Boundaries and e-health implementation in health and social care.

Background: The major problem facing health and social care systems globally today is the growing challenge of an elderly population with complex health and social care needs. A longstanding challenge to the provision of high quality, effectively coordinated care for those with complex needs has been the historical separation of health and social care. Access to timely and accurate data about patients and their treatments has the potential to deliver better care at less cost.

Self-reported "communication technology" usage in patients attending a cardiology outpatient clinic in a remote regional hospital.

Purpose: This study assessed the perceived usage of, and attitudes toward, communication technologies (mobile phone and texting, e-mail, and the World Wide Web) in patients attending a cardiology clinic with a view to guiding future health service redesign.

Methods: This was performed in a remote regional hospital serving both urban and rural populations. A self-completion questionnaire was completed by a convenience sample of 221 patients attending a general cardiology clinic.

Rational development of telehealth to support primary care respiratory medicine: patient distribution and organisational factors.

Aims: Telehealth may offer opportunities to support primary and secondary care of patients with respiratory disease. This study examined the potential for applying telehealth in a region of the UK by exploring the distribution of patients and examining attitudes to implementation of telehealth.

Methods: The distribution of patients with asthma, COPD, lung cancer and obstructive sleep apnoea (OSAS) in the NHS Highland Region (309,900 residents, 12,507 square miles) was determined from Quality and Outcomes Framework data and disease registers.

Exploring public perspectives on e-health: findings from two citizen juries.

Background: Interest and investment in e-health continue to grow world-wide, but there remains relatively little engagement with the public on this subject, despite calls for more public involvement in health-care planning.

Design: This study used two modified citizen juries to explore barriers and facilitators to e-health implementation and the priorities for future e-health research from the perspective of health service users and lay representatives. Citizen juries bring together a group of people to deliberate over a specific issue.

Territorial tensions: misaligned management and community perspectives on health services for older people in remote rural areas.

This paper presents findings from a qualitative study investigating older people's health service provision in remote rural Scotland. Comparing stakeholders' perspectives, contested issues were exposed where community members, service managers and policymakers disagreed. Considering these, led to the proposal that fundamental tensions exist between community and management/policy stakeholders' perspectives and these underlie service change conflicts.

What older people want: evidence from a study of remote Scottish communities.

Introduction: The growing proportions of older people in rural areas have implications for the provision of health and social care services. Older people are more likely to have complex health needs compared with other age groups, requiring a full range of primary, community and acute hospital services. The provision of services to older people in rural areas is challenged by diseconomies of scale, travel costs and difficulties in attracting staff.

The introduction of a new consulting technology into the National Health Service (NHS) for Scotland.

New technologies can change healthcare delivery. Cisco HealthPresence, an integrated platform that combines video, audio, and call center technology with medical information to create a virtual clinic experience, was piloted on emergency department patients. The aim was to assess primary care consultations.

The influence of context and process when implementing e-health.

Background: Investing in computer-based information systems is notoriously risky, since many systems fail to become routinely used as part of everyday working practices, yet there is clear evidence about the management practices which improve the acceptance and integration of such systems. Our aim in this study was to identify to what extent these generic management practices are evident in e-health projects, and to use that knowledge to develop a theoretical model of e-health implementation. This will support the implementation of appropriate e-health systems.

Adoption of telemedicine in Scottish remote and rural general practices: a qualitative study.

We conducted a qualitative interview study to explore the factors that have facilitated and prevented the adoption of telemedicine in general practice in remote and rural Scotland. Face-to-face interviews were carried out with general practitioners (GPs) and practice nurses in 26 of Scotland's most remote practices and five of the seven most rural health boards. The interview study found that GPs were more positive about the use of computers and telemedicine than nurses.

Remote working: survey of attitudes to eHealth of doctors and nurses in rural general practices in the United Kingdom.

Background: Health professionals in rural primary care could gain more from eHealth initiatives than their urban counterparts, yet little is known about eHealth in geographically isolated areas of the UK.

Objective: To elicit current use of, and attitudes towards eHealth of professionals in primary care in remote areas of Scotland.

Methods: In 2002, a questionnaire was sent to all general practitioners (n=154) in Scotland's 82 inducement practices, and to 67 nurses.