Information Systems in hospitals and the health service
A critical report on "Increased electronic information sharing by sexual health services" by Hunter, Ede and Whiddett
Literature Review 2016 16 Pages
The paper is a critique report of Hunter, Haining Ede and Whiddett (2014) regarding “Increased electronic information sharing by sexual health services: Confidentiality and consent” published in the health informatics journal. The purpose of this report is to appraise critically of Hunter, Haining Ede and Whiddett’s (2014) article using CASP (Critical Appraisal Skills Programme) tool and comment with supportive evidence on the article by following standard review checklist (CASP, 2013). In addition, the article will be critically appraised through the various quality checklists (Quality checklist for the pilot study through questionnaire, Quality checklist for qualitative studies from Greenhalgh et al., 2008). Initially, the critique report will highlight on the author’s published article. It will also explore the study aim, objective, study design, outcomes, and any encountered biases if any. Finally, the report will summarise the key points of the article in the light of significance of the information system in hospital and health service system and how the published article integrates to the information system with sexual health services in the hospital.
Critique report or Critical appraisal is the analytical process of full of attention and systematically investigating research to assess its reliability, and its significance and relevance with an individual context (Burls, 2009). In addition, While Chambers, Boath, and Rogers (2007, p.51) defined that “critical appraisal as the assessment of evidence by systematically reviewing its relevance, validity and results to specific situations”. Moreover, in case of health research studies, critical appraisal is fundamental and significant component in term of evidence-based health services, treatment, medicine, and public health practice in the hospital or in the community what includes scrutinising the strengths, weaknesses, and the areas of improvement of a particular study (Fowkes and Fulton, 1991).
Hunter, Haining Ede and Whiddett (2014) presented in their published article regarding the implication of introducing the National Health Index (NHI) to share patient health information by sexual health services (SHS) with other external providers in New Zealand. This article, Authors inspected patient attitudes towards the modification in health services to support a combined model in the current care setting in New Zealand. Based on research outcomes, increasing sharing patient’s information without consent among external health providers’ would influence people to stop visiting in sexual clinic. Consequently, the rate of STIs could be increased, while currently STIs are very common in New Zealand even higher thank United Kingdom (The Environmental Institute of Science and Research, 2016). Therefore, the authors suggested that consent and confidentiality could be taken place in a serious manner in national health policy particularity for the patient in sexual health services.
Hunter, Haining Ede and Whiddett (2014) carried out significant research regarding sharing patient confidential information in sexual health services through UPI (Unique Patient Identifier) without patient’s consent among various health services providers. Adler et al., (2002) stated that sexual health is very crucial part of an individual in term of physical and mental health of an individual. It is an integral part of our identity as human beings along with important human rights to their privacy and dignity, social and family life, and living in the civil society with equal opportunities. Better sexual health is depends on some factors for instances good sexual relationship and adequate access to sexual health service centre what ultimately prevent the risk of STIs and unwanted pregnancy (Edwards and Coleman, 2004).
This article has been chosen to critique as its contextual significant regarding patient’s confidentiality and sharing information without consent in sexual health services. Sexual health is very important issue for human being and STIs (Sexually Transmitted Infections like chlamydia, HIV) are the current global public health concerns. On the other hand, Patient confidentiality is also very important issue in term of sexual health service providers and obtaining consent would be necessary step before sharing patient’s information to other health providers. Moreover, the critique will address the strengths and weaknesses of the published article based on supportive evidence and explanation.
The following part of the report will analyse the article based appropriate evidence and logical explanation.
Authors highlighted that patient’s health information sharing system is increasing among external health services providers electronically. Studied found that patients attending in sexual health service were unwilling to share their in health information. Therefore, it was major concern for the patients to attend the sexual health clinic. Consequently, rate of infection might be increased due to stop visiting sexual clinic. Author provided recommendation to Sexual health services as they could compromise their information sharing system based on patient’s consent.
The authors conducted qualitative pilot study in local hospital based on Sexual health services in New Zealand. Data was collected through the distribution of questionnaire by the clinic receptionist to avoid any kind of biasness. Participants could complete the self-administered questionnaire into two ways for instances sitting in waiting areas or complete at home and send back by post in a prepaid envelop. However, authors did not mention their research question clearly based on PICO (Patient, Problem or Population, Intervention, Comparison, Control or Comparator, Outcomes) tools where they could identify the particular participants and specific questions in the questionnaire (Stolberg, Norman, and Trop, 2004).
In addition, the full article is evaluated through the numerous critical assessment criteria based on the Effective Public Health Practice Project (EPHPP) shown in the following table 1:
Table 1: Summary of the quality appraisal of the published selected article based the Effective Public Health Practice Project (EPHPP) (EPHPP, 2009)
Abbildung in dieser Leseprobe nicht enthalten
Based on various appraisal tools, there are some strengths and weakness of the published article which are pointed in the following section:
There are many strengths of the article which is discussed below:
The title is the most important element to evaluate instantly the quality of any article. The key words like sexual health service, patient confidentiality, and consent are the most important issue in the health industry. Therefore, the article title is quite durable and realistic (Crombie, 2011). In addition, abstract is also very crucial to evaluate the quality of the article. Bowling and Ebrahim (2005) stated that abstract gives the overview about the whole study as well as the research outcomes. As a whole, the article has met the criteria and this is the strength point of the article.
Regarding study aim and objectives, the authors tried to explore the patient awareness about the NHI number and actual motive of their clinic visit in the sexual health services. The authors also tried to fix up the patient behaviour and attitude to make familiarise with HNI number in term of various health service centre from primary to tertiary care level. Furthermore, the authors tried to convince to the health policy maker to redesign the electronic sharing information without patient consent and highlight the negative impact (stop visiting sexual clinic what might increase the risk of STIs) of sharing information especially in sexual health clinic data towards external health providers (Fernando and Clutterbuck, 2008). The authors had clear and specific realistic aim and objectives in their pilot study what makes strong point in the published article (Moher et al., 2010).
EPHPP (2009) stated that project or research timeline is very important to produce a good quality research. Study was carried out from 10 August to 11 September 2009 what provided specific period of time. The authors conducted qualitative pilot study and used questionnaire to collect data from the patients. The questionnaire was collected from previous study of Whiddett et al. (2006) and designed to complete around 10 minutes. All participants were eligible if they were 16 years or over and had no mental problems or language barrier. In the pilot study, total 249 patients participated and filled out the questionnaire in the Sexual Health Services centre, while questionnaire was distributed by the receptionist to avoid any kind of biasness. In addition, participants would complete the questionnaire either in waiting room or at home and return the completion questionnaire by post in prepaid envelop. Consent was asked just before choosing participants. In addition, questionnaire and NHI number was also explained in the information leaflet to avoid any kind of confusion or dilemma (Hunter, Haining Ede and Whiddett, 2014).
Data was analysed through the descriptive statistics and chi-squared tests was done by using PASW Statistics v18 software, while highest margin of error of ±6.9% was found in the final result. Among 249, only 87% (216) participants completed the questionnaire. However, 209 respondents completed full questionnaire and 7 questionnaires were rejected due to incomplete information, where 80 (38%) were men and 129 (62%) were women respondents and overall the response rate was 84% in the study and 91% respondents were identified as heterosexual. The authors analysed properly the participant’s feedback and discarded some questionnaire based on their completeness what was actually strong point and made quality research (Greenhalgh et al., 2008) (CASP, 2013).
In term of ethical consideration, the authors received ethical approval from the Central Regional Health and Disability Ethics in New Zealand. This is actually crucial consideration to conduct a good research (EPHPP, 2009). The authors completed this important part before data collection. This is also strong evidence of the article (CASP, 2013)