Development and formative evaluation of the e-Health implementation toolkit

<b>Background</b> The use of Information and Communication Technology (ICT) or e-Health is seen as essential for a modern, cost-effective health service. However, there are well documented problems with implementation of e-Health initiatives, despite the existence of a great deal of research into how best to implement e-Health (an example of the gap between research and practice). This paper reports on the development and formative evaluation of an e-Health Implementation Toolkit (e-HIT) which aims to summarise and synthesise new and existing research on implementation of e-Health initiatives, and present it to senior managers in a user-friendly format.<p></p> <b>Results</b> The content of the e-HIT was derived by combining data from a systematic review of reviews of barriers and facilitators to implementation of e-Health initiatives with qualitative data derived from interviews of "implementers", that is people who had been charged with implementing an e-Health initiative. These data were summarised, synthesised and combined with the constructs from the Normalisation Process Model. The software for the toolkit was developed by a commercial company (RocketScience). Formative evaluation was undertaken by obtaining user feedback. There are three components to the toolkit - a section on background and instructions for use aimed at novice users; the toolkit itself; and the report generated by completing the toolkit. It is available to download from http://www.ucl.ac.uk/pcph/research/ehealth/documents/e-HIT.xls<p></p> <b>Conclusions</b> The e-HIT shows potential as a tool for enhancing future e-Health implementations. Further work is needed to make it fully web-enabled, and to determine its predictive potential for future implementations

Expanding Philanthropy’s Reach

When New York’s F.B. Heron Foundation, a private, grant-making institution, was created, it had a mandate to invest assets and donate 5 percent of returns annually to help low-income people and communities to help themselves.1 The year was 1992, the cusp of one of the greatest economic booms in U.S. history. But as Heron’s asset base swelled, 5 percent for community work began to look insufficient to help the many Americans who were missing out on the boom. In a 1996 meeting, directors realized they were spending too much time reviewing a particular investment manager’s performance and too little time discussing Heron programs. It was time to reevaluate priorities. The foundation’s social mission and tax-exempt status suggested that it should be more than a private investment company using excess cash for charitable purposes. It needed to be different from conventional investment managers. Heron concluded that the 5 percent payout requirement was the narrowest expression of its philanthropic goals. The other 95 percent of assets, the corpus, could give the board the tools it needed for greater social impact. Staff members were encouraged to explore ways in which Heron could engage more of its assets through a combination of grants and mission-related investment strategies.2 The foundation decided to leverage an increasing amount of its resources to pursue its mission and to maximize its impact in low-income communities

Examining the uptake of low-carbon approaches within the healthcare sector: case studies from the National Health Service in England

The National Health Service (NHS) in the UK, is one of the largest organisations in Europe and indeed the world. It therefore has a significant ecological footprint. As a result there are key corporate, financial and environmental targets that the organisation is expected to meet as a means of reducing resource consumption. Using a case study approach, this manuscript examines best practice examples for the uptake of low-carbon strategies for energy conservation. These strategies included sustainable procurement, use of renewable energy technologies, supply chain management, use of building management systems, renegotiating energy contracts, undertaking energy audits, and behaviour change, to realise significant financial, as well as energy and carbon savings. A key focus was management of water resources, including the use of recycling and recovery of heat. The implications of the findings for building ecological and financial resilience within the organisation are also discussed

The Heron Foundation expands philanthropy's reach

Contrary to the perception of trade-offs between financial return and social impact, the F.B. Heron Foundation demonstrates that it’s possible to achieve competitive returns while incorporating mission-related investments into an overall portfolio and asset allocation.Community development

Tanzania: labour, fraught with danger

The sociocultural, economic and policy contexts in Tanzania have made fishers vulnerable to environmental, social and work-related problems