Wairoa Medical, Midwifery & Practice

Nurse staff

Tuesday 27th April

Thank you

especially to

Ron Janes

FAQ(Frequently Asked Questions)

OutlineIntroduction

Subject area

Research questions

Methodology

Your assistance with this project

INTRODUCTION

Who am I?

Dallas Knightstudent researcherUniversity of Otago

Why am I here?

SUBJECT AREA

Health Informatics

What am I studying?

Information & communication technologies

in

health care service delivery

More specifically Internet and mobile

technologies.

Service sector under scrutiny

Midwifery service delivery.

So…….this is an

exploratory study

A case study

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.

exploring elements within the current use

and possible future use

of Internet and mobile

technologies

to enhance health service delivery

Acknowledging that

technology as used in healthcare service delivery

is a

Socio-technical system

A socio-technical system

and

There has been a convergence of technologies

Smart phones (3G) are now

computers

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)

RESEARCH QUESTIONS

asking

Can Internet and mobile

technologies be leveraged ?

How?

What current hardware,

software/applications and services could be

considered

to enhance

midwifery service delivery?

(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?

The trust factorAdditionally, 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?

Three-phase approachPhase One

User needs (perceived and assessed)

Phase TwoPilot study using Action Research methodology?

Phase ThreeEvaluation?

Why ask these questions?

because

Information and communicationtechnologies are now able to

provide more and diverse ways for health care providers and patients to communicate and

transfer information.

The rise and rise of mobile phone subscribers *

http://www.itu.int/newsroom/press_releases/2008/29.html

Explosion in growthThere 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

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)

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

For exampleRefrigerator

Touch screen technology

Digital images

iPod and iTunes

Cloud computing

Skype and VOIP

Web 2.0

Web 2.0Participatory – 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

Consumer expectations

Web 2.0 aware consumers will demand to have access to, and to control their data.

Eysenbach: Consumer health informaticshttp://www.slideshare.net/eysen/eysenbach-consumer-health-informatics

One patient one record?or

information in inaccessible and

unconnected silos?

Healthcare restraints are necessitating a move towards

increased patient engagement, involvement, participation,

empowerment and responsibility

for their own health outcomes.

The rise of the ePatient

Whywas the midwifery health service sector chosen?

because

Midwives practice in clinics and

birthing centres/hospitals and women’s homes.

It is therefore a mobile service setting with

mobility presenting as a challenge

and

Women ~15 – 45 are more likely to be active users of

new technologies

compared with other groups of people receiving

healthcare.

also

Data collection does not interfere with service

delivery

because

semi-structured interview data is collected

after the healthcare service

encounter.

Users of midwifery service

are well women

who receive relatively standardised care

for a clearly defined period of time

and

areinformation hungry

(normally, especially primigravidas).

Midwifery service to each woman could be viewed as single health episode

or unit of service delivery.

Duration of health episode/service

METHODOLOGY

Ethics approvalUniversity of Otago Ethics

Central EthicsApproved

Plunket Ethics CommitteePending

DocumentationInformation describing the project

Informed consent process

How am I trying to answer the

research questions?

Paradigm viewConstructivist

Hermeneutical

Interpretive

Pragmatic

Grounded Theory Methodology

Data collection:Semi-structured interviewsMidwives: who practice independently within the

Hawke’s Bay region.

Women: after they have been discharged from midwifery care.

Data collection

Midwives’ demographic data

Women’s demographic data

Constant review process

Status27/30 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.

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.

YOUR ASSISTANCE

Please assist by:

1. Consenting to be interviewed

MidwivesGP LMCs?GPs?

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

If you are agreeable

I will come to Wairoa for ~3 days at a convenient time to carry out interviews.

Thank you

Dallas Knight

2 Milton Terrace,

Hospital Hill, Napier 4110

dknight@actrix.co.nz

Ph: [H] 06 835 5939

Ph: [M] 021 105 9866

Slides will be stored at Slideshare &Google Docs