Abstract
Healthcare software evaluation is a complex process. Specifically, in the health information systems, focusing on the patients' health and on the healthcare professionals' motivation is particularly important. Doctors, nurses and other healthcare professionals use software that indirectly affects the patients. Does software improve the patients' health, their satisfaction, or the healthcare professionals' commitment/job satisfaction? How can the impact of an information system be measured from the perspective of the patients, the doctors, the nurses or the supporting staff? Some relevant efforts have been made in the last years to measure healthcare software impact. Nevertheless, the decision to extend a study to different fields may lead to many difficulties as far as its conclusions are concerned. By identifying the research questions and the most relevant works, as well as indicating the open research issue, this article is a revision of the literature on the subject. This work may be expected to be useful to all those wishing to contribute by their research in this field.
TopBackground
According to the World Health Organization (World Health Organization, n.d.), e-health can be defined as the providing of services and resources per electronic means either for health professionals, health consumers or for health systems management. Software plays in this way a central role in the healthcare systems because it can interact with the patients or doctors, or being embedded software in medical instrumentation, and other healthcare-oriented life-critical systems. Software is becoming more pervasive in all facets of medical device design and development. As transitions from hardware to software controls occur, there is a growing need for formalized software assurance processes (Cooper & Pauley, 2006).
The use of the modern information technology in health offers tremendous opportunities: 1) to reduce clinical errors, e.g., medication errors, diagnostic errors; 2) to support health care professionals, e.g., availability of timely, up-to-date patient information; 3) to increase the efficiency of care, e.g., less waiting times for patients; 4) or even to improve the quality of patient care (Elske Ammenwerth, Gräber, Herrmann, Bürkle, & König, 2003)(Walker et al., 2005). According to Alalwany (2010), e-health supports disease allows people to better manage their own health and provides more accessible and consistent healthcare services, besides improving the efficiency of healthcare systems. Despite the opportunities, e-health presents some challenges namely considering that modern information technology systems are costly (Drouin, Hediger, & Henke, 2008)(Deloitte Touche Tohmatsu Limited, 2015) and that their failures may cause negative effects on both patients and staff. Adopting e-health applications is also highly complex. Finally, the privacy and security concerns in e-health applications are other key challenges. Therefore, a rigorous evaluation of IT in health care is recommended (Brender et al., 2013) and of great importance for decision makers and users (Kaplan & Shaw, 2004). Evaluation is likewise of some importance considering the high rate of failed IT projects in public sector where 35 percent of IT government projects have been classified as total failures, and 50 percent as partial failures (Heeks, 2006).
Key Terms in this Chapter
Software Quality: The “ capability of software product to satisfy stated and implied needs under specified conditions ” (“ISO/IEC 25010:2011 Systems and software engineering -- Systems and software Quality Requirements and Evaluation (SQuaRE) -- System and software quality models,” 2011) and as “ the degree to which a software product meets established requirements; however, quality depends upon the degree to which those established requirements accurately represent stakeholder needs, wants, and expectations ” ( IEEE P730 TM /D8 Draft Standard for Software Quality Assurance Processes , 2012 AU27: The in-text citation "Software Quality Assurance Processes, 2012" is not in the reference list. Please correct the citation, add the reference to the list, or delete the citation. ).
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS): A standardized survey instrument and data collection methodology for measuring patients' perspectives on hospital care. The HCAHPS survey contains 21 patient perspectives on care and patient rating items that encompass nine key topics: communication with doctors, communication with nurses, responsiveness of hospital staff, pain management, communication about medicines, discharge information, cleanliness of the hospital environment, quietness of the hospital environment, and transition of care. The survey also includes four screener questions and seven demographic items, which are used for adjusting the mix of patients across hospitals and for analytical purposes. The survey is 32 questions in length ( National Quality Forum, 2013 ).
Patient Satisfaction Questionnaire Short Form (PSQ-18): PSQ-18, Likert scale questionnaire proposes seven dimensions of patient satisfaction directed toward their healthcare professionals. These are 1) general satisfaction, 2) technical quality, 3) interpersonal manner, 4) communication, 5) financial aspects, 6) time spent with doctor, and 7) accessibility and convenience. Each domain is tested through different related questions, which is of substantial benefit when one aims to identify a particular area to improve on. The general satisfaction has strong correlation with the other domains and thus it is important to improve in all ( Marshall & Hays, 1994 ).
Organizational Commitment: Organizational commitment refers to the extent to which the employees of an organization see themselves as belonging to the organization (or parts of it) and feel attached to it ( Meyer, Kam, Goldenberg, & Bremner, 2013 )( van Dick & Ullrich, 2013 ).
Usability: Usability relates with the concept of ease of use and the ability to use a product for its intended purpose ( Bevan, 1995 ).
User Acceptance: For technology to improve productivity in organizations first users’ must accept the technology and use it. Models explaining the factors and predicting user intention for using technology are of great importance for health information systems development ( Venkatesh et al., 2003 ).
E-Health: According to the World Health Organization ( World Health Organization, n.d. ), e-health is: “ the transfer of health resources and health care by electronic means. It encompasses three main areas: 1) the delivery of health information, for health professionals and health consumers, through the Internet and telecommunications; 2) the use of the power the power of IT and e-commerce to improve public health services, e.g. through the education and training of health workers; 3) the use of e-commerce and e-business practices in health systems management ”.