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1 – 10 of 545Kanida Narattharaksa, Mark Speece, Charles Newton and Damrongsak Bulyalert
The purpose of this paper is to investigate the elements that health care personnel in Thailand believe are necessary for successful adoption of electronic medical record (EMR…
Abstract
Purpose
The purpose of this paper is to investigate the elements that health care personnel in Thailand believe are necessary for successful adoption of electronic medical record (EMR) systems.
Design/methodology/approach
Initial qualitative in-depth interviews with physicians to adapt key elements from the literature to the Thai context. The 12 elements identified included things related to managing the implementation and to IT expertise. The nationwide survey was supported by the Ministry of Public Health and returned 1,069 usable questionnaires (response rate 42 percent) from a range of medical personnel.
Findings
The key elements clearly separated into a managerial dimension and an IT dimension. All were considered fairly important, but managerial expertise was more critical. In particular, there should be clear EMR project goals and scope, adequate budget allocation, clinical staff must be involved in implementation, and the IT should facilitate good electronic communication.
Research limitations/implications
Thailand is representative of middle-income developing countries, but there is no guarantee findings can be generalized. National policies differ, as do economic structures of health care industries. The focus is on management at the organizational level, but future research must also examine macro-level issues, as well as gain more depth into thinking of individual health care personnel.
Practical implications
Technical issues of EMR implementation are certainly important. However, it is clear actual adoption and use of the system also depends very heavily on managerial issues.
Originality/value
Most research on EMR implementation has been in developed countries, and has often focussed more on technical issues rather than examining managerial issues closely. Health IT is also critical in developing economies, and management of health IT implementation must be well understood.
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Fauziah Rabbani, Farah Naz Hashmani, Aftab A Ali Mukhi, Xaher Gul, Nousheen Pradhan, Peter Hatcher, Mounir Farag and Farhat Abbas
The WHO Eastern Mediterranean Regional Office has emphasized health system strengthening among the top five strategic priorities. One of the integral elements of health systems…
Abstract
Purpose
The WHO Eastern Mediterranean Regional Office has emphasized health system strengthening among the top five strategic priorities. One of the integral elements of health systems are the hospitals. The purpose of this paper is to review the need for formalized training in hospital management to improve the quality of care.
Design/methodology/approach
Literature review and hands on experience of conducting a regional training in hospital management for Eastern Mediterranean Region (EMR) countries.
Findings
Majority of patients in EMR bypass Primary Health Care facilities due to inadequate quality of services and prefer seeking specialized care at a tertiary level. There is mounting evidence of mediocre to poor patient satisfaction due to inefficient health care practices in hospitals of EMR. Strengthening the management capacity of the hospitals through a formal training programme is therefore necessary for improving the performance of health care delivery and the overall health system. Hospital management encompasses hospital planning and operational activities including development and implementation of organizational strategies to ensure adequate numbers and quality of trained human resources and effective financial management, disaster management, health management information system utilization, support services, biomedical engineering, transport and waste management. Such training will prepare health care professionals with leadership skills to deliver quality hospital services.
Originality/value
This is one of the first papers emphasizing the need for a formal structured regional training in hospital management for the countries of EMR. A modular incremental training approach developing an EMR Credit Transfer and Accumulation system is proposed.
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Research on mental illness stigma in the Arab world has traditionally focused on socio-cultural barriers that deprive persons with mental illness from their fundamental human…
Abstract
Purpose
Research on mental illness stigma in the Arab world has traditionally focused on socio-cultural barriers that deprive persons with mental illness from their fundamental human right for privacy and informed consent. The purpose of this paper is to address the question whether or not mental health legislations in a number of Arab countries effectively safeguard the human rights of people with mental illness and protect them from stigmatizing and discriminatory practices.
Design/methodology/approach
A qualitative review of literature was performed over two rounds of search, targeting published research on mental illness stigma in the Arab world from year 2000 until now and existing national mental health legislations in the Arab world, using English and Arabic databases.
Findings
The review reveals that beyond society and culture, persistence of mental illness stigma in the Arab world may be explained by absent or inefficient monitoring mechanisms of mental health legislations and policies within the health-care setting. Although integration of mental health services into the primary health care system is being gradually implemented as a step toward de-stigmatization of mental illness, more remains to be done to change the stigmatizing behavior of the health personnel toward mental illness.
Originality/value
Mental health authorities in the Arab world need to be more aware of the public perceptions explaining people’s fear and reluctance to seek mental health care, so as to ensure that the control and monitoring mechanisms at both the primary and mental health care levels foster a human rights, culturally competent, patient-friendly and non-stigmatizing model of mental health care.
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Ali Kazemi Karyani, Enayatollah Homaie Rad, Abolghasem Pourreza and Faramarz Shaahmadi
Health can be influenced by many factors. One of the factors is the political context of the country and democracy. The purpose of this paper is to examine the effects of freedom…
Abstract
Purpose
Health can be influenced by many factors. One of the factors is the political context of the country and democracy. The purpose of this paper is to examine the effects of freedom in press and polity index in overall, public, private and out of pocket health expenditures.
Design/methodology/approach
A long-term panel data approach has been used to examine the relationship between democracy and health expenditures. The authors inserted polity and freedom into press indexes in the health expenditure model.
Findings
Increase in freedom of the press and democracy will increase the overall, public and private health expenditures while they decrease out of pocket health expenditures.
Originality/value
Polity and freedom index has a significant impact on all the health expenditure models.
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Pien Walraven, Rogier van de Wetering, Remko Helms, Marjolein Caniëls and Johan Versendaal
Advanced Electronic Medical Records (EMR) provide many potential benefits to hospitals. However, because of their broad scope, many stakeholders deal with the EMR and a continuous…
Abstract
Purpose
Advanced Electronic Medical Records (EMR) provide many potential benefits to hospitals. However, because of their broad scope, many stakeholders deal with the EMR and a continuous effort has to be made to keep up with internal and external change. Therefore, hospitals need to deliberately shape their organizational competencies considering the pursuit of alignment, i.e. making sure that the EMR remains optimally aligned with strategies, goals and needs of the hospital and its stakeholders. This paper aims to investigate the evolutionary paths of these alignment competencies and their drivers, from a theoretical perspective of co-evolutionary information systems alignment (COISA).
Design/methodology/approach
This paper reports on a longitudinal multiple case study of three Dutch hospitals which each recently implemented an advanced EMR system. The authors conducted 35 in-depth interviews in 2 phases (before and after go-live of the EMR), and studied documentation related to the EMR implementations.
Findings
The findings show that each hospital's COISA capability shows a different evolutionary path. However, two of the three case hospitals ended up coordinating part of their COISA capability to an ecosystem level, i.e. they incorporated other hospitals using the same EMR system to coordinate their alignment efforts, either from an operational perspective, or in terms of orchestration and strategy. The found evolutionary paths' key drivers include “stakeholder initiative”, “accumulating experience”, “driving events” and “emerging issues”.
Originality/value
The findings help healthcare practitioners to deliberately shape their organization's COISA capability in pursuit of EMR alignment. Furthermore, the authors add to the knowledge base on co-evolutionary approaches to alignment through the longitudinal approach.
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Nicola Shaw, Victoria Aceti, Denise Campbell‐Scherer, Marg Leyland, Victoria Mozgala, Lisa Patterson, Shanna Sunley, Donna Manca and Eva Grunfeld
This paper aims to explore the perceptions of facilitators and barriers to their using electronic medical records (EMRs) for these functions and contributes baseline data about…
Abstract
Purpose
This paper aims to explore the perceptions of facilitators and barriers to their using electronic medical records (EMRs) for these functions and contributes baseline data about the use of EMRs for chronic disease management. The sub‐study reported here is a baseline process evaluation of EMRs and their current use, preliminary to a larger, pragmatic, randomized controlled trial. Its purpose is to understand how EMRs are currently being used by primary care physicians to facilitate chronic disease prevention and screening in their practices.
Design/methodology/approach
This is a qualitative case study where the lead physician at each of eight primary care clinics (four in Alberta, four in Ontario) participated in semi‐structured interviews. Data were analyzed using thematic content analysis.
Findings
Although EMRs are being used in a limited fashion for chronic disease prevention and screening, clinicians identified few current benefits. Participants noted some instances in which paper charts were preferred and that the lack of human and financial resources is inhibiting the use of chronic disease applications already incorporated in EMRs.
Research limitations/implications
To understand fully how EMRs can best be used in the logistical management of chronic disease prevention and screening requires research efforts towards improvement of the data structures they contain.
Practical implications
Data extraction needs to be easier so that screening of patients, at risk or living with chronic disease, can be facilitated.
Social implications
Evaluation of the benefits, for the content of care and care relationships, conferred by this new method of communicating, needs to be complemented by a parallel exploration of the risks.
Originality/value
The paper illustrates that with the tremendous investments in EMRs it is important to learn how changes in their design could facilitate improvements in patient care in this important area.
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Jafar Sadegh Tabrizi and Farid Gharibi
Accreditation is an essential component in primary healthcare (PHC) systems. The purpose of this paper is to investigate the most suitable PHC accreditation models and standards…
Abstract
Purpose
Accreditation is an essential component in primary healthcare (PHC) systems. The purpose of this paper is to investigate the most suitable PHC accreditation models and standards, worldwide, and to prepare a comprehensive and unbiased summary from research on these models.
Design/methodology/approach
A systematic search was undertaken using Web of Science, Scopus, Science Direct, Springer, PubMed and ProQuest databases in August 2016 and updated in January 2018. English language studies addressing PHC accreditation standards and models, published between 1995 and January 2018, were included, resulting in 9051 citations. After excluding duplicates and irrelevant studies, 19 were included in the final review. Two independent reviewers critically appraised the studies. Consequently, accreditation standards in the models were extracted and compared.
Findings
Results indicate that USA, Australia, Canada, UK and New Zealand (non-eastern Mediterranean regions (EMR)) and Jordan, Saudi Arabia, Lebanon and Egypt (EMR) had well-developed and high-quality PHC accreditation models. The Jordanian, Egyptian and Saudi models had the highest diversity in their PHC standards domains. Community-oriented care, safe care, high-quality care, care continuity and human resource management had the highest priority among PHC accreditation programs.
Originality/value
The authors provide PHC accreditation benchmarks and determine high priority practical domains in accreditation standards. The findings should help health system managers and policymakers design new PHC accreditation programs and promote PHC service quality.
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This paper proposes a Web-based patient portal based on the electronic medical record. Such a portal can allow patients to manage their own health care, reduce health-care visits…
Abstract
Purpose
This paper proposes a Web-based patient portal based on the electronic medical record. Such a portal can allow patients to manage their own health care, reduce health-care visits and significantly improve the quality of their health care.
Design/methodology/approach
A patient portal prototype and an accompanying online survey were distributed to assess the adoption readiness among a group of people in the United Arab Emirates (UAE).
Findings
The results from 470 survey participants demonstrated an enhanced awareness of this technology, and support the study hypotheses indicating that both intrinsic and extrinsic factors are important when considering the implementation of a patient portal in the UAE.
Originality/value
This study adds value to the few research studies undertaken in the Middle East discussing online health information technology and its adoption and usage among the population at large. The extended technology acceptance model, which contains two additional constructs, had not been previously validated in terms of a patient portal in the UAE, according to the author’s knowledge, adding more value. The UAE’s health-care system must use the benefits from the available IT infrastructure to provide a user-friendly online portal to encourage patients to manage their health care and health information.
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