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Complementi di Informatica Medica a.a. 2009-2010
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JunHua Li and Pradeep Ray - University of New South Wales, Sydney, Australia
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.
JunHua Li and Pradeep Ray - University of New South Wales, Sydney, Australia
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.
JunHua Li and Pradeep Ray - University of New South Wales, Sydney, Australia
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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.
JunHua Li and Pradeep Ray - University of New South Wales, Sydney, Australia
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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
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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.
JunHua Li and Pradeep Ray - University of New South Wales, Sydney, Australia