The Impact of Health Information Technology on Hospital Performance: A Systematic Integrative Literature Review

Objective: To review, categorise, and synthesise findings from literature on health information technology (HIT) functionalities, HIT use, and the impact of HIT on hospital performance. Materials and Methods: We conducted a systematic integrative literature review based on a compre-hensive database search. To organise, categorise and synthesise the ex-isting literature, we adopted the affordance actualization theory. To align the literature with our research framework, we used four categories: 1) the functionalities of HIT and how these functionalities are measured;2) use and immediate outcomes of HIT functionalities;3) different perfor-mance indicators and how HIT functionalities affect them;and 4) what hospital characteristics influence the outcome of hospital performance. Results: Fifty-two studies were included. We identified four types of HIT. Only ten studies (19.2%) define the use of HIT by explicitly meas-uring the use rate of HIT. We identified five dimensions of hospital per-formance indicators. Every dimension showed mixed results;however, in general, HIT has a positive impact on mortality and patient readmis-sions. We found several hospital characteristics that may affect the rela-tionship between HIT and hospital-level outcomes. Discussion: Further efforts should focus on embedded research on HIT functionalities, use and effects of HIT implementations with more performance indicators and adjusted for hospital characteristics. Conclusion: The proposed framework could help hospitals and researchers make decisions regard-ing the functionalities, use and effects of HIT implementation in hospi-tals. Given our research outcomes, we suggest future research opportuni-ties to improve understanding of how HIT affects hospital performance. .

Mental Health Impacts of Information and Communication Technology Usage in South Africa

This study examined mental health issues affecting the group of individuals who are in the social media contact list of the researchers.This was done by administering a closed structured questionnaire,covering information from participants’demographic characteristics,duration of time spent on ICT usage,to their perceived health effects thereof.Male respondents,largely unemployed are active ICT users,addicted to the Internet,and also suf-fer from unspecified ailments.Aged 31–35 and above,half of men and all women participants spend more than 5 h per day.High-intensive ICT use is associated,in general,with concurrent symptoms of information overload,depression and Internet addiction.It is insignificantly associated with composite stress.Medium intensive ICT use is correlated with fatigue and depression in equal measure but in opposite direction.There are significant differ-ences in demographic attributes as they explain intensity of ICT Usage.The older the employed survey partici-pants are,the less they suffer from composite stress.However,black South Africans suffer significantly from composite stress,fatigue and depression,though negatively from internet addiction.The results also indicate that South African men have negative experiences of composite stress,depression and internet addiction.Educated South Africans have negative experiences of fatigue,but positive experiences of composite stress,depression and internet addiction.Low intensive use of ICT has no impact on composite stress,fatigue and depressive moods of survey participants.It impacts negatively on internet addiction.Medium intensive use of ICT impacts posi-tively on survey participants’experiences of fatigue,but negatively on composite stress,depression and internet addiction.High-intensive use of ICT impacts positively on survey participants’experiences of composite stress and depression.

The Effects of Information and Communication Technology on Health Service Delivery at Tafo Government Hospital

This study sought to find out the effects of Information and Communication Technology (ICT) on health service delivery at Tafo Government Hospital. A descriptive survey design was used. Data were collected through the use of semi-structured questionnaire and administered to 50 respondents where stratified random sampling technique was used by ranking position as strata. Data were analyzed using descriptive statistics. From the findings, 56% of the respondents overwhelmingly agreed to the fact that the applications of ICT provide quicker medical diagnoses, reduced workload among users, improvement in patients’ waiting time and information accessibility. Nonetheless, 72% bemoaned lack of ICT infrastructure, poor ICT network concerns coupled with that insufficient knowledge on the use of ICT could impede the impact of ICT in quality service delivery. This could be deduced from the findings that ICT improves collaboration and clinical decision support in facilitating clinical work flow integration among nurses and other medical professionals. Moreover, the findings above affirm the fact that without electricity, ICT infrastructure, insufficient skills and technical knowledge in dealing with ICT innovations, it is impossible to successfully adopt ICT resources in health care delivery. The above findings show that the majority of healthcare professional generally had a positive attitude towards ICT prospects as they rated their skill as fairly well. The study recommends that the Ministry of Health plays a supporting role by investing in health care ICT.

The Elder Health Information Technology Framework for Geriatric Care in Rural India: A Policy Initiative

Healthcare monitoring and analysis of healthcare parameters is a reality to reduce costs and increase access to specialist and experts that holds the future for geriatric care in India. This paper proposes distinct methods towards the implementation of rural elder health information technologies (IT), which includes electronic medical records, clinical decision support, mobile medical applications, and software driven medical devices used in the diagnosis or treatment of disease for the older adult population in the villages of India. The purpose is online patient satisfaction at the microlevel (village panchayat) through methods accessible and affordable by establishing a common standard of operations at the village primary care units giving way to early disease detection and routine screening among the aged population avoiding institutionalization. The rural elder health IT framework is of great interest for all stakeholders in the field, as it benefits the investors and the consumers, adding to the technological infrastructure, thereby opening new avenues of research in health informatics, telemedicine and enhancing the scope of geriatric research, which in turn enhances the health-related quality of life for the rural older adults in the remote villages of the nation.

Information on Mapping and Vaccination Data in a Locality System

During the pandemic, technological innovation provided a platform with a range of uses, including in the healthcare industry. Technology is currently being used in vaccination drives run by many governments across the world to help spread vaccines quickly and efficiently. The technology makes healthcare personnel more effective at their professions and greatly raises the standard of service in the industry. The researchers undertook this study to create a suitable and long-lasting immunization database with a mapping method to give a better perspective of the immunization status. To gather essential information for this study, the researchers spoke with the local health officer in the targeted area. The obtained data then served as the basis for the system’s capabilities and features, becoming the target problems addressed by the developers. The investigation found that the majority of procedures and interactions are carried out manually and recorded on an unprotected, antiquated Excel spreadsheet. The researchers’ technology also shows to be a superior way to deal with the problems and difficulties while making their health-related transactions and operations quicker, safer, and much more effective.

High Immunization Coverage but Delayed Immunization Reflects Gaps in Health Management Information System (HMIS) in District Kangra, Himachal Pradesh, India—An Immunization Evaluation

Background: Complete and timely childhood immunization is one of the most cost-effective interventions in improving child survival in developing countries. Computerized HMIS has been recently introduced to collect aggregated data on service beneficiaries in Himachal Pradesh. HMIS provides coverage estimates for immunization while information on timeliness is currently not available. Hence we conducted a study to validate coverage and assess the timeliness of immunization in Kangra District of Himachal Pradesh. We surveyed mothers (224) of children aged 12 - 23 months (as on January 2008) and selected 32 clusters in the district between January and March 2008. Design/Methods: We conducted a cross sectional survey and selected 32 clusters by probability proportional to size method whereas seven eligible children per cluster were randomly selected. We interviewed mothers using a structured interview schedule, examined immunization card & looked for Bacillus Calmette Guierre (BCG) Scar. Vaccination after 30 days from national schedule was considered “delayed”. We computed proportions of children completely immunized, immunization delayed, frequency of reasons for delay and 95% Confidence Interval (CI) for significance of associated factors. We conducted a case control analysis of factors associated with timely immunization by taking timely immunized children as cases and delayed immunized ones as controls. Results/Outcome: Reported coverage was universal (100%). Validated full immunization coverage was 94.2% by card/record & 99% by history. Only 29.5% (CI = 20.6% - 37.4%) of children were fully immunized as per schedule (delay less than 30 days). Median delay was 21 days for BCG, 28 days for Diptheria Pertussis Tetanus (DPT 3) and 25 days for measles. Among those with delayed vaccinations, reasons were forgetfulness (36%), lack of correct knowledge (27%) & mother gone to parents’ home (27%) & insufficient children in a camp to open full dose BCG vial (22%). Our case control analysis of timely vaccinated versus delayed vaccination revealed that “precall” (reminder) was significantly [OR = 0.1, CI = 0.2 - 0.5] protective against delayed vaccination. Logistic Regression of delay > 30 days revealed that having returned unimmunized from immunization camp earlier due to insufficient children to open vaccine vial (because of high wastage factor) was significantly associated with delayed immunization (p = 0.0000), while knowledge of date of immunization camp was significantly protective from delayed immunization (p = 0.0026). 68% of the children were having at least one immunization delayed over 30 days from recommended schedule, while the proportion of children whose immunization was delayed by over 90 days was 9.4%. Conclusions: Validated field coverage estimates are lower than reported which can be due to inclusion of children of migrants in numerator & not in the denominator. High proportion of children (>70%) were delayed, suggesting implications for WHO’s strategy of measles control & national Tuberculosis (TB) control programmes, as 4.5% of them had suffered from measles. To avoid delays we recommend (i) use of mono dose vials for BCG;(ii) precall notice to mothers;(iii) modification of HMIS software to track immunization status and timeliness of individual beneficiaries rather than aggregate numbers.

Mobile technology:Usage and perspective of patients and caregivers presenting to a tertiary care emergency department

BACKGROUND:Developments in information technology(IT)have driven a push in healthcare innovation in the emergency department(ED).Many of these applications rely on mobile technology(MT)such as smartphones but not everyone is comfortable with MT usage.Our study aims to characterize the technology usage behavior of users in the ED so as to guide the implementation of IT interventions in the ED.METHODS:A cross-sectional survey was conducted in the emergency department of a tertiary hospital.Patients and their caregivers aged 21 and above were recruited.The survey collected demographic information,technology usage patterns,and participant reported comfort level in the usage of MT.We performed descriptive statistics and multivariate logistic regression to identify factors differentially associated with comfort in usage of MT.RESULTS:A total of 498 participants were recruited,and 299(60%)were patients.English was the most commonly written and read language(66.9%)and 64.2%reported a comfort level of 3/5 or more in using MT.Factors that were associated with being comfortable in using MT include having a tertiary education,being able to read and write English,as well as being a frequent user of IT.Caregivers were more likely to display these characteristics.CONCLUSION:A large proportion of ED patients are not comfortable in the usage of MT.Factors that predicted comfort level in the usage of MT were common amongst caregivers.Future interventions should take this into consideration in the design of MT interventions.

How reliable is online diffusion of medical information targeting patients and families?

AIM: To determine whether online diffusion of the "Ten Warning Signs of Primary Immunodeficiency Diseases(PID)'' adheres to accepted scientific standards.METHODS: We analyzed how reproducible is online diffusion of a unique instrument, the "Ten Warning Signs of PID", created by the Jeffrey Modell Foundation(JMF),by Google-assisted searches among highly visited sites from professional, academic and scientific organizations;governmental agencies; and patient support/advocacy organizations. We examined the diffusion, consistency of use and adequate referencing of this instrument.Where applicable, variant versions of the instrument were examined for changes in factual content that would have practical impact on physicians or on patients and their families.RESULTS: Among the first 100 sites identified by Google search, 85 faithfully reproduced the JMF model, and correctly referenced to its source. By contrast, the other15 also referenced the JMF source but presented one or more changes in content relative to their purported model and therefore represent uncontrolled variants, of unknown origin. Discrepancies identified in the latter included changes in factual content of the original JMF list(C), as well as removal(R) and introduction(I) of novel signs(Table 2), all made without reference to any scientific publications that might account for the drastic changes in factual content. Factual changes include changes inthe number of infectious episodes considered necessary to raise suspicion of PID, as well as the inclusion of various medical conditions not mentioned in the original.Together, these changes will affect the way physicians use the instrument to consult or to inform patients,and the way patients and families think about the need for specialist consultation in view of a possible PID diagnosis.CONCLUSION: The retrieved adaptations and variants,which significantly depart from the original instrument,raise concerns about standards for scientific information provided online to physicians, patients and families.

基于虚拟增强现实交互技术的茶疗养生文旅产业研究

以茶疗养生为主题,以虚拟增强现实交互(augmented reality,AR)技术为科技手段和技术优势,通过创新驱动发展实现茶疗养生文旅场景设计应用的新突破。在现实场景下,用户可使用具备AR功能的各种智能设备,通过识别物理空间中的标识物触发AR应用,从而实现茶疗养生信息及时推送,实现现实场景与虚拟信息之间的交互,从而达到信息补充连贯及情景增强效果,使用户构建起茶疗养生的整体观念。通过解析茶疗养生文旅产业的研发思路,丰富茶疗养生信息体系的承载维度,探索实现茶疗养生文旅产业迭代的新途径。

智慧康养服务模式下认知症老人服务质量提升的路径探析

在不断加快的老龄化进程中,认知症老年人数量与日俱增,如何为他们提供高质量、专业化的照护服务成为一项重要的社会议题。智慧康养服务模式作为一种革新的养老服务模式,在改善老年人的照护效果和生活质量方面展现出巨大的潜力,在认知症的预防和早期筛查、认知症的临床诊疗与康复、认知症老年人的居家照护等方面,也提供了新的发展方向。然而,从智慧康养服务供应端看,目前仍存在智慧化程度不突出、服务效益滞后及消费市场活力不够、深层次需求挖掘不足及人文关怀特征欠缺、隐私权可能受损及数据安全性难以保障等发展瓶颈;从需求端看,则存在疾病特征阻碍服务接受度、经济负担限制服务消费积极性、技术焦虑制约服务普及等问题的困扰。有鉴于此,在加强科技与企业创新的广度和深度、深化多方主体间的共享与合作、建立产业标准与服务规范、健全监管与反馈机制的同时,有关各方应增加技术的安全性以保障认知症老年人的权益和安全,增加智慧照护产品的友好性和亲和性,培养认知症老年人及家属的数字素养,发挥医疗和护理人员的专业作用,释放认知症群体消费潜力并激发智慧康养市场活力,从而加快我国认知症老年人照护的智慧化进程。

面向HIT人才培养的医学信息学知识体系探讨

卫生信息技术(HIT)人才培养是卫生信息化建设的关键要素。美国ONC的HIT培训课程开发项目提出了20个课程构件,供不同职业定位和专业背景者选择使用。生物医学信息学(BMI)是HIT知识的源泉,它运用计算机、通讯和信息技术,开发、研究和应用一系列理论、方法和技术,用于生物医学数据、信息和知识的处理,使基础医学、临床研究和实践以及各类医疗保健机构实现对接和协同。BMI包括转化生物信息学、临床信息学、公共卫生信息学等研究方向,其知识体系的构成因人才培养层次和从事HIT工作的种类而异。我国目前HIT从业者的培训和高校BMI学历教育的课程内容尚不完善,急需跟进学科发展的国际前沿,进行科学系统的设计。

印度儿童青少年心理健康教育模式探索

对儿童青少年心理健康的教育既是学生自身健康成长的需要,也是社会健康发展的需要。印度作为人口大国,对学生的心理健康也尤为关注。文章介绍了印度心理健康教育的政策与实践探索,包括推出支持和保障儿童青少年心理健康的政策,特别是开始重视女性心理健康教育;将学校教育和社会教育相结合,发挥社区的重要作用;依据各地区发展情况,并结合大数据手段,因地制宜地探索并开展心理健康服务实践。目前,印度的儿童青少年心理健康教育在面对问题和挑战的过程中不断发展。

关爱未来:家校社全方位护航——美国儿童青少年心理健康服务概述

美国儿童青少年心理健康问题的现状是一个备受关注的议题。文章概括了美国儿童青少年的心理问题类别及现状,梳理了美国政府有关心理健康问题的职能、应对措施及关注儿童青少年心理健康问题的机构和政策,并在此基础上重点介绍了美国学校、社区、社会和家庭心理健康服务,以及信息化手段在儿童青少年心理健康的咨询、评估和治疗中的重要应用。总体而言,美国以其多层次的机构共建和家校社的全方位护航,为儿童青少年的健康发展赋予希望和未来。

南非儿童青少年心理健康服务研究

文章采用文献分析法,对南非当前儿童青少年突出的心理健康问题以及心理健康服务现状进行了研究。结果表明,南非儿童青少年的心理健康问题主要包括情绪问题、酒精与药物滥用、校园暴力和自杀等。同时,南非依托卫生、社会发展和基础教育等政府部门,联合“家庭-学校-社会”多方资源,构建了全方位、多渠道的心理健康支持体系,为儿童青少年的健康发展提供了重要保障。目前,南非对心理健康服务领域的关注度和投入比例逐渐提高,但仍然面临资源不足、覆盖率低等一系列挑战,尤其在信息技术应用方面目前仍有较大提升空间。

用关爱和包容建设儿童青少年的心理安全网——新加坡儿童青少年心理健康服务研究

儿童青少年的心理健康成为新加坡社会特别关注的问题。文章概括了新加坡儿童青少年心理健康状况,梳理了新加坡心理健康政策发展历程,重点论述了新加坡学校、家庭、社会组织的针对性心理健康服务。新加坡通过多方联动的REACH模式对儿童青少年的心理健康进行干预,利用信息化手段应对新冠疫情带来的心理危机并助力心理健康服务创新发展,努力为儿童青少年的健康发展构建充满关爱与温暖的安全网,为世界贡献了新加坡经验。

法国中小学生心理健康服务概述

法国中小学生心理健康问题日趋严重,检出率较高的几种类型为抑郁、焦虑和成瘾行为,并已引起政府和全社会的广泛关注。为促进学生心理健康发展,法国政府、学校还有社会组织协同努力,构建了全面护航中小学生心理健康的服务网络。政府发挥主导作用,制定相关政策和行动路线;学校开设心理健康教育课程和各类活动,并提供心理健康咨询、诊断等服务;社会组织则面向青少年及其家长提供各类咨询和治疗服务,并开展“精神疾病去污名化”相关宣传活动。各主体间紧密联系,使心理健康服务全面且连贯,同时充分利用信息化手段,为心理健康服务提供丰富资源与在线支持。法国的实践与经验对我国全面构建心理健康服务网络具有启示作用。

阿根廷儿童青少年心理现状及应对策略

阿根廷是世界上心理学家人均数量最多的国家,但由于新旧观念碰撞的冲突、贫困人口较多、疫情的影响等因素,儿童青少年面临较严峻的心理健康问题。为此,阿根廷政府、学校、社区多方协作,通过不断扩大心理健康服务,建立并实施国家级学校卫生保健方案,基于社区开展心理健康服务,实施联邦心理健康综合方法战略,成立心理健康和成瘾局,推广“倾听空间”,实施家庭心理健康和成瘾项目等,采取多种途径,充分利用信息化等手段,全力为儿童青少年打造支持网络,提高儿童青少年心理健康水平。

武汉市结直肠癌筛查项目管理策略优化研究

目的优化武汉市结直肠癌筛查项目管理策略,以降低筛查成本,提高筛查效益。方法采用方便抽样法,选取39名关键知情人进行访谈。运用主题框架分析法对访谈资料进行整理分析。结果结直肠癌筛查流程包括宣传动员、实施筛查、结果告知、诊断治疗、随访管理5大关键环节,存在缺乏高危人群宣传动员方案、筛查项目开展时间较短、筛查流程较为复杂、样本质量不合格、采样包损耗、忽视健康宣教、对初筛阳性居民不能持续追踪、社区和定点医院信息共享不充分、结肠镜操作规范执行不严格等问题。结论应建立结直肠癌筛查长效机制,全面宣传动员,充分发挥基层医疗卫生机构作用,构建医院—社区闭环管理模式等。

守护学生心理健康 奠定国家幸福根基——芬兰儿童青少年心理健康服务

芬兰作为世界教育领域的典范国家,十分注重儿童青少年教育、身心健康等方面的福利。文章对芬兰心理健康服务发展历程与政策进行了梳理,概括了芬兰儿童青少年心理健康问题主要类型及表现,重点介绍了芬兰学校及社会的心理健康服务举措,以及信息化手段在心理健康服务中发挥的作用。总的来说,芬兰学校、社会、家庭等各方众擎易举,为儿童青少年构建了心理健康服务的全阶段全覆盖安全网络,以保障儿童青少年健康成长、社会平稳运行。