Primary Care Informatics Response to Covid-19 Pandemic: Adaptation, Progress, and Lessons from Four Countries with High ICT Development

OBJECTIVE: Internationally, primary care practice had to transform in response to the COVID pandemic. Informatics issues included access, privacy, and security, as well as patient concerns of equity, safety, quality, and trust. This paper describes progress and lessons learned. METHODS: IMIA Primary Care Informatics Working Group members from Australia, Canada, United Kingdom and United States developed a standardised template for collection of information. The template guided a rapid literature review. We also included experiential learning from primary care and public health perspectives. RESULTS: All countries responded rapidly. Common themes included rapid reductions then transformation to virtual visits, pausing of non-COVID related informatics projects, all against a background of non-standardized digital development and disparate territory or state regulations and guidance. Common barriers in these four and in less-resourced countries included disparities in internet access and availability including bandwidth limitations when internet access was available, initial lack of coding standards, and fears of primary care clinicians that patients were delaying care despite the availability of televisits. CONCLUSIONS: Primary care clinicians were able to respond to the COVID crisis through telehealth and electronic record enabled change. However, the lack of coordinated national strategies and regulation, assurance of financial viability, and working in silos remained limitations. The potential for primary care informatics to transform current practice was highlighted. More research is needed to confirm preliminary observations and trends noted

Organisational maturity and information systems and technology projects in healthcare: the mediation of project management.

Doutoramento em GestãoThe challenges that health organisations face today is to get better organisational performance, reliable information, faster quality services at prices that should be affordable to the entire population. To fulfil this important goal, health organisations require more comprehensive and integrated approaches such as, but not limited to, optimise their available resources, eliminate inefficiencies and achieve the planned benefits from investments in Information Systems and Technology (IS/IT). Healthcare organisations must improve their management practices and internal procedures to answer the increasing demand of managers, health professionals and the public in general, for more and better information. Health organisations adopt a patient-centred care approach and invest massively in IS/IT, hoping that these investments will improve medical care and patient needs. The main objective of our research is to analyse how the Organisational Maturity affect IS/IT Project Success in Healthcare and if that success is enhanced by using Project Management practices. There is evidence that there is a direct relationship between these variables and that Project Management practices can mediate it, helping to increase the effectiveness of IS/IT projects. Furthermore, the application of the Project Management practices can also improve confidence that the results of these investments meet stakeholders’ expectations, both by the benefits accomplishment and by adding a perceived value to organisations. This study develops and validates an instrument to analyse the data collected from a survey to professionals’ perceptions about the IS/IT Project Success in Healthcare organisations. The results confirm that Project Management has a mediating effect on the relationship between Organizational Maturity and success of IS/IT projects and higher levels of Organisational Maturity will generate more successfully IS/IT projects, although the presence of the mediator Project Management can, in specific situations, affect negatively the correlation between Organisational Maturity and IS/IT Project Success.Os desafios que enfrentam atualmente as organizações de saúde estão diretamente relacionados com o fato de ambicionarem um melhor desempenho, mais e melhor informação de saúde, serviços de qualidade mais céleres. a custos acesíveis à maioria da população. Para o total cumprimento deste desiderato as organizações de saúde têm investido em soluções tecnológicas mais abrangentes e integradas de forma a otimizar os recursos disponíveis, eliminar ineficiências e atingir os benefícios plenos dos investimentos em Sistemas e Tecnologias da Informação (SI/TI). As organizações de saúde procuram melhorar as suas práticas de gestão para dar resposta a uma crescente procura de informação de saúde por parte de gestores, profissionais e público em geral. As organizações de saúde adotaram uma abordagem centrada no paciente e realizaram significativos investimentos em SI/TI na expetativa de que estes trouxessem melhorias ao nível assistencial e na satisfação das expetativas dos seus utilizadores. O principal objetivo deste trabalho é analisar como a Maturidade Organizacional afeta o sucesso do projeto em SI/TI em saúde e se esse sucesso é potenciado pela utilização de práticas de gestão de projetos. Há evidências da existência de uma relação direta entre esstas duas variáveis e que as práticas de Gestão de Projetos a podem mediar, ajudando a aumentar a eficácia dos projetos de SI/TI. Além disso, a aplicação das práticas de Gestão de Projetos podem melhorar a confiança nos resultados dos investimentos e atender às expectativas das diferentes partes interessadas, tanto pela realização de benefícios quanto pela criação de valor percebido para as organizações. Este estudo analisa os dados recolhidos de um questionário à perceção dos profissionais sobre o sucesso dos projetos IS/IT nas organizações de saúde. Os resultados obtidos confirmam. Os resultados confirmam que o Gestão de Projetos tem um efeito mediador na relação entre Maturidade Organizacional e Sucesso de Projetos de SI/TI e níveis mais elevados de Maturidade Organizacional gerarão projetos SI/TI mais bem-sucedidos, embora a presença do mediador Gestão de Projetos, possa, em circunstâncias específicas situações, afetar negativamente a correlação entre as duas variáveis.N/

Offenders and E-Learning - a literature review on behalf of Becta

This literature review has been prepared by the Hallam Centre of Community Justice at Sheffield Hallam University, on behalf of Becta. The literature review provides a summary of existing research and knowledge relating to e-learning in the offending learning sector with a view to developing a range of e-maturity indicators across the sector. The review also highlights linkages with current Government policy in relation to offender learning and skills

Strategic information system planning in healthcare organizations

Copyright © 2015, IGI Global. The healthcare industry is a critical and growing part of economies worldwide. To provide better quality of care, and value for money, billions of dollars are being spent on bettering information systems in healthcare organizations. Strategic Information System Planning (SISP) is instrumental in making informed decisions to achieve the health organizations' goals and objectives. This paper undertakes a systematic review to gain insight into existing studies on SISP in healthcare organizations. Our systematic review of papers on SISP from 1985 to 2011 examines the background and trend of research into SISP in the healthcare industry, classification of topics in SISP, as well as sets of tools and guidelines to aid practitioners and the research community alike

Collaboration through Patient Data Access and sharing in the cloud

(c) 2014 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other users, including reprinting/ republishing this material for advertising or promotional purposes, creating new collective works for resale or redistribution to servers or lists, or reuse of any copyrighted components of this work in other works.There have been many socio-political and technological developments in the area of Electronic Patient Records (EPR). The technological aspects include EPR implemented using Online Transaction Processing (OTP) using Internet and Internet based systems, more recently via Cloud- Based systems (CBS) exploiting Cloud Service Models (CSM). Additionally, there are many socio-political considerations comprising: (1) political moves, including UK Government policy, which aims to deliver for patients 27/7 online access to their patient record, (2) considerations around ethical issues and informed permission and acceptance by the public and non-governmental organizations (NGO), (3) technological considerations about identification of suitable CBS and data structures in distributed systems characterized by unstructured data and, finally (4) sharing and collaboration as means of increasing efficiency, security, privacy, etc. In all, the aim is to provide professionals in medical domain with advanced platforms to not only access but also most importantly to share and collaborate at a wide scale level (e.g. National level). Addressing these aspects of EPR requires collaboration between all stakeholders in EPR, this paper considers these and concludes that such collaboration is essential if EPR are ever to become a reality.Peer ReviewedPostprint (author's final draft

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

Computers in general practice: Clinical governance data quality and adoption

This travelling fellowship allowed for me to expand he international exposure and collaboration involved in work at the local level and international. Locally as Director of Research at the Inner Eastern Melbourne Medicare Local (IEMML) I have been involved in the setting up over 5 years of a data collection and management program involving the practice of the division. Using the PDSA cycle over the time we have been taking practice through now multiple iterative cycles of data collection analysis and feedback. Whilst primarily for improved care within the practice the outcomes from IEMML perspective have been firstly improved data quality and secondly the practices have allowed IEMML to collect and pool the data for knowledge creation purposes. We now have over a hundred practices and data on over half a million patients.The research reported in this paper is a project of the Australian Primary Health Care Research Institute which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research Evaluation and Development Strategy

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

A contingency management framework to mitigate cybersecurity threats to electronic health records in the public health sector in South Africa

Most developing countries in the African continent, including South Africa, seem to be lagging behind in research, policy development, and how to prevent cybersecurity threats. These findings are evident in the significant number of cyberattacks recorded in the Cost of Data Breach Study and Global Analysis by Ponemon Institute. Research studies are placing the blame on the element of portability in electronic health records (EHRs) that has contributed to numerous vulnerabilities to hospital healthcare data. As a result, the healthcare information of patients in those hospitals that are equipped with interconnected medical devices is exposed to cybersecurity threats. The purpose of the study was to develop a healthcare contingency management framework that can be used by healthcare institutions to mitigate cybersecurity threats to EHRs in the public health sector in South Africa. The integrated systems theory (IST) which amalgamated five different theories relating to information security management was used as a theoretical foundation in this study. In achieving this purpose, the literature review was selected as the research design best suited to answer the question presented in this research study. An expert review was used to refine the framework outcome using interviews and questionnaires. The contribution that will be made by this study will be in a form of a conceptual framework that will be used to mitigate cybersecurity threats concerning EHRs in the public health sector. The healthcare contingency management framework (HCMF) can be adopted by either the National Health Department or Provincial Health Department to be used by healthcare facilities as a guide in reviewing their support function, process management, governance management, and their contingency management. Similar future studies need to be conducted on large scale such as in the whole public sector with the focus on the health sector.Thesis (MA) -- Faculty of Management and Commerce, 202