A cost-effectiveness study of ICT training among the visually impaired in the Netherlands.

BACKGROUND: Due to the ageing population, the number of visually impaired people in the Netherlands will increase. To ensure the future availability of services in rehabilitative eye care, we aim to assess the cost-effectiveness of information and communication technology (ICT) training among visually impaired adults from a societal perspective, using primary data from two large rehabilitative eye care providers in the Netherlands. METHODS: Participants were asked to fill in a questionnaire, which used six different instruments at three different time points: pre training, post training and three months post training. We investigated whether the participants' quality of life and well-being improved after the training and whether this improvement persisted three months post training. Economic evaluation was conducted by comparing costs and outcomes before and after training. Quality of life and well-being were derived from the EQ-5D and ICECAP-O, respectively. Costs for productivity losses and medical consumption were obtained from the questionnaires. Information regarding the costs of training sessions was provided by the providers. RESULTS: Thirty-eight participants filled in all three questionnaires. The mean age at baseline was 63 years (SD = 16). The effect of ICT training on ICT skills and participants' well-being was positive and persisted three months after the last training session. Assuming these effects remain constant for 10 years, this would result in an incremental cost-effectiveness ratio (ICER) of € 11,000 per quality-adjusted life-year (QALY) and € 8000 per year of well-being gained, when only the costs of ICT training are considered. When the total costs of medical consumption are included, the ICER increases to € 17,000 per QALY gained and € 12,000 per year of well-being gained. Furthermore, when the willingness-to-pay threshold is € 20,000 per year of well-being, the probability that ICT training will be cost-effective is 75% (91% when including only the costs of ICT training). CONCLUSION: Our study suggests that ICT training among the visually impaired is cost-effective when the effects of ICT training on well-being persist for several years. However, further research involving a larger sample and incorporating long-term effects should be conducted.

Costs of health IT: beginning to understand the financial impact of a dental school EHR.

Health Information Technology (Health IT) constitutes an integral component of the operations of most academic dental institutions nowadays. However, the expenses associated with the acquisition and the ongoing maintenance of these complex systems have often been buried among costs for other electronic infrastructure systems, distributed across various cost centers including unmeasured central campus support, covered centrally and therefore difficult to quantify, and spread over years, denying school administrators a clear understanding of the resources that have been dedicated to Health IT. The aim of this study was to understand the financial impact of Health IT at four similar U.S. dental schools: two schools using a purchased Electronic Health Record (EHR), and two schools that developed their own EHR. For these schools, the costs of creating ($2.5 million) and sustaining ($174,000) custom EHR software were significantly higher than acquiring ($500,000) and sustaining ($121,000) purchased software. These results are based on historical data and should not be regarded as a gold standard for what a complete Health IT suite should cost. The presented data are intended to inform school administrators about the myriad of costs associated with Health IT and give them a point of reference when comparing costs or making estimates for implementation projects.

An extension of trust and TAM model with IDT in the adoption of the electronic logistics information system in HIS in the medical industry.

PURPOSE: Ever since National Health Insurance was introduced in 1995, the number of insurants increased to over 96% from 50 to 60%, with a continuous satisfaction rating of about 70%. However, the premium accounted for 5.77% of GDP in 2001 and the Bureau of National Health Insurance had pressing financial difficulties, so it reformed its expenditure systems, such as fee for service, capitation, case payment and the global budget system in order to control the rising medical costs. Since the change in health insurance policy, most hospitals attempted to reduce their operating expenses and improve efficiency. Introducing the electronic logistics information system is one way of reducing the cost of the department of central warehouse and the nursing stations. Hence, the study proposes a technology acceptance research model and examines how nurses' acceptance of the e-logistics information system has been affected in the medical industry. METHODS: This research combines innovation diffusion theory, technology acceptance model and added two research parameters, trust and perceived financial cost to propose a new hybrid technology acceptance model. Taking Taiwan's medical industry as an experimental example, this paper studies nurses' acceptance of the electronic logistics information system. The structural equation modeling technique was used to evaluate the causal model and confirmatory factor analysis was performed to examine the reliability and validity of the measurement model. RESULTS: The results of the survey strongly support the new hybrid technology acceptance model in predicting nurses' intention to use the electronic logistics information system. CONCLUSION: The study shows that 'compatibility', 'perceived usefulness', 'perceived ease of use', and 'trust' all have great positive influence on 'behavioral intention to use'. On the other hand 'perceived financial cost' has great negative influence on behavioral intention to use.

Preparing for a software transition: how the VNA of Central Jersey cured its training ailments in record time.

This article outlines the way a home health agency successfully used an Internet-based eLearning product (ePath Learning) to transition all laptop users to a new software version in a live environment on the same day. By using the technology as a primary teaching strategy, the training was conducted in an effective and efficient manner.

A web-based therapeutic workplace for the treatment of drug addiction and chronic unemployment.

This article describes a Web-based therapeutic workplace intervention designed to promote heroin and cocaine abstinence and train and employ participants as data entry operators. Patients are paid to participate in training and then to perform data entry jobs in a therapeutic workplace business. Salary is linked to abstinence by requiring patients to provide drug-free urine samples to gain access to the workplace. Prior data show that a prototype of the intervention could promote drug abstinence. Preliminary data on the Web-based intervention suggest that it should be able to teach adults with histories of chronic unemployment and drug addiction to become skilled data entry operators in about 3 to 6 months. Early experience in the business provides preliminary evidence that it might become financially successful. The therapeutic workplace intervention may serve as an effective and practical long-term treatment for chronic unemployment and heroin and cocaine addiction.

Gaining support from health disciplines and other stakeholders.

The Health industry employs health professionals from many disciplines all of whom need to have a basic understanding of health informatics principles and how information technologies may be used to improved health service delivery and patient/community/population health outcomes. This is not well understood by the workforce as a whole resulting in a low demand for health informatics education. Many health service managers and policy makers do not appreciate the power and potential usefulness of all health related information and the many technologies now available. This impacts on decisions regarding their acquisition, implementation and staff training/education support. This chapter includes recommended strategies on how to best overcome such knowledge deficits so that greater support for Health Informatics education is achieved.

Computing and information technology skills of final year medical and dental students at the College of Medicine University of Lagos.

This study was conducted to determine awareness, level of use of computers and the use of the Internet for medical research amongst final year medical and dental students at the University of Lagos. A self-administered structured questionnaire was used to collect data. A response rate of 88% was achieved (136/155). Eighty per cent had used the computer before. Use of software applications was poor with computer games being the most frequently used (19%) followed by word processing softwares (18%). The Internet and electronic mail had been used by 58% but only 23% had used the Internet for medical research. Twenty-one percent classified themselves as proficient on the computer, 59% had little skills and 20% had no skills. Younger students (age less than 26 years) were found to have significantly better skills than older colleagues (p = 004). Majority of final year students at College of Medicine, University of Lagos have little computing skills.

Virtual reality--current multimedia--the world of virtual reality for children.

Some people go as far to say that the invention of virtual technology is comparable to Columbus' discovery of the American continent. Nowadays, computers are regarded as essential tools for children to explore their new world. It will be interesting to observe and guide the growth of these children who have entered into such a world filled with many possibilities.

Training needs for information management: a national programme.

This paper briefly describes major changes in the, management and organization of the English National Health Service from 1985. The information consequences of those changes and the central programme necessary both to realize and to achieve them, are summarized. The requirements for training flowing from these developments are analysed, as are some of the obstacles to be overcome in meeting them. The national programme of training in information management, currently in its third year, is set out, and its particular aims described.

A cost-effective, unit-based approach to computerized care planning education.

This article describes a grassroots approach to developing an educational program on nursing diagnosis and computerized care planning. The process involved staff nurses in program design, implementation, and evaluation. Using this process, staff development educators will be better able to successfully initiate grassroots programs that educate large numbers of nurses at minimal cost.

Computer training in nurse education: a bird's eye view across the UK.

This paper is borne of the increasing interest and relevance of computers in nursing. It describes the method, and results obtained from a postal questionnaire survey distributed across the United Kingdom to gain information about the developments in computing in nursing education. The results indicate that considerable developments have been made, but that they are more piecemeal than co-ordinated. A selection of the results are presented and discussed, and one or two points concerning future proceedings are raised.

Computer competencies identified for nursing staff development educators.

As part of a national study, eleven staff development/inservice educators identified, critiqued, and ranked present and future (1990) computer competencies needed by nurse educators teaching in basic and continuing education. Now, nursing staff development/inservice educators can compare their present level of knowledge of the technology to the important competencies ranked by their peers. Based on this assessment, continuing education strategies can be designed so the educator can be a responsive decision-maker regarding computer technology in the information-based health care delivery system.

CBT (computer-based training) product improves training quality at reduced cost.

The training demands imposed by HIS installations are often substantial. And since hospitals have limited training budgets, quality can suffer. One hospital found that computer-based training (CBT) helped it meet the challenge.