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

Exploring the challenges of implementing e-health: a protocol for an update of a systematic review of reviews.

There is great potential for e-health to deliver cost-effective, quality healthcare and spending on e-health systems by governments and healthcare systems is increasing worldwide. However, the literature often describes problematic and unsuccessful attempts to implement these new technologies into routine clinical practice. To understand and address the challenges of implementing e-health, a systematic review was conducted in 2009, which identified several conceptual barriers and facilitators to implementation. As technology is rapidly changing and new e-health solutions are constantly evolving to meet the needs of current practice, an update of this review is deemed necessary to understand current challenges to the implementation of e-health. This research aims to identify, summarise and synthesise currently available evidence, by undertaking a systematic review of reviews to explore the barriers and facilitators to implementing e-health across a range of healthcare settings

The rationale of e-health evaluation: The case of NHS Direct

An important area of research is that of the evaluation of e-health services. A holistic e-health evaluation framework should address the aspects that are hampering healthcare services from embracing the full potential of information and communication technologies towards successful e-health initiatives. Towards building a holistic evaluation framework for e-health services, this paper is intended to examine the rationale of e-health evaluation, as the paper argues that this aspect should be addressed first in the development of such a framework. NHS Direct which is one of the largest e-health services in the world has been chosen to discuss and validate a set of evaluation rationales and their applicability in practice

Intuitive querying of e-Health data repositories

At the centre of the Clinical e-Science Framework (CLEF) project is a repository of well organised, detailed clinical histories, encoded as data that will be available for use in clinical care and in-silico medical experiments. An integral part of the CLEF workbench is a tool to allow biomedical researchers and clinicians to query – in an intuitive way – the repository of patient data. This paper describes the CLEF query editing interface, which makes use of natural language generation techniques in order to alleviate some of the problems generally faced by natural language and graphical query interfaces. The query interface also incorporates an answer renderer that dynamically generates responses in both natural language text and graphics

Charting Complex Changes: Application of the eHealth Implementation Toolkit (e-HIT) in the Delivering Assisted Living Lifestyles at Scale (dallas) Programme

The 'dallas' (Delivering Assisted Living Lifestyles at Scale) programme is a UK-wide digital healthcare initiative that has been designed to support independent living, enhance preventative care, and improve lifestyles by harnessing the potential of e-health technologies and digital services. This short paper presents a brief update on one strand of the University of Glasgow evaluation of the dallas programme. We have used the e-Health Implementation Toolkit (e-HIT) to investigate processes involved in the implementation of e-health tools and digital services being developed and deployed across the dallas communities and to assess 'distance travelled' by communities from baseline to midpoint of a three year programme. Qualitative data analysis was guided by the Normalisation Process Theory (NPT) and Framework Analysis. The e-HIT scores indicated that the dallas communities had underestimated the amount of work involved in implementing at scale. Qualitative data analysis showed that communities have successfully navigated barriers in order to make significant progress in strategic areas, including the development of new models of partnership working resulting in brand recognition and agile service design. The dallas communities are now sharing lessons learned and generating new professional knowledge, skills and understanding across several key strategic areas required for operationalising the implementation of e-health technologies and digital services at scale. The new knowledge being generated through the dallas programme will contribute to the ongoing transformation of digitally enabled healthcare based on more personalised flexible models of provision which resonates with the current e-health policy environment

Implementing Operations Support Systems in E-Health Based Systems

Information and communication technologies have been introduced in different dimensions of the health care. e-Health is the use of advanced communications technologies such as the Internet, portable, wireless and other sophisticated devices to support health care delivery and education. It has the potentials of improving the efficiency of health care delivery globally. With the increasing demand for information at the point of care, health care providers could explore the advances provided by mobile technologies and the increasing capabilities, compactness and pervasiveness of computing devices to adopt operations supports systems (OSS) in e-Health based systems in order to provide efficient services and enhance their performances. In this paper, we present, the development and implementation of operations supports in e- Health based systems. The system promises to deliver greater productivity for health care practitioner

Reporting an Experience on Design and Implementation of e-Health Systems on Azure Cloud

Electronic Health (e-Health) technology has brought the world with significant transformation from traditional paper-based medical practice to Information and Communication Technologies (ICT)-based systems for automatic management (storage, processing, and archiving) of information. Traditionally e-Health systems have been designed to operate within stovepipes on dedicated networks, physical computers, and locally managed software platforms that make it susceptible to many serious limitations including: 1) lack of on-demand scalability during critical situations; 2) high administrative overheads and costs; and 3) in-efficient resource utilization and energy consumption due to lack of automation. In this paper, we present an approach to migrate the ICT systems in the e-Health sector from traditional in-house Client/Server (C/S) architecture to the virtualised cloud computing environment. To this end, we developed two cloud-based e-Health applications (Medical Practice Management System and Telemedicine Practice System) for demonstrating how cloud services can be leveraged for developing and deploying such applications. The Windows Azure cloud computing platform is selected as an example public cloud platform for our study. We conducted several performance evaluation experiments to understand the Quality Service (QoS) tradeoffs of our applications under variable workload on Azure.Comment: Submitted to third IEEE International Conference on Cloud and Green Computing (CGC 2013

A Review into eHealth Services and Therapies: Potential for Virtual Therapeutic Communities - Supporting People with Severe Personality Disorder

eHealth has expanded hugely over the last fifteen years and continues to evolve, providing greater benefits for patients, health care professionals and providers alike. The technologies that support these systems have become increasingly more sophisticated and have progressed significantly from standard databases, used for patient records, to highly advanced Virtual Reality (VR) systems for the treatment of complex mental health illnesses. The scope of this paper is to initially explore e-Health, particularly in relation to technologies supporting the treatment and management of wellbeing in mental health. It then provides a case study of how technology in e-Health can lend itself to an application that could support and maintain the wellbeing of people with a severe mental illness. The case study uses Borderline Personality Disorder as an example, but could be applicable in many other areas, including depression, anxiety, addiction and PTSD. This type of application demonstrates how e-Health can empower the individuals using it but also potentially reducing the impact upon health care providers and services.Comment: Book chapte

National Hospital Management Portal (NHMP): a framework for e-health implementation

Health information represents the main basis for health decisionmaking process and there have been some efforts to increase access to health information in developing countries. However, most of these efforts are based on the internet which has minimal penetration especially in the rural and sub-urban part of developing countries. In this work, a platform for medical record acquisition via the ubiquitous 2.5G/3G wireless communications technologies is presented. The National Hospital Management Portal (NHMP)platform has a central database at each specific country’s national hospita