高校学生微信平台学术公众号采纳意愿影响因素研究

目的：以技术接受模型和信息系统成功模型为基础构建研究模型,对高等院校在校大学生微信平台学术公众号采纳意愿的影响因素进行研究。方法：采用网络问卷调查北京中医药大学在校大学生微信平台学术公众号采纳意愿的影响因素,利用最小二乘结构方程对模型进行验证,分析各个因素对高校学生微信平台学术公众号采纳意愿的影响。结果：用户习惯、感知易用性、创新性、社会影响、系统质量对高校学生微信平台学术公众号采纳意愿有显著正向影响,感知有用性和信息质量对采纳意愿没有显著影响。结论：通过对高校学生微信平台学术公众号采纳意愿影响因素的深入分析,可为平台的服务提供方和运营商提高平台服务质量和提升用户体验提供参考。     

Assessing Differences Between Physicians’ Realized and Anticipated Gains from Electronic Health Record Adoption

Return on investment (ROI) concerns related to Electronic Health Records (EHRs) are a major barrier to the technology’s adoption. Physicians generally rely upon early adopters to vet new technologies prior to putting them into widespread use. Therefore, early adopters’ experiences with EHRs play a major role in determining future adoption patterns. The paper’s purposes are: (1) to map the EHR value streams that define the ROI calculation; and (2) to compare Current Users’ and Intended Adopters’ perceived value streams to identify similarities, differences and governing constructs. Primary data was collected by the Texas Medical Association, which surveyed 1,772 physicians on their use and perceptions of practice gains from EHR adoption. Using Bayesian Belief Network Modeling, value streams are constructed for both current EHR users and Intended Adopters. Current Users and Intended Adopters differ significantly in their perceptions of the EHR value stream. Intended Adopters’ value stream displays complex relationships among the potential gains compared to the simpler, linear relationship that Current Users identified. The Current Users identify “Reduced Medical Records Costs” as the gain that governs the value stream while Intended Adopters believe “Reduced Charge Capture Costs” define the value stream’s starting point. Current Users’ versus Intended Adopters’ assessments of EHR benefits differ significantly and qualitatively from one another.     

Engagement in E-Learning Opportunities: An Empirical Study on Patient Education using Expectation Confirmation Theory

Medical e-learning technology is widely employed to create an online platform for patients and healthcare providers alike. However, there are few studies that have investigated the reasons why some users reject e-learning technology usage after their initial experience. This study was conducted with the aim to better understand the factors leading to patients’ continued usage of e-learning technologies. The theoretical foundation was based on the expectation-confirmation theory (ECT). The questionnaire survey was conducted during a two-month period and covered a total sample of 281 outpatients in a regional-teaching hospital. We found that the intention to continue e-learning usage was significantly related to patients’ education level, expectation, perceived performance, confirmation and satisfaction. The use of this ECT model may provide administrators in the healthcare industry insights into the implementation of e-learning technologies. This research also opens up a new direction and enhances the completeness of related researches in the fields of medical informatics and health education.     

Barriers to Physicians’ Adoption of Healthcare Information Technology: An Empirical Study on Multiple Hospitals

Prior research on technology usage had largely overlooked the issue of user resistance or barriers to technology acceptance. Prior research on the Electronic Medical Records had largely focused on technical issues but rarely on managerial issues. Such oversight prevented a better understanding of users’ resistance to new technologies and the antecedents of technology rejection. Incorporating the enablers and the inhibitors of technology usage intention, this study explores physicians’ reactions towards the electronic medical record. The main focus is on the barriers, perceived threat and perceived inequity. 115 physicians from 6 hospitals participated in the questionnaire survey. Structural Equation Modeling was employed to verify the measurement scale and research hypotheses. According to the results, perceived threat shows a direct and negative effect on perceived usefulness and behavioral intentions, as well as an indirect effect on behavioral intentions via perceived usefulness. Perceived inequity reveals a direct and positive effect on perceived threat, and it also shows a direct and negative effect on perceived usefulness. Besides, perceived inequity reveals an indirect effect on behavioral intentions via perceived usefulness with perceived threat as the inhibitor. The research finding presents a better insight into physicians’ rejection and the antecedents of such outcome. For the healthcare industry understanding the factors contributing to physicians’ technology acceptance is important as to ensure a smooth implementation of any new technology. The results of this study can also provide change managers reference to a smooth IT introduction into an organization. In addition, our proposed measurement scale can be applied as a diagnostic tool for them to better understand the status quo within their organizations and users’ reactions to technology acceptance. By doing so, barriers to physicians’ acceptance can be identified earlier and more effectively before leading to technology rejection.     

The Relationship Between Local Hospital IT Capabilities and Physician EMR Adoption

In light of new federal policies allowing hospitals to subsidize the cost of information systems for physicians, we examine the relationship between local hospital investments in information technology (IT) and physician EMR adoption. Data from two Florida surveys were combined with secondary data from the State of Florida and the Area Resource File (ARF). Hierarchal logistic regression was used to examine the effect of hospital adoption of clinical information systems on physician adoption of EMR systems after controlling for confounders. In multivariate analysis, each additional clinical IT application adopted by a local hospital was associated with an 8% increase in the odds of EMR adoption by physicians practicing in that county. Given this existing relationship between hospital IT capabilities and physician adoption patterns, federal policies designed to encourage this more directly will positively promote the proliferation of EMR systems.     

Exploring Physician Adoption of EMRs: A Multi-Case Analysis

The adoption of new technology within healthcare has been promoted as a way to reduce costs and increase efficiencies as well as improve quality. The literature has documented a significant number of implementation failures by large groups and hospitals with access to IT skills and resources. Given the low adoption rate among physicians, the challenges facing small practices can be daunting. While financial and technical barriers have been explored at the physician level, the actual implementation challenges facing small groups have not been explored. This paper presents a qualitative three case analysis of physician groups that have employed EMRs and the pre and post adoption insights. Results show that planning was a key common variable missing; the anticipated downtime was longer than expected and the workflow disruption and maintenance costs were underestimated.     

Towards Improved Healthcare Performance: Examining Technological Possibilities and Patient Satisfaction with Wireless Body Area Networks

This paper investigates the benefits of using less intrusive wireless technologies for heart monitoring. By replacing well established heart monitoring devices (i.e. Holter) with wireless ECG based Body Area Networks (BAN), improved healthcare performance can be achieved, reflected in (1) high quality ECG recordings during physical activities and (2) increased patient satisfaction. A small scale clinical trial was conducted to compare both technologies and the results illustrate that the wireless ECG monitor was able to detect ECG signals intended for arrhythmia diagnostics. Furthermore, from a patient’s perspective, both technologies were evaluated using three dimensions, namely; hygienic aspects, physical activity, and skin reactions. Results demonstrate that the wireless ECG BAN showed better performance, especially regarding the hygienic aspects. It was also favourable for use during physical activities, and the signal quality of the wireless sensor system demonstrated good performance regarding signal noise and artefact disturbances. This paper concludes that wireless cardiac monitoring systems have significant benefits from a patient’s perspective, and further clinical trials should be conducted to further evaluate the new ECG based BAN system, to identify the possibility of widespread adoption and utilisation of wireless technology for arrhythmia diagnostics.     

Regional Health Information Organizations: A Vehicle for Transforming Health Care Delivery?

Information technology (IT) has the potential to be a significant enabler in transforming the health care delivery system. New types of organizations are needed to guide the change. Regional Health Information Organizations (RHIOs) hold promise as agents for transformation. This essay discusses the results from a case study on how RHIOs are advancing IT adoption in the health care community. Results indicate that the RHIO model is early in its evolution. To be a catalyst of change, the RHIO must overcome privacy barriers, actively engage purchasers of care, and create compelling incentives for clinicians to adopt the RHIOs’ services. Michael R. Solomon is on the College of Health & Human Services faculty at the University of Phoenix Online. He is also an independent consultant to the health care information technology industry and is affiliated with Point-of-Care Partners, an e-health strategy consulting firm. The research presented in this article was conducted as part of Michael’s doctoral studies work at Walden University.     

Development of a Health Management Support System for Patients with Diabetes Mellitus at Home

Recently, a patient with diabetes mellitus (DM) type 2 has been increasing in Japan. The patient should be managed not only by a specialist but also by himself focusing his attention on the improvement of his lifestyle at home. In the present study, we tried to develop a health management support system by which a diabetic patient in early stage can easily enter his daily life information, i.e. the biological information such as the data of blood sugar levels and blood pressure levels etc., the information of exercise and diet and send the information to the medical institution with a personal digital assistant (PDA). Afterwards, the patient can receive health instruction information by the physician in charge for self-care at his home with a PDA. The daily life information sent from the patient is stored in a server installed at the medical institution and analyzed. The physician can obtain the results of analysis by using a PC and send the instruction information necessary for patient management to the patient at home by using e-mail after diagnosing the patient’s condition by the system. To evaluate usability of the developed patient information input system with a PDA, an experiment was conducted by corporation of 20 volunteers who were possible self management and whose age’s range from 20s to 60s by questionnaire survey. As a result, almost examinees answered that lifestyle information could be easily entered by the sense like a mobile-phone and lots of positive opinions were obtained.     

Calcaneal Osteotomy Preoperative Planning System with 3D Full-Sized Computer-Assisted Technology

In this study, we developed a CT-based computer-assisted pre-operative planning and simulating system for the calcaneal osteotomy by integrating different software’s function. This system uses the full-scaled 3D reverse engineering technique in designing and developing preoperative planning modules for the calcaneal osteotomy surgery. The planning system presents a real-sized three-dimensional image of the calcaneus, and provides detailed interior measurements of the calcaneus from various cutting planes. This study applied computer-assisted technology to integrate different software’s function to a surgical planning system. These functions include 3-D image model capturing, cutting, moving, rotating and measurement for relevant foot anatomy, and can be integrated as the user’s function. Furthermore, the system is computer-based and computer-assisted technology. Surgeons can utilize it as part of preoperative planning to develop efficient operative procedures. This system also has a database that can be updated and extended and will provide the clinical cases to different users for experienced based learning.     

Computer-Aided Intelligent System for Diagnosing Pediatric Asthma

Asthma is a lung chronic inflammatory disorder estimated between 1.4% and 27.1% in different area of the world. Result of various studies show that asthma is usually underdiagnosed especially in developing countries, because of limitations on access to medical specialists and laboratory facilities. In this paper, we report on the development and evaluation of a novel patient-based fuzzy system that promotes the diagnosis method of asthma. The design of this application addresses five critical issues included: 1) modular representation of asthma diagnostic variables regard to patients’ perception of the disease, 2) algorithmic approaches conducting inference of diagnosing based on patient’s response to questions, 4) front-end mechanism for capturing data from patient, 5) output for both patient and physician regard to asthma possibility. for the system output score (0–10) the efficacy of this system calculated in the study sample included 139 asthmatic patients and 139 non-asthmatic patients (age range 6–18) reinforce the sensitivity of 88% and specificity of 100% for cut off value 0.7.     

Management of Barrett’s oesophagus in 2001 in Ireland

Background Endoscopic surveillance of patients with Barrett’s oesophagus is recommended to detect early carcinoma. The practice patterns of endoscopists since the publication of more recent management guidelines remain unknown. Methods All endoscopists (n=68) in the Irish Medical Directory and their trainees were sent a postal questionnaire on Barrett’s surveillance. Results Fifty-five per cent (30/54) perform surveillance on all patients with Barrett’s oesophagus and 38% on selected patients. In patients with no dysplasia, repeat endoscopy was more commonly practiced annually (28/54) than every two to three years (23/54). Surgeons were more likely to perform surveillance annually than gastroenterologists (75% vs 40%). Only 26% of endoscopists took four-quadrant biopsies every 2cm. Intervention was recommended by a majority (28/54) of endoscopists in a patient with high grade dysplasia. A majority of respondents (47/54) would have surveillance if they were found to have Barrett’s oesophagus. Conclusion Most endoscopists in Ireland do not adhere to recent guidelines in their management of Barrett’s oesophagus. Surgical endoscopists perform surveillance more frequently than their medical colleagues.     

Implementing a Pharmacy System: Facilitators and Barriers

To describe facilitators and barriers to the implementation of an inpatient pharmacy system at two pediatric hospitals. Interviews, pre- and post-implementation, were conducted with pharmacy and clinical managers. Key findings from the pre-implementation survey were included in the post-implementation survey to further assess facilitators and barriers to the adoption of a pharmacy system. The majority of pharmacy participants and all clinical leaders believed that project goals were being met. Pharmacist’s described staff readiness-to-change as the most significant facilitator to adoption and concerns with the usability of information in the pediatric drug file as the most significant barrier. Clinical managers described system training and education as the most significant facilitator to adoption and adjustment to new work processes as the most significant barrier. We described major facilitators and barriers to the adoption of an inpatient pharmacy system at two pediatric hospitals. Strategies identified by our informants to overcome barriers may promote successful pharmacy implementations at other pediatric facilities.     

我国医学科技70年发展态势研究

以SCI-E数据库为信息源,从科技研究产出规模、学术影响力、研究主题、国际合作4个方面对新中国成立70年来医学科技发展态势进行研究分析,从定量角度客观反映我国医学科技发展历程和取得的成果,为未来新形势下我国医学科技创新发展提供参考。     

HIV risk behaviour in Irish intravenous drug users

The aim of the study was to measure HIV prevalence and risk behaviour in 185 Irish Intravenous Drug Misusers. Information was obtained by application of a standardised WHO questionnaire covering HIV risk behaviour in the preceding 6 months. HIV serostatus was obtained by saliva/ blood sample testing. One hundred and 3(55.7 per cent) shared and 114 (61.6 per cent) lent used injecting equipment in the previous 6 months. 97 (94.2 per cent) of those who shared always cleaned the needles before use but only 48 (49.5 per cent) of these always cleaned in an efficient manner. One hundred and 14(79.2 per cent) males and 28 (68.3 per cent) females reported heterosexual activity in the preceding 6 months. On examination sexual risk behaviour was found to be high. 50.5 per cent of males and 63 per cent of females never used condoms with regular partners. 32.6 per cent of males never used condoms with casual partners. The large majority of partners of male I.D.U’.s (both regular and casual) were non injectors. Therefore there is potential for sexual spread of HIV into the non-injecting heterosexual population. Conversely the vast majority of partners of female IDU’s were injectors. This suggests that female IDU’s are at higher risk of HIV infection than their male counterparts. HIV prevalence in the study group was 8.4 per cent. Implications of results for future intervention are discussed.     

Nurses’ Views on Electronic Medical Records (EMR) in Turkey: An Analysis According to Use,Quality and User Satisfaction

Electronic medical records are generally used by nurses in hospitals. However, studies investigating views on and evaluations of electronic medical records by nurses are limited in Turkey and in other countries around the world. Thus, in this study, nurses’ views on electronic medical record systems will be investigated in terms of use, quality and user satisfaction. Our goal was to investigate the views on electronic medical records used by nurses working at hospital clinics (inpatient care units). Moreover, in this study, we will examine whether there are relationships among the use, quality and user satisfaction of electronic medical records. This study is composed of field research conducted using questionnaires. To prepare the data-measuring instrument, the literature on electronic medical records was reviewed. In addition, during the pilot run of the questionnaire, some revisions were made to the measuring instrument to account for the views of nurse managers in the field. The questionnaire consists of 35 items: 12 items for use, 12 items for quality and 11 items for user satisfaction. A Likert scale type was used in this questionnaire. Responses for usage and quality were assigned a value of 1–5 (‘never/almost never/not at all’ to ‘always/almost always’) for each item. Responses for user satisfaction were assigned a value of 1–5 (‘not at all’, to ‘very great’) for each item. The study was planned and conducted on nurses working at inpatient care units at one public university hospital, one Turkish Ministry of Health hospital and one private hospital in Kocaeli. A sampling technique was not used because we aimed to conduct the questionnaire among all nurses. At the end of this study, the questionnaire had been conducted on 200 nurses. We found that the average score for the nurses’ satisfaction with electronic medical records was 3.28, the average score for using electronic medical records was 1.96, and the average score for the quality of electronic medical records was 3.16. We also determined that there are significant relationships among the use, quality and user satisfaction of electronic medical records. This study revealed that there are significant differences among the mean quality scores for the EMR systems in the Ministry of health hospital, the university hospital and the private hospital. Interestingly, 59.0% of all participants in this study felt that EMR systems were not well integrated into their workflow. In addition, half of all respondents had not been trained in using EMR systems.     

An Implementation of Wireless Medical Image Transmission System on Mobile Devices

The advanced technology of computing system was followed by the rapid improvement of medical instrumentation and patient record management system. The typical examples are hospital information system (HIS) and picture archiving and communication system (PACS), which computerized the management procedure of medical records and images in hospital. Because these systems were built and used in hospitals, doctors out of hospital have problems to access them immediately on emergent cases. To solve these problems, this paper addressed the realization of system that could transmit the images acquired by medical imaging systems in hospital to the remote doctors’ handheld PDA’s using CDMA cellular phone network. The system consists of server and PDA. The server was developed to manage the accounts of doctors and patients and allocate the patient images to each doctor. The PDA was developed to display patient images through remote server connection. To authenticate the personal user, remote data access (RDA) method was used in PDA accessing the server database and file transfer protocol (FTP) was used to download patient images from the remove server. In laboratory experiments, it was calculated to take ninety seconds to transmit thirty images with 832 × 488 resolution and 24 bit depth and 0.37 Mb size. This result showed that the developed system has no problems for remote doctors to receive and review the patient images immediately on emergent cases.     

单人显微操作下大鼠肝移植模型的建立

目的 评价新的肝上下腔静脉显微缝合方法、新的袖套和支架制作技术.方法 将186只SD大鼠分为4组,前3组予肝移植,每组60只,供、受体各30只;第4组为假手术对照6只.肝移植第1组和第2组采用新的肝上下腔静脉缝合方法+新的单槽袖套,其中第1组采用新的无损胆道支架,第2组采用传统的粗制支架.第3组采用传统的双定点肝上下腔...     

Measuring Hospital Efficiency with Data Envelopment Analysis: Nonsubstitutable vs. Substitutable Inputs and Outputs

There is a conflict between Data Envelopment Analysis (DEA) theory’s requirement that inputs (outputs) be substitutable, and the ubiquitous use of nonsubstitutable inputs and outputs in DEA applications to hospitals. This paper develops efficiency indicators valid for nonsubstitutable variables. Then, using a sample of 87 community hospitals, it compares the new measures’ efficiency estimates with those of conventional DEA measures. DEA substantially overestimated the hospitals’ efficiency on the average, and reported many inefficient hospitals to be efficient. Further, it greatly overestimated the efficiency of some hospitals but only slightly overestimated the efficiency of others, thus making any comparisons among hospitals questionable. These results suggest that conventional DEA models should not be used to estimate the efficiency of hospitals unless there is empirical evidence that the inputs (outputs) are substitutable. If inputs (outputs) are not substitutes, efficiency indicators valid for nonsubstitutability should be employed, or, before applying DEA, the nonsubstitutable variables should be combined using an appropriate weighting scheme or statistical methodology.