These results provide an initial guide for the tasks and appearance appropriate for a robot to provide assistance in aged care facilities and highlight concerns.
Summary Background: While health informatics recommendations on competencies and education serve as highly desirable corridors for designing curricula and courses, they cannot show how the content should be situated in a specific and local context. Therefore, global and local perspectives need to be reconciled in a common framework. Objectives: The primary aim of this study is therefore to empirically define and validate a framework of globally accepted core competency areas in health informatics and to enrich this framework with exemplar information derived from local educational settings. Methods: To this end, (i) a survey was deployed and yielded insights from 43 nursing experts from 21 countries worldwide to measure the relevance of the core competency areas, (ii) a workshop at the International Nursing Informatics Conference (NI2016) held in June 2016 to provide information about the validation and clustering of these areas and (iii) exemplar case studies were compiled to match these findings with the practice. The survey was designed based on a comprehensive compilation of competencies from the international literature in medical and health informatics. Results: The resulting recommendation framework consists of 24 core competency areas in health informatics defined for five major nursing roles. These areas were clustered in the domains “data, information, knowledge”, “information exchange and information sharing”, “ethical and legal issues”, “systems life cycle management”, “management” and “biostatistics and medical technology”, all of which showed high reliability values. The core competency areas were ranked by relevance and validated by a different group of experts. Exemplar case studies from Brazil, Germany, New Zealand, Taiwan/China, United Kingdom (Scotland) and the United States of America expanded on the competencies described in the core competency areas. Conclusions: This international recommendation framework for competencies in health informatics directed at nurses provides a grid of knowledge for teachers and learner alike that is instantiated with knowledge about informatics competencies, professional roles, priorities and practical, local experience. It also provides a methodology for developing frameworks for other professions/disciplines. Finally, this framework lays the foundation of cross-country learning in health informatics education for nurses and other health professionals.
Background: Barriers to accessing perinatal health services in New Zealand remain a significant problem, especially for Māori and rural populations. Information technologies and telehealth can facilitate the distribution of health-related information and promote provider engagement during the perinatal period. Aim: This study explored the perceptions and use of technologies by women and their partners who were pregnant or new mothers/caregivers and who utilised Kaupapa Māori perinatal health services. Method: A Kaupapa Māori consistent methodology was applied. An equal explanatory sampling approach was used for recruitment. Conversational interviews were conducted with a total of nine Northland-residing participants of an antenatal programme. Data were analysed thematically. Findings: Four overarching themes emerged from the interview narratives: communication, information, facilitators and barriers. Participants used a range of online tools to access diverse healthrelated topics and executed autonomous control over the information gained. The credibility and reputability of sources as well as knowledge sharing were valued. Similar technologies were used to communicate with perinatal healthcare providers, including lead maternity carers, and to make in-person appointments. Barriers were related to the technology itself or the experience of using it, whilst ease of access and emotional elements facilitated engagement. Participants were generally satisfied with the technologies. Conclusion: Technology can play an important role in health literacy and minimising barriers to perinatal healthcare, by facilitating the distribution of information and promoting provider engagement. As the research indicated that online tools and services available in Northland are generally adequate for the population served, perinatal healthcare providers should leverage these to further promote engagement with service users. It is crucial that Māori health values such as whānau (extended family structures) and kanohi ki te kanohi (face-to-face interactions) are incorporated for successful perinatal healthcare delivery via telehealth.
The Hackathon concept is attracting interest as a vehicle for participatory development in both Health and Information systems. Publically available datasets, cloud based data storage, and increasingly sophisticated analytical methods, combined with user friendly development tools for mobile devices are inspiring innovation in the participatory medicine space. This has the potential to disrupt traditional methods and deliver solutions more rapidly, and in a form more likely to meet requirements. In health applications this involves putting the patient and their supports at the centre of design. This work contributes to solving the challenges involved in bringing a diverse cohort of designers, developers, problem owners, healthcare providers, patients, and citizens together to solve user-driven self-care problems using technology. We use a descriptive case study approach focussing on two weekend-long hackathons dubbed "Health Hackathon: Solving Self-care". We gather thick data from multiple sources according to the process defined by Geertz (1994) first, to provide a rich picture of the role of hackathons in participatory medicine and second, to contribute evidence to the practise of running a hackathon. Some key originalities of our work include seeking more candid responses via selfserve interviews. Through this, controversially, we noted a marked emphasis on the creative process over concerns for privacy and ethics around the personal data cloud created by hackathon products. We build on existing theories of participatory medicine and emerging methodologies for conducting hackathons to provide evidence of the efficacy of the hacking approach both in terms of outcome and team dynamics. Through interviews, observation, twitter feeds and a pre-survey, we identify a number of success factors including (1) group size, (2) maturity of the idea, (3) level of involvement of a mentor, and (4) involvement of students. In addition we identify five skills identified by successful health hackathon participants; knowledge, patient focussed skills, analytical skills, software design skills and professional perspective. In common with previous studies we find that there are considerable social benefits that accrue in running a hackathon. Participants meet new people and learn first-hand of the challenges and opportunities provided by the skill sets and work environments of others. This work builds on the existing body of research concerning hackathons and in particular work in the context of participatory medicine
INTRODUCTION: New Zealand health policy encourages patient access to their electronic medical records via portals.AIM: To discover patient and general practitioner (GP) perspectives of access to electronic medical records and e-messaging in the early portal implementation phase. METHODS:In 2014, Auckland primary health organisations and an Accident & Medical organisation were asked to invite their GPs to complete an online survey and consent for a researcher to attend their waiting room and invite patients to complete a survey. RESULTS:In total, 421 patients (13% Maori, 18% Pacific, 7% Asian, 53% NZ European/Other) participated from 13 general practices. Most (77%) knew they were entitled to see their medical records and 90% were interested in viewing them. Over two-thirds thought that viewing their records online and e-messaging their practice was a good idea. Over 80% disagreed that they would be worried, confused or embarrassed by seeing their records, with 59% expecting portals to facilitate understanding of their medical conditions. Internet security and privacy concerned 40% of patients. Among 83 GPs who completed the survey, six (7%) had already implemented portals. Few were comfortable to open up the whole health record, especially visit notes. While GPs thought that portal access may help patients better understand their plan of care, their main concerns related to causing confusion and worry. Portal implementation was expected to change GP documentation and increase practice workload and costs without demonstrable benefit to practices. DISCUSSION:At the beginning of portal adoption, patients were interested. GPs were more reticent, unsure whether the benefits would outweigh the downsides for their patients and practice workload.
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