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application, these challenges should be taken into
consideration.
reducing them. (Gururajan, Baig & Kerr, 2008;
Stead & Lin, 2009)
According to another survey conducted at
the Healthcare Information and Management
Systems Society (HIMSS) 2008 conference, the
interviewees rated the level of difficulty for “us-
ability of the mobile user interface” as moderate,
and it was seen as the most difficult challenge
when compared to “security of patient data” and
other technical challenges.(Alasaarela, Nemana
& DeMello, 2009)
William Stead (2009) observes another notice-
able factor in regard to interface usability. He puts
forth the fact that majority of the applications are
designed and implemented automate business
processes that basically provide digital forms for
activities currently carried out on paper (Stead
& Lin, 2009). Clinical acts resulting from the
clinicians' personal cognition or experience are
not taken into consideration (Stead & Lin, 2009).
Stead insists that the routine procedures of the
targeted users are also not supported well-enough
by the system. (Stead & Lin, 2009)
Confidentiality of Hospital/Patient Data
One of the concerns is the security of hospital
data (Paradiso, 2005) as well as ensuring secure
data exchange (Havenstein, 2005). Havenstein
reports that in some hospitals of North California
Sutter Health has installed wireless networks
(Havenstein, 2005). To resolve the security issue,
when using handheld devices for viewing patient
records, the only thing the doctors are able to
download is the “view of a screen” (Havenstein,
2005), which does not let them make amendments
to patient's sensitive data. Also wireless local area
networks in hospitals are secured so they cannot
be used as a public Wi-Fi site (Havenstein, 2005).
According to reference (Alasaarela, Nemana
& DeMello, 2009) security of patient data is not
considered as one of the most severe challenges.
Interface Usability
Clinical Process Change
In a study by Gururajan, Baig and Kerr (2008) on
“wireless technology in Pakistani healthcare set-
ting”, the results showed that usability of wireless
devices was an important issue towards achieving
a better standard of clinical performance Difficult
data entry and poor interface design have been
reported to be the key barriers to adoption (). In
order to ensure that the new technology would
be accepted and would be actually used by the
clinicians, the interface of the application should
be effectively designed. (Gururajan, Baig & Kerr,
2008) An effective design could be defined as the
one that allows easy navigation and formatted
display of the required information on the wire-
less handheld device. (Gururajan, Baig & Kerr,
2008) A poor interface design not conforming to
human-computer interface principles may also
lead to incorrect interpretation of results that would
lead to new forms of medication errors instead of
The process changes that take place in a healthcare
organization with the adoption of new wireless
technologies are seen as a challenge more difficult
than technical challenges. (Alasaarela, Nemana &
DeMello, 2009) Some clinicians show resistance
to adapt to the technology change because they
believe that it is difficult to replace routine clinical
processes with digitized processes as these pro-
cesses strengthen the bonds between the patient
and the doctor, and reflect uniqueness upon the
healthcare industry. (The Mobile Health Crowd,
n.d.) According to another survey conducted at
the HIMSS08 conference, the challenge that was
regarded as extremely difficult is “process change
from the doctor's point of view” and it's level of
difficulty scores way more than technical chal-
lenges. (Alasaarela, Nemana & DeMello, 2009)
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