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HEALTH AND SAFETY (526 journals)                  1 2 3 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access  
A Life in the Day     Hybrid Journal   (Followers: 9)
Acta Informatica Medica     Open Access   (Followers: 1)
Acta Scientiarum. Health Sciences     Open Access  
Adultspan Journal     Hybrid Journal  
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10)
Advances in Public Health     Open Access   (Followers: 23)
African Health Sciences     Open Access   (Followers: 2)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 6)
African Journal of Health Professions Education     Open Access   (Followers: 6)
Afrimedic Journal     Open Access   (Followers: 2)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 4)
AJOB Primary Research     Partially Free   (Followers: 3)
American Journal of Family Therapy     Hybrid Journal   (Followers: 11)
American Journal of Health Economics     Full-text available via subscription   (Followers: 13)
American Journal of Health Education     Hybrid Journal   (Followers: 30)
American Journal of Health Promotion     Hybrid Journal   (Followers: 24)
American Journal of Health Sciences     Open Access   (Followers: 6)
American Journal of Health Studies     Full-text available via subscription   (Followers: 10)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 25)
American Journal of Public Health     Full-text available via subscription   (Followers: 202)
American Journal of Public Health Research     Open Access   (Followers: 29)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 2)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 4)
Annals of Global Health     Open Access   (Followers: 9)
Annals of Health Law     Open Access   (Followers: 3)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 15)
Applied Biosafety     Hybrid Journal  
Applied Research In Health And Social Sciences : Interface And Interaction     Open Access   (Followers: 2)
Archive of Community Health     Open Access  
Archives of Medicine and Health Sciences     Open Access   (Followers: 3)
Arquivos de Ciências da Saúde     Open Access  
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 8)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 3)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 8)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 3)
Association of Schools of Allied Health Professions     Full-text available via subscription   (Followers: 6)
Atención Primaria     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 2)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 6)
Autism & Developmental Language Impairments     Open Access   (Followers: 5)
Behavioral Healthcare     Full-text available via subscription   (Followers: 6)
Best Practices in Mental Health     Full-text available via subscription   (Followers: 8)
Bijzijn     Hybrid Journal   (Followers: 2)
Bijzijn XL     Hybrid Journal   (Followers: 1)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 8)
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 5)
BMC Pregnancy and Childbirth     Open Access   (Followers: 20)
BMJ Simulation & Technology Enhanced Learning     Full-text available via subscription   (Followers: 7)
Brazilian Journal of Medicine and Human Health     Open Access  
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 17)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Canadian Family Physician     Partially Free   (Followers: 12)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 12)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 1)
Canadian Journal of Public Health     Full-text available via subscription   (Followers: 20)
Case Reports in Women's Health     Open Access   (Followers: 3)
Case Studies in Fire Safety     Open Access   (Followers: 12)
Central Asian Journal of Global Health     Open Access   (Followers: 2)
Central European Journal of Public Health     Full-text available via subscription   (Followers: 4)
CES Medicina     Open Access  
Child Abuse Research in South Africa     Full-text available via subscription   (Followers: 1)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 10)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access  
Christian Journal for Global Health     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia y Cuidado     Open Access  
Ciencia, Tecnología y Salud     Open Access  
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 2)
CME     Hybrid Journal   (Followers: 1)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 2)
Conflict and Health     Open Access   (Followers: 8)
Contraception and Reproductive Medicine     Open Access  
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 3)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Digital Health     Open Access   (Followers: 1)
Dramatherapy     Hybrid Journal   (Followers: 2)
Drogues, santé et société     Full-text available via subscription  
Duazary     Open Access   (Followers: 1)
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 15)
East African Journal of Public Health     Full-text available via subscription   (Followers: 3)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 16)
EcoHealth     Hybrid Journal   (Followers: 4)
Education for Health     Open Access   (Followers: 5)
electronic Journal of Health Informatics     Open Access   (Followers: 6)
ElectronicHealthcare     Full-text available via subscription   (Followers: 4)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 5)
Emergency Services SA     Full-text available via subscription   (Followers: 2)
Ensaios e Ciência: Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access   (Followers: 2)
Environmental Sciences Europe     Open Access   (Followers: 2)
Epidemics     Open Access   (Followers: 4)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 5)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 20)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 2)
Ethiopian Journal of Health Development     Open Access   (Followers: 8)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 7)
Ethnicity & Health     Hybrid Journal   (Followers: 13)
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 2)
European Medical, Health and Pharmaceutical Journal     Open Access  
Evaluation & the Health Professions     Hybrid Journal   (Followers: 10)
Evidence-based Medicine & Public Health     Open Access   (Followers: 6)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Expressa Extensão     Open Access  
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 8)
Family & Community Health     Partially Free   (Followers: 12)
Family Medicine and Community Health     Open Access   (Followers: 6)
Family Relations     Partially Free   (Followers: 11)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 1)
Food and Public Health     Open Access   (Followers: 11)
Frontiers in Public Health     Open Access   (Followers: 7)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access  
Geospatial Health     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 9)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Health : Science and Practice     Open Access   (Followers: 5)
Global Health Promotion     Hybrid Journal   (Followers: 16)
Global Journal of Health Science     Open Access   (Followers: 9)
Global Journal of Public Health     Open Access   (Followers: 12)
Global Medical & Health Communication     Open Access   (Followers: 1)
Globalization and Health     Open Access   (Followers: 5)
Hacia la Promoción de la Salud     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 3)
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 15)
Health & Justice     Open Access   (Followers: 5)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 7)
Health and Human Rights     Free   (Followers: 8)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 7)
Health and Social Work     Hybrid Journal   (Followers: 51)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 1)
Health Care Analysis     Hybrid Journal   (Followers: 14)
Health Inform     Full-text available via subscription  
Health Information Management Journal     Hybrid Journal   (Followers: 15)
Health Issues     Full-text available via subscription   (Followers: 2)
Health Notions     Open Access  
Health Policy     Hybrid Journal   (Followers: 36)
Health Policy and Technology     Hybrid Journal   (Followers: 1)
Health Professional Student Journal     Open Access   (Followers: 1)
Health Promotion International     Hybrid Journal   (Followers: 21)
Health Promotion Journal of Australia : Official Journal of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 10)
Health Promotion Practice     Hybrid Journal   (Followers: 15)
Health Prospect     Open Access   (Followers: 1)
Health Psychology     Full-text available via subscription   (Followers: 48)
Health Psychology Research     Open Access   (Followers: 18)
Health Psychology Review     Hybrid Journal   (Followers: 40)
Health Renaissance     Open Access  
Health Research Policy and Systems     Open Access   (Followers: 12)
Health SA Gesondheid     Open Access   (Followers: 2)
Health Science Reports     Open Access  
Health Sciences and Disease     Open Access   (Followers: 2)
Health Services Insights     Open Access   (Followers: 2)
Health Systems     Hybrid Journal   (Followers: 3)
Health Voices     Full-text available via subscription  
Health, Culture and Society     Open Access   (Followers: 13)
Health, Risk & Society     Hybrid Journal   (Followers: 12)
Healthcare     Open Access   (Followers: 1)
Healthcare in Low-resource Settings     Open Access   (Followers: 1)
Healthcare Quarterly     Full-text available via subscription   (Followers: 8)
Healthy-Mu Journal     Open Access  
HERD : Health Environments Research & Design Journal     Full-text available via subscription  
Highland Medical Research Journal     Full-text available via subscription  
Hispanic Health Care International     Full-text available via subscription  
HIV & AIDS Review     Full-text available via subscription   (Followers: 11)
Home Health Care Services Quarterly     Hybrid Journal   (Followers: 6)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 2)
Hospitals & Health Networks     Free   (Followers: 4)
IEEE Journal of Translational Engineering in Health and Medicine     Open Access   (Followers: 3)
IMTU Medical Journal     Full-text available via subscription  
Indian Journal of Health Sciences     Open Access   (Followers: 2)
Indonesian Journal for Health Sciences     Open Access   (Followers: 1)
Inmanencia. Revista del Hospital Interzonal General de Agudos (HIGA) Eva Perón     Open Access  
Innovative Journal of Medical and Health Sciences     Open Access  
Institute for Security Studies Papers     Full-text available via subscription   (Followers: 5)
interactive Journal of Medical Research     Open Access  
International Health     Hybrid Journal   (Followers: 5)
International Journal for Equity in Health     Open Access   (Followers: 7)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 34)
International Journal of Applied Behavioral Sciences     Open Access   (Followers: 2)
International Journal of Behavioural and Healthcare Research     Hybrid Journal   (Followers: 8)
International Journal of Circumpolar Health     Open Access   (Followers: 1)
International Journal of Community Medicine and Public Health     Open Access   (Followers: 5)
International Journal of E-Health and Medical Communications     Full-text available via subscription   (Followers: 2)
International Journal of Environmental Research and Public Health     Open Access   (Followers: 20)
International Journal of Evidence-Based Healthcare     Hybrid Journal   (Followers: 8)
International Journal of Food Safety, Nutrition and Public Health     Hybrid Journal   (Followers: 16)
International Journal of Health & Allied Sciences     Open Access   (Followers: 3)
International Journal of Health Care Quality Assurance     Hybrid Journal   (Followers: 10)

        1 2 3 | Last

Journal Cover Health Policy and Technology
  [SJR: 0.271]   [H-I: 6]   [1 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 2211-8837
   Published by Elsevier Homepage  [3089 journals]
  • Mapping the dimensions of Health Policy and Technology
    • Authors: W. Ken Redekop; Donald R.J. Singer
      Pages: 121 - 123
      Abstract: Publication date: June 2017
      Source:Health Policy and Technology, Volume 6, Issue 2
      Author(s): W. Ken Redekop, Donald R.J. Singer

      PubDate: 2017-06-08T09:07:00Z
      DOI: 10.1016/j.hlpt.2017.05.001
  • Patient Access to Electronic Health Records: Differences Across Ten
    • Authors: Anna Essén; Isabella Scandurra; Reinie Gerrits; Gayl Humphrey; Monika Alise Johansen; Patrick Kiergegaard; Jani Koskinen; Siaw-Teng Liaw; Souad Odeh; Peeter Ross; Jessica S. Ancker
      Abstract: Publication date: Available online 21 November 2017
      Source:Health Policy and Technology
      Author(s): Anna Essén, Isabella Scandurra, Reinie Gerrits, Gayl Humphrey, Monika Alise Johansen, Patrick Kiergegaard, Jani Koskinen, Siaw-Teng Liaw, Souad Odeh, Peeter Ross, Jessica S. Ancker
      Objectives Patient-accessible electronic health records (PAEHRs) are being implemented at international scale. Comparing policies and systems could allow countries to learn from each other to address global and nation-specific challenges. We compare national PAEHR policy (hard and soft regulation) and services in 10 countries. Methods PAEHR policy and system documentation was gathered from Australia, Denmark, Estonia, Finland, France, the Netherlands, New Zealand, Norway, Sweden and the United States. A basic analytic model for policy analysis was used to delimit our focus to policy content, followed by an inductive thematic analysis across countries, in which we clustered initial themes into a set of categories of PAEHR service “approaches” related to three specific content areas. Results Although all 10 countries ensured some patient rights to access medical records, policies and systems were highly variable, as were the technological processes arising from these. In particular, three policy areas showed great variability. Depending upon country of origin, a patient would encounter differences in: login procedures (security), access to own and other patients’ data during adolescence (user rights), and types of medical data made available to the patient (data sets). Conclusions Individuals encounter very different access rights to their health data depending on where they live. Countries may be able to develop improved policies by examining how other nations have solved common problems. Harmonizing policies is also an initial step likely to be needed before cross-national PAEHRs could be possible.

      PubDate: 2017-11-23T03:08:51Z
      DOI: 10.1016/j.hlpt.2017.11.003
  • Promoting China's mHealth Market: A Policy Perspective
    • Authors: Xiaofei Zhang; Kee-hung Lai; Xitong Guo
      Abstract: Publication date: Available online 10 November 2017
      Source:Health Policy and Technology
      Author(s): Xiaofei Zhang, Kee-hung Lai, Xitong Guo
      Background The mobile health (mHealth) service is experiencing worldwide escalation due to the invaluable support it provides to a rapidly expanding elderly population and patients with chronic conditions. However, the mHealth market in China is aberrated in comparison with other countries in two major aspects: 1) the monitoring service is a minority market; and 2) the potential users (the elderly and patients with chronic conditions) lack the interest for using this service. Method To explain this understated condition, we examine the specific policies on the mHealth service and the current healthcare system in China, with suggestions for forming mHealth policies. Results Based on our policy analysis, this research proposes several political and practical suggestions for mHealth implementation in China. Along with the characteristics of the mHealth market, this research further develops a healthcare ecosystem connecting major stakeholders, including the government, the community, service providers, health professionals, drug manufacturers, and data-analysis organizations. Our suggestions will be beneficial to China's mHealth market in the business sense and provide insights for policymakers on how to regulate the market.

      PubDate: 2017-11-10T21:07:14Z
      DOI: 10.1016/j.hlpt.2017.11.002
  • Evolving Large Scale Healthcare Applications using Open Standards
    • Authors: Shelly Sachdeva; Shivani Batra; Subhash Bhalla
      Abstract: Publication date: Available online 8 November 2017
      Source:Health Policy and Technology
      Author(s): Shelly Sachdeva, Shivani Batra, Subhash Bhalla
      Electronic Health Records (EHRs) are becoming more prevalent in health care. Worldwide exchange of healthcare data demands adherence to semantic interoperable standards to overcome the language and platform barriers. Various healthcare organizations in developing countries such as, India adopt their own independent information systems without adhering to standard guidelines. Thus, this tends to sacrifice interoperability. This affects permanent persistence of longitudinal health records for future reference and research purpose. Current research implements a standard based clinical application to be used for healthcare domain in India. The study has been done for enhancing the data quality through standardization. It aims at providing a generic permanent persistence to track life-long interoperable health records of patients. This is the first effort for exploring its adoption for various regional languages in India. The user interfaces have been generated for various Indian languages for testing on a sample set of archetypes. The clinical application deployed in ‘Hindi’ language can be easily deployed for other people in ‘Tamil’ language, while maintaining semantic interoperability. The persistence will also be maintained, with the same meaning (of data) for both the regions. Implementing these standard based healthcare applications helps in reducing the costs while enhancing patient care. Thus, this study aims to build a standard based, and platform independent healthcare application to provide support for interoperability, usability and generic persistence.

      PubDate: 2017-11-10T21:07:14Z
      DOI: 10.1016/j.hlpt.2017.10.001
  • Patient Health Records: An Exploratory Study of Patient Satisfaction
    • Authors: Michele Heath; Tracy H. Porter
      Abstract: Publication date: Available online 8 November 2017
      Source:Health Policy and Technology
      Author(s): Michele Heath, Tracy H. Porter
      Objective This study seeks to understand what factors might influence a patient's perception of PHRs in early adoption. We draw from social contagion theory to examine how beliefs and behaviors are subject to those who are important to them. Methods This is a quantitative study with data collected information from a self-selected patient panel residing in the United States. Cross-sectional data were used to examine a patient beliefs and behaviors as they use personal health records. Results The findings demonstrated patient skills and abilities to conduct PHR tasks plays a role in the feelings developed toward the change. Behavioral resistance was shown to negatively impact patient satisfaction. Cognitive resistance was significant but, not in the hypothesized direction. We found a strong relationship between affective and cognitive resistance. This research suggests when affective is high, cognitive scope is out shadow and whereas affective is low, cognitive scope will broaden. Discussion After adoption, a patient might still resistance the PHR system. Hospitals and physicians should emphasize the importance of PHR to every patient, seek to offer training opportunities, offer avenues for discussion, and recognize the existence of resistance factors. Conclusion This study illustrates the need for physicians and hospitals to reshape patient's beliefs about PHRs by helping individuals understand and internalize the change toward PHRs. To ensure the promotion and engagement of the PHR system, all interested parties (hospital administrators, government agencies, policy makers, and physicians) must communicate and publicize a consistent message related to the importance of PHR use.

      PubDate: 2017-11-10T21:07:14Z
      DOI: 10.1016/j.hlpt.2017.10.002
  • Maximizing Returns for Public Funding of Medical Research with Open-source
    • Authors: J.M. Pearce
      Abstract: Publication date: Available online 6 October 2017
      Source:Health Policy and Technology
      Author(s): J.M. Pearce

      PubDate: 2017-10-13T03:31:32Z
      DOI: 10.1016/j.hlpt.2017.09.001
  • The impact of healthcare informatics competencies on dynamic capabilities:
           A multilevel study of paramedic services
    • Authors: Michael S. Dohan; Marlene Green; Joseph Tan
      Abstract: Publication date: Available online 14 September 2017
      Source:Health Policy and Technology
      Author(s): Michael S. Dohan, Marlene Green, Joseph Tan
      Objectives Despite the importance placed on technology in healthcare, there is a lack of studies that link technology-related skillsets of healthcare professionals to the ability of an organization to innovate. This research investigates the role of Healthcare Informatics Competencies (HICs) of front-line healthcare workers for the ability of their healthcare organizations to innovate. This research employs a multilevel perspective, nesting paramedics within their respective services, and measuring the impact of group-level HICs on Dynamic Capabilities. Methods Data from Canadian paramedic services (n = 43) and paramedics (n = 502) was analyzed. Exploratory Factor Analysis (EFA) was used to detect factors from the competency models, which were then aggregated to the group level. Partial Least Squares (PLS) was used to measure the impact of group-level competency on organization-level dynamic capabilities, specifically sensing, learning, integrating and coordinating capabilities. Results Three factors emerged from the paramedic competency data, labeled “Technology Application Competencies” (TAC), “Information Processing Competencies” (IPC), and “Understanding of the Workings of Technology” (UWT). At the group-level, TAC significantly impacted learning, integrating and coordinating capabilities, and UWT impacted sensing and coordinating capabilities. Conclusions Results suggest that paramedics who possess an understanding of technology and where it can be applied in a paramedicine context contribute to the innovativeness of their paramedic services. This research underlines the importance of HICs as an organizational resource in both paramedicine and healthcare, and draws attention to their importance to policy makers. This study also advances the use of HICs as part of an evidence-based approach to studying technology adoption in healthcare.

      PubDate: 2017-09-15T21:51:08Z
      DOI: 10.1016/j.hlpt.2017.07.009
  • Editorial Board/Aims and Scope
    • Abstract: Publication date: September 2017
      Source:Health Policy and Technology, Volume 6, Issue 3

      PubDate: 2017-09-03T20:49:03Z
  • Erratum to “Assessing eHealth skills across Europeans” [Health Policy
           Technol. 6/2 (2017) 161–168]
    • Authors: María Rosalía Vicente; Gary Madden
      Abstract: Publication date: Available online 25 July 2017
      Source:Health Policy and Technology
      Author(s): María Rosalía Vicente, Gary Madden

      PubDate: 2017-07-26T15:32:57Z
      DOI: 10.1016/j.hlpt.2017.07.008
  • Evaluating the Current Situation of Oral and Dental Healthcare Services in
           Turkey and Recommending Solutions
    • Authors: Omer Ekici; Dilaver Tengilimoglu; Oguz Isik
      Abstract: Publication date: Available online 20 July 2017
      Source:Health Policy and Technology
      Author(s): Omer Ekici, Dilaver Tengilimoglu, Oguz Isik
      Objectives To identify issues with Turkey's oral and dental healthcare services and develop recommendations for their effective resolution. Methods This study analyzes Turkey's oral and dental healthcare system and its problematic issues and surveys other systems and reform strategies being implemented worldwide. The questionnaire-based field survey asked 560 dentists and 84 managers working in public oral and dental healthcare centers in 12 different regions and 52 central and chamber directors affiliated with the Turkish Dental Association about dental health issues and potential restructuring in dental healthcare in Turkey. The survey comprised four sections that, in addition to gathering participant information, inquired into the current overall condition of the Turkish dental healthcare system, the problems necessitating system restructuring, and recommendations to resolve these problems. Results Participants agree that there are structural and functional problems in Turkey's dental healthcare system. Although there is an overall consensus in regard to the recommendations for resolving the problems, priorities differ among participant groups. However, participants do agree that preventive services in Turkey are insufficient and require improvement. Conclusions This study exposed issues in oral and dental healthcare services in Turkey that fall into four categories: management and organization, service delivery, human resources, and financing. Based on the results, we propose a new organization model for oral and dental healthcare in Turkey that is integrated within the healthcare system using a public health approach and that prioritizes preventive healthcare services.

      PubDate: 2017-07-26T15:32:57Z
      DOI: 10.1016/j.hlpt.2017.07.006
  • Paramedics Declare Death – A Lifesaving decision
    • Authors: Eli Jaffe; Roman Sonkin; Jillian Goldberg; Refael Strugo
      Abstract: Publication date: Available online 20 July 2017
      Source:Health Policy and Technology
      Author(s): Eli Jaffe, Roman Sonkin, Jillian Goldberg, Refael Strugo
      Objective Mobile Intensive Care Units (MICUs) are a valuable resource and their effective use is essential. In May 2012 Magen David Adom (Israeli National EMS) paramedics were allowed to declare and document death. The aim of this study is to assess if allowing paramedics to declare death leads to better utilization of MICUs. Methods Records were retrospectively analyzed before and after the adoption of the new directive allowing paramedics to declare and document death. MICU dispatches to declare death were retrospectively analyzed to evaluate dispatch times and call quantity difference. Results A total of 31,096 cases were evaluated where a MICU was dispatched to declare death. Average time on scene of the MICU pre-protocol was 63.14 minutes (N=15,408, sd=28.77), compared to a post-protocol time of 67.31 minutes (N=15,688, p=0.024, sd=28.30). A total of 110.44 minutes was used to declare death pre-protocol. These 110.44 minutes are significantly longer than the post-protocol average of 68.56 minutes (p<0.01; 95% CI (35.94, 47.81)) conservatively saving 41.88 minutes per call. In addition, there were 2,196 cases of ROSC (Return of Spontaneous Circulation). Conclusion Applying the 41.88 excess minutes to the yearly 2,543 calls pre-protocol extra yearly 1,828 valuable hours have been saved. A recent study in Jerusalem concluded the percentage of survival to discharge was 6.1%, of whom 3.4% were neurologically intact. Applying these findings to this study we find that approximately 25 more patients per year survive to discharge neurologically intact post-protocol, therefore such guidelines not only save time, but might also save lives.

      PubDate: 2017-07-26T15:32:57Z
      DOI: 10.1016/j.hlpt.2017.07.005
  • Investigation of Physicians' Awareness and Use of mHealth Apps: A Mixed
           Method Study
    • Authors: Emre Sezgin; Sevgi Özkan-Yildirim; Soner Yildirim
      Abstract: Publication date: Available online 19 July 2017
      Source:Health Policy and Technology
      Author(s): Emre Sezgin, Sevgi Özkan-Yildirim, Soner Yildirim
      Objective The study aims to understand physicians’ awareness of mobile health (mHealth) apps and their intentions to use these apps in medical practice. Method Mobile Health Technology Acceptance Model (M-TAM) was tested employing the sequential explanatory mixed method. An online survey and focus group interviews were conducted for data collection. Physicians were invited to participate in the survey. Structural Equation Modeling (SEM) was used in quantitative data analysis. Qualitative data were analyzed using coding, memo, and contextual analyses. Results 151 physicians participated in the survey, representing a 15% response rate. The model was able to explain physicians’ intention to use mHealth apps by explaining 59% of the total variance. Performance Expectancy, Mobile Anxiety, Perceived Service Availability and Personal Innovativeness were major influencing factors of Behavioral Intention. Qualitative codes outlined that information gathering and communication purposes were the major enablers in mHealth app usage. In that regard, Communication and Consulting, Clinical Decision Making, Reference and Information Gathering, and Information Management are the most popular app categories. On the other hand, lack of knowledge and lack of investment were seen as the major barriers to mHealth app usage. Conclusions User perception and intentions are important factors in technology use. Thus, the preferences, expectations, and characteristics of physicians which were outlined in this research could be significant inputs for researchers, app developers, managers and policymakers.

      PubDate: 2017-07-26T15:32:57Z
      DOI: 10.1016/j.hlpt.2017.07.007
    • Authors: Jorge Osma; Michaela Sprenger; Tobias Mettler
      Abstract: Publication date: Available online 14 July 2017
      Source:Health Policy and Technology
      Author(s): Jorge Osma, Michaela Sprenger, Tobias Mettler
      Objectives Evidence exists that e-mental health applications for maternal depression could assist in diagnosing such conditions in an early stage. This study explores the intention of health professionals to use and recommend e-mental health applications and how they think these applications should be integrated in the national health system. Methods We applied an exploratory sequential mixed-method research design. First, we collect and analyze responses from 131 health professionals in the field of pregnancy and maternal care. Based on these findings, we conduct semi-structured interviews with 16 experts for expanding and broadening the initial results. Results Our study reveals that health professionals would in general intend to recommend and use e-mental health applications. However, their attitude towards e-mental health applications varies with respect to the coverage of the mental health process. Conclusion The results are of relevance for research and practice. Two scenarios are described that show how health professionals perceive an introduction of e-mental health to be useful.

      PubDate: 2017-07-19T14:32:35Z
      DOI: 10.1016/j.hlpt.2017.07.001
  • Telemedicine services: how to make them last over time
    • Authors: Federica Segato; Cristina Masella
      Abstract: Publication date: Available online 13 July 2017
      Source:Health Policy and Technology
      Author(s): Federica Segato, Cristina Masella
      Objectives Telemedicine is extensively used in healthcare settings, although we still lack knowledge on how to make telemedicine services last over time. This study aims to: investigate how the factors supporting the implementation of telemedicine services affect their duration over time; explore if further factors need to be considered, to foster the services duration. Methods We conducted a six-year in-depth study on three Italian cases of telemedicine services lasting more than 10 years. Dimensions explaining the duration of services over time are explored and discussed against existing literature. Results The three cases show that, to support the duration over time, financial and organizational stability should be set before the “champion” leaves the service. Financial stability was reached through different strategies. About organizational stability, we found that providing opportunities to enrich the competences and getting more responsibilities over the patients enhanced the professionals’ acceptance, which, in turn, supports the organizational stability of the service over time. About patients, to meet their crucial needs for their health and to receive the nurses’ support on the use of technologies contains the abandon and increases the chances for the service to last over time. Last, the three services observed pursued a strategy of focalization on a specific need. Conclusions The findings provide insights for policy makers and hospital managers on how to set effective services and avoid service abandon, thus reducing waste of resources, and on how to motivate the professionals and patients, by increasing the chances of duration of the services over time.

      PubDate: 2017-07-19T14:32:35Z
      DOI: 10.1016/j.hlpt.2017.07.003
  • Health and well-being of middle age Indonesians: An application of
           seemingly unrelated regression (SUR) models
    • Authors: Hui-Peng Liew
      Abstract: Publication date: Available online 12 July 2017
      Source:Health Policy and Technology
      Author(s): Hui-Peng Liew
      Objective This study used multiple indicators of health simultaneously to examine how the socio-demographic characteristics of an individual (age, gender, education, marital status, etc.) affect health and well-being in Indonesia. Methods The empirical work of this study is based on data from the 2007 Indonesian Family Life Survey (IFLS4). This study used seemingly unrelated regression (SUR) to examine how the socio-demographic characteristics of an individual (age, gender, education, marital status, etc.) affect health and well-being in Indonesia. Results Findings from the seemingly unrelated regression (SUR) suggest that physical, cognitive, and mental health functioning problems co-occur more commonly than expected. Conclusion: Indonesian women, those with two or more comorbid conditions, smokers, those who are divorced or separated, and those with low education should be the main targets of policy interventions designed to reduce health inequality because they experience more barriers to health and socioeconomic well-being.

      PubDate: 2017-07-19T14:32:35Z
      DOI: 10.1016/j.hlpt.2017.07.002
  • From policy towards pharmacy practice: A review of the intended use of
           ehealth in pharmacy in Scotland
    • Authors: Katie MacLure; Derek Stewart
      Abstract: Publication date: Available online 12 July 2017
      Source:Health Policy and Technology
      Author(s): Katie MacLure, Derek Stewart
      Background Policy-driven ehealth underpins the delivery of healthcare in which pharmacy practice plays an increasingly integral role. As health is a devolved matter within the UK, responsibility for policy development and service delivery lies with the parliament of each of the home nations. Aim The aim of this research was to describe the policy-driven intended use of ehealth as the landscape of pharmacy practice evolves in Scotland. Methods A content analysis of current policy and strategy documents was conducted. A framework approach was applied (transcribing, familiarising, coding, developing/applying analytical framework, mapping data to the framework, interpreting patterns across and within constructs) from which a conceptual model of the intended use of technology in pharmacy was developed along with this explanatory narrative. Results Four key documents were identified for inclusion with a subsequent policy refresh incorporated. Key constructs were identified with associated sub-themes inducted from the data: Patient care: safety, partnership, integration, resources; Education and training: fit-for-future needs, multidisciplinary, delivery mode; Information governance: systems, staff; Implementation: accessibility, interoperability, support for role development. Conclusions The policy-driven strategy for ehealth in pharmacy practice in Scotland values the pharmacy team and promotes their role in multidisciplinary healthcare delivery. The clearly described intention is to facilitate and develop the patient-facing clinical role of the pharmacist and more integrated role of pharmacy in Scotland. This integrated role for pharmacy practice within the healthcare team, based on a secure, shared EHR, is a 2020 target for Scotland moving policy towards pharmacy practice.

      PubDate: 2017-07-19T14:32:35Z
      DOI: 10.1016/j.hlpt.2017.07.004
  • Technology supporting cooperative practice: A Norwegian municipality's
           implementation of electronic plan
    • Authors: Mary Genevieve Billington; Brita Gjerstad; Svein Ingve Nødland
      Abstract: Publication date: Available online 1 July 2017
      Source:Health Policy and Technology
      Author(s): Mary Genevieve Billington, Brita Gjerstad, Svein Ingve Nødland
      Objectives This research explores, primarily from a user perspective, the introduction of the electronic individual plan, eIP, in a municipality in Norway. Individual plans are tools designed to coordinate the range of healthcare, welfare and other support services required by individual citizens over a longer term. The plan should empower the main user and support cooperative practices amongst instances involved in care and support. The concepts of affordances and constraints provide a theoretical framework to structure the analysis. According to Greeno [1], affordances are attributes of a setting that provide potential for action while constraints are the conditions and relationships that provide structure and guidance for action. Methods An embedded case study of one municipality, based on semi-structured interviews with plan owners and with representatives from their service providers. Results and conclusions In general, the electronic plans were used only sporadically. Use was impeded by practical limitations such as technical problems and insufficient time and by personal preferences for more familiar and personal forms of communication, such as telephone and e-post. The various user groups voiced differing perceptions of the potential for action inherent in the electronic plan but all were well attuned to the structural impositions of the welfare system. The theoretical framework is presented as a useful tool for understanding and interpreting phenomena around the introduction of new technology into the healthcare and social welfare systems.

      PubDate: 2017-07-03T13:03:38Z
      DOI: 10.1016/j.hlpt.2017.06.002
  • Patient access to electronic psychiatric records: A pilot study
    • Authors: Pamela Peck; John Torous; Meghan Shanahan; Alan Fossa; William Greenberg
      Abstract: Publication date: Available online 23 June 2017
      Source:Health Policy and Technology
      Author(s): Pamela Peck, John Torous, Meghan Shanahan, Alan Fossa, William Greenberg
      Background OpenNotes, a national movement offering patients access to their doctor׳s notes, lies at the intersection of health policy and health technology. Despite interest in OpenNotes, little is known about how such may be implemented in psychiatry departments using electronic medical records. This study reports on the first pilot project to examine the experience of patients and clinicians when open access to psychiatric records was provided within an ongoing treatment relationship. Methods Fifteen clinicians in an outpatient psychiatry clinic in a Boston medical center agreed to participate in the study and 52 of their patients to participate. Those patients had the opportunity to read their progress notes through a patient site linked to an electronic medical record. Patients and clinicians were surveyed 20 months later. Results Results from this select group suggest that open access to notes was perceived as helpful to patients and did not negatively impact the patients or the treatment relationship. In addition, our experience was that mental health clinicians could be engaged in the process of OpenNotes. Conclusion This is the first study to implement and assess the impact of patients’ access to psychiatric records in an outpatient setting. Although many questions remain to be studied and a more diverse sample is needed for future research, the potential impact to enhance mental health treatment and the patient-clinician relationship is suggested for selected psychiatric patients. Policy around providing psychiatry patients access to their notes can be informed by reactions of both clinicians and patients.

      PubDate: 2017-07-03T13:03:38Z
      DOI: 10.1016/j.hlpt.2017.06.003
  • Development and performance of the external reference pricing system in
           Slovenia from 2007 to 2012
    • Authors: Nika Marđetko; Nika Rijavec; Mitja Kos
      Abstract: Publication date: Available online 21 June 2017
      Source:Health Policy and Technology
      Author(s): Nika Marđetko, Nika Rijavec, Mitja Kos
      Background From 2007 to 2012 five changes of the Rules defining Slovenian external reference pricing (ERP) were introduced to reduce medicine expenditure. Objective To assess the cost-saving effect of five ERP updates and the cost-saving effect of specific price reduction agreements, and to identify potential inconsistencies in determining the maximum allowed prices (MAPs) based on ERP. Methods To obtain MAPs from 2012 and four sets of MAPs that would be valid if ERP upgrades did not occur, Rules from 2012 and four previous Rules were applied to the same data on prices in reference countries. To assess the ERP updates cost-saving effect, one-year validity of each Rules was assumed. The assumed annual medicine expenditure was calculated considering MAPs according to each Rules and medicine consumption. To detect inconsistencies in determining MAPs, the official MAPs were compared to the MAPs calculated within the study. Results The total cost-saving effect resulting from the difference in assumed medicine expenditure based on the 2012 Rules and 2007 Rules was 5.45%. The greatest cost-saving effect of 3.59% was observed for the 2012 Rules compared to the 2010 Rules, while a 2.28% cost increase was detected when comparing the 2009 Rules to those from 2008. Specific price reduction agreements contributed to 2.32%, 4.51% and 6.74% expenditure reductions, respectively. Inconsistences in the formulation of MAPs were found as 4.75% lower monthly expenditure based on the calculated MAPs. Conclusions ERP system upgrades affected medicine expenditure; however, specific price reduction agreements were shown as a more effective cost-containment measure.

      PubDate: 2017-06-22T11:46:09Z
      DOI: 10.1016/j.hlpt.2017.06.005
    • Authors: Pamphile Thierry Houngbo; Marjolein Zweekhorst; Joske Bunders; Harry Laurence Selby Coleman; Daton Medenou; Laurent Dakpanon; Tjard De Cock Buning
      Abstract: Publication date: Available online 20 June 2017
      Source:Health Policy and Technology
      Author(s): Pamphile Thierry Houngbo, Marjolein Zweekhorst, Joske Bunders, Harry Laurence Selby Coleman, Daton Medenou, Laurent Dakpanon, Tjard De Cock Buning
      This study aims to identify the root causes and solutions of main problems facing Healthcare Technology Management in Benin's public health sector. Conducted in Benin from 2008 to 2010, two surveys were used with key actors in Healthcare Technology Management. The first survey was based on 377 questionnaires and 259 interviews, and the second involved observation and group interviews at selected health facilities The findings of the two surveys show that the problems are based on both high- and low-level corruption, characterized by self-interest and unwillingness of the policy makers to solve healthcare care equipment and maintenance problems. Appropriate solutions include: (i) development of policy and management tools to guide distribution, (ii) the use of reference price lists for procuring equipment, (iii) development of policy and management tools to guide financial resource allocation on the life cycle cost of the equipment, (iv) creation of a healthcare equipment and maintenance directorate, (v) development of policy and management tools for obsolete equipment, and (iv) the development of a new healthcare technology management policy with a budgeted action plan. We suggest that much can be improved by the strict development and implementation of policy and management tools, as well as regulations at each level of the Healthcare Technology Management process. A key role has to be attributed to the technical specialists, and the end users of equipment in healthcare facilities. Furthermore, there is a need for capacity building in Healthcare Technology Management institutions.

      PubDate: 2017-06-22T11:46:09Z
      DOI: 10.1016/j.hlpt.2017.06.004
  • Editorial Board/Aims and Scope
    • Abstract: Publication date: June 2017
      Source:Health Policy and Technology, Volume 6, Issue 2

      PubDate: 2017-06-08T09:07:00Z
  • Making Health Technology Assessment More Dynamic - Temporal Trend Analysis
           to Capture Performance Trajectories
    • Authors: Patrik Hidefjäll; Magnus Backheden
      Abstract: Publication date: Available online 23 April 2017
      Source:Health Policy and Technology
      Author(s): Patrik Hidefjäll, Magnus Backheden
      Objectives Health technology assessment (HTA) has an increasing role in evaluating not only drugs, but also medical devices. Assessing medical devices is more challenging as outcomes tend to improve substantially over time. This paper analyzes clinical outcomes over time of insulin pump therapy in adult type 1 diabetes. Meta-regression was used to capture outcome trends while considering innovation theory. Methods A systematic review of 4.297 studies was conducted covering a 35 year time period. To meet the need for a more dynamic evaluation method, temporal trend analysis was applied based on meta-regression of three extracted outcome parameters: HbA1c, incidence of severe hypoglycemia and ketoacidosis. Results The systematic review included 150 studies. Performance improvement in HbA1c and ketoacidosis was rapid during the 1980 and 90s.Thereafter the improvement trajectory of insulin pumps measured by HbA1c, ketoacidosis or severe hypoglycemia was essentially flat. Meta-regression of several covariates was performed showing publication year to be statistically significant. Retrospective recruitment and the percentage of female patients were also statistically significant. A technology cycle model analysis revealed convergence to a dominant design by the end 1990s, followed by slower progress in outcomes. Conclusions Insulin pump technology currently does not offer an improving performance trajectory according to key indicators HbA1c, incidence of severe hypoglycemia and ketoacidosis, but compares well to manual insulin injections in terms of quality of life. Applying temporal trend analysis is especially valuable in an early technology cycle stage when uncertainty is high, and when predicted improvements in future performance can influence the choice of technology.

      PubDate: 2017-04-27T10:54:40Z
      DOI: 10.1016/j.hlpt.2017.04.005
  • Development of Nationwide Electronic Health Record (ΝEHR): An
           international survey
    • Authors: Leonidas L. Fragidis; Prodromos D. Chatzoglou
      Abstract: Publication date: Available online 14 April 2017
      Source:Health Policy and Technology
      Author(s): Leonidas L. Fragidis, Prodromos D. Chatzoglou
      The primary aim of this research is to capture the existing experience from countries where nationwide EHR systems have already been implemented or the development is in a mature phase. To capture the necessary information, an international survey has been conducted with expert participants from 13 countries. The results of this research show that private vendors’ involvement in most of the system development lifecycle phases is inevitable. However, the phase where most private vendors are involved in during the development of an EHR system is System Design. Interestingly, their involvement does not depend on who has the responsibility of the EHR system development (either a national organization or a private vendor). Finally, examining the supported standards by EHR systems and their interoperability with other information systems, in respect to both technical and semantic interoperability, it is found that more efforts should be made for the integration of the most widely supported standards, and the enhancement of interoperability among health information systems, which will lead to the successful integration of a NEHR system.

      PubDate: 2017-04-19T10:02:38Z
      DOI: 10.1016/j.hlpt.2017.04.004
  • Assessing eHealth skills across Europeans
    • Authors: María Rosalía Vicente; Gary Madden
      Abstract: Publication date: Available online 13 April 2017
      Source:Health Policy and Technology
      Author(s): María Rosalía Vicente, Gary Madden
      The Internet has made health information more assessable to the general public. However, some serious concerns remain about the quality and reliability of that information, and the ability of the population to accurately interpret these data. An important aspect interpreting healthcare information are eHealth skills. To date, the available evidence is usually based on national analyses of composite measures of eHealth skills. To contribute to the debate our paper analyses particular eHealth skills based on data from a pan-European Union data set. In particular, with microdata from a representative sample, five skills are analysed, viz. searching, locating, understanding, evaluating and using online health information. We use a discrete choice model to identify statistical associations between respondent socio-demographic characteristics and skills. Our analysis reveals a complex pattern of eHealth skills is present across socio-demographic groups, with only self-reported health status and Internet experience influential for all skills. This finding suggests that targeted training actions are necessary to improve eHealth kills, with the seniors and the less educated the groups most in need of training.

      PubDate: 2017-04-19T10:02:38Z
      DOI: 10.1016/j.hlpt.2017.04.001
  • Supporting the Critical role of Family Carers in Wellness Management
    • Authors: Audrey Grace; Robert Gleasure
      Abstract: Publication date: Available online 13 April 2017
      Source:Health Policy and Technology
      Author(s): Audrey Grace, Robert Gleasure
      Aging populations, the increased prevalence of chronic disease, and spiraling healthcare costs have led to calls for policy and technology that focuses on wellness management, preventative interventions, and decentralized healthcare. This has prompted several initiatives aimed at empowering individuals to proactively manage their wellness, including employee wellness programmes, step-tracking mobile apps, etc. However, a critical actor in this proposed new healthcare model is the family carer. These individuals are charged with managing outpatients’ wellness, tracking deteriorations, providing support, and even administering routine care in order to minimize and/or delay the need for further clinical intervention. Yet for most people, ‘wellness’ is a poorly understood and ambiguously measured concept. Hence, family carers are often asked to rely upon personal discretion to perform their duties. This paper uses a qualitative case study based on a series of semi-structured interviews to explore how family carers manage this responsibility, the support available to them (technologically and socially), and the challenges they face. It is informed by a research model which combines activity theory and attribute substitution theory in order to make sense of how the diverse actors involved in wellness management (e.g. the family carers, the patients, other family members, clinical/non-clinical healthcare workers) communicate and coordinate. Findings suggest family carers’ role in managing outpatient wellness is hindered by their inability to gather/share key wellness-related information with others involved. The study concludes by calling for better technological infrastructure linking carers with clinical professionals and more standardized information channels between various stakeholders in the caring activity.

      PubDate: 2017-04-19T10:02:38Z
      DOI: 10.1016/j.hlpt.2017.04.002
  • Editorial Board/Aims and Scope
    • Abstract: Publication date: March 2017
      Source:Health Policy and Technology, Volume 6, Issue 1

      PubDate: 2017-03-22T07:01:15Z
  • Stakeholder Consensus on the Purpose of Clinical Evaluation of Electronic
           Health Records is Required
    • Authors: Lisa Ericson; Tora Hammar; Nils Schönström; Göran Petersson
      Abstract: Publication date: Available online 1 March 2017
      Source:Health Policy and Technology
      Author(s): Lisa Ericson, Tora Hammar, Nils Schönström, Göran Petersson
      Objective To explore the purpose and performance of clinical evaluation of electronic health records (EHRs) among stakeholders in order to identify any need for regulatory actions or guidelines. Methods This was a qualitative study of information collected in semi-structured interviews (n=28) of representatives of the five largest EHR vendors in Sweden, healthcare provider IT managers, users, and representatives of national authorities. Results We found a difference between the stated purpose of clinical evaluation of EHRs by the authorities and the perception of the purpose by the vendors, IT managers, and the users. The respondents gave divergent answers about the medical purpose of the application: e.g. availability of data, overview and documentation, patient safety, process efficiency, decision support, a working tool, and an aid to communication and follow-up. Several vendors found it difficult to put the term clinical evaluation in its specific context, instead referring to literature reviews, risk analyses, risk-management processes, acceptance tests, test facilities, pilot tests, and proven experience. Conclusions Stakeholders need to agree on a mutually acceptable, consistent method to guide regulatory decisions. The lack of consensus regarding the purpose and performance of clinical evaluation of EHRs could impact negatively on a safe and efficient documentation in healthcare. Thus, there is a need for more consistent use of terms and concepts in, and a more systematic approach to, clinical evaluation of EHRs. To ensure that the implementation of IT in healthcare meets expectations, delivers the desired outcome, and does not create new problems, it should be evaluated.

      PubDate: 2017-03-03T03:12:22Z
      DOI: 10.1016/j.hlpt.2017.02.005
  • Dynamic capabilities in e-health innovation: Implications for policies
    • Authors: Niels Frederik Garmann-Johnsen; Tom Roar Eikebrokk
      Abstract: Publication date: Available online 24 February 2017
      Source:Health Policy and Technology
      Author(s): Niels Frederik Garmann-Johnsen, Tom Roar Eikebrokk
      Objective To mitigate the effect of caregiver shortage, collaborative networks in Norwegian municipalities are exploring the possibilities provided by e-health and welfare technologies. However, extracting benefits from such technologies depends on many factors. Methods In this study, an extensive literature review is performed to compare e-health and other sectors in terms of the critical success factors in collaborative business process management. Using the dynamic capabilities view as a general theoretical lens, and a process orientation framework for operationalization, these factors are then conceptualized and validated in a cross-sectional study of cases in the Norwegian municipal e-health sector. Results The study contributes to e-health research by identifying the key factors that influence performance. These factors are significantly driven by government policies and regulations. Our findings challenge the assumption that welfare technology networks can be built from the bottom up without government intervention. Regulatory interventions are needed, to obtain process performance metrics and foster viable, long-term business models for the participating institutions. Conclusion The findings have an impact on research and practice, especially in local public management, for predicting and prescribing future development in this context. There are indications of significant gaps in government policies and regulations. Further research should examine whether and how these findings transcend the chosen context.
      Graphical abstract image

      PubDate: 2017-03-03T03:12:22Z
      DOI: 10.1016/j.hlpt.2017.02.003
  • Convergent analytics and informed decision-making: A retrospective
           multimethod case study project in Kenya
    • Authors: Irene Podolak; Anteneh Ayanso; Maureen Connolly; Madelyn Law; Jarold Cosby
      Abstract: Publication date: Available online 24 February 2017
      Source:Health Policy and Technology
      Author(s): Irene Podolak, Anteneh Ayanso, Maureen Connolly, Madelyn Law, Jarold Cosby
      Objective The objective of this qualitative, retrospective case study was to explain how and why the Chaguo Letu project was able to successfully make informed strategic decisions on how to implement a Cervical Self Sampling Program (CSSP) in Kenya. Methods This qualitative, inductive, study applied the case study method; a retrospective, explanatory, single bounded case study involving critical reflection on four embedded units of analysis: 1) Participatory Action Research (PAR) methodology, 2) Scenario Based Planning (SBP) method, 3) Existential Phenomenology (EP) method, and 4) Convergent Analytics (CA) model. Theory-related analytic generalization provided the foundation for the data analysis approach. Results The PAR methodology was critical to grounding this complex study and provided a new way of interacting and learning. The SBP data collection and analysis tools performed well in conducting perception analysis and trend/uncertainty analysis exercises. Incorporating EP enabled a deeper investigation of the phenomenon of cervical self-sampling and determined which units of significance (i.e., situational or emotional) had a greater influence on CSSP social acceptability. The CA model provided an approach to make sense of data, turn it into meaningful information and facilitate the convergence of tacit, explicit and cultural knowledge, which ultimately enabled informed decision-making for an uncertain future. Conclusions Applying an integrated approach encompassing the PAR methodology, SBP method, EP method and CA model enabled the Chaguo Letu project to make informed strategic choices on how to implement a CSSP in Kenya. Each element of the study design, by itself, could not have achieved this outcome.

      PubDate: 2017-03-03T03:12:22Z
      DOI: 10.1016/j.hlpt.2017.02.004
  • The politics of participatory epidemiology Technologies, social media and
           influenza surveillance in the US
    • Authors: Gabriel Blouin-Genest; Allison Miller
      Abstract: Publication date: Available online 20 February 2017
      Source:Health Policy and Technology
      Author(s): Gabriel Blouin-Genest, Allison Miller
      Background Health surveillance is now being augmented and transformed by the use of “unofficial” knowledge or sources of information. This unofficial data largely comes from Internet-based systems which gather information from non-state actors through intelligence networks, Internet and media scrawling, metadata analysis (online drug sale reports, Google searches, online forums, etc.) and social media analysis. Objectives The main objective of this article is to explore the policy implications of such a revolution, an issue that has been surprisingly largely ignored by the literature in public policy. The research question underpinning this analysis is: What are the policy implications of the growing use of knowledge/data from Internet-based technologies for health surveillance in the US? The theoretical importance and challenges of these technologies for public policies conclude this paper. Methods Using influenza as a case study, this article conducts a review of the documented impacts, for public health policy, of the use of communication and Internet-based technologies for surveillance. To do so, we inventory different social media-based initiatives currently used for influenza and public health surveillance while evaluating their consequences/impacts for public health policy. Conclusions The main conclusion is that the way we access, produce and distribute data/information about influenza (through the use of communication and Internet-based technologies for surveillance) has a direct impact on the risk perception and, ultimately, on public health policies through an “overload” of data.

      PubDate: 2017-02-24T00:42:10Z
      DOI: 10.1016/j.hlpt.2017.02.001
  • Predicting Obesity Rate and Obesity-Related Healthcare Costs using Data
    • Authors: Stephanie Revels; Sathish A.P Kumar; Ofir Ben-Assuli
      Abstract: Publication date: Available online 17 February 2017
      Source:Health Policy and Technology
      Author(s): Stephanie Revels, Sathish A.P Kumar, Ofir Ben-Assuli
      Objective Obesity is a worldwide problem that has been linked to serious medical issues. Obesity-related conditions drain healthcare expenditures globally, and in particular in the U.S. This article suggests methods to forecast future costs associated with obesity-related healthcare in the next two decades. Methods An Auto Regressive Integrated Moving Average (ARIMA) time series analysis was implemented to model the data published by the Center for Disease Control and Prevention. Results The findings suggest that the proportion of individuals in the population defined as overweight will decline slowly in the next 20 years. However, the proportion of the population considered obese will increase substantially and could represent as much as 45% of the entire population by 2035. The proportion of morbidly obese will also increase considerably. These trends are likely to impact the actual costs of healthcare considerably. Conclusions Policy makers in the healthcare sector should be aware of this trend and prepare to deal with increasing numbers of medical problems related to obesity. Concrete recommendations for policy makers are put forward in the discussion as well as avenues for future research.

      PubDate: 2017-02-24T00:42:10Z
      DOI: 10.1016/j.hlpt.2017.02.002
  • Factors Influencing Health Data Sharing Preferences of Consumers: A
           Critical Review
    • Authors: Lisa A. Moon
      Abstract: Publication date: Available online 25 January 2017
      Source:Health Policy and Technology
      Author(s): Lisa A. Moon
      The purpose of this critical review is to synthesize available literature and identify factors influencing consumer data sharing preferences, while presenting a logic model for legal / public policy development that aligns with consumer expectations for management of ePHI. Eighteen articles were included for the critical review; including 16 studies from three countries. The fourteen cross-sectional studies were evaluated using Olsen and St. George's (2004) Cross-sectional Study Design and Data Analysis framework and two qualitative studies were assessed using Kuper, Lingard, & Levinson (2008) Critically Appraising Qualitative Research strategies. An emerging classification schema of statistically significant factors identified in this critical review shows that, 1) Trust relationship, 2) Harm Threshold, 3) Balance Risk and Benefits, 4) Transparency of Data Exchange and 5) Access and Control of Data are important when considering how to best include the consumer voice in the development of legal / public policies related to the privacy, security and consent management of ePHI.

      PubDate: 2017-01-29T18:00:03Z
      DOI: 10.1016/j.hlpt.2017.01.001
  • Privacy and Security Issues in Mobile Health: Current Research and Future
    • Authors: Soumitra Bhuyan; Hyunmin Kim; Oluwaseyi O. Isehunwa; Naveen Kumar; Jay Bhatt; David K. Wyant; Satish Kedia; Cyril F. Chang; Dipankar Dasgupta
      Abstract: Publication date: Available online 25 January 2017
      Source:Health Policy and Technology
      Author(s): Soumitra Bhuyan, Hyunmin Kim, Oluwaseyi O. Isehunwa, Naveen Kumar, Jay Bhatt, David K. Wyant, Satish Kedia, Cyril F. Chang, Dipankar Dasgupta
      Mobile health (mHealth) is being recognized as an innovative approach to deliver health care in an accessible, portable and cost effective manner. Despite the numerous benefits associated with the use of mobile devices, there are major concerns with mhealth in the area of privacy and security. These aspects need to be considered at every stages of design and development of mHealth devices and applications and need to be developed by security-trained, trusted manufacturers who need to take responsibilities to minimize damages in healthcare industry. It is also crucial for users and/or organizations to be more cautious and responsible to use mobile devices. Major stakeholders, including those in the users community (patients and providers), vendors and developers, and policy makers, to come together to survey the landscape, identify the issues, and develop policies, regulations, safeguards and industry standards.

      PubDate: 2017-01-29T18:00:03Z
      DOI: 10.1016/j.hlpt.2017.01.004
  • Constructing a nationwide interoperable health information system in
           China: The case study of Sichuan Province
    • Authors: Huiping Zhang; Bernard T. Han; Zhiwei Tang
      Abstract: Publication date: Available online 23 January 2017
      Source:Health Policy and Technology
      Author(s): Huiping Zhang, Bernard T. Han, Zhiwei Tang
      Objectives China has set up an ambitious goal to complete the construction of a nationwide interoperable health information system (HIS) by the end of 2020. This paper provides a policy analysis, from the perspective of a province, on how China achieves nationwide interoperability through integrating Population Health Information Platforms (PHIP), developed by healthcare authorities at different levels, with HIS implemented by healthcare institutions. Methods An analytical framework, with a focus on interoperability between PHIPs and healthcare institutions’ HIS, is proposed and used to analyze Sichuan Province's interoperable HIS to shed light on China's approach. To assure the validity of our research, this study analyzed data collected from multiple sources including literature review, web-based search, and interviews with staff from healthcare institutions. Results China's approach to constructing a nationwide HIS offers great potential and flexibility through delegating PHIP construction to healthcare authorities at different levels. Our findings reveal that developed PHIPs have strong capacities for health information exchange. China's approach provides clear guidelines and standards such that healthcare authorities able to complete the construction of PHIPs on time. However, remedial policies are needed to improve the effective use and sustainability of completed systems. Conclusions To maximize use of developed systems, China government should: a) define a monitoring policy to ensure full observation of construction guidelines; b) promote a new payment mechanism to motivate information sharing; c) clarify the role of PHIPs, at different levels, to assure their effective use; d) provide incentives for non-public institutions to participate in EMR adoption.

      PubDate: 2017-01-29T18:00:03Z
      DOI: 10.1016/j.hlpt.2017.01.002
  • Patient Empowerment and Engagement with a Health Infomediary
    • Authors: Jiban Khuntia; Dobin Yim; Mohan Tanniru; Sanghee Lim
      Abstract: Publication date: Available online 13 November 2016
      Source:Health Policy and Technology
      Author(s): Jiban Khuntia, Dobin Yim, Mohan Tanniru, Sanghee Lim
      Objectives This study explores the role of three types of empowerment, psychological, discretionary, and leadership, on sustained engagement with a health infomediary. Discretionary empowerment refers to authority, psychological empowerment is the manifestation of inherent motivation and response, and leadership empowerment is the trait of knowledge-based control and governance for a group in an infomediary. Sustained engagement is critical for patients to derive long-term benefits from an infomediary. Relationships between the three types of patient empowerments on sustained patient engagement is conceptualized and operationalized with testable hypotheses. Methods Data from a health infomediary providing a knowledge exchange platform for patients interested in cosmetic surgery was obtained through the website. Probit regression models were used to test hypotheses using daily activity observations of 21,715 patients during the first 30 and 60 days of their engagement with the infomediary platform. Results All three empowerment types have positive association with sustained engagement. In addition, leadership empowerment is shown to play a higher role than discretionary or psychological empowerments in sustaining patient engagement. Conclusions Identifying empowered patients is likely to benefit health infomediaries. Leadership empowerment has a greater role than discretionary or psychological empowerments in sustaining patient engagement with infomediaries. Incentive structures around promoting patients towards leadership empowerment are likely to generate positive returns for health infomediaries.

      PubDate: 2016-11-17T03:27:20Z
      DOI: 10.1016/j.hlpt.2016.11.003
  • eHealth strategies and platforms - the issue of health equity in Sweden
    • Authors: Sofie Hellberg; Peter Johansson
      Abstract: Publication date: Available online 9 November 2016
      Source:Health Policy and Technology
      Author(s): Sofie Hellberg, Peter Johansson
      Objective This paper critically reviews the national strategies on e-health development in Sweden during the last decade. The aim is to identify the discourses that drive the development and implementation of eHealth in Sweden, with a particular focus on the rationales behind the government initiated PHR platform HälsaFörMig (HealthForMe), and discuss them in relation to health equity. Methods The empirical base for this study is government policy documents and interviews made with policy makers in the e-health sector in Sweden. The research design builds on qualitative text analysis method drawing on epistemological and ontological assumptions from discourse analysis. Results Our framework for analysis focuses on governing aspects of the eHealth sector drawing on the works of governmentality theorists. We have identified how the eHealth sector is increasingly governed through market mechanisms, healthism and responsibilisation and is forming individuals into self-managing health-conscious consumers in a way that may undermine reaching other core values in society such as health equity. It also shows that the design and administration of HälsaFörMig aim to stimulate innovation in the eHealth sector thereby illustrating the interrelationship between the governing techniques of market mechanism and healthism. Conclusion In order to close health gaps in a population the core governing rationalities driving the development in the eHealth sector have to be identified, monitored and evaluated to foresee if they help or hinder health equity.

      PubDate: 2016-11-10T02:25:49Z
      DOI: 10.1016/j.hlpt.2016.09.002
  • Editorial: Patient-Centered Health Information Technology: Preparing for a
           New Era
    • Authors: Reeva Lederman; Ofir Ben-Assuli
      Abstract: Publication date: Available online 4 November 2016
      Source:Health Policy and Technology
      Author(s): Reeva Lederman, Ofir Ben-Assuli

      PubDate: 2016-11-10T02:25:49Z
      DOI: 10.1016/j.hlpt.2016.11.001
  • The disconnect between healthcare provider tasks and privacy requirements
    • Authors: Michael Lapke; Christopher Garcia; David Henderson
      Abstract: Publication date: Available online 20 August 2016
      Source:Health Policy and Technology
      Author(s): Michael Lapke, Christopher Garcia, David Henderson
      Objectives Healthcare organizations have been digitizing their Electronic Medical Records (EMRs) for several years now and one of the primary concerns of their widespread implementation is the assurance of privacy for the sensitive information [22,23]. The objective of this study is to shed light into healthcare providers׳ attitudes towards privacy with regards to EMRs. We argue that healthcare providers place a priority on privacy issues given regulatory, fiscal, and reputation repercussions. Methods Using Information Boundary Theory [41] as a theoretical framework, we established four research questions. These questions formed the basis for the hypotheses that healthcare providers would agree with withholding information (to prevent loss and increase gains) as well as disagree with sharing information. We constructed a survey from this framework and administered it to 327 subjects (with a 45% response rate). Survey validation was conducted as well as hypothesis testing. Results The analysis of the data yielded a result that indicated that the survey responses did not support the hypotheses. Healthcare providers strongly disagreed that they would withhold information to solidify gains or mitigate losses. The subjects also agreed that they would share information in order to solidify gains or mitigate losses. Conclusions This led to the surprising conclusion that healthcare providers do not place privacy as a high-priority within the context of their duties. Healthcare professionals prioritize personal and organizational gain as well as mitigating personal and organizational loss over privacy of EMRs.

      PubDate: 2016-09-15T12:19:00Z
      DOI: 10.1016/j.hlpt.2016.08.004
  • A review of PHR, EMR and EHR integration: A more personalized healthcare
           and public health policy
    • Authors: Tsipi Heart; Ofir Ben-Assuli; Itamar Shabtai
      Abstract: Publication date: Available online 20 August 2016
      Source:Health Policy and Technology
      Author(s): Tsipi Heart, Ofir Ben-Assuli, Itamar Shabtai
      Objective To review and present the relationship and need for integrating EMR, EHR and PHR data, by highlighting its use and value challenges and threats. Method Critical overview of the literature. Results Electronic Medical Records (EMR) and Electronic Health Records (EHR) are used by physicians to improve quality of care and contain costs. Whereas EMR is usually considered an internal organizational system, the EHR is defined as an inter-organizational system. Recently, a computerized platform for patient-centered medical care known as Personal health records (PHR) was introduced, as an enabler for self-management of medical records. PHRs are online systems used by patients. Their transparency of information should lead to better informed and engaged patients. PHR, EMR and EHR can reside on different platforms under various technologies and standards. Although EMR contains local information and provides fast and accurate delivery, the major advantage of EHR in medical practice is the availability of cross-provider medical information. Patient-centered health initiatives such as PHR enable the integration of the prime information components in the EMR and the EHR systems. Conclusion This integration of medical information combines demographic, lifestyle and behavioral data with health records, thus providing a comprehensive view that coincides with the definition of patient-centered medical care. It can lead to a dramatic amelioration in personalized care as well as public health decision-making, resulting in improved health and wellness, but also poses serious challenges and threats to security and privacy.

      PubDate: 2016-09-15T12:19:00Z
      DOI: 10.1016/j.hlpt.2016.08.002
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