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The use of telecare with appropriate domiciliary care packages may provide the means to manage many of the risks associated with the increasing number of older people who wish to continue to live independently in their own homes. Those who become especially frail or disabled can retain their independence and quality of life if their homes are made ‘smart’. This paper discusses the range of services that are available, or under development, for the prototype ‘MIDAS’ (Modular Intelligent Domiciliary Alarm System) telecare system, which enable traditional community alarm, telecare and assistive technologies to be used in an integrated and intelligent fashion. A range of services that allow autonomous operation within the home (and hence increase the perceived independence of a client by decreasing the reliance on a response centre operator) known as ‘HAMISH’ may be used. It offers a wider range of cost‐effective services of relevance to both the individual, and to society, in different types of home environment including dispersed housing and new sheltered housing schemes.

Diabetes is regarded as a global epidemic with 382 million people globally suffering from diabetes. It also has major implications on patients’ quality of life. There are also high cost of treatment associated with diabetes for both patient and healthcare provider. Telemonitoring represents an excellent technology opportunity to redefine health care delivery. Using technology for home-based care promises the ability to deliver more cost effective care whilst also enhancing quality of care and patient satisfaction. The paper aims to discuss these issues.

The current research aims to contribute to the methodological design of action research projects in their use to implementation health technologies such as telemonitoring. In particular, it seeks create a model which can be used to demonstrate the efficacy of the use of the action research method as a viable alternative to the traditional randomised control trials methodology currently employed in healthcare.

The paper contributes towards the methodological design to investigate the area of practice making use of the telemonitoring programme within a Victorian Health Services Network using action research.

It intends to address the research problem of the low utilisation of telemonitoring within Monash Health as a whole, and more specifically within the diabetes unit. In this context the research intends to utilise the benefits of telemonitoring to improve clinical outcomes of patients by increasing insulin stabilisation. It is also intended the research organisation benefits by increased efficiency by decreasing clinical workforce time spent on managing patient insulin data.

The purpose of this paper is to understand how digital technologies can help healthcare organisations and improve the exploration-exploitation paradox over time. The authors explore inputs, processes and outcomes of implementing digital transformation programs and advance four testable propositions.

The authors conducted multiple case studies with embedded units of analysis: digital transformation processes; hospitals; and regional healthcare systems. Primary sources come from 107 semi-structured interviews with key informants within 14 Italian hospitals between 2009 through 2011.

Three complementary paths emerge as fundamental to balance exploratory and exploitatory efforts in healthcare: assets digitalisation within hospitals; digitally based process integration; and disruptive decision-making through analytics. Intra- and inter-path characteristics are discussed to show how digital transformation can both move hospital within the exploration-exploitation space.

By its very nature, this study is exploratory. Notwithstanding the number of cases and interviews, its generalisability is limited.

Digital transformation programs are fundamental to resolve the tensions raised by the exploration-exploitation paradox. Their implementation leads to better performance (cost reductions, quality improvements). A framework is provided for practitioners to make better decisions.

This study sheds new light on how digital technologies are actually adopted and adapted in healthcare contexts. It does it by entailing a longitudinal perspective.

The purpose of this paper is to propose and test a healthcare framework of service quality, perceived value, and satisfaction in Ghana. More specifically, this study investigates the role and effect of service quality on patient satisfaction and perceived value in Ghana’s healthcare delivery.

Data were gathered through surveys administered to 113 healthcare patients in Ghana. partial least square-structural equation modeling analysis was used to empirically test the research model.

Results show healthcare quality significantly influences satisfaction and perceived value of healthcare delivery. Additionally, perceived value’s impact on satisfaction and behavioral intention shows that increasing perceived benefits while reducing perceived costs leads to repeat behavior and paves the way for retention strategy for healthcare management.

This study yields a series of limitations in its results and conclusions. These limitations and future research are discussed in Section 7 of the study.

This study contributes to the literature by examining the effects of healthcare service quality on patient satisfaction and perceived value, determining the effect of healthcare service quality on patients’ behavioral intention, and testing the proposed framework in Ghana, a fast growing and economically liberalized emerging country in Sub-Saharan Africa.

The purpose of this paper is to better understand how and why adoption and implementation of healthcare IT innovations occur. The authors examine two IT applications, computerised physician order entry (CPOE) and picture archiving and communication systems (PACS) at the meso and micro levels, within the context of the National Programme for IT in the English National Health Service (NHS).

To analyse these multi-level dynamics, the authors blend Rogers’ diffusion of innovations theory (DoIT) with Webster’s sociological critique of technological innovation in medicine and healthcare systems to illuminate a wider range of interacting factors. Qualitative data collected between 2004 and 2006 uses semi-structured, in-depth interviews with 72 stakeholders across four English NHS hospital trusts.

Overall, PACS was more successfully implemented (fully or partially in three out of four trusts) than CPOE (implemented in one trust only). Factors such as perceived benefit to users and attributes of the application – in particular speed, ease of use, reliability and flexibility and levels of readiness – were highly relevant but their influence was modulated through interaction with complex structural and relational issues.

Results reveal that combining contextual system level theories with DoIT increases understanding of real-life processes underpinning implementation of IT innovations within healthcare. They also highlight important drivers affecting success of implementation, including socio-political factors, the social body of practice and degree of “co-construction” between designers and end-users.

The originality of the study partly rests on its methodological innovativeness and its value on critical insights afforded into understanding complex IT implementation programmes.

This paper aims to outline an approach to study the implementation and adoption of information technology systems in healthcare.

The authors use the introduction of electronic health records, part of the English National Programme of Information Technology, as an example to illustrate how theoretical lenses need to be effectively integrated with practical considerations in order to help researchers to overcome the theory‐practice gap in relation to research in this area.

Integrating actor‐network theory (ANT) with other theoretical lenses can usefully inform the design of evaluation of the implementation of electronic health record systems into healthcare settings, but it is necessary that such deliberations are informed by guidance on how to use conceptual considerations in practice.

The paper outlines how combining a case study‐based approach informed by multi‐sited ethnography and drawing on ANT offers a method for a theoretically‐based approach to such evaluations.

There is an increasing interest in understanding how innovation processes can address current challenges in healthcare. The purpose of this paper is to analyze the wider socio-economic context and conditions for such innovation processes in the Stockholm region, using the functional dynamics approach to innovation systems (ISs).

The analysis is based on triangulation using data from 16 in-depth interviews, two workshops, and additional documents. Using the functional dynamics approach, critical structural and functional components of the healthcare IS were analyzed.

The analysis revealed several mechanisms blocking innovation processes such as fragmentation, lack of clear leadership, as well as insufficient involvement of patients and healthcare professionals. Furthermore, innovation is expected to occur linearly as a result of research. Restrictive rules for collaboration with industry, reimbursement, and procurement mechanisms limit entrepreneurial experimentation, commercialization, and spread of innovations.

In this study, the authors analyzed how certain functions of the functional dynamics approach to ISs related to each other. The authors grouped knowledge creation, resource mobilization, and legitimacy as they jointly constitute conditions for needs articulation and entrepreneurial experimentation. The economic effects of entrepreneurial experimentation and needs articulation are mainly determined by the stage of market formation and existence of positive externalities.

Stronger user involvement; a joint innovation strategy for healthcare, academia, and industry; and institutional reform are necessary to remove blocking mechanisms that today prevent innovation from occurring.

This study is the first to provide an analysis of the system of innovation in healthcare using a functional dynamics approach, which has evolved as a tool for public policy making. A better understanding of ISs in general, and in healthcare in particular, may provide the basis for designing and evaluating innovation policy.

Considers the problems of a multi‐disciplinary team working together to understand and evaluate a healthcare information system, which itself is situated in a complex organisational and political environment. Provides general discussion of problems faced by evaluators of such systems. Describes this specific evaluation project (Electronic Patient Records in the UK National Health Service), gives an account of the evaluation process as it occurred, highlights some of the problems encountered, and discusses attempts to overcome these. Suggests that social, organisational and political factors are inherent in all such research enterprises, and that in order to facilitate a rich understanding of complex systems, these factors must also be considered as part of the research data.

Pharmacy sales of over‐the‐counter medicines in the UK represent an economically significant and important mechanism by which customers self‐medicate. Sales are supervised in pharmacies, but this paper seeks to question whether patients' electronic health records (EHRs) – due to be introduced nationally – could be used, ethically, by pharmacists to ensure safe medicines sales.

Using theoretical arguments, three areas of ethical concern are identified and explored in relation to pharmacists' access to EHRs‐consequentialsim, analogies and confidentiality/privacy.

Consequentialist arguments include positive benefits to customer's welfare and control of medicine of abuse, but negative economic healthcare burdens and consequences due to potentially increased or paradoxically, decreased presentation of patients to doctors. Socially accepted analogous practices – credit checks, existing pharmacy access to information and hospital treatment – are then argued to be ethically relevant and supportive of access. Privacy and confidentiality are then considered as reasons not to allow EHR access. A contrasting view is that pharmacy access to EHRs is another form of surveillance and hence the question of pharmacists' assess to EHRs may be answered negatively by empirical research that locates pharmacy customers as expert users and identifies confidentiality and privacy concerns about information technology in healthcare more generally.

This paper offers a unique and valuable contribution to the debate about healthcare professionals' role‐based access to patients' medical records and offers a reflection on the ethical concerns surrounding patient information and the rival concerns of patient qua customer autonomy and safety.

The concept of the paper is how the library can be a useful framework for designing nurses' computer skills. The overarching aim of the research is to focus on how the computer skills involved in nurses' increasing access to health informatics can be used to improve nursing practice, consequently leading to better health care delivery. The objectives involved in achieving this aim include: finding out the level of nurses' computer literacy; finding out nurses' quest for electronic information for problem‐based nursing practice; investigating nurses' level of awareness of research‐based nursing practice; and finding out areas of desirability of informatics in nursing practice.

The measuring instrument used was a self‐administered questionnaire to senior nursing cadres in the Teaching Hospitals Complex, Ile‐Ife, Nigeria. There were 230 nurses in these categories, of whom 180 were given questionnaires to fill in. The questionnaire was pre‐tested and validated. A total of 167 copies were returned and found to be usable. Simple percentages and a summation weighted index were used to analyse the data.

The paper provides empirical insight into nurses' computer skills and the library's role. The majority of the respondents did not have knowledge of computers; in the School of Nursing they learned it through various means while practising, while a few could access and retrieve information from the available databases. Some difficulties were expressed, such as workload, lack of skills, location of the library with regard to the hospital, etc. The desirability of the introduction of health informatics to the profession is high.

The study is limited to a teaching hospital and the results may not be generalisable to non‐teaching hospitals, hence the need for further studies.

The impact of health informatics on nurses' computer skills and the library's role will save nurses from routine work, enhance their productivity, and will equip them better for the challenges that information technology presents for health professionals.

This paper fulfils and identifies the need to introduce health informatics to nursing practice in order to improve patient care.