The relevance of telehealth across the digital divided the transfer of knowledge over distance

This paper explores the concept of Relevance as an explanatory factor to the diffusion of ITuse, or, in this paper particularly, the use of Telehealth. Relevance is the net value of performance expectancy and effort expectancy and contains both micro-relevance (i.e. here-and-now) and macro-relevance (i.e. actual goals) Following the case-study approach, two Telehealth situations were studied in Rwanda and The Netherlands. In the comparison, two more existing studies in Canada and Tanzania were included. The conclusion is that Relevance is the explanatory factor, whereas particularly micro-relevance is crucial. Without the micro-relevant occasions that initiate use, there will be no use on longer term In the cases studied the micro-relevance of knowledge-transfer was crucial. Furthermore distance determined Telehealth relevance. Practical conclusions to cases were drawn

Workflow Management for Multiple Sclerosis Patients: IT and Organization

Patients with Multiple Sclerosis (MS) visit various healthcare providers during the course of their disease. It was suggested that IT might help to\ud orchestrate their care provision. We have applied the USE IT-tool to get insight in the relevant problems, solutions and constraints of the MS-care and the MS care providers both in the organizational and the information technological area. There is hardly a chain of healthcare, but rather, a network in which informal communication plays an important role. This informal network worked reasonably effective, but inefficient and slow. The patient himself plays a keyrole in information exchange between care-providers. Many providers were unaware of the services that other healthcare providers could give in general or did provide to a specific patient. MS patients-count is only small for most care providers. None of the interviewed patients mentioned a lack of contacts between careproviders as a problem. They thought that lack of\ud experience caused their major problems: insufficient and inadequate care. To improve care, we proposed a solution that combines a “short MS-protocol”, the\ud introduction of a central coordinator of care and a Patient Relation Management (PRM) System. This is a simple web-based application that is based on agreement by the caregivers that supports routing, tracking and tracing of a MS patient and supplies the caregivers with professional guidelines, as written down in the protocol. It is likely that we would have suggested a far more complicated ICT solution if we had only analyzed the MS-care process as such, without specific consideration of the USE IT dimensions

Towards a better understanding of the e-health user: comparing USE IT and Requirements study for an Electronic Patient Record.

This paper compares a traditional requirements study with 22 interviews for the design of an electronic patient record (EPR) and a USE IT analysis with 17 interviews trying to understand the end- user of an EPR. Developing, implementing and using information technology in organizations is a complex social activity. It is often characterized by ill-defined problems or vague goals, conflicts and disruptions that result from organizational change. Successfully implementing information systems in healthcare organizations appears to be a difficult task. Information Technology is regarded as an enabler of change in healthcare organizations but (information) technology adoption decisions in healthcare are complex, because of the uncertainty of benefits and the rate of change of technology. (Job) Relevance is recognized as an important determinant for IS success but still does not find its way into a systems design process

Youth Quarter: Success and Failure Factors of a Digital Platform for Youth Care Professionals

The digital platform Youth Quarter is built by youth care organizations with the intention to facilitate youth care professionals to share knowledge. The adoption of Youth Quarter is investigated using the USE IT-adoption-model. Interviews with 27 youth care professionals demonstrated that the main problem they experience is high working pressure. Youth Quarter does not relieve the working pressure nor solves other relevant problems. Youth Quarter is regarded as having little relevance and not meeting users’ requirements, because of the little content and low number of users. Youth care professionals prefer to consult colleagues, and professionals they know. To increase the adoption, Youth Quarter should reward users by providing up-to-date relevant information and knowledge, and support efficient and effective working processes. Management should share clear goals for Youth Quarter and encourage the use of Youth Quarter, in order to increase the adoption

Electronic prescription system: do the professionals use it?

User-adoption of new IT-applications is the proof-of-the-pudding when it comes to IT-success in healthcare. As a consequence, many studies are made of the role of the users in the introduction of new IT in both theory and practice. User satisfaction is widely accepted as a criterion for IS success. However, to understand IS success or failure, it is necessary to recognise its social and technical causes. The USE IT model has four determinants that have to be balanced in assessing the diffusion and use of information systems. Resistance is defined as the degree to which the surroundings and locality negatively influences the users of IT and the degree to which IT-users themselves are opposing or postponing the IT change. Relevance is the degree to which the user expects that the IT-system will solve his problems or help to realise his actually relevant goals. Micro-relevance is the degree to which IT-use helps to solve the here-and-now problem of the user in his working process. Requirements are defined as the degree to which the user needs are satisfied with the product quality of the innovation. Resources are defined as the degree to which material and immaterial goods are available to design, operate and maintain the information system. The USE IT model clearly makes the transition in the onion model of the book from change management (USE) to technological innovation (IT). The empirical results of this qualitative study with 56 cases show that time and communication are the most important factors for General Practitioners for the diffusion and use of an Electronic Prescription System (EPS). The social aspects and technical aspects have to be balanced to get to real use of the information system. The (job) relevance of the EPS to the working process of the professional was, in all 56 cases, the most important determinant. The resistance of the professional that is often used as the main reason for plateaued diffusion was shown to be the cumulative effects of the other determinants. For instance a GP with limited resources (like a slow PC) will get annoyed by the waiting time and will resist the new system using a lot of processing time. At first the technical determinants, requirements and resources, seemed to be a prerequisite for the social determinants. Analysis of this presumption showed that a thorough check on resources is necessary and that a user–provider contract on requirements would help bridge the information gap

Electronic prescription system: do the professionals use it?

User-adoption of new IT-applications is the proof-of-the-pudding when it comes to IT-success in healthcare. As a consequence, many studies are made of the role of the users in the introduction of new IT in both theory and practice. User satisfaction is widely accepted as a criterion for IS success. However, to understand IS success or failure, it is necessary to recognise its social and technical causes. The USE IT model has four determinants that have to be balanced in assessing the diffusion and use of information systems. Resistance is defined as the degree to which the surroundings and locality negatively influences the users of IT and the degree to which IT-users themselves are opposing or postponing the IT change. Relevance is the degree to which the user expects that the IT-system will solve his problems or help to realise his actually relevant goals. Micro-relevance is the degree to which IT-use helps to solve the here-and-now problem of the user in his working process. Requirements are defined as the degree to which the user needs are satisfied with the product quality of the innovation. Resources are defined as the degree to which material and immaterial goods are available to design, operate and maintain the information system. The USE IT model clearly makes the transition in the onion model of the book from change management (USE) to technological innovation (IT). The empirical results of this qualitative study with 56 cases show that time and communication are the most important factors for General Practitioners for the diffusion and use of an Electronic Prescription System (EPS). The social aspects and technical aspects have to be balanced to get to real use of the information system. The (job) relevance of the EPS to the working process of the professional was, in all 56 cases, the most important determinant. The resistance of the professional that is often used as the main reason for plateaued diffusion was shown to be the cumulative effects of the other determinants. For instance a GP with limited resources (like a slow PC) will get annoyed by the waiting time and will resist the new system using a lot of processing time. At first the technical determinants, requirements and resources, seemed to be a prerequisite for the social determinants. Analysis of this presumption showed that a thorough check on resources is necessary and that a user–provider contract on requirements would help bridge the information gap