LA PATERNIDAD ADOPTIVA EN LA ALTA EDAD MEDIA.

The penetration of ubiquitous mobile technology into the healthcare domain has seen the growing demand for m-health applications to address many issues facing New Zealand as well as many other developed countries. The pilot study participants responded very positively in respect of mobile devices in New Zealand healthcare; these results can be extrapolated to most developed nations who face similar challenges. The devices studied were identified with many potential applications. Overall, all participants were very confident and encouraged the use of mobile devices in New Zealand healthcare.

Mobile devices are required in all healthcare sectors. However, the community sector is considered to be one of the main areas that could benefit the most. Community care consists of a majority of mobile personnel who perform home visits or help in

community-based projects. Mobile devices facilitate real-time access to information at point-of-care. Laptops, tablet PCs, and PDAs with wireless communication allow healthcare workers to collect data at point-of-care in electronic format rather than on paper. Data can be synchronised with the healthcare provider without requiring the field personnel to return to the office for several days. The potential application is very significant because electronic format is of high value in the healthcare industry as it can be stored, analysed, and interpreted correctly to make better decisions. However, accessing data would be limited when there is no Internet available.

The patient’s failure to attend appointments has a significant impact on the ability of healthcare providers to provide efficient and effective healthcare services. Health planners suggested a lot of potential for the use of simple SMS technology; this can facilitate sending appointment reminders and lab results, and facilitate preventive care and patient support applications. Moreover, SMS can be used for monitoring patients and helping to maintain contact between patient and provider while away from practice/hospital. Appointment reminders help reduce DNAs (Do Not Attend) significantly, which enables full utilisation of clinical and administrative staff and increases revenue opportunities. Moreover, it decreases the period of time that patients must wait for an appointment booking. This application implementation is very reasonable compared to its benefits. The ubiquity of mobile phones in New Zealand encourages the adoption of SMS alerts and educates citizen for healthy well-being. Preventive care methods promote healthier living, which in turn reduces health budgets and increases the quality of life for the population.

Health strategists and technologists consider RFID technology to have huge potential in the secondary healthcare sector and in the pharmaceutical industry. RFID still has not been exploited in New Zealand’s healthcare industry. RFID provides many applications which would greatly assist in reducing administration costs and increasing efficiency and patient safety. It has the ability to track patients and staff, manage assets, and provide traceability across the pharmaceutical supply chain. It will help stop the counterfeit of drugs, and achieve the five rights of medication safety by using RFID tags in hospitals. New Zealand needs to conduct a pilot study to evaluate the benefits; based on the results, it should implement RFID technology throughout New Zealand’s health industry.

The pilot study uncovered several applications for each of the devices examined; laptops, tablet PCs, PDAs, smart phones, mobile phones and RFIDs. PDAs and laptops were the most effective devices. Both clinical and non-clinical applications were described in the thesis. However, RFID was especially effective in non-clinical

applications. The utility of each application is directly dependent on which sector and audience is being targeted.

6.2

Challenges and Implications

The adoption of m-health applications in New Zealand healthcare is directly dependent on the challenges and implications mobile devices introduce into the healthcare environment. Challenges include addressing inherent technical constraints, privacy, security, and ethical issues surrounding mobile devices. Some of the challenges which were discovered in this pilot study are opinion-based, and should not be generalised across the whole New Zealand population. In this section, the most significant challenges and implications will be described.

One of most mentioned technical constraints across all mobile devices is their size. Both health and technology strategists argued regarding screen size and form factor of mobile devices. The small screen real state would create problems for building smart applications, and is considered to be a major constraint to adoption of mobile devices. Mobile devices are not always considered as user-friendly, hence functionality, comfort, and form factors need to be addressed to suit its application. Most of the mobile devices are fairly expensive, and very fragile. They need to be constructed to withstand accidental drops and spills. This would encourage adoption and allow health workers to perform in various conditions and environments.

Most modern devices include storage space (memory), which could be used to store various data, including personal and clinical information. However, security of mobile devices is one of the challenges yet to be addressed thoroughly; they tend to easily be lost or stolen which could breach user privacy, as there is no effective security on most devices. One possible solution would be to have the data accessed from a secure online repository.

RFID technologies tracking capability raises many questions about potential violations of personal privacy. Reading distance of RFID is considered to be a constraint when used in hospitals. Instead of scanning one patient, it might return information on multiple patients located in the same area, which could create confusion. RFID systems are different compared to other identification methods because communication is without any contact and line-of-sight. This makes it very difficult to detect when communication is taking place via the RFID tag.

New Zealand has a wide range of ethnic backgrounds and languages making it challenging to convey the benefits of mobile devices to each group in the community. For example, some groups prefer paper-based reports rather than electronic. New Zealand citizens need to be educated and well-informed about mobile technology to ensure adoption across all health sectors.

There are many political and cost-related implications which affect the expansion of m-health applications. Currently in New Zealand, there is no clear guidance of national standards (security and privacy standards) for m-health applications; this slows the development of new initiatives by health technology experts. Funding and payments of new projects will be debated among patients, providers, and government. For example, patients would not want to pay additional costs as they are used to getting free healthcare by paying their taxes.