electronic Journal of Health Informatics http://www.ejhi.net/ojs/index.php/ejhi <strong>The e-Journal of Health Informatics is dedicated to the advancement of Health Informatics and information technology in healthcare.  eJHI is an</strong><strong> international </strong><strong>Open Access journal committed to scholarly excellence and has a global readership in all health professions and at all levels. </strong><br /><br /> en-US <p>Copyright for articles published in this journal is retained by the authors, with first publication rights granted to the journal. <!--Creative Commons License--><a href="http://creativecommons.org/licenses/by-nc-sa/2.5/au/" rel="license"><img style="border-width: 0;" src="http://creativecommons.org/images/public/somerights20.png" alt="Creative Commons License" /></a><br />This work is licensed under a <a href="http://creativecommons.org/licenses/by-nc-sa/3.0/au/" rel="license">Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License</a>.<!--/Creative Commons License--><!-- <rdf:RDF xmlns="http://web.resource.org/cc/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:rdf="http://www.w3.org/1999/02/22-rdf-syntax-ns#"> <Work rdf:about=""> <license rdf:resource="http://creativecommons.org/licenses/by-nc-sa/2.5/au/" /> </Work> <License rdf:about="http://creativecommons.org/licenses/by-nc-sa/2.5/au/"><permits rdf:resource="http://web.resource.org/cc/Reproduction" /><permits rdf:resource="http://web.resource.org/cc/Distribution" /><requires rdf:resource="http://web.resource.org/cc/Notice" /><requires rdf:resource="http://web.resource.org/cc/Attribution" /><prohibits rdf:resource="http://web.resource.org/cc/CommercialUse" /><permits rdf:resource="http://web.resource.org/cc/DerivativeWorks" /><requires rdf:resource="http://web.resource.org/cc/ShareAlike" /></License></rdf:RDF> --> The journal/publisher is not responsible for subsequent uses of the work, including uses infringing the above license. It is the author's responsibility to bring an infringement action if so desired by the author.</p><p><strong>Authors may, of course, use and distribute their published paper as desired and place the published version in repositories of their choice.</strong></p> Editors@eJHI.net (eJHI Editorial Office) Admin@eJHI.net (eJHI Support Team) Thu, 07 May 2015 08:57:28 -0500 OJS http://blogs.law.harvard.edu/tech/rss 60 Editorial - Special Issue on Informatics for Ageing and Aged-Care http://www.ejhi.net/ojs/index.php/ejhi/article/view/319 Jeffrey Soar, Margee Hume, Andrew Georgiou http://www.ejhi.net/ojs/index.php/ejhi/article/view/319 Fri, 08 May 2015 00:00:00 -0500 Exploring One Accord for the Business of Aged Care Industry: The CEO's Perspective http://www.ejhi.net/ojs/index.php/ejhi/article/view/287 <p>Three million Australians are aged over 65 years with a third requiring some level of assistance with their everyday activities   Australian Government expenditure will need to increase from 0.8% of GDP in 2010 to 1.8% of GDP by 2050 as ABS projected growth of 65 years or over to increases from 15 per cent to 21 per cent by 2026 and 28 per cent by 2056 (AIHW 2012, ABS 2011).  With the aged care industry growing faster than any other industry research, benefit realization in leadership, efficiency and productivity will impact to a great extent across the industry.  Using a convenience sample, the purpose of this paper was to develop a better understanding of trends, issues, challenges and opinions of 24 Chief Executive Officers (CEO) and sector leaders in aged care toward government reforms and current aged care policy in Australia, in 2013.  The in-depth interviews advanced the topics of aged care work force, work conditions, attractiveness of the industry to investment, funding models, government relationships, research data management and the future. The paper culminates in a research and practice agenda for the future and accentuates the areas that our sector leaders believe need focus.</p> Paul Johnston, Margee Hume http://www.ejhi.net/ojs/index.php/ejhi/article/view/287 Fri, 08 May 2015 00:00:00 -0500 Research Note: Small Pilot of Home Tele-Health in a Hospital Heart Failure Outreach Service http://www.ejhi.net/ojs/index.php/ejhi/article/view/285 <p><strong>Aims: </strong>To demonstrate the feasibility of the use of telehealth to better support patients and staff operating a hospital outreach heart failure (HF) service.</p><p><strong>Patients and Methods: </strong>Telehealth with interactive audio and video between the hospital and patients’ homes was used to supplement the delivery of care. The Royal Brisbane and Women’s Hospital, Tunstall Healthcare and researchers from the University of Southern Queensland developed this collaboration in 2012 to establish a telehealth pilot program to support risk assessment and services to patients in a hospital outreach heart failure service. A convenience sample consisting of 10 patients and 6 HF Service clinical staff utilised the telehealth system during 2012. Feedback from staff was gathered to assess perceptions of impacts and satisfaction.</p><p><strong>Results: </strong>Focus groups of the participating staff were held mid-project and end of project. There was consensus about a range of perceived benefits.</p><p><strong>Conclusion: </strong>Collaborations using telehealth to supplement an outreach specialty care model can be seen to have a positive impact on a patient’s care and be well-received by clinical staff.</p> Jeffrey Soar, Lisa Capamagian, Charles Denaro, Linda Prentice, Ruth Skinner-Smith http://www.ejhi.net/ojs/index.php/ejhi/article/view/285 Fri, 08 May 2015 00:00:00 -0500 Transition from Paper to Electronic Nursing Documentation in Residential Aged Care: an Actor Network Theory Analysis http://www.ejhi.net/ojs/index.php/ejhi/article/view/278 <p class="Abstract"><strong>Objectives:</strong> To examine the role of technology when introduced into the specific setting of residential aged care and then analyse the associated changes to this complex socio-technical network of human and technology actors on the introduction of this technology using the rich lens of Actor Network Theory.</p><p class="Abstract"><strong>Methods:</strong> An exploratory qualitative single case study was conducted. The specific focus being the implementation of a nursing information system in an aged care context, i.e. the transition from paper-based nursing documentation to electronic nursing documentation. A series of 19 semi structured interviews with facility managers, nursing coordinators, and the nursing and care staff were conducted. The collected data were analysed using standard qualitative techniques such as thematic analysis and a priori themes were developed from the application of Actor Network Theory.</p><p class="Abstract"><strong>Results:</strong> A priori themes coupled with emergent themes served to highlight the impact of a disruptive technology solution into a complex context.</p><p class="Abstract"><strong>Conclusion:</strong> An Actor Network Theory analysis enables a rich theoretical lens to be used to examine the introduction of a disruptive technology into a complex context.  On such examination critical success factors were identified as well as key barriers. Moreover, people issues were found to be central to the success of such a solution.</p> Lemai Nguyen, Lachlan Bakewell, Nilmini Wickramasinghe, Peter Haddad, Imran Muhammad, Hoda Moghimi, David Wilde, Bernice Redley, Julie Considine, Mari Botti http://www.ejhi.net/ojs/index.php/ejhi/article/view/278 Fri, 08 May 2015 00:00:00 -0500 Collaborative Multi-Touch Clinical Handover System for the Neonatal Intensive Care Unit http://www.ejhi.net/ojs/index.php/ejhi/article/view/291 <p><strong>Background</strong>: A critically ill infant admitted to a neonatal intensive care unit requires complex, critical, and coordinated care performed by multidisciplinary healthcare teams. Since the infant is not monitored by an individual over the entire duration of stay, clinical handover enables the necessary transfer of health information between physicians involved in the care.</p><p><strong>Objective</strong>: Handover at present is largely conducted in an informal and ad hoc way. Many handover mnemonics have been developed to support efficient transfer of critical information. These mnemonics, however, remain largely unused. <strong></strong></p><p><strong>Methods:</strong> A qualitative study in a quaternary neonatal intensive care unit, at The Hospital for Sick Children was undertaken to understand clinical handover and derive usability requirements. This is then used to inform a high level design of a multi-touch tabletop application for handover the design was then evaluated against senior neonatologists and neonatal fellows using rapid prototyping methods.  <strong></strong></p><p><strong>Results</strong>: The results of the qualitative study showed that an effective handover application should at minimum include: tight integration with workflow and the physical environment, intuitive and simplicity, and minimalistic design following the ‘less is more’ philosophy. <strong></strong></p><p><strong>Conclusion</strong>: There is a need to optimize handover such that the information transferred is standardized, and the loss of information and/or misinformation is minimized. We argue that natural user interface design employed in the proposed design will result in improved care and less information loss during clinical handover. </p> Rishikesan Kamaleswaran, Rina R. Wehbe, J. Edward Pugh, Lennart Lennart, Carolyn McGregor, Andrew James http://www.ejhi.net/ojs/index.php/ejhi/article/view/291 Fri, 08 May 2015 00:00:00 -0500 Fundamental Elements Identified for Success of Disease State Management Clinical Decision Support Systems http://www.ejhi.net/ojs/index.php/ejhi/article/view/289 <p>Traditional forms of communicating best practice disease state management do not adequately support appropriate prescribing in patients with complex needs, such as those with multi-morbidities or aged patients. An effective solution is the use of clinical decision support systems; however, currently available systems do not meet the needs of health professionals (HPs). We wished to evaluate whether HPs find the way in which an early-stage prototype delivers information is useful; however, during prototype development, articles defining fundamental elements of clinical decision support systems (CDSS) success, process model and data requirements were found to be widely dispersed and lacking. We describe a new CDSS prototype for healthcare information delivery tailored for health professional using the identified fundamental elements for success. Concepts described in this article could be used to as the foundation for other CDSS and to inform electronic medical record design.</p> Paulina Stehlik, Amirhossein Bahmanpour, Y. Ahmet Sekercioglu, Pēteris Dārziņš, Jennifer L. Marriott http://www.ejhi.net/ojs/index.php/ejhi/article/view/289 Fri, 08 May 2015 00:00:00 -0500 Understanding Pharmacists’ Intention to Use Medical Apps http://www.ejhi.net/ojs/index.php/ejhi/article/view/297 <strong>Objectives:</strong> The goal of this study is to investigate pharmacists’ perception towards mobile medical apps use in pharmacy practice and to explore both the enabling and inhibiting factors that govern the adoption of this Mobile Health tool.<br /><br /><strong>Methods:</strong> This study employed quantitative research methodology to examine the relationships between key constructs and pharmacists’ intention to use medical apps. Multi-items questionnaire was developed to draw participation of pharmacists from various fields of practice in Malaysia. Quantitative data was analyzed using partial least squares (PLS) modeling statistical technique.<br /><br /><strong>Results:</strong> The findings provided strong empirical support for six positive determinants (perceived usefulness, perceived ease of use, result demonstrability, subjective norm, compatibility, facilitating conditions) and two negative (security, resistance to change) determinants of intention to use medical apps. The proposed model had good predictive relevance to infer actual medical apps.<br /><br /><strong>Discussion:</strong> Pharmacy informaticists are able to manipulate the key factors presented in the research model in such a way to maximize the adoption of medical apps amongst the pharmacists. The study showed that the usefulness of the apps along with their reliability were the most effective influence on intention to use. Pharmacists were also worried about the data security which could potentially hinder the adoption. <br /><br /><strong>Conclusions:</strong> This study represents a pioneer dual-factor model technology adoption study. It has shed light on the aspects where decision makers from managerial stand-point are able to manipulate to achieve maximum diffusion of mobile technology within the health institution. Sze-Nee Ng, David Matanjun, Urban D'Souza, Rayner Alfred http://www.ejhi.net/ojs/index.php/ejhi/article/view/297 Fri, 08 May 2015 00:00:00 -0500 Issues to Consider in Designing Health Care Information Systems: A User-centred Design Approach http://www.ejhi.net/ojs/index.php/ejhi/article/view/218 <p><strong>Objectives:</strong> This paper presents a literature review of recent research on user-centred requirements of Healthcare Information Systems. <strong></strong></p><p><strong>Methods:</strong> Our aim is to identify key issues that should be considered when designing, developing, and implementing Healthcare Information Systems at the user level. Based on the literature, the paper describes a multi-dimensional framework that incorporates user requirements and perspectives to support the development and design process of Healthcare Information Systems. The framework serves to categorize the lessons learned from the literature review and the issues that healthcare organizations and Healthcare Information Systems’ vendors might analyse before and during the implementation of such systems.</p><p><strong>Conclusion:</strong> Our literature review provides useful guidelines for healthcare organizations that plan to implement information systems as well as for organizations that have already implemented such systems but have found a mismatch between the systems and their work requirements. The guidelines presented herein serve as techniques or suggestions that might be helpful in addressing incompetent system design.</p> Ahed Jabor Abugabah, Osama Alfarraj http://www.ejhi.net/ojs/index.php/ejhi/article/view/218 Fri, 08 May 2015 00:00:00 -0500 A Retrospective Analysis of Health, Health Care, and Legal Requirements as Reflected in Predefined Headings in an EHR http://www.ejhi.net/ojs/index.php/ejhi/article/view/300 <p class="Abstract"><span lang="EN-AU"><strong>Objectives:</strong> To study health, health care, and legal requirements as reflected in predefined headings that were applied by users in a Swedish multi-professional electronic health record (EHR). </span></p><p class="Abstract"><span lang="EN-AU"><strong>Method:</strong> Predefined headings (n = 3 596) applied to 20 398 104 occasions by health care professionals in a module for care documentation in an EHR were analysed. A conventional qualitative content analysis was used to explore health and health care as reflected in the predefined headings. Furthermore, a comparison was made between the health and health care aspects and the Swedish Patient Data Act (PDA) to examine whether the aspects corresponded to legal requirements. </span></p><p class="Abstract"><span lang="EN-AU"><strong>Results:</strong> The analysis yielded a meaningful structure that included five categories and 23 subcategories. The categories were Description of the patient, Health care process, Resources employed, Administrative documentation, and Development and research. Of the 23 subcategories, 15 corresponded to four of the seven legal requirements in the PDA. No corresponding subcategories were observed for three of the legal requirements. </span></p><p class="Abstract"><span lang="EN-AU"><strong>Conclusions:</strong> The predefined headings of the multi-professional EHR were possible to analyse and categorise. The analysis showed that the headings reflected a wide range of health and health care and that synonyms or similar terms occurred as headings. The majority of the subcategories corresponded to the legal requirements of the PDA. The legal requirements that referred to patient rights did not have any corresponding subcategory. Subcategories that were found and that concerned goals to be attained and intervention outcomes were not explicitly expressed as legal requirements in the PDA.</span></p> Annika Terner, Helena Lindstedt, Mia Pless, Karin Sonnander http://www.ejhi.net/ojs/index.php/ejhi/article/view/300 Fri, 08 May 2015 00:00:00 -0500 The Development of the Public Health Research Data Management System http://www.ejhi.net/ojs/index.php/ejhi/article/view/301 The design and development of the Public Health Research Data Management System highlights how it is possible to construct an information system, which allows greater access to well, preserved public health research data to enable it to be reused and shared. The Public Health Research Data Management System (PHRDMS) manages clinical, health service, community and survey research data within a secure web environment. The conceptual model under pinning the PHRDMS is based on three main entities: participant, community and health service. The PHRDMS was designed to provide data management to allow for data sharing and reuse. The system has been designed to enable rigorous research and ensure that: data that are unmanaged be managed, data that are disconnected be connected, data that are invisible be ?ndable, data that are single use be reusable, within a structured collection. The PHRDMS is currently used by researchers to answer a broad range of policy relevant questions, including monitoring incidence of renal disease, cardiovascular disease, diabetes and mental health problems in different risk groups. Deborah van Gaans, Katina D'Onise, Tony Cardone, Robyn McDermott http://www.ejhi.net/ojs/index.php/ejhi/article/view/301 Fri, 08 May 2015 00:00:00 -0500 An Exploratory Qualitative Study to Identify Factors that Influence the Use of Electronic Patient Journey Boards in Queensland Health http://www.ejhi.net/ojs/index.php/ejhi/article/view/225 Technology in the healthcare and use of Information and Communication technologies (ICT) in healthcare is on the rise among the developing economies. In spite of some limitations and limited use of ICT in the healthcare domain, ICT is expected to grow in the Australian Healthcare system. This research paper provides preliminary findings on views expressed by users regarding the use of Electronic Patient Journey Boards (EPJBs) in Queensland Health. Initial data was collected through a qualitative approach in order to understand the views of health professionals regarding EPJBs. This was achieved through interviews, brainstorming sessions and focus groups held with healthcare professionals who have used the EPJB and those who will be using EPJBs in the future. This qualitative data was analysed through the lens of three key critical variables, namely people, processes and technology. The preliminary findings show that these three variables are critical for the success of the use and implementation of EPJBs in the healthcare domain. Furthermore, this research paper was also able to identify factors that will have a significant influence on the implementation of a technology in a healthcare setting. This study is limited to Queensland Health and needs further research to test the findings of the study in order to apply the findings more generally. Raj Gururajan, Abdul Hafeez-Baig, Julie Sturgess, Kevin Clark, Vijaya Gururajan http://www.ejhi.net/ojs/index.php/ejhi/article/view/225 Fri, 08 May 2015 00:00:00 -0500