Can caregivers trust information technology in the care of their patients? A systematic review

The barriers and challenges of using health information technology in medication administration process for pediatrics and neonates: A qualitative study

Background and Aims

Children and neonates are more susceptible to diseases and are a vulnerable group in medication administration (MA). Nurses interact directly with patients, ensuring safety and preventing unintended outcomes. Health Information Technology (HIT) has transformed health care, aiding nurses in decision-making and treatment responses. Despite its benefits, technology presents challenges that must be overcome to facilitate the nursing practice. Therefore, the present study aimed to explore the barriers to HIT use in the process of MA in children and neonates in a developing country.

Methods

Semi-structured face-to-face interviews were conducted with 22 health care professionals across seven pediatric and neonatal settings. Also, observations were made of these settings for 3 weeks. A qualitative analysis was performed using the conventional content analysis method, recommended by Colaizzi's seven-step approach.

Results

The results showed that the most significant barriers to adopting technology in MA process could be classified into two main categories: "inappropriate management approaches" with two sub-categories ("Managers' reluctance to adopt new technology", "lack of adequate budget for hardware resources"), and "resistance to change" with two sub-categories ("A desire to use conventional (traditional) approaches in care", "cultural issues and impracticality of providing some specialized technology services").

Conclusion

The findings revealed MA process complexities, which have been insufficiently examined in the current literature. We have highlighted the need for improved "effectiveness of HIT systems in administering medication processes, budget for hardware resources, and managers" interest in using new technology. The present findings can guide the development of more effective and user-friendly HIT systems in pediatric and neonatal care settings.

The impact of eHealth on relationships and trust in primary care: a review of reviews

BACKGROUND

Given the increasing integration of digital health technologies in team-based primary care, this review aimed at understanding the impact of eHealth on patient-provider and provider-provider relationships.

METHODS

A review of reviews was conducted on three databases to identify papers published in English from 2008 onwards. The impact of different types of eHealth on relationships and trust and the factors influencing the impact were thematically analyzed.

RESULTS

A total of 79 reviews were included. Patient-provider relationships were discussed more frequently as compared to provider-provider relationships. Communication systems like telemedicine were the most discussed type of technology. eHealth was found to have both positive and negative impacts on relationships and/or trust. This impact was influenced by a range of patient-related, provider-related, technology-related, and organizational factors, such as patient sociodemographics, provider communication skills, technology design, and organizational technology implementation, respectively.

CONCLUSIONS

Recommendations are provided for effective and equitable technology selection, application, and training to optimize the impact of eHealth on relationships and trust. The review findings can inform providers' and policymakers' decision-making around the use of eHealth in primary care delivery to facilitate relationship-building.

The ethical challenges of personalized digital health

Personalized digital health systems (pHealth) bring together in sharp juxtaposition very different yet hopefully complementary moral principles in the shared objectives of optimizing health care and the health status of individual citizens while maximizing the application of robust clinical evidence through harnessing powerful and often complex modern data-handling technologies. Principles brought together include respecting the confidentiality of the patient-clinician relationship, the need for controlled information sharing in teamwork and shared care, benefitting from healthcare knowledge obtained from real-world population-level outcomes, and the recognition of different cultures and care settings. This paper outlines the clinical process as enhanced through digital health, reports on the examination of the new issues raised by the computerization of health data, outlines initiatives and policies to balance the harnessing of innovation with control of adverse effects, and emphasizes the importance of the context of use and citizen and user acceptance. The importance of addressing ethical issues throughout the life cycle of design, provision, and use of a pHealth system is explained, and a variety of situation-relevant frameworks are presented to enable a philosophy of responsible innovation, matching the best use of enabling technology with the creation of a culture and context of trustworthiness.

Identifying the Knowledge Structure and Trends of Nursing Informatics: A Text Network Analysis

With the advent of the information age and technological development, the importance of digital health technologies has increased. Subsequently, nursing informatics has been developed to enhance the effectiveness of healthcare information management and communication. This study aimed to identify the nursing informatics knowledge structure and research trends through quantitative analysis using text network analysis. Here, we analyzed 14 225 studies published by 2020. The knowledge structure of nursing informatics and changes therein were clarified by identifying and analyzing the core keywords, topics, and changes in the topics of related studies over time. We identified "patient," "health," "system," and "information" as core keywords connecting other keywords. Over time, the networks between "information," "communication," and "technology" strengthened, and "patient safety" and "quality" have recently emerged as research keywords. This change indicates an increase in the importance of nursing education on technology. Similar changes appeared in the topic analysis, showing an increased proportion of research related to system and technology and nursing education. These results can broaden a systematic understanding of nursing informatics research. Furthermore, given these findings, the importance of nursing informatics on patient safety and nursing education-based on the development of systems and technology-can be expected to continue growing.