E-Health and its impact on Stakeholders

For the final post on this blog I would like to finish on a positive note. The World Health Organisation have listed all the benefits of E-Health and so this week I will focus on what these advances mean for the stakeholders. This information was gathered from the Irish Department of Health’s publication: eHealth strategy for Ireland.

The first and largest stakeholder group, the patients and citizens are impacted most significantly by the e-health enabling personalised, preventative and proactive care throughout the health system and across their lifespan. The patient, therefore, is more empowered to manage their own health course. There are however many other ways in which citizens will benefit from eHealth. As patients/citizens interact with the healthcare system, healthcare providers will know who they are and have access to relevant details of their health information. Patients will have the ability to access their own health records which also is another step in empowering them. As more accredited sources of health information becomes accessible to citizens via the web 2.0, people will be better able to manage and learn how to improve their health. As data on patients becomes digitalised and protected by highly secure databases, people will have more confidence in the maintained confidentiality of their information. Focus will be shifted to prevention due to the education of patients and self-management plans. Another very important advance especially to rural patients is that care can be distributed to those areas as the relevant knowledge can be accessed by anyone nearby. This eradicates the previous distance problem. These bountiful gains for the patient/ citizen pleases me greatly as they are often the last stakeholder to be taken into consideration when implementing changes(Department of Health, 2015)

For care providers, three main benefits are provided. Firstly, like patients, they benefit from the ease of self-education brought about by the information and course now available online. This also ensures that the most up to date and advanced knowledge is available to them. Secondly, communication between patient and care giver is vastly improved due to the ease in which the internet enables communication in a multitude of different forms. Finally, care providers can speedily receive a professional second opinion or consultation no matter how remote the location and due to the high level of communication available to them and the now existing professional networks. (Department of Health, 2015)

For healthcare management, several extremely important advances are made. E- Health monitors quality and safety which improves care processes and reduces the possibility of medical errors. It allows transparency of delivery system and enables budget, pricing, billing, claims and resource management systems. Mobility of citizens and their medical records are greatly assisted meaning that patient information is available immediately when and where it is needed. New opportunities in basic and applied research are feasible. More reliable, responsive and timely reporting on public health will occur which is imperative as health becomes increasingly central to economy, security, foreign affairs and international relationships. Technology advances make it more possible to identify disease and risk factor trends, to analyses demographic, social and health data. (Department of Health, 2015)

To the business and economy, E- Health also brings opportunity. Investment in eHealth brings new markets and encourages business start-up and entrepreneurial activities which are imminently exportable once developed. Development and innovation of eHealth services will lead to extensive research and development and product opportunities. (Department of Health, 2015)

This is just the dawn of the the shift in Healthcare towards a more technology shifted system and already the prosperity is evident or at least very soon will be. 10 years down the line we can be sure that advances will have been made that we couldn’t even have dreamt of today.

 

Bibliography

Department of Health, (2015). ehealth strategy for ireland. Dublin: Department of Health.

The impact of Smartphones on our health

This blog has mainly focused on the positive impacts of technology and IT on healthcare. This week however, I would like to look more closely at some of the more negative impacts brought about by the vast increase of technology in our day to day lives.

More specifically I would like to focus my attention on smartphones, beginning with the anxiety, stress and sometimes depression that they are responsible for. From research I have found that I am not alone in my experiences of anxiety from not checking my phone, panic when I can’t find it or when the battery dies. There is in fact a term coined to describe exactly that, namely FIMO or fear of missing out. However, the anxiety does not disappear when the phone is in hand and notifications are checked. The FIMO is replaced by needing to reply to messages and notification immediately or else feelings of inadequacy from not being able to replicate the “far superior more exciting” lives of others that are depicted by their social media accounts.

Dr. David Shanley, an anxiety specialist (Dr. David Shanley, 2015), states that

“People feel compelled to check their phone constantly, which can then lead to disappointment when there are no new messages, and increased stress about why no one is messaging them, or when the next message might come”

It is ironic that social media sites which were original joined for fun and relaxation have now become a huge source of stress for us. The stress levels are relatively small. They could be over something insignificant like how many “likes” or comments a post or photo gets, or why someone hasn’t replied to a message. However, while the stress dosage isn’t high, it is constant, from the minute we wake to the moment we go to sleep, we are constantly connected, and constantly have low levels of stress.

While on the topic of sleep. It is common knowledge that the blue light emitted by phones, prevents the brain from producing the hormone Melatonin, crucial to inducing sleep. The negative impacts of sleep deprivation are boundless but certainly contribute to increase anxiety and stress levels. The light emitted by phones however, may also have some other negative impacts on our health. There exists some evidence that the light may also be damaging our retina over time and possibly may lead to Cataracts. However, this research is in its early stage as this is a relatively recent phenomenon, the data set is quite limited. (body, 2015)

Radiation emissions from smartphones are also questionable. While there is no concrete data to prove that this is going to be a major factor in the future, it’s hard not to worry as already stated, the impacts are still unknown as phones are too recent an addition to our lives to have legitimate answers to our concerns.

Phone usage in bathrooms is another area of concern. Marketing firm 11Mark surveyed 1,000 Americans and found that three-fourths of the participants admitted to using their smartphones in the bathroom. One-quarter of the respondents said they never go into the bathroom without their phone (Jr, 2015). This habit is a very obvious health hazard, as bathrooms are generally germ saturated environments. You’ll wash your hands but not your phone!

Unfortunately, this is just a tiny area and example of some of the negative impacts of technology on our health. However, that being said, I cannot stress how much the positives outweigh the negatives in this particular field.

Bibliography

Jr, J. (2015). Smartphone Owners Prone to Using their Devices in the Bathroom. [online] PCWorld. Available at: http://www.pcworld.com/article/249022/smartphone_owners_prone_to_using_their_devices_in_the_bathroom.html [Accessed 13 Dec. 2015].

Dr. David Shanley, (2015). Technology and Anxiety and Stress – Dr. David Shanley. [online] Available at: http://drdavidshanley.com/technology-anxiety-stress/ [Accessed 13 Dec. 2015].

body, H. (2015). How smartphone light affects your brain and body. [online] Tech Insider. Available at: http://www.techinsider.io/how-smartphone-light-affects-your-brain-and-body-2015-9 [Accessed 13 Dec. 2015].

The Technology Acceptance Model

The Technology Acceptance Model (TAM) is something I came across recently. A study done in the healthcare field using both this model and its revision yielded something interesting results. The model was first developed by Davis F D ^[2] to in IBM to assess their acceptance of new software (Ketikidis et al., 2012)

It is a basic model which has three core predictor tools in its original model, namely Perceived usefulness (PU), Perceived Ease of Use (PEOU) and Attitude. These 3 factors were seen to be the strongest predictors of whether a new technology would be accepted and used or not. However, Davis in collaboration with Venkatish ^[1] then revised the model in 2000 which excluded attitude as a variable but kept the other 2 as they proved to be strong drivers of intentions to use technology. The revision of TAM, TAM 2 saw the addition of the provisions Subjective Norms, Image, Job Relevance, Output Quality and Results Demonstrability. These were all deemed important factors which heavily influenced the original PU and PEOU components.

So why is this all so important? Berg M stated that “The implementation of comprehensive information systems in health care practices has proved to be a path ridden with risks and dangers. It has become evident that there are many more failure stories to tell than there are success stories—and the more comprehensive the technology, or the wider the span of the implementation, the more difficult it appears to achieve success […] whether an information system is ‘successful’ or not is decided on the work floor”. In short, the technology can have flawless design and be as multi-faceted and innovative as it likes but unless a system is accepted and effectively used, it is doomed to failure. (Ketikidis et al., 2012)

 

So did results of the studies support the models?

 

The results of the studies made it clear that while all the factors of the model would in fact have an impact on the acceptance and use of IT in healthcare, some were much more significant than others.

Ironically, perceived ease of use and not actually usefulness itself more significantly predicted health IT usage intentions. This finding has interesting implications for policy-makers and Health IT system designers, because it shows that information about the effective use of Health IT systems, development user-friendly application, and the provision of hands-on workshops to enhance familiarity and competence skills among potential users of Health IT systems can bring changes to perceived ease of use, and in turn, lead to higher acceptance. (Ketikidis et al., 2012)

 

The effect of job relevance was also significant, showing that the more healthcare professionals know about the applicability of Health IT systems on their daily work routines, the more likely they are to accept those systems. This finding shows that prior to the implementation of Health IT systems in the healthcare setting, it is advisable to educate potential end-users about the applicability of the systems to their work. This may include information about how the tasks can become easier, or how the workload can be reduced or become more manageable. (Ketikidis et al., 2012)

 

Strikingly, subjective (perceived acceptance and approval of Health IT by others) but not descriptive (perceived prevalence of Health IT acceptance by others) norms predicted usage intentions with more exactitude.

To conclude, I feel that the TAM 2 model gives a greater understanding of the necessary steps in ensuring that new technologies and more infusion of IS in healthcare are accepted and exploited.

 

References

[1] Venkatesh V, Davis F D. A theoretical extension of the Technology Acceptance Model: four

longitudinal field studies. Management Science 2000; 46: 186-204.

 

[2] Davis F D. Perceived usefulness, perceived ease of use, and user acceptance of information

technology. MIS Quarterly 1989;13:319–39.

 

Bibliography: Ketikidis, P., Dimitrovski, T., Lazuras, L. and Bath, P. (2012). Acceptance of health information technology in health professionals: An application of the revised technology acceptance model. Health Informatics Journal, 18(2), pp.124-134.

 

If IS is such an asset to healthcare, why and who is resisting it?

The topic I want to look at this week is that if technology is so beneficial to healthcare, why is it in some cases and areas being resisted? Who is resisted and why? In researching this particular area I found that the industry may not specifically be resisting technology, it is just an industry which is exceptionally resistant and slow to change. A particular Forbes article captured the reasons behind this well.

One of the predominant reasons, the article states and that I have to agree with, is the risk-adverse culture. Physicians are trained extremely early in their careers not to make decisions or changes without data and proof to back it up. This is completely understandable due to the fact that they are responsible for people’s lives, however, “This conservative culture affected doctors’ willingness to try not only new drugs and treatments but also new administrative procedures and educational methods.”(Forbes.com, 2015)  Physicians are slow or unenthusiastic about introducing or trying out new things in their jobs. This seriously hinders the acceptance of technology use within the industry, as without their collaboration, the full profit of IT cannot be realized.

Another substantial point made by the article was that the healthcare industry is already a vast trillion dollar industry with a huge work force and billions of dollars of “sunk cost” investments have been made in facilities and infrastructure. This serves to cause resistance in the industry as these previous successes have a strong gravitational pull, and subvert the desire to develop or use innovative approaches to render change (Forbes.com, 2015). There is financial attachment to old models which inhibits innovation or colossal, rapid changes.

A third point made by the article is where the innovation in healthcare has actually been. There has been a lot of development around the actual tools used in healthcare and technology use in the industry has certainly increased. However, the innovation and changes around the actual processes of healthcare, the powerful use of information systems has been largely ignored in comparison.

An article published in the European Journal of Information Systems goes on to claim that Physicians found it took too much out of their working day to input everything onto software “complaining that the system was too great a distraction from their medical duties” (Bhattacherjee and Hikmet, 2007). It seems to me that perhaps that merely introducing and training those on the ground level how to use IS isn’t enough. They can know how to use and the software but until they are fully convinced of its benefits and are educated by research and shown results of its use, they will never really get on board fully. Without their full devotion, the system will lack comprehensiveness. Without comprehensiveness, IS lacks usefulness and without its usefulness, the users will stop using it. Basically, without getting all users on board the system will spiral into becoming a hindrance as opposed to massive asset.

Forbes.com, (2015). Forbes Welcome. [online] Available at: http://www.forbes.com/sites/roysmythe/2014/02/24/why-changing-health-care-is-hard/ [Accessed 3 Nov. 2015].

Bhattacherjee, A. and Hikmet, N. (2007). Physicians’ resistance toward healthcare information technology: a theoretical model and empirical test. European Journal of Information Systems, 16(6), pp.725-737.

The jobs of those introducing augmented use of technology in the healthcare industry

Often we talk about how IS is dramatically changing healthcare, but does anyone really know the actual jobs of the people bringing about change? The main issue is filling in the gaps. There’s no good in having a group of people who have a vast and in depth knowledge of the human anatomy, every illness in the world but who knows next to nothing about technology and its capabilities. Likewise, the most talented software engineer can be of no use to the healthcare industry without a thorough understanding of it. It’s this gap in knowledge that needs to be filled. While the 2 are experts in their relative fields, they cannot bring about the fruitful advances that technology can bring without comprehensive collaboration and sharing of intellect capital.

So who are the people who are bridging this gap?

First up is the Clinical Applications Analyst. These individuals will have a strong clinical background and work to improve workflows using their unique experience, whether it’s on the revenue side or in the operating room. Clinical application analysts work as a liaison of sorts between patient care and clinical technologies. They help to design, implement, maintain and train to support clinical and/or business systems. (Hein, 2015)

“These are people who are able to manage what the transformation of those work processes need to do. They are the lingo bridge, the flow bridge, the translation bridge and they are the lexicon bridge between clinical workflow and application functionality,” says Randy Gaboriault, Christiana Care Health System.

Clinical Informatics. These are people who help us look at the data and information and how we use that information. As you might expect, hospitals collect an enormous amount of data and someone needs to be able to make that data useful.  “The whole goal of meaningful use is to have improved health outcomes. They [clinical informatics] identify trends and then apply the data to real-life scenarios, “says Liann Brobst a national healthcare IT recruiter with Modis.  (Hein, 2015)

ICD-10 Conversion Project Manager. ICD stands for International Classification of Diseases. These project managers are overseeing the conversion from ICD-9 to ICD-10. They are experienced software developers and so will be in charge of the update. ICD-10 deals with all the necessary encoding of data that goes on in the hospital

ICD-10 Testing Coordinators/Coders.  These will responsible for the increase of the 4,000 codes for diagnosis and procedure in ICD-9 to the 70,000 of ICD-10.

HL7/Interface Analyst/ Developer. HL7 is a non-profit organization that provides a common standard for all healthcare organizations to use to make sure every system implemented can talk to every other system. “It focuses on connecting one health system to another. (Hein, 2015)

Meaningful Use Business Analyst. Legislation surrounding the use of electronic medical data means that certain rules have to be obeyed, especially to receive funding and government incentives. These analysts will make sure that the required functionality is met.

Lastly is the Clinical Application Trainers. These are HIT pros that work with analysts and end-users to walk them through the applications they will use. They work both in the classroom and side-by-side with nurses and doctors. This is a vital job to ensuring that new technologies are being used and to their maximum value

Bibliography: Hein, R. (2015). 7 Healthcare IT Roles That Are Transforming Tech Careers. [online] CIO. Available at: http://www.cio.com/article/2385786/it-strategy/7-healthcare-it-roles-that-are-transforming-tech-careers.html [Accessed 28 Oct. 2015].

The undeniable benefits that technology brings to the healthcare industry are not without their challenges

Perhaps the biggest change that technology is bringing to the healthcare industry is the ease in which information can be captured and shared. People’s health can now be monitored invariably by the smallest devices and the data converted into meaningful information by software gives “individual patients greater oversight and control over their own health while also revealing population-wide trends of great value to scientists and policy makers”. (Financial Times, 2015)

For example, Google, in coordination with Swiss company Novartis, are currently developing a contact lens equipped with a hair width sized transmitter to monitor glucose levels by analysing tear fluid. (Financial Times, 2015)

The benefits and potential of such technologies are blatant and their conception has only just begun. Sir John Chisholm, executive chairman of Genomics England stated that “The digital revolution has already swept through other industries and now it is starting in healthcare” (Financial Times, 2015)

More significantly to Ireland where cases of depression, anxiety and suicide are disturbingly high, software is being developed to aid those who suffer from such turmoil. Lyra Health is a prime example. They vow to provide analytics and screening tools to identify people who can benefit from mental health care, match patients to the right providers and treatments for their unique needs and preferences, track outcomes and share analyses with patients and providers (Lyra Health, 2015)

Simon Hammett, head of healthcare and life sciences for Deloitte in the UK sates that technology advances in healthcare will reduce avoidable costs, transform patient monitoring, integrate services, increase productivity and improve outcomes (Financial Times, 2015) but more significantly the vast improvement management of long-term chronic care made possible by technology will be crucial in keeping people out of hospitals, an issue very relevant to Ireland where hospitals bedding difficulties are insuppressible.

The integration of technology into the health industry is not without its challenges. While it is an industry still very much behind others in the use of technology and one which would benefit hugely from it, there are many hurdles to overcome before it can really become of irrefutable value.

The first and probably the most obvious is that of security. Data collected related to health is often very confidential. People need to have complete thrust in the security of the software and database before allowing meaningful details to be stored about them. Simon Hammett (head of healthcare and life sciences for Deloitte in the UK) insists that if people can see the benefits, they will eventually warm to the more frequent use of technology in the industry. (Financial Times, 2015)

The second big challenge is the severe lack of standardisation of healthcare data. (Harvard Business Review, 2014) Data is being collected by so many different companies in so many different ways which makes it very difficult to use computers for analyses. The lack of cooperation between public and private healthcare globally is going to greatly impede the speed and potential of technologies assistance to the industry. The data collecting community in healthcare described as heterogeneous and so its extraction and integration will involve much collaboration. (Harvard Business Review, 2014) this huge task has already begun and is already yielding very positive results. Since no human can analyse, monitor and identify patterns from huge databases with anyway near the agility and precision of computers, healthcare’s inevitable reliance and benefit from technology in years to come will become conspicuous.

Bibliography

Lyra Health, (2015). New Home. [online] Available at: http://www.lyrahealth.com/#our_impact [Accessed 18 Oct. 2015].

Harvard Business Review, (2014). Why Health Care May Finally Be Ready for Big Data. [online] Available at: https://hbr.org/2014/12/why-health-care-may-finally-be-ready-for-big-data [Accessed 19 Oct. 2015].

Financial Times, (2015). Society stands to be winner in the race for digital health – FT.com. [online] Available at: http://www.ft.com/intl/cms/s/0/51e7e792-e1ca-11e4-bb7f-00144feab7de.html#axzz3ox2fNN6j [Accessed 18 Oct. 2015].