The development and implementation of e-health services for the Libyan NHS: case studies of hospitals and clinics in both urban and rural areas

This thesis provides an assessment of the readiness levels within both urban and rural hospitals and clinics in Libya for the implementation of E-health systems. This then enabled the construction of a framework for E-health implementation in the Libyan National Health Service (LNHS). The E-health readiness study assessed how medications were prescribed, how patients were referred, how information communication technology (ICT) was utilised in recording patient records, how healthcare staff were trained to use ICT, and how the ways in which consultations were carried out by healthcare staff. The research was done in five rural clinics and five urban medical centres and focused on the E-health readiness levels of the technology, social attitudes, engagement levels and any other needs that were apparent. Collection of the data was carried out using a mixed methods approach with qualitative interviews and quantitative questionnaires. The study indicated that any IT equipment present was not being utilised for clinical purposes and there was no evidence of any E-health technologies being employed. This implies that the maturity level of the healthcare institutions studied was at level zero in the E-health maturity model used in this thesis. In order for the LNHS to raise its maturity levels for the implementation of E-health systems, it needs to persuade LNHS staff and patients to adopt E-health systems. This can be carried out at a local level throughout the LNHS, though this will need to be coordinated at a national level through training, education and programmes to encourage compliance and providing incentives. In order to move E-health technology usage in the participating Libyan healthcare institutions from Level 0 to Level 2 in the E-health Maturity Model levels, an E-health framework was created that is based on the findings of this research study. The primary aim of the LNHS E-Health Framework is the integration of E-health services for improving the delivery of healthcare within the LNHS. To construct the framework and ensure that it was creditable and applicable, work on it was informed directly by the findings from document analysis, literature review, and expert feedback, in conjunction with the primary research findings presented in Chapter Five. When the LNHS E-Health Framework was compiled there were several things taken into consideration, such as: the abilities of healthcare staff, the needs of healthcare institutions and the existing ICT infrastructure that had been recorded in the E-readiness assessment which was carried out in the healthcare institutions (Chapter 5). The framework also provides proposals for E-health systems based on the infrastructure network that will be developed. The processes addressed are electronic health records, E-consultations, E-prescriptions, E-referrals and E-training. The researcher has received very positive, even enthusiastic, feedback from the LNHS and other officals, and that expect the framework to be further developed and implemented by the LNHS in the near future

e-Health systems adoption and telemedicine readiness: practitioner perspective from Libyan healthcare sector

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University LondonHealthcare service providers have reasons to consider e-Health systems and Telemedicine solutions when determining the best practices for healthcare provision in developing countries. The focus of this research is to inspect the readiness to adopt eHealth systems at an organisational level in Libya and utilise Telemedicine technologies in order to provide healthcare to service users. The main application is monitoring chronic (ongoing) health conditions such as diabetes, high blood pressure, and also for patients following strokes and paralysis, regardless of where they are. This research highlights that the success of Telemedicine adoption could be influenced by various health-specific organisational factors including organisational capabilities and resources. This research aims to provide a model to assess the e-Health systems and Telemedicine readiness in Libya from the healthcare providers’ perspective. This research employed a questionnaire-based survey targeting mainly Libyan clinicians and healthcare staff who are on training programmes and studying for further education in the UK and who have been healthcare providers in Libya. 161 participants responded to the questionnaire with a rate of 31% and the data was analysed using SPSS statistic software (V.20). This research has found that various organisational factors have an impact on Telemedicine adoption and thus on the implementation of such technology including Healthcare Provider (HP) HR, IT infrastructure, technology ease of use and healthcare providers’ perspective. In the regression analysis, it was found that Telemedicine Readiness [influenced by Telemedicine Ease of Use, HP IT Infrastructure and HP HR Capability (p < 0.001, R2= 0.472)], Telemedicine Outcome Expectations [influenced by HP User Expectations and HP HR Capability (p < 0.001, R2= 0.522)] and HP Operational Capability [influenced by HP User Expectations, Telemedicine Ease of Use, HP Learning Capabilities and HP IT Infrastructure (p < 0.001, R2= 0.353)] have a positive significant impact on Telemedicine Adoption (p < 0.001, R2= 0.477). These findings indicate that in order to adopt Telemedicine technologies in healthcare establishments, the focus should be on human resources’ capabilities and the first line staff such as clinicians and nurses with consideration to their involvement in project plans ensuring that the introduced Telemedicine technologies’ compatibility with their routine practices would not be affected and the technology should be easy to use.Libyan Culture Affairs, Libyan Embassy in Londo

Federal Register

Daily publication of the U.S. Office of the Federal Register contains rules and regulations, proposed legislation and rule changes, and other notices, including "Presidential proclamations and Executive Orders, Federal agency documents having general applicability and legal effect, documents required to be published by act of Congress, and other Federal agency documents of public interest" (p. ii). Table of Contents starts on page iii

Brexit and future of Europe – A new multilateral agenda? Egmont Commentary, 17 August 2016

With the European Union Global Strategy endorsed by the European Council, Balazs Ujvari, of Egmont – Royal Institute for International Relations, assesses the long-term prospects for the EU’s multilateral action

Medical-Data-Models.org:A collection of freely available forms (September 2016)

MDM-Portal (Medical Data-Models) is a meta-data repository for creating, analysing, sharing and reusing medical forms, developed by the Institute of Medical Informatics, University of Muenster in Germany. Electronic forms for documentation of patient data are an integral part within the workflow of physicians. A huge amount of data is collected either through routine documentation forms (EHRs) for electronic health records or as case report forms (CRFs) for clinical trials. This raises major scientific challenges for health care, since different health information systems are not necessarily compatible with each other and thus information exchange of structured data is hampered. Software vendors provide a variety of individual documentation forms according to their standard contracts, which function as isolated applications. Furthermore, free availability of those forms is rarely the case. Currently less than 5 % of medical forms are freely accessible. Based on this lack of transparency harmonization of data models in health care is extremely cumbersome, thus work and know-how of completed clinical trials and routine documentation in hospitals are hard to be re-used. The MDM-Portal serves as an infrastructure for academic (non-commercial) medical research to contribute a solution to this problem. It already contains more than 4,000 system-independent forms (CDISC ODM Format, www.cdisc.org, Operational Data Model) with more than 380,000 dataelements. This enables researchers to view, discuss, download and export forms in most common technical formats such as PDF, CSV, Excel, SQL, SPSS, R, etc. A growing user community will lead to a growing database of medical forms. In this matter, we would like to encourage all medical researchers to register and add forms and discuss existing forms