Syracuse University SURFACE Dissertations - ALL SURFACE May 2014 Introducing Wireless Grids Technology to the Field of Telemedicine Dale W. Meyerrose Syracuse University Follow this and additional works at: https://surface.syr.edu/etd Part of the Social and Behavioral Sciences Commons Recommended Citation Meyerrose, Dale W., "Introducing Wireless Grids Technology to the Field of Telemedicine" (2014). Dissertations - ALL. 74. https://surface.syr.edu/etd/74 This Dissertation is brought to you for free and open access by the SURFACE at SURFACE. It has been accepted for inclusion in Dissertations - ALL by an authorized administrator of SURFACE. For more information, please contact [email protected]. ABSTRACT While telemedicine and technology-enabled education are not new concepts and have significant bodies of research, in depth application to management and treatment of veteran Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI) is relatively new. The conflicts in the Southwest Asia over the last two decades have significantly increased the need for healthcare and support services for these returning warriors. Creative thinking and innovative technologies are needed to meet the growing and changing demand of these patients in the face of many competing demands within the U.S. healthcare sector. This doctoral research study investigated the potential for a platform-agnostic (ad hoc) networking technology to serve as a trusted social networking and training platform for healthcare providers who are striving to provide quality healthcare that meets the needs of veterans suffering from PTSD and TBI. This research study analyzed the effectiveness of a digitally networked environment to deliver desired training and certification outcomes in a military healthcare environment. The level of acceptance of an ad hoc network technology (GridstreamRx) by healthcare professionals using it as an enabler of collaboration during the training process was evaluated. The results also assessed the readiness of healthcare professionals to use this Information Communications Technology (ICT), or analogous new applications and services, to help them perform their healthcare responsibilities. This thesis study, accomplished with the support of the U.S. Army and National Science Foundation, took place at two large military medical centers over a twelve- month period of time. Data was gathered from 568 healthcare professionals using quantitative survey instruments. Ninety-six respondents provided additional quantitative and qualitative inputs at various times during a proscribed training regimen. DeLone and McLean’s 2003 Information System Success Model, modified by findings of more recent research, provided the theoretical lens for analyzing the data from 32 of the training participants in determining the perceived net benefit of the GridstreamRx technology. The data gathered for the study showed, at the 95% level of confidence, that a majority of the professionals of these two medical centers would perceive a positive net benefit from using GridstreamRx in a healthcare training environment. The conclusion from this analysis was that not only are the healthcare providers in this study ready to use ICT and social networking in this professional setting, but also that GridstreamRx is an acceptable platform for performing these functions. The study participants provided input with respect to their priorities regarding information sharing techniques, functionality, and suggestions for improving the platform. The outcomes confirmed that GridstreamRx can be a successful introduction of ad hoc networking to telemedicine. This thesis concluded with recommendations for scholars and practitioners to pursue in the future; and should be followed up with further research and actions in order to build toward a Fully Integrated Virtual Healthcare Environment (FivHe). INTRODUCING WIRELESS GRIDS TECHNOLOGY TO THE FIELD OF TELEMEDICINE By Dale W. Meyerrose B.S., U.S Air Force Academy, 1975 M.B.A., University of Utah, 1978 Dissertation Submitted in partial fulfillment of the requirements for the degree of Doctor of Professional Studies in Information Management Syracuse University May 2014 ©2014 Dale W. Meyerrose All Rights Reserved ACKNOWLEDGEMENTS No one travels far in life—or starts a worthwhile enterprise—by walking alone. One of Life’s Lessons I want to acknowledge my doctoral committee members, Dr. Scott A. Bernard, Dr. Evelyn Lewis MD, Dr. Arthur P. Thomas, and especially my advisor, Dr. Lee W. McKnight. Each of you inspired and guided me in many more ways than I can count. Thanks also go to my graduate examination chair, Dr. Cathryn R. Newton and reader Dr. Marilyn P. Arnone for seeing me across the finish line. The journey would not have been possible without the people associated with the Doctorate of Professional Studies program in the School of Information Studies at Syracuse University. Faculty, program directors, administrators, facilitators, assistants, staff, and my cohort colleagues and friends all assisted and motivated me along the way—and helped to make the experience fun and worthwhile. I could not have completed the research study without the help of Ron Steptoe and the Steptoe Group. In spite of U.S. Government Sequestration and shutdown, and other unexpected surprises along the way, Ron personally came through when it counted. In the wake of the unfortunate passing of Terry Campbell who was working with the Steptoe Group, her husband Mike Campbell made a special effort to make sure that nothing fell through the cracks, even during his time of sorrow. The folks in the Syracuse Wireless Grids Innovation Testbed gave generously of their time and talent, as did Stump, JD, Jon, Josh, and Michele. v This study received a National Science Foundation Veterans Supplement Award, under the direction of Lee W. McKnight, Tamal Bose, Bruce Kingman, Craig Watters, Peter Y. Wong , entitled: "PFI: Wireless Grid Innovation Testbed." Award date: September 11, 2013. Grant Number: IIP-0917973, Amendment No. 007, Proposal No. IIP-1352510. This support is gratefully acknowledged. I am a blessed man. The rest of my special “thanks” is personal—no last names needed—you all know who you are—and that’s all that matters. Linda, you are the best of everything in life about which I care—for the past forty years—and the forty on the horizon. To the women of my life: Madonna, Julia, Laura, Alexandra, Kylie, Danielle, Beth, Dee Ann, Dawn, Esther, Opal, Josephine, Patty, Winnona, and Margaret. To the men: Allen, Geoff, Tim, Mike, Rick, Greg, Elmer, Glenn, Tom, Jerry, Tom, Sammy, Edwin, Don, Buddy, John T, Gerry, Robert T, Jim B, and Dale Too. To the: Generals, Admirals, Colonels, Majors, Captains, Lieutenants, Chiefs, Shirts, NCOs, Airmen, U.S. Government civilians, ’75 Best Alive, USAFAPT, and ROTS. Finally, I humbly salute those comrades in arms—who selflessly stood the watch for America—willingly paid the price for freedom—and now need our best efforts to help them deal with the both the visible and invisible scars of their sacrifice. That which is hard-earned is treasured; that which is free or easily gained is less valued. Unknown vi CONTENTS CHAPTER I. INTRODUCTION................................................................................... 1 Overview ................................................................................................................... 1 General Context and Issues 3 Warrior-Centric Healthcare Training 7 Research Sites 8 GridstreamRx 9 Research Approach ................................................................................................. 9 Prior Research ....................................................................................................... 10 Deficiencies in Addressing the Problem 11 Research Question ................................................................................................ 12 Purpose of the Study ............................................................................................. 13 Significance of the Study ...................................................................................... 13 CHAPTER II. LITERATURE ..................................................................................... 15 Information Systems ............................................................................................. 17 GridstreamRx 17 Security 20 Compliance 20 Technically Meeting the Security Requirements/Standards 23 Networked Multimedia Information Services (NMIS) Project 24 Theoretical Framework 26 Adult Learning........................................................................................................ 31 Applicable Theories, Methodologies, and Their Scholars and Practitioners 32 WCHT Methodology 41 Military Culture 43 Healthcare Implications and Learning 44 Information Sharing ............................................................................................... 46 Social Networking 47 Telemedicine 50 Clinician Acceptance 52 Military Acceptance 55 CHAPTER III. METHODOLOGY ................................................................................ 58 Framing the Study ................................................................................................. 58 Bias 60 Research Design .................................................................................................... 61 Thesis Research Synchronization ........................................................................ 64 vii Study Participants ................................................................................................