Didattica Cif 35 b Valutazione Sistemi E-Health

8/3/2019 Didattica Cif 35 b Valutazione Sistemi E-Health

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Complementi di Informatica Medica a.a. 2009-2010

JunHua Li and Pradeep Ray - University of New South Wales, Sydney, Australia


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Healthcare services are increasingly neededby people and should be efficiently provided

and made fully accessible to all E-Health (healthcare based on the Internet

technologies) promises to overcomeproblems in traditional (i.e. paper-based)healthcare.


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Electronic Health Record (EHR) systems, forexample can partially address some of theseproblems

Ex:

limited access and sharing of patient records inefficient documentation, Incomplete health records

Nevertheless, EHR implementation is still a bigproblem as evidenced by the low rate ofadoption of EHR



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Its a way of identifying the potential causes offailure to innovate

development of an assessment methodologyat the pre-implementation stage of EHRsystems so as to assess the status of E-Healthreadiness.



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1. Identify key components for E-Healthreadiness assessment and develop an E-

Health readiness assessment framework

2. Develop a process of E-Health readinessassessment

3. Develop a tool facilitating the assessmentprocess.



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Many frameworks has been reviewed. They were derived from different

perspectives to evaluate E-Health readiness.


E- health evaluation may serve different purposes for differentstakeholders, and therefore concede that no single evaluationframework or methodology is totally objective


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In order to investigate providers view (e.g. physicians,nurses and administrative personnel) for the readinessevaluation of E-Health applications, Campbell et al.(2001) developed a readiness framework byconducting semi-structured interviews (regardingboth the video and computer components oftelemedicine).

Results of thematic analysis reveal five themes:Efficacy, Practice context, Apprehension, Time tolearn, Ownership.The mechanism does not involve organisational,public or patient readiness for E-Health.



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By contrast, the readiness framework from Jennett et al.(2003; 2004; 2005) is relatively comprehensive in terms ofthe evaluation scope.

Sixteen semi-structured telephone interviews to four setsof stakeholders (patient, practitioner, organisation andpublic) were conducted to examine complex social,political, organisational and infrastructure factors.

As a result, three types of readiness were found:Engagement, Structural readiness, and Concernof non-readiness.



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Integrated E-Health Readiness AssessmentFramework (EHRAF) makes an assumption

that a typical EHR system will be fullyimplemented. It includes four main readiness components:

coreengagementtechnologicalsocietal readiness



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Core readiness assessment is concernedabout patient records generation, storage

and retrieval with paper-based health recordsystems. In particular, it involves documentation

efficiency of patient records, patient privacy,and the degree of physicians satisfactionwith completeness and accuracy of patientrecords and of sharing patient records.



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Core readiness assessment result determined by thevariables

V(ED): efficient documentation of patient records V(PP): protected patient privacy V(CA): satisfaction of completeness and accuracy V(SR): as well as of sharing patient records



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The assessment process has been developedto highlight the reiteration of assessing E-

Health readiness, i.e., once the readinessassessment is done and then the organisationtakes action to improve the deficiencies, thenext readiness assessment can be conducted



13/17JunHua Li and Pradeep Ray - University of New South Wales, Sydney, Australia


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A set of hierarchical evaluation criteriahas been developed

The criteria include those that have beenraised in the literature



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This is followed by the definition of eachevaluation parameter



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Subsequently, a questionnaire is designed forinterviews with groups of healthcarepractitioners (including doctors, nurses,administration officers, IT technicians andany other stakeholders) in order to determinesignificant parameters.

Statistical analysis (e.g. cross tabulationtests, statistically significant correlations) isundertaken to assess the current E-Healthreadiness status of the given context.



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This paper has discussed the development of theEhealth Readiness Assessment Methodology(EHRAM) that involved:

a new E-Health readiness assessment framework(EHRAF),

a process for the readiness assessment, And a toolset for the readiness assessment (EHRAT).

EHRAM deals with a number of factors from theperspectives of E-Health service and organisations.


Didattica Cif 35 b Valutazione Sistemi E-Health

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