Examining the post-adoptive infusion of mobile technology in a healthcare domain: determinants and outcomes

The healthcare industry is beginning to appreciate the benefits which can be obtained from using Mobile Health Systems (MHS) at the point-of-care. As a result, healthcare organisations are investing heavily in mobile health initiatives with the expectation that users will employ the system to enhance performance. Despite widespread endorsement and support for the implementation of MHS, empirical evidence surrounding the benefits of MHS remains to be fully established. For MHS to be truly valuable, it is argued that the technological tool be infused within healthcare practitioners work practices and used to its full potential in post-adoptive scenarios. Yet, there is a paucity of research focusing on the infusion of MHS by healthcare practitioners. In order to address this gap in the literature, the objective of this study is to explore the determinants and outcomes of MHS infusion by healthcare practitioners. This research study adopts a post-positivist theory building approach to MHS infusion. Existing literature is utilised to develop a conceptual model by which the research objective is explored. Employing a mixed-method approach, this conceptual model is first advanced through a case study in the UK whereby propositions established from the literature are refined into testable hypotheses. The final phase of this research study involves the collection of empirical data from a Canadian hospital which supports the refined model and its associated hypotheses. The results from both phases of data collection are employed to develop a model of MHS infusion. The study contributes to IS theory and practice by: (1) developing a model with six determinants (Availability, MHS Self-Efficacy, Time-Criticality, Habit, Technology Trust, and Task Behaviour) and individual performance-related outcomes of MHS infusion (Effectiveness, Efficiency, and Learning), (2) examining undocumented determinants and relationships, (3) identifying prerequisite conditions that both healthcare practitioners and organisations can employ to assist with MHS infusion, (4) developing a taxonomy that provides conceptual refinement of IT infusion, and (5) informing healthcare organisations and vendors as to the performance of MHS in post-adoptive scenarios

Exploring user behaviours when providing electronic consent on Health Social Networks: a ‘Just Tick Agree’ approach

In an online world, the distinction between public and private is becoming increasingly blurred with rising concerns about the privacy and security of personal health information. The aim of this study is to explore electronic consent (eConsent) on a Health Social Network (HSN) – PatientsLikeMe - to improve both the form and accessibility of contractual information presented to HSN users. Participants registered on this HSN and their interaction/behaviours was observed when agreeing to the site’s Terms and Conditions (T&C’s) and Privacy Policy (PP) documents. Focus group discussions were used to help us understand how and why certain events occurred. Several themes emerged from this data - ‘Just Tick Agree’ phenomenon, perceived societal benefits for the public good, data privacy concerns and emotional drivers towards eConsent. By achieving a deeper understanding of the eConsent process to an HSN, contributions are presented for both theory and practice. We argue that the complex language used for T&C’s and PP statements when simplified would increase user knowledge, awareness and understanding. Furthermore, HSN user behaviours (i.e. ‘Just Tick Agree’) must change when registering on HSNs and, developers of HSNs should enable user choice on registration by changing how users’ control their personal health-related data

Privacy by Design: informed consent and Internet of Things for smart health

Check: I accept the terms and conditions and privacy policy statements associated with this technological artefact! The informed consent process is becoming more of a challenge with the emergence of Internet of Things (IoT) as data may be collected without the digital health citizen being aware. It is argued in this paper that the first phase for universal usability of IoT within the smart health domain is to ensure that digital health citizens (i.e. user of technology) are fully aware of what they are consenting to when they register an account with such technological artefacts. This point is further reinforced by the proposed ‘Privacy by Design’ requirements associated with the forthcoming General Data Protection Regulation (GDPR). This paper proposes some practical approaches which should be considered when designing and developing IoT for data collection and data sharing within the health domain

Establishing contextual control over symmetry and asymmetry performances in typically-developing children and children with autism

Experiments 1, 2, and 3 investigated generalized contextually controlled symmetry and asymmetry in typically developing children and children with autism. In Experiment 1, eight typically developing children demonstrated the target performances without intervention. In Experiment 2, multiple-exemplar training and the use of familiar stimuli appeared to be effective in establishing the target performances for some of the children with autism. Experiment 3 examined an alternative intervention, based on alternating between correct and incorrect responding, for children with autism who appeared to have even greater difficulties in establishing contextually controlled symmetry and asymmetry. The findings are discussed in the context of the existing literature and interventions for establishing new repertoires in children with developmental disabilities

A ground-up approach to mHealth in Nigeria: A study of primary healthcare workers’ attitude to mHealth adoption

Mobile Health (mHealth) has been piloted in developing countries to transform the delivery of healthcare services. Despite this heightened focus on mHealth, the number of fully operational mHealth solutions implemented in these locations remains surprisingly low. To extend mHealth projects beyond pilot stage it is imperative that the primary end user is positively predisposed to engaging with the mHealth intervention. Through exploring initial perceptions, we can inform later stages of mHealth projects or develop interventions to convert attitudes into commitment or motivation to use mHealth. This qualitative exploratory study aims to understand end users’, namely Primary Healthcare (PHC) workers, initial attitudes towards a mHealth project called IMPACT (usIng Mobile Phones for Assessing, Classifying and Treating sick children). We conducted a field study in Enugu State, Nigeria to understand end users’ perceptions of the relevance, benefits, threats and initial understanding of the technology influencing end users’ attitudes towards adoption of mHealth. The initial findings indicate that PHC workers expressed positive perceptions regarding the relevance and benefits associated with the IMPACT app. PHC workers focus on how the technology could support them to be more efficient and effective in their roles. However, they advocate the need for community wide education and training to eradicate negative perceptions or misgivings about the potential use of mHealth as part of a patient’s assessment

Starting with small health data opportunities for mHealth in Africa

The need to obtain data to understand effective and available child mortality-reducing control measures in rural areas of developing countries is great. Evidence shows that this challenge can potentially be overcome with the increased availability of Information and Communication Technology (ICT) to support the data/information/ knowledge needs of healthcare delivery services in low resource settings. Recognising the benefits of ICT and the need for improvements in the Nigerian health sector, this paper outlines the plans for the technical feasibility assessment of the IMPACT (usIng Mobile Phones for Assessing, Classifying and Treating sick children) smartphone application to capture, store and analyse of child health assessment data. IMPACT is a secure, scalable, user friendly mobile health (mHealth) innovation that is being developed to support ‘small data’ capabilities within the context of healthcare in the community in Enugu State, Nigeria, Africa. Notwithstanding the heightened focus on ‘big data’ in health, this research is interested in investigating the opportunities associated with doing ‘small healthcare data’ well, with the long term view of building to the big data scenario for healthcare in the community in Enugu. This paper outlines the plan for the IMPACT project considering the implications for health data, knowledge management in healthcare and the big data opportunities to support disease surveillance, healthcare delivery and resourcing and healthcare practitioner education

Contextual barriers to mobile health technology in African countries: a perspective piece

On a global scale, healthcare practitioners are now beginning to move from traditional desktop-based computer technologies towards mobile computing environments[1]. Consequently, such environments have received immense attention from both academia and industry, in order to explore these promising opportunities, apparent limitations, and implications for both theory and practice[2]. The application of mobile IT within a medical context, referred to as mobile health or mHealth, has revolutionised the delivery of healthcare services as mobile technologies offer the potential of retrieving, modifying and entering patient-related data/information at the point-of-care. As a component of the larger health informatics domain mHealth may be referred as all portable computing devices (e.g. mobile phones, mobile clinical assistants and medical sensors) used in a healthcare context to support the delivery of healthcare services

Adjustment to short-term imprisonment under low prison staffing

Aims and method To understand experience of early imprisonment in one prison under low staffing levels. A researcher, independent of the prison, interviewed each prisoner soon after reception and 3–4 weeks later. The first question of the second interview was: ‘I’d like to start by asking you about your experience of the last 3–4 weeks in prison'. Data are verbatim answers to this. Narratives were brief, so responses from all 130 participants were analysed, using grounded theory methods. Results The core experience was of ‘routine’ – characterised by repetitive acts of daily living and basic work, and little reference to life outside prison – generally resolved passively, towards boredom and ‘entrapment’. Clinical implications This ‘routine’ seems akin to the ‘institutionalism’ described in the end days of the 1960s’ mental hospitals. In an earlier study of similar men at a similar stage of imprisonment, under higher staff:prisoner ratios, experience was initially more distressing, but resolved actively and positively, suggesting that staff loss may have affected rehabilitative climate

Relational Flexibility and Human Intelligence: Extending the remit of Skinner’s Verbal Behavior

The current article will discuss recent research encompassing the relevance of derived relational responding in intelligence, and the establishment of procedures to target this type of flexibility in derived relational responding in practical learning situations. The chapter will review research findings that indicate correlations between speed in flexible relational responding and higher scores on IQ tests. Relevant to flexibility in relational responding, research has demonstrated that children with autism showed poorer flexibility in relational responding than typically-developing peers, and procedures to remediate this type of “rigid” responding are described. Research on derived manding also has practical implications for incorporating derived relational responding into a mand training program to facilitate a “generative” or flexible component

Investigating the antecedents of perceived threats and user resistance to health information technology: a case study of a public hospital

Health information technology (HIT) can improve the quality of healthcare, but improvements are likely to be hindered if physicians and nurses resist HIT. In response, this study investigates the antecedents of the perceived threats to HIT and user resistance by examining the organisational factors, the personal traits of users, HIT-related factors, and the factors related to the interaction between physicians, nurses, and the organisation. By building on an in-depth case study of a public hospital, the study develops a conceptual model. The main findings of the study suggest that perceived dissatisfaction and loss of professional autonomy are the main perceived threats of HIT for physicians and nurses. Furthermore, five factors that influence these perceptions are identified, and they include related knowledge, management support, user involvement, system performance, and social influences. The study will ensure a better understanding of the phenomenon, as it will contribute to identifying the core reasons for resistance