Development Of E-health Systems Research Articles

E-HEALTH TECHNOLOGY ACCEPTANCE: A META-ANALYSIS

Despite the potential benefits of e-health systems in sharing health information, the relationship between technology providers and potential users is inherently complex. This study aims to elucidate the factors driving the acceptance of new technologies among users by synthesizing results on the adoption of e-health technologies using the constructs and relationships outlined in the Unified Theory of Acceptance and Use of Technology (UTAUT) model. Additionally, the impact of moderating variables—including gender, age group, presence of illness, user types, technological application, and publication year—was examined through meta-regression. Significant effects were observed for "Performance Expectancy," "Effort Expectancy," and "Social Influence" on "Behavioral Intention," as well as the influence of "Behavioral Intention" and "Facilitating Conditions" on "Usage Behavior." Among the tested moderating variables, all except for "age group" demonstrated significant moderation effects in various relationships. This research provides detailed estimates of the factors influencing the acceptance of new health technologies and offers strategic directions for the development of e-health systems, considering user acceptance. It contributes to a deeper understanding of the complex interplay between e-health systems and their users, highlighting the importance of tailored approaches to enhance technology adoption.

EXPLORING HEALTH AND DESIGN EVIDENCE PRACTICES IN EHEALTH SYSTEMS’ DEVELOPMENT

AbstractEvidence-based practices play an essential role in the development of eHealth systems. Prior research has investigated the challenge of shared understanding between professionals from the fields of health sciences and design and has highlighted the need for effective alignment of development and research practices in eHealth. However, there is a limited understanding of epistemological differences between these fields and how professionals conceptualise evidence. In this paper, we investigate how healthcare and design professionals think about evidence and how they implement evidence practices in their work. We interviewed eight professionals and used reflexive thematic analysis to identify the challenges and strategies associated with their evidence practices. Our results identify five shared evidence practices between healthcare and design professionals: stakeholder-driven, process-driven, problem-driven, effect-driven, and solution-driven. These five evidence practices indicate opportunities for closer alignment of development and research practices among healthcare and design professionals and offer a basis to create a shared understanding of evidence between both fields.

Medical Records: A Historical Narrative.

The history of medical records is thousand-year-long, with earlier roots in ancient civilizations. Until the 19th century, medical records mainly served educational purposes, later assuming other roles such as in insurance or legal procedures. This article comprehensively describes and reviews the development of medical records from ancient to modern times in Europe and North America, reflecting alterations and adaptations compliant with the mental and technological capabilities of a given period. We searched PubMed and Google Scholar databases to collect pertinent articles. English articles or those having English abstracts were considered. The search terms included “Medical Records,” “Health Records,” “History of Medicine,” and “eHealth” and covered the last hundred years. References were also picked out from the identified articles. Overall, 600 articles were identified, 158 of which were judged thematically relevant. The general conclusion is that medical records undergo a revolutionary change from paper-based to electronic format, which reflects the development of eHealth systems. The migration process to eHealth records involves the use of artificial intelligence (AI) algorithms that streamline medical services by using faster and simpler working methods. AI benefits both patients and providers as it improves patient management and communication among medical centers, spares resources, identifies contamination or infections, and limits health costs. These advantages have become pointedly apparent during the recent COVID-19 scourge.

EHealth: A Survey of Architectures, Developments in mHealth, Security Concerns and Solutions.

The ramifications of the COVID-19 pandemic have contributed in part to a recent upsurge in the study and development of eHealth systems. Although it is almost impossible to cover all aspects of eHealth in a single discussion, three critical areas have gained traction. These include the need for acceptable eHealth architectures, the development of mobile health (mHealth) technologies, and the need to address eHealth system security concerns. Existing survey articles lack a synthesis of the most recent advancements in the development of architectures, mHealth solutions, and innovative security measures, which are essential components of effective eHealth systems. Consequently, the present article aims at providing an encompassing survey of these three aspects towards the development of successful and efficient eHealth systems. Firstly, we discuss the most recent innovations in eHealth architectures, such as blockchain-, Internet of Things (IoT)-, and cloud-based architectures, focusing on their respective benefits and drawbacks while also providing an overview of how they might be implemented and used. Concerning mHealth and security, we focus on key developments in both areas while discussing other critical topics of importance for eHealth systems. We close with a discussion of the important research challenges and potential future directions as they pertain to architecture, mHealth, and security concerns. This survey gives a comprehensive overview, including the merits and limitations of several possible technologies for the development of eHealth systems. This endeavor offers researchers and developers a quick snapshot of the information necessary during the design and decision-making phases of the eHealth system development lifecycle. Furthermore, we conclude that building a unified architecture for eHealth systems would require combining several existing designs. It also points out that there are still a number of problems to be solved, so more research and investment are needed to develop and deploy functional eHealth systems.

Innovative Concept of Application of Electronic Modeling in Building e-Health Systems

The paper presents a concept of application of electronic modeling in the development of e-Health systems for prevention in the diagnosis of problematic skin wounds, which include prevention and treatment, allowing uniformity in the assessment and increase the reliability of treatment tools to achieve a full life without pain, risk, and stress. Health and disease are two phases, changing smoothly or dramatically. It is to this uniqueness of the influences for their direct or indirect management that the research is directed - providing the practicing medical specialists with an opportunity for alternative and adequate diagnostics to ensure the subsequent normal life of the patient. The developed e-Health systems have been applied in the training of specialists in the specialties "Midwife" and "Nurse" and in the specialty "Electronics" at the University of Ruse. They are used in practical training of future doctors in UMHAT KANEV Ruse.

The Sustainable e-Health System Development in COVID 19 Pandemic – The Theoretical Studies of Knowledge Management Systems and Practical Polish Healthcare Experience

The paper describes the sustainable e-health system concerning the theoretical studies and practical Polish healthcare experience. The aim of the paper is to describe the theoretical issues of sustainable development in e-health, and to show practical issues of information and communication technologies (ICTs) as the knowledge management factor in healthcare system.

E-Health in Australia: A synthesis of thirty years of e-Health initiatives

This paper provides an overview of the history of e-Health initiatives in Australia. It highlights the importance of contextual factors in their evolution and the way in which certain initiatives have been managed. The first section outlines the development of e-Health systems in Australia from their inception to the present day. Then, Australia’s e-Health system is evaluated in relation to comparable countries using social mechanism theory. This provides a process-based approach for understanding the relationship between process, context and outcomes in the evaluation of e-Health initiatives in Australia and in comparable countries.

Development of E-Health System with Resource Allocation Forecasting for Local Health Communities

Development of E-Health System with Resource Allocation Forecasting for Local Health Communities

Stakeholder driven indicators for eHealth performance management

The goal of the present article is to compile a corpus of indicators of eHealth development evaluation that would essentially reflect stakeholder approaches and complement technical indicators of assessment of an eHealth system. Consequently, the assessment of the development of an eHealth system would reflect stakeholder approaches and become an innovative solution in attempting to improve productivity of IT projects in the field of health care. The compiled minimum set of indicators will be designed to monitor implementation of the national eHealth information system. To ensure reliability of the quality research, the respondents were grouped in accordance to the geographical distribution and diversity of the levels and types of the represented jobs and institutions. The applied analysis implies several managerial insights on the hierarchy of eHealth indicators. These insights may be helpful in recommending priority activities in implementation of an eHealth data system on the national or international level. The research is practically useful as it is the first to deal with the topic in Lithuania and its theoretical and practical aspect are particularly relevant in implementation of an eHealth data system in Lithuania. The eHealth assessment indicators presented in the article may be practically useful in two aspects: (1) as key implementation guidelines facilitating the general course of eHealth system development and (2) as a means to evaluate eHealth outcomes.

Ten Demands of Improved Usability in eHealth and Some Progress - Co-Creation by Health and Social Care Professionals.

Current healthcare organizations often do not accomplish the intended effects of their eHealth systems due to inadequate usability. Commissioned by the Swedish Ministry of Health and Social Affairs, the usability of current eHealth systems in Swedish health and social care has been analysed from the perspective of their professionals. The objective of the study was to report on current problems, potential solutions as well as to relate these to research in relevant areas. Using a participatory approach, nine workshops were held where health informatics researchers guided staff from different care organizations, representatives of the national associations of health and social care professionals and the national eHealth system vendor organization. This paper presents ten demands that Swedish health and social care professionals find imperative to prioritize. The study emphasizes that development of eHealth systems must be integrated into the care practice improvement process and iteratively evaluated regarding usability.

A patient centered electronic health: eHealth system development.

Medical practice and patient-doctor relationship will continue improving while technology is integrated in our everyday life. In recent years the term eHealth landmarked a new era with improved health provider's skills and knowledge, and increased patient participation in medical care activities. To show why the design and implementation of a healthcare system needs to follow a specific philosophy dictated by the level of eHealth maturity of a country and its citizens. Based on the maturity level, an adaptable framework for implementing an Electronic Health System at national level is derived, guided by the Patient Centered Philosophy as defined and introduced by the EU directives. Implementation prerequisites are analyzed together with guiding principles for identifying the maturity level of an organization or country. Cyprus being a small EU country, it can be used as pilot site for the whole Europe, was chosen for this study and its maturity level analysis is presented. Recommendations that determine general steps needed to prepare the ground for an adequate patient-centered national healthcare system are accompanied. The implementation of an integrated Electronic Health Record at National level, as a prerequisite for a patient-centered eHealth environment is evidently demonstrated.

Power supply issues in e-health monitoring applications

Recent years have seen a rapid growth in the development of e-health systems for the continuous remote patient monitoring of physiological data such as temperature, heart rate (HR), Blood pressure (BP), oxygenation (SpO2), respiration and glucose levels. The roll-out of such schemes show promise in delivering improvements in patient care while at the same time reducing both the demand for resources and the financial burden on healthcare systems. These wearable monitoring systems are used to monitor, log and transmit patient data to a central health authority. Depending on the patient, it is often critical that the monitoring system reliability is high to deliver the appropriate patient care and ensure patient safety. However, since wearable systems are solely dependent on battery power, continuous monitoring will rapidly deplete the battery energy making the system prone to failure. In this paper, methods to reduce power consumption will be discussed using the example of prosthetic socket temperature monitoring data.

Disturbing or facilitating?--on the Usability of Swedish eHealth Systems 2013.

As many evaluations show, healthcare organizations do not accomplish the intended effects of their eHealth systems due to inadequate usability. On behalf of the Swedish Ministry of Health and Social Affairs, the usability of current eHealth systems in Swedish healthcare have been analysed from the perspective of healthcare and social service professionals. The objective of the study was to report on current problems, potential solutions as well as to relate these to research in relevant areas. Using a participatory approach, seven workshops were held where researchers within health informatics collaborated with staff from different care providers, representatives of the national associations of health and social care professionals and the national eHealth system vendor organization. This paper presents a foundation for further development of eHealth systems, condensed into 10 issues that the Swedish health and social care professionals find imperative to improve. The study emphasizes that the development of eHealth systems is always a matter of organizational and process development and must be integrated into the care practice improvement process. Further, based on the findings, some identified challenges are discussed.

Human factors considerations when developing eHealth solutions to support patients: comparison of Danish and Australian experiences

Single snapshot evaluations of eHealth projects often lack depth when explaining the impact of human factor influences at the conceptualisation stages of a project. This paper explores the conceptualisation and prototype building of two eHealth projects undertaken in Denmark and Australia and develops a human factors evaluation framework applicable for use during the initial phases of eHealth projects for patient use. Initially the projects were reviewed using a human factors lens to identify individual project phases. Project elements in each project were determined and analysed using thematic analysis. A conceptual framework was then developed and applied to the project phases resulting in the identification and exploration of five key themes. The developed framework can complement existing eHealth evaluation frameworks and enrich them with a human factors viewpoint and highlights the need for further research on cultural influences and the intersections between each framework component. Finally, the paper highlights the need for patients to be considered as end users of eHealth systems and engaged early and throughout the development of eHealth systems.

Suinteresuotųjų požiūrio į e. sveikatos elementus kokybinė diagnostika

Many countries encounter different problems that are being experienced during the process of design, implementation and development of innovative information and communication technologies (ICT) in healthcare, known as eHealth solutions. Some of these problems are more challenging and influential than others. One of those is ensuring coherent stakeholders’ involvement in all the stages of eHealth development, matching of stakeholders’ interests and maintaining close cooperation. Therefore, in order to evaluate or prognosticate further development of eHealth, it is expedient to research stakeholders’ involvement, their attitudes towards diverse elements of eHealth and satisfaction with both eHealth development process and results. An increasing number of research evidences demonstrate the necessity to pursuit eHealth actors’ abilities to discuss demands and expectations, and negotiate changes of performance. The present research aims to investigate eHealth stakeholders’ attitudes towards eHealth elements through applying qualitative method approach. The paper identifies eHealth elements, develops the methodology allowing collecting data on eHealth stakeholders’ perceptions of these elements, tests the methodology and discusses generalized results of qualitative research. The methodology is based on semi-structural interviews. The authors of the research completed 41 individual and 3 group interviews with employees (heads of administrations, medical staff and ICT specialists) from different eHealth system institutions (hospitals, primary healthcare organizations, ministry of health, IT companies and other) from 10 Lithuanian cities.Preliminary results of qualitative research revealed that eHealth stakeholders acknowledge the importance of all eHealth elements. However, the focus of attention was put on the elements related to inter-institutional cooperation among the institutions of eHealth system and on interaction within healthcare institutions installing eHealth solutions. The respondents agreed that participation of employees from all the organizational structures (doctors and nurses, administration, IT specialists) plays a crucial role for the success of system development. However, the research evidences that cooperation that is more active is demonstrated within organizations. Interaction among different institutions concerning eHealth policy design, planning and implementation of eHealth solutions remains fragmented, based on individual communication but not on systemic stakeholders’ participation and matching of interests.The interviews evidenced several basic challenges on the interviewees’ opinions creating the majority of problems in eHealth development. Among those are the following: balancing eHealth system development top down and bottom up; compatibility of diverse information systems; stakeholders’ involvement and cooperation; budgeting of eHealth system creation, implementation and maintenance.

E. sveikatos paslaugų naudotojo portretas Lietuvoje

The development of Lithuanian e-health system underwent quite a few challenges and fails when the effort did not bring the expected result. However, it is worth mentioning a few major breakthroughs creating its separate parts. To improve the e-health system purposefully and to increase the popularity of using e-health system, it is needed to have specific knowledge about the drawbacks of the system. The users and their willingness to use the created systems are the best reflection of the accessibility of e-health. “User profile” reveals characteristic target user group features and lets to predict other users behaviour in the future. “User profile” is one of the recognised means to improve e-services.Objective. The objective of the research, presented in the article, is to determine e-health services “user profile” or “profiles”, ascertaining which e-health services “user profile” is satisfied with the current e-health system in Lithuania.Methods and data. One thousand inhabitants who know and use e-health services in Lithuania were questioned to determine e-health “user profile” or “profiles” in Lithuania. The necessary empirical data were given by the project “Integrated Transformation of E-Health: Perspectives of Stakeholders’ Network” VP1-3.1-ŠMM-07-K-02-029/2013, which performed the quantitative survey of Lithuanian inhabitants. Secondary analysis of quantitative data method was applied to analyse the data. Statistical data analysis was performed using the statistical package “SPSS” (Version 17), “WinPepi” and “Microsoft Excel 2010” programmes. The using of the services was analysed according to the socio-demographical characteristics, i.e. gender, living place, age, education, occupation, family status, number of the family members and income. The frequency of using healthcare services, and the fact which healthcare institutions – private or state – were attended, was also taken into consideration.Results. During the research the objectives were reached and two types of health services were revealed: e-health services “user profiles” and the “profile” of a frequent healthcare user in Lithuania. It is noted that e-health service users and healthcare services “user profiles” are very different. The research of the “profiles” showed that there are objective socio-demographical inequalities between e-health users, which clearly show inequalities in e-health development.E-health services function more effectively in bigger cities; internet connection is more accessible for people with higher income, better education and younger inhabitants. Meanwhile, the need for e-services in other age groups is even more necessary because of the greater demand in healthcare. Summing up, socio-demograpical inequalities in “user profiles” allows to determine e-health system development drawbacks, which could be suggested for further improvement as the priority.

The Public User's Role in Breast Self-Examination Teleconsultation System Development: Modified User-Created Content Approach

Problem statement: Teleconsultation services had been introduced in Malaysia for almost 10 years yet it has not been optimally adopted even th ough it was found that teleconsultation in Malaysia is cost saving, efficient in allocating resources, enh ances diagnostic options and better health outcomes . At present, the underutilized service is due to its fa ilure to satisfy the user's demands on various aspe cts. Since Teleconsultation in BSE is at proposal stage, there is strong need for user's involvement in suggesting its contents to harvest end-user accepta nce. This study describes the development process of the Web-based Breast Self-Examination (BSE) Teleconsultation System, emphasizing the role of public users in identifying the contents of the system and its functionality using our proposed Modified UCC (MUCC) approach. To help understanding the process we first presents the key concepts related to original User-Created Content (UCC) approach; next we describes in details the data gathering process which applied qualitative method; we then describes the web-based application for BSE Teleconsultation, as well as, the development process illustrating th e transition from the MUCC to the system development; and finally we discusses the importance of the user 's input in the system development from our experience. Approach: A semi-structured one-to-one interviews with 15 public users was carried out in October 2008 in one of the public university in Mal aysia to capture the content of the system based on our proposed MUCC approach. Results: By using our MUCC approach, the content of the proposed system has been identified and the BSE Teleconsultation system has been successfully developed. Conclusion/Recommendations: MUCC approach proposed and used in this study has provides insights on user's role in e-health system development.

Willingness to use eHealth services in Lithuanian healthcare institutions. Countrywide survey

Lithuania started to implement its own National eHealth Service System (NESS) in 2005. In May 2007, an eHealth system development strategy for the period 2007-2015 was prepared. In general, it is expected that these processes will lead to a higher level of citizens' awareness and involvement in protecting their health, as well as more effective use of available resources for provision and expansion of healthcare services, based on modern IT technologies. However, the implementation of the system is very slow and difficult. We aimed to assess competence and willingness of healthcare institutions (HCIs) to implement the NESS in primary care healthcare institutions in Lithuania. A cross-sectional study design was used. Questionnaires with letters of invitation to participate in the study were sent to 150 Lithuanian HCIs by mail. Only one questionnaire per HCI was sent. HCI head administrative staff (e.g., director, medical director, head of administration) was asked to answer the questionnaires. A total of 68 replies from all HCIs were received. Response rate to the survey was 45.3%. The eHealth system implementation was mostly expected in eAdministration (77.9%), eReimbursement (47.1%) and Institutional EPR systems (47.1%). There was a lower willingness to start implementing ePrescriptions (4.4%), a picture archiving and communication system (PACS, 8.8%), eLaboratory (11.8%) and Telemedicine (13.2%) services. A lack of competence and knowledge in eHealth system implementation was recorded in the following: digital data protection (p=0.006), IT (p=0.028), health technology (p=0.032) and National eHealth Strategy (p=0.036). Most Lithuanian HCIs are planning to participate in the implementation of NESS. HCIs are mostly willing to use eAdministration, eReimbursement and Institutional electronic patient record systems. HCIs highlighted a lack of key competences in eHealth system implementation.

Investigating risk exposure in e-health systems

Purpose Health managers, administrators and health practitioners now face new challenges due to the increasing dependency being placed on electronic health information systems. This paper focuses on Electronic Health Records for determining the critical attributes for e-health system development. The proposed QUiPS model aims to provide a framework for building trustworthy solutions by identifying the pertinent issues needed to determine the risk exposure with a given system. Approach To produce dependable, low risk and viable IT solutions, each critical attribute needs to be specifically addressed and prioritized. It is shown how these attributes possess a number of interdependencies making the analysis and prioritization tasks complex and hence, in practice, often incomplete. Two Australian case studies are presented that access enterprise level applications of live health records where these risk based techniques have been applied. Results The value and the shortcomings of taking a risk based approach to developing and deploying electronic health information systems that are safe and secure, is evaluated. The case studies presented indicate that traditional methods used to derive the requirements are often inadequate and the risks that are faced in ensuring a safe and secure system are highly application dependent and dynamic. Conclusions Convergence towards a viable universal solution for our electronic health records is not imminent and trust in e-health is fragile. Policies that data custodians follow need to be flexible and updated on a regular basis. Technological solutions are at best a stop gap to avoid the common hazards associated with access control and secure messaging. A wider range of analysis techniques to determine the key issues for a dependable health information system can derive longer term sustainable solutions.