International Journal of Electronic Healthcare (8 papers in press)
Factors Affecting Mobile Immunization Notification System Adoption in Uganda
by Jackson Abandu, Florence Kivunike
Abstract: Objective: The aim of this study was to assess factors that affect the adoption of mobile immunization notification system in Uganda.
Methods: Descriptive survey design and structured questionnaires were employed for the study that was carried out in Northern part of Uganda. A total of 51 health workers and mothers were purposively sampled from Gulu Referral and Independent hospitals. Statistical package for social sciences was used to evaluate the impact of the identified factors on the adoption of the proposed system.
Results: The findings showed that e-health knowledge; trust; ICT skills; accessibility; support; awareness; knowledge sharing and compatibility affect the adoption of the proposed system. Conclusions: The study provides informative directions to adopt the proposed system. Government needs to improve ICT infrastructure and support user training on e-health to promote the adoption of the system.
Keywords: Mobile; e-health; Immunization; Infrastructure; Process; Contextual and Content.
Special Issue on: Improving healthcare through IT Interventions
Analysis and Development of Mobile Perinatal Mental Health System
by Mohammad I. Merhi, Naima Islam, Greg Hintz
Abstract: Perinatal depression includes major and minor depressive episodes during pregnancy or in the first twelve months after birth. The American College of Obstetricians and Gynecologists recommends that clinicians screen patients at least once during pregnancy for depression and anxiety symptoms using a standardized tool. This paper attempts to consolidate current depression screening tools into an electronic application that can be accessed from a computer, tablet or cell phone and can be sent directly to the primary care physicians office for review. The object-oriented approach was used to analysis and design the system. The systems requirements are first gathered using questionnaire and interviews with practitioners; then, analyzed based on unified modeling language techniques such as use case, class, and sequence diagrams. This system will aid healthcare providers in identifying patients who are at risk of perinatal depression.
Keywords: Mental health system; perinatal mental health; depression system; health systems; perinatal system.
Special Issue on: Bridging the Digital Divide in Healthcare
The Moderating Effect of Information Technology on the Relationship between Self-Efficacy and Self-Management for Patients with Type(2) Diabetes in Jordan
by Fadi Qutaishat
Abstract: The purpose of this study is to investigate the moderating effect of Information Technology on the relationship between self-efficacy and self-management for patients with type (2) diabetes in Jordan. To achieve this, a survey questionnaire was developed and then distributed to participants of this study. Participants were chosen based on their diagnosis with diabetes (type (2) only) and also based on their experience of using Information Technology to access diabetes-related information. Several statistical tests were used to examine the research hypotheses including descriptive analysis, simple regression analysis and moderated hierarchical regression. It was evident according to the results of this study that self-efficacy was a predictor for self-management, and Information Technology positively moderated the relationship between these variables.
Keywords: Self-Efficacy; Self-Management; Information Technology; Type (2) Diabetes; Jordan.
Connecting digital pharma and e-healthcare value networks through product-service design: a conceptual model
by Tomás S. Harrington, Thomas A. Burge
Abstract: With the move towards more outcome and value-based treatment regimens increasingly tailored for the individual patient there is growing pressure on healthcare systems and the pharmaceutical sector to collaborate and co-develop innovative models of care and medication. This paper focuses on the impact disruptive digital technologies may have on the UK Pharma/National Health Service (NHS) ecosystem, and is set within the boundaries of treating chronic diseases. A comprehensive generic model for designing more connected value networks is developed, and validated by an expert panel in the specific case of type 2 diabetes. An underlying disconnection between e-healthcare and pharma value networks, operating as independent entities, is demonstrated. Moreover, the extant literature details only simple product-fee relationships, without considering the value potential of more digitally connected partnerships. Hence, we explore the potential for emerging product-service system (PSS) concepts involving, for example, health information exchange mechanisms, interoperability and data analytics, wearable technologies, and patient Apps. Scenarios involving more distributed make-to-order service models are also represented by the model - demonstrating the potential for technologies, such as 3D printing, to enable localised and personalised medication manufacture Underpinned by the literature on digital/IoT-based business models and PSSs, the conceptual model reduces complexity and provides practical guidance on future operating principles and protocols to be used in the design and implementation of improved e-healthcare solutions. In turn, this enables stakeholders to better understand potential relationships, serviceable aspects, data flows and revenue streams. Through use of the model, various disparities in key stakeholder perspectives are also captured in this paper. Findings include concerns on the collection and use of patient data, except if partnering mechanisms with the NHS were in place, and when devices/services could be provided for free. Stakeholder viewpoints expressing a preference to be at the centre of data collection, disagreement over data ownership and financial models, and the difficulty in establishing partnerships from a wearables technology provider perspective are highlighted.
Keywords: e-healthcare; Pharma; Value Network; Digitalisation; Servitization.
eHealth in India: A Model for Healthcare Accessibility at the Bottom of the Pyramid
by Ridhi Bhatia, Udita Taneja
Abstract: The objective of this research is to study the scope of eHealth as a means to reach the Bottom of the Pyramid (BOP) in India and making health care services accessible to this segment. For this purpose, a detailed study of the eHealth initiatives in India is done in terms of their objectives, value proposition, penetration, customer segment, and operating model. This study also analyses the macro-economic, technological, social and other demographic factors in India in order to understand the scope of eHealth in terms of its drivers and inhibitors in the growth of eHealth in India. This is a qualitative and descriptive research study that is based on secondary research which involves review of existing literature and data. The findings and analyses done on the basis of secondary research are further reinforced through discussions with health care providers, researchers and consumers.
Keywords: eHealth; Healthcare accessibility; Healthcare technology; Bottom of the Pyramid; Healthcare services.
User-centered design and assessment of a prescription prior authorization processing system
by Ramandeep Kaur, Patricia Morreale
Abstract: Electronic Prior Authorization (ePA) is an efficient way to ensure prior authorization completion for delivery of patient medications. Benefits include time savings for prescribers as well as cost-saving and quality-assurance solutions for insurers. Existing ePA systems have a gap in knowledge among medical professionals using the ePA systems and the IT solution providers designing the ePA systems. As a result, standard ePA designs lack components to facilitate the workflow. The research study presented here interviewed key stakeholders, including prescribers, care nurses, and call center agents, and used that information for development. Focusing on Case Create and Case Search functions, a new user-centered ePA system was designed. Assessment outcomes of the new system, SmartPA, include advocacy for secure centralized portals, with cross-checking search fields and integration with major formulary vendors. SmartPA proved to be more efficient in usability testing with stakeholders and provided a clean UI, supporting faster, secure case creation and searching, on a stable platform.
Keywords: human computer interaction (HCI); user centered design (UCD); electronic prior authorization (ePA); pharmacy benefit management (PBM); digital healthcare systems.
Impact of perceived HIS users performance on job satisfaction: Moderating effect of perceived HIS quality
by Bassem Maamari, Johnny Chaanine
Abstract: The study surveys the effect of perceived healthcare information system users performance on their job satisfaction, and the moderating role of employees perception of the healthcare information systems quality on the relationship. The results show that the perceived quality of the system coupled with their perceived performance using the system affect their job satisfaction. In these facilities, health information systems add value to their services at the expense of the employees work load and performance, and thereby satisfaction. Therefore managers and administrators need to provide inclusion programs as well as training workshops and follow-up sessions. In addition, these healthcare facilities can build internal marketing programs to boost employees perception of the systems quality and use
Keywords: Healthcare; Information system; HIS Quality; performance; job satisfaction.
Understanding EHRs Continuance Intention to Use from the Perspectives of UTAUT: Practice Environment Moderating Effect and Top Management Support as Predictor Variable
by Adi Alsyouf, Awanis Ku Ishak
Abstract: The purpose of this paper is to comprehend the factors affecting nurses intentions to continue using Electronic Health Records (EHR) in Jordan. Nurses are important providers of healthcare services and are among the main users of EHR system. Therefore, their acceptance of an EHR system and its usage are of great significance when evaluating the success of an EHR system. A cross-sectional survey was conducted in the Jordanian public hospitals, which are fully implementing the EHR system, and, an extended model of the UTAUT and TMS was used as a framework. The findings indicate that effort expectancy, performance expectancy and facilitating conditions all influenced nurses Continuance intention positively to use EHRs. In addition, the results also show that top management support had a negative and significant relationship with nurses Continuance intention to use EHRs. In addition, social influence had an insignificant relationship with Continuance intention to use EHRs. Moreover, the results for multigroup analysis indicates that the relationship between effort expectancy and CI was more significant for nurses working in a ward than for nurses working in special units. The findings are an attestation of the need to support new technologies based on managerial and practical perspectives. This study contributes to the body of knowledge of UTAUT by investigating the impact of top management support as exogenous factor with Continuance intention. In addition, this study provides methodological contributions by adapting new instrument and testing it in health context.
Keywords: Unified Theory of Acceptance and Use of Technology (UTAUT); Continuance intention; Electronic Health Records; Top Management Support; nurses; Jordan.