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An International Survey with Health Informatics Experts

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An International Survey with Health Informatics Experts Published online: 2021-04-21 61 © 2021 IMIA and Georg Thieme Verlag KG How to Improve Information Technology to Support Healthcare to Address the COVID-19 Pandemic: an International Survey with Health Informatics Experts Max Topaz (first co-author)1, Laura-Maria Peltonen (first co-author)2, James Mitchell3, Dari Alhuwail4, 5, Seyedeh-Samin Barakati6, Adrienne Lewis7, Hans Moen8, Sai Pavan Kumar Veeranki9, 10, Lori Block11, Tracie Risling12, Charlene Ronquillo6, 11 1 School of Nursing, Columbia University, New York, USA 2 Department of Nursing Science, University of Turku, Finland 3 School of Computing and Mathematics, Keele University, UK 4 Information Science Department, Kuwait University, Kuwait 5 Health Informatics Unit, Dasman Diabetes Institute, Kuwait 6 Daphne Cockwell School of Nursing, Ryerson University, Toronto, Canada 7 Splatsin Health Services, Enderby, BC, Canada 8 Department of Future Technologies, University of Turku, Finland 9 Health & Bioresources / Molecular Diagnostics, AIT Austrian Institute of Technology GmbH, Graz, Austria 10 Technical University of Graz, Graz, Austria 11 School of Nursing, University of British Columbia Vancouver, BC, Canada 12 College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada Summary information and communication technologies that can help 1 Introduction and Objectives to provide better healthcare to patients during the COVID-19 Objectives: To identify the ways in which healthcare infor- The coronavirus (SARS-CoV-2) pandemic pandemic, including telehealth, advanced software, electronic mation and communication technologies can be improved to has challenged the healthcare sector globally health records, remote work technologies (e.g., remote desktop address the challenges raised by the COVID-19 pandemic. in several ways. The pandemic has worsened computer access), and clinical decision support tools. Methods: The study population included health informatics the shortage of the healthcare workforce Conclusions: Our results help to identify several important experts who had been involved with the planning, development [1, 2] and increased the workload [3] and healthcare information and communication technologies, and deployment of healthcare information and communica- psychosocial burden of health professionals recommended by health informatics experts, which can help to tion technologies in healthcare settings in response to the [4-6]. Healthcare providers have reorganized provide better care to patients during the COVID-19 pandemic. challenges presented by the COVID-19 pandemic. Data were resources to manage the increased demands The results also highlight the need for improved interopera- collected via an online survey. A non-probability convenience of care [7]. However, shortages in medical bility, intuitive user interfaces and advocating the adoption of sampling strategy was employed. Data were analyzed with equipment, [8-10] personal protective equip- standards of care. content analysis. ment, [2, 8-12] and healthcare information Results: A total of 65 participants from 16 countries responded technologies further challenged the response to the conducted survey. The four major themes regarding rec- Keywords to the COVID-19 pandemic [13, 14]. ommended improvements identified from the content analysis Health Informatics, COVID-19, international survey, telehealth Advanced technological solutions that included: improved technology availability, improved interop- can reduce the burden of limited health care Yearb Med Inform 2021:61-8 erability, intuitive user interfaces and adoption of standards resources perpetuated by this pandemic are http://dx.doi.org/10.1055/s-0041-1726491 of care. Respondents also identified several key healthcare necessary [15]. Globally, the application of IMIA Yearbook of Medical Informatics 2021 62 Topaz et al. healthcare information and communication This study aimed to identify the ways in survey used the OpinioTM software provided technologies varies with respect to coun- which healthcare information and commu- by Ryerson University with servers located tries’ economic status and the expenditure nication technologies can be improved to in Canada. Ethical approval was obtained on these technologies corresponding to address challenges raised by the COVID-19 from Ryerson University Research Ethics their national budgets. Nonetheless, the pandemic. Board (REB 2020-175), Kuwait University COVID-19 pandemic has boosted the rate (KU-CLS-20-05-13) and the University of of technology adoption, particularly, related Keele (ECL270420). to digital health services [16, 17]. Multiple This paper reports the responses to the technology tools have rapidly been adopted question “What technologies do you wish to assist in the struggle against the pandemic. 2 Methods you had to help address COVID-19 in your Examples include tools for case identifica- The study had a descriptive exploratory setting?” Initially, the study team considered tion [18], contact tracing [19], mobility data design and data were collected via an online providing a structured checklist option of communication [20], robotic disinfection survey. The population was international selected technologies to the question men- [21] among many others. health informatics experts who have been tioned above. In this case, study participants On the one hand, physical distancing involved with the planning, development would have been expected to select several has become a key strategy in containing the and deployment of health information tech- specific technologies from a dropdown list. spread of the virus, and on the other hand, nology in healthcare settings in response However, no such comprehensive list of technologies such as chatbots and virtual to challenges presented by the COVID-19 technologies was available and we designed care technologies have filled the gap in pro- pandemic. The data collection time consid- an open ended question that would provide viding healthcare services previously done ered responses from March to May 2020. A study participants the freedom to respond to face to face [22, 23]. Artificial intelligence non-probability convenience sampling meth- the question in a non-restrictive manner [36]. has also been identified as one of the key od, where the population cannot be identified We implemented qualitative thematic technologies used during the pandemic. For [32] was employed given the exploratory content analysis to analyze the responses [37]. example, it has been used in the detection nature of the survey and the aim, which was Specifically, two PhDs prepared reviewers of COVID-19 cases, diagnosis, monitoring to be as wide-reaching as possible. This (LMP and MT), with backgrounds in health vital parameters, contact tracing, predic- method allowed the research team to select informatics and experience in thematic con- tion of virus spread, treatment suggestions samples based on selective judgement, rather tent analysis, independently reviewed each of as well as vaccine development [22-24]. than by random selection [32]. As such, it the study responses. The researchers assigned However, the applied use and research was not possible to predetermine a specified the responses with a set of preliminary and on interoperability standards, like FHIR sampling frame. An invite to participate in emerging themes. As each individual response [25], OpenEHR [26], and SNOMED-CT the study was sent out through the IMIA could contain several technologies, it was [27], and telehealth technologies (includ- Students and Emerging Professionals Spe- possible that several themes were coded for ing the Internet of Things), to succor the cial Interest Group networks (including the one response (e.g., ”better user interfaces” and COVID-19 pandemic, have received less group’s mailing list, professional networks, “improved technology availability”). The can- attention [28]. Further, the application and other relevant mailing lists, social media, didate list of themes was then discussed and usability of these technologies on patient word of mouth, and snowball sampling [33]). finalized with the broader study team (LMP, safety are yet to be fully understood in this The web-based survey was developed MT, S-SB, CR). Specifically, the assigned pandemic context [29, 30]. and advertised as per best practices on Web emerging themes were discussed, harmonized, There is a need to reflect on the use of survey design as outlined in the Tailored assigned a consistent name and agreed on by healthcare information and communication Design Method [34, 35]. This included both reviewers and the study team. This result- technologies during the COVID-19 pan- consultation with health informatics experts ed in a final list of major themes and several demic to find ways to better support health as part of survey development, to assure specific sub-themes. These major themes are systems during pandemics. The International adequate functionality, clarity and content presented with their number of mentions in Medical Informatics Association (IMIA) validity prior to distribution. Recognizing the collected data. Students and Emerging Professionals Spe- that our target sample group was health in- cial Interest Group conducted an interna- formatics experts who were working under tional survey targeted at health informatics immense pressures, a very brief, open-end- experts. As there is a large variation in ed survey was developed to maximize the application of healthcare information and likelihood of response. The survey
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