ICTs and Public Health in the Context of COVID-19

The globe is currently gripped by the deadliest and most widespread pandemic it has faced in over a century. Confronted by accelerating death tolls and widespread fear, societies around the world have also been forced to acknowledge points of stress in their economic and social fabrics that had long gone overlooked. In the midst of this turmoil, Information and Communications Technology (ICT) has played an essential role in facilitating the safe relief and treatment of affected populations. ICT has also shown itself to be essential both to bolstering long-term resiliency against future pandemics and to resolving the secondary challenges that emerge within a socially distanced environment. However, involving ICT in pandemic relief and prevention carries with it its own set of challenges involving transparency, accountability, and privacy. Governments which apply ICT must ensure that far-reaching crisis measures do not become permanently entrenched in society, and that measures which are taken are deemed fair, proportional and just

The Quest for National Digital Agility: Digital Responses to Covid-19 in Five Countries

Countries worldwide have employed different digital solutions to contain and cope with the Covid-19 pandemic. In this explorative case research, we examine national-level digital responses to the pandemic in four specific areas—tracking and tracing, health data reporting, teleconsultation, and vaccination mobilization—across five countries: China, Denmark, Germany, South Korea, and the U.S. Drawing on the notion of agility and digital infrastructures, our cross-case analysis unveils how the countries’ digital responses to the pandemic have been shaped by their national health system characteristics. In addition, we highlight how existing digital health infrastructures, regulatory adaptations, and industry collaborations fostered the alacrity with which nations responded to the pandemic. We define national-level digital agility as the ability of a nation to leverage digital infrastructure capabilities to address urgent societal challenges in a contextually appropriate way. Our key contribution is a model of this complex, but urgently needed concept containing five building blocks, each of which is a critical prerequisite to building such agility. Despite focusing on addressing the existing challenges of the ongoing Covid-19 pandemic, we believe that researchers and policymakers can also take pointers away from our framework to tackle other socio-environmental challenges

Addressing Resource Gaps in the U.S. Health Care Safety Net: An Assessment of the Free Clinic Network

Based on a survey of free clinics serving uninsured low-income patients, examines the resource constraints limiting the expansion of healthcare services provided, including the high costs of labs, equipment, and medication. Makes recommendations

Health Information Technology in the United States, 2008

Provides updated survey data on health information technology (HIT) and electronic health records adoption, with a focus on providers serving vulnerable populations. Examines assessments of HIT's effect on the cost and quality of care and emerging issues

Perceived critical success factors of electronic health record system implementation in a dental clinic context: An organisational management perspective

Background Electronic health records (EHR) make health care more efficient. They improve the quality of care by making patients’ medical history more accessible. However, little is known about the factors contributing to the successful EHR implementation in dental clinics. Objectives This article aims to identify the perceived critical success factors of EHR system implementation in a dental clinic context. Methods We used Grounded Theory to analyse data collected in the context of Brunei’s national EHR − the Healthcare Information and Management System (Bru-HIMS). Data analysis followed the stages of open, axial and selective coding. Results Six perceived critical success factors emerged: usability of the system, emergent behaviours, requirements analysis, training, change management, and project organisation. The study identified a mismatch between end-users and product owner/vendor perspectives. Discussion Workflow changes were significant challenges to clinicians’ confident use, particularly as the system offered limited modularity and configurability. Recommendations are made for all the parties involved in healthcare information systems implementation to manage the change process by agreeing system goals and functionalities through wider consensual debate, and participated supporting strategies realised through common commitment

Effects of critical success factors on maturity level of Hospital information systems

Hospitals are regarded as the most important part of a healthcare system. Generally, hospitals use Hospital Information System (HIS) as an infrastructure for recording, retrieval, and transmission of data, facilitation of decision-making processes, and other healthcare-related functions. An issue in HIS is that the implementation of the system in hospitals has always been associated with a high risk of failure. This study, therefore, aims to first assess the maturity of HIS in Iranian hospitals and then, examine the related Critical Success Factors (CSF) in order to mitigate the implementation risks of HISs to the authorities. Eleven hospitals under the administration of Medical University of Isfahan, Iran, were selected. Data was collected through a checklist designed based on Electronic Medical Record Adoption Model (EMRAM) expectations. Questionnaires were distributed to employees of the eleven identified hospitals using stratified sampling method in which 126 completed questionnaires were returned. The results revealed that all of the hospitals have reached to elementary stages of (EMRAM). In addition, 26 CSFs were found to be effective in HIS implementation success in the hospitals but some factors were found to be higher in the level of effectiveness. The findings were then evaluated by 14 experts who are familiar with the selected hospitals, the HIS concept and project implementation. The final results which included a comprehensive picture about the initial maturity status of HIS and also 12 more effective CSFs for successful implementation of HIS in the hospitals can provide guidance for hospital top managers and healthcare policy makers in developing appropriate strategic IT plans and HIS implementation frameworks

An Integrated and Distributed Framework for a Malaysian Telemedicine System (MyTel)

The overall aim of the research was to produce a validated framework for a Malaysian integrated and distributed telemedicine system. The framework was constructed so that it was capable of being useful in retrieving and storing a patient's lifetime health record continuously and seamlessly during the downtime of the computer system and the unavailability of a landline telecommunication network. The research methodology suitable for this research was identified including the verification and validation strategies. A case study approach was selected for facilitating the processes and development of this research. The empirical data regarding the Malaysian health system and telemedicine context were gathered through a case study carried out at the Ministry of Health Malaysia (MOHM). The telemedicine approach in other countries was also analysed through a literature review and was compared and contrasted with that in the Malaysian context. A critical appraisal of the collated data resulted in the development of the proposed framework (MyTel) a flexible telemedicine framework for the continuous upkeep o f patients' lifetime health records. Further data were collected through another case study (by way of a structured interview in the outpatient clinics/departments of MOHM) for developing and proposing a lifetime health record (LHR) dataset for supporting the implementation of the MyTel framework. The LHR dataset was developed after having conducted a critical analysis of the findings of the clinical consultation workflow and the usage o f patients' demographic and clinical records in the outpatient clinics. At the end of the analysis, the LHR components, LHR structures and LHR messages were created and proposed. A common LHR dataset may assist in making the proposed framework more flexible and interoperable. The first draft of the framework was validated in the three divisions of MOHM that were involved directly in the development of the National Health JCT project. The division includes the Telehealth Division, Public and Family Health Division and Planning and Development Division. The three divisions are directly involved in managing and developing the telehealth application, the teleprimary care application and the total hospital information system respectively. The feedback and responses from the validation process were analysed. The observations and suggestions made and experiences gained advocated that some modifications were essential for making the MyTel framework more functional, resulting in a revised/ final framework. The proposed framework may assist in achieving continual access to a patient's lifetime health record and for the provision of seamless and continuous care. The lifetime health record, which correlates each episode of care of an individual into a continuous health record, is the central key to delivery of the Malaysian integrated telehealth application. The important consideration, however, is that the lifetime health record should contain not only longitudinal health summary information but also the possibility of on-line retrieval of all of the patient's health history whenever required, even during the computer system's downtime and the unavailability of the landline telecommunication network

Smart Healthcare solutions in China and Europe, an international business perspective

The thesis is part of the Marie Curie Fellowship project addressing health related challenges with IoT solutions. The author tries to address the challenge for the implementation of telehealth solutions by finding out the demand of the telehealth solution in selected European economies and in China (chapter 1), analyzing the emerging business models for telehealth solution ecosystems in China (chapter 2), how to integrate telehealth solutions with institutional stakeholders (chapter 3) and why are elderly users willing to use telehealth solutions in China. Chapter 1 and chapter 2 form the theoretical background for empirical work in chapter 3 and chapter 4. The thesis addressed four research questions, namely “Which societal and social-economics unmet needs that Internet of Healthcare Things can help to resolve?”, “What are the business model innovation for tech companies in China for the smart health industry?”, “What are the facilitators and hurdles for implementing telehealth solutions”, “Are elderly users willing to use telehealth solutions in China?”. Both qualitative study and quantitative analysis has been made based on data collected by in depth interviews with stakeholders, focus group study work with urban and rural residents in China. The digital platform framework was used in chapter 2 as the theoretical framework where as the stakeholder power mapping framework was used in chapter 3. The discretion choice experiment was used in chapter 4 to design questionnaire study while ordered logit regression was used to analyze the data. Telehealth solutions have great potential to fill in the gap for lack of community healthcare and ensuring health continuity between home care setting, community healthcare and hospitals. There is strong demand for such solutions if they can prove the medical value in managing chronic disease by raising health awareness and lowering health risks by changing the patients’ lifestyle. Analyzing how to realize the value for preventive healthcare by proving the health-economic value of digital health solutions (telehealth solutions) is the focus of research. There remain hurdles to build trust for telehealth solutions and the use of AI in healthcare. Next step of research can also be extended to addressing such challenges by analyzing how to improve the transparency of algorithms by disclosing the data source, and how the algorithms were built. Further research can be done on data interoperability between the EHR systems and telehealth solutions. The medical value of telehealth solutions can improve if doctors could interpret data collected from telehealth solutions; furthermore, if doctors could make diagnosis and provide treatment, adjust healthcare management plans based on such data, telehealth solutions then can be included in insurance packages, making them more accessible

Information Technology's Role in Global Healthcare Systems

Over the past few decades, modern information technology has made a significant impact on people’s daily lives worldwide. In the field of health care and prevention, there has been a progressing penetration of assistive health services such as personal health records, supporting apps for chronic diseases, or preventive cardiological monitoring. In 2020, the range of personal health services appeared to be almost unmanageable, accompanied by a multitude of different data formats and technical interfaces. The exchange of health-related data between different healthcare providers or platforms may therefore be difficult or even impossible. In addition, health professionals are increasingly confronted with medical data that were not acquired by themselves, but by an algorithmic “black box”. Even further, externally recorded data tend to be incompatible with the data models of classical healthcare information systems.From the individual’s perspective, digital services allow for the monitoring of their own health status. However, such services can also overwhelm their users, especially elderly people, with too many features or barely comprehensible information. It therefore seems highly relevant to examine whether such “always at hand” services exceed the digital literacy levels of average citizens.In this context, this reprint presents innovative, health-related applications or services emphasizing the role of user-centered information technology, with a special focus on one of the aforementioned aspects