Issues Regarding Information Technology Implementation for Aged

Care: Systematic Literature Review

Kapadia V, Li J, Bakshi A

Asia-Pacific ubiquitous Healthcare research Centre (APuHC)

University of New South Wales

Sydney, Australia

Objective

To synthesise evidence of using IT applications for aged care services and understand issues in

the implementation of these applications

stage 1 stage 2 stage 3

7360

Exclusion based on duplicates

4702

592

107

Exclusion based on title,

abstract , keywords

Exclusion based on full text

Characteristics of studies

Types of study Qualitative Quantitative Mixed method Literature review

39 48 5 15

Technology used Telehealth Electronic documentation systems Electronic health records Sensor technology Robotic technology

35 15 6 6 5

Setting Home care Residential care facilities Community and residential care facilities Hospitals

42 36 5 2

Year of publication 2003-2007 2008-2013

22 85

IT applications

• Telehealth application

• Electronic documentation system

• Wireless sensor monitoring system

• Electronic health record

• Robots

5

Benefits from IT

• Improved documentation efficiency

• Improved communication and coordination

• Better quality of care services

• Reduced health care cost

6

categories

Clustered into 4 main categorises • Management’s prospective • Health professional’s perspective

• Elders perspective • Technology perspective

Management perspective Issues • Poor leadership: Management’s lack of knowledge about IT and

change management • Lack of support: Management’s IT and training support provided to

the end users to enhance IT system adoption.

• Funding: Concern about cost associated with IT system implementation and maintenance

• Poor collaboration: with external organisation for sharing

knowledge and technical help • Shortage of staff: High turn over and poor retention of health care

staff in aged care

Health professional’s perspective Issues

• Lack of knowledge of IT: Health professional’s IT knowledge

and skill acquired by past experience and/or training • Age: End users engagement with IT system decreases as the

age progresses • Privacy and security of patient’s record: Privacy and

security Issues associated with data accessibility and sharing

• Threat to professional autonomy: Health professional’s

perception of losing power of making decisions regarding patients’ disease management

Health professional’s perspective IT applications Issues usefulness

IT experience

Age Privacy Autonomy

Telehealth services

Electronic Health Record

Wireless sensor monitoring technology

Electronic documentation system

Artificial intelligence

• High

• Medium

• Low

Elder’s perspective

Issues • Privacy: Concern about the protection of their identity

and sharing of personal information • Human interaction: Loss of face to face contact with

the health other people • Social stigma: Elderly people’s perception of social

disapproval due to wearable devices (example pedant for fall detection)

• Cost: purchasing and maintenance cost associated with IT devices

Elders’ perspective IT applications Issues usefulness

Privacy Human interaction

Social stigma

Cost

Telehealth services

Electronic Health Record

Wireless sensor monitoring technology

Electronic documentation system

Artificial intelligence

• High

• Medium

• Low

Technological prospective

Issues • System integration: Poor linkage between IT system

network with in and across the organisation

• Accessibility: Poor accessibility of IT system due to less number of computer terminals, far locations of computers from nursing staff work station and use restricted up to management personal

• Design: Alignment of design and functionality of IT

applications with users’ expectation

13

Future work

• Evaluation of the effect of aged care work environment on IT system implementation and adoption

• Analysis of the cost benefits of IT investment

• Pre implementation assessment studies are required

Conclusion

• Decision makers can make decision better way

•Designers can develop users friendly device.

15