Organizational Factors

The influence of organizational factors on the success of informatics interventions in healthcare has been clearly demonstrated. This health specific research, informed by a larger body of evidence emerging from interdisciplinary organizational, psychological and sociological research, has confirmed the view that organizational factors can be the decisive factor in the success of an intervention (Lorenzi et al, 1997). However it remains rare for organizational factors to be explicitly addressed in the implementation process. As such their contribution to the success or failure of informatics applications is not properly understood. This has implications for future interventions. Applications which were not utilized or did not perform adequately in a particular setting may be dismissed, while other, less appropriate systems may be adopted because organizational factors influenced their success. Explicit study of the role of organizational factors on the implementation of health informatics interventions is necessary to develop an understanding of their influence in the healthcare context. Healthcare organizations tend to be highly task oriented, labor intensive and dependent on interdisciplinary teamwork, so the influence of organizational factors within them may differ considerably from the business settings in which they have traditionally been studied (Chau, 2001). Health organisations are also increasingly underresourced due to the global downturn in government social spending, health sector privatization and aging populations. It is these characteristics which necessitate rapid uptake of informatics applications, capable of automating aspects of healthcare provision and reducing labor intensity (Coiera, 2004). From a technical perspective, rapid and fundamental transformation of the healthcare sector through informatics is achievable. However, without a clear understanding of, and ability to manage organizational factors it is unlikely that informatics applications will realize their potential in the health sector. This short review provides an overview of the key organizational factors influencing the success of informatics interventions. It begins by positioning informatics interventions in the broader context of organizational change, before discussing the current understanding of selected factors.

Computerised Decision Support for Women's Health Informatics

Decision analysis techniques attempt to utilize mathematical data about outcomes and preferences to help people make optimal decisions. The increasing uses of computerized records and powerful computers have made these techniques much more accessible and usable. The partnership between women and clinicians can be enhanced by sharing information, knowledge, and the decision making process in this way. Other techniques for assisting with decision making, such as learning from data via neural networks or other machine learning approaches may offer increased value. Rules learned from such approaches may allow the development of expert systems that actually take over some of the decision making role, although such systems are not yet in widespread use.

The Electronic Health Record to Support Women's Health

The seamless electronic health record is often hailed as the holy grail of health informatics. What is an electronic health record? This question is answered and consideration is given to the advantages and disadvantages of an electronic health record. The place of the electronic health record at the centre of a clinical information system is discussed. In expanding on the advantages several areas are covered including: analysis of data, accessibility and availability, and access control. Middleware technology and its place are discussed. Requirements for implementing a system and some of the issues that can arise in the field of women’s health are elucidated. Finally, in this exciting and fast moving field, future research is discussed.

eHealth Systems, Their Use and Visions for the Future

eHealth refers to use of information and communication technologies to improve or enable health and healthcare. eHealth broadens the scope of health care delivery, citizens are in the center of services and services are offered by information systems often via the Internet. In this chapter eHealth systems are classified on the basis of their use and their functionality and the use is discussed from the viewpoints of citizens and health professionals. Citizens are increasingly using Internet and eHealth systems to search for medicine or health related information, and they become better informed and may take more responsibility of their own health. Health professionals are more reluctant to use the Internet and eHealth systems in physician-patient communication due to power and responsibility problems of decisions. In the future the socio-technical nature of eHealth should be considered and future systems developed for real use and user environment with user acceptable technology.

Evaluation of Health Information Systems

This chapter summarizes the problems and challenges which occur when health information systems are evaluated. The main problem areas presented are the complexity of the evaluation object, the complexity of an evaluation project, and the motivation for evaluation. Based on the analysis of those problem areas, the chapter then presents recommendations how to address them. In particularly, it discusses in more detail what benefits can be obtained from applying triangulation in evaluation studies. Based on the example of the evaluation of a nursing documentation system, it shows how both the validation of results and the completeness of results can be supported by triangulation. The authors hope to contribute to a better understanding of the peculiarities of evaluation.

Electronic Information Sources for Women's Health Knowledge for Professionals

In an age where health professionals lead very busy working lives, electronic information sources provide ease of access to vast amounts of health information on an unprecedented scale. Health professionals have the ability to access the information they require from a location convenient to them and can do so at any time, day or night. This convenience has resulted in an increasing reliance upon electronic sources of information amongst women’s health professionals. As technologies develop, both the importance placed on the electronic dissemination of information by women’s health professionals and the use of such resources will increase dramatically. This chapter outlines the different sources of electronic information available to women’s health professionals, the constantly evolving online accessibility issues, the importance of critical appraisal when assessing the validity of online resources, and the role of the information specialist in the health sector. As this topic is currently under-researched a number of future research directions are also proposed.

Coding and Messaging Systems for Women's Health Informatics

Recording information about symptoms, observations, actions, and outcomes is a key task of health informatics. Standardization of records is vital if data is to be used by different groups, and transferred between organizations. Originally, coding focused on causes of death and other outcomes. Such systems include the international classification of diseases (ICD). However, more recently the need to allow communication between health organizations has encouraged the development of standards such as health level seven (HL7). Further work has focussed on vocabularies such as systematic nomenclature of medical terms (SNOMED), which allow standardised recording of any health-related information. Coded data is necessary to allow computers to assist in decision making and for audit purposes. With the rapid development of computer networks and the Internet, there has been a growing effort to include semantic information with computer data so that the meaning of the data can be bound to the data store. The chapter discusses these standards and the areas that are undergoing rapid development.

Computer Assisted Cervical Cytology

Automation and emerging information technologies are being adopted by cytology laboratories around the world to augment Pap test screening and improve diagnostic accuracy. Informatics, the application of computers and information systems to information management, is therefore essential for the successful operation of the cytopathology laboratory. This chapter describes how laboratory information management systems can be used to achieve an automated and seamless workflow process. The utilization of software, electronic databases and spreadsheets to perform necessary quality control measures will be discussed. The emerging role of computer assisted screening and application of digital imaging to the field of cervical cytology will be described, including telecytology and virtual microscopy. Finally, this chapter will reflect on the impact of online cytology resources and the emerging role of digital image cytometry.

Women's Health Informatics

Principlism (derived from common sense morality) is the most common theory used within the healthcare sphere. The elements of this theory are explored and discussed in context. A theoretical woman presenting in pregnancy is used to identify issues which can arise and explore the potential conflicts. In the second half of the chapter, health informatics and the law are discussed. Issues such as consent, confidentiality, privacy, and human rights are discussed in general. Legislation in the United Kingdom, United States, Canada, Australia, and New Zealand are discussed in detail.

Women's Health and Health Informatics

Information and communication technologies include computers, telecommunication, digital networks, and television. Using informatics in healthcare systems can improve the quality of healthcare through the effective use of information systems. Nursing Informatics (NI) is a component of health informatics, and it has become a widely used tool in the nursing profession. Information technology has begun to be employed in the field of women’s health. The perinatal period is one of the topics related to women’s health, as well as to that of their newborn infants. Information technology in patients’ health education process empowered patients, and enhanced their self-management skills. However, applications of health informatics in perinatal care for women and their newborn infants have not been reported widely in research studies and projects. Thus, there is a gap of knowledge related to this topic on the Internet.