Complementi di Informatica Medica a.a JunHua Li and Pradeep Ray - University of New South Wales, Sydney, Australia

Transcription

1 Complementi di Informatica Medica a.a

2 Healthcare services are increasingly needed by people and should be efficiently provided and made fully accessible to all E-Health (healthcare based on the Internet technologies) promises to overcome problems in traditional (i.e. paper-based) healthcare.

3 Electronic Health Record (EHR) systems, for example can partially address some of these problems Ex: limited access and sharing of patient records inefficient documentation, Incomplete health records Nevertheless, EHR implementation is still a big problem as evidenced by the low rate of adoption of EHR

4 It s a way of identifying the potential causes of failure to innovate development of an assessment methodology at the pre-implementation stage of EHR systems so as to assess the status of E-Health readiness.

5 1. Identify key components for E-Health readiness assessment and develop an E- Health readiness assessment framework 2. Develop a process of E-Health readiness assessment 3. Develop a tool facilitating the assessment process.

6 Many frameworks has been reviewed. They were derived from different perspectives to evaluate E-Health readiness. E- health evaluation may serve different purposes for different stakeholders, and therefore concede that no single evaluation framework or methodology is totally objective

7 In order to investigate providers view (e.g. physicians, nurses and administrative personnel) for the readiness evaluation of E-Health applications, Campbell et al. (2001) developed a readiness framework by conducting semi-structured interviews (regarding both the video and computer components of telemedicine). Results of thematic analysis reveal five themes: Efficacy, Practice context, Apprehension, Time to learn, Ownership. The mechanism does not involve organisational, public or patient readiness for E-Health.

8 By contrast, the readiness framework from Jennett et al. (2003; 2004; 2005) is relatively comprehensive in terms of the evaluation scope. Sixteen semi-structured telephone interviews to four sets of stakeholders (patient, practitioner, organisation and public) were conducted to examine complex social, political, organisational and infrastructure factors. As a result, three types of readiness were found: Engagement, Structural readiness, and Concern of non-readiness.

9 Integrated E-Health Readiness Assessment Framework (EHRAF) makes an assumption that a typical EHR system will be fully implemented. It includes four main readiness components: core engagement technological societal readiness

10 Core readiness assessment is concerned about patient records generation, storage and retrieval with paper-based health record systems. In particular, it involves documentation efficiency of patient records, patient privacy, and the degree of physicians satisfaction with completeness and accuracy of patient records and of sharing patient records.

11 Core readiness assessment result determined by the variables 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

12 The assessment process has been developed to highlight the reiteration of assessing E- Health readiness, i.e., once the readiness assessment is done and then the organisation takes action to improve the deficiencies, the next readiness assessment can be conducted

13

14 A set of hierarchical evaluation criteria has been developed The criteria include those that have been raised in the literature

15 This is followed by the definition of each evaluation parameter

16 Subsequently, a questionnaire is designed for interviews with groups of healthcare practitioners (including doctors, nurses, administration officers, IT technicians and any other stakeholders) in order to determine significant parameters. Statistical analysis (e.g. cross tabulation tests, statistically significant correlations) is undertaken to assess the current E-Health readiness status of the given context.

17 This paper has discussed the development of the Ehealth 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 the perspectives of E-Health service and organisations.