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Introduction: In nursing, professionals are expected to base their practice on evidence-based knowledge, however the successful implementation of this knowledge into nursing practice is not always assured. Clinical Decision Support Systems (CDSS) are considered to bridge this evidence-practice gap., Methods: This study examines the extent to which evidence-based nursing (EBN) practices influence the use of CDSS and identifies what additional factors from acceptance theories such as UTAUT play a role., Results and Discussion: Our findings from three regression models revealed that nursing professionals and nursing students who employ evidence-based practices are not more likely to use an evidence-based CDSS. The relationship between an EBN composite score (model 1) or is individual dimensions (model 2) and CDSS use was not significant. However, a more comprehensive model (model 3), incorporating items from the UTAUT such as Social Influences, Facilitating Conditions, Performance Expectancy, and Effort Expectancy, supplemented by Satisfaction demonstrated a significant variance explained (R2 = 0.279). Performance Expectancy and Satisfaction were found to be significantly associated with CDSS utilization., Conclusion: This underscores the importance of user-friendliness and practical utility of a CDSS. Despite potential limitations in generalizability and a limited sample size, the results provide insights into that CDSS first and foremost underly the same mechanisms of use as other health IT systems.

Nurses who provide the majority of hands-on care for hospitalized patients are disproportionately affected by the current state of electronic health records (EHRs), and little is known about their lived perception of EHR use. Using a mixed-methods research design, we conducted an in-depth analysis and synthesis of data from EHR usage log files, interviews, and surveys and assessed factors contributing to the nurse documentation burden in acute and critical at a large academic medical center. There remain substantial spaces where we can develop viable solutions for enhancing the usability of multi-component EHR systems.

The use of smart mobile devices has been getting increasingly popular. The focus of this study is an attempt to explore the development of mobile medical App by medical centers and regional hospitals of Taiwan and the function of the App for comparison. The results show indicated that many hospitals developed Apps for the public for mobile medical service, of which 26 medical centers (100%) and 72 regional hospitals (84.7%) availed appointment making service via Apps. The result indicated variance at significant level (p < 0.01). There are 23 medical centers (88.5%) and 74 regional hospitals (87.1%) availed Apps for checking service progress. The result indicated insignificant variance level (p > 0.01). We can see that mobile medical service is gradually emerging as a vital issue. Yet, this is a new domain in medical service. With the mushrooming of medical applications in smart mobile devices, the medical service system is expected to be installed in these devices to enhance interactive mode of operation and inquiry services, such as medication and inquiries into physical examination results. By then, people can learn the status of their health with this system.

The purpose of this project was to reveal the status quo of mHealth application in clinical settings in China, especially in reducing patient falls and pressure ulcers and discuss how patient safety could be enhanced in the context of global collaboration on patient safety. The literature search resulted in a total of 290 articles. A steady increase is witnessed in the field of mHealth, especially after the year 2010. Personal digital assistant and electronic cart are the two main devices used in mobile nursing workstation. mHealth was mainly focused on two clinical areas, nursing practice (60.69%) and nursing management (25.86%). mHealth has begun to change the way of nursing process in prevention of adverse nurse events with an encouraging results in reducing the rate of pressure ulcer and falls. Healthcare educators should fully recognize the characteristics of mHealth and enhance a clinical informatics component in the curricula.

We reviewed the effect sizes of pediatric obesity intervention studies using mobile technology. Ten databases (Cochrane CENTRAL, CINAHL, EMBASE, PubMed/Medline, KoreaMED, KMBASE, KISS, NDSL, KSITI, and RISS) were reviewed, and four studies were included in a qualitative synthesis. To obtain significant change in obesity-related outcomes among elementary school students, including parents and utilizing text messages in interventions are recommended. Furthermore, devices such as accelerometers may aid obesity management. A meta-analysis of four studies indicated that the mobile intervention positively influenced dropout rates but was ineffective for outcomes of weight control, exercise, and sugar-sweetened beverage intake.

This research was conducted to understand clinical nurses' and nursing students' current use of a clinical nursing information system to document their patient care activities in an OB/GYN nursing ward at a medical center in central Taiwan. A semi-structure interview and participant observation methods were used to gather the data. The results showed that the majority of participants regarded the clinical nursing information system as a useful system in terms of saving documentation time and improving communication among healthcare providers. This study provided some empirical evidence of the attitudes/behaviors of nurses and student nurses about electronic documentation. However, more studies were recommended to evaluate the impact of electronic nursing documentation on the quality of care delivered to patients.

Medicine management is at the core of hospital care and digitalization of prescribing and administration of medicines is often the focus of attention of health IT programs. This may be conveyed to the public in terms of the elimination of paper-based drug charts and increased readability of doctors' prescriptions. Based on analysis of documents about hospital medicines supply and use (including systems' implementation) in the UK, in this conceptual paper electronic prescribing and administration are repositioned as only one aspect of an important wider transformation in medicine management in hospital settings, involving, for example, procurement, dispensing, auditing, waste management, research and safety vigilance. Approaching digitalization from a systemic perspective has the potential to uncover the wider implications of this transformation for patients, the organization and the wider health care system.

National Health Insurance Administration established Pharma Cloud System in July 2014. The purpose is to decrease therapeutic duplications and enhance public medication safety. Comparison will be made among individual hospitals and the administering branches of National Health Insurance Bureau (NHIB) on the statistical data on the inquiry of the cloud medication history record system to understand the result of the installation and advocacy of this system. The results show (1) there were 2,329,846 entries of data collected from the branches of the NHIB from 2015 on cloud medication history record and 50,224 entries of data from individual hospitals. (2) The inquiry rate at the branches of the NHIB was 43.2% from January to April, 2015 and at individual hospitals was 18.8%. (3) The improvement rate at the branches of the NHIB was 32.5% and at the individual hospitals was 47.0% from January to April, 2015.

Adoption of new health information technology is shown to be challenging. However, the degree to which new technology will be adopted can be predicted by measures of usefulness and ease of use. In this work these key determining factors are focused on for design of a wound documentation tool. In the context of wound care at home, consistent with evidence in the literature from similar settings, use of Speech Recognition Technology (SRT) for patient documentation has shown promise. To achieve a user-centred design, the results from a conducted ethnographic fieldwork are used to inform SRT features; furthermore, exploratory prototyping is used to collect feedback about the wound documentation tool from home care nurses. During this study, measures developed for healthcare applications of the Technology Acceptance Model will be used, to identify SRT features that improve usefulness (e.g. increased accuracy, saving time) or ease of use (e.g. lowering mental/physical effort, easy to remember tasks). The identified features will be used to create a low fidelity prototype that will be evaluated in future experiments.

Chronic pain places a significant burden on individuals as well as health services. Long wait lists to access public clinical pain management services can result, and health outcomes deteriorate. Innovative technologies, such as social media provide opportunities to support self-management within the participatory health framework. This paper aims to investigate patients' perceptions towards using social media while waiting for clinic access, with a particular focus on therapeutic affordances. Seventeen wait-listed patients underwent intervention using various social media resources as part of self-management. Thematic content analysis of semi-structured interviews examined patients' perceptions about social media use and participation. Three therapeutic affordances were most evident in the qualitative data: exploration, connection and narration. Barriers to participation were also identified, such as 'specificity of the resources'. Findings suggest social media are perceived positively. However, there is also the need to balance a desire to deliver evidence-based practice with patient-preferences in shared-decision making about social media use.

Unlabelled: The study hospital had developed a multiple account recording system that generates the accounting information of the consumed materials based on daily nursing records. A questionnaire survey was delivered to further investigate the impact of the system., Methods: Four concepts of the system were investigated. (1) Supportive and time saving; (2) impact on workflows and job satisfactions; (3) ease of use; and (4) overall satisfactions., Results: The system scored 4.03 out of 5 as the highest for helpfulness for daily practices, 3.98 for decrease the time for recording material consumptions, 3.98 for actually changed the way they work., Discussion: Users mostly expressed positive attitude towards the system.

The purpose of this study is to explore the usage frequency of the decision support instruction in the nursing information system, and to survey the technology acceptance among nurses in one hospital. The results indicated that the usage frequency of the care instruction was increased from 191.3 to 1308.5 per month. Nurses also rated the "perceived usefulness" the highest score, followed by "perceived ease of use" in the survey.

Access logs for electronic medical records (EMRs) are a useful source of data for understanding how nurses' perform their duties. The purpose of this study was to understand how nurses' used an EMR system, by inspecting and analyzing from one week EMR access logs (394,708) of accessing 'outcome Input' screen. Anytime day and night, nurses accessed 'outcome Input' screen. Viewing and information input obtained from observations, in order to monitor patients' conditions over tasks such as keeping nursing records.

The study focused on real-time video consultations (tele-consultations) as experienced by Danish hospital-based, respiratory nurses (tele-nurses) and patients with chronic obstructive pulmonary disease, COPD, discharged after hospitalization with acute exacerbation (tele-patients). Tele-patients and tele-nurses consider tele-consultations as distinct, but qualified care, enabling close relationships between patient and nurse. The nurses' performance and their professional identity changed. The patients become active, participants in their treatment and care.

The aim was to study the opinions of tuberculosis patients and doctors and identify perceived opportunities and barriers to using a Web portal to optimize its use. The perceptions of 30 tuberculosis patients and 18 doctors (10 general practitioners and 8 tuberculosis specialists) from Tomsk, Russia were collected through semi-structured interviews. The responses were analysed for content using principles of the grounded theory and thematic analysis, in order to gain insight into the participants' beliefs and attitudes towards adopting tuberculosis web-portal to increase the efficiency of the treatment and rehabilitation process.

International Classification for Nursing Practice (ICNP ® ) was developed as the standardized terminology by the International Council of Nursing (ICN) since 1999. It is important to evaluate the applicability of using ICNP ® as the electronic nursing data exchange standardization when adopting in Taiwan. A total of 87% clinical nursing problems could be cross-mapped to DC axis of ICNP ® version 2 in traditional Chinese language (Kappa = .96). Only five nursing problems (following care problem; blood transfusion; potential risk for unstable blood sugar level; hyperbilirubinemia; and caregiver anxiety) couldn't be matched. ICNP ® could mostly support the electronic nursing data exchange standardization. Developing Taiwan-ICNP ® as the local terminology was seemed to be the strategy to create a more adoptive standardization across the country for Taiwan health care data exchange in the future.

Unlabelled: There is poor penetration of trauma healthcare delivery in rural areas. On the other hand, mobile penetration in India is now averaging 80% with most families having access to mobile phone., Aims and Objectives: The aim of this study was to evaluate the effectiveness of tele-consultation by nurses using an integrated call centre., Materials and Methods: This was a prospective observational study carried out over a 6-month period at a level I trauma Center in New Delhi, India. Patients called the call centre and the specially trained call centre staff answered the calls who handled their simple queries, if they were unable to respond, the call was directed to the nurse informatics specialist on duty responded to their queries with the help of senior residents who were posted in emergency department. The nurse informatics specialist documents a tele-consult note in CPRS (Computerized Patient Record System)., Results: Of the total 150 calls, 64 calls were diverted to the nurse informatics specialist (NIS). Of the 64 calls received by the NIS 55 (85%) were rectified by the nurses at their level and 9 calls (14%) were further discussed with the concerned doctors., Conclusions: As shown by our case study, call centers can be used for tele consultation with the help of nurse informatics specialist.

This study explores Chinese nurses' acceptance of PDA, using a questionnaire based on the framework of Technology Acceptance Model (TAM). 357 nurses were involved in the study. The results reveal the scores of the nurses' acceptance of PDA were means 3.18~3.36 in four dimensions. The younger of nurses, the higher nurses' title, the longer previous usage time, the more experienced using PDA, and the more acceptance of PDA. Therefore, the hospital administrators may change strategies to enhance nurses' acceptance of PDA, and promote the wide application of PDA.

Aim: The scope of the research was to increase the understanding of social media's influence among nurses while highlighting gaps in the literature and areas for further research., Methods: The search of PubMed database was performed in November 2015, using terms to identify peer-reviewed articles that describe the use of social media for nursing students or nurse practitioners. A systematic approach was used to retrieve papers and extract relevant data., Results: There were identified 23 full text articles involving social media and nurse-related terminology. The majority of the studies were interventional (n = 20) that assessed social media as a teaching tool. Podcasts, Multiplayer virtual worlds and mixed social media platforms has also been assessed., Conclusion: Social media is used as a tool of information for nurses mainly as the means for engaging and communicating.

In this ever-changing health care environment, nurses employ technologies and information systems to accomplish the intentions of the practice of nursing. Information technology supports the basic and advanced nursing practices in all settings. This review provides evidence about applications of information technology in Iranian nursing. We systematically searched all papers about applications of information technology in nursing in Iran that were indexed in SID, Magiran, Iran medex, PubMed and scopus databases. This study indicated that 12 (%52) studies used information technologies in the nursing education domain. Also, in 6 (%26) studies telenursing was used for patient care. 3 (13%) of the articles were related to the impact of the use of computer-based information system on nursing practice. In 2 (%9) papers the researchers developed computerized software for nursing processes. The results of this study indicate the use of information technology in nearly every aspect of nursing in Iran.

Online bibliographic databases constitute the access to information supporting evidence-based practice. The purpose of the present survey is to evaluate the awareness, the use and the impact that online evidences have in clinical practice. An online survey was conducted using a 25 item questionnaire which was completed by 263 healthcare practitioners (nurses and doctors). Chi-square analysis and t-tests were used and comparisons between both groups were made. Multiple logistic regression to predict databases use was employed. Ninety-three percent (n = 206) of participants had heard about the online bibliographic databases; 5.7% of participant sample have heard about online databases but they do not use them. 18.3% was the total sample of non-users (n = 48). The main reason of using was filling a knowledge gap (50.7%), and the main reasons of not using were both that they use another information source and they don't need them to do their job. Both nurses and doctors believe that the use of online databases improves patient care it is a part of their legitimate clinical role. They need more training to improve their searching skills, enhancing them in everyday clinical place.

Information technological advances to develop health care-related systems, Improve clinical efficiency through introducing information technology, Simplify processes to enhance the quality of nursing care. Study investigated the regional hospital nurses after initial information system the use of satisfaction surveys, Study for unit 50-bit nurse the use questionnaires collection, not satisfied is 30%, For analysis in found to be not satisfied. 1. Aged between 38-50 years old. 2. The operating practices are not familiar. 3. Typing is siow the fee time is more long. 4. The slow operation of the system. 5. Information ability is low. For the above reasons and after improvement and guidance dissatisfaction reduced to 5%, multi-enhancing information related to education and training in future, Increase nurses information literacy competency.

This study aims at evaluating hospital information systems (HIS) acceptance factors among nurses, in order to provide suggestions for successful HIS implementation. The study used mainly quantitative survey methods to collect data directly from nurses through a questionnaire. The availability of computers in the hospital was one of the most influential factors, with a special emphasis on the unavailability of laptop computers and computers on wheels to facilitate immediate data entry and retrieval when nurses are at the point of care. Nurses believed that HIS might frequently slow down the process of care delivery and increase the time spent by patients inside the hospital especially during slow performance and responsiveness phases. Recommendations were classified into three main areas; improving system performance and availability of computers in the hospital, increasing organizational support in the form of providing training and protected time for nurses' to learn and enhancing users' feedback by listening to their complaints and considering their suggestions.

We developed a tool that allows a medical facility to offer efficient nursing care with limited human resources by optimizing the distribution of hospital ward nursing tasks. The use of information and communications technology to visualize daily workloads and make use of quantified workload data is important for identifying management elements that allow the efficient allocation of personnel and tasks. The goal of this study was to utilize data from the ward management tool that we developed to consider workflow processes for nursing staff and the relationships between the nursing competence of the nursing staff and the patients' conditions and how these impact on workloads. We found a correlation between workload and staff competence. With respect to the teamwork index and patient condition, structural equation modeling analysis using the intensity of nursing care needs and degree of independent daily living showed that patient condition had a meaningful effect on workload.

This study investigated the major NIS implementation factors and their capability of predicting the effectiveness of NIS implementation by using the clinical information systems success model. The triangulation method was employed in this study. A total of 348 nurses were recruited from regional hospitals in two districts of Taipei through purposive sampling. Research data were collected through questionnaires and focus group interviews 3 and 6 months after an NIS was implemented at their hospital. The result show the explanatory power of use dependence, use satisfaction, and net benefits in predicting NIS effectiveness was approximately 64.5%-89.4%. The explanatory power of net benefits in predicting NIS effectiveness after 3 and 6 months exceeded 80%. The nurses reported that NIS implementation changed their workflow and positively influenced medication administration safety. This study empirically identified the critical factors that affect the successful implementation of NISs and reported the nurses' experience of NIS use.

The use of electronic health records (EHR) has changed the quality of clinical documentation and improved quality of patient assistance, allowing better communication between health professionals and increased data recording that helps the nursing assistance process. The use of mobile devices for compiling data at the assistance moment has increased, and more studies have demonstrated its usefulness. The aim of this study was to evaluate the use of mobile devices in the nursing staff of the Hospital Italiano de Buenos Aires, in a pilot test to measure their use and user satisfaction.

This paper describes the evaluation of a computerized clinical decision support system (CCDSS) for Emergency Department (ED) triage. The CCDSS for triage was developed as a means to improve ED quality and safety. Whilst there is significant research on the role of CCDSS in health care, their role in EDs remains under-investigated. In this study, a CCDSS for ED triage was developed and evaluated using a quasi-experimental interrupted time-series design. Data was collected at four time points before and after the introduction of the CCDSS to assess key aspects of quality and safety within the ED. The results demonstrated a statistically significant improvement in triage prioritization (p < 0.001), pain scoring (p < 0.001) and pain management (p < 0.001). This study clearly identifies the positive clinical impact that a CCDSS can have on quality and safety for ED patients and provides a unique contribution to the current knowledge base.

Effective communication among the healthcare team is a very important skill to support team resource management (TRM). However, we take too much effort to connect with other team members by using traditional telephone communication. In this study, we developed an instant messaging system embedded in the original hospital information system and evaluated the preliminary outcome and the usage of the system.

Effective self-management can decrease up to 50% of heart failure (HF) hospitalizations. However, self-management by patients with HF remains poor. We describe the development and usability testing of an interactive digital e-health game (IDEG) for older patients with HF in Central Texas, USA. Majority of the participants (5 out of 6) who participated in the usability testing found the game interesting, enjoyable and helpful to play. Developing an IDEG that is satisfying and acceptable to older adults with HF is feasible.

Given that acceptance of systems within the healthcare domain multiple papers highlighted the importance of integrating tools with the clinical workflow. This paper analyse how clinical context management could be deployed in order to promote the adoption of cloud advanced services and within the clinical workflow. This deployment will be able to be integrated with the eHealth European Interoperability Framework promoted specifications. Throughout this paper, it is proposed a cloud-based service-oriented architecture. This architecture will implement a context management system aligned with the HL7 standard known as CCOW.

Current self-quantification systems (SQS) are limited in their ability to support the acquisition of health-related information essential for individuals to make informed decisions based on their health status. They do not offer services such as data handling and data aggregation in a single place, and using multiple types of tools for this purpose complicates data and health self-management for self-quantifiers. An online survey was used to elicit information from self-quantifiers about the methods they used to undertake key activities related to health self-management. This paper provides empirical evidence about self-quantifiers' time spent using different data collection, data handling, data analysis, and data sharing tools and draws implications for health self-management activities.

This paper reports on selected findings from a Danish national survey of citizens' perception and use of information and communication technology (ICT) for their health care [1]. Focus is on citizens' use of ICT and on communication with their General Practitioner (GP). It also focuses on citizens' experience of their GPs' ICT use and no use during medical consultations. The responsibility for medical service in Denmark is to a large extent handed over to the primary sector where the GP is the gatekeeper. Our data display that 65% of the adult citizens or their relatives have been using ICT to communicate with their GP. Twenty-two percent have experienced their GP use a computer screen to actively show them something while they have a consultation. Further, our data supports the assumption that the higher the education people have, the more likely they are to use ICT for their health care. The understanding of the use of ICT in communication with the GP is central to monitoring and developing an ICT that supports all citizens and considers new ways in which to enhance quality of care.

The objective of this research is to evaluate empirically the effectiveness of eHealth in Nishi-aizu Town, Fukushima Prefecture, based on a mail survey to the residents and their receipt data of National Health Insurance from November 2006 to February 2007. The residents were divided into two groups, users and non-users, and sent questionnaires to ask their characteristics or usage of the system. Their medical expenditures paid by National Health Insurance for five years from 2002 to 2006 are examined. The effects were analyzed by comparison of medical expenditures between users and non-users. The interests are focused on four chronic diseases namely heart diseases, high blood pressure, diabetes, and strokes. A regression analysis is employed to estimate the effect of eHealth to users who have these diseases and then calculate the monetary effect of eHealth on reduction of medical expenditures. The results are expected to be valid for establishment of evidence-based policy such as reimbursement from medical insurance to eHealth.

Although national eHealth strategies have existed now for more than a decade in many countries, they have been implemented with varying success. In Germany, the eHealth strategy so far has resulted in a roll out of electronic health cards for all citizens in the statutory health insurance, but in no clinically meaningful IT-applications. The aim of this study was to test the technical and organisation feasibility, usability, and utility of an eDischarge application embedded into a laboratory Health Telematics Infrastructure (TI). The tests embraced the exchange of eDischarge summaries based on the multiprofessional HL7 eNursing Summary standard between a municipal hospital and a nursing home. All in all, 36 transmissions of electronic discharge documents took place. They demonstrated the technical-organisation feasibility and resulted in moderate usability ratings. A comparison between eDischarge and paper-based summaries hinted at higher ratings of utility and information completeness for eDischarges. Despite problems with handling the electronic health card, the proof-of-concept for the first clinically meaningful IT-application in the German Health TI could be regarded as successful.

While occupational health is a significant driver of population health, productivity, and well-being in Canadian society, most workers do not currently have adequate access to qualified occupational health services. A case study is used to demonstrate the utility of a telehealth approach to service delivery.

Computer-based decision support information systems have been promoted for their potential to improve physician performance and patient outcomes and support clinical decision making. The current case study reported design and implementation of a high-level decision support system (DSS) which facilitated the flow of data from operational level to top managers and leadership level of hospitals. The results shows that development of a DSS improve data connectivity, timing, and responsiveness issues via centralised sourcing and storing of principal health-related information in the hospital. The implementation of the system has resulted in significant enhancements in outpatient waiting times management.

From 2007 through 2014, the authors participated in the implementation of open source hospital information systems (HIS) in 19 hospitals in Rwanda, Burundi, DR Congo, Congo-Brazzaville, Gabon, and Mali. Most of these implementations were successful, but some failed. At the end of a seven-year implementation effort, a number of risk factors, facilitators, and pragmatic approaches related to the deployment of HIS in Sub-Saharan health facilities have been identified. Many of the problems encountered during the HIS implementation process were not related to technical issues but human, cultural, and environmental factors. This study retrospectively evaluates the predictive value of 14 project failure factors and 15 success factors in HIS implementation in the Sub-Saharan region. Nine of the failure factors were strongly correlated with project failure, three were moderately correlated, and one weakly correlated. Regression analysis also confirms that eight factors were strongly correlated with project success, four moderately correlated, and two weakly correlated. The study results may help estimate the expedience of future HIS projects.

In developing countries, patients are now more informed about their healthcare options as a result of their use of mobile health (mHealth) technologies. The purpose of this paper is to describe the opportunities and challenges in using mHealth technologies for developing countries. In April 2015, Google Scholar and PubMed were searched to identify articles discussing the types, advantages and disadvantages, effectiveness, evaluation of mHealth technologies, and examples of mHealth implementation in developing countries. A total number of 3,803 articles were retrieved from both databases. Articles reporting the benefits and risks, effectiveness, and evaluation of mHealth were included. Articles that were written in English and from developing countries were also included. We excluded papers that were published before 2005, not written in English, and that were technical in nature. After screening the articles using the inclusion and exclusion criteria, 27 articles were selected for inclusion in the study. Of the 27 papers included in the review, eight described opportunities and challenges relating to mHealth, four focused on smoking cessation, three focused on weight loss, and four papers focused on chronic diseases. We also identified four articles discussing mHealth evaluation and four discussing the use of mHealth as a health promotion tool. We conclude that mHealth can improve healthcare delivery for developing countries. Some of the advantages of mHealth include: patient education, health promotion, disease self-management, decrease in healthcare costs, and remote monitoring of patients. However, there are several limitations in using mHealth technologies for developing countries, which include: interoperability, lack of evaluation standards, and lack of a technology infrastructure.

Implementing consumer oriented digital health products and services at scale is challenging and a range of barriers to reaching and recruiting users to these types of solutions can be encountered. This paper describes the experience of implementers with the rollout of the Delivering Assisted Living Lifestyles at Scale (dallas) programme. The findings are based on qualitative analysis of baseline and midpoint interviews and project documentation. Eight main themes emerged as key factors which hindered participation. These include how the dallas programme was designed and operationalised, constraints imposed by partnerships, technology, branding, and recruitment strategies, as well as challenges with the development cycle and organisational culture.

Telemedicine applications have the potential to enhance patient's safety at home by remote monitoring of chronic diseases. Telemedicine involves the interaction between multiple user groups through a system, making the usability aspect of such system crucial for the continuous, efficient and satisfactory use of the application. The main objective of this study was to carry out a usability evaluation in the field of a telemedicine application for remote monitoring of chronic obstructive pulmonary disease (COPD) patients to improve the application's user interface before system deployment. A field trial was performed with six COPD patients at their homes, continuously using the system's application on a tablet for seven days. The usability evaluation identified 23 usability problems related to users' interactions and system's functionality. These problems were solved with the refinement of the system through an iterative application development process. The outcome of the study was the improved telemedicine application that was adopted by the partners of the FP7 EU project United4Health.

The appearance of eHealth adds a new dimension to health informatics competencies--they are not necessary just for health providers and health information system users and developers, but also for health consumers.

The European PALANTE project aims to improve patient empowerment. The Austrian contribution to the PALANTE objectives is the personal, electronic Xray-Record "eRöntgenpass", which has been available to the public since October 2014. The eXray-Record is integrated into the patient portal of the Styrian Hospital Cooperation KAGes and can accesses data of recent radiological examinations which were carried out in KAGes hospitals. The main goal is to provide necessary information on the personal radiological exposure to allow for informed decisions of patients, when discussing diagnostic alternatives with health care providers. This paper describes the multi-step process of setting up an evaluation for these goals which can be adapted to other online portals for accessing medical data. Pre-tests showed that the integration of the evaluation process from the beginning of the project has led to a more concise evaluation method which is still able to produce relevant data for assessing the project objectives. This emphasizes the necessity of an integrated evaluation process from the beginning of portal development in contrast to an evaluation task at the end of the development.

This research focuses on a major health priority for Australia by addressing existing gaps in the implementation of nursing informatics solutions in healthcare. It serves to inform the successful deployment of IT solutions designed to support patient-centered, frontline acute healthcare delivery by multidisciplinary care teams. The outcomes can guide future evaluations of the contribution of IT solutions to the efficiency, safety and quality of care delivery in acute hospital settings.