Rashid Bashshur, PhD

ABSTRACT

The purpose of this paper is to examine the potential for telemedicine to address health concerns among the elderly on a global basis. Of necessity, the global position of the elderly must first be briefly addressed here, as well as their basic needs that might be particularly relevant to their health status and social well being. Once these issues have been clarified, the potential role of telemedicine to address these basic health and social needs can be articulated, including a proposed typology of global telemedicine programs as well as significant issues facing their development. The paper concludes with a discussion of an agenda for action and the human dimensions that must be considered in developing global telemedicine programs for the elderly.
 

Dr Georg A Brox, MIHM, Janis L Huston, PhD, MEd, RHIA

ABSTRACT

One goal of the National Health Service (NHS) Care Record Service (NCRS) is to increase secure accessibility to vital patient data. This pilot demonstrated how JavaTM2Platform MicroEdition (J2ME™) software could be applied to provide secure mobile access to eHealth information. Since J2ME™ became commercially available, it has mainly focused on the entertainment industry. Widespread availability is due to the lucrative games market and it is currently installed in most picture-enabled mobile phones and some personal digital assistants (PDAs). Sun JavaTM Studio Mobility 6(2004Q3) authoring software was used with J2ME™ to create multimedia-based care record elements on a PDA, including both text and non-x-ray digital images. The creation of multimedia records was possible but, as J2ME™ is primarily used for entertainment, it was quite cumbersome. The devices necessary for this application are presently limited to mobile phones and mobile players as the main target devices. Once CLDC (Connected, Limited Device Configuration) and NCRS-specific MIDP (Mobile Information Device Profile) standards are developed by the NHS, secure access to the NCRS will be ensured. By developing J2ME™ applications in healthcare and applying these standards, secure mobile access could play a key role in meeting future challenges in eHealth.
 

Cheng-Ching Wang, PhD, MBA, BSN, RN

ABSTRACT

Although two million Americans live in nursing homes, there currently is no instrument to measure the perceived care needs of the nursing home residents. Since the quality of an older adult’s life is affected by their care needs being readily identified and met, the Perceived Nursing Home Care Needs (PNHCN) was designed. The purpose of this study was to assess the reliability and validity of the PNHCN.
The PNHCN was developed by Chaska and Deets based on Chaska’s Model. Initially, the PNHCN consisted of nine dimensions with 61 items. A convenience sample of 29 newly admitted residents was recruited from three nursing homes. Participants rated each item using a Likert technique format. Exploratory factor analysis with both Alpha Factoring and Principle Component Analysis (PCA) was applied to assess the construct validity. Twenty-four items were removed due to little variance. A reanalysis using PCA resulted in 37 items categorized under the four factors of Adequacy of Personnel, Personal Care, Non-Physical Care, and Adequacy of Resources. Cronbach’s Alpha of the PNHCN demonstrated good internal consistency reliability (α = .94). The PNHCN was found to provide good validity using a content validity index developed by three experts and lay people. The results provide evidence for the construct validity and reliability. Although it did not reflect the original nine dimensions, the four-factor structure shows adequate reliability and can better represent the domain of the PNHCN. However, the stability needs further testing.
 

Gerald-Mark Breen, MA, Jonathan Matusitz, PhD

ABSTRACT

The purpose of this analysis is to examine telemedicine’s implications in the context of interpersonal communication. As telemedicine is a form of computer-mediated communication that exchanges and/or delivers healthcare information between people – particularly medical practitioners, patients, and general healthcare consumers – it is appropriate to investigate it in terms of its on-line, interpersonal communication conditions and corollaries. In order to do so, three interpersonal communication theories are considered specifically with respect to telemedicine: social penetration theory, uncertainty reduction theory, and social presence theory. By gaining an understanding of telemedicine as an interpersonal channel and a resource that seeks to facilitate interpersonal communication when geographical distance does not allow for face-to-face contact, new insights into telemedicine’s interpersonal implications can be seen, thereby enabling an exploration of how its “impersonal,” nature can reduced, if not eliminated.
 

Shariq Khoja MD, PhD, Ann L Casebeer, PhD, Richard Scott, PhD, Salman Gilani, MD

ABSTRACT

The use of eHealth to enhance healthcare provision is becoming a global objective. eHealth readiness assessment tools can determine the preparedness of healthcare institutions to adopt programs related to eHealth. These tools can become important components of eHealth implementation, especially in developing countries. Objective of this study was to validate eHealth readiness assessment tools for healthcare institutions in developing countries, in public and private healthcare institutions of Pakistan. Qualitative methods, borrowed from the tradition of ‘case-study’, were used to determine the face and content validity of eHealth readiness assessment tools. All healthcare institutions in Pakistan were taken as a single case, and in-depth interviews were conducted with managers and healthcare providers from four institutions. All the participants were involved in planning and implementation of eHealth programs. eHealth readiness assessment tools were considered comprehensive, relevant, and beneficial for each level and sector of care. Participants’ views were obtained on the importance, relevance, and placement of each item and section in the tools. Valuable insight and suggestions for development and improvement of the tools were provided. These suggestions included placing extra emphasis on certain issues based on the conditions in Pakistan, such as comfort with the use of technology in maintaining patients’ records, proper budgeting and identification of sources of funds, external evaluation, socio-cultural factors among staff and clients, and building trust among policy-makers, senior administrators and faculty members. eHealth readiness assessment tools were found valid for face and content validity.
 

Shariq Khoja, MD, PhD, Richard Scott, PhD, AFM Ishaq, PhD, M Mohsin

ABSTRACT

Use of Information and Communication technology in healthcare (eHealth) is growing rapidly in both developing and developed countries. It is important that the healthcare institutions and the communities assess their preparedness for implementing eHealth, to enhance their chances of success. eHealth readiness assessment tools can help in determining such preparedness of healthcare institutions. This study is part of a larger study that develops and validates eHealth readiness assessment tools for healthcare institutions in developing countries. The study used survey methodology to determine the internal consistency reliability of eHealth readiness assessment tools. A total of fourteen healthcare institutions were selected in two areas of Pakistan, and all the managers and healthcare providers in these institutions, who had experience with eHealth programs, were asked to complete the tools. In total, 50 managers and 48 healthcare providers completed the survey. Cronbach’s alpha score for the tool for managers was 0.94, and for the tool for healthcare providers was 0.91. Also, the Cronbach’s alpha score for each category was found to be greater than 0.81. All the items, in both the tools, revealed significant correlation with the mean scores for that category. Thus the study showed significant internal consistency for both the e-readiness assessment tools. eHealth readiness assessment tools, tested in this study, demonstrated reasonable internal consistency reliability. These results, along with the face and content validities, reported in another study, provide confidence to the planners of eHealth programs to use these tools as part of the planning process.
 

Julius Licata, PhD, Lorrie Henderson, PhD, Krista McIlhaney, MA, Tom Wasser, PhD

ABSTRACT

Teens have limited access to professional help with emotional issues due to embarrassment, privacy concerns, lack of direct access to professionals, lack of funds and/or the absence of insurance for counseling. However, they do have anonymous access to the Internet, where they can access medical information as well as informal discussion. This paper describes the utility of researchable data contained in TeenCentral.Net, an interactive Web site for teens. The site boasts membership of more than 430,000 teens, with detailed stories posted by more than 150,000 members. This paper compares demographic variables between Web site members, and those who post their own stories to the site.  Additionally, it presents qualitative examples of the types of postings from teens troubled by the ‘Guilt/Shamed’ code and struggling with issues related to ‘Premarital Sex’. Data include: gender, race, location, grade in school, feelings about school, living arrangements, number of other children in the home and birth order. The illustration contains 138 teens (23 male, 115 female) and describes issues currently being dealt with, such as conflict of religion and sex, pornography and masturbation, incest, sexually transmitted disease, desire for sex, masturbation and relationship issues. The Web site enables teens facing crisis to view immediate responses to issues that they are facing by reading stories submitted by their peers. Further, teens receive direct feedback on their stories from a Masters-level counselor within 24 hours. The research use of this database of stories, has not been fully realized, but the possibilities appear to be substantial.
 

Aijaz Qadir Patoli, MBBS, MBA, DISM

ABSTRACT

Sexually Transmitted Diseases (STDs) constitute important primary health issues in Pakistan which face inadequacy of resources required in early detection and investigative procedures for their diagnosis and treatment. Syndromic approach to management of STDs is based on the identification of a consistent group of symptoms and syndromes to classify the exact disease or infection beforehand, so that further investiga-tions are sought for based on these initial criteria. This paper envisions the results based on two different approaches: Human and Artificial Intelligence (AI) along with some examples of on-going usage e of Artificial Intelligence in Medicine.

Pakistan is at an early stage regarding the use of such state-of-the-art-technology in health care for sustainable health system but is also under international obligation to adapt it as the World Health Organization (WHO) Regional Office for the Eastern Mediterranean (EMRO) has devel-oped an e-Health plan for the member countries including Pakistan.

The development of such e-health applications like one discussed in this paper may have significant impact on the future of e-Health in Pakistan.