Outcomes of international ehealth implementations in aged care

Abstract

This paper reports upon an investigation into the effectiveness of ehealth implementations in the aged care sector throughout the world. The purpose of the research was to better understand the link between goals and outcomes in the provision of geriatric ehealth services. Telemedicine implies a limited service provided by doctors while ehealth means the application of information communication technology by a range of healthcare professionals. Ehealth has emerged as a means to facilitate geriatric care in the face of increased demand for services. It also has the potential to offer a number of benefits to older citizens, including increased quality of care. Data collection was based an extensive search of electronic databases that indexed technology and medical journals, using terms established by two researchers trained in Information Systems. A review of the 647 primary articles identified, found 66 that met all the search criteria. These papers were then categorised using a framework from the geriatric ehealth literature (Nebeker, Hurdle & Bair, 2003), enabling the identification of Provider-Provider, Provider-Patient and Provider Decision-Support studies. Within these three perspectives the papers were classified according to the nature of the research undertaken, and the number of papers was recorded. Any positive outcomes or limitations reported in the sources were also collated for each category. The results revealed that most of the papers were derived from Provider-Patient studies, with only very limited Provider-Provider or Provider Decision Support papers. Much of the Provider-Patient research focussed on teleconference implementations, often for particular health conditions. The limited result for Provider-Provider studies was surprising given the emphasis in the wider ehealth literature on the timely and current exchange of health data and information, including the adoption of Electronic Medical Records. Most of the Provider Decision Support studies considered individuals or groups with specific medical conditions. It was found that ehealth was generally accepted by patients and healthcare providers, and a range of mainly social and technical constraints was identified. However, the limited number of studies, the dominance of trials, the repetitiveness of the studies and the limited degree of innovation found failed to confirm any perceived 'disconnect' between organisational goals and outcomes in ehealth aged care. Further studies need to be undertaken before the nature of the link between goals and outcomes in ehealth aged care can be established, along with the reasons that may account for any mismatch.