Alcuni abstract di articoli che trattano argomenti relativi all'eHealth

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Intention to use Medical Apps Among Older Adults in the Netherlands: Cross-Sectional Study

BACKGROUND: The increasing health service demand driven by the aging of the global population calls for the development of modes of health service delivery that are less human resource-intensive. Electronic health (eHealth) and medical apps are expected to play an important role in this development. Although evidence shows mobile medical apps might be effective in improving the care, self-management, self-efficacy, health-related behavior, and medication adherence of older adults, little is known about older adults' intention to use these technologies when needed, or the factors influencing this intention. OBJECTIVE: The objective of this study was to investigate the relationship of technology acceptance factors and intention to use mobile medical apps among community-dwelling older adults. METHODS: Data was collected using questionnaires. The factors selected from the literature have been validated using Cronbach α and tested for significance using logistic regressions. RESULTS: Almost half (49.7%) of the included older adults reported no intention to use medical apps. Adjusted logistic regression analysis per factor showed that the factors Attitude toward use (odds ratio [OR] 8.50), Perceived usefulness (OR 5.25), Perceived ease of use (OR 4.22), Service availability (OR 3.46), Sense of control (OR 3.40), Self-perceived effectiveness (OR 2.69), Facilities (OR 2.45), Personal innovativeness (OR 2.08), Social relationships (OR 1.79), Subjective norm (OR 1.48), and Feelings of anxiety (OR 0.62) significantly influenced the intention to use mobile medical apps among older adults, whereas the factor Finance (OR 0.98) did not. When considered together, a controlled multivariate logistic regression yielded high explained variances of 0.542 (Cox-Snell R2) and 0.728 (Nagelkerke R2). CONCLUSIONS: The high odds ratios and explained variance indicate that the factors associated with the intention to use medical apps are largely understood and the most important factors have been identified. To advance the evidence base, experimental controlled research should investigate the causality between the factors, intention to use, and actual use. For this purpose, our evidence suggests that policies designed to improve Attitude toward use appear most effective, followed by policies addressing Perceived usefulness, Perceived ease of use, Service availability, and Sense of control

The perception of primary health care's physicians in adoption of electronic health record-Timor Leste

Introduction: Electronic health record becomes the 21st-century innovation trend in developing countries. This digital system provides accurate, real data in real-time access, decreases paper-based documentation, enables access to patient’s previous health status and easy for follow-up, reduces of health status duplication and, allows accessible data sharing among health professionals in the primary health care setting. Purpose: This research aimed to identify and understand the perceptions of primary health care physicians in adopting the electronic health record in the Timor Leste context, specifically to identify benefit, barrier, and satisfaction of this system. Method: A cross-sectional online questionnaire survey was based on the study objectives administered to the medical doctor in primary health care level in Timor Leste who, received an electronic health record training and had an opportunity to utilize in the period between 2015 to 2017. The form was composed of 4 sections (sociodemographic information, benefit, barrier, and satisfaction), rated on a five-point Likert-scale. The samples were calculated by G*Power 3.1.9.4. The reliability was tested by Cronbach’s alpha. The statistical analysis with α= .05, CI= 95%. Result: The online questionnaire was distributed among 193 general physicians with, 84.5% responded rates. Most of the participants had young ages that acknowledge the importance of EHR in the primary health care sector. The majority perceived the most benefit of the EHR: decreased paper-based documentation, facilitated accessibility to patient data recorded previously, provided real-time data access, and reduction on health data duplication. However, barriers remain on the eHealth system indicated by a medical doctor, such as the necessity of frequent revision to technological development, compatibility of web browser, connectivity, and cost in adopting it. Overall, the physician in primary care settings perceived satisfaction toward the digital system. The eHealth was useful, appropriate, and essential for their work area, improved patient safety, elevated quality care, and enabled better communication among health professionals. There were statistically significant differences among ages toward benefit, the ability to use computer toward barrier and place using computer toward satisfaction of EHR usage. The positive slope of the benefit (β= .498; t= 11.361), had a statistically significant predictor on satisfaction on EHR implementation but barrier had negative statistical significance toward satisfaction (β = -.086; t= -1.794). The adjusted (R2= 51.0%). Conclusion: The satisfaction of EHR was influenced by the benefit perceived while utilizing the system and reducing the barrier. Political commitment, financial support, friendly user application, improved quality of internet connection and had a positive attitude toward EHR were crucial for successful implementation.open석

International Profiles of Health Care Systems, 2011

This publication presents overviews of the health care systems of Australia, Canada, Denmark, England, France, Germany, Japan, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States. Each overview covers health insurance, public and private financing, health system organization, quality of care, health disparities, efficiency and integration, use of health information technology, use of evidence-based practice, cost containment, and recent reforms and innovations. In addition, summary tables provide data on a number of key health system characteristics and performance indicators, including overall health care spending, hospital spending and utilization, health care access, patient safety, care coordination, chronic care management, disease prevention, capacity for quality improvement, and public views

eHealth and mHealth initiatives in Bangladesh: A scoping study

BACKGROUND: The health system of Bangladesh is haunted by challenges of accessibility and affordability. Despite impressive gains in many health indicators, recent evidence has raised concerns regarding the utilization, quality and equity of healthcare. In the context of new and unfamiliar public health challenges including high population density and rapid urbanization, eHealth and mHealth are being promoted as a route to cost-effective, equitable and quality healthcare in Bangladesh. The aim of this paper is to highlight such initiatives and understand their true potential. METHODS: This scoping study applies a combination of research tools to explore 26 eHealth and mHealth initiatives in Bangladesh. A screening matrix was developed by modifying the framework of Arksey & O’Malley, further complemented by case study and SWOT analysis to identify common traits among the selected interventions. The WHO health system building blocks approach was then used for thematic analysis of these traits. RESULTS: Findings suggest that most eHealth and mHealth initiatives have proliferated within the private sector, using mobile phones. The most common initiatives include tele-consultation, prescription and referral. While a minority of projects have a monitoring and evaluation framework, less than a quarter have undertaken evaluation. Most of the initiatives use a health management information system (HMIS) to monitor implementation. However, these do not provide for effective sharing of information and interconnectedness among the various actors. There are extremely few individuals with eHealth training in Bangladesh and there is a strong demand for capacity building and experience sharing, especially for implementation and policy making. There is also a lack of research evidence on how to design interventions to meet the needs of the population and on potential benefits. CONCLUSION: This study concludes that Bangladesh needs considerable preparation and planning to sustain eHealth and mHealth initiatives successfully. Additional formative and operational research is essential to explore the true potential of the technology. Frameworks for regulation in regards to eHealth governance should be the aim of future research on the integration of eHealth and mHealth into the Bangladesh health system.DFI