Opportunities and barriers for m-health in New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Master of Information Science in Software Engineering at Massey University
This thesis describes a study to determine the opportunities and barriers for mobile health in New Zealand. The world total of mobile phones currently stands at 2.5 billion and is set to reach 3 billion by the end of 2007 . New Zealand has approximately 3.8 million mobile subscribers , and this country, along with many others, recognizes the opportunities for using mobile technology in healthcare. Mobile health (m-health) has moved past the hype stage overseas; there is good evidence for improved productivity, and growing evidence for improved patient engagement. Broadband wireless, improved mobile devices and integrated mobile applications will continue this growth. New Zealand health and disability providers can adapt these overseas m-health successes to develop their own mobile health strategies . M-health involves the use of mobile technology to enhance health services. The mobile technology can be either a short-distance or long-distance technology, or be device driven. The health industry is an information intensive industry, and as New Zealand has a public healthcare model, the idea of information integration among and within health sectors is encouraged. The purpose of this study is to identify the barriers and opportunities of m-health in New Zealand. Following an introduction, the literature survey defines the scope of the study. It first discusses wireless and mobile computing technologies, then looks at New Zealand healthcare information strategies and the importance of information in the health industry. Finally, these two topics are investigated by exploring the literature on the use of wireless technology in healthcare - in both clinical and non-clinical applications. M-health is a new area of development in the health industry. Hence the practical part of the research used a qualitative research strategy, determined to be appropriate to obtaining a better understanding of any phenomena about which little is yet known . The two main parts of this research include the questionnaire and the interviews. The questionnaire sample was selected from health users, health planners, health technology suppliers, and academics, and covered areas of patient care, primary care, secondary care, community care, and integrated care. The interview sample consisted of technology strategists, primary healthcare planners, secondary healthcare planners, and community healthcare planners. The main focus of the interview was to find out about the future of m-health in New Zealand, analyze which sectors can benefit from m-health, examine the opportunity for customized software on mobile devices, gather possibilities of mobile assistance toward integrated care, and lastly, find out about the privacy and security issues of using mobile technology in healthcare. The questionnaire results indicate that the patients would appreciate receiving health services on their mobile phones. There is strong agreement that patients will benefit from text reminders, health awareness campaigns, and patient monitoring. The findings indicate that community nurses could use m-health technology to improve integration of information. There are two differing opinions on Electronic Health Records (EHRs) and their mobility across all sectors - the technology strategists think it is very important, but the health planners are divided. The opportunities that have been identified from the interviews include monitoring, health alarms, patient engagement in healthcare, community workers information integration, SMS reminders and alerts, ability of health workers to work offsite, prescription feedback, and using PDAs where necessary to enable electronic data capture. The barriers include legacy systems, disparate systems, lack of standards, lack of integration tools, lack of bandwidth, DHB-led initiatives, older health planners who are resistant to technology, ill population having the least uptake of technology, inability to share information with patients, development of mobile applications, infrastructure investment, telecommunication barriers, changed management, lack of technical capabilities, and cultural barriers.