1. 0 INTRODUCTION

1.1 INTRODUCTION

Radio Frequency Identification (RFID) is regarded as a state of the art technology that makes use of electromagnetic fields which are attached to a tag for the purposes of identifying objects. The tags are basically used for tracking and identification of products. However, the technology has been applied in several other sectors with key functions of tracking and identifying that are aimed at reaching a designated end. RFID is growing trend in the field of health care and is driven by the greater need to ensure patient safety. The technology can help in ensuring that every patient receives the services that they pay for.

There are two major types of RFID tags, the active and the passive tags. Active tags are expensive but play an exceptional role facilitated by their internal power to allow for a two way flow of information. Information in the active tags flows from the server to the tag and back to the server and they are more applicable in tracking application (Ferrer-Roca 2011). Passive tags, on the other hand, are less expensive but they lack an internal power and hence have to be activated by an outside power source. Compared to the active tags, the passive tags have a shorter range and can only transmit data from RFID to the server.

The increasing trend in the adoption of the RFID technology by healthcare institutions has been facilitated by the immense benefits of the technology. In the medical field, RFID has three major uses, which include tracking staff, tracking equipment, and tracking patients. Tracking expensive medical equipment through the use of RFID technology has tremendous benefits. Medical equipment that has historically been forgotten in storage are now tagged with RFID hence making them easily recoverable on need basis. Hospitals can be able to cut on the number of equipment they hold on hand because such equipment can be easily recovered (MobiHealth 2011 & Nikita 2012). Additionally, the number of staff that may be required to scout for lost items is minimized hence serves as a cost saving strategy.

Further, RFID is useful in tracking and monitoring of patients. The technology has evolved to ensure proper monitoring of patients on matters of their location, to control documentation and administration of medication, and also to monitor the interaction between the staff and the patients. However, improvements can still be made to improve the application of RFID in furthering the improvement of patient safety. The expectation is that future application of the technology will help in preventing falling of patients from hospital beds. More amazingly, the RFID system is likely to take things further through the incorporation of facial recognition software. The software has the capacity of determining whether a patient is experiencing excessive pain or whether a patient has a stroke based on the facial expression (Shor 2015). Furthermore, RFID can be used with dementia patients and can assist in preventing the patients from wandering off the premises.

Billing in hospitals is based on the interaction between the staff and patients as well as the services provided. RFID technology enables a hospital to closely monitor these interactions, which ensure accurate billing. Additionally, RFID has the capacity of tracking admissions into the hospital and consequently facilitate discharge and movement of patients. This tracking allows an opportunity for maximization of bed space at a specified period. By tracking patients, hospitals have an opportunity of maximizing billing and consequently increase the revenue generated. Tracking and monitoring of staff using the RFID system enables the hospital management to control costs incurred by the institution (Shor, 2015). By tracking the staff, the hospital management is in a position to determine how much time a given employee spends with a patient. This is important in determining the quality of services offered by the hospital.

1.2 STATEMENT OF THE PROBLEM

The continuing challenges in the human resource, higher wage bills that leave little resources for delivery of services, stagnation in the provision of public health services, dismal performance in the monitoring of health systems, and the difficulties of achieving behavioural change have worsened the health situation across the globe. The emergence of the RFID technology as a solution to the existing problems in the health care system requires proper actualisation within the various sectors in service delivery (Dolicanin et al. 2009). Having a well-outlined strategy is essential in ensuring that the use of technology in health care services will serve the purpose of quality facility services (Garrety et al. 2014). This paper, therefore, undertakes a critical a critical analysis of e-Health and specifically the RFID technology in solving problems in the health care system. An entry strategy for a startup in the industry presents unprecedented desire by various players in the sector to play a part in the problems facing the society across the globe.

1.3 RESEARCH QUESTIONS

1. What is the effectiveness of e-Health in meeting the needs of the patients?
2. What are the viable strategies for starting a RFID technology system in the health sector?
3. What are the challenges facing the health care sector whose solution is the RFID technology?

1.4 RESEARCH OBJECTIVES

1. To determine the effectiveness of e-Health in meeting the needs of patients
2. To determine the strategies for starting a RFID technology system in the healthcare sector
3. To outline the challenges facing the healthcare sector that the RFID technology seeks to solve

1.5 BACKGROUND INFORMATION

Several hospitals in Europe are facing similar threats and challenges in the provision of health care services. The challenges and threats are in equal measure presented with opportunities for improving the quality of services provided. One of the notable solutions in the provision of these services is the introduction of RFID in most hospitals across the continent and in the world. The core mission of every hospital is to offer quality services to their patients. Devising better measures to address the situation is critical in ensuring meeting of the objectives of every institution.

Over the course of the 21st century, there have been greater efforts to address the critical health problems across the globe. The pursuit has been there for over 40 years due to the deteriorating situation in the health sector. For instance, the declaration of the Alma Ata in 1978 categorised health as a very vital social good across the world (Shor 2015). The declaration brought about the concept of primary health care which has formed the basis of the delivery system in the health services.

More recently, there was the development of the millennium development goals that were aimed at providing macro-level targets alongside the efforts to improve the outcome of health are efforts to reduce the digital divide and the differential access to technology by people of various categories. On the aspect of the digital divide, the world has witnessed an increasing number of internet users (Sedlmayr & Munch 2012). The increasing technological advancement is key to improving the service delivery in the health care system. The introduction of technology in the healthcare system creates the unprecedented opportunity of improving access to efficiency and services in the healthcare system.

In the modern day, the management of data and information plays a very vital role in the provision of health care services. The various providers of the healthcare services such as the doctors and the hospitals often generate and process information while attending to the patients. Similarly, patients create, access, process, and exchange information concerning their health status. Information and communication technologies related to health can play a significant role in the management of the data as well contribute to potential gains in financial savings, efficiency and improved patient safety. The use of technology can play a pivotal role in the shift towards patient-centric care (World Health Organisation & United States 2005). The patient-centric care is an approach that aims at building a treatment regime that is tailored towards an individual patient.

The major objective of e-Health programs is to make use of the information and communication technology to improve service delivery. Professionals in the health sector hope that through e-Health more health care services will be brought to the needy population. The strategic use of technologies like the internet, computers, mobile phones, satellite receivers, and Personal Digital Assistants has been among the key technologies in improving the provision of healthcare across the globe (Sitting & Singh 2011). The increasing presence of free and open source software brings about greater chances of improving the delivery of services in the healthcare sector and seeks to offer solutions to lower income earners on easier accessibility to the healthcare.

E-Health offers a great potential in promoting healthy lifestyles, improving decisions by the various players in the healthcare sector, and enhancing the quality of healthcare through improved access to medical and health information and consequently promoting instantaneous communication in places where this was previously unavailable (Raffaeli et al. 2016). The increased use of information and communication technology in the health care sector can help in reducing the cost of the system by improving efficiency in the provision of health care as well as promoting prevention through behavior change communication (Saunders et al. 2009). The introduction of e-health has the potential of advancing the public health services and clinical care by promoting health professional practice and reducing disparities by introducing new approaches to improving the health of isolated populations.

The initial focus of many e-Health initiatives, concerns the use of the internet in promoting the organisation and access of the health-related information. In the health sector, the main areas to benefit from the e-Health include the development of Health Information System, Electronic Patient Health Records, training and eLearning for professionals in the health care, Knowledge Management, and open access to electronic medical journals. As of the first decade of the 21st century, the overall penetration of internet users across the globe was at approximately 21.2%. The emergence of Internet kiosks and cafes has been of significant influence into the use and access to internet services by population across the globe. There has also been a growing interest in the health sector to capitalise on the uptake of mobile communication technologies in the provision of services (Ferrer-Roca 2011).

The healthcare market is on the move from a paper work world to an electronic world. In an era where there is increased managed care, thin financial margins, specialised medicine, difficult insurance claims, the emergence of confidentiality in health information, and increased government demand for secure health, the competitiveness of the health care providers may depend on the usage of information technology (Phan 2008). The increased computerisation, movement of sensitive information, and reliance on databases there is a need to have strict controls that will safeguard the security and ensure confidentiality of the health care records. There are several concerns that have been raised in the health care system.

With the advancement in electronic usage, protection of data has been a key concern in the healthcare system. This has come in handy with legislation to promote the protection of data. The current health care requires the existence of an efficient and secure access to information without compromising the privacy (Ries 2014). RFID technology represents a unique opportunity that offers health care solutions that combine access to secure information and management with data mobility as well as patient privacy (Perry et al. 2004). Healthcare administrators are the major consumers of ink and paper. Keeping patient records, writing prescriptions, following up claims, and making referrals have always been based on manual operations. The few areas that have been automated tend to operate independently of each other. There has been a strong affinity by physicians and other health professionals on the use of paper-based media in undertaking their roles.

RFID is essential as it serves to reduce the amount of paperwork transactions in the health care sector and consequently serve to protect health data and patient records. RFID can hold patient information that has been encrypted and makes use of a digital signature or biometric signature to reduce the ambiguity on the identity of the card holder (Murray et al. 2013). The technology also has the potentiality of reducing fraud in claiming for insurance cover. There is a high likelihood that many health care providers will choose the technology based solution due to their capacity to ensure patient safety. The technology can also provide clean data to be used for eligibility verification as well as claims processing (MobiHealth 2011 & Nikita 2012). The current process of eligibility verification is often characterised by redundant information collection, lengthy delays, and multiple reinforcement forms.

The use of paper-based manual process has an increased risk of human error which may result in avoidable costs to insurers, health care providers, and national health agencies. These processes often result in significant delays due to the complications involved in the paper-based system. The technology can be a solution to these challenges due to their capacity to provide clean data for eligibility verification (Miller & Sim 2004). The technology has the capacity of preventing administrative errors as well as streamlines the process of payment alongside preventing medical errors from rising when the process involves multiple medical practitioners.

Test results that are conducted by one practitioner can be available to other practitioners and hence an easier way of engaging each on their issue. The technology helps the physician to preview the recent history of the patient regarding medical condition that a given patient may have. The information stored in the system is essential in informing any practitioner of the health trend of a given patient (Michael &Michael 2009). It becomes possible for physicians to track the record of the patients and hence in a position to provide the relevant diagnosis. This reduces the trend of giving wrong medication as the physician is in a position to review a patient’s recent diagnosis. As such, there is a high possibility that health care technology can have a greater impact in saving lives.

The ability of RFID to disaggregate data and undertake information encryption can protect the right to privacy of an individual while at the same time allowing multiple health care facilities to share patient information in enhancing facilitation of proper health care. The technology has the capacity of managing very vital health information, and they are also involved in the billing and collection function of information systems. The technology is also vital in the areas of clinical research (Karamanlis et al 2012). The perspective arises from the fact that issues of confidentiality and data protection can encourage participation of patients in research studies. Regardless whether the technology stores confidential information or not it acts as a key to open repositories of patient information, it is an idea whose time is ripe. RFID technology presents a practical enabling technology that has the capacity of ensuring and enhancing confidentiality and privacy of patient’s information. This paper analyses the challenges within the health care system and the clear opportunities arising from the use of RFID technology in the health care (Mantas et al. 2009). Of critical analysis is the entry strategy for startups in the e-Health sector in health care provision across the globe.

Information and communication technology offers several opportunities for improving and enhancing the performance of health systems. The availability of affordable systems and ones that are easy to use presents unprecedented benefits in solving problems arising in their health care system. The availability of affordable systems that are easy to use has led to the establishment of several initiatives that are aimed at improving the effectiveness of the providers of health care alongside offering opportunities for consumers of health care. As such, an increase in demand for use of information technology in the health care system has been experienced (Hannan 1996). These new demands shave arisen in part due to the insights concerning the extent to which information communication technology can alter the provision of health care in the society.

The delivery of health care should take advantage of the opportunities presented by the use of information technology is service delivery. These opportunities range from improvements in management and technical processes that lead to an efficient and effective health services in the growing limitation of resources (Ferrer-Roca 2011). The use of RFID technology in health care implies that the providers of health services and the managers of these systems will have a better control of resources and consequently ensure there is the optimal outcome in the health care services.

1.6 LOCAL SITUATION

Just as any other region, Malta is faced with challenges of achieving patient satisfaction through provision of quality services. One of the challenges in Malta is an increasing population that is seeking health services. The increasing demand for health care seems to strain the existing resources and hence need for having a well outlined system to address the situation. The challenge of ensuring quality health care has come along with challenges such increase in operational costs. The acute general hospital in Malta has 928 inpatient beds and about 100 day care beds. The hospital is served by 3,800 staff. There has been an incremental expenditure of the hospital that necessitates better measures be put in place (Department of Health 2011).

1.7 IMPLICATIONS OF THE STUDY

This paper considers that the providers of the health care, as well as the consumers of health care, may need further evidence on e-Health as a convincing way of starting e-service provision in the health industry. The providers of services require a well-outlined strategy for an e-startup that is based on solid research into the use of information technology in the health sector. There is a need to invest more into the research as well as an investment into e-Health startups that will provide more advanced and innovative solutions to the health problems.

The major purpose of the study is to offer detailed evidence on why RFID technology should be adopted in the health sector and the strategies within which this technology can be adopted. There is a need for collaboration between various sectors in the health care system to ensure effective coordination of the various technologies in the health care sector (MobiHealth 2011 & Nikita 2012). Developing a personalized RFID is essential in transferring and maintaining patient’s health records. Each patient has their medical records stored in the electronic technology. Health providers are responsible for updating information on the system so that it becomes available to any other practitioner in the health sector.

1.8 OUTLINE OF THE STUDY

This study will make use of both descriptive and qualitative technique in addressing the research question. Questionnaires and interviews will be used to facilitate data mining and hence better conclusion from the study.

1.9 FRAMEWORK OF THE STUDY

This researcher proposal consists of three chapters. The first chapter is the introduction which offers a brief introduction into the issues of RFID and also provides background information on the study. The second chapter is the literature review which offers an analysis of previously done research and overview of available literature. The third chapter provides the methodology that the study will follow in addressing the research question. Descriptive and qualitative techniques will be considered for this study.

2.0 LITERATURE REVIEW

2.1 INTRODUCTION

This chapter reviews the existing literature on the adoption of a health information technology system that is patient centered. This technology is essential in serving the needs of the patients in a more effective way and also in ensuring efficiency in the health system. A wide range of information is adopted in this sector to outline the various issues surrounding the incorporation of health information technology in the health sector. The information presented is essential in offering an insight into the various challenges that may be encountered while incorporating the system into the health sector. This information will be essential in offering insight into the strategies to be adopted in putting up a start-up in e-Health.

Several studies have undertaken a review concerning the potential use of RFID technology in hospital environments. Quite often research points on the efficiencies that can be realized in the field of patient and equipment tracking.

2.2 ELECTRONIC HEALTH

According to Hamilton (2009) the electronic health technology is system is currently gaining momentum in several parts of the world, especially the developed economies though at a very slow speed. The Electronic Health Records (EHR) system is being implemented in the United States and several other areas across the globe. The RFID technology is designed to offer the patients a virtual assistance that is accessible through card readers the system allows the patients and the health service providers to update information such as health history, demographic information, health information, and any other relevant information pertinent to the patient. The health providers and the patients can access the EHR of a patient through an internet platform that is cloud-based. The information can also be accessed through data readers that are provided in several locations. The RFID technology allows the patients to access their health records with explanations that are easy to understand concerning their conditions and treatment. While the technology has a wide usage in the United States, the country’s health care system may significantly benefit from the health IT to enhance better coordination of patient care.

Grizzlies et al. (2012) argue that the lack of an integrated health system often leads to a redundancy on the part of the part of the patient while the health providers, on the other hand, struggle to control costs and coordinate care. Patients often become frustrated while repeating several sets of tests with multiple providers of health. This information can be successfully stored in an electronic data system that will enable the providers to get the history of a patient just by the click of a button. According to Fischer et al. (2013) cases of emergency often take to time to address especially when the patients have to be subjected to several sets of tests that may have been previously done. Lack of a proper health technology causes a delay in the provision of health care and consequently affects the quality of medication that is offered to the patient. Such a trend may lead to losing of faith by both the patients and the providers of health care.

Al-Khanjari et al. (2014) argue that information that patients convey may not be properly captured in the paper-based system, and hence the electronic health technology can be essential in solving such a technology. Providers need to document the data and consequently share it with the various health providers to ensure patient compliance with the medical care that has been prescribed while at the same time ensure proper management of costs in the health care. There have been proposals by various agencies in the health sector on the need to have IT professionals to assist the health care workers to communicate more effectively in care coordination for better efficiency, cost reduction, and patient safety across the globe.

Today, most patients do not have control over their health records. The introduction of RFID technology can have a great deal in ensuring that issues of privacy and control being at the helm of the issues tackled by the RFID system. Any person making use of the technology need to have a unique personal number also referred to as personal identification pin. This pin is very vital in safeguarding the security and privacy of the health data. RFID also has the benefit of interacting reliable with several other ranges of systems (Menachemi & Singh 2012). RFID technology has the capacity of operating over the Internet to verify information that is saved in the database and can be updated and read offline at the office of the physician. The technology offers a range of benefits in the healthcare sector as shown in figure 2 in the appendix.

The information technology in the health sector also allows an extensive service provision geographic wise, even in low and middle-income countries across the world where there are critical challenges in the shortage of health care providers as outlined by Mantas et al. (2009). To ensure control of costs while at the same time ensuring maintenance of quality, the healthcare sector has adopted systems improvement initiatives like the PDCA (Plan, Do, Check, Act) cycles and the TQM (Total Quality Management). Breakthrough in the technological advances such ads the Electronic Medical Records (EMR) and the Electronic Health Records (ERH) are becoming increasingly used to boost the medical capacity and consequently ensure there is sustainability in the healthcare systems particularly on the information concerning the vast data on the patient. In the United States, the increase in the adoption of EHR arose from the pressure that was exerted by the Obama presidency, which offered $2.5 billion incentives to increase the usage of these systems. Due to this intervention, the number of office-based physicians that made use of the EHR certification through the Office of the National Coordinator (ONC) for Health Information Technology increased to over 100,000 countrywide. A National Ambulatory Medical Care Survey (NAMCS) of physicians found out that 57% across the country make use of some form of the EHR / EMR system. This implies that there is a huge proportion of the population that is yet to adopt the technology. A worse situation is expected in the less developed and developing countries.

Hovenga and Grain (2013) finds that EHR is capable of interoperability between different organisations. However, EMR does not communicate with other EMRs or EHR. The adoption of EHR and EMR has increased redundancy in the updating of manual data. However, the inability of the system to share accurate data remains a barrier in the realisation of return on investment in the use of EMR and EHR. Some of these systems can deliver content that is not modified which may prove difficult for the patient to understand the information that is being communicated. Instead, the RFID technology can be an essential replacement for these systems as it can solve some of the problems experienced in the healthcare sector. The system allows for correction of any wrong information that may be put in the system. This helps in solving the inefficiencies that may be brought about by the use of EMR.

There has been an increase in the use of technology in the health care sector across the globe. The advancement in technology is responsible for the improving condition of health care delivery. A global projection indicates an increasing trend in the revenue generated from the RFID technology across the globe. This is evident due to the increase in revenue which is an indication of an increasing adoption and application of the technology. Graph 1 represented in the appendix shows the global trend in the application and adoption of RFID in terms of the revenue generated with a projection of up to year 2020.

In the context of health care the Radio Frequency Identification (RFID) technology can be employed in many sectors such as bring down the costs of health care and facilitating automation and streamlining the identification process of patients in hospitals. This is possible through the use of mobile devices such as the smart phones (MobiHealth 2011 & Nikita 2012). RFID has several benefits in its application over the traditional bar code system as demonstrated in figure the appendix.

The development of an e-health strategy constitutes certain stages that ensure effective adoption of the strategy. The first stage constitutes a long-term undertaking that is aimed at raising the performance levels of the health sector in every area of service delivery. This stage constitutes a framework that engages the consumers of the health services by ensuring they contribute effectively towards raising the health status of the population across the globe. The technology at large is a tool that is placed in the hands of the health care providers to empower them overcomes the existing barriers insuring quality provision for the health care services. This serves as a means where the managers of the health care can improve the potential of the service in resource mobilisation by having an effective control of resources and demonstrating accountability and efficiency (Gregoire 2006). The second stage involves constant monitoring and evaluation of the effectiveness of the system in meeting the set objectives. Several review reports have shown the need for having the innovation to push for higher performance levels.

2.3 ETHICAL ISSUES

2.3.1 DATA INTEGRITY

Hamilton (2009) argues that the proliferation of the EHR and the data transition across the health information exchanges has opened a loophole for the for data corruption. As these systems become larger and more complex, greater vulnerabilities come in. There is a need to safeguard the information that is found in the electronic system. In several industries such as the health sector, integrity of data is held in high regards, especially in countries that value the privacy of patient’s data. Rectifying the mistakes in the data system can play a greater role in safeguarding the life of patients. One of the basic concerns in maintaining the integrity of the patient information is the maintenance and implementation of a consistent approach to the health information exchanges and proper matching of the patients with their data. Both the patients and the physicians have to trust that the data is up to date and accurate and hence can be relied upon to make a diagnosis.

The escalating complexity in sharing of data and the increasing provision of information across several platforms necessitates the existence of common standards across the world. This requires a concerted effort between the various players in the execution of the technology. Archer et al. (2011) posit that the ultimate solution for ensuring data integrity from end-to-end does not emanate from one company, but requires the involvement of every player in the sector. The information put into the system by one physician needs careful consideration before it is corrupted or edited by another physician. Given that the medical practitioners play the biggest role regarding updating the information there is a need for consistency in their work. The integrity of health data and the quality of care begins with the accurate identification of the patient. There is no important step in the health care delivery than the proper identification of the patient. This ensures that the right information is matched with the right patient (Hamilton 2009). The reliability of health information depends on the accuracy of information that is presented to the various players in the health sector. Proper matching also requires to be backed up by up to date and accurate data and the systems have to be properly linked.

According to Ashinda et al. (2013) in order to ensure safety in care, the RFID technology needs to be matched with updated security system. One of the advantages of RFID technology is that it offers security and privacy of the data stored in it. This data is only accessible upon authorisation by the card holder. The information stored can either be secured by the use of personal identification number. Without this number, it is difficult for any individual to access the information. The patient has the authority of the individuals to allow access to the information. Installing card readers in specific locations also ensure that only authorised individuals will have access to the system. The various governments have a greater role to play in securing information that is kept on the cards. As such, this can be achieved by ensuring that the card readers are those that are authorised by the government and distributed by the government to specific locations. Gritzalis et al. (2009) posit that government policies can play a huge role in ensuring that proper grounds are laid out to protect the usage of the cards. A more secure card system can be the introduction of a biometric system. This will secure the information stored on the card and consequently facilitate the effectiveness of the system.

RFID based solutions are frequently becoming deployed for the healthcare related applications, and their usage depends on the proper authentication of the information provided on the cards. Properly secured RFID technology will increase efficiency in the authorisation of payment and secure any health related records. As opposed to paper records, the RFID technology has a longer life. A RFID technology solution for patient applications allows the providers of the health care to streamline the process of patient intake and reduce errors such as duplication of information (Menachemi & Singh 2012). RFID increases the safety of the patient while at the same time ensuring efficient record management and cost effective record management.

Ball et al. (2007) argues that besides the safety that comes with the RFID technology, the card is also efficient regarding portability. The paper work system may make individuals to be constantly carrying huge loads of papers when seeking medical attention. At times the patients do not carry records of their previous medication, and hence diagnosis depends on whatever tests are done at the time of visit. The availability of information as and to when is required ensures that physicians can review the information of a particular patient and offer medication considering previous treatment (European Commission. & Deloitte & Touche. 2013). Medical records play a very fundamental role in the healthcare since they communicate information pertinent to a patient between professionals.

The information helps in administering the necessary medication to the patient. Any bottleneck that may arise in this process has the capacity of slowing down the patient care or even compromising the care that is given to the patient. Medical records consist of physician orders as well as test and exam reports. These reports are considered to be legal documents and hence should always be kept in a form that is not adulterated. Doctors and other professionals are prone to making errors, and thus it is vital to maintaining truthfulness and accuracy of information concerning patients. There has been an increase in bipartisan support for the electronic medical records. Several countries have passed legislation that safeguards and promote the use of electronic records (European Commission. & Deloitte & Touche. 2013). However, there are countries that are yet to pass policies that will assist the health care providers in the process of transition from a manual based system to an electronic system. Due to lack of such policies, several health institutions are reluctant to adopt the RFID system in their mandate to offer professional care to the patients.

Medical records are currently being kept in a variety of formats that range of folders kept in cabinets to electronic databases in the modern world. It is very common to see computers installed in healthcare facilities with many instruments being electronic. The majority of the health care facilities across the world have a certain form of electronic instruments that are used in serving the population. The challenge, however, is on the interconnectivity of these systems in offering coordinated services. A research by Bria (2011) finds that a majority of the healthcare providers continues to make use of the traditional paper-based systems.

The traditional system has existed for a longer time, even longer than the time most doctors have been in practice. The introduction of the electronic system is meant to maximise the privacy of patients as well as ensure there is accountability of health professionals. The problem that exists with paper records is a lack of efficiency in operations. The storage of records in many formats and the fact that most patients seek services from different providers makes it difficult to achieve efficiency in the provision of health care. The traditional system is fragmented to the extent that the transfer of information between the different service providers very limited (European Commission. & Deloitte & Touche. 2013). The fragmentation of information increases the risk in the provision of services by increasing the chances of medical errors, time wastage, and duplicate procedures. Interoperable electronic records have the capacity of ensuring increased savings and proper delivery of services. Maintaining the status quo is tantamount to compromising the security needs of the patient and the efficiency of the service providers.

Cimino (2013) posits that the electronic health records system offers an infrastructure where the medical records are digitised and consequently stored and transferred electronically. Popular companies are fond of publishing reports that favour the use of electronic medical records. Healthcare providers must adopt the use of information technology to enable a better-coordinated system in the provision of health services. An institution has to select an electronic system that is desirable and is capable of meeting the various needs of the institution. However, a coordinated system in every part of the country is essential as individuals can access health services in any of the facilities. When there is a coordinated and a common system across geographical locations, it makes it easier for practitioners to access the information of a patient from any location.

As such, they need to collaborate with various stakeholders in the provision of services may be difficult when the various electronic systems are not compatible geographic wise. The implication is that physicians in different locations may find it difficult to retrieve patient information. A fully electronic system in most health institutions readily works well internally, but find it difficult to accommodate information from outside. Developing a personal medical card system for transferring and maintaining the records of a patient is a plausible solution to the challenges facing the health sector. Although this may take time and is also tedious, the long-term benefits exceed the costs that are incurred in developing the system. There is a need to have a coordinated effort between the various players in the system to ensure proper transitioning.

2.4 EFFECTIVENESS OF RFID TECHNOLOGY

Radio frequency identification is a wireless system that comprises of tags and readers. The reader is often a device that emits radio waves and as well receives signals from the Radio Frequency Identification (RFID). Gartee (2007) posits that there have been several uses of RFID in health sector. The technology can be used in tracking of patient and also monitoring of staffs. This ensures efficiency in the provision of health care and consequently increases patients’ safety. The health care environment is characterized by plenty of products and services and associated information and data that are transferred across several participants of the healthcare sector participants. Health institutions in Germany have made use of RFID to facilitate communication among the various participants in the healthcare sector. The RFID technology has been used in monitoring the interaction between the staff and patients. This helps in determine the quality time spent by the physicians in attending to the patients. Majority of the healthcare units in German and in entire Europe are yet to adopt full implementation of RFID system. While this creates a challenge in the provision of quality services it also offers a growth opportunity for the technology.

According to e-Health 2008, & Weerasinghe (2009) the introduction of the RFID technology in the health sector is expected to meet several requirements in the provision of services. Developing an electronic system comes about with varied specifications on the hypothesis designed for the system. The expectation of the system is that it will streamline the registration and discharge of the patient. This will consequently decrease the time used in the waiting bay and hence heighten the efficiency in the provision of services. The access to insurance details and verification becomes easier.

There is a minimal error in the process since the process does not rely on transcription or human data entry. During discharge, the patient enters the card into a reader, and the system recognises the card and matches it with the patient data and consequently update to the information portal with the necessary discharge information. The RFID technology is also expected to fulfill the government requirement for confirming verification of a patient’s identity. The various government workers often have medical covers that allow them to seek medication across various health providers. Having a RFID technology will enable the government to track the usage of the technology by their employee and also verify sickness claims by the employees.

Busch (2008) posits that RFID can facilitate health information exchange. A onetime initial registration ensures that the information is available across the reader platforms for the entire period the card is active. Any outpatient or inpatient clinics that are fitted with the RFID technology will have access to the information concerning the patients and their welfare. By prepopulating verification as well as registration screens with key data and patient identity, there is coordination of care, and this prevents the patients from having to register in the physician’s office, at the lab’s desk and reregister at the radiography section and so on.

Day & Gu (2012) posit that the RFID technology prevents duplication of such details and even fastens the process of patient care. The information on the RFID platform is also available for updating and thus any new information discovered is added to the record of the patient. Another vital reason for having RFID technology is to ensure security and privacy. The RFID technology solutions meet all the specifications concerning the security and privacy of patients, records, and ensure confidentiality of the information shared. The system also allows for time-based reporting and review of the patient data, hence protecting the health care information with encryption that only allow for authorised access to the information stored (Blobel et al. 2008). The technology can also allow for multi-factor authentication that requires the use of second security such as personal identification number. This has the capacity of providing strong authentication.

RFID also prevents duplication of records. By reducing the incidences of duplicate records, RFID reduces the expenses that are associated with the development of these records. Linking each patient to their records may seem a simple process, but the human error like the transcription of the wrong medical number can often result to issues such as matching a patient with the wrong medical record. Such a circumstance can lead to wrong medication. If such a problem is noted, the chances are that the attending physicians will create another record which will be a duplicate of the record that is not found. Ensuring the existence of one-patient-one record will incorporate the used of authenticated identifiers on the card that will help in matching the patients to their individual medical records (Emani et al. 2012). This will consequently improve the administrative functions such as billing as well as registration and consequently enhance the continuity of care. On incidences of emergency, the RFID technology can facilitate immediate identification of patients and their details.

As such, this will also ensure easier access to the details of the patient. There are instances when the patient is in a critical situation and cannot express themselves clearly in terms of giving a clear medical record. Sometimes the patients may have the problem of speech and as such expressing, their medical situation may be difficult, and this may compromise the kind of medical attention given to the patient. However, the RFID a solution since information pertinent to a patient can be retrieved from the medical data stored in the card. In the case of critical situations, RFID offers a solution by providing key relevant health information that will facilitate better treatment and diagnosis (DiSantosstefano 2007). While the patients can benefit from a quicker and improved medical treatment and care, medical centers and hospitals benefit from a better coordination and management of care from the first responders through the departments of emergency rooms.

The retrieved data can be validated by the first responder and consequently used to offer treatment to the patient (Bailey 2007). The RFID is also essential in facilitating research in the field of medicine. Consumers of the health care can facilitate research by offering the relevant information to the medical researchers. The medical reports generated from this platform are effective in undertaking research since it undertakes a consideration of the medical history of a given patient. It is possible to trace the intervention measures that have been applied to certain condition and the ones that have been successful in terminating a condition. The validity of the information is key to providing valid information on various interventions. The findings of any research are essential in developing possible future interventions to problems that may arise in the course of healthcare.

3.0 METHODOLOGY

3.1 INTRODUCTION

This study will be conducted to determine the strategy for a startup in the e-Health field. E-Health has been an issue of concern for health professionals who seek to improve the quality of the services they offer to the people. As such, issues that are pertinent to individuals in the health sector form the major basis of the study. A case study of RFID technology system will be undertaken to determine the perfect way in which improvements in the health care sector can be improved. To gather the necessary information, descriptive method will be used using the qualitative approach (Ketchen & Bergh 2006). The respondents for the study will be chosen randomly from the health sector. The survey methods will be the research method that will be used in gathering data.

The employees of the healthcare sector will be chosen to accomplish the survey questionnaire to evaluate the strategies of an entry startup in healthy and issues facing the use of RFID technology in the health sector. The credibility of the findings, as well as the conclusions, will extensively depend on the quality of data collection, research design, data analysis, and data management. This chapter is dedicated to giving an outline of the methods as well as the procedures that will be followed to obtain the data, data analysis, and how the data will be analysed and interpreted to arrive at the conclusion. This section will help in justifying the approach that will be undertaken in data mining and analysis as the ultimate way of achieving the desired results. Specifically, this section covers the research design and method, the respondents, data collection instruments, and data analysis.

3.2 RESEARCH DESIGN

The study will make use of the descriptive method of research. The descriptive method is widely accepted as a method of research that entails fact finding to ensure accurate and adequate interpretation of the findings. Descriptive research explains a certain present situation. Relatively, this method is efficient in undertaking this study since it describes the existing situation in the health sector by identifying the problems affecting the sector and consequently developing a startup strategy that will help in solving these problems. The technique that will be used under the descriptive is the normative survey approach and evaluation. This technique is commonly used to explore opinions as raised by the respondents and which are trusted to represent the whole population (Laake et al. 2007). This kind of survey is effective since it allows the researcher to form generalisations of the data collected. Specifically, the study will involve two types of data survey. These direct data survey techniques are the interviews and surveys. The interview will be done with researchers and healthy practitioners and investors as they are aware of the pertinent issues facing the health sector. The direct data type of survey is very effective and reliable since it involves the researcher getting firsthand information direct from the respondents.  The respondents for the questionnaires will be given ample time so as to assess the challenges facing the provision of better health services.

The purpose of making use of the descriptive method is to describe the nature of the condition as currently is during the time of the study. This will ensure, further, exploration of the issues causing certain occurrences on the subject of the study. The major for this kind of researcher is that the study will be in a position to obtain first-hand information that will enable sound and rational conclusions and recommendations. The descriptive study aims at gathering information regarding the current situation of the issue at hand. Two types of data will be used in this study: the primary data and the secondary data. The primary data will be obtained from the information that will retrieve from the questionnaires that will be distributed to the specific respondents. Further, primary data will be obtained from the interviews that will be conducted. These sources of primary data are essential due to their ability to offer first-hand information. Secondary data, on the other hand, will be obtained from then literature review and other published researches related to the research problem. The secondary data will be based on current information.

Regarding approach, the study will adopt the qualitative approach. The interviews and the questionnaires will form the qualitative approach of the study since it is focused on observations, personal accounts, description as well as individual insights into the issue of RFID system in the healthcare sector. The qualitative research approach is direct and aims at the detailed description. The researcher may only have a rough knowledge of what they are expecting from the study. The qualitative approach allows the design of the study to unfold as the design emerges. The data collected through the qualitative approach is often in the form of words, pictures or objects. As such the approach is a simplified one since it does not require statistical analysis. The approach is subjective in nature. The description of the information is subjective in nature (Van 1979). From the observations made from the study, the observer is at will to offer an explanation that reflects the feelings on the information collected. The analysis depends on the data collected. The qualitative research is richer as it allows the respondents an avenue to describe what they feel concerning certain issues in the research paper. The rich information, offers a wide and in-depth knowledge of the issues pertinent to the research. However, the study is time-consuming, and it may take the time to collect. The objective is to achieve quality information and hence the time was taken is a non-issue in the study. The researcher tends to be immersed subjectively in the subject matter.

3.3 DIRECT DATA SURVEY

The objective of the direct-data survey is to collect pertinent data on the issues affecting the healthcare sector. Accordingly, the direct-data survey is used to reveal the status of s particular phenomenon within an identified class of people, organisation, or even region at a certain time through the issue of interviews and questionnaires to directly collect information from the respondents. The major objective of the study is to obtain pertinent data that seeks to achieve the set objectives. The site of the study is the healthcare sector in the Unites Kingdom. The random sampling method will be used to select the institutions that will take place in the study as well as the individual respondents to participate in the study. Random sampling technique minimises the incidences of bias and hence the information obtained is reliable. There are various types of sampling, but a random sampling is considered less complex and hence easier to administer. The key thing is that this sampling eliminates bias which is one of the critical issues to consider when undertaking research (Yin 2003). This study will make use of self-administered interviews and questionnaires.

3.4 RESPONDENTS OF THE STUDY

The respondents of the study will be directly chosen from the sector health industry. This may include nurses and physicians and managers of the health institutions. To offer equal opportunities to each of the members under this category, a random sampling technique is identified as the most appropriate technique to conduct the study. Every member of the society has equal chances to be included in the study. The process will involve the definition of the population. The members will be outlined from which a sample will be selected through the random sampling method. A self-administered survey will be given to the respondents for their consequent action.

The sample size will consist of 100 participants for the questionnaire while the interviews will consist of five individuals. The same questions administered through the questionnaire will also be administered through the interview. The interviews will serve as a control mechanism for ensuring that the information collected through the questionnaires somehow agrees with the information obtained from the interviews. A period of five days will be given to the respondents to respond to the questionnaire upon request. Upon collecting the questionnaires, the information will be analysed to arrive at the discussion and conclusion of the study. On the other hand, the interviews will be given time to respond to the questions according to their desire and convenience. Choices will be given to the interviewees to either take the interview questions through phone or face-to-face. There were only five participants who will take part interview.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Appendix

Comparison between traditional system and RFID

Capability Technology	Bar Code	RFID	RFID Benefit Example
Line of Sight Requirement	Required	Not Required	No need to orientate scanned items
Number of items that can be scanned	One	Multiple	Very fast inventory scan
Automation and accuracy	Manual read errors and prone to mis-scanning	Fully automated and highly accurate	Error free inventory
Identification	Only series or type	Unique item level	Targeted recall
Data storage	Limited Codes	Up to several kB data	Real time data access in any location

Figure 1

 

 

 

Benefits of RFID

Graph 1