Wairoa

1. Wairoa Medical, Midwifery & Practice Nurse staffTuesday 27th April

2. Thank you

3. especially toRon Janes

4. FAQ(Frequently Asked Questions)

5. Outline Introduction Subject area Research questions Methodology Your assistance with this project

6. INTRODUCTION

7. Who am I?Dallas Knightstudent researcherUniversity of Otago

8. Why am I here?

9. SUBJECT AREA

10. Health Informatics

11. What am I studying?

12. Information & communication technologies in

13. health care service delivery

14. More specifically Internet and mobile technologies.

15. Service sector under scrutiny

16. Midwiferyservice delivery.

17. So…….this is an

18. exploratory study

19. A case study

20. Case study Using one (of twenty one) District Health Boards (DHB) in New Zealand. One clearly defined geographical region (Hawke’s Bay). Using only independent midwives gives a tightly defined group. Using a population which includes a high percentage of Maori women, Pacific Island women, and rural women groups.

21. exploring elements within the current use

22. and possible future use

23. of Internet and mobile technologies

24. to enhance health service delivery

25. Acknowledging that technology as used in healthcare service delivery is a

26. Socio-technical system

27. A socio-technical system

28. and

29. There has been a convergence of technologies

30. Smart phones (3G) are now computers

31. They Collect video, image, voice and text data Send data Send and receive emails Access Web services Are personal devices Sync with laptop and PC Send and receive SMS (text) messages Have a standardised platform for application developers Are mobile phones Access the social web (Facebook, Twitter, YouTube, Skype, Google)

32. RESEARCH QUESTIONS

33. asking

34. Can Internet and mobile technologies be leveraged ?

35. How?

36. Whatcurrent hardware, software/applications and services could be considered

37. to enhancemidwifery service delivery?

38. (continued) Are there time saving efficiencies? Are there perceived and assessed risks? Are there perceived and assessed benefits? Can current information and communication technologies enhance the service delivery process? If so, how?

39. The trust factor Additionally, perceptions of trust, surveillance and their relationship to consumer satisfaction will be investigated. How does each primary group (women and midwives) view the trust element? Does frequency and characteristics of the communication medium increase or decrease aspects of trust?

40. Three-phase approach Phase One User needs (perceived and assessed) Phase Two Pilot study using Action Research methodology? Phase Three Evaluation?

41. Whyask these questions?

42. because

43. Information and communicationtechnologies are now able to provide more and diverse ways for health care providers and patients to communicateand transfer information.

44. The rise and rise of mobile phone subscribers * http://www.itu.int/newsroom/press_releases/2008/29.html

45. Explosion in growth There has been an explosion in the growth of information and communication technologies and particularly mobile technologies. There are around 45 million Internet users compared with <4 billion mobile phone subscribers (2008)* Cost is an inhibiter for mobile but many more now rely on mobile only and there is a clear shift in this direction.. *http://www.itu.int/newsroom/press_releases/2008/29.html

46. Mobile phones Mobile phones could be seen as disruptive technologies /disruptive innovation* because they are changing the ‘traditional’ way of communicating and transferring information. *Clayton Christensen (Harvard Prof of Business Studies)

47. Disruptive technology and disruptive innovation are terms used in business and technology literature to describe innovations that improve a product or service in ways that the market does not expect Disruptive technologies

48. For example Refrigerator Touch screen technology Digital images iPod and iTunes Cloud computing Skype and VOIP Web 2.0

49. Web 2.0 Participatory – user generated content Collaborative – Google Docs Social – social networks [Facebook, Twitter] Multi-media – Youtube, podcasts, Flickr Dynamic – blogs http://www.jisc.ac.uk/media/documents/techwatch/tsw0701b.pdf

50. Consumer expectations Web 2.0 aware consumers will demand to have access to, and to control their data. Eysenbach: Consumer health informatics http://www.slideshare.net/eysen/eysenbach-consumer-health-informatics

51. One patient one record?orinformation in inaccessible and unconnected silos?

52. Healthcare restraints are necessitating a move towards increased patient engagement, involvement, participation, empowerment and responsibility for their own health outcomes.

53. The rise of the ePatient

54. Whywas the midwifery health service sector chosen?

55. because

56. Midwives practice in clinics and birthing centres/hospitals and women’s homes.

57. It is therefore a mobile service setting with mobility presenting as a challenge

58. and

59. Women ~15 – 45 are more likely to be active users of new technologies

60. compared with other groups of people receiving healthcare.

61. also

62. Data collection does not interfere with service delivery

63. because

64. semi-structured interview data is collected afterthe healthcare service encounter.

65. Users of midwifery service

66. are well women

67. who receive relatively standardised care

68. for a clearly defined period of time

69. and

70. areinformation hungry(normally, especially primigravidas).

71. Midwifery service to each woman could be viewed as single health episode or unit of service delivery.

72. Duration of health episode/service

73. METHODOLOGY

74. Ethics approval University of Otago Ethics Central Ethics Approved Plunket Ethics Committee Pending

75. Documentation Information describing the project Informed consent process

76. How am I trying to answer the research questions?

77. Paradigm view Constructivist Hermeneutical Interpretive Pragmatic

78. Grounded Theory Methodology

79. Data collection:Semi-structured interviews Midwives: who practice independently within the Hawke’s Bay region. Women: after they have been discharged from midwifery care.

80. Data collection

81. Midwives’ demographic data

82. Women’s demographic data

83. Constant review process

84. Status 27/30 Napier – Hastings midwives have been interviewed. All general practices in Napier, Hastings and Central Hawke’s Bay have been personally approached and given documentaion. 14/? Women have been interviewed.

85. Next stage (April 2010) Interview data is presenting fascinating insight and will continue to saturation. Teen aged parents, rural women and Maori women are currently being recruited. Internet and mobile technologies (hardware, software, applications, services) are constantly under review.

86. YOUR ASSISTANCE

87. Please assist by:

88. 1. Consenting to be interviewed Midwives GP LMCs? GPs?

89. 2. Recruiting women Briefly explain the project (documentation) Fill in a form with the women’s contact details Fax form to me so I can arrange interview times

90. If you are agreeable I will come to Wairoa for ~3 days at a convenient time to carry out interviews.

91. Thank you

92. Dallas Knight 2 Milton Terrace, Hospital Hill, Napier 4110 dknight@actrix.co.nz Ph: [H] 06 835 5939 Ph: [M] 021 105 9866

93. Slides will be stored at Slideshare &Google Docs