The effectiveness of Electronic Care Plan Approach (eCPA) in Health Care treatment in the UK.
The effectiveness of Electronic Care Plan Approach (eCPA) has been a prominent issue currently advocated by the National Health Care reform. Attention to this matter in recent years has been accompanied by improvements in understanding how health care technology affects not only economic matters, but patient outcomes and most importantly improvements in the quality of care.
The Electronic Care Plan Approach (eCPA) gives clinician and medical staff the ability to access a patient's care plan, governing all aspects of the patient's treatments, on-line at any time. The eCPA solution integrates with existing data, which stores and incorporate a legacy database, as well as disparate file formats that have previously been localised and heterogeneous in nature (Octavia, 1981).
This section of the research proposal will review various literatures on the effectiveness of eCPA in health care treatment. The development of health care technologies in improving quality of life has attracted the attention of researchers as well as theorist. Evidence from several current studies of health care can testify that the role of Electronic Care Plan Approach (eCPA) has been a strong indicator in the quality of health care treatment in the UK. Patients, clinicians and medical staff continue to demand better delivery of health services. Thereby, prompting policymakers to adopt health plans that are efficient at all levels. Although, the electronic care plan implementation has gone through a lot of phases, among its developments, is the trend towards higher standards evidence of health care, regarding efficacy and effectiveness which aim at improving better health care delivery. Patients, clinicians, health care managers and policy makers are increasingly concerned about eCPA effectiveness as well as efficacy.
The developments of technological system as a systemic enquiry into health care delivery started in the 1960's and 1970's. This coincided with the idea of introducing health care technologies, which prompted widespread public interest in matters affecting immediate health care plans. Health care technologies were among the topics of early technology assessment which included multiphase health screening, in-vitro fertilisation, and retardation of ageing as well as predetermination of the sex of children (Goodman, C., 1994). Making technology application in health services a focal point to all stakeholders.
The application of technology to assist people who are physically challenge is now improving and becoming more available to everyone. But the quality of services delivered by these technologies varies considerably. This is due to the fact that the potential technical assertive tools have not been fully realised (Allen, B., 1993). To realise the full potential of a health technology, there should be enough education on the benefits of the services to all users, in other to enhance acceptance. The increase in the absolute number of people requiring medical support led the government in exploring various ways and policies of coping with the demand. Most of the factors considered were more aligned to its cost-effectiveness, related economic implications as well as socio-cultural factors. Over the years, alternative ways of funding health care has been explored, including private insurance as well as new ways of organising existing services. The involvement of physicians and other medical staff is a key factor in the implementation and decision process of health care development. This gives medical staff, the first hand opportunity to evaluate and reengineer the system (Buell, J.M., 2009).
Following the advancement in technology and increasing life expectancies, medical technologies has contribute to a continuous higher quality of our health care, but at what cost? (Fitzmaurice, J.M, 1994). Although cost is been a major factor in health care delivery, it is advisable that policy makers adopt and implement health care plans that are beneficial to the entire economy. Considering the tremendous development of health care technologies, the overall costs of health care delivery have significantly diminished. This is due to the fact that technology has become a marketing tool to combat health care cost (Grundfest, W.S., 1994). Therefore the increase in modern technology can save cost in the future and the betterment of the economy. Policy makers should identify what works and apply the best practices consistently. Health care implementation is more successful if is well planned and tailored to the needs of patients rather than dictating what kind of care should be provided (Robson, B.,2009).
Among the major factors that are becoming more paramount in technological and quality services delivery can be identified as technical performance, reliability and ease of use. Here in the UK, the NHS plan published in 2000, pronounced that “we live in a consumer age”. Thus services have to be tailor-made, not mass produced. This idea was geared towards the needs of the users not the convenience of producers. Hence patients should have the main control and to monitor their records as to what services they are getting from their doctors. By means of this, the electronic choose and book system was introduced, which is supposed to provide patients with the choice of place, date and time for their outpatient appointment in a hospital or a clinic (Lapsely, I., 2009).
An outstanding advantage of the Electronic Care Plan Approach (eCPA) is that , users mainly medical staff and patients can find health information, reinforce motivation to change health behaviour, track health status, communicate with providers and run decision support tools to identify risk (Goldschmidt, .P.C.,2005). This helps to enhance a better managed health record which delivers potential quality health care. An electronic medical record system will also helps in the management information systems which is very vital in addressing health care inflation (Hochstadt, B., 2009). Major significant efficiencies includes increasing prescription drug compliance, reducing gaps in care and providing safe redirection from the emergency room to other more appropriate care settings. Areas were eCPA are making huge impacts includes mental, elderly and disabled people who represents a large number of the UK population. Elderly people are living longer due to better medical conditions which in previous time would have been fatal can now be cured. This has increased the number of elderly people who may require high degree of care (Maquire, 1988).
In March 12, 2003 Octavia announced that it has completed the key Electronic Care Plan Approach (eCPA) project for South West London and St Georges Mental NHS Trust. It has over 2000 users across approximately 50 sites. This system enables a secure access to patients file playing an imminent role in their care plan. The unpredicted nature of mental health care in the community means that on occasion, a member of staff may be dealing in an emergency situation with a patient who is not theirs (Octavia, 2003). The inability of health care systems to respond adequately to the need for fundamental changes in their structures and function has thrust the health field irretrievably into a political arena, for where else can the public turn to, nowhere but to its government. Most often governments use this as a playing field to implement policies that are suitable to their budget and plans forgetting patients who are the main focal points for the service. The digitization of patient's records has had tremendous effects in this modern age of technology. A typical disclosure of a patient's record on a computer highlights major negative impacts such as fraud, breeches of security and theft of information (Angrey, C.M., 2009).
Although there is a lot of literature on health care, there seem to be a limited number of literatures identifying the sustainability and user ownership of healthcare. These two (2) prime factors are the most important things to consider in any health care implementation. Therefore the research will focus on these areas to help identify those factors. Throughout the research, the researcher also found out that, most of the articles often talk about health care plan for only a certain group of people. This shouldn't be the case if health care system is for the whole populace. A holistic system is the one that brings about a total quality improvement in health care. Having analysed the various literatures, the question that raises an eye brow is; in what ways is Electronic Care Plan Approach (eCPA) being used to enhance user-sustainability treatment in health care delivery? This is the question that my research proposal is addressing.
Aim and objectives
The aim of this research is to investigate the effects of Electronic Care Plan Approach (eCPA) on health care treatment in UK.
The objective of the research proposal is to achieve the stated aim. To accomplish the aim of this research proposal, the following measures will be undertaken:
· Academic literature review on previous and existing health care services and technologies. This will be achieved by examining relevant journals, articles, books and past studies.
· Information gathering. Details of data covering previous and existing health care systems will be obtained via government websites, reports and on-line academic publications.
· Qualitative analysis towards generalizing the results to help draw a sound conclusion.
· A critical analysis of how the system is used in providing quality health care from clinicians, medical staff to patients.
· Write-up and submit research proposal.
This research will be done using qualitative research methods. The researcher chose qualitative approach because qualitative studies are becoming more popular in the health care context as it provides more insights into important questions or issues in health care and clinical research. Other important question dealing with why, how, context, and experiences of individuals or groups, can be best addressed using qualitative methods (Murphy et al., 1998).
Qualitative researches usually start with a clearly profound problem, which identifies the appropriate strategy to gather data from. It also uses a multifaceted tool kit of analytic methods to work with those data and then proceeds to investigate the data for their insights into the research problem and interpretation of the findings (Meadows et al., 2003).
The researcher will conduct interviews, where the main topic; the effectiveness of Electronic Health Care Plan Approach (eCPA) will be introduced. The interviewees are allowed to freely structure their respond and answers. In this way data gathered can be in-depth, detailed and specific to the topic domain. Questionnaires will be administered in this research, this will include self administered questionnaires where respondent answer the question on their own.
A design of eCAP system can be implemented through the use of prototype - led RAD development methodology, by gathering valuable feedback from clinical and clerical staff during its development process. This justifies qualitative methodology to be an appropriate method, to use for this research proposal.
Testing and evaluating
To test and evaluate the topic, the researcher will conduct the following approach;
· Questionnaires .This will mainly take the form of open questions where replies are easy to process. It will include the use of surveys as well as face-to-face questionnaires, where the respondents are allowed to answer the questions on their own.
· Unstructured and semi-unstructured interviews
This will involve data gathering where the research proposal is introduced to the interviewee and they are allowed to brainstorm the topic to generate a detailed consensus on each and every one opinion. In this way the data gathered can be in-depth, detailed and specific to the topic domain. This finally can help in generalizing the result, to test if eCPA is effective to enhance user sustainability in health care delivery.
Demographics of users
The demographics of this research will be mainly derived from clinicians and medical staff of St Georges mental NHS Trust. As well as south west London communities, especially Putney community, where there are over 5000 users.
Programme of work
Task 1: Literature review (5 weeks)
Conduct a review of academic literature on eCPA. Here the research will explore other existing health care plans to analyse their success and failure. A review of other health care plans, implementation cost and patient-user information will be analysed.
Outcome: Draft literature review in an organised and coherent format.
Task 2: Methodology review (2 weeks)
This will include a review of all the methodologies other researchers have used to conduct their work on electronic health care plans. This will help to give a better explanation on why certain data are collected, what data is collected, from where the research collects it's data, when the data can be collected , how the data is collected and how it is being analysed in regards to the research question.
Outcome: Agree research methodology strategy.
Tasks 3: Data gathering (3 weeks)
Conduct appropriate strategy to gather data. This will mainly place emphasis on qualitative research data gathering methodologies. It will include the use of both unstructured and semi-structured type of interview as well as administering questionnaires, where respondents are allowed to answer the questions on their own.
Outcome: Analyse and interpret research data to provide answers to the research question.
Task 4: Writing up and analysis (1 weeks)
This will involve putting all the gathered data and the research methodologies in a nice and neatly coherent format and to provide concrete solutions to the research project.
Outcome: Completed draft including formatting of bibliography.
Task 5: Revised draft (6 days)
Reviewing the draft to make sure all grammatical errors are omitted and making sure that all ethical consideration policies are followed.
Outcome: An organised and well formatted research proposal.
Task 6: Submission (1 day)
It is the policy of the National Health Care System that any research involving human subjects or animals is carried out in accordance with high ethical standards. Therefore this research will be done in accordance with the ethical policy regarded by the health care reform. Any difficulties encountered in complying with these policies shall be reported. The final technical report will also give a brief description of how the ethical standard was carried out in the project (IDRC, 2009).The researcher will comply with policies which aims at protecting the dignity and privacy of every individual in the course of the research work.
Following that any person to be associated with the subject of the research, he/she shall be notified of the aim, methods, anticipated benefits and potential hazards of the research. The person's right to abstain from participation in the research and their right to terminate at any time. Information obtained in the course of the project will be kept strictly confidential to participants. This will encouraged them to give more open and honest responses. The concluding part of the research will destroy the identity of any individual unless they want their identity to be included in the research.
Although there are strong indicators that eCPA is playing an important role in electronic care treatment in the UK, many are the problems associated with its delivery. Therefore, the research will be looking at the effectiveness of eCPA from the user perspective.
This research proposal can be advantageous to policy makers, researchers and theorist who are involved in innovation, development and testing of health care systems, especially future research into health care sustainability. In which patients become more integrated into the health system, to enhance quality delivery of services.
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