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Drug utilization studies: their transferability between industrialized and developing countries

Lee D, Balasubramaniam K, Ali HM

WHO Reg Publ Eur Ser, 1993;45:193-218.
PMID: 8442847
Matched MeSH terms: Diffusion of Innovation*
Fulltext Health innovation for patient safety improvement

Sellappans R, Chua SS, Tajuddin NA, Lai PSM

Australas Med J, 2013;6(1):60-3.
PMID: 23423150 DOI: 10.4066/AMJ.2013.1643

Medication error has been identified as a major factor affecting patient safety. Many innovative efforts such as Computerised Physician Order Entry (CPOE), a Pharmacy Information System, automated dispensing machines and Point of Administration Systems have been carried out with the aim of improving medication safety. However, areas remain that require urgent attention. One main area will be the lack of continuity of care due to the breakdown of communication between multiple healthcare providers. Solutions may include consideration of "health smart cards" that carry vital patient medical information in the form of a "credit card" or use of the Malaysian identification card. However, costs and technical aspects associated with the implementation of this health smart card will be a significant barrier. Security and confidentiality, on the other hand, are expected to be of primary concern to patients. Challenges associated with the implementation of a health smart card might include physician buy-in for use in his or her everyday practice. Training and technical support should also be available to ensure the smooth implementation of this system. Despite these challenges, implementation of a health smart card moves us closer to seamless care in our country, thereby increasing the productivity and quality of healthcare.

Matched MeSH terms: Diffusion of Innovation
E-health implementation challenges in Iranian medical centers: a qualitative study in Iran

Sharifi M, Ayat M, Jahanbakhsh M, Tavakoli N, Mokhtari H, Wan Ismail WK

Telemed J E Health, 2013 Feb;19(2):122-8.
PMID: 23374035 DOI: 10.1089/tmj.2012.0071

E-health encompasses a wide scope and has excellent potential to grow in the future. Growing numbers of experts believe that e-health will fuel the next breakthroughs in health system improvements throughout the world. There is frequent evidence that largely indicates failures or unsustainable e-health implementations in different countries for different reasons. Iran is also a developing country that is presently applying this promising technology for its traditional healthcare delivery.

Matched MeSH terms: Diffusion of Innovation
Categorizing the telehealth policy response of countries and their implications for complementarity of telehealth policy

Varghese S, Scott RE

Telemed J E Health, 2004;10(1):61-9.
PMID: 15104917

Developing countries are exploring the role of telehealth to overcome the challenges of providing adequate health care services. However, this process faces disparities, and no complementarity in telehealth policy development. Telehealth has the potential to transcend geopolitical boundaries, yet telehealth policy developed in one jurisdiction may hamper applications in another. Understanding such policy complexities is essential for telehealth to realize its full global potential. This study investigated 12 East Asian countries that may represent a microcosm of the world, to determine if the telehealth policy response of countries could be categorized, and whether any implications could be identified for the development of complementary telehealth policy. The countries were Cambodia, China, Hong Kong, Indonesia, Japan, Malaysia, Myanmar, Singapore, South Korea, Taiwan, Thailand, and Vietnam. Three categories of country response were identified in regard to national policy support and development. The first category was "None" (Cambodia, Myanmar, and Vietnam) where international partners, driven by humanitarian concerns, lead telehealth activity. The second category was "Proactive" (China, Indonesia, Malaysia, Singapore, South Korea, Taiwan, and Thailand) where national policies were designed with the view that telehealth initiatives are a component of larger development objectives. The third was "Reactive" (Hong Kong and Japan), where policies were only proffered after telehealth activities were sustainable. It is concluded that although complementarity of telehealth policy development is not occurring, increased interjurisdictional telehealth activity, regional clusters, and concerted and coordinated effort amongst researchers, practitioners, and policy makers may alter this trend.

Matched MeSH terms: Diffusion of Innovation
An overview of the national telehealth initiative in Malaysia

Maon SN, Edirippulige S

Stud Health Technol Inform, 2010;161:95-103.
PMID: 21191162

Malaysia's national health statistics for the last half century show a remarkable improvement in the nation's health status. One important factor for this improvement is the Malaysian government's proactive intervention in the health sector. Among others, e-health has played a vital role in delivering and managing healthcare services in Malaysia. While the Government has integrated telehealth in its national digital infrastructure re-design, it has heavily invested in telehealth. The enactment of new laws to facilitate telehealth practices can also be noted as an important measure.

Matched MeSH terms: Diffusion of Innovation*
Health information systems adoption: findings from a systematic review

Yusof MM, Stergioulas L, Zugic J

Stud Health Technol Inform, 2007;129(Pt 1):262-6.
PMID: 17911719

Earlier evaluation studies on Health Information Systems (HIS) adoption have highlighted a large number of adoption problems that were attributed to the lack of fit between technology, human and organisation factors. Lessons can be learned from these evaluation studies by identifying the most important factors of HIS adoption. In order to study the adoption issue, a qualitative systematic review has been performed using a recently introduced framework, known as HOT-fit (Human, Organisation and Technology fit). The paper identifies and highlights the following critical adoption factors: technology (ease of use, system usefulness, system flexibility, time efficiency, information accessibility and relevancy); human (user training, user perception, user roles, user skills, clarity of system purpose, user involvement); organisation (leadership and support, clinical process, user involvement, internal communication, inter organisational system, as well as the fit between them. The findings can be used to guide future system development and inform relevant decision making.

Matched MeSH terms: Diffusion of Innovation*
Antimicrobial Efficacy of Extemporaneously Prepared Herbal Mouthwashes

Dua K, Sheshala R, Al-Waeli HA, Gupta G, Chellappan DK

Recent Pat Drug Deliv Formul, 2015;9(3):257-61.
PMID: 26051152

Natural products like plants and its components have been in use for treatment and cure of diseases all around the globe from ancient times much before the discovery of the current modern drugs. These substances from the nature are well known to contain components which have therapeutic properties and can also behave as precursors for the synthesis of potential drugs. The beneficial results from herbal drugs are well reported where their popularity in usage has increased across the globe. Subsequently developing countries are now recognizing the many positive advantages from their use which has engaged the expansion of R & D from herbal research. The flow on effect from this expansion has increased the awareness to develop new herbal products and the processes, throughout the entire world. Mouth washes and mouth rinses which have plant oils, plant components or extracts have generated particular attention. High prevalence of gingival inflammation and periodontal diseases, suggests majority of the patients practice inadequate plaque control. Of the currently available mouthwashes in the market, Chlorhexidine gluconate (CHX) has been investigated on a larger scale with much detail. CHX is associated with side effects like staining of teeth when used daily as well as the bitter taste of the mouthwash which leads to patient incompliance. The present research encompasses the antibacterial activity of extemporaneously prepared herbal mouthwash using natural herbs and therefore allows for the potential commercialization with in the herbal and pharmaceutical industries. Also, the present research article reviewed details of various existing patents of herbal mouthwashes which shows the trend of existing market and significance of emerging mouthwashes in both pharmaceutical and herbal industries. The antimicrobial activity of prepared mouthwashes was found to be effective against various strains of bacteria. It also suggests that the prepared herbal mouthwashes may provide an alternative to those containing chemical entities, with enhanced antimicrobial properties and better patient compliance.

Matched MeSH terms: Diffusion of Innovation
Nanospray Drying Technology: Existing Limitations and Future Challenges

Wui WT

Recent Pat Drug Deliv Formul, 2015;9(3):185-6.
PMID: 25966873
Matched MeSH terms: Diffusion of Innovation
Fulltext Critical Factors Influencing Decision to Adopt Human Resource Information System (HRIS) in Hospitals

Alam MG, Masum AK, Beh LS, Hong CS

PLoS One, 2016;11(8):e0160366.
PMID: 27494334 DOI: 10.1371/journal.pone.0160366

The aim of this research is to explore factors influencing the management decisions to adopt human resource information system (HRIS) in the hospital industry of Bangladesh-an emerging developing country. To understand this issue, this paper integrates two prominent adoption theories-Human-Organization-Technology fit (HOT-fit) model and Technology-Organization-Environment (TOE) framework. Thirteen factors under four dimensions were investigated to explore their influence on HRIS adoption decisions in hospitals. Employing non-probability sampling method, a total of 550 copies of structured questionnaires were distributed among HR executives of 92 private hospitals in Bangladesh. Among the respondents, usable questionnaires were 383 that suggesting a valid response rate of 69.63%. We classify the sample into 3 core groups based on the HRIS initial implementation, namely adopters, prospectors, and laggards. The obtained results specify 5 most critical factors i.e. IT infrastructure, top management support, IT capabilities of staff, perceived cost, and competitive pressure. Moreover, the most significant dimension is technological dimension followed by organisational, human, and environmental among the proposed 4 dimensions. Lastly, the study found existence of significant differences in all factors across different adopting groups. The study results also expose constructive proposals to researchers, hospitals, and the government to enhance the likelihood of adopting HRIS. The present study has important implications in understanding HRIS implementation in developing countries.

Matched MeSH terms: Diffusion of Innovation
Responding to the call of home

Dolgin E

Nature, 2019 02;566(7742):143-145.
PMID: 30723358 DOI: 10.1038/d41586-019-00448-8
Matched MeSH terms: Diffusion of Innovation
Determinants of telemedicine acceptance in selected public hospitals in Malaysia: clinical perspective

Zailani S, Gilani MS, Nikbin D, Iranmanesh M

J Med Syst, 2014 Sep;38(9):111.
PMID: 25038891 DOI: 10.1007/s10916-014-0111-4

The purpose of this study is to explore the determinants of telemedicine acceptance in selected public hospitals in Malaysia and to investigate the effect of health culture on the relationship between these determinants and telemedicine acceptance. Data were gathered by means of a survey of physicians and nurses as the main group of users of telemedicine technology from hospitals that are currently using telemedicine technology. The results indicated that government policies, top management support, perception of usefulness and computer self-efficiency have a positive and significant impact on telemedicine acceptance by public hospitals in Malaysia. The results also confirmed the moderating role of health culture on the relationship between government policies as well as perceived usefulness on telemedicine acceptance by Malaysian hospitals. The results are useful for decision-makers as well as managers to recognize the potential role of telemedicine and assist in the process of implementation, adoption and utilization, and, therefore, spread the usage of telemedicine technology in more hospitals in the country.

Matched MeSH terms: Diffusion of Innovation*
External factors in hospital information system (HIS) adoption model: a case on Malaysia

Lee HW, Ramayah T, Zakaria N

J Med Syst, 2012 Aug;36(4):2129-40.
PMID: 21384267 DOI: 10.1007/s10916-011-9675-4

Studies related to healthcare ICT integration in Malaysia are relatively little, thus this paper provide a literature review of the integration of information and communication technologies (ICT) in the healthcare sector in Malaysia through the hospital information system (HIS). Our study emphasized on secondary data to investigate the factors related to ICT integration in healthcare through HIS. Therefore this paper aimed to gather an in depth understanding of issues related to HIS adoption, and contributing in fostering HIS adoption in Malaysia and other countries. This paper provides a direction for future research to study the correlation of factors affecting HIS adoption. Finally a research model is proposed using current adoption theories and external factors from human, technology, and organization perspectives.

Matched MeSH terms: Diffusion of Innovation*
Attitudes of medical school deans toward interprofessional education in Western Pacific Region countries

Lee B, Celletti F, Makino T, Matsui H, Watanabe H

J Interprof Care, 2012 Nov;26(6):479-83.
PMID: 22830530 DOI: 10.3109/13561820.2012.706336

To examine the attitudes of medical school deans toward interprofessional education (IPE) and collaborative practice (CP), we conducted survey research in the Western Pacific Region. This regional survey was conducted as a collaborative research project with the World Health Organization. A survey was distributed to the medical school deans in Malaysia, the Philippines, Republic of Korea and Japan. Thirty-five surveys were returned from four countries. The survey demonstrated that many medical school deans have positive attitudes toward IPE and CP. However, respondents also reported that it is not easy to introduce interprofessional learning in their academic settings. It is suggested that collaboration between education systems and health systems is needed to introduce IPE in the academic setting. The possible role of international organizations is mentioned. This information helps to identify local efforts on which global health organizations and national governments can build.

Matched MeSH terms: Diffusion of Innovation*
User-driven health care - answering multidimensional information needs in individual patients utilizing post-EBM approaches: a conceptual model

Biswas R, Martin CM, Sturmberg J, Shanker R, Umakanth S, Shanker S, et al.

J Eval Clin Pract, 2008 Oct;14(5):742-9.
PMID: 19018905 DOI: 10.1111/j.1365-2753.2008.00998.x

Evidence based on average patient data, which occupies most of our present day information databases, does not fulfil the needs of individual patient-centred health care. In spite of the unprecedented expansion in medical information we still do not have the types of information required to allow us to tailor optimal care for a given individual patient. As our current information is chiefly provided in disconnected silos, we need an information system that can seamlessly integrate different types of information to meet diverse user group needs. Groups of certain individual medical learners namely patients, medical students and health professionals share the patient's need to increasingly interact with and seek knowledge and solutions offered by others (individual medical learners) who have the lived experiences that they would benefit to access and learn from. A web-based user-driven learning solution may be a stepping-stone to address the present problem of information oversupply in medicine that mostly remains underutilized, as it doesn't meet the needs of the individual patient and health professional user. The key to its success would be to relax central control and make local trust and strategic health workers feel more engaged in the project such that it is truly user-driven.

Matched MeSH terms: Diffusion of Innovation
The process of evidence-based medicine and the search for meaning

Biswas R, Umakanth S, Strumberg J, Martin CM, Hande M, Nagra JS

J Eval Clin Pract, 2007 Aug;13(4):529-32.
PMID: 17683292 DOI: 10.1111/j.1365-2753.2007.00837.x

BACKGROUND AND RATIONALE: Evidence based medicine is the present backbone of rational and objective, modern medical problem solving and is a meeting ground for quantitative and qualitative researchers alike as it culminates into applying the fruits of clinical research to the individual patient. A systematic enquiry into the evolving paradigms in EBM is a need of the hour.
AIMS AND METHODS: A qualitative enquiry examining the impact of different methodologies in EBM and their role in generating meaning interpretable at individual levels.
RESULTS: Present day outcome based research deals less with patients as individuals than as populations. Evidence based medicine struggles to apply the fruits of population based research to individuals who are often not as predictable as linear quantitative research would like them to be. The present EBM literature neglects a lot of events it doesn't believe to be statistically significant and perhaps here is an area that needs to be improved on - it assumes that because associations are demonstrated between interventions and outcomes in RCTs/meta-analysis, these associations are linear and causal in the real world. While they may be demonstrated repeatedly in highly controlled environments, in the real 'uncontrolled' world of clinical practice with real people, their validity breaks down.
CONCLUSIONS: One needs to make the EBM standard model patient-individual (a projection of collective patient event data) resemble the real human individual patient so that optimal EBM individual data that matches our query can be easily and quickly spotted from the dense jungle of information that has grown over the years. This hints at rethinking our entire research methodology and modifying it to suit the needs of the individual patient.

Matched MeSH terms: Diffusion of Innovation
Diffusion and utilization of magnetic resonance imaging in Asia

Hutubessy RC, Hanvoravongchai P, Edejer TT, Asian MRI Study Group

Int J Technol Assess Health Care, 2002;18(3):690-704.
PMID: 12391959

An assessment of the current status of magnetic resonance imaging (MRI) was undertaken to provide input for future government decisions on the introduction of new technologies in Asia. The objective of the study is to describe and explain the diffusion pattern of this costly technology in several Asian settings.

Matched MeSH terms: Diffusion of Innovation*
Fulltext HISTORICAL DEVELOPMENT OF THE HTAsiaLINK NETWORK AND ITS KEY DETERMINANTS OF SUCCESS

Teerawattananon Y, Luz K, Yothasmutra C, Pwu RF, Ahn J, Shafie AA, et al.

Int J Technol Assess Health Care, 2018 Jan;34(3):260-266.
PMID: 29911515 DOI: 10.1017/S0266462318000223

OBJECTIVES: The aim of this study was to describe the historical development of the HTAsiaLink network, draw lessons for other similar initiatives globally, and to analyze key determinants of its success and challenges for its future development.
METHODS: This study is based on the collective and direct experiences of the founding members of the HTAsiaLink Network. Data were collected from presentations they made at various international forums and additional information was reviewed. Data analysis was done using the framework developed by San Martin-Rodriguez et al.Results and Conclusions:HTAsiaLink is a network of health technology assessment (HTA) agencies in Asia established in 2011 with the aim of strengthening individual and institutional HTA capacity, reducing duplication and optimizing resources, transfer and sharing of HTA-related lessons among members, and beyond. During its 6 years, the network has expanded, initiating several capacity building activities and joint-research projects, raising awareness of the importance of HTA within the region and beyond, and gaining global recognition while establishing relationships with other global networks. The study identifies the determinants of success of the collaboration. The systemic factors include the favorable outlook toward HTA as an approach for healthcare priority setting in countries with UHC mandates. On organizational factors, the number of newly established HTA agencies in the region with similar needs for capacity building and peer-to-peer support was catalytic for the network development. The interactional aspects include ownership, trust, and team spirit among network members. The network, however, faces challenges notably, financial sustainability and management of the expanded network.

Matched MeSH terms: Diffusion of Innovation*
Toward understanding Malaysian fishermen's decision making on the use of fishing technology: a mental model approach

Hamzah A, Krauss SE, Shaffril HA, Suandi T, Ismail IA, Abu Samah B

Int J Psychol, 2014 Oct;49(5):397-403.
PMID: 25178962 DOI: 10.1002/ijop.12010

The vast majority of Malaysia's fishermen are located in rural areas, specifically in the Western and Eastern coastal regions of Peninsular Malaysia and the Sabah and Sarawak central zones. In these areas, the fishing industry is relied upon as a major economic contributor to the region's residents. Despite the widespread application of various modern technologies into the fishing industry (i.e., GPS, sonar, echo sounder, remote sensing), and the Malaysian government's efforts to encourage their adoption, many small-scale fishermen in the country's rural areas continue to rely on traditional fishing methods. This refusal to embrace new technologies has resulted in significant losses in fish yields and needed income, and has raised many questions regarding the inputs to decision making of the fishermen. Drawing on multiple literatures, in this article we argue for the use of a mental model approach to gain an in-depth understanding of rural Malaysian fishermen's choices of technology adoption according to four main constructs--prior experience, knowledge, expertise and beliefs or values. To provide needed inputs to agricultural specialists and related policy makers for the development of relevant plans of action, this article aims to provide a way forward for others to understand dispositional barriers to technology adoption among fishermen who use traditional methods in non-Western contexts.

Matched MeSH terms: Diffusion of Innovation*
Organizational decision to adopt hospital information system: an empirical investigation in the case of Malaysian public hospitals

Ahmadi H, Nilashi M, Ibrahim O

Int J Med Inform, 2015 Mar;84(3):166-88.
PMID: 25612792 DOI: 10.1016/j.ijmedinf.2014.12.004

This study mainly integrates the mature Technology-Organization-Environment (TOE) framework and recently developed Human-Organization-Technology (HOT) fit model to identify factors that affect the hospital decision in adopting Hospital Information System (HIS).

Matched MeSH terms: Diffusion of Innovation
Adoption of clinical decision support systems in a developing country: Antecedents and outcomes of physician's threat to perceived professional autonomy

Esmaeilzadeh P, Sambasivan M, Kumar N, Nezakati H

Int J Med Inform, 2015 Aug;84(8):548-60.
PMID: 25920928 DOI: 10.1016/j.ijmedinf.2015.03.007

The basic objective of this research is to study the antecedents and outcomes of professional autonomy which is a central construct that affects physicians' intention to adopt clinical decision support systems (CDSS). The antecedents are physicians' attitude toward knowledge sharing and interactivity perception (about CDSS) and the outcomes are performance expectancy and intention to adopt CDSS. Besides, we include (1) the antecedents of attitude toward knowledge sharing-subjective norms, social factors and OCB (helping behavior) and (2) roles of physicians' involvement in decision making, computer self-efficacy and effort expectancy in our framework.

Matched MeSH terms: Diffusion of Innovation

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