TELEMEDICINE AND ELECTRONIC HEALTH RECORD IMPLEMENTATION IN RURAL AREA: A LITERATURE REVIEW

The Indonesian Minister of Health 2019 issued regulations regarding the implementation of telemedicine services between health service facilities. Telemedicine is aimed primarily at rural areas. This research aims to look at the quality of telemedicine-based services, which are documented in an electronic health record (EHR) with complete information. This research uses the narrative literature review method:  Garuda journal channels, Google Scholar, IEEE Explorer, ProQuest, PubMed, Science Direct, and Scopus. With the input-output process approach, eight scientific articles were published on countries with telemedicine/telehealth policies in rural areas. The implementation of telemedicine has advantages and disadvantages depending on the things supported and the target users. It must have policies, infrastructure, financial resources, and human resources to use, maintain and develop telemedicine. Telemedicine will help the health service process by increasing the degree of public health in rural areas if it is used on a large scale. The completeness of the EHR seems to be lacking in terms of informed consent. Still, a quality EHR can make it easier for health workers to enforce the history, establish the diagnosis, and provide patient healthcare

An assessment of information communication technology content, context and process dimensions in public health facilities in Machakos and Nairobi Counties, Kenya

Objective: To establish the level of ICT related content, context and process dimensions vis- a- vis the upscaling of ICT in health care facilities in Nairobi and Machakos counties.Design: A cross sectional studySetting: Machakos and Nairobi counties levels 4-6 hospitalsSubjects: Seventy three (73) respondents drawn from the health facilities were interviewed.Results: ICT content variables studied were operations computerised, ICT facilities provided and breakdown-replacement protocol. Context variables included on-job ICT trainings, ICT training sponsorships by facility and presence of institutional ICT induction program. The process variables were staff involvement in design of ICT aspects and presence of ICT policy. Among contextual factors, presence of institutional induction training program on ICT was relatively high compared to ICT training on job and ICT training sponsorship offered by facility (χ= 28.15, d.f=2, p<0.001 at 95%CI). Under process dimensions, presence of ICT policy at facility was higher compared to staff involvement in design of ICT aspects (χ =15.03, d.f =2 and p<0.001). Among the content factors, the ICT facilities provided was relatively high in all the facilities compared to levels of services operations computerised and breakdownreplacement protocol (χ=18.4, d.f =6 and p<0.005). Under the challenges, reliability of ICT infrastructure posed the greatest challenge towards up scaling of ICT among the content factors (χ=10.79, d.f. = 4, p-value=0.029). Process factor related challenges also had major impact on up scaling of ICT i.e. less up scaling of ICT that was attributed to lack of support from hospital top management team (χ 9.44, d.f.=4 and p=0.005). Comparing levels 5 and 6 facilities, the context dimension; presence of institutional induction training on ICT was the main factor that affected both facilities equally in relation to up scaling of ICT (p-value=0.021). Comparing level 4 facilities to level 6, process and content dimensions were the main factors that determined ICT uptake specifically availability of ICT policies in the institutions (p=0.011) and the levels of services operations that have been computerized (p=0.010) respectively.Conclusion: The study findings showed that content and process dimensions were the major aspects that were critical for positive up scaling of ICT in public health facilities. These factors were setting-dependent on the classification of the facility levels, in this study the level 4 facilities had poor up scaling of ICT compared to level 5 and level 6. The specific key attributes included: Strong management involvement in ICT related matters (process dimensions), availability and implementation of an ICT policy especially among level 4(process dimension), presence of an institutional induction training program on ICT (context dimension), type of ICT support provided and its reliability (content dimension) and level of services operations computerized (content). The major challenges that hindered up scaling of ICT were reliability of ICT infrastructure under the content factors and lack of support from hospital top management team under the process related factors

Factors affecting health care workers' acceptance and use of Telehealth in hospitals in Kwazulu-Natal

Magister Public Health - MPH (Public Health)Background and rationale: Telehealth is a collection of methods for enhancing health care, public health, and health education delivery and support using telecommunications technologies. Despite the many reported benefits of telehealth, there are challenges to its continued and widespread use in South Africa. It remains unclear what facilitates or hinders the integration of telehealth into routine clinical practice. Study aim and objectives: Drawing on the Unified Theory of Acceptance and Use of Technology (UTAUT), this study investigated factors affecting healthcare workers' acceptance and use of telehealth in hospitals in KwaZulu-Natal (KZN). Specifically, it described the frequency and nature of telehealth use and the factors associated with technology acceptance; and evaluated the influence of socio-demographic factors (age, experience, profession, qualification) and acceptance factors on use and behavioural intention to use telehealth. Methods: A quantitative survey in seven hospitals (2 tertiary, 3 regional, 2 district) with telehealth facilities falling under the KZN Department of Health, was conducted. 177 medical, nursing, pharmacy and allied staff consented to complete an on-line, closed ended and structured self-administered questionnaire based on the UTAUT model. The responses to the individual likert scale items were assigned a score (1-4), and from this, total scores calculated for each construct. Respondent characteristics were converted into binary variables and associations with total scores on each of the UTAUT acceptance domains were tested using t-test. The associations between behavioural intention and actual use (as binary dependent variables); and the respondent profiles, scores for performance expectancy, effort expectancy, social influence, and facilitating conditions (independent variables) were assessed in two multivariate logistic regression models

The Trajectory of IT in Healthcare at HICSS: A Literature Review, Analysis, and Future Directions

Research has extensively demonstrated that healthcare industry has rapidly implemented and adopted information technology in recent years. Research in health information technology (HIT), which represents a major component of the Hawaii International Conference on System Sciences, demonstrates similar findings. In this paper, review the literature to better understand the work on HIT that researchers have conducted in HICSS from 2008 to 2017. In doing so, we identify themes, methods, technology types, research populations, context, and emerged research gaps from the reviewed literature. With much change and development in the HIT field and varying levels of adoption, this review uncovers, catalogs, and analyzes the research in HIT at HICSS in this ten-year period and provides future directions for research in the field

Guía de la Cooperación Española para la incorporación de las TIC en las intervenciones de Salud en la Cooperación para el Desarrollo

El objetivo de esta guía es aportar herramientas y ejemplos reales para lograr aprovechar el potencial que ofrecen las nuevas tecnologías para fortalecer los sistemas de salud de los países socios, línea prioritaria de la cooperación española dentro de la estrategia de salud

Guía de la Cooperación Española para la incorporación de las TIC en las intervenciones de Salud en la Cooperación para el Desarrollo

El objetivo de esta guía es aportar herramientas y ejemplos reales para lograr aprovechar el potencial que ofrecen las nuevas tecnologías para fortalecer los sistemas de salud de los países socios, línea prioritaria de la cooperación española dentro de la estrategia de salud

Investigating factors that hinder the adoption and use of primary healthcare information systems (phcis) in the western cape of South Africa

Magister Commercii (Information Management) - MCom(IM)In the past, the Western Cape Department of Health had no formal or technologically enabled system for patient administration. This resulted in an administrative burden, increased waiting times for patients and doctors who needed results back from other sections, and missing patient files within the community health institutions such as clinics and hospitals. The Primary Healthcare Information System (PHCIS) was developed to solve this problem. However, it was later discovered that even though the PHCIS had been installed across the Western Cape clinics, there was a limited adoption and use of the PHCIS. Hence, the aim of this study was to investigate the factors that hinder the adoption and use of PHCIS by healthcare workers in the public healthcare clinics in the Khayelitsha sub-district in the Western Cape Provinc

Towards a better understanding of the intention to use eHealth services by medical professionals :the case of developing countries

PhD ThesisHealthcare services are a necessity for every country, and particularly in developing countries, where the shortage of medical professionals is greatest. To resolve this issue, it requires substantial resources that are not available. Therefore, the recent advancement in Information and Communication Technology (ICT) provides the platform for innovative eHealth services and the opportunity for improving access to medical services. Despite Governments, International Organisations, and companies‟ growing interest in eHealth Services for enabling access to medical treatment using ICT, research in developing countries related to user behavioural intention of these services remains relatively scarce. This is a research study to identify and measure the motivational factors that would expedite the introduction and widespread use of eHealth services in developing countries. More specifically, it endeavours to understand what factors would motivate medical professionals to successfully adopt eHealth Services. The study aims to identify and measure the determinants that would lead to successful adoption of eHealth services. This thesis is, thus, a services marketing study. To achieve this goal, a literature review was conducted in order to develop an original conceptual model of eHealth services in developing countries. Based on the literature review, an exploratory qualitative study was undertaken to assess awareness and gain insight into specific motivational factors which are incorporated into the original conceptual behavioural model. A reliable and valid model to measure behavioural intention to use eHealth services in developing countries was developed. This model incorporates several influencing factors determining usage intention and the analysis also tests a set of hypotheses covering moderating effects. The experimental fieldwork was conducted in cooperation with the International Telecommunications Union Study Group on eHealth and with local medical institutions in several developing countries having formalized cooperation agreements with the University where the researcher works. The study draws on responses from a sample of 549 medical professionals from ten developing countries. As the nature of this study is exploratory, factor and multiple regression analysis were used to test the hypotheses.This thesis answered the research questions, “What are the motivational factors influencing the “intention to use” of eHealth services by medical staff in developing countries”, and the managerial sub-questions, “What do the empirical results imply for the development of marketing strategies for eHealth services in developing countries? Can medical professionals be segmented on the basis of eHealth early adoption dimensions? What marketing strategies are necessary to gain the acceptance and adoption of eHealth services in developing countries? The main contributions of this thesis to theory and practice are as follows: Overall Research Question: - What are the motivational factors influencing the “intention to use” of eHealth services by medical staff in developing countries? Value-added #1: Created a new unique behavioural intention model for developing countries (did not exist before) Value-added #2: Validated and measured new influencing factors Value-added #3: Validated new scales for a new domain, eHealth and in a new context, developing countries The Managerial sub-questions are: - What do the empirical results imply for the development of marketing strategies for eHealth services in developing countries? - Can medical professionals be segmented on the basis of eHealth early adoption dimensions? - What marketing strategies are necessary to gain the acceptance and adoption of eHealth services in developing countries? Value-Added #4: Principles of marketing strategies developed based on measured influencing factors Value-added # 5: Identified the early adopters of eHealth services based on moderation effects Value-added #6: Developed a Segmentation and positioning framework This study contributes to academic theory through the creation of a behavioural intention model for eHealth services in developing countries, and by extending and modifying the UTAUT model to a new service (eHealth) and a new environment (developing countries). eHealth has not reached critical mass and this research study aims to move this new innovative service from pilot to full-scaled schemes. The study contributes to management practice by providing a new understanding of the factors that would encourage medical professionals and medical administration to use eHealth Services. These results can be used to develop principles for a marketing strategy framework aimed at providers of eHealth services in the private sector. Specifically, this thesis identifies the early adopters of these services and proposes a market segmentation and positioning strategy focused on the key stakeholders in this field. The results of this study can also inform international bodies tasked with promoting eHealth solutions in developing countries, such as the International Telecommunications Union Development Sector to help in the progression of eHealth services in developing countries. eHealth is an important international topic and is on the agenda of international and governmental organisations, such as: the International Telecommunications Union (ITU), the World Health Organisation (WHO), the European Union (EU), and others for more than ten years. However, the diffusion of eHealth services is rather slow and for this reason it is important to understand the main obstacles and user influencing factors for developing an applied marketing strategy

National e-health innovation : conduct of international e-health technology transfers in Africa

The sociology and economics of the conduct of international e-health technology transfers (IeTTs) is examined. Most African countries are perennial recipients with variations in their domestic e-health utilisation, development and implementation. We identify, explore, and demonstrate how complex and interlinked global, continental, national and subnational actions and institutions condition their national e-health implementations. Multidisciplinary literatures are from national e-health implementations, national innovation system (NIS) interactive learning, international technology transfers, global development and globalisation. Methodically, a unique combination of middle-range and moderate Science and Technology Studies constructivism, NIS institutionalism and Deleuzian poststructuralist narrative is employed. The conduct of IeTTs is characterised by technological path dependency, history, complexity, power, politics, multiple identities, self-interests and contestations in complex global and transnational interactions. Recipients‘ exercises of National Agency mirror their varied domestic technology acquisition dynamics and trajectories. Successful transfers are institutionally conditioned by interactions of global geopolitics, fragmented continental governance and national reticence. Agential asymmetry that results, accounts for why most recipients are variably struggling in their technology acquisitions. The exercise of National Agency is paramount. National economic size and maturity of extant national innovation capacity can determine if a recipient can acquire domestic e-health innovation and industrial competences. Actions taken by National governments, can strategically determine if technologies are accumulated and technical knowledge assimilated, for addressing the challenges of technology inappropriateness, incompatibilities and obsolescence encountered during subnational utilisations. We contend that implementing a national e-health infrastructure is a long-term and large-scale institutional engineering endeavour. Cumulative advantage explains difference between Schumpeter and Schumacher on e-health technology design and production. A Schumpeterian domestic industrial model of hi-tech e-health technology development, rather than a cosmopolitan Schumacher consumerist one, is proposed. Whilst, appreciating that Schumacher on incremental accumulation and assimilation from small-scale technological implementations can be instrumental. Uniquely, we identify that global geopolitical contention between global west and east economies and competitive global markets and global technoeconomic changes can either condition scale and depth of domestic acquisition. Nevertheless, these conditions and events have historically and contemporaneously shaped global e-health innovations. In a Schumpeterian evolutionary sense, Satcom technologies that powered e-health services in the past are now being substituted by mobile ones. This technological transition is bringing about a convergence of consumer electronics (i.e. Smartphones) and lifesciences industries, driven by a combinatorial biomedical, telecommunication and computing e-health innovations. With these findings, an innovation-based macro-societal perspective is proposed for studying e-health implementation, as opposed to the prevalent information based microbehavioural studies. Further contributions to academia and policy are made to ICT4D, Global Health and m-health practices. Policy recommendations are made to national, continental and global institutions on how to foster national technology acquisitions. Recipients are encouraged to learn from incremental domestic e-health implementations in global technology frontiers. Their share in intellectual property rights accruing from global-subnational e-health coinnovations must be repatriated. We conclude by proposing a global collaboration framework to guide and to foster cooperation amongst those involved in the conduct of IeTTs. Symmetry – an alignment of vertical hierarchical and diffuse horizontal complex sociotechnical interactions, though, not as the implied flat, circumscribed and cyclical dynamics of actor network theory, is proposed. So, an alignment of the constitutive diverse and competing interests and identities, is deemed strategic, to foster domestic accumulations and assimilations.EThOS - Electronic Theses Online ServiceGBUnited Kingdo