Information communications technology and health information systems

A critical review of:

Lewis, D., Hodge, N., Gamage, D., & Whittaker, M. (2011, June). Understanding the role of technology in health information systems [Working paper].

Information and communications technology (ICT) has created many innovations to help people in a variety of areas such as business, government and education. Although there has been a lot of research into ICT, how this technology can be used effectively in healthcare has been overlooked—even in first-world countries such as Australia. This critique examines a study of the role ICT can play in the health information systems (HIS) of developing countries—specifically the Pacific Island countries and territories—and the challenges associated with implementing them.

The authors of this paper describe its purpose as being ‘four-fold’. Their aim is:

• To create a common language for defining the components of HIS.
• To highlight the opportunities and benefits available through the use of ICT in healthcare.
• To analyse the success and failure of existing ICT-enabled HIS.
• To use models to assess the plausibility of adopting HIS in developing countries

According to the authors, there are very few ‘rigorously evaluated health ICT interventions’ available to base their analysis on. This situation is confirmed by investigations conducted by researchers such as Wootton (2009), who states that ‘most of the material…has been in the form of comments, letters, discussions, product reports, news items or case reports’ (p. 229). Even enabled by Australia’s National Broadband Network (NBN), healthcare using ICT is still in the early stages of development (NICTA, 2010).

Despite this, the authors have created a common language for defining the components of extensive HIS—modelled on those used in first-world countries. This common ground is very useful in deciding how to design effective HIS for Pacific Island communities. However the authors do note that a proper maturity model would be required to avoid unsustainable development and inappropriate use of ICT—especially since the infrastructure of the Pacific Islands is quite weak.

The article does well in highlighting the opportunities and benefits available when ICT is used in HIS. The lack of data for existing ICT use in healthcare has not stopped the authors from putting together a list of investment ideas that would work for anyone constructing HIS. These ideas are well thought-out and have a good grounding in what the ICT systems would depend on if they were implemented. I believe the list could be improved if more data was available but the authors have done a good job with what they have.

The authors give many reasons for ICT failure when it is used to support HIS. The Pacific Islands classified as developing countries, and as the authors point out, they are home to populations which are separated by large distances and generally located in remote areas. This adds the burden of a socioeconomic digital divide to the geographical one already in place. Although the divide is mentioned as a large component of ICT project failure in HIS, the authors don’t focus on socioeconomic information in much detail. The education of clinicians, doctors and people in management positions is looked at—which is reasonable since they would be the ones implementing the systems.

The authors could have followed the lead of Panir (2011) and Sanderson (2007) who take a closer look at people on the ‘have not’ level of the Pacific Islands’ socioeconomic divide. An understanding of the constraints imposed on the resource-poor would have been a valuable asset to their research on why ICT-enabled HIS projects fail.

The last part of the article deals with frameworks, evaluation tools and methodologies for ‘reducing the amount of trial and error and wasted resources in eHealth interventions.’ The authors don’t spend much time on this, promising a second paper to examine these models.

The authors have written a fairly comprehensive paper which fulfils the goals they set for themselves at the start. I would have liked to have seen more detail in certain areas but for the most part they have done what they set out to do. The article gives an insight into how having access to ICT is not the same as implementing it successfully, especially in the area of health. As information professionals in any country we need to ensure we have the right information, infrastructure and data to base our decisions on before going forward with ICT projects of any sort.

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Additional references

NICTA. (2010, June). Telemedicine in the context of the National Broadband Network. Retrieved from Australian Government, Department of Broadband, Communications and the Digital Economy website.

Panir, J. H. (2011). Role of ICTs in the health sector in developing countries: a critical review of literature. Journal of Health Informatics in Developing Countries, 5(1), 197-208.

Sanderson, P. (2007, August). Designing and evaluating healthcare ICT evaluation: a cognitive engineering view. Paper presented at the Third International Conference on Information Technology in Healthcare - Sociotechnical Systems, Sydney, Australia.

Wootton, R. (2009). The future use of telehealth in the developing world. In R. Wootton, N. Patil, R. Scott & K. Ho (Eds.), Telehealth in the Developing World (pp. 299-308). London: Royal Society of Medicine Press.

Preparing libraries for the future

A critical review of:

Ministry Advisory Council on Public Libraries. (2012, February). Tomorrow's library [Discussion paper].

In a society that is becoming increasingly dependent on information technology and social media, the role of public libraries has changed considerably. It is therefore important to come up with effective and relevant strategies to develop the services of these libraries so that they can anticipate and be ready to adapt to the public’s needs.

In their discussion paper Tomorrow’s library, the Ministry Advisory Council on Public Libraries encourages a variety of people to contribute ideas to, and consider the challenges of shaping the future of public libraries in Victoria. The target groups for this paper are key stakeholders in the delivery of public library services and the library-using public. The council is of the opinion that by asking for input from these groups, they can create a ‘future focused and forward thinking’ (p. 3) plan to be used in developing Victorian public libraries.

The document is divided into several sections, with the body of the text covering what the council considers to be key areas of development: library buildings, technology, service delivery, collections, resources and programs. Each segment begins with statistics taken from other Victorian Government publications and the Australian Bureau of Statistics (ABS) to provide an introduction to and justification for the council’s ideas. The section then tackles why the area under discussion is a key area of concern, and lists challenges for participants to consider when contributing to the general public library development plan. Each section ends with questions to the readers about how their own library services relate to those challenges.

As the nature of an article like this is to inspire discussion, Tomorrow’s library contains very general information on the key topics presented; this can be a disadvantage. As the Municipal Association of Victoria (2012, p. 3) points out, the article doesn’t discuss the specific objectives of library services. Without these, it is difficult for group members to identify which objectives and goals would be appropriate for their individual libraries. The omission could lead to decisions resulting in wasted funds.

Something that is missing from this document is a detailed study of the challenges surrounding public libraries and e-books. Since Australia is ‘one of the leading markets for e-book adoption’ (ALIA, 2013), it is essential that this topic is addressed. Library Journal (2012, p. 4) found that public libraries ‘are on the front lines of the unresolved tug of war between book publishers, e-book vendors, and libraries.’ As information professionals we need to be aware of this battle and its implications.

Funding is always an issue when it comes to expanding library collections, and there are hidden costs involved with the circulation of e-books. It’s not as easy as buying a copy of an e-book file and lending it out electronically. Publishers such as Harper Collins restrict their e-books to twenty-six circulations—after which the library must buy a new licence (O’Brien, Gasser & Palfrey, 2012, p. 9). E-book prices have also risen considerably; in March of 2012, Random House publishing tripled the price of many of its library-licenced e-books (Kelley, 2012). Although Tomorrow’s library mentions e-books needing to be part of future collections, the authors have not considered these costs to be part of their challenges. In addition, there is no consideration given to how issues such as privacy, copyright and ownership will impact e-book collections in the future.

The cost of infrastructure for supporting electronic resources is also not mentioned in the article. Burke (2009, p. 130) points out that (as well as the cost of the resources) libraries need to consider the time and expense involved with operating, maintaining and updating the e-book software database. Exploring these issues in the discussion paper (even briefly) could have given increased the knowledge of the stakeholders, letting them make informed decisions on how to improve their libraries. I was disappointed in this discussion paper as it glosses over many of the issues that I consider to be essential for developing plans for ‘tomorrow’s libraries’. I realise it is the nature of such papers is to generate ideas, but not mentioning issues such as those surrounding e-books can be detrimental to planning the needs of libraries in the future.

Additional references

ALIA (2013, January). Ebooks and elending issues [Paper]. Retrieved from Australian Library and Information Association website.

Burke, John J. (2009). Neal-Schuman library technology companion: A basic guide for library staff (3rd ed.). New York: Neal-Schuman Publishers.

Kelley, Michael. (2012, March). Librarians feel sticker shock as price for Random House ebooks rises as much as 300 percent. Retrieved from Library Journal, The Digital Shift website.

Library Journal (2012). 2012 E-book usage report for U.S. public libraries. Retrieved from Library Journal, The Digital Shift website.

Municipal Association of Victoria. (2012, May). Municipal Association of Victoria Submission to the Tomorrow’s library discussion paper. Retrieved from Municipal Association of Victoria website.

O’Brien, David., Gasser, Urs., Palfrey, John G., Jr. (2012, July). E-Books in libraries: A briefing document developed in preparation for a workshop on e-lending in libraries. Retrieved from Harvard University, Berkman Center for Internet & Society website.

Why organisations use Web 2.0

A critical review of:

Saldanha, T.J.V & Krishnan, M.S. (2012). Organizational adoption of Web 2.0 technologies: An empirical analysis, Journal of Organizational Computing and Electronic Commerce, 22 (4), 301-333.

The purpose of Saldanha and Krishnan’s (2012) article is to determine what drives businesses to internally utilise Web 2.0 technologies such as blogs, wikis and social bookmarking (ITmatters, 2011). The authors state that although previous studies have focused on the use of Web 2.0 technologies at the individual (employee) level, there has been no specific examination of the motivations behind why organisations adopt these technologies. As such, there is little empirical evidence concerning this subject (Boyles, 2011).

Saldanha and Krishnan (2012) use what is known as the Technology-Organization-Environment (TOE) framework to document their results, since this system has been used by other researchers to ‘examine the organizational adoption of Information Technology’.

Their hypotheses are as follows:

1. If organisations regard open standards as important they will be more likely to adopt Web 2.0. Open standards ‘facilitate interoperability and data exchange among different products or services and are intended for widespread adoption’ (ITU, 2005). Since Web 2.0 is able to connect to services already in place (McAfee 2006), businesses that are familiar with such open standards are more likely to make use of Web 2.0.


2. Larger businesses are more open to social technologies than smaller ones because they have more resources and greater scope for experimentation. As a result of their size, bigger organisations can find it difficult to generate communication and collaboration between employees without the social connections available through the use of Web 2.0.


3. If businesses employ knowledge processes and resources they can use Web 2.0 to disseminate and manage them more easily. Technologies such as blogs can be used to communicate and share knowledge, and wikis can act as a dynamic repository for storing, retrieving and building knowledge information.


4. The greater the amount of competition in the marketplace, the more Web 2.0 is needed. Competition has always driven organisations to come up with better and more efficient solutions to their business problems. By using Web 2.0 to boost communication and collaboration, businesses can use the results of such technologies to gain an edge over their competitors.

Saldanha and Krishnan (2012) use data collected from a survey (conducted by InformationWeek—an information technology publication for business and information technology managers) to see if their hypotheses are supported in real world organisations. Collecting survey data via sources such as magazines would appear to be a dubious way of obtaining it; however Saldanha and Krishnan (2012) are able to justify their use of this method. Considering that past surveys conducted in InformationWeek have been used successfully in other academic studies, such data is considered to be as accurate as that gathered from other secondary sources (Rai, Patnayakuni, & Patnayakuni, 1997). In addition, the responses to the survey came from 195 different firms, allowing for a wide information gathering area. The final data analysis supports the points set down in the author’s first three hypothesis.

Saldanha and Krishnan’s (2012) article deals with the reasons why businesses adopt Web 2.0 technologies, but because it is such a broad study it doesn’t look at specific types of organisations. This is not a flaw, since the scope of their study is more of an overview and does not focus on individual businesses. However, as information professionals it is important to examine Web 2.0 with regard to businesses such as libraries.

Since Web 2.0 services have become part of everyday life, libraries around the world have started to implement social media tools to promote their services, connect with users and share information on a local, national and international level (Slainte, 2012). Although Saldanha and Krishnan (2012) concentrate on the internal use of social technologies, it would be interesting to see if their hypotheses can be applied to the external way in which libraries use Web 2.0.

Additional references

Boyles, T. (2011). Small business and Web 2.0: Hope or hype?. Entrepreneurial Executive 16 81-96.

ITmatters. (2011, January 12). What is Web 2.0 technology.Australian Business Forum.

ITU. (2005). Definition of ‘open standards’. International Telecommunication Union.

McAfee, A. (2006). Enterprise 2.0: The dawn of emergent collaboration. MIT Sloan Management Review 47(3) 21-28.

Rai A., Patnayakuni, R., & Patnayakuni N. (1997). Technology investment and business performance. Communications of the ACM 40(7) 89-96.

Slainte. (2012). A guide to using Web 2.0 in libraries.