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5.7.1Resistance of uptake on mobile devices

The research conducted identified a whole range of areas where health planners, users, and solution providers are resistant to mobile technologies. This section summarises these issues.

Generally, people are resistant to uptake for many reasons, some of these include the elder generation (majority of population who require care) who are not technologically savvy. The questionnaire results highlighted a sense of debate among the participants — whether negative perception of patients or physicians (see chapter 4.1, q#3.5) is an important m-health challenge or not. (38% had a neutral opinion and 38% considered it a very important challenge). However, this barrier can be overcome by educating both patients and physicians about the benefits of adoption.

Moreover, statistics from the survey emphasised that personal factors such as large fingers, poor eyesight, and forgetfulness of carrying a device are considered as a significant challenge in m-health applications (see chapter 4.1, q#3.6). This could well be due to the variety of ethnicities in New Zealand. Additionally, language barrier is another problem, as the solution end users may not be English speaking. The cost of the mobile devices is very high, particularly the ones which qualify enabling healthcare applications. The public system would resist changing, as they need to pay extra for healthcare due to new technology. The effectiveness and efficiency gains need to be communicated to everyone in order for them to accept and adopt mobile technology.

Technology is not always the problem; it is also about how it is applied, educated, and deployed effectively. It cannot be generalised whether or not to resist, it is more of a case-by-case scenario where it may or may not be beneficial to resist mobile technologies.

Patients

Often patients resist, especially when technology requires additional payments to be made, when there is no motivation whatsoever. They would create excuses which will limit the uptake. Some patients are found to be a bit reluctant to change. Hence, the change control will be a challenge to introducing new devices.

Providers

Healthcare providers tend to focus primarily on patient care, and if technology is going to obstruct or alter their routine in proving patient care, they resist the change.

Also, clinicians might feel that their decisions are being made using a machine (knowledge base) rather than their knowledge.

Providers need to be motivated, and benefits of the respective application must be clearly explained for them to make a decision on whether or not they wish to use it. Providers would also resist if it is going to affect their personal life(e.g. getting text message in regards to their budgets, while they are on a vacation).

Government

The government is resistant, as they are responsible for funding the majority of the projects throughout NZ’s healthcare sectors; however, the government has future strategies which mobile technologies can complement.

5.7.2Adoption of mobile devices in New Zealand

New Zealand is considered to be slow at adopting new applications rather than a fast implementer. A countrywide initiative needs to take place to introduce new m-health applications into New Zealand healthcare. Since NZ is a small country, it is more controllable. Initiating projects throughout a large country would be much more complex, compared to New Zealand, which is more easily controlled.

In recent times, government has displayed definite leadership in addressing problems of patient safety. Once the project of using RFID is launched, it will provide a good momentum to take New Zealand forward. There are also widespread SMS applications being used, showing signs of adoption and acceptance.

The survey results of Chapter 4.1, question 4, are valuable for addressing which critical success factors can be achieved using which mobile devices. The critical success factors which are relevant to New Zealand healthcare include reduced cost, user acceptance, increased efficiency, improved patient safety and care, quality of service, secure connectivity, remote access for clinicians, sustainability of mobile applications, and location independence for patients. The majority of CSFs could be met by a variety of mobile devices. However, the two most significant mobile devices were PDA and laptop as they were considered to be capable of facilitating most of the CSFs. Hence, New Zealand should consider adopting PDAs and laptops throughout all healthcare sectors. Nevertheless, RFID was the only mobile device which could meet the “improve patient safety” CSF, which could be argued.

How to reduce resistance and provide opportunities

Healthcare providers require sufficient service plans with an efficient quick turnaround for repairs and/or having replacement units available in case something breaks. There has to be minimal disruption to both patients and healthcare providers.

Privacy, security and budget issues, and training required to operate the system appropriately should be addressed prior to full deployment. As long as there is proven value to the healthcare sector and its users, a lot of resistance would be diminished.

No resistance

The patients would not resist adopting new applications driven by mobile devices, if they could go home early from hospital or receive appointment or medication reminders on their mobile phone. Additionally, the results highlighted that the clinicians or patients are not resistant to uptake of mobile devices, once they are informed or educated about the benefits.