National eHealth Research Articles

Concept Libraries for Repeatable and Reusable Research: Qualitative Study Exploring the Needs of Users.

BackgroundBig data research in the field of health sciences is hindered by a lack of agreement on how to identify and define different conditions and their medications. This means that researchers and health professionals often have different phenotype definitions for the same condition. This lack of agreement makes it difficult to compare different study findings and hinders the ability to conduct repeatable and reusable research.ObjectiveThis study aims to examine the requirements of various users, such as researchers, clinicians, machine learning experts, and managers, in the development of a data portal for phenotypes (a concept library).MethodsThis was a qualitative study using interviews and focus group discussion. One-to-one interviews were conducted with researchers, clinicians, machine learning experts, and senior research managers in health data science (N=6) to explore their specific needs in the development of a concept library. In addition, a focus group discussion with researchers (N=14) working with the Secured Anonymized Information Linkage databank, a national eHealth data linkage infrastructure, was held to perform a SWOT (strengths, weaknesses, opportunities, and threats) analysis for the phenotyping system and the proposed concept library. The interviews and focus group discussion were transcribed verbatim, and 2 thematic analyses were performed.ResultsMost of the participants thought that the prototype concept library would be a very helpful resource for conducting repeatable research, but they specified that many requirements are needed before its development. Although all the participants stated that they were aware of some existing concept libraries, most of them expressed negative perceptions about them. The participants mentioned several facilitators that would stimulate them to share their work and reuse the work of others, and they pointed out several barriers that could inhibit them from sharing their work and reusing the work of others. The participants suggested some developments that they would like to see to improve reproducible research output using routine data.ConclusionsThe study indicated that most interviewees valued a concept library for phenotypes. However, only half of the participants felt that they would contribute by providing definitions for the concept library, and they reported many barriers regarding sharing their work on a publicly accessible platform. Analysis of interviews and the focus group discussion revealed that different stakeholders have different requirements, facilitators, barriers, and concerns about a prototype concept library.

Discoursing Terminology Standards and Interoperability in relation to the Philippine eHealth Strategy

Background. eHealth is the use of information and communication technologies (ICT) for health. It helps in improving the flow of information, through electronic means, in support of the delivery of health services, and the management of health systems. eHealth is used as the strategic context and tool in achieving population health, improved health system status, and socio-economic development goals.
 Objectives. This study is aimed at looking at the Philippine National eHealth Strategy, particularly the components of Terminology Standards and Interoperability concerning the eHealth strategy in the Philippines, and to assess the barriers and gaps in the integration of these two components.
 Methods. This study used secondary literature, internet search, Philippine laws, administrative orders, memorandum circulars, and grey literature to discourse terminology standards and interoperability in the Philippine eHealth system, and issues and gaps related to these components that may impede the delivery of Universal Health Coverage in the country.
 Results. The current Philippine National eHealth strategy includes the following sector governance, legislation, policy and compliance, eHealth solution (i.e., services and applications), strategy and investment, infrastructure (government), human resources, and standards and interoperability. Philippine Health Information Exchange (PHIE) is a software platform in the country that aims to connect many isolated electronic health systems. The proposed interoperability layer across health systems and services in the Philippines includes Patient’s Primary Healthcare Consultation at the Rural Health Unit, health research, legal information, patient healthcare at tertiary hospital, and health insurance claims. The study results showed that issues and gaps related to the interoperability of eHealth in the Philippines include technical issues such as lack of common semantics, lack of an institutional mechanism to regulate EMR, lack of incentives among eHealth providers and stakeholders to adopt standards for interoperability.
 Conclusion. The effort of the Philippines to achieve interoperability and standards in eHealth goals can be characterized as a work in progress. The government, private sector, physician, patient, and other stakeholders are deemed to continuously develop a shared vision and interoperate under a standardized guide as eHealth is a complex endeavor that covers many aspects.

Digital Transformation as One of the Instruments for Overcoming the Public Health Crisis: The Role and Use of Ehealth Solutions during the Covid-19 Pandemic in Slovenia

The comprehensive digital transformation of the Slovenian healthcare system and the use of national eHealth solutions would enable the citizens and healthcare professionals to access data and information relevant to highquality healthcare services, and healthcare managers to take evidence-based decisions and measures. This paper analyses the role and use of selected eHealth solutions during the Covid-19 pandemic in Slovenia. The pandemic has led to significant growth in interest in digital transformation processes and the use of eHealth solutions. It also breaks down the normative framework of eHealth and the compliance of eHealth solutions with the fundamental principles of information security and the General Data Protection Regulation. The study proceeded from a review of the literature, followed by discussions with experts engaged in managing eHealth solutions and an examination of current statistical data on the use of these solutions from administrator modules. The results of the study show that the Covid-19 pandemic could constitute a turning point in our understanding of digital transformation, which is becoming not only a key public health management instrument, but also an indispensable driver to further develop the healthcare system, and empower patients at times of national and international public health crises.

Telemedicine options to address identified health needs in Botswana.

ObjectiveGlobal efforts to implement national ehealth strategies have occurred, yet specific telemedicine implementations have fallen behind. A weakness inherent within many, perhaps most, national ehealth strategies, including Botswana's – is a lack of telemedicine focus. This is despite its potential to address many current healthcare system needs. The development of a telemedicine-specific strategy, to complement the existing ehealth strategy, has been proposed. This paper reports on an emulated process to determine prioritised health needs, identify broad solutions, consider ehealth and then telemedicine solutions, and prioritise these as insight for telemedicine-specific strategy development.MethodsThe eHealth Strategy Development Framework (eHSDF) was adopted and steps 5–7 were emulated. Key informants participated in telephone-based semi-structured interviews in November 2020, using a key informant interview guide. Participants were asked specific questions related to national health needs, proposed solutions, and prioritisation. The interviews were recorded and transcribed for analysis.ResultsEleven key informants identified the top five perceived health issues as human resource shortages, congestion and overcrowding, prevalence of diseases, poor referral system, and lack of diagnostic and case management skills. Solutions were proposed, some of which included: Telehealth (including telemedicine), health informatics, and elearning. Telemedicine solutions included: a health professional help desk, teleconsultations, and apps for specialist referral. eLearning solutions were training, mentoring, and continuing professional development.ConclusionA telemedicine-specific strategy, addressing the identified health issues and aligned to the existing national ehealth strategy, would provide the required focus to enable the development and deployment of telemedicine activities in the country.

Development of a conceptual framework for linking mHealth applications to eRecord systems in Botswana

BackgroundThe proliferation of mHealth solutions and eRecord systems is inevitable in developing countries, and ensuring their bi-directional interoperability is essential. Interoperability has been described as the ability for two or more systems or components to exchange information and use the information that has been exchanged. Given the importance of linking mHealth solutions to eRecord systems in the developing world, a suitable interoperability framework is required to provide an agreed approach to interoperability and specify common elements. Although eHealth interoperability frameworks exist in the literature, none meet all the requirements for linking mHealth solutions to eRecord systems in developing countries. The aim of this paper was to describe the design and development of a conceptual framework for linking mHealth solutions to eRecord systems in Botswana, as an exemplar.MethodsAn iterative and reflective process was adopted, supported by existing literature and research including consultations with eHealth experts, and guidance from existing frameworks. These collectively identified key elements, concepts, and standards relevant and essential for framework design and development.ResultsThe mHealth-eRecord Interoperability Framework (mHeRIF) was developed which highlights the need for: governance and regulation of mHealth and eRecord systems, a national health information exchange, and which interoperability levels to achieve. Each of these are supported by integral themes and concepts. It also addresses the need for regular review, accreditation, and alignment of framework concepts and themes with a National eHealth Strategy Interoperability Development Process. To demonstrate the framework’s applicability, a proposed architecture for the Kgonafalo mobile telemedicine programme is presented.ConclusionInteroperable mHealth solutions and eRecords systems have the potential to strengthen health systems. This paper reports the design and development of an evidence-based mHeRIF to align with, build upon, and expand National eHealth Strategies by guiding the linking of mHealth solutions to eRecord systems in Botswana and other developing countries facing similar circumstances.

EHealth platforms as user–data communication: Examining patients’ struggles with digital health data

AbstractSundhed.dkis Denmark's national eHealth platform allowing citizens to access their personal health data. Based on 16 qualitative interviews with patients, our aim in this article is to examine how patients engage with their health data. First, we illustrate how patients struggle in different ways to make sense of numerical measurements and written notes. Second, we examine the platform as a communicative space and suggest that a new “medical-domestic” space arises in which medical data is interpreted and negotiated at home. Third, we investigate how health data affects patients’ experiences of being involved as equal partners and how access to data potentially enhances patient empowerment, but also how expectations are sometimes unfulfilled. In conclusion, we argue for a broader public dialogue in order to make sure that the data provided actually creates an optimal starting point and does not foster insecurity or self-doubt on the patient's side.

Interoperability opportunities and challenges in linking mhealth applications and eRecord systems: Botswana as an exemplar

BackgroundSignificant investments have been made towards the implementation of mHealth applications and eRecord systems globally. However, fragmentation of these technologies remains a big challenge, often unresolved in developing countries. In particular, evidence shows little consideration for linking mHealth applications and eRecord systems. Botswana is a typical developing country in sub-Saharan Africa that has explored mHealth applications, but the solutions are not interoperable with existing eRecord systems. This paper describes Botswana’s eRecord systems interoperability landscape and provides guidance for linking mHealth applications to eRecord systems, both for Botswana and for developing countries using Botswana as an exemplar. MethodsA survey and interviews of health ICT workers and a review of the Botswana National eHealth Strategy were completed. Perceived interoperability benefits, opportunities and challenges were charted and analysed, and future guidance derived.ResultsSurvey and interview responses showed the need for interoperable mHealth applications and eRecord systems within the health sector of Botswana and within the context of the National eHealth Strategy. However, the current Strategy does not address linking mHealth applications to eRecord systems. Across Botswana’s health sectors, global interoperability standards and Application Programming Interfaces are widely used, with some level of interoperability within, but not between, public and private facilities. Further, a mix of open source and commercial eRecord systems utilising relational database systems and similar data formats are supported. Challenges for linking mHealth applications and eRecord systems in Botswana were identified and categorised into themes which led to development of guidance to enhance the National eHealth Strategy.ConclusionInteroperability between mHealth applications and eRecord systems is needed and is feasible. Opportunities and challenges for linking mHealth applications to eRecord systems were identified, and future guidance stemming from this insight presented. Findings will aid Botswana, and other developing countries, in resolving the pervasive disconnect between mHealth applications and eRecord systems.

Data resource profile: Norwegian Databases for Drug Utilization and Pharmacoepidemiology

In this article we aim to give researchers and other users of drug utilization data a current overview of the twonationwide Norwegian drug databases located at the Norwegian Institute of Public Health (NIPH), withreference to some historical background. The first database, “The Norwegian Drug Wholesales Statistics”,dating back to 1974, provides total sale figures of all medicines on the market. The second database, “TheNorwegian Prescription Database” (NorPD), dates back to 2004 and covers prescription drugs dispensed bypharmacies. This database will be modernized during 2021 and renamed (“The Norwegian Prescribed DrugRegistry”, name not finally decided), and all historical data will be migrated to the modernized registry. In thefuture, the most valuable add-on to the modernized prescription database will be individual level data fromin-patients in hospitals and health care institutions, and the possibility to obtain aggregated data from eachinstitution. Together, the two nationwide databases will continue to be the cornerstones of drug utilization data in Norway and should be used more extensively to improve health to the best for individuals and society. Development in national e-health programs will play a key role in providing easier and less time-consuming access to data and improve conditions for linkage of drug data to other health registries in the near future.

Evaluation of a Digital Health Initiative in Illicit Substance Use: Cross-sectional Survey Study.

BackgroundThe Cracks in the Ice (CITI) community toolkit was developed to provide evidence-based, up-to-date information and resources about crystal methamphetamine to Australians. Given the high rates of internet use in the community and the potential for misinformation, CITI has the potential to play an important role in improving knowledge and challenging misconceptions surrounding crystal methamphetamine.ObjectiveThis study aims to determine (1) whether the CITI toolkit is achieving its aim of disseminating evidence-based information and resources to people who use crystal methamphetamine, their family and friends, health professionals, and the general community and (2) examine the association between the use of CITI and the knowledge and attitudes about crystal methamphetamine.MethodsA cross-sectional web-based survey, open to Australian residents (aged ≥18 years), was conducted from November 2018 to March 2019. People who had previously visited the website (referred to as “website visitors” in this study) and those who had not (“naïve”) were recruited. At baseline, knowledge, attitudes, and demographics were assessed. CITI website visitors then completed a series of site evaluation questions, including the System Usability Scale (SUS), and naïve participants were asked to undertake a guided site tour of a replicated version of the site before completing the evaluation questions and repeating knowledge and attitude scales.ResultsOf a total 2108 participants, 564 (26.7%) reported lifetime use of crystal methamphetamine, 434 (20.6%) were family/friends, 288 (13.7%) were health professionals, and 822 (38.9%) were community members. The average SUS score was 73.49 (SD 13.30), indicating good site usability. Health professionals reported significantly higher SUS scores than community members (P=.02) and people who used crystal methamphetamine (P<.001). Website visitors had significantly higher baseline knowledge than naïve participants (P<.001). Among naïve participants, knowledge scores increased following exposure to the website (mean 15.2, SE 0.05) compared to baseline (mean 14.4, SE 0.05; P<.001). The largest shifts in knowledge were observed for items related to prevalence, legal issues, and the effects of the drug. Stigmatizing attitude scores among the naïve group were significantly lower following exposure to CITI (mean 41.97, SE 0.21) compared to baseline (mean 44.3, SE 0.21; P<.001).ConclusionsThis study provides an innovative evaluation of a national eHealth resource. CITI is achieving its aim of disseminating evidence-based, nonstigmatizing, and useful information and resources about crystal methamphetamine to key end user groups and has received good usability scores across its target groups. Interaction with CITI led to immediate improvements in knowledge about crystal methamphetamine and a decrease in stigmatizing attitudes. CITI demonstrates the important role of digital information and support platforms for translating evidence into practice and improving knowledge and reducing stigma.

Nursing informatics competences of Finnish registered nurses after national educational initiatives: A cross-sectional study

BackgroundNursing informatics competences (ie. knowledge and skills in electronic and structured documentation) have become a necessary prerequisite for nurses to carry out their professional roles. Therefore, there is a global need to integrate nursing informatics into nursing curricula. In Finland, the requirements to increase nursing informatics education were noted in eHealth strategies in 2015. However, it is not known whether these educational initiatives have succeeded in increasing nursing informatics competences of recent nursing graduates. ObjectivesTo examine whether nurses who graduated after the Finnish educational initiatives have higher nursing informatics competences than nurses who graduated before the initiatives. Additionally, the associations of age, gender, work setting and geographical area with the nurses' informatics competences were examined. DesignCross-sectional study. SettingsThe study was carried out between October–December 2018 in Finland. ParticipantsRegistered nurses who graduated before (n = 931) and after (n = 712) the 2015 educational initiatives. MethodsNursing informatics competences were measured by four items: (1) terminology-based documentation, (2) patient-related digital work, (3) general IT competency and (4) electronic documentation according to structured national headings. The associations of the year of the graduation and demographic background variables with nurses' overall nursing informatics competence and also separately with four specific competence items were examined with analysis of covariance. ResultsNurses' graduation year was associated with their overall nursing informatics competence and the specific competence related to terminology-based documentation. Nurses who had graduated after the initiatives had higher competence than nurses with earlier graduation years. Associations were also found between age and work setting with the nursing informatics competences. Younger nurses and nurses working in specialised healthcare and elderly care had the highest competence. ConclusionsThe national eHealth strategies with educational initiatives seem to have affected favorably on nursing informatics education in Finnish nursing programs and have potentially led to increased nursing informatics competences of recent nursing graduates. The results of this study highlight the importance of educational policies stating the directions and objectives of education programs.

Behind passwords: An analysis of preliminary results in order to understand how users protect their privacy

Nowadays, the Internet is the most common source of information, it is the means of almost any activity, such as shopping, online banking, getting informed or keeping contacts. Users need to know privacy regulations, read privacy and cookie policies to protect themselves against illegal or unwanted data use. The answers obtained to our questionnaire have been analyzed and they prove our hypothesis that users’ privacy awareness is low, and highlight that users need a deeper education in privacy protection. In our questionnaire people were asked general questions, such as “Do you always read cookie policies?” or “Do you have deep knowledge of privacy regulations?”, and more specific questions, such as “Have you ever used the Hungarian National eHealth Infrastructure (EESZT)?” or “Do you know that Facebook plugins follow all your online activities?”.

Benefits, challenges, and contributors to success for national eHealth systems implementation: a scoping review.

Our scoping review aims to assess what legal, ethical, and socio-technical factors contribute to or inhibit the success of national eHealth system implementations. In addition, our review seeks to describe the characteristics and benefits of eHealth systems. We conducted a scoping review of literature published in English between January 2000 and 2020 using a keyword search on 5 databases: PubMed, Scopus, Web of Science, IEEEXplore, and ProQuest. After removal of duplicates, abstract screening, and full-text filtering, 86 articles were included from 8276 search results. We identified 17 stakeholder groups, 6 eHealth Systems areas, and 15 types of legal regimes and standards. In-depth textual analysis revealed challenges mainly in implementation, followed by ethico-legal and data-related aspects. Key factors influencing success include promoting trust of the system, ensuring wider acceptance among users, reconciling the system with legal requirements, and ensuring an adaptable technical platform. Results revealed support for decentralized implementations because they carry less implementation and engagement challenges than centralized ones. Simultaneously, due to decentralized systems' interoperability issues, federated implementations (with a set of national standards) might be preferable. This study identifies the primary socio-technical, legal, and ethical factors that challenge and contribute to the success of eHealth system implementations. This study also describes the complexities and characteristics of existing eHealth implementation programs, and suggests guidance for resolving the identified challenges.

Integration of Biobanks in National eHealth Ecosystems Facilitating Long-Term Longitudinal Clinical-Omics Studies and Citizens' Engagement in Research Through eHealthBioR.

Biobanks have long existed to support research activities with BBMRI-ERIC formed as a European research infrastructure supporting the coordination for biobanking with 20 country members and one international organization. Although the benefits of biobanks to the research community are well-established, the direct benefit to citizens is limited to the generic benefit of promoting future research. Furthermore, the advent of General Data Protection Regulation (GDPR) legislation raised a series of challenges for scientific research especially related to biobanking associate activities and longitudinal research studies. Electronic health record (EHR) registries have long existed in healthcare providers. In some countries, even at the national level, these record the state of the health of citizens through time for the purposes of healthcare and data portability between different providers. The potential of EHRs in research is great and has been demonstrated in many projects that have transformed EHR data into retrospective medical history information on participating subjects directly from their physician's collected records; many key challenges, however, remain. In this paper, we present a citizen-centric framework called eHealthBioR, which would enable biobanks to link to EHR systems, thus enabling not just retrospective but also lifelong prospective longitudinal studies of participating citizens. It will also ensure strict adherence to legal and ethical requirements, enabling greater control that encourages participation. Citizens would benefit from the real and direct control of their data and samples, utilizing technology, to empower them to make informed decisions about providing consent and practicing their rights related to the use of their data, as well as by having access to knowledge and data generated from samples they provided to biobanks. This is expected to motivate patient engagement in future research and even leads to participatory design methodologies with citizen/patient-centric designed studies. The development of platforms based on the eHealthBioR framework would need to overcome significant challenges. However, it would shift the burden of addressing these to experts in the field while providing solutions enabling in the long term the lower monetary and time cost of longitudinal studies coupled with the option of lifelong monitoring through EHRs.

HAKEEM E-SYSTEMS USABILITY IN JORDAN PUBLIC HOSPITALS: A CASE STUDY OF PRINCE HAMZA HOSPITAL

Information technology has become a major part in all sectors, especially medical services, as this technology provides great support for health care at all levels, the most important of which is electronic medical records, given the importance of medical information systems, Jordan recently launched a project Hakeem program for the purposes of developing the Jordanian medical sector to determine the importance of This program by exploring the relationship between its usability and the performance of the medical sector, and it was verified that there are statistically significant differences between two groups of Al-Hakim program users (residents and consultants / specialists) according to their initial training, age and gender in Prince Hamzah Hospital, where the questionnaire was manually distributed to a target sample formed From 83 doctors (resident, specialist/consultant) from various departments and specialties in Princess Hamzah Hospital, descriptive statistics were adopted, in addition to two independent samples T-test to describe the research sample and test the research hypotheses. The results showed that the independent variables of age and gender had a significant effect on the doctor's performance in Prince Hamzah Hospital, while the initial training did not show any significant effect on the doctor's performance using Hakeem. In view of this results increasing demand for the health information system in Jordan and with the presence of responsible and active parties, there is a need for administrators in the medical sector to pay attention to indicators of usability effectively in order to improve system performance and accountability so that the indicators can measure concepts related to the needs of specific actors and should not focus only To measure what is available or easy to measure in order to enhance the ability to understand and use a judicious system among clinicians primarily so that the use of data in performance is an integral part of clinical education and professional development now and in the future to ensure that performance indicators are clear, consistent and fit within the conceptual framework the chosen. Finally, since the Hakeem program is a national e-health program, this type of study should be carried out not only in one site in Prince Hamzah Hospital, so for future studies it should be conducted in multiple facilities to enrich the result.

EHealth Patient Portal - Becoming an Indispensable Public Health Tool in the Time of Covid-19.

Patient Portal represents a connecting service for the Slovenian eHealth solutions and enables patients with effective and secure access to their medical documentation. Ever since its national roll-out in 2017 the number of visits of the Patient Portal has been constantly growing, however, during the time of Covid-19, the number of visits has increased dramatically to reach almost 1.9 million visits in 2020. This article initially presents the functionalities of the Patient Portal and the dynamics of the visits to the Patient Portal in the time of Covid-19. In the second part, the article outlines the most significant benefits to healthcare stakeholders provided by the Patient Portal in the period of Covid-19. The study applies a focus group methodology. Structured focus group discussions were carried out with prominent experts, who are in charge of the Patient Portal and other national eHealth solutions in Slovenia. Research results indicate that the Patient Portal has attracted enormous interest and has become one of the essential public health tools empowering patients and supporting the enactment of public health policies and measures during the Covid-19 crisis.

Health literacy and cancer screening behaviors among community-dwelling female adults in Taiwan

ABSTRACT This study was designed to explore the association among health literacy and cancer screening behaviors in Taiwanese females. A total of 353 community-dwelling females were recruited in this cross-sectional study from February to October 2015. Demographic, socioeconomic and personal behavior variables including physical activity, community activity, smoking, alcohol consumption, and betel nut chewing were recorded. Health literacy was evaluated using the Mandarin version of the European Health Literacy Survey Questionnaire. Data on screening behaviors for cervical, breast and colorectal cancers were confirmed by the Taiwanese National eHealth Database. Most respondents with inadequate or problematic general health literacy had no or irregular screening behaviors for cervical, breast and colorectal cancers. In multivariable regression analysis, women with inadequate health literacy were at a greater risk (Odds ratio = 5.71; 95% CI: 1.40–23.26) of having no previous Pap smear screening or >3 years screening interval regardless of education level. However, this association was not detected for breast or colorectal cancer. Women with inadequate health literacy were more likely to have irregular cervical cancer screening, however no associations among health literacy and breast or colorectal cancer were detected. The impact of health literacy on cancer screening behavior warrants further attention and research.

‘To be on the safe side’: a qualitative study regarding users’ beliefs and experiences of internet-based self-sampling for Chlamydia trachomatis and Neisseria gonorrhoeae testing

ObjectivesIn Sweden, an increasing number of tests for sexually transmitted infections are conducted. Self-sampling services are provided free of charge at the national eHealth website. Our aim was to obtain...

Applying eHealth for Pandemic Management in Saudi Arabia in the Context of COVID-19: Survey Study and Framework Proposal.

BackgroundThe increased frequency of epidemics such as Middle East respiratory syndrome, severe acute respiratory syndrome, Ebola virus, and Zika virus has created stress on health care management and operations as well as on relevant stakeholders. In addition, the recent COVID-19 outbreak has been creating challenges for various countries and their respective health care organizations in managing and controlling the pandemic. One of the most important observations during the recent outbreak is the lack of effective eHealth frameworks for managing and controlling pandemics.ObjectiveThe aims of this study are to review the current National eHealth Strategy of Saudi Arabia and to propose an integrated eHealth framework that can be effective for managing health care operations and services during pandemics.MethodsA questionnaire-based survey was administered to 316 health care professionals to review the current national eHealth framework of Saudi Arabia and identify the objectives, factors, and components that are key for managing and controlling pandemics. Purposive sampling was used to collect responses from diverse experts, including physicians, technical experts, nurses, administrative experts, and pharmacists. The survey was administered at five hospitals in Saudi Arabia by forwarding the survey link using a web-based portal. A sample population of 350 was achieved, which was filtered to exclude incomplete and ineligible samples, giving a sample of 316 participants.ResultsOf the 316 participants, 187 (59.2%) found the current eHealth framework to be ineffective, and more than 50% of the total participants stated that the framework lacked some essential components and objectives. Additional components and objectives focusing on using eHealth for managing information, creating awareness, increasing accessibility and reachability, promoting self-management and self-collaboration, promoting electronic services, and extensive stakeholder engagement were considered to be the most important factors by more than 80% of the total participants.ConclusionsManaging pandemics requires an effective and efficient eHealth framework that can be used to manage various health care services by integrating different eHealth components and collaborating with all stakeholders.

Information and Communication Technology Recommendations for the Further Development of a Robust National e-Health Strategy for Epidemics and Pandemics

This paper aims to provide recommendations for information and communication technology strategy that can support government actions to overcome epidemics and pandemics in Indonesia. The method used in this research is a qualitative approach by conducting a narrative review and discussion with four experts in the field of information and communication technology. The results of this study are recommendations related to people, process, technology, and data. The recommendations are inspired by the success of Internet in establishing public and private collaboration. This research is intended to assist the government in formulating information and communication technology policies to support government and health organization actions to overcome epidemics and pandemics.

Adoption of a Personal Health Record in the Digital Age: Cross-Sectional Study.

BackgroundAs health care organizations strive to improve health care access, quality, and costs, they have implemented patient-facing eHealth technologies such as personal health records to better engage patients in the management of their health. In the Kingdom of Saudi Arabia, eHealth is also growing in accordance with Vision 2030 and its National Transformation Program framework, creating a roadmap for increased quality and efficiency of the health care system and supporting the goal of patient-centered care.ObjectiveThe aim of this study was to investigate the adoption of the personal health record of the Ministry of National Guard Health Affairs (MNGHA Care).MethodsA cross-sectional survey was conducted in adults visiting outpatient clinics in hospitals at the Ministry of National Guard Health Affairs hospitals in Riyadh, Jeddah, Dammam, Madinah, and Al Ahsa, and primary health care clinics in Riyadh and Qassim. The main outcome measure was self-reported use of MNGHA Care.ResultsIn the sample of 546 adult patients, 383 (70.1%) reported being users of MNGHA Care. MNGHA Care users were more likely to be younger (P<.001), high school or university educated (P<.001), employed (P<.001), have a chronic condition (P=.046), use the internet to search for health-related information (P<.001), and use health apps on their mobile phones (P<.001).ConclusionsThe results of this study show that there is substantial interest for the use of MNGHA Care personal health record with 70% of participants self-reporting use. To confirm these findings, objective data from the portal usage logs are needed. Maximizing the potential of MNGHA Care supports patient engagement and is aligned with the national eHealth initiative to encourage the use of technology for high-quality, accessible patient-centered care. Future research should include health care provider perspectives, incorporate objective data, employ a mixed-methods approach, and use a theoretical framework.