[New technologies in primary care: people, machines, records, and networks. SESPAS Report 2012]. / Nuevas tecnologías en atención primaria: personas, máquinas, historias y redes. Informe SESPAS 2012.

The new technologies and the importance of their development in primary care are clear. Technology is important insofar as it helps to resolve practical problems that arise when attempts are made to improve patient care. Many applications can be found under the heading of "new information and communication technologies" in healthcare, but the present article focusses on two of the most significant examples: the electronic health record and the Internet, bearing in mind that the aims being sought and the people using these applications are more significant than the technologies themselves.

Implementing a web-based oncology protocol system in Australia: evaluation of the first 3 years of operation.

BACKGROUND: EviQ is a web-based oncology protocol system launched across Australia in 2005 (http://www.eviq.org.au). We evaluated eviQ use at the point-of-care and determined the factors impacting on its uptake and routine use in the first three years of operation. METHODS: We conducted a suite of qualitative and quantitative studies with over 200 Australian oncology physicians, nurses and pharmacists working at treatment centres in diverse geographical locations. RESULTS: EviQ was part of routine care at many hospitals; however, the way in which it was used at the point-of-care varies according to clinician roles and hospital location. We identified a range of factors impacting on eviQ uptake and routine use. Infrastructure, such as availability of point-of-care computers, and formal policies endorsing eviQ are fundamental to increasing uptake. Furthermore, the level of clinical and computer experience of end-users, the attitudes and behaviour of clinicians, endorsement and promotion strategies, and level and type of eviQ education all need to be considered and managed to ensure that the system is being used to its full potential. CONCLUSION: Our findings show that the dissemination of web-based treatment protocols does not guarantee widespread use. Organisational, environmental and clinician-specific factors play a role in uptake and utilisation. The deployment of sufficient computer infrastructure, implementation of targeted training programmes and hospital policies and investment in marketing approaches are fundamental to uptake and continued use. This study highlights the value of ongoing monitoring and evaluation to ensure systems like eviQ achieve their primary purpose - reducing treatment variation and improving quality of care.

Laptop programs for students.

With the continuing decline in costs of technology, programs are proliferating worldwide to put networked laptop computers into the hands of millions of students on a routine basis. The reasons policy-makers support these programs are based on economic arguments, equity concerns, and widespread interest in education reform. Studies of laptop programs in schools report that they increase students' engagement in school, improve technology skills, and have positive effects on students' writing. However, evidence of the effectiveness of large-scale laptop programs in other learning domains is scarce. Research in many nations suggests that laptop programs will be most successful as part of balanced, comprehensive initiatives that address changes in education goals, curricula, teacher training, and assessment.

Mobile computing initiatives within pharmacy education.

OBJECTIVES: To identify mobile computing initiatives within pharmacy education, including how devices are obtained, supported, and utilized within the curriculum. METHODS: An 18-item questionnaire was developed and delivered to academic affairs deans (or closest equivalent) of 98 colleges and schools of pharmacy. RESULTS: Fifty-four colleges and schools completed the questionnaire for a 55% completion rate. Thirteen of those schools have implemented mobile computing requirements for students. Twenty schools reported they were likely to formally consider implementing a mobile computing initiative within 5 years. CONCLUSIONS: Numerous models of mobile computing initiatives exist in terms of device obtainment, technical support, infrastructure, and utilization within the curriculum. Responders identified flexibility in teaching and learning as the most positive aspect of the initiatives and computer-aided distraction as the most negative, Numerous factors should be taken into consideration when deciding if and how a mobile computing requirement should be implemented.

ED adds business center to wait area.

Providing your patients with Internet access in the waiting area can do wonders for their attitudes and make them much more understanding of long wait times. What's more, it doesn't take a fortune to create a business center. The ED at Florida Hospital Celebration (FL) Health made a world of difference with just a couple of computers and a printer. Have your information technology staff set the computers up to preserve the privacy of your internal computer system, and block out offensive sites. Access to medical sites can help reinforce your patient education efforts.

E-health: determinants, opportunities, challenges and the way forward for countries in the WHO African Region.

BACKGROUND: The implementation of the 58th World Health Assembly resolution on e-health will pose a major challenge for the Member States of the World Health Organization (WHO) African Region due to lack of information and communications technology (ICT) and mass Internet connectivity, compounded by a paucity of ICT-related knowledge and skills. The key objectives of this article are to: (i) explore the key determinants of personal computers (PCs), telephone mainline and cellular and Internet penetration/connectivity in the African Region; and (ii) to propose actions needed to create an enabling environment for e-health services growth and utilization in the Region. METHODS: The effects of school enrolment, per capita income and governance variables on the number of PCs, telephone mainlines, cellular phone subscribers and Internet users were estimated using a double-log regression model and cross-sectional data on various Member States in the African Region. The analysis was based on 45 of the 46 countries that comprise the Region. The data were obtained from the United Nations Development Programme (UNDP), the World Bank and the International Telecommunications Union (ITU) sources. RESULTS: There were a number of main findings: (i) the adult literacy and total number of Internet users had a statistically significant (at 5% level in a t-distribution test) positive effect on the number of PCs in a country; (ii) the combined school enrolment rate and per capita income had a statistically significant direct effect on the number of telephone mainlines and cellular telephone subscribers; (iii) the regulatory quality had statistically significant negative effect on the number of telephone mainlines; (iv) similarly, the combined school enrolment ratio and the number of telephone mainlines had a statistically significant positive relationship with Internet usage; and (v) there were major inequalities in ICT connectivity between upper-middle, lower-middle and low income countries in the Region. By focusing on the adoption of specific technologies we attempted to interpret correlates in terms of relationships instead of absolute "causals". CONCLUSION: In order to improve access to health care, especially for the majority of Africans living in remote rural areas, there is need to boost the availability and utilization of e-health services. Thus, universal access to e-health ought to be a vision for all countries in the African Region. Each country ought to develop a road map in a strategic e-health plan that will, over time, enable its citizens to realize that vision.

Representative survey of dental students about the present state of education, PC equipment and configuration requirements for a net-based dental education system.

A representative survey of 130 dental students revealed that the necessary conditions for using net-based education systems seem to exist, as 99% of all students have access to a PC, of which most (78%) own one. As most of them use the PC at least several times a week, they seem to be adequately skilled to deal with hard- and software. Internet and emailing are the most commonly used features of the PC after text documentation, therefore it can be inferred that almost all computers have Internet access. The students' requirements for the planned net-based dental education system are case documentation, multimedia documented work-flows, checklists related to workflows, a training tool for prosthetic therapy planning, practical advice and films about dental treatment methods, timetables and discussion fora. The net-based dental education system can support private study but may also be used for seminars in small groups.

Handheld computers in critical care.

BACKGROUND: Computing technology has the potential to improve health care management but is often underutilized. Handheld computers are versatile and relatively inexpensive, bringing the benefits of computers to the bedside. We evaluated the role of this technology for managing patient data and accessing medical reference information, in an academic intensive-care unit (ICU). METHODS: Palm III series handheld devices were given to the ICU team, each installed with medical reference information, schedules, and contact numbers. Users underwent a 1-hour training session introducing the hardware and software. Various patient data management applications were assessed during the study period. Qualitative assessment of the benefits, drawbacks, and suggestions was performed by an independent company, using focus groups. An objective comparison between a paper and electronic handheld textbook was achieved using clinical scenario tests. RESULTS: During the 6-month study period, the 20 physicians and 6 paramedical staff who used the handheld devices found them convenient and functional but suggested more comprehensive training and improved search facilities. Comparison of the handheld computer with the conventional paper text revealed equivalence. Access to computerized patient information improved communication, particularly with regard to long-stay patients, but changes to the software and the process were suggested. CONCLUSIONS: The introduction of this technology was well received despite differences in users' familiarity with the devices. Handheld computers have potential in the ICU, but systems need to be developed specifically for the critical-care environment.

Are you Y2K-ready for low vision assistive technology?

The new Millennium brings a new breed of low vision assistive technology--some of it straight out of science fiction--and a surge in patients who can benefit from it.