HOW INFORMATION USED AND MANAGED IN ORGANIZATIONS IS CHANGING WITH NEW TECHNOLOGIES
The way healthcare organizations use and manage information has changed significantly in the recent past due to the adoption and use of new technologies, especially mobile devices and applications in healthcare delivery processes (Migo et al., 2015). However, the benefits of adopting and implementing mobile technology in the healthcare industry are not experienced by hospitals alone. Intermediaries in the healthcare sector, such as suppliers also benefit from new technology. Patients also experience positive effects of mobile technology in healthcare, such as improved efficiency and alignment of care services with their unique medical needs (Quinn et al., 2013). In addition to informational benefits, mobile technology enables healthcare organizations to run complex operations with efficiency and to enhance the quality of their services (Naslund et al., 2015). The specific benefits of mobile technology in the healthcare sector are discussed in this paper in the context of the impact of mHealth solutions on the use and management of information by stakeholders in the healthcare sector. Real-world examples and case material are used to demonstrate that the use and management of information within the healthcare sector are being transformed by mobile technology.
The use of mHealth Solutions
Kitsiou et al. (2017) reveal that mobile health solutions range from easy-to-implement applications to complicated and integrated information communication technology systems. The application of mobile health solutions in the Royal Berkshire NHS Foundation Trust demonstrates that they contribute to operational efficiency, quality of care, and significant cost-savings (CSC, 2011). Notably, there are three main categories of mHealth solutions used to manage information within contemporary healthcare organizations: simple, advanced, and regulatory mHealth solutions. Deliberato et al. (2017) define mHealth solutions as mobile devices, applications, and wireless technologies used to manage information, improve communication and enhance the experiences of consumers of healthcare services. Wiederhold (2015) adds that mHealth solutions allow healthcare organizations to expand the geographical coverage of their services. They are used in the Royal Berkshire NHS Foundation Trust to promote connectivity among healthcare providers and to enable collaboration in the delivery of care services regardless of location or time (CSC, 2011).
Simple mHealth Solutions
Simple mHealth solutions are mobile applications, such as text messaging used to enhance the management and sharing of information in healthcare. Case studies on the efficiency of the UK National Health Service (NHS) reveal that there are specific cost inefficiencies related to the management and use of medical information (Lindsay et al., 2014). Winstein & Requejo (2015) illustrate that missed appointments and resultant severe illness and complications cost NHS services more than £789 million annually. For this reason, NHS facilities are increasingly adopting simple mHealth solutions to enable providers to send patients appointment reminders through SMS. This is aimed at decreasing the cost of missed healthcare appointments (Lindsay et al., 2014). In addition, simple mHealth solutions enable NHS facilities to reduce waiting times in their hospitals.
Sectra (2013) illustrates that management of health information through the use of simple mHealth solutions enables Guy's and St Thomas' Hospital NHS to improve efficiency, reduce costs and enhance patient satisfaction. Deliberato et al. (2017) indicate that simple mHealth solutions allow providers to manage information on appointments in an effective manner, which increases attendance to appointments by patients. Sectra (2013) notes that the increase in the utilization of physician services within Guy's and St Thomas' Hospital NHS is attributed to the use of mHealth solutions in the management and use of health-related information. However, it is argued that business interests motivate the mHealth market more than the need to advance the needs of patients (Migo et al., 2015). Deliberato et al. (2017) illustrate that the increasing use of simple mHealth solutions has enabled mobile network operators in the UK to experience significant increases in revenue from SMS services.
Advanced mHealth Solutions
Remote monitoring of patients is a good example of the application of advanced mHealth solutions in healthcare. Wiederhold (2015) demonstrates that the processes of collecting, transmitting, and applying medical information have been improved significantly through the use of advanced mHealth solutions in the healthcare industry. Comparative studies across the UK and the US indicate that the adoption of advanced mHealth solutions by hospitals, such as remote monitoring devices, is increasing. This is attributed to the important use of advanced mHealth solutions by physicians to monitor the vitals of patients remotely (Quinn et al., 2013). For example, advanced mHealth solutions are used to monitor heart rates and blood sugar levels of patients with chronic heart conditions and diabetes respectively (Quinn et al., 2013).
Empirical studies reveal that the duration of hospital stay reduces dramatically when patients are monitored remotely using advanced mHealth solutions. Tamrat & Kachnowski (2012) add that the risk of re-hospitalization among aged patients is also reduced when advanced mHealth solutions are used to manage patient vitals from remote locations. Deliberato et al. (2017) explain that mHealth solutions enable healthcare organizations to cut costs as patients do not have to occupy hospital beds when they can be monitored from their homes. Nonetheless, there are notable methodological challenges, such as the lack of comparison groups, which limit the external validity of research findings on the benefits of advanced mHealth solutions (Quinn et al., 2013).
Regulatory mHealth Solutions
Regulatory mHealth solutions refer to technologies that enable healthcare organizations to protect the privacy and confidentiality of medical data (Migo et al., 2015). Wei et al. (2016) demonstrate that the use and sharing of information within hospitals should be aligned with regulatory and ethical frameworks on information security due to the sensitive nature of medical data. Notably, the Caldicott Report recommended that both NHS and non-NHS services should develop security protocols meant to protect the confidentiality and privacy of medical data in all inter-organizational data exchanges (Pouloudi, Currie & Whitley, 2016). Teo, Ng & White (2017) explain that healthcare organizations integrate regulatory mHealth solutions into their electronic data management systems with the goal of adhering to their legal and ethical obligations of protecting the privacy of their patients.
Authentication applications are examples of regulatory mHealth solutions that have been adopted by health facilities in the UK, such as NHS Greater Glasgow and Clyde and the Institute of Cancer Research Royal Cancer Hospital, to secure medical data during inter-organizational prescription transfers (Frame, Watson & Thomson, 2008). Notably, regulatory mHealth solutions allow health facilities to secure patient-identifiable data (Migo et al., 2015). Encrypted data logins are also used by pharmacists in securing prescription transfers between health facilities. Teo, Ng & White (2017) recommend that all healthcare organizations in the UK should adopt regulatory mHealth solutions as they enable them to comply with regulatory requirements on data security during the management, transfer, and use of medical records. However, advanced data security solutions, such as ClearDATA Security Suite and Norton Internet Security are better than most regulatory mHealth solutions in securing medical data within cloud computing environments (Chamberlain, Elcock & Puligari, 2015).
Healthcare Challenges Necessitating Mobile Technology
Healthcare organizations face a wide range of challenges that can be mitigated through the adoption and implementation of mobile technology solutions in health record management processes. Challenges related to the care of the aging population are among the main concerns of healthcare organizations in the UK (Chamberlain, Elcock & Puligari, 2015). Deliberato et al. (2017) reveal that healthcare providers are facing the challenge of meeting the individual needs of members of the growing aging population in the UK. Kitsiou et al. (2017) note that the demand for chronic care services in the UK is increasing. Wiederhold (2015) explains that the increase in the incidence and prevalence of chronic conditions in the UK contributes most to the challenge healthcare professionals face today.
Statistical data reveals that 52% of visits to general practitioners are related to chronic conditions (Migo et al., 2015). In addition, researchers project that the incidence of chronic conditions in the UK, including cardiac disorders, hypertension, diabetes, chronic obstructive airway diseases (COADs), and kidney diseases will continue to increase. The challenge of meeting the demand for chronic care is worsened by the fact that most NHS facilities face a shortage of providers (Quinn et al., 2013). Deliberato et al. (2017) recommend that mHealth solutions should be adopted by healthcare organizations to meet the increasing demand for chronic care and to fill gaps in staffing.
Benefits of Mobile Technology in Health Information Management
Diabetes monitoring is a distinct example of the benefits of mobile technology in healthcare. For example, remote sensors embedded in glucose monitors are used in BMI Health Care to transmit data on the conditions of patients with diabetes via mobile networks to general practitioners (Reynolds, 2017). Medical data on any abnormalities or warming signs are transmitted automatically to general practitioners within BMI Health Care to enable them to make effective and timely clinical decisions on courses of action. It is estimated that the use of mobile technology to manage and use medical information on diabetic patients will enable NHS to save up to £1 billion annually due to a reduction of visits to general providers (Burns, Keating & Free, 2016). Mobile phone applications are also used in BMI Health Care to monitor patients with asthma (Reynolds, 2017). The peak flow meters present asthmatic patients with medical information on their conditions, which they input into mHealth applications and transmit it to doctors. Since COADs are among the commonest medical conditions in the world, a lot of time will be saved through the use of mobile technology to access and apply medical data in informing care interventions for patients with COADs.
Wei et al. (2016) disclose that mobile technology is increasingly applied in promoting compliance with prescribed drugs by patients. For instance, SMS medication reminders are used in NHS Fife to alert patients and doctors when medication has been skipped or taken. However, the use of medication bottles containing mobile technology modules to promote dose compliance has not been successfully implemented in the health facility (Reynolds, 2017). Winstein & Requejo (2015) argue that further developments in mobile technology are needed to make their application in promoting medication compliance more feasible. Regardless of the noted challenge, case studies of mHealth models from Thailand indicate that the use of mobile technologies increases the compliance of patients to medications by up to 90% Iribarren, Cato, Falzon & Stone, 2017).
The dissemination of medical information among providers and patients is facilitated through the use of mobile technologies. Guy's and St Thomas' Hospital NHS uses interactive SMS services to disseminate information on topical areas, such as sexual health to patients (Sectra, 2013). Providers within the health facility effectively apply the responses of patients on mHealth platforms to plan and implement patient-centered and evidence-based care interventions. Wei et al. (2016) illustrate that hospitals in the UK are increasingly using mHealth solutions to reach out to specific patient populations, such as promoting Chlamydia screening among young women below the age of 24. Electronic prescriptions are also becoming common among NHS facilities. For example, registered pharmacists are able to receive information on prescriptions from providers in Guy's and St Thomas' Hospital NHS via electronic transmission across mobile networks (Sectra, 2013). The information is used to provide patients with the right kind of medication and dosage. Wiederhold (2015) reveals that prescription errors are reduced when hospitals integrate and apply mobile technologies to make electronic prescriptions possible. In addition, problems related to loss of prescriptions are mitigated when electronic information transfer technologies are used to manage data-prescribed drugs (Migo et al., 2015).
Mobile technology is also applicable in the management of imaging data. Kitsiou et al. (2017) illustrate that mHealth solutions enable providers at the Institute of Cancer Research Royal Cancer Hospital to access radiological images and test results from remote locations. Generic remote monitoring has also been made possible through the use of mobile technology to access and use health information. For example, healthcare providers at the Institute of Cancer Research Royal Cancer Hospital can share real-time data, such as cardiac monitoring and fetal heart rate, to support both outpatient and inpatient services. Therefore, providers who may not be in surgery or in the ward are able to access real-time data which enables them to participate actively in healthcare processes. Kitsiou et al. (2017) demonstrate that mobile technology is also used to promote asset management in hospitals. This includes the use of mHealth applications to track patient samples, which improves efficiency in conducting tests and sharing findings among providers. Tamrat & Kachnowski (2012) explain that loss of test samples and errors in laboratory tests are effectively reduced through the use of mobile technology.
Teo, Ng & White (2017) indicate that mobile technology leads to improved sharing of information and communication between providers and their patients. For instance, the National Pandemic Flu Service added mHealth solutions to its telephone and online resources to promote communication between healthcare providers and patients during flu pandemics Iribarren, Cato, Falzon & Stone, 2017). In addition, consultations in healthcare through NHS Direct are facilitated by mobile technologies (Reynolds, 2017). Deliberato et al. (2017) reveal that the mHealth solutions used by the NHS facilities allow providers to direct their patients to the nearest surgical services or clinics on the basis of the information they provide via mobile networks. Integration of patient records with communication services within healthcare facilities also supports regular checks, such as annual cholesterol and blood pressure tests (Burns, Keating & Free, 2016).
According to Teo, Ng & White (2017), mobile technology has led to an overall improvement in treatment and care within NHS facilities. Tamrat & Kachnowski (2012) explain that automated data transmission and monitoring are associated with improved patient outcomes. For instance, early warning systems are integrated into mHealth solutions at Royal Berkshire NHS Foundation Trust to prevent complications from chronic illnesses (CSC, 2011). However, healthcare organizations need additional medical software to facilitate the analysis of data that is transmitted electronically from electronic monitoring devices and test kits (Migo et al., 2015). Winstein & Requejo (2015) indicate that medical software within electronic health record management systems is used to analyze data on the conditions of patients, which is used to identify early signs of complications or abnormalities. Therefore, the integration of mobile technologies and medical software enables providers to prevent the deterioration of the conditions of patients, leading to an overall increase in the quality of care.
New Opportunities in Mobile Health
According to Wei et al. (2016), healthcare organizations integrate mobile technologies into their electronic medical record systems mainly to achieve cost-saving objectives. This means that healthcare organizations continue to focus on profitability objectives regardless of their ethical obligations of prioritizing safety, quality, and efficiency. Deliberato et al. (2017) explain that the efficiencies that result from the adoption and implementation of mHealth solutions in the healthcare industry benefit health professionals, government healthcare systems, and insurance companies. It is estimated that the mobile health market across Eastern and Western Europe is worth over $2 billion (Reynolds, 2017). Wiederhold (2015) asserts that the increasing expenditure on healthcare in the UK is mainly attributed to the adoption and implementation of new technologies to minimize costs and support healthcare. Therefore, healthcare organizations in the UK have the opportunity of investing more money in the acquisition, implementation, and integration of mHealth solutions into their information management systems.
Winstein & Requejo (2015) reveal that revenue from mobile health technologies mainly streams from mobile personal monitoring solutions, Personal Emergency Response Systems (PERS), and remote patient management solutions. Another notable opportunity for automating healthcare information management systems is the adoption of imaging software that enables providers to view X-ray images on their mobile devices (Chamberlain, Elcock & Puligari, 2015). Furthermore, healthcare organizations have the opportunity of improving the process of monitoring the usage of hospital beds through the installation of M2M modules inwards (Burns, Keating & Free, 2016). According to Deliberato et al. (2017), messaging solutions, such as SMS appointment reminders are the most utilized of the various mHealth solutions. However, messaging solutions do not need the integration of embedded mobile technology. Wei et al. (2016) recommend that healthcare organizations should focus on capturing both value and cost savings in the adoption, implementation, and integration of mHealth solutions into their information management systems. Wiederhold (2015) explains that hospitals capture value by ensuring that the acquired technologies serve their core functions, such as providing safe and high-quality care. Innovative mHealth solutions also present healthcare organizations with opportunities of promoting personalized care and achieving desired patient outcomes (Migo et al., 2015).
Addressing Future Challenges
Healthcare organizations should consider challenges that will affect the success of the adoption and implementation of mobile health technologies to support access to information, its dissemination, and use in supporting care delivery processes. For example, planning and design challenges related to mobile health technologies must be considered because of the conflicting interests of vendors and users, such as patients, healthcare providers, and insurers (Naslund et al., 2015). Wei et al. (2016) reveal that vendors and network operators are concerned with the incremental revenue emanating from the sale and use of mHealth solutions. On the other hand, users are concerned with the impact of mHealth solutions on specific outcomes, such as efficiency, costs, quality, and safety (Kitsiou et al., 2017). Therefore, healthcare organizations should address the planning and design challenges of mobile technologies with a view to ensuring that they are aligned with organizational and user needs.
Healthcare organizations should ensure that mobile health technologies, including devices and software applications, are easy to use. Deliberato et al. (2017) explain that the user-friendliness of mHealth solutions determines the willingness of providers and patients to use them in accessing, sharing, and applying the information to support healthcare processes. In addition, healthcare organizations should ascertain that mHealth solutions from various vendors and mobile operators provide them with clear benefits. Wei et al. (2016) indicate that mHealth solutions should allow healthcare organizations to overcome challenges related to the management of medical data, such as the protection of privacy and confidentiality of patients. Therefore, mHealth solutions should be designed to comply with the legal obligations of hospitals of protecting the security of medical data. Teo, Ng & White (2017) add that effective mHealth solutions present healthcare organizations with clear benefits related to positive patient outcomes. Furthermore, hospitals must ensure that mobile network operators guarantee reliable connections for efficiency in the dissemination of medical information (Burns, Keating & Free, 2016).
The way information is used and managed within healthcare organizations has been changed significantly by mobile technologies. The NHS healthcare facilities are increasingly adopting mHealth solutions because they facilitate access, dissemination, and use of medical information for the delivery of efficient and patient-centered care. The quality and safety of care have also been improved through the adoption and implementation of innovative mobile technologies in various aspects of care, such as diabetes and asthma monitoring, medication compliance, dissemination of information, mobile imaging, electronic prescriptions, asset management, and generic remote monitoring. Researchers recommend that healthcare organizations should be aware of the conflicting interests of vendors and mobile network operators, such as focusing on incremental revenues from mobile technology sales. Therefore, hospitals should address planning and design challenges to ensure that mHealth solutions are aligned with their needs, such as promoting the quality and safety of care and enhancing the management of medical data.
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