http://hdl.handle.net/10037/195 2012-02-12T06:28:25Z http://hdl.handle.net/10037/3627 Kalam, Abul<br /> Developing countries are leisurely adopter of new technologies, particularly with regards to the health services of these countries. This study explores the current health information infrastructure and future prospects of information and communication technology in health system of Bangladesh using an interpretative case study approach and proposes apply Telemedicine system to ensure health for all. This study almost certainly the first of its variety in Bangladesh; there have been some inadequate studies of Telemedicine early trials in some developing countries assessing the challenges of implementation. This study briefly mentions one of such; the Indian Telemedicine system. Some confronts that would obstruct the implementation of Telemedicine in Bangladesh are the initial huge start up costs, poor ICT culture of healthcare professionals and people embedding political meanings into the system. The weak state of information infrastructure at the hospital would be another challenge in implementation Telemedicine. Here Telemedicine could potentially reduce waiting times for patients, reduce the cost of the health system’s operations, improve interdepartmental, inter-hospital communication and collaboration, provide opportunity for sharing best practices among physicians within Bangladesh and international hospitals, and enhance better resource allocation.<br /> 2011-08-14T22:00:00Z Kalam, Abul http://hdl.handle.net/10037/3546 Wefuan, Fatimatou Kuhmbou<br /> Health care systems nowadays are affected by quality problems, most of which occur in developing countries due to the lack of adequate infrastructural, human, and financial resources. This has also caused the data quality generated in developing countries to be often poor. As a result, most governments in developing countries are in the process of improving quality in their health care systems through the introduction of Information Technology (IT) support systems. This thesis explored the challenges and opportunities involved in the path to improving the quality of laboratory documentation in a Cameroonian hospital. The study employed the qualitative research approach whereby interpretive research methods were used during data collection. These consisted of participant observations, interviews, and document analysis. A total of 24 respondents were interviewed comprising of 19 hospital staff and 5 patients. The data was collected at the medical laboratory department of the Regional Hospital Bamenda over a period of two months. The theories of Information Infrastructures and Actor Network guided the study, that is, they were used to discuss the laboratory documentation, and the implementation of the IT support system in the everyday work practice. The study findings primarily revealed certain quality-related lapses in the laboratory documentation. For example, illegible laboratory test orders, common errors in laboratory test ordering and result reporting, just to name a few. It further revealed that IT support systems have great potential to improve upon the quality of the laboratory documentation. Thus, it suggested that a tailored IT support system could be implemented to address this issue. However, the greatest challenge discovered was the lack of resources to make this happen. Based on these findings, it was suggested that if resources are made available to implement this system, the socio-technical approach should be employed in order to ensure success. This is because this approach has proven to be effective since it does not only take into consideration the new technology implemented, but also the interaction between the technology and its users.<br /> 2011-05-14T22:00:00Z Wefuan, Fatimatou Kuhmbou http://hdl.handle.net/10037/3545 Johnson, Beatrice Bella<br /> Quality patient’s information has been proven to enhance the quality of care the patients receive as well as the guarantee of their safety. This is because information would be available to inform others and subsequently aid appropriate decision making concerning patients care. On the other hand, nurses being the professionals who spend twenty-four hours with the patients have a lot of information to capture from patients observation and care. Hence Nursing Documentation provides a lot of information to guide decision-making, and it therefore needs to be efficient in order to be effective. The purpose of this study was to assess the effectiveness of nursing documentation as a communication tool among health professionals involved in patients care. Other aims were the extent to which nursing documentation fosters communication in the care setting and also to exploit ways in which nursing documentation could be improved upon to enhance efficiency. The study was conducted within a period of two months at the Volta Regional Hospital, Ho, in Ghana. Qualitative research method particularly case study was used to find answers to the research question. Also Actor Network and Information Infrastructures theories guided the study. 27 nurses with different work experience and ranks, 2 physicians and 1 information officer were interviewed to exploit their divergent viewpoints on nursing documentation. In addition, participant observation was done in 4 of the wards on health personnel during work practice. The findings of the study indicated that work overload resulting from scarcity of nurses prevents the nurses from making time for documentation. Also there were too many sources of documentation with some levels of duplication without any definite structure. Further, a standard to guide nursing documentation was absent. In addition, nurses are trained in nursing care plan but had to use other types of documentation style at the work setting. Also the nurses make use and rely more on oral account of patient care than the written documentation. In conclusion the study revealed that at times the information captured was not adequate to communicate to others. However deployment of electronic nursing documentation at the wards was found to be appropriate in addressing this problem. Also the study provides insight into issues in the nursing documentation and accordingly would inform the Nursing Body in Ghana.<br /> 2011-05-29T22:00:00Z Johnson, Beatrice Bella http://hdl.handle.net/10037/3543 Shrestha, Pritam Lal<br /> The use of ICT in the medical field has given rise to a new dimension so called telemedicine. Telemedicine is not a new concept, but the level of use differs between the developed and the developing countries, because of the limited infrastructural development and high expenses of technology in the later case. Though it is certain that using ICT in healthcare will improve health status of the nation, answers to the questions like which technology to choose; and what strategy to follow in order to achieve maximum benefit from minimum investment is still under consideration for developing countries. This study was carried out at Dhulikhel Hospital to explore the infrastructural development of telemedicine, its usage, benefits and users’ perspectives on the stability and sustainability of the services in future with context to hospitals in Nepal. A qualitative method with interpretive research approach was chosen for the study using informal discussions, observation and semi-structured interviews with open-ended questionnaires as data collection tools. The empirical findings have been generalized via Information Infrastructure (II) and Actor Network Theory (ANT) as theoretical framework. The findings from the study indicate that telemedicine is not simply technology; rather it is teamwork which requires good relationship between the users and good understanding of the setup. Furthermore, the study concludes that even a simple technology if implemented with proper vision and strategy can save many lives, and sustainability with telemedicine for developing countries can be achieved through slow and steady progression. Key words: Telemedicine, Nepal, sustainability, strategy, slow and steady progression.<br /> 2011-05-14T22:00:00Z Shrestha, Pritam Lal http://hdl.handle.net/10037/3522 Dawson, Joanna Adobea<br /> Rationale: Attempts to successfully develop telemedicine solutions by specifying the require-ments and critical success factors of these solutions are on-going in sub-Saharan Africa (SSA) countries as a means of improving access to high-quality healthcare. European Space Agency (ESA) (Dario et al. 2005) have explored the challenges and benefits of telemedicine solutions in these regions in the domains of eGovernment such as billing and administrative data management to support the healthcare process, aggregation and reporting of administrative data including quality, clinical outcomes, improving decision making through access to information and ad-vocacy through modern technology. This thesis builds on from the comparative analysis of the healthcare systems in Ghana and Nigeria, in order to specify the system requirements for teleme-dicine solutions supporting health governance in these countries. Motivation: Relevant literature in the domains of public health and information systems (IS) which studies requirements and success factors of telemedicine solutions in SSA countries sug-gests specific attention to be paid to the ability of such solutions to support health system gover-nance. This is due to the complex institutional context involving technical, legal, organizational, and financial issues to be solved which makes it difficult to transfer decision-making, planning, budgeting, management and resource allocation from the national level to the country-regional, district, sub-district and community levels (Braa et al. 2001). Method: This thesis performs a thorough review of published evidence to acquire information on the governance structures of healthcare systems in Ghana and Nigeria as well as successful operative telemedicine applications and services in these countries. UML modeling of the struc-tures is used to describe the processes which link the national level to the level of the (Regional Economic Communities) RECs of which these two countries are part. The open source District Health Information System 2 (DHIS 2) developed by Jørn Braar and collaborators is analyzed to assess functionalities it has to support health governance and health system management. The system is also analyzed in terms of what it stores, its extensibility and scalability by functions. A structured interview on health system governance in Ghana and Nigeria is conducted with key respondents such as health workers, persons dealing with statistics and training, system users, Health Information System (HIS) managers and planners. The research questions are tailored towards decision making processes in the running of healthcare system from national level to community level. Issues around funds, budgets and resource allocations are discussed. Decisions made with regard to the implementation of health policies such as the implementation of new types of healthcare services (i.e. eHealth services) are also discussed. Results: A main finding in the thesis is that the development of information systems at district and Primary Health Care (PHC) levels in Ghana and Nigeria needs to be an integrated effort across health sectors. With this focus, requirements and critical success factors of telemedicine solutions for Ghana and Nigeria have been specified by assessing the governance structures of health services in the two countries and by analyzing the DHIS 2 to identify scenarios in health-care that need telemedicine support. In the case of Ghana, the local control and empowerment of information at lower levels should be embedded into PHC. This is due to the fact that the man-agement of the source of healthcare information is usually a top-down approach (from national level to lower level) toppled with the differences that exists in the collection of healthcare data. This causes delays in healthcare decision making and duplications and omission of key data sets for performance assessment by the government. As such, the DHIS 2, although being used for information reporting in the Ghanaian healthcare system extended in terms of functionalities it is proposed as a system to support healthcare governance. In the case of Nigeria, there exists a Na-tional Health Management Information System (NHMIS) as a management tool for informed decision making at all the levels of government in Nigeria. However, there is no clearly defined role of the different tiers of government which affects the proper functioning of the NHMIS in terms of data input and data quality. As such, integrating the DHIS 2 to be used alongside the NHMIS at the Local Government Areas (LGAs) may enhance data quality and improved infor-mation reporting in healthcare decisions. Conclusion: Telemedicine and eHealth activity around developing countries is increasing, and this fact cannot be denied. Although such activities could be a daunting task, they are emerging as a promising means for achieving quality healthcare. The specific healthcare situations in Ghana and Nigeria have resulted in the specification of seven requirements regarding to the utili-zation of a HIS (specifically the DHIS 2). This is hoped to assist in the effective governance of healthcare systems in these countries.<br /> 2011-05-31T22:00:00Z Dawson, Joanna Adobea http://hdl.handle.net/10037/2969 Ravuri, Ashok Babu<br /> This Master thesis is based on an ongoing project work titled ―Context-Sensitive systems for mobile communication in hospitals‖ at Norwegian Centre for Integrated care and Telemedicine (NST), University Hospital of North Norway (UNN). The project group is working on context-sensitive communication in hospitals based on Ascom/trixbox experimental (ATE) platform. The ATE based protocol system designed/developed to manage mobile communication interruptions in hospitals presents a new context-sensitive communication system for hospitals. The intended ATE based mobile communication work is based on different context information, in this case it is location information. This Master thesis is intended to provide a motivation for researchers and developers to develop/implement a context-sensitive mobile communication in hospitals.<br /> 2010-09-22T22:00:00Z Ravuri, Ashok Babu http://hdl.handle.net/10037/2956 Ruba, Wael Abdulhafeeth<br /> Using mobiles for health related purposes have been studied for a while and new concepts such as mhealth have been introduced. The latter is believed to have a great potential in taking health related applications to a higher level especially with the introduction of a high-tech mobile phones called “smartphones”. This research presents different aspects of mobile’s potentials that have been employed in ActiveTeen which is a Mobile Social Networking Mapping and Gaming Application that intends to help adolescents in doing at least 1 hour of physical activity.<br /> 2010-12-14T23:00:00Z Ruba, Wael Abdulhafeeth http://hdl.handle.net/10037/2638 Hagen, Kari<br /> The ambulatory consulting service is a corner stone in the services of a resource centre for rare disorders. Videoconferencing is considered an alternative way of meeting, to decrease costs and time spent on travelling and to increase the number of professionals from Frambu participating at the conference. Additionally, it can lead to a broader multidisciplinary scope. The Technology Acceptance Model (TAM) is used as theoretical framework. TAM is a theory useful to predict user acceptance of information technology, with its two determinants “perceived usefulness” and “perceived ease of use”. The aim of the study was to compare two modalities of conducting a clinical conference: face-to-face and videoconference. Clinical conferences from January 2008 until March 2010 were assessed, resulting in 375 informants. The participants received questionnaires to assess their satisfaction with the conference. The main result was that both clients and providers were satisfied with the service, whether it was delivered as a videoconference or as a face-to-face meeting. Clients and providers were equally satisfied. There were no significant differences in satisfaction depending on neither the age of the participants nor on former experience with videoconferencing.<br /> 2010-05-13T22:00:00Z Hagen, Kari http://hdl.handle.net/10037/2624 Kamble, Priya Suresh<br /> The aim of this thesis was to implement prototype which, provides relevant information to the user at right time. The personal information that is targeted here was health-related information. This may include various type of information, such as drug information, education information, health monitor data for instance glucoses meter, step counter, personal notes, health related images ,PDF files. To implement prototype, we use metadata of the information. Some of the metadata of the information describes the context of the information. We used time, date and location context of information to implement our goal successfully. By using these contexts of the information, the relevant information to user is provided. The four components were implemented to implement prototype: Metadata extractor, Information manger, controller and user interface. The metadata extractor allows user to download files and automatically store file in to the download folder and context of these files was extracted and stored in to the database. The second component was information manger; the main function of this component was to reads the context of downloaded files and make association of similar files by using context. The third component was controller, it was use to represent related files to the end users and the user interface allows user to interact with our system. The implemented prototype was tested for providing related information to the users. The information access was based on the context of the information, which eases to get results and to recognize useful information for the users. It was also tested whether the prototype stores updated files or not. The prototype makes association of new downloaded files to the database and it also avoids redundancy of files. Thus, it helps users to access the updated information and to reduce redundancy of data. The prototype provides user with the right set of information to the right time, by identifying the need of the users by matching with available information.<br /> 2010-05-31T22:00:00Z Kamble, Priya Suresh http://hdl.handle.net/10037/2614 Hagen, Oddvar<br /> Video conferencing is used as communication between smaller institutions and hospital to access emergency specialists.What are the reasons for using a video-congerence solution compared with traditional communication between institutions. Professional health workers are interviewed according their preferences after more than one year after the implementation at their institution.<br /> 2010-05-30T22:00:00Z Hagen, Oddvar