literature review Aida Isabel Tavares FEUC, Feb. 2015 PhD programme in Gesto Cincia Aplicada Deciso
Aims
A1: exploratory research
research area of ehealth
in
the
emergent
A2: accomplish the evaluation requirements of
eGovernment; use a manager references software; learn how to do systematic literature review A3: provide answers to the research questions
Aida Isabel Tavares, FEUC/2015
Introduction 1/6 eHealth importance for society delivery of high quality and affordable healthcare improve the quality of treatment and broaden access to medical care it can help to reduce pressures on public healthcare budgets it allows health care professionals to place patients rather than budgets at the centre of their health systems European Commission has placed eHealth activities at the centre of the Information Society and its eEurope Action Plan: EU have funded more than 500 million Euros of R&D in the eHealth area (2003, for 15y) Aida Isabel Tavares, FEUC/2015
Introduction 2/6 European Commission's eHealth Action Plan 2012 2020 : provides a roadmap to empower patients and healthcare workers, link up devices and technologies, and invest in research towards the personalised medicine of the future. This means providing smarter, safer and patient-centred health services. Given the fast growing uptake of smartphones and tablets, the action plan also includes a specific focus on mobile health (mHealth).
Aida Isabel Tavares, FEUC/2015
Introduction 3/6 Global Observatory for eHealth (WHO)
http://www.who.int/goe/en/
Mission improve health by providing Member States with strategic information and guidance on effective practices and standards in eHealth Objectives -provide relevant and high-quality evidence and information to support national governments and international bodies in improving policy, practice, and management of eHealth; -increase awareness and commitment of governments and of the private sector to invest, promote, and advance eHealth; -generate knowledge that contribute to the improvement of health through the use of ICT; -disseminate research findings through publications on key eHealth research topics as a reference for governments and policy-makers. Aida Isabel Tavares, FEUC/2015
Introduction 4/6 Global survey (WHO) 2005 / 2009 / 2013 summarizes the needs for eHealth tools and services of WHO member states eHealth tools & services: Electronic Health Records (eHR)
National drug registries
Patient Information Systems Directories of healthcare
(PIS) professionals and institutions Hospital Information Systems (HIS)
Decision Support Systems
(DSS)
General Practitioner Information Systems Aida Isabel Tavares, FEUC/2015 (GPIS)
Telehealth
Introduction 5/6
Portugal profile - p.186
Atlas eHealth country profiles: based on the findings of the second global survey on eHealth, WHO (2011) http://apps.who.int/iris/bitstream/10665/44502/1/9789241564168_eng.pdf
Aida Isabel Tavares, FEUC/2015
Introduction 6/6
Several other EU initiatives
eHealth News Portal: http://www.ehealthnews.eu/ European eHealth Governance Initiative http://www.ehgi.eu/default.aspx eID EU Governance for eHealth Services; - Semantic and Technical Interoperability; - Data Protection; - Patient Summary and Other Priorities
Report
Redesign health in Europe for 2020, European Union 2012
Aida Isabel Tavares, FEUC/2015
Concepts 1/2 e-Health (WHO glossary) - the use of ICT for health and more It is the transfer of health resources and health care by electronic means. It covers 3 main areas: i) The delivery of health information, for health professionals and health consumers, through the Internet and telecommunications. ii) Using the power of IT and ecommerce to improve public health services, e.g. through the education and training of health workers. iii) The use of ecommerce and ebusiness practices in health systems management.
Aida Isabel Tavares, FEUC/2015
Concepts 1/2 e-Health (WHO glossary, cont) ehealth it provides a new method for using health resources such as information, money, and medicines and in time should help to improve efficient use of these resources. The Internet also provides a new medium for information dissemination, and for interaction and collaboration among institutions, health professionals, health providers and public.
Aida Isabel Tavares, FEUC/2015
Concepts 2/2 Electronic health records EHR ( electronic medical records EMR) a record in digital format that is capable of being shared across different healthcare settings, by being embedded in network connected enterprisewide information systems. (data includes demographics, medical history, medication and allergies, immunization status, laboratory test results, radiology images, vital signs, personal stats like age and weight, and billing information) EMR it is the legal patient record created in hospitals and ambulatory environments that is the data source for the EHR
Aida Isabel Tavares, FEUC/2015
Research questions
Q1: What are the drivers and the difficulties
for implementing and adopting ehealth initiatives, mainly concerned with electronic health records, in the healthcare systems during the period 2010-2015? Q2: What is the evaluation of the ehealth initiatives during that period?
Aida Isabel Tavares, FEUC/2015
Research method
Systematic literature approach
(Dyba et al., 2007) and (Kitchenham, 2004)
1. Define search terms;
2. Select sources (digital libraries) on which to perform search; 3. Application of search terms on sources; and 4. Selection of primary studies by application of inclusion and exclusion criteria on search results.
Aida Isabel Tavares, FEUC/2015
Search strategy 1/2
B-on / Biblioteca da FEUC
2010-2015
ehealt h ehealth
605 1
ehealt h ehealth
Academic journals Integral text
Aida Isabel Tavares, FEUC/2015
677
refine the search
Search strategy 1/2
Procedure for identifying primary studies 2010-2015
ehealt h ehealth
ehealt h ehealth
537
171
ehealth e-health electronic h records
67
Academic journals Integral text Disciplines: Business and Management, Public Health
ehealth e-health electronic h records
44
Aida Isabel Tavares, FEUC/2015
Further criteria: -availability for download - exclusion nonscientific work - exclusion out of health field
15
21 Exclusion : ehealth not in title
Search strategy 1/2
Procedure for identifying primary studies 2010-2015
ehealt h ehealth
ehealth e-health electronic h records
67
Further criteria: - no duplicaton -availability for download - exclusion nonscientific work - exclusion out of health field --excusion: ehealth not in title
Academic journals Integral text Disciplines: Business and Management, Public Health
Aida Isabel Tavares, FEUC/2015
15
Overview of included studies 1/3
Research methods theoretical; qualitative multi-method multicase; study design; qualitative research; quantitative research; experimental methods; case study; argumentative Aida Isabel Tavares, FEUC/2015
Overview of included studies 2/3
Countries (origin data) 5 developing countries Australia Canada Denmark Germany Kuwait Netherlands Scotland South Africa USA
Aida Isabel Tavares, FEUC/2015
Journals (15) BMC Public Health (1) Health Management Technology (1) Health Policy and Technology (3) Information Systems Fronteirs (3) International J Environmental Research and Public Health (1) International J Healthcare Management (2) Journal of Advertising Research (1) Milbank Quarterly (1) Nurse Leader (1) Quality in Primary Care (1)
Overview of included studies 3/3
Stage focus of selected articles Implementation and adoption (5)
Two focus: 1) Interoperability of information systems 2) Use of ehealth by health care professionals
Aida Isabel Tavares, FEUC/2015
References - Mendley Evaluation and assessment (Conway et al., 2014) (Delano, 2011) (Greenhalgh, Russell, Ashcroft, & Parsons, 2011) (Hendrikx, van de Wetering, P, & Batenburg, 2013) (Hove, Paek, & Isaacson, 2011) (Kierkegaard, 2015) (Klocker, Bernnat, & Veit, 2015) (Reinwand, De Vries, K, Wienert, & Lippke, 2013) (Van Zyl, Kotze, & Laubscher, 2014) (Zibrik et al., 2015)
Four Focus: 1) Patients and users 2) Policymakers 3) Stakeholders 4) Several
Aida Isabel Tavares, FEUC/2015
Criticism and limitations
1) Time constraints 2) B-on search engines are imperfect: - titles without provided word (ehealth) - articles not covering the EMR - duplication of entries
3) Future improvements: Different strategy for articles selection
