The Australian general public's perceptions of having a personally controlled electronic health record (PCEHR)

Objective The move internationally by Governments and other health providers to encourage patients to have their own electronic personal health record (e-PHRs) is growing exponentially. In Australia the initiative for a personally controlled electronic health record (known as PCEHR) is directed towards the public at large. The first objective of this study then, is to examine how individuals in the general population perceive the promoted idea of having a PCEHR. The second objective is to extend research on applying a theoretically derived consumer technology acceptance model to guide the research. Method An online survey was conducted to capture the perceptions and beliefs about having a PCEHR identified from technology acceptance models and extant literature. The survey was completed by 750 Queensland respondents, 97% of whom did not have a PCEHR at that time. The model was examined using exploratory factor analysis, regressions and mediation tests. Results Findings support eight of the 11 hypothesised relationships in the model. Perceived value and perceived risk were the two most important variables explaining attitude, with perceived usefulness and compatibility being weak but significant. The perception of risk was reduced through partial mediation from trust and privacy concerns. Additionally, web-self efficacy and ease of use partially mediate the relationship between attitude and intentions. Conclusions The findings represent a snapshot of the early stages of implementing this Australian initiative and captures the perceptions of Queenslanders who at present do not have a PCEHR. Findings show that while individuals appreciate the value of having this record, they do not appear to regard it as particularly useful at present, nor is it particularly compatible with their current engagement with e-services. Moreover, they will need to have any concerns about the risks alleviated, particularly through an increased sense of trust and reduction of privacy concerns. It is noted that although the respondents are non-adopters, they do not feel that they lack the necessary web skills to set up and use a PCEHR. To the best of our knowledge this is one of a very limited number of studies that examines a national level implementation of an e-PHR system, where take-up of the PCEHR is optional rather than a centralised, mandated requirement.

Electronic conveyancing in Australia : is anyone concerned about security?

We have previously suggested that three proof requirements are essential for a sustainable land registration system. These were proof of identity, proof of ownership and authority to deal. Our attention in this article is drawn to the security framework that surrounds these requirements. We will ask whether the introduction of the Property Exchange of Australia (PEXA), and its underpinning regulatory regime will meet the concerns that we have in relation to them. In drawing out some problems with PEXA, we then offer an innovative idea, sourced from the transfer of equities that could serve to generate discussion on how we can ensure the Torrens system of land registration is sustainable for another 160 years. We also canvass some more incremental suggestions that evolve out of what we currently do, as well as outlining some comparative externally sourced ideas as to how the transfer and ownership of land can be made safer for all citizens. Such a goal is imperative when land transfer and secure property ownership is a critical component of the economic infrastructure of a modern society.

Surviving the electronic panopticon: New lessons in democracy, surveillance, and community in young adult fiction

The ability of new information and communication technologies to pierce previously impenetrable physical, personal, and social boundaries has particular relevance to contemporary society and young people as there is now more information that can be collected, accessed, and distributed about individuals and groups. The ability to know about each other has become a central feature of many young people’s lives. The need to know is further complicated by other questions – Who knows? What do they know? What are the implications of this knowledge?. These questions are a consequence of society having become more mobile and networked enabling increased surveillance, tracking, and spreading of dis/information. With the acceleration of new pervasive and immersive technologies, these questions have taken on a new urgency and significance that go beyond an Orwellian Big Brother scenario. This chapter extends Foucault’s notion of the panopticon to take account of the challenges of an AmI environment of smart networked devices. By drawing on examples of recent young adult fiction, I examine some of the ways in which these texts invite their readers to reflect and speculate on the uneasy relationship between surveillance and democracy and what this means for individual rights and freedom, and a sense of place and belonging.

Storytelling; safeguarding; treatment; and responsibility; attributes of recovery in psychiatric intensive care units

Background and aim In recent years policy in Australia has endorsed recovery-oriented mental health services underpinned by the needs, rights and values of people with lived experience of mental illness. This paper critically reviews the idea of recovery understood by nurses at the frontline of services for people experiencing acute psychiatric distress. Method Data gathered from focus groups held with nurses from two hospitals were used to ascertain their use of terminology, understanding of attributes and current practices that support recovery for people experiencing acute psychiatric distress. A review of literature further examined current nurse based evidence and nurse knowledge of recovery approaches specific to psychiatric intensive care settings. Results Four defining attributes of recovery based on nurses’ perspectives are shared to identify and describe strategies that may help underpin recovery specific to psychiatric intensive care settings. Conclusion The four attributes described in this paper provide a pragmatic framework with which nurses can reinforce their clinical decision-making and negotiate the dynamic and often incongruous challenges they experience to embed recovery-oriented culture in acute psychiatric settings.

Development of an electronic role-play assessment initiative in bioscience for nursing students

Devising authentic assessments for subjects with large enrolments is a challenge. This study describes an electronic role-play assessment for approximately 600 first-year nursing students to learn and apply pathophysiology (bioscience) concepts to nursing practice. Students used Microsoft Office PowerPoint® to prepare electronic role-plays both between a nurse and patient, and between two nurses, thus simulating workplace scenarios. Student feedback demonstrated that respondents found this assessment useful for learning pathophysiology, and for applying pathophysiology to a nursing clinical setting. This electronic presentation circumvented issues associated with a traditional oral presentation such as embarrassment and logistics of scheduling groups, and rated well with students of non-English speaking background. The electronic role-play assessment initiative encouraged students to apply their bioscience knowledge to a clinical setting, and allowed students to conceptualise the importance of bioscience within both the nursing degree and the profession.

Contextualising co-creation of value in electronic personal health records

This conceptual paper is a preliminary part of an ongoing study into take-up of electronic personal health records (ePHRs). The purpose of this work is to contextually ‘operationalise' Grönroos’ (2012) model of value co-creation in service for ePHRs. Using findings in the extant literature we enhance theoretical and practical understanding of the potential for co-creation of value with ePHRs for relevant stakeholders. The research design focused on the selection and evaluation of relevant literature to include in the discussion. The objective was to demonstrate which articles can be used to 'contextualise' the concepts in relation to relevant healthcare providers and patient engagement in the co-creation of value from having shared ePHRs. Starting at the service concept, that is, what the service provider wants to achieve and for whom, there is little doubt that there are recognised benefits that co-create value for both healthcare providers and healthcare consumers (i.e. patients) through shared ePHRs. We further highlight both alignments and misalignments in the resources and activities concepts between stakeholder groups. Examples include the types of functionalities as well as the interactive and peer communication needs perceived as useful for healthcare providers compared to healthcare consumers. The paper has implications for theory and practice and is an original and innovative approach to studying the co-creation of value in eHealth delivery.

Impact of PV units in LV feeders on distribution system reliability

Re-supplying loads on outage through cross-connect from adjacent feeders in a distribution system may cause voltage drop and hence require load shedding. However, the surplus PV generated in some of the LV feeders can prevent load shedding, and improve reliability. In order to measure these effects, this paper proposes the application of Direct Load Flow method[1] in reliability evaluation of distribution systems with PV units. As part of this study, seasonal impacts on load consumption together with surplus PV output power injection to higher voltage networks are also considered. New indices are proposed to measure yearly expected energy export, from LV to MV and from MV to higher voltage network.