Health Information Management

There is much interest in the application of technologies that can be supported by the National Broadband Network (NBN) (for example, interventions using mobile phone technology, internet, computers, telehealth, etc). This is particularly pertinent in those States with a large rural / remote population. The main aim of this report is to investigate the significance of e-Health and identify the e-Health initiatives are currently being delivered to rural and remote communities in Queensland. It will also examine best practice in e-Health as informed by practices both in Australia and overseas and identify how the NBN can best be utilised to facilitate the delivery of innovative e-Health initiatives in these communities.

Background

The World Health Organization (WHO, 2015) defines e-health as “the transfer of health resources and health care by electronic means.” It mainly revolves around three areas including (1) the delivery of health information for health consumers and health professionals through the internet and other telecommunications (2) leveraging the power of e-commerce and information technology (IT) to improve public health services for instance through training and development of health workers and; (3) the use of e-business and e-commerce practices in health systems management. In essence, e-Health generally helps to bridge the gap between public health, medical informatics, and business. Some definitions however strictly associate e-Health with the Internet, owing to the increasingly significant role the latter plays in health transactions.

ICT has over the years made significant contributions towards public health. In fact, its impact on the health sector is so profound that it is almost indispensable among medical practitioners. Given the volume and complexity of knowledge and information, it has become practically impossible for health professionals to work effectively without depending on information management tools. For instance, in the field of health research, the analysis of new information has proven to be an uphill task even with the aid of ICT decision-making systems due to the high rate at which this information is being generated. Haluza & Jungwirth (2014) pointed out that the current digital revolution is particularly critical for the interaction of healthcare providers not only with patients but also the community as a whole.

The invention of ICT-assisted healthcare applications has been necessitated by the growing acceptance of new communication tools such as tablets and smart phones.

Literature Review

Several authors have acknowledged the growing significance of ICT in the delivery of effective healthcare services. Caro (2007) observed that the deployment of information and communication technologies (ICT) had resulted in a global transformation of organizational systems and opined that it would ultimately translate to the convergence of artificial intelligence, biotechnology, nano-technology, and nomadic information systems. This would in turn further spark inter-organizational and inter-sectorial interactive transformations. The health care sector is by no means an exception to these inter-organizational dynamic imperatives, which are driven by ICT innovative advances.

Schiavo (2008) also concurred that there was an increasing reliance on the internet by the healthcare community at large, which had shaped the practice of health communication by opening “the way to the use of interactive health communications tools, which [were] often designed as part of larger health communication interventions”. The author pointed out that professional and personal blogs, podcasts, chat rooms and forums have also become a prominent source of health information among different kinds of audiences. Ultimately, the internet is increasingly being perceived as an important communication channel and is functioning as some of the more established channels. Huang, Chiu-chi, & Khurana (2012) added that healthcare has in the recent past started to represent a significant portion of online content consumption, with several internet enthusiasts actively searching for information on medical complications, diseases, procedures, treatments, hospitals and particular doctors.

Hage, Roo, van Offenbeek, & Boonstra (2013) posited that e-health services could be a solution to the issue of ageing populations in most developed countries, which is seen as a threat to the quality of life and health in rural communities. The successful implementation of e-Health in organizations has however proven to be difficult and as such, policy makers should not expect the implementation of e-Health in rural areas to be any different. Notwithstanding, the lessons learnt from the implementation of e-health in organizations can be leveraged to facilitate the successful implementation of the latter in rural areas. While most medical practitioners and consumers are equally enthusiastic about the application of e-Health, others have continued to resist this change mainly due to environmental factors. In a paper that sought to investigate the reasons why employees participate in an e-health workplace physical activity (PA) intervention, Bardus, Blake, Lloyd, & Suggs (2014) analysed data collected through interviews and focus group discussions to identify clusters of “reasons for participation” and for “non-participation”. Among the reasons for participation included to increase motivation, to engage in physical activity, to be more active, and to pursue weight loss goals. The employees were attracted to the programme because it was user friendly and it provided reminders. Many were also encourage to enrol by their peers or managers. On the other end of the spectrum, the reasons for non-participation included lack of interest toward the programme, inadequate time and lack of reminders to motivate them to complete the program.

Apart from analysing the implementation of e-Health in organizations, market research should be conducted to determine individual perceptions about e-health among individuals in rural areas. In this regard, Huang, Chiu-chi, & Khurana (2012) carried out a research study that was aimed at investigating what internet users deemed essential on patient-oriented interactive e-health tools available on hospital web sites. To this end, a sample of 242 patients/users from diverse backgrounds was interviewed to determine their individual preferences. The findings of this research suggested that the respondents had a desire for core-business tools, especially access to lab results and medical records, while discounting hospitals’ initiatives to connect to social media. Moreover, it was evident that the hospitals’ e-health implementation on their web sites had greatly lagged behind what the users needed for interacting with hospitals online. It was concluded that, while continuing to support traditional functional tools, hospitals should make deliberate efforts to expedite their development in providing core e-business tools and emerging functional tools in order to accomplish multiple objectives, including service, education, and marketing.

Like most policies, the successful implementation of e-health is also hinged on the availabilty of funds. Crean (2010) observed that inventors across the globe are creating novel information and communication technology applications and systems that can improve health for people in disparate settings. Nonetheless, it is very difficult to find investment funding needed to create business models to expand and develop the prototype technologies. The author proposed that a comprehensive, long-term investment strategy for e-health and m-health would be the key to solving this challenge. The field of social entrepreneurship offers an integrated approach to develop needed investment models, so that innovations can reach more patients, more effectively. According to Crean (2010), specialized financing techniques and sustained support from investors can spur the expansion of mature technologies to larger markets, accelerating global health impacts.

Tan, Cheng, & Rogers (2002) also argued that innovative and sustainable telemedicine, telehealth and e-health developments required the strategic planning, design and implementation of appropriate telecommunication networks and infrastructures. Consistent with this argument, they conducted a research that sought to review the major aspects of networking and telecommunication technologies applicable to expanding telehealth care markets, practices and research. They explored the strategic network planning concepts required, while brainstorming on networking requirements and various telehealth and e-health applications in biomedical research, clinical care and public health domains. To provide guidance on appropriate network design and implementation, the studies they examples of telemedicine and telehealth networks deployed in terrestrial and satellite settings. From their study, they concluded that bringing together state-of-the-art telecommunication and Internet-related technologies and relevant biomedical, clinical and public health-related expertise, the field of telemedicine, telehealth and e-health would have the potential to infiltrate new frontiers and uncharted territories, particularly in the area of knowledge management. Finally, although many improvements were still possible at the time for enhancing present and future network and Internet-related technologies, we agree with the expressed view of many that advances in telemedicine, telehealth and e-health is currently impeded by the lack of clear and supportive legal infrastructures.

Huang & Chang (2013) leveraged content analysis and in-depth interviews to examine three best-practice hospital with regard to their approaches to implementing interactive e-health tools on their Web sites. The study revealed visions of and insights of the hospital administrations into developing e-health. From these findings, it was concluded that the implementation of interactive e-heath tools in not necessarily determined by the area and size of the hospital. Moreover, it was evident that the implementation of e-health on their websites facilitated the accomplishment of a myriad of goals including communication, service, and education. Such implementation also serves as an important differentiator in a competitive industry. On the bottom line, an understanding of the best practice, decision-making, planning processes, and outcomes of implementing e-health online, as well as potential obstacles to such implementation can go a long way in enabling learners and policy makers to design effective interactive e-health tools on their Web sites.

According to Dixon (2007), to achieve greater adoption and use of technology in health care, the health care community needs a roadmap, or model for adoption, that can be used to develop a business case to lower risk for providers who adopt and use technology in clinical practice. The roadmap advocates for (1) greater dissemination of implementation best practices, (2) continued development of a strong e-health workforce, and (3) sustainable resources to help those seeking to adopt and use e-health technologies in clinical practice. The e-health community is invited to advance the roadmap to assist providers in embracing and utilizing information and communication technologies for health care system improvements.

Mair, May, O’Donnell, Finch, & Sullivand (2012) systematically reviewed the literature on the implementation of e-health to identify barriers and facilitators to e-health implementation, and outstanding gaps in research on the subject. The use of normalization process theory as a conceptual framework revealed that relatively little attention was paid to: (1) work directed at making sense of e-health systems, specifying their purposes and benefits, establishing their value to users and planning their implementation; (2) factors promoting or inhibiting engagement and participation; (3) effects on roles and responsibilities; (4) risk management, and (5) ways in which implementation processes might be reconfigured by user-produced knowledge.

References

[WHO] World Health Organization . (2015, September 8). E-Health. Retrieved from World Health Organization : http://www.who.int/trade/glossary/story021/en/

Bardus, M., Blake, H., Lloyd, S., & Suzanne Suggs, L. (2014). Reasons for participating and not participating in a e-health workplace physical activity intervention: A qualitative analysis. International Journal of Workplace Health Management, 246-229.

Caro, D. H. (2007). Evolving E-Health System Symbiosis: Theoretical Constructs in International Realpolitik Space. International Journal of E-Business Research, 67-78.

Crean, K. W. (2010). Accelerating Innovation In Information And Communication Technology For Health. Health Affairs, 278-83.

Dixon, B. E. (2007). A Roadmap for the Adoption of e-Health. E – Service Journal, 3-13.

Hage, E., Roo, J. P., van Offenbeek, M. A., & Boonstra, A. (2013). Implementation factors and their effect on e-Health service adoption in rural communities: a systematic literature review. BMC Health Services Research, 19.

Haluza, D., & Jungwirth, D. (2014). ICT and the future of health care: aspects of doctor-patient communication. International Journal of Technology Assessment in Health Care, suppl. Theme: Adaptive Approaches to Licensing, 298-305.

Hassan, M. M. (2015). Cost-effective resource provisioning for multimedia cloud-based e-health systems. Multimedia Tools and Applications, 5225-5241.

Huang, E., & Chang, C.-c. A. (2013). Case Studies of Implementation of Interactive E-Health Tools on Hospital Web Sites. E – Service Journal, 46-62.

Huang, E., Chiu-chi, A. C., & Khurana, P. (2012). Users’ preferred interactive e-health tools on hospital web sites. International Journal of Pharmaceutical and Healthcare Marketing, 215-229.

Kwankam, S. Y. (2004). What e-Health can offer. World Health Organization. Bulletin of the World Health Organization, 800-802.

Lankton, N., & Wilson, E. V. (2007). Factors Influencing Expectations of e-Health Services within a Direct-Effects Model of User Satisfaction. E – Service Journal, 85-95,97,99-111.

Mair, F. S., May, C., O’Donnell, C., Finch, T., & Sullivand, F. (2012, MAy). Factors that promote or inhibit the implementation of e-health systems: an explanatory systematic review. World Health Organization. Bulletin of the World Health Organization, pp. 357-64.

Schiavo, R. (2008). Digital Marketing; The rise of e-health: Current trends and topics on online health communications. Journal of Medical Marketing, 9-18.

Tan, J., Cheng, W., & Rogers, W. J. (2002). From telemedicine to e-health: Uncovering new frontiers of biomedical research, clinical applications & public health services delivery. The Journal of Computer Information Systems, 7-18.