Information systems and healthcare XXIV: Factors affecting the EAI adoption in the healthcare sector

Recent developments in the field of integration technologies like Enterprise Application Integration (EAI) have emerged to support organizations towards improving the quality of services and reducing integration costs. Despite the importance of EAI, there is limited empirical research reported on its adoption in the healthcare sector. Khoumbati et al. [2006] developed a model for the evaluation of EAI in healthcare organizations. In doing so, the causal interrelationship of EAI adoption factors was identified by using fuzzy cognitive mapping. This paper is a progression of previous work in the area and seeks to contribute by validating the model through a different case environment. Thus, this paper contributes by deriving and proposing the MAESTRO model for EAI adoption. MAESTRO identifies a set of factors that influence EAI adoption and it is evaluated through a real-life case study. It provides an understanding of the EAI adoption process through its grounding on empirical data. In doing so, the MAESTRO model supports the management of healthcare organizations during the decision-making process for EAI adoption

Co-innovation: the future of telemedicine in developing countries

Telemedicine which has been widely adopted in developed countries to reach all its citizens irrespective of their location is only being used for education purposes or disaster relief in developing countries. Since developing countries already suffer inadequate healthcare provision especially in remote areas, it would be essential to implement telemedicine practices for daily clinical uses rather than education use. This research argues that to understand the future of telemedicine in developing countries, both well-established technology innovations adoption factors as well as co-innovation factors should be addressed. In the context of healthcare provision, we propose a conceptual framework that integrates the healthcare resources and the organisational affiliations in co-innovation

Business models for sustained ehealth implementation: lessons from two continents

There is general consensus that Computers and Information Technology have the potential to enhance health systems applications, and many good examples of such applications exist all over the world. Unfortunately, with respect to eHealth and telemedicine, there is much disillusionment and scepticism. This paper describes two models that were developed separately, but had the same purpose, namely to facilitate a holistic approach to the development and implementation of eHealth solutions. The roadmap of the Centre for eHealth Research (CeHRes roadmap) was developed in the Netherlands, and the Telemedicine Maturity Model (TMMM) was developed in South Africa. The purpose of this paper is to analyse the commonalities and differences of these approaches, and to explore how they can be used to complement each other. The first part of this paper comprises of a comparison of these models in terms of origin, research domain and design principles. Case comparisons are then presented to illustrate how these models complement one another

Reasoning of Competitive Non-Functional Requirements in Agent-Based Models

During the decision-making process in real-time competitive environments, there is a need to perform concurrent optimisation of multiple competitive objectives to select an optimal design decision for interdependent stakeholders. To handle such issues, this thesis successfully assimilates the goal-oriented requirements-engineering knowledge with analytical decision-making approaches to facilitate reasoning and analysis by encouraging stakeholders’ involvement. This leads to optimal decisions with domain knowledge improvement in the agent-based i*-goal model by balancing multiple conflicting non-functional requirements reciprocally

AHP based Optimal Reasoning of Non-functional Requirements in the i∗ Goal Model

Goal-Oriented Requirements Engineering (GORE) has been found to be a valuable tool in the early stages of requirements engineering. GORE plays a vital role in requirements analysis like alternative design/ goal selection during decision-making. The decision-making process of alternative design/ goal selection is performed to assess the practicability and value of alternative approaches towards quality goals. Majority of the GORE models manage alternative selection based on qualitative approach, which is extremely coarse-grained, making it impossible for separating two alternatives. A few works are based on quantitative alternative selection, yet this does not provide a consistent judgement on decision-making. In this paper, Analytic Hierarchy Process (AHP) is modified to deal with the evaluation of selecting the alternative strategies of inter-dependent actors of i∗ goal model. The proposed approach calculates the contribution degrees of alternatives to the fulfilment of top softgoals. It is then integrated with the normalized relative priority values of top softgoals. The result of integration helps to evaluate the alternative options based on the requirements problem against each other. To clarify the proposed approach, a simple telemedicine system is considered in this paper

Implementing telemedicine technologies through an unlearning context in a homecare setting

Despite the opportunities the health sector will offer as a result of the design and development of a technology infrastructure, the fact is that hospitals have been slow to adopt telemedicine technologies, largely because very few organisations are prepared to face this challenge. A possible explanation for the efficiency and effectiveness gaps of services provided by Hospital-in-the-Home Units (HHUs) may relate to the advantages and disadvantages of the knowledge processes that these units exhibit as a result of their different structural properties. This paper investigates the approaches that HHUs have used to update the knowledge of physicians and their members' knowledge of technology, and relates them to an unlearning context (UC) and improvement in the quality of health services. These relationships are examined through an empirical investigation of 55 doctors and 62 nurses belonging to 44 HHUs. The research findings suggest that the key benefits of a UC in HHUs are clear. It enables them to identify and replace poor practices and also avoids the reinvention of the wheel; it enables cost reduction by minimising unnecessary work caused by the use of poor methods and it enables improvements adopting new telemedicine technologies.Ministerio de Educación CO2008-0641-C02-02Junta de Andalucía SEJ-608

Towards a Conceptual Framework of Actors and Factors Affecting the EAI Adoption in Healthcare Organizations

The non-integrated nature of Healthcare Information Systems (HIS) is strongly associated with a reduction in the quality of care and the medical errors that occur. In particular, around 80,000 people die per year or paralyse in Australia due to problems related to medical errors and are mainly caused by the non-integrated nature of HIS. There is therefore a real need to integrate the Information Technology (IT) infrastructures, to improve the quality of care provided. During the last years much emphasis has been given on Enterprise Application Integration (EAI) technology to bridge heterogeneous systems. Although EAI is being widely used by public and private organisations, it is underutilised in the area of healthcare. Thus, it is of high importance to investigate this area and result in research that contributes towards successful adoption of EAI. Currently, much of the literature on EAI in healthcare has focused on the identification of the factors that influence its adoption. In this paper, the authors attempt to extend this research area, by identifying the actors involved in the EAI adoption process. In doing so, the paper describes the causal relationships among the healthcare actors and factors that influence its adoption. Thus, the paper results in a novel approach that: (a) identifies the healthcare actors that are involved in the EAI adoption process and (b) combines these actors with the factors influencing the adoption of EAI. The proposed approach is significant, as it (a) extends the existing models on EAI adoption by incorporating an actor-oriented analysis and (b) might enhance the decision-making process for EAI adoption by supporting a more detailed level of analysis

A framework for evaluating telemedicine-based healthcare inequality reduction in Ethiopia : a grounded theory approach

Text in EnglishTelehealth makes healthcare services accessible by underserved and resource-constrained rural communities of developing countries such as Ethiopia. However, the limitation of frameworks on telemedicine-based healthcare inequality reduction is a challenge for developing countries. In Ethiopia there are four telemedicine projects; however, there is no evidence that any of these projects have been evaluated by considering contextual issues. This academic research explored telehealth practices in Ethiopia with the aim of developing a comprehensive telehealth evaluation framework for developing countries. Such a conceptual framework could be used to inform health institutes and governmental policy makers and in so doing create a vehicle for the implementation of improved health practices in Ethiopia. A grounded theory approach is used to qualitatively explore the usefulness of telemedicine practices in Ethiopia, in mitigating healthcare inequality. Grounded theory makes use of emerging insights in order to contribute to new knowledge. From the inductive analysis of the study, themes such as barrier removal, service quality, synergetic effect, localization, technical setup, resource utilization and managerial readiness emerged to formulate a framework for evaluating telemedicine-based healthcare inequality reduction in the context of developing countries like Ethiopia. This study contributes to the understanding of the question of how telemedicine practices can be evaluated, to support the healthcare service and reduce the healthcare inequalities in resource constrained communities in Ethiopia. Moreover, the framework could be used during evaluation of telemedicine-based healthcare inequality reduction in the context of developing countries like Ethiopia.School of ComputingPh.D. (Information Systems