Information Systems (IS) innovations in healthcare sector are seen as panacea to control burgeoning demand on healthcare resources and lack of streamlining in care delivery. Two particular manifestations of such innovations are telehealth and electronic records in its two forms: the electronic medical records and the electronic health records. Deployment efforts concerning both of these IS-innovations have encountered a rough terrain and have been slow. Problems are also faced while evaluating the effectiveness of innovations on health and care delivery outcomes through strategies such as randomised controlled trials- particularly in case of telehealth. By taking these issues into account, this research investigates the issues that affect IS innovation deployment and its evaluation. The strategy adopted in this research was informed by recursive philosophy and theoretical perspectives within IS that strived to expound this recursive relationship. It involved conducting two longitudinal case studies that are qualitative in nature. The first study involved telehealth deployment and its evaluation in the UK, while the second case study involved the deployment of electronic medical/health records in the US. Data was collected through focus group discussions, interviews and online discussion threads; and was analysed thematically. The results of this research indicate that there are nine issues that arise and affect the deployment and evaluation of IS innovation in healthcare; and these are design, efficiency and effectiveness, optimality and equity, legitimacy, acceptance, demand and efficacy, expertise, new interaction patterns, and trust. These issues are attributes of relationships between the IS innovation, context of healthcare and the user. The significance of these attributes varies during the deployment and evaluation process, and due to iterative nature of IS innovation. This research further indicates that all the attributes have either direct or indirect impact on work practices of the user.

Thesis (M.Info.Tech.)--University of Wollongong, 2006. / Typescript. "Includes an observation study" Includes bibliographical references: p. [135-141].

The study sought to investigate the viability of digital records management in the Office of the Premier (OTP) in the Eastern Cape Province. The objectives of the study were to establish the current status of digital records management in the OTP, determine the compliance with the legal framework, identify the requisite infrastructure for digital records management (DRM), describe the security and preservation measures for DRM, and the challenges of managing digital records. Purposive sampling was used to select 40 participants. A questionnaire was used to collect data. The study revealed that the OTP has taken a number of initiatives aimed at establishing records management practices. However, the study found that the OTP is faced with a number of challenges in trying to use the Electronic Document and Records Management System (EDRMS). The majority of the employees did not have any qualification in records management. This lack of skills and competencies affects the implementation of the new system. The findings of the study showed that most of the employees were resisting using the new system because they were not comfortable with it. The study recommends that the department should encourage its staff to get training to be knowledgeable in the use of EDRMS which generates records; the staff should work closer with the consultancy in order to gain skills and knowledge to facilitate the change process, and the security and preservation of digital records should be enhanced.

Theoretically, the use of Electronic Medical Records (EMRs) holds promise of numerous benefits in healthcare provision, including improvement in continuity of care, quality of care and safety. However, in practice, there is evidence that the adoption of electronic medical records has been slow and where adopted, often lacks meaningful use. Thus there is a clear dichotomy between the ambitions for EMR use and the reality of EMR implementation. In the USA, a legislative approach was taken to turn around the situation. Other countries such as Canada and European countries have followed suit (in their own way) to address the adoption and meaningful use of electronic medical records. The South African e-Health strategy and the National Health Normative Standards Framework for Interoperability in eHealth in South Africa documents both recommend the adoption of EMRs. Much work has been done to establish a baseline for standards to ensure interoperability and data portability of healthcare applications and data. However, even with the increased focus on e-Health, South Africa remains excessively reliant on paper-based medical records. Where health information technologies have been adopted, there is lack of coordination between and within provinces, leading to a multitude of systems and vendors. Thus there is a lack of systematic adoption and meaningful use of EMRs in South Africa. The main objective of this research is to develop the components required to engender meaningful use of electronic medical records in the South African healthcare context. The main contributors are identified as EMR certification and consistent, proper use of certified EMRs. Literature review, a Delphi study and logical argumentation are used to develop the relevant components for the South African healthcare context. The benefits of EMRs can only be realized through systematic adoption and meaningful use of EMRs, thus this research contributes to providing a road map for engendering the meaningful use of EMRs with the ultimate aim of improving healthcare in the South African healthcare landscape.

Philosophiae Doctor - PhD / South Africa has placed emphasis on evidence-based decision-making for justifying service delivery improvement decisions. Evidence-based decision-making entails decisions made by referring to verifiable facts and figures available from a variety of sources of evidence such as organizational records. Records are created or received during the conduct of business and contain evidence of organizational activities. Their use as sources of evidence is continuous. Most records management scholars hypothesize that the use of records as sources of evidence for decision-making contributes to improved service delivery. In the same breath, some scholars lament their minimal use as sources of evidence for decision-making in the South African public sector due to poor records management. This descriptive, positivist quantitative study used a cross-sectional survey to determine the extent to which records as sources of evidence were used for evidence-based decision-making by senior managers in Western Cape governmental bodies,

Published Article / The purpose of this project is to investigate the application of Radio Frequency Identification, RFID, to automatic student attendance register. The aim is that the students in any class can be recorded when they carry their student cards with them without having to individually swipe the card or allocate special interaction time. The successful implementation of this proposal will facilitate such record keeping in a non-intrusive and efficient manner and will provide the platform for further research on the correlation between attendance and performance of the students. The opportunity for related research is identified regarding the range of the parameters involved, ensuring that individual identifications do not clash and interfacing challenges with the central record keeping are overcome.

This Ph.D. project started from a broad analysis aiming at investigating the key issues in the development of Information and Communication Technologies (ICT) in the health care sector, with the aim of making an in depth investigation to evaluate the effects of Electronic Medical Record (EMR) implementation on the organizations adopting them. Furthermore the study examined two study settings which have adopted the same EMR system produced by the same provider. This comparative study aims, in particular, to analyse how EMR systems are adopted by different health organizations focusing on the antecedents of the EMR project, on the implementation processes used and on the impacts produced. Diffusion theory, through the lens of socio-technical approach, represents the theoretical framework of the analysis. The research results are based on policy evaluation and case studies. The two hospitals selected for the case study analysis are the Regional Hospital of Local Health Authority in Aosta, Italy and the Royal Infirmary of Edinburgh, Scotland. In conducting the data collection several strategies have been used: documentary analysis, interviews and observations have been carried out. This work provides an overview of the key issues arising over e-health policy development through a comparative analysis of the UK and Italy and provides an insight into how EMR systems are adopted, implemented and evaluated within acute care organizations. The thesis is a comparative international research about the development of e-health and the use of ICT in health care sector. This approach makes a both a theoretical and methodological contribution. By focusing, in particular, on EMR systems, it offers to practitioners and policy makers a better basis of analysing ICT usage and its impacts on health care service delivery.

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Background: Electronic Health Records (EHR) are digital versions of patients' charts (HealthIT.gov, 2013). The government has incentivized current use to allow all healthcare organizations to progress from paper charting. Goals of EHR adoption include improving workflow, documentation, and to improve the quality of care being provided (Weiner, Fowles, & Chan, 2012). Objective: The purpose of this DNP project was to conduct a readiness assessment of the asthma and allergy specialty organization's staff members to identify perceived barriers and advantages of adopting an EHR. Design: This project was guided by the Institute for Healthcare Improvement (IHI) Model for Improvement (Institute for Healthcare Improvement [IHI], 2016). This model was incorporated with the PDSA cycle and DOQ-IT EHR Implementation Roadmap. Descriptive statistics were used for data analysis. Setting: Allergy and asthma specialty practice consisting of 12 clinics within the Denver Metro and Northern Colorado area. Participants: 155 members of the organization including physicians, nurse practitioners, physician assistants, nurses, medical assistants, front office and administrative staff. Measurements: 60 out of 155 staff members completed the readiness assessment survey from HealthInsight (HealthInsight, n.d.).Results: A response rate of 38.7% (n=60) of participants completed the readiness assessment survey. The top two barriers were medical records being unavailable (n= 48, 80%) and the inability to read what is written in the medical record (n= 51, 85%). The top barrier for adopting EHR is having the system freeze or crash (n=36, 65%), followed by, 22 participants or 40% stating EHR is depersonalizing in an exam room. The highest advantage identified was the reduction in paper-based medical charting and filing (n=56, 93%). The second highest advantage was more timely access to patient records (n=55, 92%).Conclusion: Perceived barriers and advantages for EHR adoption within the organization are similar to what literature has currently identified. The information gained from this study will provide a better understanding of the decision and adoption process. The information will help the organization decide whether or not to adopt EHR and how to successfully move through the DOQ-IT EHR Implementation Roadmap, IHI Model for Improvement and PDSA cycle.