Thesis (PhD)-- Stellenbosch University, 2013. / ENGLISH ABSTRACT: A telemedicine service is a healthcare service (-medicine) that is delivered over
a distance (tele-). The interest in the potential of telemedicine to increase the
quality, accessibility, utilization, e ciency and e ectiveness of healthcare services
is fuelled by the rapid development of information and communication technology
(ICT) and connectivity. Despite this potential, the success rate of telemedicine
services disappoints. Many mistakes in the implementation of telemedicine services
are repeated over and over again and best practices are not captured and replicated.
This study responds to the need for reference models for the assessment and
optimization of telemedicine services in a consistent, systematic and systemic way.
Maturity models are reference models that describe typical patterns in the development
of organizational capabilities and depict a sequence of stages towards the
desired state. Many reference models exist that are applicable to telemedicine
services, but none of these provide guidance for the optimization of services, like a
maturity model does. Many maturity models exist within a health systems context,
but none of these can be applied "as is" to telemedicine services.
In this study an iterative top-down design approach is followed to develop a Telemedicine
Service Maturity Model (TMSMM). This model facilitates the assessment
of a telemedicine service on micro, meso, and macrolevel along all the domains
that comprise the telemedicine health system. Sets of capability statements are
de ned, which follow each other in a cumulative manner, hence providing a maturation
path towards the desired maturity state.
These sets of capability statements provide yardsticks according to which quantitative
values are allocated to an intangible concept, such as maturity. Once
an individual service is assessed, further actions towards the optimization of the
service can be derived from these yardsticks. The multidimensional design of the
TMSMM, as well as the fact that capability statements facilitate the consistent
quanti cation of maturity, makes it possible to analyze the aggregated results of
cohort of services. To accomplish this, principles of business intelligence and data
warehouse design are applied together with online analytic processing (OLAP)
procedures.
The TMSMM addresses the previously unful lled need for a reference model to
assess and optimize telemedicine services in a consistent, systematic and systemic
way. This study spans several academic and professional domains and thereby
contributes to the scienti c world of telemedicine and ehealth. / AFRIKAANSE OPSOMMING: 'n Telegeneeskunde diens is 'n gesondheidsdiens (-geneeskunde) wat oor 'n afstand
gelewer word (tele-). Met die snelle ontwikkeling van inligtings-en kommunikasietegnologie
hou telegeneeskunde die potensiaal in om die kwaliteit, toeganklikheid,
benutting, doelmatigheid en doeltre endheid van gesondheidsdienste te verhoog.
Ten spyte van hierdie potensiaal, stel die aantal onsuksesvolle telegeneeskunde
dienste teleur. Heelwat foute in die implementering van telegeneeskundedienste
word oor en oor gemaak, terwyl die beste praktyke nie vasgevang en herhaal word
nie. Hierdie studie is onderneem in reaksie op die behoefte aan 'n verwysingsmodel
vir die assessering en optimering van telegeneeskunde dienste op 'n konsekwente,
sistematiese en sistemiese manier.
Volwassenheidsmodelle is verwysingsmodelle wat tipiese patrone in die ontwikkeling
van organisatoriese vermoeëns beskryf. Dit stip 'n aantal fases neer wat uiteindelik
behoort te lei na die ideale organisatoriese toestand. Daar bestaan verskeie verwysingsmodelle
wat van toepassing is op telegeneeskunde dienste, maar geeneen
daarvan gee leiding met die oog op die optimering van die diens, soos in die geval
van 'n volwassenheidsmodel nie.
In hierdie studie word 'n iteratiewe van-bo-na-onder ontwerpsbenadering gevolg
om 'n telegeneeskunde volwassenheidsmodel (TMSMM) te ontwikkel. Hierdie
model fasiliteer die assessering van 'n telegeneeskunde diens op 'n mikro-, mesoen
makrovlak en met betrekking to al die fasette waaruit 'n telegeneeskunde stelsel
bestaan. 'n Aantal vermoeëstellings is gede nieer. Hierdie stellings volg op mekaar
en akkumuleer om sodoende 'n volwassenheidspad na die verlangde toestand aan
te dui.
Hierdie vermoeëstellings verskaf maatstawwe waarvolgens kwantitiewe waardes
toegeken kan word aan 'n ontasbare konsep, soos volwassenheid. Sodra 'n individuele
diens geassesseer is, kan verdere aksies met die oog op die optimering van die
diens afgelei word. Die multidimensionele ontwerp van die TMSMM, tesame met
die feit dat die vermoeëstellings volwassenheid op 'n konsekwente manier kwanti
seer, maak dit moontlik dat die data van 'n kohort dienste saamgevoeg kan
word met die oog op analise. Beginsels van besigheidsintelligensie, datastoorontwerp
asook aanlyn analitiese prosessering (OLAP) word hiervoor ingespan. Die TMSMM spreek tot die voorheen onvervulde behoefte aan 'n verwysingsmodel
waarmee telegeneeskunde dienste geassesseer in geoptimeer word in 'n konsekwente,
sistematiese en sistemiese manier. Hierdie studie strek oor verskeie akademiese
en professionele domeine en lewer sodoende 'n bydrae tot die multidissiplinêre
wetenskapswêreld van telegeeskunde en e-gesondheid.
Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/85787 |
Date | 12 1900 |
Creators | Van Dyk, Liezl |
Contributors | Schutte, C. S. L., Stellenbosch University. Faculty of Engineering. Dept. of Industrial Engineering. |
Publisher | Stellenbosch : Stellenbosch University |
Source Sets | South African National ETD Portal |
Language | en_ZA |
Detected Language | Unknown |
Type | Thesis |
Format | xxi, 262 p. : ill. |
Rights | Stellenbosch University |
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