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  • 1. Wairoa Medical, Midwifery & Practice Nurse staffTuesday 27th April
  • 2. Thank you
  • 3. especially toRon Janes
  • 4. FAQ(Frequently Asked Questions)
  • 5. Outline
    Introduction
    Subject area
    Research questions
    Methodology
    Your assistance with this project
  • 6. INTRODUCTION
  • 7. Who am I?Dallas Knightstudent researcherUniversity of Otago
  • 8. Why am I here?
  • 9. SUBJECT AREA
  • 10. Health Informatics
  • 11. What am I studying?
  • 12. Information & communication technologies in
  • 13. health care service delivery
  • 14. More specifically Internet and mobile technologies.
  • 15. Service sector under scrutiny
  • 16. Midwiferyservice delivery.
  • 17. So…….this is an
  • 18. exploratory study
  • 19. A case study
  • 20. Case study
    Using one (of twenty one) District Health Boards (DHB) in New Zealand.
    One clearly defined geographical region (Hawke’s Bay).
    Using only independent midwives gives a tightly defined group.
    Using a population which includes a high percentage of Maori women, Pacific Island women, and rural women groups.
  • 21. exploring elements within the current use
  • 22. and possible future use
  • 23. of Internet and mobile technologies
  • 24. to enhance health service delivery
  • 25. Acknowledging that technology as used in healthcare service delivery is a
  • 26. Socio-technical system
  • 27. A socio-technical system
  • 28. and
  • 29. There has been a convergence of technologies
  • 30. Smart phones (3G) are now computers
  • 31. They
    Collect video, image, voice and text data
    Send data
    Send and receive emails
    Access Web services
    Are personal devices
    Sync with laptop and PC
    Send and receive SMS (text) messages
    Have a standardised platform for application developers
    Are mobile phones
    Access the social web (Facebook, Twitter, YouTube, Skype, Google)
  • 32. RESEARCH QUESTIONS
  • 33. asking
  • 34. Can Internet and mobile technologies be leveraged ?
  • 35. How?
  • 36. Whatcurrent hardware, software/applications and services could be considered
  • 37. to enhancemidwifery service delivery?
  • 38. (continued)
    Are there time saving efficiencies?
    Are there perceived and assessed risks?
    Are there perceived and assessed benefits?
    Can current information and communication technologies enhance the service delivery process?
    If so, how?
  • 39. The trust factor
    Additionally, perceptions of trust, surveillance and their relationship to consumer satisfaction will be investigated.
    How does each primary group (women and midwives) view the trust element?
    Does frequency and characteristics of the communication medium increase or decrease aspects of trust?
  • 40. Three-phase approach
    Phase One
    User needs (perceived and assessed)
    Phase Two
    Pilot study using Action Research methodology?
    Phase Three
    Evaluation?
  • 41. Whyask these questions?
  • 42. because
  • 43. Information and communicationtechnologies are now able to provide more and diverse ways for health care providers and patients to communicateand transfer information.
  • 44. The rise and rise of mobile phone subscribers *
    http://www.itu.int/newsroom/press_releases/2008/29.html
  • 45. Explosion in growth
    There has been an explosion in the growth of information and communication technologies and particularly mobile technologies.
    There are around 45 million Internet users compared with <4 billion mobile phone subscribers (2008)*
    Cost is an inhibiter for mobile but many more now rely on mobile only and there is a clear shift in this direction..
    *http://www.itu.int/newsroom/press_releases/2008/29.html
  • 46. Mobile phones
    Mobile phones could be seen as
    disruptive technologies /disruptive innovation*
    because they are changing the ‘traditional’ way of communicating and transferring information.
    *Clayton Christensen (Harvard Prof of Business Studies)
  • 47. Disruptive technology and disruptive innovation are terms used in business and technology literature to describe innovations that improve a product or service in ways that the market does not expect
    Disruptive technologies
  • 48. For example
    Refrigerator
    Touch screen technology
    Digital images
    iPod and iTunes
    Cloud computing
    Skype and VOIP
    Web 2.0
  • 49. Web 2.0
    Participatory – user generated content
    Collaborative – Google Docs
    Social – social networks [Facebook, Twitter]
    Multi-media – Youtube, podcasts, Flickr
    Dynamic – blogs
    http://www.jisc.ac.uk/media/documents/techwatch/tsw0701b.pdf
  • 50. Consumer expectations
    Web 2.0 aware consumers will demand to have access to, and to control their data.
    Eysenbach: Consumer health informatics
    http://www.slideshare.net/eysen/eysenbach-consumer-health-informatics
  • 51. One patient one record?orinformation in inaccessible and unconnected silos?
  • 52. Healthcare restraints are necessitating a move towards increased patient engagement, involvement, participation, empowerment and responsibility for their own health outcomes.
  • 53. The rise of the ePatient
  • 54. Whywas the midwifery health service sector chosen?
  • 55. because
  • 56. Midwives practice in clinics and birthing centres/hospitals and women’s homes.
  • 57. It is therefore a mobile service setting with mobility presenting as a challenge
  • 58. and
  • 59. Women ~15 – 45 are more likely to be active users of new technologies
  • 60. compared with other groups of people receiving healthcare.
  • 61. also
  • 62. Data collection does not interfere with service delivery
  • 63. because
  • 64. semi-structured interview data is collected afterthe healthcare service encounter.
  • 65. Users of midwifery service
  • 66. are well women
  • 67. who receive relatively standardised care
  • 68. for a clearly defined period of time
  • 69. and
  • 70. areinformation hungry(normally, especially primigravidas).
  • 71. Midwifery service to each woman could be viewed as single health episode or unit of service delivery.
  • 72. Duration of health episode/service
  • 73. METHODOLOGY
  • 74. Ethics approval
    University of Otago Ethics
    Central Ethics
    Approved
    Plunket Ethics Committee
    Pending
  • 75. Documentation
    Information describing the project
    Informed consent process
  • 76. How am I trying to answer the research questions?
  • 77. Paradigm view
    Constructivist
    Hermeneutical
    Interpretive
    Pragmatic
  • 78. Grounded Theory Methodology
  • 79. Data collection:Semi-structured interviews
    Midwives: who practice independently within the Hawke’s Bay region.
    Women: after they have been discharged from midwifery care.
  • 80. Data collection
  • 81. Midwives’ demographic data
  • 82. Women’s demographic data
  • 83. Constant review process
  • 84. Status
    27/30 Napier – Hastings midwives have been interviewed.
    All general practices in Napier, Hastings and Central Hawke’s Bay have been personally approached and given documentaion.
    14/? Women have been interviewed.
  • 85. Next stage (April 2010)
    Interview data is presenting fascinating insight and will continue to saturation.
    Teen aged parents, rural women and Maori women are currently being recruited.
    Internet and mobile technologies (hardware, software, applications, services) are constantly under review.
  • 86. YOUR ASSISTANCE
  • 87. Please assist by:
  • 88. 1. Consenting to be interviewed
    Midwives
    GP LMCs?
    GPs?
  • 89. 2. Recruiting women
    Briefly explain the project (documentation)
    Fill in a form with the women’s contact details
    Fax form to me so I can arrange interview times
  • 90. If you are agreeable
    I will come to Wairoa for ~3 days at a convenient time to carry out interviews.
  • 91. Thank you
  • 92. Dallas Knight
    2 Milton Terrace,
    Hospital Hill, Napier 4110
    dknight@actrix.co.nz
    Ph: [H] 06 835 5939
    Ph: [M] 021 105 9866
  • 93. Slides will be stored at Slideshare &Google Docs