Patient-Centric Decision-Making Health Information System (PDM-HIS) Adoption Framework

Hospital Information Systems (HIS) are implemented to support the provision of high-quality patient- centered care. Yet, there is little evidence about how to achieve meaningful involvement of patients in the decision-making process for the adoption of HIS. Furthermore, there is little known whether particular HIS adoption decision-making frameworks in which patients are involved are employed in hospitals. To address this gap, we conducted a study allowing us to gain insight on how to practically and meaningfully involve patients in this process. A synthesis of literature and case studies have indicated that there is no single, optimal approaches of involving the patients in the adoption decision-making process. In this article, we present evidence from 15 semi-structured patient interviews to understand the phenomenon of involving patients in the decision-making for the adoption of HIS. Extending the DECIDE model, we consider the key HIS adoption factors found in the literature and interviews and present a Patient-Centric Decision-Making HIS (PDM-HIS) framework. The key contribution of this research is twofold. First, we extend the DECIDE model within a HIS context and explain the importance of adopting a patient-centric approach to HIS adoption. Secondly, we offer hospitals guidance about how to involve patients and in which specific activities of the adoption decision-making they can be involved. These research recommendations will form the basis of a future study

Developing a decision-making framework for the adoption of health information systems

Context - Across today’s patient-centric healthcare models, Health Information System (HIS) have become integral to deliver healthcare benefits across society. For example, through HIS adoption, healthcare stakeholders can benefit from added efficiencies associated with technology-enabled healthcare services and often promote the opportunities for improved ‘patient-centric care’. Problem - Decision-making plays a pivotal role in the adoption of HIS. However, HIS adoptions are fraught with challenges and the growing recognition that issues often stem from a lack of guidance in HIS adoption decision-making. Furthermore, there is little documented evidence of the particular HIS decision-making frameworks employed in hospitals, resulting in unsuccessful HIS adoption. The adoption of HIS is considered one of the most important decisions in hospitals; yet, hospital decision-makers, specifically the Chief Clinical Information Officers (CCIO) and patients' roles in decision-making processes for adopting HIS remain unclear. Objective - This research aims to identify key adoption decision-making factors associated with HIS from the hospital stakeholder’s perspective. Based on the stakeholder’s feedback, this research further explores the role of the CCIO and patients and the key challenges they faced during HIS’s adoption decision-making. Methods - To address the objective, a mixed-method approach was taken. A systematic literature review looked into different HIS adoption factors, adoption theories, and decision-making theories to address the documented evidence of specific HIS adoption decision-making factors. Building on the literature review, multiple case study approaches were conducted to understand the phenomenon of HIS's adoption decision-making from different healthcare stakeholders' perspectives. For interviews, Interpretative Phenomenological Analysis (IPA) qualitative methodology was used by the researcher. Data analysis was undertaken using thematic analysis, coding data according to key themes and subcategories. Each phase yielded an augmented set of recommendations. The derived themes and recommendations were evaluated by conducting inter-rater reliability tests. A systematic literature review was then done on the patient’s technology adoption decision-making to find how patients can be involved in the decision-making process. In the end, patients were interviewed to identify their perspective on the decision-making phenomenon and integrated it into the final framework. Results – From the literature, the DECIDE model was identified as a theoretical foundation for decision-making within a hospital context and extended further by considering the influence of patient involvement in HIS adoption decision-making. One of the factors (patient centric) appeared to be overlooked in the literature and the hospital. To see how patient-centric can be achieved, an additional literature review and interviews were carried out. The research drew from the literature and interviews and learned about hospital stakeholders' needs and challenges during HIS adoption decision-making. Also, the result identified that there was no standardised approach for the HIS adoption decision-making used in the hospitals. Thus, this research proposes a new decision-making framework for adopting HIS (DMFA-HIS), offering hospitals guidance on adopting HIS. The DMFA-HIS integrates two different aspects of decision-making and adoption, making it more robust, covering multi-aspects for the hospitals. It is anticipated that the DMFA-HIS will be generalisable across all national hospitals and healthcare organisations. Conclusions - This research can support researchers and hospital management identify and manage adoption decision-making factors and helping hospitals make better decisions for HIS adoption. The decision on adopting HIS is a complex process, and consequently, there are many perspectives to be considered. This research contributes to the literature about adoption decision-making by summarising the key research findings on the state-of-the-art developments on decision-making on HIS adoption. It also provides vital recommendations towards the key decision-making factors that can help in adopting HIS and making it patient centric at the same time. The DECIDE model has been developed explicitly to aid healthcare managers. However, a single theory is insufficient to explain a complex interdependent phenomenon, such as patient involvement in the decision-making process. Given shortcomings recognised in this research, this thesis has extended the DECIDE model to the DMFA-HIS, considering decision-making for HIS adoption in hospitals and explicitly focusing on patients' impact on the HIS adoption decision-making process

Assessing the need of decision-making frameworks to guide the adoption of health information systems in healthcare

Technological advancements have accelerated the deployment of healthcare information systems (HIS) with the potential to enhance productivity, lower costs, reduce medication errors, and ease the manpower strain on the healthcare industry. Although HIS can provide various benefits to healthcare professionals and patients, there is a high occurrence (50%) of unsuccessful HIS projects and problems with initiating their adoption. To investigate this phenomenon, this paper identifies decision-making theories, their short-coming of adopting HIS in healthcare organisations and decision-making facets that influence the adoption. These review will shed some light for future researchers to conceptualize, distinguish and comprehend the underlying decision-making models and theories that may affect the future application of HIS adoption. A literature search was conducted to identify studies presenting HIS decision-making adoption theories/models in a healthcare environment. From synthesis of 26 studies, we identified five major facets that provides a structure to organize and capture information on the decision-making and adoption of HIS. The themes presented here provide a starting point in understanding the decision-making adoption theories, their major facets and their short-coming in adopting HIS. This will facilitate our future research on decision-making framework for the adoption of HIS

Trust factors in healthcare technology: a healthcare professional perspective

Being able to trust technology is of vital importance to its potential users. This is particularly true within the healthcare sector where lives increasingly depend on the correct application of technology to support clinical decision-making. Despite the risk posed by improper use of technology in the healthcare domain, there is a lack of research that examines why healthcare professionals trust healthcare technology. Therefore, there is little evidence regarding the key trust facilitators and barriers. In this paper, we investigate the concept of trust within a healthcare technology context. We conducted a systematic mapping study to identify relevant trust facilitators and barriers in published work in well-known bibliographic databases. Our results present a synthesis of 47 studies that describe trust factors that healthcare professionals associate with healthcare technology. Facilitators include compatibility and perceived systems usefulness, while barriers include privacy concerns and lack of knowledge. We conclude that HCT trust is complex, multi-dimensional, and influenced by a variety of factors at individual and organizational levels

Crystalline and porous CoSe dendrimeric architectures for efficient oxygen evolution reaction

Developing an efficient and economical electrocatalyst for oxygen evolution reaction is the key challenge to renewable energy technologies. Metal selenides are attractive candidates for electrocatalytic water oxidation because they provide suitable surface-active sites for the reaction. Herein, we report less explored hexagonal cobalt selenide (CoSe) preparation for oxygen evolution reaction through the facile and environmentally benign one-step hydrothermal method. Reaction conditions were precisely tailored to develop highly crystalline and porous dendrimeric architectures of CoSe. Owing to its exclusive porous and dendrimeric crystalline network and large electrochemical surface area, the superior CoSe electrocatalyst (that is 16H) showed excellent electrochemical activity with remarkably low overpotential (250 mV at 10 mA cm−2) and very high current density (570 mA cm−2) in a small potential window. The Tafel slope of 16H sample was 56 mV dec−1, indicating the faster kinetics at the catalyst surfaces. Moreover, it also showed excellent stability under harsh oxidative conditions in a 24-hour long stability test experiment

Best practice guidance for digital contact tracing apps: a cross-disciplinary review of the literature

Background: Digital contact tracing apps have the potential to augment contact tracing systems and disrupt COVID-19 transmission by rapidly identifying secondary cases prior to the onset of infectiousness and linking them into a system of quarantine, testing, and health care worker case management. The international experience of digital contact tracing apps during the COVID-19 pandemic demonstrates how challenging their design and deployment are. Objective: This study aims to derive and summarize best practice guidance for the design of the ideal digital contact tracing app. Methods: A collaborative cross-disciplinary approach was used to derive best practice guidance for designing the ideal digital contact tracing app. A search of the indexed and gray literature was conducted to identify articles describing or evaluating digital contact tracing apps. MEDLINE was searched using a combination of free-text terms and Medical Subject Headings search terms. Gray literature sources searched were the World Health Organization Institutional Repository for Information Sharing, the European Centre for Disease Prevention and Control publications library, and Google, including the websites of many health protection authorities. Articles that were acceptable for inclusion in this evidence synthesis were peer-reviewed publications, cohort studies, randomized trials, modeling studies, technical reports, white papers, and media reports related to digital contact tracing. Results: Ethical, user experience, privacy and data protection, technical, clinical and societal, and evaluation considerations were identified from the literature. The ideal digital contact tracing app should be voluntary and should be equitably available and accessible. User engagement could be enhanced by small financial incentives, enabling users to tailor aspects of the app to heir particular needs and integrating digital contact tracing apps into the wider public health information campaign. Adherence to the principles of good data protection and privacy by design is important to convince target populations to download and use digital contact tracing apps. Bluetooth Low Energy is recommended for a digital contact tracing app's contact event detection, but combining it with ultrasound technology may improve a digital contact tracing app's accuracy. A decentralized privacy-preserving protocol should be followed to enable digital contact tracing app users to exchange and record temporary contact numbers during contact events. The ideal digital contact tracing app should define and risk-stratify contact events according to proximity, duration of contact, and the infectiousness of the case at the time of contact. Evaluating digital contact tracing apps requires data to quantify app downloads, use among COVID-19 cases, successful contact alert generation, contact alert receivers, contact alert receivers that adhere to quarantine and testing recommendations, and the number of contact alert receivers who subsequently are tested positive for COVID-19. The outcomes of digital contact tracing apps' evaluations should be openly reported to allow for the wider public to review the evaluation of the app. Conclusions: In conclusion, key considerations and best practice guidance for the design of the ideal digital contact tracing app were derived from the literature

Sentiment analysis of user feedback on the HSE’s Covid‑19 contact tracing app

Background Digital Contact Tracing is seen as a key tool in reducing the propagation of Covid-19. But it requires high uptake and continued participation across the population to be efective. To achieve sufcient uptake/participation, health authorities should address, and thus be aware of, user concerns. Aim This work manually analyzes user reviews of the Irish Heath Service Executive’s (HSE) Contact Tracker app, to identify user concerns and to lay the foundations for subsequent, large-scale, automated analyses of reviews. While this might seem tightly scoped to the Irish context, the HSE app provides the basis for apps in many jurisdictions in the USA and Europe. Methods Manual analysis of (1287) user reviews from the Google/Apple play stores was performed, to identify the aspects of the app that users focused on, and the positive/negative sentiment expressed. Results The fndings suggest a largely positive sentiment towards the app, and that users thought it handled data protection and transparency aspects well. But feedback suggests that users would appreciate more targeted feedback on the incidence of the virus, and facilities for more proactive engagement, like notifcations that prompt users to submit their health status daily. Finally, the analysis suggests that the “android battery” issue and the backward-compatibility issue with iPhones seriously impacted retention/uptake of the app respectively. Conclusion The HSE have responded to the public’s desire for targeted feedback in newer versions, but should consider increasing the app’s proactive engagement. The results suggest they should also raise the backward compatibility issue, regarding older iPhones, with Apple