Alcuni abstract di articoli che trattano argomenti relativi all'eHealth

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On Adoption and Use of Hospital Information Systems in Developing Countries: Experiences of Health Care Personnel and Hospital Management in Tanzania

The use of health IT has become prevalent in hospitals across the world. Hospital information system (HIS) is the backbone of a modern hospital. It generally consists of several integrated modules covering distinct parts of administrative and clinical functions of a hospital, including inpatient and outpatient operations, human resources, electronic medical records (EMR), information on imaging, laboratory, and pharmacy. HIS can improve the operational performance of a hospital, and ultimately lead to better patient experience, improved health outcomes, and increased revenue for the hospital. Developing countries have special challenges in adopting and using these systems, including low computer skills of personnel, substandard ICT infrastructure, and widely prevalent paper-based systems across hospitals. The government of Tanzania has recently implemented a national eHealth strategy to support the adoption of health IT. As a result, local health care facilities have started adopting hospital information systems, and decision-makers at hospitals need guidance on how to select an appropriate HIS. As user experience is an important aspect of health IT affecting the adoption and use of these systems, we studied the perceptions of health care personnel and hospital management in regard to three hospital information systems, AfyaPro, Care2X, and GoTHoMIS, used in Tanzanian hospitals. The thesis consists of the qualitative user study and literature review of HIS adoption and use in developing countries. The thesis has been done in collaboration with Capacity Building of Tanzanian Health Information System project, a multi-stakeholder initiative consisting of partners in Finland and Tanzania. The project aims to build eHealth competencies in Tanzania. The study found out that hospital information systems provide a myriad of quantifiable benefits to both hospitals and patients, but they still pose many challenges to the users. Automation, reduction in manual work, and tracking various hospital metrics were perceived as major benefits of HIS. However, hospital personnel’s lack of ICT skills, frequent power cuts, lack of necessary HIS integrations, and usability issues were perceived as challenges in HIS use. The main rationale for this thesis was to explore the user perceptions of HISs and to inform decision-makers in Tanzanian hospitals for selecting an appropriate hospital information system and guide HIS developers in creating better systems

A Model for patient engagement integration in perinatal eHealth development and quality assurance

The aim of this study was to construct a model for patient engagement integration in perinatal eHealth development and quality assurance. The model was developed in four phases. The first three phases produced evidence for the development of a model. In the final phase, a qualitative interpretive synthesis was conducted using grounded theory to articulate a patient engagement model composed of three steps. The first phase was a scoping review aimed at describing the nature and range of patient engagement from the perspective of access, personalization, commitment, and therapeutic alliance within perinatal eHealth. A narrative synthesis was used to describe findings. Phase two consisted of two studies exploring engagement practices of pregnant users during their use of a self-monitoring health promotion eHealth system. A descriptive comparative analysis was completed to understand user engagement patterns based on physical use of the wearable device. A mixed-methods convergence evaluation was conducted to understand the process of accessing the health promotion eHealth system. In phase three a process evaluation tool for parent participation and collaboration (in the neonatal intensive care unit) was developed and psychometrically tested. For the interpretive synthesis, articles from the first three phases of this study were purposively sampled. A deductive codebook was developed using Donabedian’s model, and an adapted version of Lewin’s Action Research Cycle. Donabedian’s model consists of quality assurance through the examination of structure, process, and outcomes. Lewin’s Action Research Cycle informs iterative steps in development and implementation of health systems. Phase four resulted in a model for patient engagement integration in perinatal eHealth development and quality assurance. Three steps of the model were identified as being: Person-centered Perinatal eHealth program mapping; Process evaluation through monitoring of patient engagement processes; and Co-creation of perinatal eHealth programs through real-life testing of perinatal eHealth systems.Malli potilaan osallistumisesta perinataaliajan sähköisen terveydenhuollon kehittämiseen ja laadunvarmistukseen Tutkimuksen tavoitteena oli kehittää malli ohjaamaan potilaan osallistumista perinataaliajan sähköisen terveydenhuollon kehittämiseen ja laadunvarmistukseen. Malli kehitettiin neljässä vaiheessa. Kolmessa ensimmäisessä vaiheessa tuotettiin tutkimusnäyttöä kehittämisen tueksi. Viimeisessä vaiheessa laadullisen tulkitsevan synteesin avulla muodostettiin potilaan sitoutumisen malli. Ensimmäisessä vaiheessa tehtiin kartoittava kirjallisuuskatsaus, joka kuvasi potilaiden sähköiseen terveydenhuoltoon osallistumisen tavat ja laajuuden saatavuuden, yksilöllisyyden, sitoutumisen ja terapeuttisen hoitosuhteen näkökulmasta. Aineisto analysoitiin teorialähtöisellä sisällönanalyysillä ja tulokset kuvattiin narratiivisen synteesin avulla. Toinen vaihe muodostui kahdesta tutkimuksesta, jotka tarkastelivat itsemonitorointisysteemin avulla raskaana olevien henkilöiden osallistumistapoja terveydenedistämiseen. Tutkimuksissa odottajat käyttivät itsemonitorointisysteemiä. Osallistumistapoja analysoitiin puettavan laitteen käyttöajan pohjalta tehtyjen vertailevien analyysien avulla. Monimenetelmällisessä tutkimuksessa muodostettiin analyysin pohjalta ymmärrys itsemonitorointisysteemin saatavuuteen liittyvästä prosessista. Kolmannessa vaiheessa kehitettiin ja psykometrisesti testattiin prosessievaluaatiomittari arvioimaan vanhempien osallistumista ja yhteistyötä henkilökunnan kanssa vastasyntyneiden teho-osastolla. Viimeisen vaiheen tulkitsevaa synteesiä varten valittiin tarkoituksenmukaisia artikkeleita. Donabedianin terveydenhuollon laadunvarmistuksen malli ja Lewinin muokatun toimintatutkimuksen syklin pohjalta muodostettiin teorialähtöinen analyysirunko. Neljännen vaiheen tuloksena muodostettiin malli potilaan osallistumisesta perinataaliajan sähköisen terveydenhuollon kehittämiseen ja laadunvarmistukseen. Malli kostuu kolmesta askeleesta: Yksilökeskeisen sähköisen terveydenhuollon kartoitus, potilaan osallistumisprosessin monitorointiin perustuva prosessievaluaatio ja perinataaliajan sähköisen terveydenhuollon yhteiskehittäminen kliinisessä todellisuudessa

E-Health information seeking behavior of older Finnish adults from the value-based care point of view

Health information seeking behavior is a widely discussed topic in the field of information studies. However, the current study is about observing and evaluating the efficiency of health information seeking behavior through E-Health service and devices. The main reason that motivated the researcher to carry out the current research was high cost of healthcare services in Finland. It is expected that health information obtained through electronic or online sources would help people to improve their health conditions. Therefore, this thesis is an empirical study on observing E-Health information seeking behavior and evaluating the efficiency of E-Health service and devices. In order to estimate the efficiency of E-Health service and products, this study considered some criteria generated by previous studies. These criteria were employed in the current study as indicators of the health information seeking efficiency. The current study developed a customized model of health information seeking behavior based on the general model of information seeking behavior. The model contains some further criteria to measure the efficiency of the information seeking process. The primary tool to collect data were a multiple-choice questionnaire. The questionnaires were distributed through two main methods, namely hard copy and online. The participants in this study were either Finnish older adults who were over 50 years old, or other persons who were responsible for providing health information for them. The results of this study show that using E-Health service and products has neither a positive effect on improving the health condition of patients, nor does it motivate people to a healthier lifestyle, or make them feel more satisfied. However, it is expected that the results provide a framework for further studies to develop more efficient E-Health-related tools and services

Students’ competence as eHealth and eWelfare service developers based on the International Medical Informatics Association IMIA’s curriculum structure and design thinking

Multidisciplinary cooperation is required to develop digital health and welfare services. The aim of this article is to determine the eHealth and eWelfare service design competences that multidisciplinary students need to be able to develop digital services in health and social care. A secondary aim is to develop a measurement tool based on the International Medical Informatics Association (IMIA) curriculm for future assessment of such competences. Based on basic descriptive statistics results show that most students felt they have good skills in e-communication, basic IT, literature retrieval and research methods; some students, however, reported that they lack these basic skills. It is crucial that instructors be aware of student variations so that they can support the learning of the basics and further the biomedical and health informatics (BMHI) and design thinking (DT) competences. Principal components analysis (PCA) was used to determine the principal components (PC) from measured responses to BMHI and DT sections. Data were collected from 64 students. The components were explored and compared to constructs used to design the original measurement tool. A twenty-component structure showed the simplest solution and explained (80%, 68%, 73%) of variances in BMHI and 83% DT competences, respectively, in the measurement tool, each part of which was analysed by PCA. The PC can be the core areas in different professions taking part in developing eHealth and eWelfare. The parts of measurement tools relied on item reliability and content validity testing. This study provided a base for further measurement tool revision and theoretical testing

The Development of eServices in an Enlarged EU: eGovernment and eHealth in Estonia

In 2005, IPTS launched a project which aimed to assess the developments in eGoverment, eHealth and eLearning in the 10 New Member States at national, and at cross-country level. At that time, the 10 New Member States were Cyprus, the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Malta, Poland, and Slovakia. A report for each country was produced, describing its government and health systems and the role played by eGovernment and eHealth within these systems. Each report then analyzes, on the basis of desk research and expert interviews, the major achievements, shortcomings, drivers and barriers in the development of eGovernment and eHealth in one of the countries in question. This analysis provides the basis for the identification and discussion of national policy options to address the major challenges and to suggest R&D issues relevant to the needs of each country ¿ in this case, Estonia. In addition to national monographs, the project has delivered a synthesis report, which offers an integrated view of the developments of each application domain in the New Member States. Furthermore, a prospective report looking across and beyond the development of the eGoverment, eHealth and eLearning areas has been developed to summarize policy challenges and options for the development of eServices and the Information Society towards the goals of Lisbon and i2010.JRC.J.4-Information Societ

Influencing Factors of Clinical Patient Recruitment Systems Design

Clinical patient recruitment (CPR) is a critical function in clinical research. However, there is no holistic design for CPR systems that incorporates functions to support all critical success factors of clinical trial performance. In order to fill this gap, a study based on a literature review and several semi-structured expert interviews was conducted. Existing theory was synthesized with newly found influence factors using categories from CPR theory and factors gathered from literature and experts. The result is a systematization of influence factors of CPR that can be used for derivation of requirements for CPR systems in a subsequent research step or for the purpose of causal modeling

Usability analysis of contending electronic health record systems

In this paper, we report measured usability of two leading EHR systems during procurement. A total of 18 users participated in paired-usability testing of three scenarios: ordering and managing medications by an outpatient physician, medicine administration by an inpatient nurse and scheduling of appointments by nursing staff. Data for audio, screen capture, satisfaction rating, task success and errors made was collected during testing. We found a clear difference between the systems for percentage of successfully completed tasks, two different satisfaction measures and perceived learnability when looking at the results over all scenarios. We conclude that usability should be evaluated during procurement and the difference in usability between systems could be revealed even with fewer measures than were used in our study. © 2019 American Psychological Association Inc. All rights reserved.Peer reviewe