Developing a model of technology acceptance within the Australian healthcare sector

The research reported in this paper elucidates the development, empirical validation and preliminary analysis of a model of technology acceptance by Australian occupational therapists. The study described involved the collection of quantitative and qualitative data through a national survey and a longitudinal multi-method case study within a communitybased healthcare organisation. The theoretical significance of this work is that it uses a thoroughly constructed research model, with potentially the largest sample size ever tested (2000+), to extend technology acceptance research into the health sector. Results provide support for the proposed model. This work reveals the complexity of the constructs and relationships that influence technology acceptance and highlights a need for reconceptualising current models. Results also demonstrate the importance of qualitative methodologies in information systems research. The significance and implications of the findings are discussed

Designing a multifaceted quality improvement intervention in primary care in a country where general practice is seeking recognition: the case of Cyprus

<p>Abstract</p> <p>Background</p> <p>Quality Improvement Interventions require significant financial investments, and therefore demand careful consideration in their design in order to maximize potential benefits. In this correspondence we present the methodological approach of a multifaceted quality improvement intervention aiming to improve quality of care in primary care, properly tailored for a country such as Cyprus where general practice is currently seeking recognition.</p> <p>Methods</p> <p>Our methodological approach was focused on the design of an open label, community-based intervention controlled trial using all patients from two urban and two rural public primary care centers diagnosed with hypertension and type II diabetes mellitus. The design of our intervention was grounded on a strong theoretical framework that included the Unified Theory of Acceptance and Use of Technology, and the Chronic Care Model, which synthesize evidence-based system changes in accordance with the Theory of Planned Behavior and the Theory of Reasoned Action. The primary outcome measure was improvement in the quality of care for two chronic diseases evaluated through specific clinical indicators, as well as the patient satisfaction assessed by the EUROPEP questionnaire and additional personal interviews.</p> <p>Results</p> <p>We designed a multifaceted quality improvement intervention model, supported by a varying degree of scientific evidence, tailored to local needs and specific country characteristics. Overall, the main components of the intervention were the development and adoption of an electronic medical record and the introduction of clinical guidelines for the management of the targeted chronic diseases facilitated by the necessary model of organizational changes.</p> <p>Conclusion</p> <p>Health planners and policy makers need to be aware of the potential use of certain theoretical models and applied methodology as well as inexpensive tools that may be suitably tailored to the local needs, in order to effectively design quality improvement interventions in primary care settings.</p

Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

Digital Health Innovation for Consumers, Clinicians, Connectivity and Community Selected Papers from the 24th Australian National Health Informatics Conference (HIC 2016)

Selected Papers from the 24th Australian National Health Informatics Conference (HIC 2016)135 page(s

Driving reform : digital health is everyone’s business : selected papers from the 23rd Australian National Health Informatics Conference (HIC 2015)

Around the world, healthcare planners and governments are engaged in activities to stimulate innovation and reform health systems as part of the drive to deliver safe, effective, quality care to patients. ICT is both a critical component of health system innovation and key stimulus for reform. This book presents papers from the 23rd Australian national Health Informatics Conference (HIC 2015), held in Brisbane, Australia, in August 2015. The conference brings together researchers, industry groups and healthcare providers from Australia and around the world to share cutting edge research, technology updates and innovations, and the papers included here provide valuable evidence and information about the diverse role that ICT plays in the health, elderly and community care sectors internationally. They encompass a wide spectrum of work, from major theoretical concepts and examples of key applications of new technologies to important new developments in the field of health informatics. The book represents an important contribution to the health informatics evidence base and will be of interest to all those working towards better healthcare provision worldwide.178 page(s

Six countries, six individuals: resourceful patients navigating medical records in Australia, Canada, Chile, Japan, Sweden and the USA

In the absence of international standards, widely differing attitudes and laws, medical and social cultures strongly influence whether and how patients may access their medical records in various settings of care. Reviewing records, including the notes clinicians write, can help shape how people participate in their own care. Aided at times by new technologies, individual patients and care partners are repurposing existing tools and designing innovative, often ‘low-tech’ ways to collect, sort and interpret their own health information. To illustrate diverse approaches that individuals may take, six individuals from six nations offer anecdotes demonstrating how they are learning to collect, assess and benefit from their personal health information

Interactive visualisation with user perspective for biological data analysis

With an astonishing amount of genomic data generated for processing in medical field, it is essential to provide an effective methodology for understanding, reasoning and supporting decision making of large information spaces. This paper presents an interactive interface that provides a mechanism to analyse large scale biological and clinical data. This aims to provide a much greater flexibility and control for the domain experts to interactively customise the visualisation according to their preferences

The Development of a National Census of the Health Information Workforce: Expert Panel Recommendations

There is a need to develop a national census of the health information workforce to inform the planning and forecasting of the workforce and inform education and training needs. Yet, this raises a number of issues that need to be incorporated into the planning stage. This paper discusses the issues and recommendations for the development of a national health information workforce census and an Expert Panel's recommendations for how we should proceed. Nominated participants from Australia and New Zealand participated as Expert Panel members in focus groups to identify and discuss the issues. Recommendations were identified during the focus groups and documented for participant verification. These were then grouped into themes. The themes of the issues and considerations identified in the focus groups were: Aim of the census; Census advertisement; Census delivery; Participants; Longitudinal study; Types of data elements; Data development and standards; Data ownership, access and governance; Global census; Dissemination of results