e-Health preparedness assessment in the context of an influenza pandemic: a qualitative study in China

BMJ Open - Tập 3 Số 3 - Trang e002293 - 2013
Junhua Li1,2, Holly Seale2, Pradeep Ray1, Quanyi Wang3, Peng Yang3, Shuang Li3, Yi Zhang3, C. Raina MacIntyre4,2
1Asia-Pacific ubiquitous Healthcare research Centre (APuHC), Australian School of Business, The University of New South Wales, Sydney, New South Wales, Australia
2School of Public Health and Community Medicine, Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia
3Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control (CDC), Beijing, China
4National Centre for Immunization Research and Surveillance of Vaccine Preventable Diseases (NCIRS), The Children's Hospital at Westmead, Sydney, New South Wales, Australia

Tóm tắt

ObjectiveTo assess the preparedness status of a hospital in Beijing, China for implementation of an e-Health system in the context of a pandemic response.DesignThis research project used qualitative methods and involved two phases: (1) group interviews were conducted with key stakeholders to examine how the surveillance system worked with information and communication technology (ICT) support in Beijing, the results of which provided background information for a case study at the second phase and (2) individual interviews were conducted in order to gather a rich data set in relation to e-Health preparedness at the selected hospital.SettingIn phase 1, group interviews were conducted at Centres for Disease Prevention and Control (CDC) in Beijing. In phase 2, individual interviews were performed at a secondary hospital selected for the case study.ParticipantsIn phase 1, three group interviews were undertaken with 12 key stakeholders (public health/medical practitioners from the Beijing city CDC, two district CDCs and a tertiary hospital) who were involved in the 2009 influenza A (H1N1) pandemic response in Beijing. In phase 2, individual interviews were conducted with 23 participants (including physicians across medical departments, an IT manager and a general administrative officer).Primary and secondary measuresFor the case study, five areas were examined to assess the hospital's preparedness for implementation of an e-Health system in the context of a pandemic response: (1) motivational forces for change; (2) healthcare providers’ exposure to e-Health; (3) technological preparedness; (4) organisational non-technical ability to support a clinical ICT innovation and (5) sociocultural issues at the organisation in association with e-Health implementation and a pandemic response.ResultsThis article reports a small subset of the case study results from which major issues were identified under three main themes in relation to the hospital's preparedness. These issues include a poor sharing of patient health records, prescription errors, unavailability of software tools to assist physicians in answering patient questions, physicians’ concerns about the reliability of ICT and the high monetary cost of e-health implementation and uncertainty over return on investment, and their dissatisfaction with the software in use.ConclusionsPrior to the implementation of e-Health, planning must be undertaken to ensure the smooth introduction of the system. The assessment of organisational preparedness is an important step in this planning process. On the basis of a case study, deficient areas of organisational preparedness were identified for the prospective implementation of electronic health records. Accordingly, we suggested possible solutions for the areas in need of improvement to facilitate e-Health implementation's success.

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Tài liệu tham khảo

WHO. Informal consultation on influenza pandemic preparedness in countries with limited resources. [Internet]: http://www.who.int/csr/resources/publications/influenza/CDS_CSR_GIP_2004_1.pdf (accessed 7 May 2009)

WHO. eHealth. [Internet] http://www.who.int/topics/ehealth/en/ (accessed 14 Jan 2010).

Li J Moore N Akter S . mHealth for Influenza Pandemic Surveillance in Developing Countries. The 43 Hawaii International Conference on System Sciences (HICSS), 5–8 January 2010, HI, USA.

Li J Ray P . Applications of e-Health for Pandemic Management. IEEE 12th International Conference on e-Health Networking, Application & Services, 1–3 July 2010, Lyon, France.

Callioni P . Successful change management. [Internet]: www.ehealthexpo.com.au/content/view/59/45/ (accessed 15 Sep 2007).

10.1197/jamia.M1913

Jennett, 2004, Organizational readiness for telemedicine: implications for success and failure, J Telemed Telecare, 9, S27

10.1258/135763303769211265

Demiris, 2004, Home telehealth: The Missouri telehospice project: background and next steps, Home Health Care Technol Rep, 1, 55

Li J Ray P Seale H . An e-Health Readiness Assessment Framework for Public Health Services—Pandemic Perspective. The 45 Hawaii International Conference on System Sciences (HICSS), 4–7 January 2012, HI, USA.

Yin RK . Case study research, design and methods. 3rd edn. Thousand Oaks, CA: Sage Publications, Inc, 2003.

Centres for Disease Control (CDC). CDC Surveillance Update. Atlanta, GA: CDC, 1998.

Gómez Reynoso JM Tulu B . Electronic medical records adoption challenges in Mexico. Chicago: AMIA Symposium Proceedings; 2007:1093.

Hsiao, 2009, Critical factors for the adoption of mobile nursing information systems in Taiwan: the nursing department administrators’ perspective, J Med Syst, 33, 369, 10.1007/s10916-008-9199-8

10.1197/jamia.M1601

Bennani, 2008, As a human factor, the attitude of healthcare practitioners is the primary step for the e-health: first outcome of an ongoing study in Morocco, Commun IBIMA, 3, 28

Kifle, 2010, Transfer and adoption of advanced information technology solutions in resource-poor environments: the case of telemedicine systems adoption in Ethiopia, Telemed J E Health, 16, 327, 10.1089/tmj.2009.0008

10.1016/j.ijmedinf.2006.09.016

Colpaert, 2009, Has information technology finally been adopted in intensive care units?, Intensive Care Med, 35, S235

Bates, 2005, Physicians and ambulatory electronic health records, Health Aff, 24, 1180, 10.1377/hlthaff.24.5.1180

10.1186/1472-6963-10-231

10.1197/jamia.M2028

10.1542/peds.2005-3000

WHO. WHO checklists for influenza pandemic preparedness planning. [Internet]. http://www.who.int/csr/resources/publications/influenza/FluCheck6web.pdf (accessed 3 Dec 2009)

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BMJ Open

Tập 3 Số 3

e002293

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