A paradigm shift is underway towards the acceptance and utility of Personal Digital Assistant (PDA) systems within mobile-based healthcare environments. This paper contends that intervening to address user concerns as they arise throughout the system development lifecycle will lead to greater levels of user acceptance, while ultimately enhancing the deliverability of a system that provides a ‘best fit’ with end user needs. It is envisaged this research will lead to the development of a framework based on an agile approach to user acceptance measurement. The results of an ongoing study of user perceptions towards a proposed mandated electronic point-of-care (ePOC) information system in the Northern Illawarra Ambulatory Care Team (TACT) are presented.

The information-intensive nature of the tourism and travel industry suggests an important role for Web technology in the promotion and marketing of tourist destinations. With reports of travel purchases and reservations being one of the fastest growing segments of the Internet community (eMarketer, 2002), it is no surprise that the number of tourism operators on the Web has increased considerably over the past few years. This paper presents the results of a longitudinal study of the use of Web technologies by Regional Tourism Organisations (RTOs) in the Asia-Pacific tourism industry. The Websites of 195 RTOs in the Asia-Pacific Region were evaluated using eMICA over the period 2001 to 2004. The study revealed that over the three year period, all 195 RTOs had established more than a basic Internet presence. In 2001, there were 12 sites located within this stage. By 2004, the number of sites that had progressed from lower levels of functionality in the second stage of eMICA (promotion and online service and support) to higher level provision had increased from 36 to 113. Another significant finding is the increase in the number of sites offering full eCommerce facilities (an increase of 14 from the 2001 study). The results of the study add further support to the premise of the model, that is, in developing commercial websites, businesses in this industry sector typically start simply by establishing a presence on the Web and build on functionality over time, as their experience and expertise in the use of Internet technologies increases.

In most developed countries, the ageing population is placing a severe strain on health systems and national budgets. In meeting this challenge, e-health initiatives seek medically focused ICT solutions for improved health services that enable senior citizens to remain living at home longer. A literature review and interviews with healthcare providers reveal that significant factors affecting the well-being of the elderly are isolation and loneliness. In this paper we report on the first stages of a study on the digital literacy of seniors and the potential development of social media to meet the capabilities of people as they age. Focus groups with senior citizen computer club members tell us that older folk are becoming more digitally literate. As social media becomes more usable and acceptable, we propose that online communities for senior citizens may have significant health benefits. As this is a multifaceted emergent phenomenon, we apply concepts from Complexity Theory to our analysis and to the design of future research on this topic using an action research methodology.

The information-intensive nature of the tourism and travel industry suggests an important role for Web technology in the promotion and marketing of tourist destinations. The rapid development of the Internet and WWW is having profound impacts on the industry. In fact, according to Tourism Australia, travel and tourism has become the single largest category of products sold over the Internet (Tourism White Paper, Destinations online: approaches for regional tourism organisations, Centre for Regional Tourism Research, Southern Cross University, 2007). With reports of travel purchases being one of the fastest growing segments of the Internet community it is no surprise that the number of tourism operators on the Web has increased considerably over the past few years. This paper presents the results of a longitudinal study that seeks to determine if and to what extent, Regional Tourism Organisations (RTOs) in Australia are leveraging the benefits of Web technology for destination marketing and eCommerce. The study was undertaken over an eight year period from 2000 to 2008, using the Extended Model of Internet Commerce Adoption (eMICA) (Burgess and Cooper, International conference on telecommunications and electronic commerce, Dallas, November, 2000). A significant finding of this study is that despite assertions that the Tourism industry is leading the field in terms of eCommerce adoption (Buhalis and Law, Information and communication technologies in tourism, Ljubljana, Springer, Berlin, 2007), and this may hold true with some providers in the sector (for example, hotels and airlines) it does not appear to be the case with Australian RTOs who have been slow to embrace eCommerce. The results of the study also add support to the premise of eMICA, that is, in developing commercial websites, businesses (particularly, SMEs) in this industry sector typically start simply by establishing a presence on the Web and build on functionality over time, as their experience with and expertise in the use of Internet and Web technologies increases and they become more aware of the benefits the Web has to offer.

The information-intensive nature of the tourism and travel industry suggests an important role for Web technology in the promotion and marketing of tourist destinations. The rapid development of the Internet is also having profound impacts on the industry. In fact, travel and tourism has become the single largest category of products sold over the Internet (Tourism White Paper, 2007). With reports of travel purchases and reservations being one of the fastest growing segments of the Internet community it is no surprise that the number of tourism operators on the Web has increased considerably over the past few years. This paper presents the results of a study of the use of Web technologies by Regional Tourism Organisations (RTOs) in the Australian tourism industry over an eight year period from 2000 to 2008. The Extended Model of Internet Commerce Adoption (eMICA) (Burgess and Cooper, 2000) was used to assess the web sites of RTOs to determine the extent of adoption of web technologies for destination marketing. A significant finding of this study is the number of RTOs sites offering Stage 3 functionality (transaction processing). The results of the study add further support to the premise of the model, that is, in developing commercial websites, businesses in this industry sector typically start simply by establishing a presence on the Web and build on functionality over time, as their experience and expertise in the use of Internet technologies increases.

This chapter discusses the broad theme of clinician-centric end-user acceptance toward the adoption of personal digital assistants (PDAs) as mobile-based health information deployment platforms within ambulatory care service settings. Personal digital assistants, ambulatory care, and point of care are defined and the interrelatedness of each discussed. Issues, controversies, and problems such as mapping existing workflows, security, and change management are identified, and solutions are suggested for the process of transforming predominantly paper-based ambulatory care systems into electronic point-of-care (ePOC) systems. A current research and development project, the ePOC PDA project, is used as a case study to highlight discussion points. The purpose of this chapter is to illustrate end-user implications and considerations when introducing ePOC systems into ambulatory care service settings and highlight ways and means of improving future levels of acceptance and support of ePOC systems for clinician end users.

Mediumto long-term archiving of digital documents, beyond the lifespan of the authoring software/hardware, is a challenging problem. Magnetic and optical media are susceptible to environmental influences and deteriorate over time, often to the point where the archived documents can no longer be retrieved. Previous attempts to address this problem include migration and emulation, both of which have their attendant difficulties. It is the contention of the present study that an Open Source approach offers several advantages. More specifically, by archiving the Open Source application programs (in source code, not executable form) along with the documents in question, in both plain and compressed form, significantly increases the likelihood of being able to retrieve such archives at some future time. The application source code can be recompiled to a form suitable for reading in (Open Source) viewers, thereby presenting to the user the archived document as the original author envisaged it. One set of experiments was undertaken distributing documents together with their (Open Source) authoring software via a Portable Virtual Machine (PVM) program to unused disk space on a network of SUN workstations. The success of this approach was evaluated using the following four measures: (i) lossiness of conversion, (ii) edit-ability, (iii) ability to save back to the original format, and (iv) functionality retention. Another series of experiments was conducted in which artificial (‘speckle’ or salt-and-pepper) noise was deliberately introduced to the archived documents in order to mimic degradation of the storage medium over time. It was found that survivability was heavily dependent on file type: simple text files and MPEG movies were impervious to even 18% introduced noise. Source code programs and JPEG images, by contrast, were intolerant to even the smallest noise levels (it has to be said however that straightforward re-editing of the former led to error-free compilation without much difficulty). Lastly, it was found that decompression (specifically the publicly available RAR decompressor) further enhanced the file recovery process. We conclude that an Open Source approach to the preservation of digital archives has considerable potential. Sherine Antoun, John Fulcher, Carole Alcock

A paradigm shift is underway towards the acceptance and utility of Personal Digital Assistant (PDA) systems within mobile-based healthcare environments. This paper contends that intervening to address user concerns as they arise throughout the system development lifecycle will lead to greater levels of user acceptance, while ultimately enhancing the deliverability of a system that provides a ‘best fit’ with end user needs. It is envisaged this research will lead to the development of a framework based on an agile approach to user acceptance measurement. The results of an ongoing study of user perceptions towards a proposed mandated electronic point-of-care (ePOC) information system in the Northern Illawarra Ambulatory Care Team (TACT) are presented.

The adoption of PDAs and mobile communication is expected to provide a solution to the use of computer technology by healthcare workers at the point-of-care.The Australian National Health Information Strategy, Health Online, is providing national leadership for approaches to address the quality and availability of information to assist in the planning and delivery of care.One area for potential growth is the availability and capture of information at the point of care by healthcare providers.A key factor in the lack of adoption of systems, is that traditionally health care information systems have been designed for desktop computing whereas many healthcare workers are highly mobile.This paper discusses phase one of a larger, four-phase project which aims to develop information access applications at point-of-care for Ambulatory Care Services.The initial phase of the research (phase one) involves workflow analysis, requirements specification and the development and testing of a system prototype to assess the feasibility of achieving increased efficiencies in workflow at the Ambulatory Care Service.

The impact of many well intentioned technology integration projects has not always been viewed favourably. In fact, many projects are destined to fail from the outset by not considering fundamental IT system inves tment risks (technical failure, data failure, user failure, organizational failure) [Lyytinen & Hirschiem, 1987]. With any new technology ‘an element of uncertainty exists in the minds of decision makers with respect to the successful adoption of them’ [Bagozzi et al, 1992]. Uncertainty towards adopting new technologies is not solely the domain of decision makers. Apart from chief technology and information officers, system administrators and help desk personnel, those who ultimately feel the greatest impac t and transformation upon work practices from any newly adopted technology application or process are end-users. In mandated technology integration environments, impressions may exist whereby any form of consultative input from end-users is inherently removed, leaving end-users disillusioned with the mandated technology. This research uses an adapted version of Kline’s Groupware Adoption Scale [Kline, 2001] in a preliminary study to ascertain end-user perceptions towards the proposed mandated implementation of a PDA-based point-of-care information system (ePOC) in The Ambulatory Care Team (TACT), Northern Illawarra, South Eastern Sydney Illawarra Health Service.

This paper represents an overview of a field trial for a patient data management system used in ambulatory care. Its purpose is to give an outline of the issues that allow technological enablement of electronic patient data management in the delivery of home-based medical care. While the replacement of more traditional paper-based patient data management using PDAs as a collection platform are technically straightforward, the organizational realignment of an electronic document management system require careful study and deployment in order to maximize success. We outline the methodological considerations for document management diffusion within this eHealth setting and describe the issues, architecture and proposed rollout of the electronic Point-OfCare (ePOC) system.

In November 1997, the South Western Sydney Area Health Service launched the Mother and Infant Network (MINET). The key objective of MINET is to develop an integrated clinical data network which has the capacity to inform and support a continuum of care for the population of all mothers, infants and children. The MINET data network integrates in-patient services, ambulatory services, and community-based services. The focus of this article is the development and implementation of MINET with reference to the crucial role of data linkage and health informatics in health outcomes/health services research.

In conjunction with information technology, workflow analysis paves a way for organisations to gain improved efficiency, better process control and flexibility. The purpose of this research is to use workflow analysis to identify the opportunities for the application of Information and Communication Technology (ICT) in Palliative Care. Information technologies have penetrated into healthcare areas. Various levels of sophisticated medical databases and Electronic Healthcare Record (EHR) have been established for different departments in hospitals. However, the application of information systems in the same or different hospitals in Australia may still be patchy and lack an integrated approach. Detailed workflow analysis to identify how various health workers work, why they work the way they do and what is the result of the work, may help healthcare organisations to identify the opportunities for effectively applying ICT to streamline and optimise their work processes. After the exploratory and descriptive study, the researchers adopted two qualitative research methods of data gathering in this research: interview and observation. The research site is the Illawarra Area Health Service (IAHS). This paper deals with research in the Palliative Care Ward. The result of this stage of the research produces a set of workflow analysis diagrams, covering nurses' normal daily procedures and ad hoc events. Several possible areas of IT application have been identified based on the results of the workflow analysis.

The ability to provide accurate, timely information to authorised health providers will unquestionably improve health care delivery. Essential to this is the development of Electronic Health Record Systems. Such systems will be dependent on accurate linking of data from disparate healthcare databases. Correct identification of Electronic Health Records(EHRs) through Universal Patient Identifiers(UPIs) and guaranteed integrity of content are two elements of importance. Where multiple databases at different locations are involved, integrity of content is difficult to achieve. This paper explores some of the problems relating to the integration of often, inconsistent information in heterogeneous multidatabase health systems. It illustrates this problem with an example of one project undertaken in a regional healthcare environment. Disparate database systems will continue to exist unless investment is made in establishing standards both in the structure and organization of databases and in the terminology used within records. The concept of a semantic network, which allows some flexibility of language in context, should also be adopted. It is unlikely that all problems of legacy systems will be resolved. However, if steps are not taken to improve confidence in the Electronic Health Record, the opportunity to greatly improve health delivery will be lost.