Holistic System Design for Distributed National eHealth Services

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Advancing Ehealth Education for the Clinical Health Professions

This is the final report of a project that aimed to encourage and support program coordinators and directors of Australian undergraduate and postgraduate coursework programs in all allied health, nursing and medical professions to address the need for Ehealth education for entry-level clinical health professionals

SERIES: eHealth in primary care. Part 1: Concepts, conditions and challenges.

Primary care is challenged to provide high quality, accessible and affordable care for an increasingly ageing, complex, and multimorbid population. To counter these challenges, primary care professionals need to take up new and innovative practices, including eHealth. eHealth applications hold the promise to overcome some difficulties encountered in the care of people with complex medical and social needs in primary care. However, many unanswered questions regarding (cost) effectiveness, integration with healthcare, and acceptability to patients, caregivers, and professionals remain to be elucidated. What conditions need to be met? What challenges need to be overcome? What downsides must be dealt with? This first paper in a series on eHealth in primary care introduces basic concepts and examines opportunities for the uptake of eHealth in primary care. We illustrate that although the potential of eHealth in primary care is high, several conditions need to be met to ensure that safe and high-quality eHealth is developed for and implemented in primary care. eHealth research needs to be optimized; ensuring evidence-based eHealth is available. Blended care, i.e. combining face-to-face care with remote options, personalized to the individual patient should be considered. Stakeholders need to be involved in the development and implementation of eHealth via co-creation processes, and design should be mindful of vulnerable groups and eHealth illiteracy. Furthermore, a global perspective on eHealth should be adopted, and eHealth ethics, patients' safety and privacy considered.Published versio

M-health adoption by healthcare professionals : a systematic review

Objective The aim of this systematic review was to synthesize current knowledge of the factors influencing healthcare professional adoption of mobile health (m-health) applications. Methods Covering a period from 2000 to 2014, we conducted a systematic literature search on four electronic databases (PubMed, EMBASE, CINAHL, PsychInfo). We also consulted references from included studies. We included studies if they reported the perceptions of healthcare professionals regarding barriers and facilitators to m-health utilization, if they were published in English, Spanish, or French and if they presented an empirical study design (qualitative, quantitative, or mixed methods). Two authors independently assessed study quality and performed content analysis using a validated extraction grid with pre-established categorization of barriers and facilitators. Results The search strategy led to a total of 4223 potentially relevant papers, of which 33 met the inclusion criteria. Main perceived adoption factors to m-health at the individual, organizational, and contextual levels were the following: perceived usefulness and ease of use, design and technical concerns, cost, time, privacy and security issues, familiarity with the technology, risk-benefit assessment, and interaction with others (colleagues, patients, and management). Conclusion This systematic review provides a set of key elements making it possible to understand the challenges and opportunities for m-health utilization by healthcare providers

Ensuring the security and privacy of information in mobile health-care communication systems

The sensitivity of health-care information and its accessibility via the Internet and mobile technology systems is a cause for concern in these modern times. The privacy, integrity and confidentiality of a patient’s data are key factors to be considered in the transmission of medical information for use by authorised health-care personnel. Mobile communication has enabled medical consultancy, treatment, drug administration and the provision of laboratory results to take place outside the hospital. With the implementation of electronic patient records and the Internet and Intranets, medical information sharing amongst relevant health-care providers was made possible. But the vital issue in this method of information sharing is security: the patient’s privacy, as well as the confidentiality and integrity of the health-care information system, should not be compromised. We examine various ways of ensuring the security and privacy of a patient’s electronic medical information in order to ensure the integrity and confidentiality of the information

Introducing mobile technologies to strengthen the national continuing medical education program in Vietnam

BACKGROUND: In 2009, the Government of the Republic of Vietnam adopted legislation requiring all clinicians to complete continuing medical education (CME) credits in order to maintain licensure. Several CME in-person and distance-based courses have been developed and as of 2015, a national distance-based electronic learning (eLearning) network was being established. However, the uptake of CME courses remained low despite high clinician demand. Vietnam’s high mobile phone ownership rate of 1.4 mobile subscriptions per person presents an opportunity to leverage this for CME. This study investigated how mobile technologies could strengthen delivery of distance-based CME courses and improve national CME program administration. METHODS: A literature and policy review was conducted. Qualitative methods were employed to collect and analyze key informant interviews of 52 global and Vietnamese experts, including selected policy makers. Interviews were supplemented by six focus group discussions with Vietnamese physicians, nurses, midwives and physician assistants. Transcripts were analyzed using an inductive coding methodology. A framework was developed to organize and present results for government consumption. RESULTS: Globally, examples and supporting evidence related to mobile technologies for CME were limited. Experts reported three main use cases for using mobile technology for CME in Vietnam: 1) delivery of CME courses (N=34; 65%); 2) registration and tracking of CME credits (n=28; 54%); and 3) sending alerts and reminders on CME opportunities (n=23; 44%). The national CME policy environment in Vietnam was supportive of introducing mobile technologies within the eLearning network. However, there was a widespread lack of awareness and capacity to design and deliver distance-based CME courses. Mobile phone ownership was high and health workers reported interest in acquiring CME credits via mobile. Financing options to develop and implement distance-based CME courses were limited. CONCLUSION: Despite the paucity of evidence related to mobile technologies for learning, there is potential to innovate and strengthen the evidence base using these technologies for CME in Vietnam. Introducing mobile technologies within the national eLearning network would improve clinicians’ access to CME, particularly in rural areas, and can strengthen national CME program administration. Key recommendations were developed to provide the government with concrete steps for national level adoption