Advances in information technology have made a significant influence on healthcare. Among technological breakthroughs, Internet has revolutionized the way people have access to health information. People increasingly use the Internet to search for, exchange and post health information on various types of websites. Internet offers invaluable benefits to its users; nevertheless, this very freedom to post information and the resulting enormous body of information is also one of the major sources of concerns. There have been misgivings about the quality of online health information since the Internet has been introduced. The 'top-down' approaches to control the quality of online health information proved to be neither practical nor desirable. The advent of web 2.0 (read and write version of web) enables user-driven approaches to improve the quality of information through 'bottom-up' approaches. The critical question is what type of bottom-up approach is suitable to provide online users with high quality health information. Drawing on the market design literature, this research proposes a framework to understand and address (improve) the problem of quality of online health information. The research aims to identify the conditions under which a market for exchange of online health information works efficiently and then study the mechanisms to achieve the efficiency conditions and maximise quality. It also highlights the literature gaps for designing an online market that ensure the quality of exchanged health information. The research collected data from question and answer platforms to carry the empirical analysis. One hundred actual question and answers from nine platforms (900 in total) were collected. The quality of health information was determined by medical expert assessors and related design features were collected form Internet. Statistical algorithmic modelling was adopted for data analysis. Supervised learning methods and mainly regression tree method was used to investigate the relationship between design and quality of health information. The study uncovers the mechanisms and design features that are associated with the quality of health information. It reveals the interaction between design features that lead to high quality health information. The results particularly highlight the importance of experts' participation in the platform for increasing health information quality. It also shed light on the importance of financial incentives in enhancing health information quality. Building on the empirical findings, the research proposes four design scenarios of an online health information market and their respective outcome in terms of quality. The research opens a new perspective for researchers on how to tackle the problem of quality of online health information by framing this problem as a 'market design' issue. It provides important design lessons for managers and designers on how to enhance the quality of online health information in their platforms. It gives policy makers empirically supported guidance for recognising and promoting online procedures that lead to production of high quality online health information.

The objectives of this thesis are to: 1) obtain a snapshot of callers of 211 Toronto, a free information and referral service, understanding how representative they are of Toronto’s general population; 2) understand how 211 Toronto callers seeking health-related information use the information they obtain when contacting the service and their overall level of satisfaction, and; 3) better understand the experience and information needs of recent immigrants struggling to navigate an unfamiliar health care system. The study had three phases: 1) a cross-sectional phone interview with 211 Toronto callers; 2) a follow-up phone interview of 211 Toronto callers who had asked health-related questions; and, 3) qualitative interviews with callers who were Spanish speakers from Latin American countries. Participants were randomly selected adult callers living within the boundaries of Toronto’s Census Metropolitan Area (CMA). Respondents were compared with the general adult population living in Toronto’s CMA, using 2001 Census data, to identify under- or overrepresented population groups. A sub-set of callers who had asked health-related questions was followed up to understand how they had used the information received and their level of satisfaction with the service. Qualitative interviews were conducted with callers who were recent immigrants and native Spanish speakers from Latin America to explore their post-migration experiences. Recent immigrants experience significant information challenges. Health-related questions reflect the multifaceted nature of the concept of health in the experience of users. Negative experiences with the health care system are common. Recent immigrants have access to disorganized, confusing, often poor quality information. 211 Toronto represents an efficient and effective way to gain access to information but does not achieve its full potential. Newcomers should receive timely, appropriate, and reliable information on existing health and health-related services as soon as possible after they relocate to Canada. Appropriate information should also be made available to potential immigrants in their countries of origin. Information and communication technologies should be used to support newcomers, increasing the efficiency and effectiveness of services such as 211 Toronto.

The objectives of this thesis are to: 1) obtain a snapshot of callers of 211 Toronto, a free information and referral service, understanding how representative they are of Toronto’s general population; 2) understand how 211 Toronto callers seeking health-related information use the information they obtain when contacting the service and their overall level of satisfaction, and; 3) better understand the experience and information needs of recent immigrants struggling to navigate an unfamiliar health care system. The study had three phases: 1) a cross-sectional phone interview with 211 Toronto callers; 2) a follow-up phone interview of 211 Toronto callers who had asked health-related questions; and, 3) qualitative interviews with callers who were Spanish speakers from Latin American countries. Participants were randomly selected adult callers living within the boundaries of Toronto’s Census Metropolitan Area (CMA). Respondents were compared with the general adult population living in Toronto’s CMA, using 2001 Census data, to identify under- or overrepresented population groups. A sub-set of callers who had asked health-related questions was followed up to understand how they had used the information received and their level of satisfaction with the service. Qualitative interviews were conducted with callers who were recent immigrants and native Spanish speakers from Latin America to explore their post-migration experiences. Recent immigrants experience significant information challenges. Health-related questions reflect the multifaceted nature of the concept of health in the experience of users. Negative experiences with the health care system are common. Recent immigrants have access to disorganized, confusing, often poor quality information. 211 Toronto represents an efficient and effective way to gain access to information but does not achieve its full potential. Newcomers should receive timely, appropriate, and reliable information on existing health and health-related services as soon as possible after they relocate to Canada. Appropriate information should also be made available to potential immigrants in their countries of origin. Information and communication technologies should be used to support newcomers, increasing the efficiency and effectiveness of services such as 211 Toronto.

This paper explores chronic health issues as it relates to baby boomers and their use of digital technology. After considering how baby boomers use mobile devices and Internet technologies and what types of information they seek out within these platforms, further examination is done on health related topics such as healthcare, health literacy, and chronic health conditions. In recognition of baby boomers' likely development of one chronic condition or multiple occurring ones (known as comorbidity), three new health technologies are analyzed based on their ability to help individuals manage their chronic conditions. From these three technologies, smart pills, the Health Journal for Pain, and lx Conversations, individual marketing plans are recommended according to how they will benefit baby boomers in regards to better self health management in later adulthood years. / text

Outsourcing involves contracting out a function, or functions, performed by an organization to another organization available in the market. It involves transferring the services, performed by internal staff, as well as the staff themselves, to an external service provider under a contractual agreement. Today in healthcare, many organizations are exploring outsourcing as a way to address demands for health information technology (HIT). This thesis researches the success of outsourcing in the health informatics industry in Canada. The study is designed to help understand whether outsourcing HIT functions, such as development, implementation, operations, and maintenance, can prove successful and result in benefits for an organization. The study finds that outsourcing all four functions of HIT development, implementation, operations, and maintenance occurs in Canada; however, the research from the semi-structured interviews finds that operations and maintenance may be more commonly outsourced in Canada, over development and implementation functions. Despite this, the research from the semi-structured interviews finds that outsourcing development and implementation may actually offer more benefits and fewer challenges than outsourcing operations and maintenance. The research also finds that there can be many benefits of outsourcing for organizations, such as gaining access to expertise and improving service levels, as well as many weaknesses of outsourcing, such as losing internal knowledge and having to manage the change required from outsourcing. The findings from this thesis were used to develop a conceptual model that can be used when an organization is looking at outsourcing. The model considers the inputs and the outputs to outsourcing as an organizational strategy, including the factors that influence an organization’s decision to outsource, the risk and challenges associated with outsourcing, and the expected outcomes and benefits that can result from outsourcing. The study proposes that there are many things that need to be considered when outsourcing to ensure it is successful. / Graduate / 0769 / smalovec@gmail.com

<p> The dynamics and progress of the integration of the electronic health record (EHR) into health-care disciplines have been described and examined using theories related to technology adoption. Previous studies have examined health-care clinician resistance to the EHR in primary care, hospital, and urgent care medical settings, but few studies have been completed that pertain specifically to behavioral health-care clinicians. The study purpose was to examine the relationships that may exist between behavioral health-care clinician perceptions of usefulness and ease of use and demographic variables on adoption of the EHR. Regression analyses were performed to test the relationship between behavioral health-care clinician personal characteristics, their perceived ease of use and usefulness of EHR, and their attitudes toward adoption of the EHR. The study utilized licensed marriage and family therapists as participants. The Physician&rsquo;s Survey Questionnaire Form was adapted to the needs of this study and utilized as the survey instrument. The study was embedded within the frame of Roger&rsquo;s diffusion of innovations theory and the technology acceptance model. The findings of the study suggest that older clinicians are less likely to perceive the EHR as useful in their professional practice. The results also demonstrate that behavioral health clinician perceived ease of use and usefulness of EHR is positively associated with attitude toward adoption of the EHR. The findings indicate that to improve the adoption of the EHR for behavioral health clinicians, the EHR needs to be viewed as useful. Interpretation of the results and suggestions for future research are offered. </p>

Class of 2014 Abstract / Specific Aims: The purpose of this study is to quantitatively analyze the pharmacy department’s performance before and after the transition from a segmented set of information technology systems to an enterprise wide electronic health record. Methods: This prospective, observational study collected data from both the pre-implementation and post-implementation electronic systems. The enterprise wide electronic system was implemented on November 1, 2013. Medication turnaround time, missing medication requests, and profile-linked automated dispensing cabinet (ADC) override rates were measured before implementation (August and September 2013) and after implementation (November 2013 and January, February, and March 2014). This study did not use patient specific data and does not involve human subjects and therefore was exempt from Institutional Review Board review. Main Results: Average medication turnaround time in November 2013 (1243.6 seconds; 95% CI 1219.55-1267.73) was significantly slower than in September 2013 (697.71 seconds; 95% CI 685.45-709.97; p<0.001). In January 2014, there was no difference (695.45 seconds; 95% CI 678.17-712.73; p = 0.83) and February 2014 showed significant improvement (619.09 seconds; 95% CI 605.18-633.00; p<0.001). There were significantly more missing medication requests in February (19002) and March 2014 (18996) than in August 2013 (1319; p<0.001 for both). The ADC override rate was significantly higher in November 2013 (5.87%) than in August 2013 (3.98%; p<.001) and lower in February 2014 (3.16%; p<0.001). Conclusion: This study suggests that implementation of an enterprise-wide electronic health record has led to improved pharmacy order processing efficiency and allowed for increased communication between healthcare professionals, albeit with a loss of efficiency initially.

The phenomenon of rapid increment of the mobile phones can be utilized through supporting patients, such as those who have tuberculosis, for treatment adherence. This utilization will enable these patients to directly communicate their needs and requirements or receive health information such as reminder messages from healthcare facilities. However, the current mobile interventions, such as text messaging and speech reminder systems have limited use for people with low literacy levels. To overcome these challenges, this study proposed that the mobile graphic-based reminders be used to support tuberculosis patients to improve compliance with treatment regimens, especially for semi-literate and illiterate patients. A review of the literature and initial investigation study were carried out. The findings from the review were useful in understanding both the current practice of tuberculosis treatment regimens and the patients' needs and requirements. These findings, in addition, were referred in the choices of the components of the mobile graphic-based reminders to be implemented. A visual aid for communication theory was applied to the design and development of graphic-based reminder prototypes. An application prototype was implemented for the Android platform. Experiments were conducted to investigate the effects of an application prototype in supporting tuberculosis treatment. To measure the effect, the recovery rate was measured based on the effect of: (1) the graphic-based reminder group versus the control group; and (2) the graphic-based reminder group versus the speech-based reminder group. Data was collected using application event logs, interviews, field notes and audio recordings. It was found that treatment adherence of patients in the graphic-based group was higher than in the speech-based or in the control groups. It was further noted that the number of reminder responses in the graphic-based group was higher than in the speech-based group. Additionally, it was observed that patients in the graphic-based group responded sooner after receiving reminder messages compared to those in the speech-based group. The qualitative feedback also indicated that most patients not only found graphic-based reminders more useful to supporting their treatment than speech-based reminders and traditional care but believed that the application met their needs. This study provides empirical evidence that graphic-based reminders, designed for and based on patients' needs and requirements, can support the treatment of tuberculosis for patients of all literacy levels.

No description available.

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg in partial fulfillment of the requirements for the degree of Master of Science in Nursing Johannesburg, 2017 / The Hajj is widely recognized as the world’s largest and globally most diverse kind of mass gathering. This annual five day gathering takes place in the city of Mecca and includes between 2.5 and 3.5 million participants. This poses a great concern by the organizers as the risk for the spread of infectious disease due to overcrowding is greatly increased. These diseases are increasingly being recognized as a potential threat to both local and international public health systems. The lack of understanding of the infectious diseases that originate and disseminate during the Hajj was raised in the Jeddah declaration. Furthermore, despite the protective measures put in place, poor health practices from selective use of the measures by the participants contributes to the increased risks. Exploring the health information needs of the pilgrims attending Hajj, would help in knowing what is required to reduce poor health practices and simplify and improve compliance with protective measures against infectious diseases before, during and after Hajj, and this will help in minimising the spread of infectious diseases in the Hajj. The aim of this study was to explore the health information needs of the pilgrims attending Hajj in order to know what was required to reduce poor health practices and simplify and improve compliance with protective measures against infectious diseases before, during and after Hajj, and this would help in minimizing the spread of infectious diseases in the Hajj. In this study, a qualitative research design was used and focus group discussion using semi-structured questions was conducted. The members were purposely recruited and divided into four groups, two groups of males and two of females. The division of participants into focus groups was in part done in compliance with the Muslim beliefs. Data were collected using a focus group discussion with semistructured questions that was recorded using a tape recorder. These discussions were transcribed verbatim before being analyzed using thematic analysis. The findings of the study showed that pilgrims need a holistic health educational program that addresses their experiences of illnesses and chosen format as educational pamphlets are no longer effective. The findings also revealed that collaboration, surveillance and screening of pilgrims for diseases prior to departure are useful as they help in spreading messages of health and diseases issues with simplicity and yield effective result as well as identifying those at risk of contracting infectious diseases, spreading infectious diseases and exacerbating their diseased conditions. The study recommends the use of digital technology such as an app for phone to send health information to participants and promptly identify and manage individuals who develop illness during mass gathering events like Hajj. It also recommends the incorporation of mass gathering medicine into the curriculum of Nursing program in order to effectively train and equip nurses with better preparation measures against infectious diseases during mass gatherings like Hajj / MT 2019