Healthcare information systems research, revelations and visions

Intelligent health in the IS area: A literature review and research agenda

As the global demand for healthcare services continues to grow, improving the efficiency and effectiveness of the healthcare ecosystem has become a pressing concern. Information systems are transforming the healthcare delivery process, shifting the focus of healthcare services from passive disease treatment to proactive health prevention and the healthcare management model from hospital-centric to patient-centric. This study focuses on reviewing research in IS journals on the topic of e-health and is dedicated to constructing a theoretical model of intelligent health to provide a research basis for future discussions in this field. In addition, as the innovation of intelligent healthcare services has led to changes in its elements (e.g., an increase in the number of stakeholders), there is an urgent need to sort out and analyze the existing research.

Scholarly communication between health informatics and information systems: A bibliometric study

The challenges of IT adoption in the healthcare sector have generated much interest across a range of research communities, including Information Systems (IS) and Health Informatics (HI). Given their long-standing interest in IT design, development, implementation, and adoption to improve productivity and support organisational transformation, the IS and HI fields are highly correlated in their research interests. Nevertheless, the two fields serve different academic audiences, have different research foci, and theorise IT artifacts differently. We investigate the dyadic relationship between health information systems (HIS) research in IS and HI through the communication patterns between the two fields. We present the citation analysis results of HIS research published in IS and HI journals between 2000 and 2020. The results revealed that despite the two fields sharing a common interest, communication between them is limited and only about specific topics. Potentially relevant ideas and theories generated in IS have not yet been sufficiently recognised by HI scholars and incorporated into the HI literature. However, the upward trend of HIS publications in IS indicates that IS has the potential to contribute more to HI.

Tools supporting polypharmacy management in Italy: Factors determining digital technologies' intention to use in clinical practice

Background and Aims

INTERCheckWEB is one of the most outstanding digital technologies, that could be implemented at the hospital level, supporting the clinicians in the evaluation of the therapy appropriateness, reducing the potentially inappropriate prescriptions, for the improvement of the clinical decision‐making process. The paper aims at investigating the relationship between clinicians' behaviors towards digital decision support system in therapy appropriateness for elderly patients in polytherapy in medical departments, defining the factors that could influence clinicians to use INTERCheckWEB, for supporting drugs' prescription.

Methods

A questionnaire was administered to 70 clinicians referring to Internal Medicine wards, of four Italian hospitals. The authors assessed how perceived usefulness, perceived ease of use, image, and output quality, would affect INTERCheckWeb intention to use. Inferential statistics, by means of a regression analysis, were conducted to define the main aspects useful to understand the factors impacting on such digital technology adoption in clinical practice.

Results

The regression analysis reported that image, perceived ease of use and perceived usefulness, as well as the moderator effect of the voluntary use between the perceived usefulness and the intention to use, are the factors that most influence the use of INTERCheckWEB (adjusted R² = 0.870).

Conclusions

Results demonstrated that clinicians would use INTERCheckWEB, when available, to identify all the information on situations that could be dangerous for the patients, thus limiting the drug–drug interactions, optimizing the overall patient's clinical pathway. Furthermore, the implementation of INTERCheckWEB could also contribute to the proper management of COVID‐19 patients, since both hospitalized and symptomatic COVID‐19 patients are frequently older, with comorbidities.

The Philosopher's Corner

A minimalist view of theory will render it more accessible for a wider range of research questions. More accessible theory will facilitate constant improvement between representations predicting particular relationships among entities of interest in IS and observations of those relationships in practice. This is needed in IS to direct research energy toward knowledge that can lead to more effective and helpful interventions for computing technology stakeholders. The paper also addresses a range of anomalies created by prevailing traditional views of theory, particularly regarding the distinction between theory existence and theory level of support. Discussion includes identifying barriers to conversion to this view of theory as well as criteria for evaluation of proposed new theory.

How Clinicians Perceive Artificial Intelligence-Assisted Technologies in Diagnostic Decision Making: Mixed Methods Approach

Background

With the rapid development of artificial intelligence (AI) and related technologies, AI algorithms are being embedded into various health information technologies that assist clinicians in clinical decision making.

Objective

This study aimed to explore how clinicians perceive AI assistance in diagnostic decision making and suggest the paths forward for AI-human teaming for clinical decision making in health care.

Methods

This study used a mixed methods approach, utilizing hierarchical linear modeling and sentiment analysis through natural language understanding techniques.

Results

A total of 114 clinicians participated in online simulation surveys in 2020 and 2021. These clinicians studied family medicine and used AI algorithms to aid in patient diagnosis. Their overall sentiment toward AI-assisted diagnosis was positive and comparable with diagnoses made without the assistance of AI. However, AI-guided decision making was not congruent with the way clinicians typically made decisions in diagnosing illnesses. In a quantitative survey, clinicians reported perceiving current AI assistance as not likely to enhance diagnostic capability and negatively influenced their overall performance (β=–0.421, P=.02). Instead, clinicians’ diagnostic capabilities tended to be associated with well-known parameters, such as education, age, and daily habit of technology use on social media platforms.

Conclusions

This study elucidated clinicians’ current perceptions and sentiments toward AI-enabled diagnosis. Although the sentiment was positive, the current form of AI assistance may not be linked with efficient decision making, as AI algorithms are not well aligned with subjective human reasoning in clinical diagnosis. Developers and policy makers in health could gather behavioral data from clinicians in various disciplines to help align AI algorithms with the unique subjective patterns of reasoning that humans employ in clinical diagnosis.

Outlining Big Data Analytics in Health Sector with Special Reference to Covid-19

With the assistance of Internet of Things (IoT), Big Data analytics has evolved tremendously. The capability of dealing and processing humongous data by high performance computing systems results in great surge in applications of Big Data analytics in various fields spanning healthcare, automobile, computing, climatology, and space communications etc. The health care sector has been recently largely benefitted by this. Driven by the compounding growth as well as impact of Big Data analytics, we endeavor to map out the areas of health sector where Big Data analytics has been largely influential as well as is having the potential for ground-breaking applications. This work starts with fundamentals of IoT driven Big Data Analytics (BDA) as well as key constitutional elements which is then followed by an application overview in healthcare sector with a simultaneous emphasis on future expectations. Besides, the real time application of BDA with special reference to Covid-19 is comprehensively highlighted with recent examples. It is envisioned that the work will serve as a basic reference for IoT driven BDA in healthcare.

Keeping pace with the healthcare transformation: a literature review and research agenda for a new decade of health information systems research

BACKGROUND

Accelerated by the coronavirus disease 2019 (Covid-19) pandemic, major and lasting changes are occuring in healthcare structures, impacting people's experiences and value creation in all aspects of their lives. Information systems (IS) research can support analysing and anticipating resulting effects.

AIM

The purpose of this study is to examine in what areas health information systems (HIS) researchers can assess changes in healthcare structures and, thus, be prepared to shape future developments.

METHOD

A hermeneutic framework is applied to conduct a literature review and to identify the contributions that IS research makes in analysing and advancing the healthcare industry.

RESULTS

We draw an complexity theory by borrowing the concept of 'zooming-in and out', which provides us with a overview of the current, broad body of research in the HIS field. As a result of analysing almost 500 papers, we discovered various shortcomings of current HIS research.

CONTRIBUTION

We derive future pathways and develop a research agenda that realigns IS research with the transformation of the healthcare industry already under way.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12525-021-00484-1.

Benefits of Blockchain Initiatives for Value-Based Care: Proposed Framework

Background

The potential of blockchain technology to achieve strategic goals, such as value-based care, is increasingly being recognized by both researchers and practitioners. However, current research and practices lack comprehensive approaches for evaluating the benefits of blockchain applications.

Objective

The goal of this study was to develop a framework for holistically assessing the performance of blockchain initiatives in providing value-based care by extending the existing balanced scorecard (BSC) evaluation framework.

Methods

Based on a review of the literature on value-based health care, blockchain technology, and methods for evaluating initiatives in disruptive technologies, we propose an extended BSC method for holistically evaluating blockchain applications in the provision of value-based health care. The proposed method extends the BSC framework, which has been extensively used to measure both financial and nonfinancial performance of organizations. The usefulness of our proposed framework is further demonstrated via a case study.

Results

We describe the extended BSC framework, which includes five perspectives (both financial and nonfinancial) from which to assess the appropriateness and performance of blockchain initiatives in the health care domain.

Conclusions

The proposed framework moves us toward a holistic evaluation of both the financial and nonfinancial benefits of blockchain initiatives in the context of value-based care and its provision.

Clinician behaviors in telehealth care delivery: a systematic review

Literature on telehealth care delivery often addresses clinical, cost, technological, system, and organizational impacts. Less is known about interpersonal behaviors such as communication patterns and therapeutic relationship-building, which may have workforce development considerations. The purpose of this study was to conduct a systematic literature review to identify interpersonal health care provider (HCP) behaviors and attributes related to provider-patient interaction during care in telehealth delivery. Electronic searches were conducted using five indexes/databases: CINAHL, ERIC, PsychInfo, ProQuest Dissertations, PubMed; with hand-searching of the immediate past 10 years of five journals. Search concepts included: communication, telehealth, education, and health care delivery. Of 5261 unique article abstracts initially identified, 338 full-text articles remained after exclusion criteria were applied and these were reviewed for eligibility. Finally, data were extracted from 45 articles. Through qualitative synthesis of the 45 articles, we noted that papers encompassed many disciplines and targeted care to people in many settings including: home care, primary and specialist care, mental health/counseling, and multi-site teams. Interpersonal behaviors were observed though not manipulated through study designs. Six themes were identified: HCP-based support for telehealth delivery; provider-patient interactions during the telehealth event; environmental attributes; and guidelines for education interventions or evaluation of HCP behaviors. Although unable to identify current best practices, important considerations for practice and education did emerge. These include: perceptions of the utility of telehealth; differences in communication patterns such as pace and type of discourse, reliance on visual cues by both provider and patient especially in communicating empathy and building rapport; and confidentiality and privacy in telehealth care delivery.

Evaluation of health information systems research in information systems research: A meta-analysis

Given the importance of the health-care industry and the promise of health information systems, researchers are encouraged to build on the shoulders of giants as the saying goes. The health information systems field has a unique opportunity to learn from and extend the work that has already been done by the highly correlated information systems field. As a result, this research article presents a past, present and future meta-analysis of health information systems research in information systems journals over the 2000–2015 time period. Our analysis reviewed 126 articles on a variety of topics related to health information systems research published in the “Senior Scholars” list of the top eight ranked information systems academic journals. Across the selected information systems academic journals, our findings compare research methodologies applied, health information systems topic areas investigated and research trends. Interesting results emerge in the range and evolution of health information systems research and opportunities for health information systems researchers and practitioners to consider moving forward.

BioMEMS-based coding for secure medical diagnostic devices

Trustworthy and usable point-of-care solutions require not only effective disease diagnostic procedures to ensure delivery of rapid and accurate outcomes, but also lightweight privacy-preserving capabilities. In this paper, we present a Biomedical Microelectromachanical System (BioMEMS)-based sensor for portable, inexpensive smartphone-based biomarker detection. The biosensor presented here provides the ability for signal encryption at the physical sensor level to ensure patient's diagnostic confidentiality. Our results show that this design allow us to protect the samples measurements while accurately distinguish different test samples.

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.

Changing Attitudes and Behavior of Stakeholders During an Information Systems-Led Organizational Change

In this article the authors use G. Morgan's (1986, 1997) metaphors to look at the changes to stakeholder attitudes and behavior during an information systems—led organizational change. They discuss the introduction of an organization-wide intranet system in a U.K. National Health Service organization and elicit metaphorical attitudes and infer behavior by using multiple research methods within a longitudinal case study. The findings show that various contextual factors shift the organization's overall stance from psychic prison (repression) to organism (flexible) metaphor. Furthermore, many stakeholders aspire to more than one metaphor at a given time, although a predominant metaphor can still be identified for most stakeholders. The authors present the metaphorical journey map as a tool for capturing attitude and behavioral changes of individuals during the change period. The authors advocate that use of metaphors in such a way can help management better understand the overall social orientation of their organizations and devise appropriate interventions to expedite the change process and increase its legitimacy.