Understanding the Role of Technology in Health Information Systems

Introduction

This working paper produced by the University of Queensland Health Information Systems Knowledge Hub aims to address four objectives, firstly the development of a 'common language' of healthcare and Information and Communication Technology (ICT) in developing countries, secondly to explore the opportunities and benefits of ICT implementation in health care, thirdly to explore critical factors which result in success or failure of ICT implementation in both the developed and developing world, and fourthly to introduce 'evaluation frameworks' for ICT in health. The paper focuses on the Western Pacific Region and the challenges in that developing region when it comes to implementing ICT and health care systems.

What it does right

The paper utilises a deft grasp of the problems and benefits of implementing ICT within healthcare systems in both the developed and developing worlds. It explores the complexity of health care knowledge entailed in providing a multifaceted health care system and acknowledges the demands placed upon that knowledge and its need to be flexible and accessible at different levels of organisation, e.g. administrative level, clinical level and global level.

The level of contrast the paper explores between developed and developing countries is extensive and very clear. The recognition that many health-based ICT innovations have been implemented with little to no evidence of effectiveness is repeated throughout the paper, and it becomes more developed in exploring the different factors that play into success or failure in developed and developing worlds. The factors that contribute to the failure of ICT in health systems in the developed world are mainly administration and managerial in nature, that is, lack of senior management sponsorship, insufficient time and resources, under-investment in human resource capacity-building, whereas contributing factors to failure in the developing world hinge mainly on infrastructure issues such as telecommunications systems and steady electricity. Both developed and developing worlds rely on people and training for any ICT venture to succeed.

The evaluation tools listed in the paper are an intuitive approach to assessing and implementing the 'stage' health care systems are currently at, allowing different levels of ICT sophistication to be applied where it is appropriate. Out of the seven different stages, it would be unlikely that many of the communities across Western Pacific Region are beyond using paper-based systems. It may be that the humidity and salt content in the air causes computer hard drives to corrode and corrupt, leaving an expensive problem without altering the reliance on paper-based data collection.

What it does wrong

The paper acknowledges the diversity in geography, populations, cultures, economics and politics in a peripheral way, it mentions that they are factors that need to be addressed but it does not give any more time to them beyond a few mentions. Cultural factors such as Languages other than English do become a significant hurdle to overcome when designing and implementing ICT and health systems. While this point is made in the paper, I feel it could have mentioned how important supporting education in the Pacific Region is to ongoing future health care and the provision of local staff who can interface with ICT-focused health systems.

In conclusion, I felt that this paper was an incredibly well thought out and implemented approach to the problem of the digital divide that exists between the developed world, such as Australia, and the developing world, such as the Pacific Islands. I found it very helpful for thinking about the different needs of organisations who perform similar tasks, for example, it caused me to reflect on public libraries, and the differences between an inner-city library and a rural library and the potential failures and successes of technological implementation.

References:

Lewis, D., Hodge, N., Gamage, D &Whittaker, M. (2011) Understanding the role of technology in health information systems. Available here: http://www.uq.edu.au/hishub/wp17

Organizational Adoption of Web 2.0 Technologies: An Empirical Analysis

Introduction

The article “Organizational Adoption of Web 2.0 Technologies: AnEmpirical Analysis” by Saldanha and Krisnan focuses on the use and adoption of Web 2.0 technologies by business firms. The authors desire to establish an empirical approach to the issue and the key factors of what may encourage and discourage the adoption of Web 2.0 technologies by businesses. While this article provides an insightful foray into business and the private sector, it does prove useful for organisations outside of the business sector when looking at factors that facilitate adoption and integration of new technologies, their potential uses, and impact upon staff and systems such as work-flow and information collation and dissemination.

What it does right

The clear establishment of research parameters in this study gives it a real authority when looking at Web 2.0 technologies and their adoption by business. The focus on the strengths of Web 2.0 technologies seeks to prove their usefulness for business and other organisations, especially through the collaborative nature of Web 2.0 techs and the way they can 'bank' the knowledge within an organisation through collaborative blogs and wikis.

The authors strive to provide a starting point for academic research in this field as there is very little empirical research available. The hypotheses they develop are great starting points for exploring the reasons why Web 2.0 technologies are and are not adopted by business.

There is also a very strong focus on the benefit of open standards, meaning that the more open an organisations IT infrastructure is to adaptation and integration of technologies, the more likely new technologies will be adopted, as there is no need to overhaul the system, or to support legacy infrastructure. Building and Maintaining open standards within Information and Communications Technology is a fundamental step in providing flexibility for the future of the organisation.

What it does wrong

Many businesses claimed the reluctance to move to Web 2.0 technology was in part based on a fear of the risk to the security of the organisation. This is not looked at very closely in this paper, as it clearly states its focus is on 'large' business and not on 'small' business. It is implied that large business invest in internal IT departmental support, whereas smaller businesses may have to out-source their support and thus may find security a more significant issue.

The focus on organisation size also creates an inhibiting factor to the study as it is assumed that larger organisations have more money to spend on new systems and adoption of new technologies, while a small firm may not be able to risk dedicating to experimental technology. This focus on non-constrained adoption is not helpful for smaller businesses or other organisations who simply cannot afford to adopt something that is not proven as helpful.

The article focuses on the private sector, and how adoption of Web 2.0 tech can improve business practices, but I think that Web 2.0 technologies have potentially more significant use and application outside of competitive market edge. Non-profit and service-industry organisations, such as libraries, can benefit greatly from the application of Web 2.0 technologies.

In conclusion, the report is a great place for the conversation to start, and for the academic research to begin, and I feel it would be a great topic to review bi-annually as the technology changes and as businesses restructure their technological commitments.

For further information listen to MIT's Andrew McAffee discuss how Web 2.0 is changing the way we work.

References:

McAffee, Andrew (2009) How Web 2.0 is changing the way we work: An interview with MIT’s Andrew McAfee, Accessed here: http://www.mckinsey.com/insights/business_technology/how_web_20_is_changing_the_way_we_work_an_interview_with_mits_andrew_mcafee

O'Reilly, Tim (2005) What Is Web 2.0: Design Patterns and Business Models for the Next Generation of Software, Accessed here: http://oreilly.com/web2/archive/what-is-web-20.html

Saldanha, T. J. V & Krishnan, M. S. (2010). Organizational Adoption of Web 2.0 Technologies: An Empirical Analysis, Journal of Organizational Computing and Electronic Commerce, 22 (4), 301-333. 

Tomorrow's Library: MAC Discussion Paper

Introduction

Looking at the article “Tomorrow's Library” one quickly realises it is not an article. Self-described as a 'consultation component', it is styled as a discussion document that functions as a survey of sorts through which stakeholders in the Victorian State public library system are given an opportunity to provide input in four key areas, being Collections/resources/programs, Library buildings, Technology, and Service delivery. The document reflects the task of the Ministerial Advisory Council on Public Libraries (MAC) to review Victorian public libraries and the services they provide today and future expectations of service. The purpose of this review is to look at what this document does right, what it does wrong, and a discussion of what I see are areas of improvement.

What it does right

The fact that the MAC is a bi-partisan body is a great move by the Ministers department. It ensures a continuity for the council that would otherwise be threatened by any change of government in the state of Victoria, and allows both parties the opportunity to focus on a key public service that benefits the Victorian community.

The document also acknowledges in many places the changing nature of library services and community expectation. In order to move toward a relevant and useful library service, the changing face of technology and the community are necessary entry points when devising what the future needs of public libraries and the communities they serve will be. A focus on equitable access for all members of the community is also a very important and key point for public libraries.

The four key areas identified are each very vital towards the goal of building 'tomorrow's libraries', with a significant amount of cross-over between them. Collections are impacted by technological advancement in e-publications and devices to read electronic materials, programs are impacted by library buildings being able to house and offer space for community use, service delivery is impacted by technology and staff ability to train for new processes, and buildings and space within libraries are impacted on changing community expectations for access to computer services.

What it does wrong

One glaringly absent factor in the discussion paper is that of budgets. Budgets are mentioned within each of the four key factors, but I feel an exploration on options for budgeting structure could have been acknowledged in more depth, perhaps as an additional key factor. This exclusion may be explained by the fact that this discussion paper is stage one of a two-pronged effort, and the second stage is the one that focuses on budgets. It is almost impossible to talk about the future direction of libraries and changing community expectations without also addressing the changing needs of budget distribution and government plans for budget futures.

There are also factors mentioned throughout the document that have unspoken implications on the staff of libraries and the communities public libraries serve. Within 'collections, resources and programs', when discussion procurement the document mentions 'shelf-ready items' as a potential way to reduce processing cost, RFID provides self check out to library users – these factors may impact upon staff appearance of necessity and encourage trends towards down-sizing staff numbers, because of the appearance of automated services.

The third key factor discussed is 'Technology' and the segment is a tiny one compared the others. This may be because technology affects each key factor in diverse ways, but the documents' treatment of technology as a key factor is thin at best. Other points of interest that could be looked at in this section could be licensing restrictions and their effect on visually-impaired users, as well as looking towards developing a focus on integrated assistive technologies throughout the state's library branches. It is also important to be aware of the digital divide – public libraries are places where the community can access technologies, but not all community members are technologically savvy, and placing too large a focus on emergent technologies, such as tablets and smart phones, may further exclude sectors of the community who don't have access to, or the skills to use, future technologies.

In conclusion, the MAC discussion paper is a good attempt to address some very central factors when considering the future of public libraries, and provides opportunity for feedback from stakeholders involved in the first stage of the review, and while it may seem thin in certain areas, as a beginning point is is to be commended.  

References:

Ministerial Advisory Council on Public Libraries (2012) Tomorrow's Library:Discussion Paper. State Government of Victoria. Accessible here: .dpcd.vic.gov.au/__data/assets/pdf_file/0009/95283/Tomorrows-Library-Discussion-Paper.pdf