Rural but not remote! Access in outback Australia. Report on the implementation of Personal Digital Assistants (PDAs) for medical students, clinical teaching staff and health librarians at the Rural Clinical Division, School of Medicine, University of Que

Funding to provide 95 Personal Digital Assistants (PDAs) to medical students, located at the Rural Clinical Divisions (RCD) in outback Australian Queensland regions, was obtained in 2003 from the Australian Government Department of Health and Ageing. The PDA Project commenced in October 2003 and will continue until the end of 2004. The objectives of the Project were to provide access to authoritative, evidence-based information to rural medical students at their point of need and to address equity issues for students placed in remote or isolated areas with limited access to information and technology infrastructure. The project will be used to identify how such technology can help to educate and prepare students for practicing medicine in the 21st Century and as a means to identify appropriate resources, training and support required to utilise PDAs. The Herston Medical Library, University of Queensland, provided a senior Liaison Librarian as the Rural Pack Project Coordinator, along with two Liaison Librarians, who are based at the rural sites in the Central Region and the South West Region of Queensland, each working at the main hospital within each region. The Coordinator of the Project has led a team of clinicians, librarians, information technology representatives, a medical education officer and medical students to evaluate the technology. Included on each PDA distributed to PDA Project participants are e-resources, including a major drug index, medical textbooks, a medical dictionary and a medical calculator. The Microsoft Office Suite of software, including Word, Excel, PowerPoint and Outlook are also included on each PDA. A report on the implementation of the Project, study design and outcomes reported during 2004 is provided. Various challenges, such as licensing complexities, that were encountered with the introduction of this innovative service are outlined, as well as future plans

Exploring end-user perceptions towards mandated deployment of PDA-based health information systems within Ambulatory Care

The impact of many well intentioned technology integration projects has not always been viewed favourably. In fact, many projects are destined to fail from the outset by not considering fundamental IT system inves tment risks (technical failure, data failure, user failure, organizational failure) [Lyytinen & Hirschiem, 1987]. With any new technology ‘an element of uncertainty exists in the minds of decision makers with respect to the successful adoption of them’ [Bagozzi et al, 1992]. Uncertainty towards adopting new technologies is not solely the domain of decision makers. Apart from chief technology and information officers, system administrators and help desk personnel, those who ultimately feel the greatest impac t and transformation upon work practices from any newly adopted technology application or process are end-users. In mandated technology integration environments, impressions may exist whereby any form of consultative input from end-users is inherently removed, leaving end-users disillusioned with the mandated technology. This research uses an adapted version of Kline’s Groupware Adoption Scale [Kline, 2001] in a preliminary study to ascertain end-user perceptions towards the proposed mandated implementation of a PDA-based point-of-care information system (ePOC) in The Ambulatory Care Team (TACT), Northern Illawarra, South Eastern Sydney Illawarra Health Service

The underestimation of threats to patients data in clinical practice

Issues in the security of medical data present a greater challenge than in other data security environments. The complexity of the threats and ethics involved, coupled with the poor management of these threats makes the protection of data in clinical practice problematic. This paper discusses the security threats to medical data in terms of confidentiality, privacy, integrity, misuse and availability, and reviews the issue of responsibility with reference to clinical governance. Finally. the paper uncovers some of the underlying reasons for the underestimation of the threats to medical data by the medical profession

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

The factors influencing nurse graduates use of mobile technology in clinical settings in Perth Western Australia: A mixed method study

The ubiquitous use of mobile technology in today’s society extends to the learning and teaching environment. Most academics in universities encourage its use, aided by libraries offering online resources. Whilst the literature highlights benefits of using mobile technology in learning, particularly for nurses to keep up-to-date, there is limited evidence on such use in clinical settings by graduate nurses in Western Australia (WA). Additionally, there is a lack of information and clarification on the use of such technology in WA hospitals. The purpose of this study was to identify and explore factors influencing the use of mobile technology by newly graduated registered nurses in the clinical area. The location of the study was in Perth, Western Australia. The study sought to answer the following questions: What factors influence nurse graduates use of mobile technology in the clinical setting? To what extent and in what ways do nurse graduates currently use mobile technology in the clinical setting? and What are the perceptions of nurse coordinators, educators and managers of graduate programs regarding mobile technology use in the clinical setting. In order to answer these questions, an explanatory, sequential, mixed method design was used. Initially, a review was undertaken of existing policy and guidelines, regarding use of mobile technology, from both public and private hospitals. This phase of the study was followed by two major phases: (quantitative and qualitative). As a preparation to the quantitative phase, a survey was developed involving the modified use of the Technology Acceptance Model (TAM2). This model was used as the theoretical framework underpinning the study. The survey was administered online to registered nurse graduates using SurveyMonkey™. Both descriptive and inferential statistics were used to analyse the data. Findings from the data informed the next phase of the study. Data collection for the qualitative phase of the study, involved synchronous Skype™ online text-based focus group interviews with the graduates. Additionally, nurse coordinators, educators and managers of graduate programs from both public and private hospitals, were invited to complete an online open-ended survey. Thematic analysis was used to analyse the data from this phase of the study. The findings from both the quantitative and qualitative phases was synthesised to answer the research questions, forming a holistic picture to offer conclusions to the study. This study is significant, as there appears to be a gap between learning with mobile technology in Universities, and its use in the clinical setting. This problem may be associated with the lack of standardised policies in the use of mobile technology, or from senior nurses’ misperception of its benefits. The results of this study may lead to policies and guidelines being reviewed and implemented by local healthcare agencies, and could lead to review of current mobile technology integration into nursing undergraduate degrees

A Software-Based Trust Framework for Distributed Industrial Management Systems

One of the major problems in industrial security management is that most organizations or enterprises do not provide adequate guidelines or well-defined policy with respect to trust management, and trust is still an afterthought in most security engineering projects. With the increase of handheld devices, managers of business organizations tend to use handheld devices to access the information systems. However, the connection or access to an information system requires appropriate level of trust. In this paper, we present a flexible, manageable, and configurable software-based trust framework for the handheld devices of mangers to access distributed information systems. The presented framework minimizes the effects of malicious recommendations related to the trust from other devices or infrastructures. The framework allows managers to customize trust-related settings depending on network environments in an effort to create a more secure and functional network. To cope with the organizational structure of a large enterprise, within this framework, handheld devices of managers are broken down into different categories based upon available resources and desired security functionalities. The framework is implemented and applied to build a number of trust sensitive applications such as health care

Prospective Analysis of the Mobile Health Information Systems in China

With the rapidly growing economy in the past few decades, people of China (mainland) are now enjoying increasingly more economic benefits than ever before. Of many growing technologies, mobile devices, especially cell phones, have been gaining popularity throughout the country. According to the latest statistics in 2007, more than one third of Chinese have cell phones. In addition to the basic uses of voice communication, cell phones have many other promising applications. Particularly, as a pervasive technology, mobile devices offer a great opportunity to deliver health information directly to people with an affordable cost. This paper analyzes the potential of mobile health information systems in China. This prospective analysis will be conducted from four important perspectives: technology, market demand, business model, and government policy