life expectancy. The association with adult mortality is negative, which is also favorable. However, the association of ICT with fertility rate is negative, which is an unfavorable effect. These results offer insight into the importance of understanding the positive and adverse impacts of ICT on public health so as to guide national policy decisions in the future.

New tools for learning: a case of organizational problem analysis derived from debriefing records in a medical center

Purpose

This article aims to present a unique systematic and validated method for creating a linkage between past experiences and management of future occurrences in an organization.

Design/methodology/approach

The study is based on actual data accumulated in a series of projects performed in a major medical center. Qualitative and quantitative content analyses were performed on 158 debriefing documents that were generated during two years. The analyses yielded a dataset which was utilized for cluster analysis to construct an organizational hierarchical risk tree.

Findings

Three major project phases were found to be the most influential: planning, executing, and controlling. The major risk areas identified were found to be those related to the initial work plan, professional responsibility definition, quality control, and communication management.

Research limitations/implications

The study focuses on the aspects of organizational learning and suggests a new interpretation method for debriefing documents and a utilization method to mitigate potential risks. The most important outcome of the synergy was a new ability enabling staff members to improve their qualifications on a continuous basis. However, further research is required to examine the medical center debriefing and risk management from a long‐term perspective.

Originality/value

The current study was conceived during a discussion on the subject of safety improvement, where the impact of human behavior on risk events occurrence was debated. Hence, the paper was dedicated to analyzing the effects of the expanding limits of the prognosis “to err is human”. The method enables organizations to develop a tailored risk mitigation plan based on its accumulated processes and projects lessons‐learned. Although the paper describes a process conducted in a medical center, the method and findings are applicable to many other organizations.

Promoting Success in the Introduction of Health Information Systems

The significant number of publications describing unsuccessful cases in the introduction of health information systems makes it advisable to analyze the factors that may be contributing to such failures. However, the very notion of success is not equally assumed in all publications. Based in a literature review, the authors argue that the introduction of systems must be based in an eclectic combination of knowledge fields, adopting methodologies that strengthen the role of organizational culture and human resources in this project, as a whole. On the other hand, the authors argue that the introduction of systems should be oriented by a previously defined matrix of factors, against which the success can be measured.