RESUMEN
BACKGROUND: While e-health readiness assessment is vital to the successful implementation of e-health innovations, there is little published guidance (i.e. e-health readiness assessment frameworks (eHRAFs)) for institutions and countries. OBJECTIVE: To develop an evidence-based and locally relevant eHRAF for Uganda. METHOD: A list of possible e-health readiness domains and constructs was developed through a structured review of the e-health literature. This list was first refined using author experience, insight and reflection. Based on this refined list, an eHRAF questionnaire was developed, which was initially pilot tested for face and content validity. Thereafter, it was distributed to 13 purposively selected study participants who were Ugandan e-health experts from the fields of health, information and communications technology (ICT) and academia. The questionnaire was discussed in a focus group setting for consensus input, where study participants confirmed, rejected or revised proposed domains and constructs suitable to guide e-health readiness assessment at either the national or site-specific level within Uganda. RESULTS: Of 148 identified literature resources, 13 met inclusion criteria. A subjective review highlighted 11 frequently used e-health domains. Further reflection reduced these to nine domains, which were shared with study participants by means of the questionnaire. Based upon prior use of, and familiarity with, a management tool (PESTEL), participants' consensus on factors essential for readiness assessment in Uganda was aligned with PESTEL's six domains: political, economic, sociocultural, technological, environmental, and legal and regulatory. The participants considered engagement, and core and societal readiness as optional domains. Based on this input, the authors developed a proposed eHRAF suitable for Uganda, comprised of domains, sub-domains and constructs. CONCLUSION: The eHRAF developed in this research is an evidence-based framework (literature and cross-sectoral expert opinion) and consists of primary domains, sub-domains and constructs suitable for assessing e-health readiness in Uganda, either nationally or locally, prior to implementation of any e-health system. The process and principles may have utility in other countries. IMPLICATIONS: A national, culturally relevant, context-specific Ugandan eHRAF could facilitate efficient and effective planning and implementation of new e-health programmes across the country and assist policymakers and legislators to develop consistent and reliable guidelines and regulations.
Asunto(s)
Telemedicina , Humanos , Encuestas y Cuestionarios , UgandaRESUMEN
BACKGROUND: Studies document e-health as having potential to improve quality of healthcare services, resulting in both developed and developing countries demonstrating continued interest in e-health uptake and use. e-Health implementations are not always successful as high failure rates have been reported in both developed and developing countries. These failures are often a result of lack of e-health readiness. e-Health readiness has been defined as the preparedness of healthcare institutions or communities for the anticipated change brought by programs related to information and communication technologies. As such it is critical to conduct an e-health readiness assessment prior to implementation of e-health innovations so as to reduce chances of project failure. Noting the absence of an adequate e-health readiness assessment framework (eHRAF) suitable for use in developing countries, the authors conceptualised, designed, and created a developing country specific eHRAF to aid in e-health policy planning. The aim of this study was to validate the developed eHRAF and to determine if it required further refinement before empirical testing. METHODS: Published options for a framework validation process were adopted, and fifteen globally located e-health experts engaged. Botswana experts were engaged using saturation sampling, while international experts were purposively selected. Responses were collated in an Excel spreadsheet, and NVivo 11 software used to aid thematic analysis of the open ended questions. RESULTS: Analysis of responses showed overall support for the content and format of the proposed eHRAF. Equivocal responses to some open ended questions were recorded, most of which suggested modifications to terms within the framework. One expert from the developed world had alternate views. CONCLUSIONS: The proposed eHRAF provides guidance for e-health policy development and planning by identifying, in an evidence based manner, the major areas to be considered when preparing for an e-health readiness assessment in the context of developing countries.
Asunto(s)
Países en Desarrollo , Encuestas y Cuestionarios , Telemedicina/organización & administración , Botswana , Política de Salud , Humanos , Formulación de Políticas , Reproducibilidad de los ResultadosRESUMEN
BACKGROUND: To date, several models have been developed to evaluate e-health readiness in healthcare organisations; however, no specific tool has been designed to assess or measure e-health readiness. OBJECTIVE: The aim of this research was to design an e-health readiness assessment tool and to apply this tool to two Iranian hospitals to assess their readiness for the implementation of e-health. METHOD: The study, which was undertaken in 2012, consisted of three phases: (i) review of existing models of e-health; (ii) design of an e-health readiness assessment tool; and (iii) trial of the assessment tool in two Iranian hospitals. Phase 1 consisted of a literature review that informed the development of the tool. In phase 2, we developed an e-health readiness assessment tool with feedback using two questionnaires from 40 employees from two teaching hospitals in Iran. In phase 3, we applied the tool to the same two Iranian teaching hospitals. Participants who completed the questionnaires were from management, health information technology, medical and nursing backgrounds and were familiar with e-health. A purposive sampling method was used to invite them to take part in the study. Data from the questionnaires were analysed using factor analysis and descriptive statistics. RESULTS: Five dimensions and twenty-one indices were selected to be included in the e-health readiness tool. The 5 dimensions and their relative importance were e-health readiness (16%), information and communication technology (ICT) functions (15%), environmental readiness (20%), human resources readiness (29%) and ICT readiness (20%). The total e-health readiness scores for hospital A and hospital B were 0.22 and 0.4, respectively (a score of 1 is the ideal). CONCLUSION: It is important to assess the e-health readiness of hospitals to save time and money and be able to better prepare for ICT implementations. The e-health readiness assessment tool provides a relatively simple method for assessing hospitals and provides essential information to assist healthcare facilities focus preparations and planning for e-health implementations.