Analysis of Barriers to the Deployment of Health Information Systems: a Stakeholder Perspective

© 2018 The Author(s). This paper argues that the cross-analysis of barriers with stakeholders provides a richer picture than analyzing the barriers on their own, as most of the literature in this area does. To test this hypothesis, we used the data from 33 interviews across 19 different types of stakeholders that were involved in a telemedicine system for the Chronically-ill Patient. Our findings show encouraging results. For instance, it was found that the group of stakeholders who are directly related to the governance and policy-making identified most of the barriers. This finding may imply that this group is more aware of the challenges when implementing HIS, or it may suggest that this group poses more resistance due to the current economic and Organizational models in health care. It was also found that some barriers are cited by all stakeholders whereas others not, suggesting that some barriers may be more relevant than others

A survey of physicians' acceptance of telemedicine

Physicians' acceptance of telemedicine is an important managerial issue facing health-care organizations that have adopted, or are about to adopt, telemedicine. Most previous investigations of the acceptance of telemedicine have lacked theoretical foundation and been of limited scope. We examined technology acceptance and usage among physicians and specialists from 49 clinical departments at eight public tertiary hospitals in Hong Kong. Out of the 1021 questionnaires distributed, 310 were completed and returned, a 30\% response rate. The preliminary findings suggested that use of telemedicine among clinicians in Hong Kong was moderate. While 18\% of the respondents were using some form of telemedicine for patient care and management, it accounted for only 6.3\% of the services provided. The intensity of their technology usage was also low, accounting for only 6.8\% of a typical telemedicine-assisted service. These preliminary findings have managerial implications

Glucose-6-phosphatase gene (727G→T) splicing mutation is prevalent in Hong Kong Chinese patients with glycogen storage disease type 1a

Glycogen storage disease type 1a (GSD1a) is an autosomal recessive metabolic disorder caused by a deficiency in glucose-6-phosphatase (G6Pase). We analyzed the G6Pase genes of two unrelated Chinese families with GSD1a. DNA sequencing of all five exons and the exon-intron boundaries revealed a G→T transversion at nucleotide 727 (727G→T) in exon 5, which has previously been reported to cause abnormal splicing. In one family, the subject and her affected sister were confirmed to be homozygous for this mutation and their parents to be heterozygotes. In the other family, the proband was identified to be heterozygous for this mutation, and a novel mutation, the 341delG in exon 2, was identified. This mutation alters the reading frame and creates a stop codon TAA 15 codons downstream from the mutation, resulting in a truncated protein. Family studies revealed that the father was heterozygous for the 727G→T mutation and that the mother was heterozygous for the 341delG mutation. This is the first time that the 727G→T mutation has been found in Chinese patients or outside Japan. Since we only tested two GSD1a families and found 727G→T in both, we believe that this mutation may also be prevalent in our local Chinese population. To investigate allele frequencies, we screened 385 Chinese healthy volunteers and found two asymptomatic carriers. Our findings suggest that the 727G→T mutation is indeed prevalent in Hong Kong.link_to_subscribed_fulltex

Determination of fetal RhD status by maternal plasma DNA analysis.

The prenatal determination of fetal rhesus D (RhD) status is useful for the management of sensitized RhD-negative women. Conventional methods for prenatal RhD status determination involve invasive methods such as amniocentesis. The discovery of circulating cell-free fetal DNA in maternal plasma and serum opens up a new source of fetal genetic material for prenatal RhD status determination. Indeed, this possibility has recently been realized by three groups who demonstrated the presence of fetal-derived RHD gene sequences in RhD-negative women bearing RhD-positive fetuses. The detection system used by our group is a homogenous assay based on real-time PCR analysis using exon 10 of the RHD gene. However, as it has been advocated that at least two independent PCR systems should be used for the clinical diagnosis of fetal RhD status, we describe, in this communication, a second real-time PCR assay for RhD status determination using sequences derived from exon 7 of the RHD gene

Programmed assembly of nanoscale structures using peptoids.

Sequence-specific polymers are the basis of the most promising approaches to bottom-up programmed assembly of nanoscale materials. Examples include artificial peptides and nucleic acids. Another class is oligo(N-functional glycine)s, also known as peptoids, which permit greater sidegroup diversity and conformational control, and can be easier to synthesize and purify. We have developed a set of peptoids that can be used to make inorganic nanoparticles more compatible with biological sequence-specific polymers so that they can be incorporated into nucleic acid or other biologically based nanostructures. Peptoids offer degrees of modularity, versatility, and predictability that equal or exceed other sequence-specific polymers, allowing for rational design of oligomers for a specific purpose. This degree of control will be essential to the development of arbitrarily designed nanoscale structures

Use of traditional medicine for the treatment of diabetes in Eastern Uganda: a qualitative exploration of reasons for choice

<p>Abstract</p> <p>Background</p> <p>While there are biomedical drugs for managing diabetes mellitus, some patients with diabetes use traditional medicine. The aim of the study was to explore why patients with diabetes use traditional medicine for the treatment of diabetes.</p> <p>Methods</p> <p>The study was conducted in Iganga and Bugiri districts in Eastern Uganda using four focus group discussions (FGDs) with patients with diabetes; two with female patients and two with male patients, thirteen key informant interviews (KIIs); nine with health workers working with patients with diabetes and four with herbalists. FGDs and KIIs focused on what respondents perceived as reasons for patients with diabetes taking traditional medicine. Analysis was done using content analysis.</p> <p>Results</p> <p>Reasons for taking traditional medicine included finding difficulties accessing hospitals, diabetic drugs being out of stock, traditional medicine being acceptable and available within community, as well as being supplied in big quantities. Others were traditional medicine being cheaper than biomedical treatment and payment for it being done in installments. Traditional medicine was also more convenient to take and was marketed aggressively by the herbalists. Influence of family and friends as well as traditional healers contributed to use of traditional medicine.</p> <p>Conclusions</p> <p>Possibilities of putting diabetic drugs at facilities closer to patients need to be considered and health facilities should have a constant supply of diabetic drugs. Community members need to be sensitized on the proper treatment for diabetes mellitus and on the dangers of taking traditional medicine.</p