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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
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