Pathways Home Project: Patient Self-management and Self-efficacy through the Deployment of ICTs

This research-in-progress paper presents an examination of, and reflections on, the challenges of using information and communication technologies (ICTs) to support patients suffering chronic respiratory conditions to achieve increased levels of selfmanagement and self-efficacy. These research insights arise as part of the planning and on-going implementation of the Pathways Home for Respiratory Illness project (Pathways). This project seeks to assist patients with either chronic obstructive pulmonary disease (COPD) or cystic fibrosis (CF) to acquire skills that empower them to comprehend and initiate action in relation to alterations in their conditions. The overall aim of Pathways is to evaluate the impact of these newly acquired skills for improving health outcomes at individual and population levels and is due for completion in 2008. Achieving benefits from the introduction of ICTs as part of processes aimed at building sustainable self-efficacy and self-management is very difficult, not least because of a desire to avoid simply replacing patient dependency on health professionals with dependency on technology. Reflections on the challenges and experiences within the project to-date illuminate some implicit assumptions underpinning existing IS models for evaluating impact in terms of adoption, usage and benefit and the end-points we presume in our system development processes

HITECH Revisited

Assesses the 2009 Health Information Technology for Economic and Clinical Health Act, which offers incentives to adopt and meaningfully use electronic health records. Recommendations include revised criteria, incremental approaches, and targeted policies

Toward Universal Broadband in Rural Alaska

The TERRA-Southwest project is extending broadband service to 65 communities in the Bristol Bay, Bethel and Yukon-Kuskokwim regions. A stimulus project funded by a combination of grants and loans from the Rural Utilities Service (RUS), TERRA-Southwest has installed a middle-mile network using optical fiber and terrestrial microwave. Last-mile service will be through fixed wireless or interconnection with local telephone networks. The State of Alaska, through its designee Connect Alaska, also received federal stimulus funding from the National Telecommunications and Information Administration (NTIA) for tasks that include support for an Alaska Broadband Task Force “to both formalize a strategic broadband plan for the state of Alaska and coordinate broadband activities across relevant agencies and organizations.” Thus, a study of the impact of the TERRA project in southwest Alaska is both relevant and timely. This first phase provides baseline data on current access to and use of ICTs and Internet connectivity in rural Alaska, and some insights about perceived benefits and potential barriers to adoption of broadband. It is also intended to provide guidance to the State Broadband Task Force in determining how the extension of broadband throughout the state could contribute to education, social services, and economic activities that would enhance Alaska’s future. Results of the research could also be used proactively to develop strategies to encourage broadband adoption, and to identify applications and support needed by users with limited ICT skills.Connect Alaska. The National Telecommunications and Information Administration. General Communications Incorporated.Part 1: An Analysis of Internet Use in Southwest Alaska / Introduction / Previous Studies / Current Connectivity / Analytical Framework and Research Methodology / Demographics / Mobile Phones: Access and Use / Access to the Internet / Internet Useage / Considerations about Internet Service / Interest in Broadband / Sources of News / Comparison with National Data / Internet Use by Businesses and Organizations / What Difference may Broadband make in the Region? / Conclusiongs / Part 2 Literature Review / Reference

Assessment of organizational readiness towards electronic health records in a tertiary care hospital, Karachi, Pakistan, a quantitative analytical cross-sectional study

Background: A medical error is one of the most preventable errors that occur frequently in hospitals, leading to millions of deaths yearly. Medical errors cost hospitals billions of dollars worldwide. Human error is also a common cause of medication errors, but this error is due to the failure of the system to detect errors. The electronic health record (EHR) is a complete set of computerized records of all information related to patient health that is used by one or more users in any care setting. This information includes demographic data of patients, patients’ progress notes, complaints and diagnoses, medications, vital signs history and records, past medical and immunization history, labs, and radiology data. Healthcare systems in Pakistan need proper and timely attention by utilizing technology. Technology can bring a positive change in the healthcare setup of Pakistan. For the time being, the most important factor that has been ignored by the government is the unavailability of technology in healthcare readiness. AKUH is planning to implement EHRs in 2024, which was an opportunity for us to assess the organizational readiness towards EHRs at AKUH before implantation.Purpose: The purpose of the study was to assess organizational readiness towards EHRs and to identify enabling factors and barriers towards their implementation.Methodology: A cross-sectional analytical study design was used for this study to respond to the research questions of the study. A universal sampling technique was used to recruit 4,146 population for the study through an online survey from a private tertiary care hospital. The targeted response rate was to recruit 60% of the sample size from the total population. Univariate and Multiple regression was run to find the association between the dependent and independent variables.Result: A total of 3,358 participants responded to the online survey, including both faculties and staff, responded to the study questionnaire through their workplace email addresses, which were kept confidential by the hospital\u27s human resource department. Thus, the response rate to the study was 81.4%. In this study, the overall readiness level for EHR adoption was 73.4% [95% CI: 95.5% and 51.3%]. Computer literacy, computer access at health facilities at home and work, awareness about EHRs, perceived benefit, and negative impact of EHRs were significantly associated with overall healthcare providers\u27 readiness for EHR adoption using a p-value less than 0.05 as a cut point.Conclusion: The study discovered significant factors in healthcare providers\u27 readiness for EHR deployment. The healthcare providers who were less than 35 years and greater than 26, those with more than six years and less than ten years of work experience, those who were familiar with EHRs, and those with higher computer literacy were more prepared. These findings offer useful insights into the characteristics of providers who are more likely to accept EHRs, underlining the importance of addressing concerns and adjusting policies to ensure effective EHR adoption

Beyond Infrastructure: Broadband for Development in Remote and Indigenous Regions

Recent telecommunications stimulus projects in the U.S. and Canada were intended to increase availability of broadband through funding infrastructure investments, largely in rural and remote regions. However, true access involves more than availability; it also includes affordability and adoption. This paper presents a framework for analyzing broadband adoption that takes into consideration geographical, economic and cultural environments in indigenous communities. It includes an overview of potential social and economic impacts of broadband in remote areas, using examples from the Alaska study and the Canadian North. It then reports on results of an evaluation of Internet use and potential adoption of broadband in remote indigenous communities of southwest Alaska. Finally, the paper provides a comparative analysis of U.S. and Canadian policies intended to achieve affordable access to broadband for rural users and sustainable business models for rural broadband providers.Ye

Rethinking Sanitation: Lessons and Innovation for Sustainability and Success in the New Millennium

This report highlights some of the key lessons learned from the past about sustainable sanitation solutions, new thinking emerging from consolidated learning and innovative experimentation on-the-ground, and some of the conditions necessary for success if real improvements in sanitation are to be achieved and sustained in rural and urban areas. Special attention is placed on the shift from supply-led sanitation projects to demand-led and market-oriented projects. The report concludes that with much deeper attention and broadened interest in sanitation, a more realistic view of the complexity, time, resources and effort needed to meet the challenge of large-scale sustainable changes in sanitation at the household level

A conceptual study of the factors influencing e-inclusion

With the advancement of the Internet and supporting Information and Communication Technologies, e-inclusion has emerged as an effective means to create opportunities for all and to further individual autonomy and capability in terms of using online services offered by public agencies. The aim of this paper is to offer a critical discussion on the role of e-inclusion from the user perspective, which goes beyond the demographic factors when adopting e-government services. Further, this paper explains the fundamental differences between digital divide and e-inclusion and examines why research focus is now shifting towards studying e-inclusion rather that digital divide in Europe. Through a conceptual analysis the authors examine the relationship between social inclusion and e-inclusion and how they contributes towards promoting the use of ICT to overcome exclusion and improve economic performance, employment opportunities, quality of life, social participation and cohesion

Electronic Medical Record Adoption in New Zealand Primary Care Physician Offices

Describes EMR adoption in New Zealand's primary healthcare system, including how government investment was secured and data protection laws, unique patient identifiers, and standards and certification were established, with lessons for the United States

Lessons From a Health Information Technology Demonstration in New York Nursing Homes

Outlines the New York State Nursing Home Health Information Technology Demonstration Project; variations in organizational aims in adopting HIT, perceived or real effects, and resulting quality improvement efforts; and considerations for replication

The Promise of Health Information Technology: Ensuring that Florida's Children Benefit

Substantial policy interest in supporting the adoption of Health Information Technology (HIT) by the public and private sectors over the last 5 -- 7 years, was spurred in particular by the release of multiple Institute of Medicine reports documenting the widespread occurrence of medical errors and poor quality of care (Institute of Medicine, 1999 & 2001). However, efforts to focus on issues unique to children's health have been left out of many of initiatives. The purpose of this report is to identify strategies that can be taken by public and private entities to promote the use of HIT among providers who serve children in Florida