AWERProcedia Information Technology & Computer Science

AWERProcedia Information Technology & Computer Science Vol 03 (2013) 68-73

3rd World Conference on Information Technology (WCIT-2012)

Measuring Knowledge Transfer of Wireless Healthcare Applications in Malaysian Rural Area: A Case Study in Malaysian Northern Region Noraziah ChePa *, School of Computing, University Utara Malaysia, 06010 UUM Sintok, Kedah, Malaysia / ITU-UUM, University Utara Malaysia, 06010 UUM Sintok, Kedah, Malaysia. Massudi Mahmudin, School of Computing, University Utara Malaysia, 06010 UUM Sintok, Kedah, Malaysia. Mazida Ahmad, School of Computing, University Utara Malaysia, 06010 UUM Sintok, Kedah, Malaysia. Mawarny Md Rejab, School of Computing, University Utara Malaysia, 06010 UUM Sintok, Kedah, Malaysia. Rosmadi Bakar, School of Computing, University Utara Malaysia, 06010 UUM Sintok, Kedah, Malaysia. Ahmad Tajudin Baharin, School of Computing, University Utara Malaysia, 06010 UUM Sintok, Kedah, Malaysia. Suggested Citation: ChePa, N., Mahmudin, M., Ahmad, M., Rejab, M., Bakar, R. & Baharin, T., A. Measuring Knowledge Transfer of Wireless Healthcare Applications in Malaysian Rural Area: A Case Study in Malaysian Northern Region, AWERProcedia Information Technology & Computer Science. [Online]. 2013, 3, pp 68-73. Available from: rd http://www.world-education-center.org/index.php/P-ITCS. Proceedings of 3 World Conference on Information Technology (WCIT-2012), 14-16 November 2012, University of Barcelon, Barcelona, Spain. Received 19 Feburary, 2013; revised 5 June, 2013; accepted 8 September, 2013. Selection and peer review under responsibility of Prof. Dr. Hafize Keser. ©2013 Academic World Education & Research Center. All rights reserved. Abstract Focusing on reducing the digital gaps among rural communities in Malaysia, particularly in obtaining online medical services, this paper discusses how medical knowledge has been transferred from medical experts to rural communities through wireless healthcare applications. Wireless healthcare application is an ideal solution for rural communities to obtain medical consultation due to some factors, particularly geographical factor, and it seems in line with today’s communication which is moving aggressively towards wireless approach. To measure the degree of knowledge transfer involved, an instrument was developed based on two main factors: wireless technology readiness among rural society and knowledge transfer between medical experts and rural communities. A detail research methodology used is discussed in this paper. Findings and the implications of the conducted survey in Malaysian Northern Region are also discussed and presented. Keywords: Wireless healthcare application, rural ICT, knowledge transfer; * ADDRESS FOR CORRESPONDENCE: Noraziah ChePa, School of Computing, University Utara Malaysia, 06010 UUM Sintok,

Kedah, Malaysia / ITU-UUM, University Utara Malaysia, 06010 UUM Sintok, Kedah, Malaysia, E-mail address: [email protected] / Tel.: +6012-472-6803

ChePa, N., Mahmudin, M., Ahmad, M., Rejab, M., Bakar, R. & Baharin, T., A., Measuring Knowledge Transfer of Wireless Healthcare Applications in Malaysian Rural Area: A Case Study in Malaysian Northern Region, AWERProcedia Information Technology & Computer Science. [Online]. 2013, 3, pp 68-73. Available from: http://www.world-education-center.org/index.php/P-ITCS

1. Introduction Equal chances of accessing medical facilities can be seen as another government effort in reducing the digital gaps among rural communities in Malaysia, particularly in obtaining online medical services. Wireless healthcare application is an ideal solution for rural communities to obtain medical consultation due to some factors, particularly geographical factor, and it seems in line with today’s communication which is moving aggressively towards wireless approach. With the advancement of technology, people can get connected to medical experts through online consultation, forums and intelligent health applications. The trend, however, becomes a minor worry in terms of how well medical experts can serve people in the rural area using this alternative channel. Thus, government thinks that there is a need to study on the effectiveness of this alternative medium in serving rural communities. To answer this, this research is conducted to measure the degree of knowledge transfer between medical experts and rural communities. A survey was conducted based on two main issues: wireless technology readiness among rural society and knowledge transfer between medical experts and rural communities. However, this paper is only focusing on the degree of knowledge transfer of wireless healthcare applications, particularly in Malaysian rural area. This paper discusses briefly on wireless healthcare application in Section 2. Section 3 shows how knowledge transfer happened in healthcare applications. Research methodology is covered in Section 4, while findings and conclusion are covered in Section 5 and 6 respectively. 2. Wireless Healthcare Applications Regardless of geographical factors, everyone deserves to have an equal access to healthcare facilities. Although there are many Klinik Desa available in Malaysian rural areas, the provided healthcare facilities still require more improvement in terms of the facilities provided particularly on accessing the medical expert or physician services. Problem becomes worst due to insufficiency of trained medical professional or physicians to the ratio of the existing population of a rural area In fact, most physicians are not prepared to be placed in the rural area. There is a trend to doctors in Malaysia who are reluctant to serve in Malaysia after they graduated [12] particularly in rural area. Various factors contribute to this issue such as the geographical barrier, and lack of financial entitlements to services among poor population, which not attract the physicians. Realizing this, Malaysian government has initiated a national broadband strategy [10] to ensure that every Malaysian citizen including people in rural areas can be reached by using the Internet access. By initiating the effort, community can be served better by the government, especially in healthcare system by providing a platform between medical professionals (medical officers and other medical practitioners) and community in transferring healthcare knowledge. Wireless healthcare application is one of the solutions to enable the use of ICT such as computers, smart phones, Personnel Digital Assistance (PDA) and other devices which are connected with unwired internet services for accessing healthcare services and information. Wireless medical applications can serve as a platform that enables communication between medical experts and everyone in community in sharing healthcare information and knowledge. Since accessibility and mobility requirements are no longer an issue, wireless is a preferred medium in accessing medical applications [6].Wireless healthcare application is a solution to enable the use of ICT such as computers, smart phones, Personnel Digital Assistance (PDA) and other devices which are connected with unwired internet services for accessing information and healthcare services. This application includes the use of ICT devices in collecting community and clinical health data, delivering healthcare information to patients, and direct provision of care via mobile telemedicine [6].

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Various wireless healthcare applications have been developed. For instance, Mobihealth is a project based on a European initiative to create a generic platform for home healthcare using Body Area Network (BAN)-based sensors and wireless telephony technology. This project would increase mobility and out of hospital care and monitoring [5]. Another project namely CONNECT is basically developed for creating solutions to help disable people in getting healthcare services. This application enables them to customize their portable devices such as PDA to keep schedules for them, receive important reminders and allow them to communicate with their caregivers using PDA. 3. Knowledge Transfer in Healthcare Healthcare industry is increasingly becoming a knowledge-based community that requires a connection between several parties including medical professionals and patients in sharing knowledge to improve the quality of healthcare [2]. The success of healthcare depends on the knowledge management solution by utilizing information or knowledge between medical professionals and patients. Indeed, knowledge management provides a mechanism for effective knowledge transfer in order to help medical professionals dealing with patients [3]. The current issue is how to disseminate the healthcare information and knowledge particularly for patients who live in rural area. Thus, knowledge management is believed to be the current solution in healthcare environment due to pitfalls in providing a mechanism for the effective transfer of the acquired knowledge to the rural communities [3,8]. Knowledge management is more than the centralized repository healthcare data and information [4]. According to Hsia et al. (2006), knowledge management involves four cyclic process namely knowledge creation, knowledge codification, knowledge transfer, and knowledge application. In terms of knowledge and capability transfer, knowledge transfer enhances patient care. Knowledge transfer is related to idea of skills or capability transfer, including the behaviour or attitude in willingness to transfer the required healthcare knowledge. In order to improve knowledge transfer in healthcare environment, rigorous results tracking capability incorporated are needed. The measurement can be done in terms of outcomes, processes and satisfactions of medical experts or patients towards the knowledge transfer facilities by using surveys or other measurement technique. Ultimately, technology and infrastructure are vital to enable knowledge transfer activities in healthcare environment such as telemedicine, tele-health, and wireless application. This study is focusing on knowledge transfer involved in healthcare wireless applications. 4. Methodology Research was conducted in six (6) main phases: theoretical study, pre-test study which involved instrument development and instrument refinement, pilot test, data collection, data analysis and research conclusion. Research instrument was constructed by adapting the instrument from Merza and [9,11] in the healthcare context. The investigated factors in this study are Socialization, Externalization, Combination and Internalization (SECI model) of managing patients’ healthcare. Four research hypotheses are formulated to answer the research questions, as shown in Table 1.

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Table 1. Research hypotheses # H1 H2

H3

H4

Hypotheses The internalization process contributes positively to new knowledge creation in term of healthcare knowledge among rural community. Interaction between people from rural area and medical experts in Socialization process contributes positively to rural community tacit knowledge transformation in an understandable form for Externalization process. Transformation of healthcare knowledge into understandable form in Externalization process contributes positively towards a complex and systematic knowledge for Combination process. Updating healthcare knowledge in Combination process contributes positively to the development of rural community’s healthcare knowledge for Internalization process.

Pilot study was conducted in Kubang Pasu district; it involved 27 respondents from different areas. While for data collection, Baling and Kupang, two rural districts of Kedah were chosen. 435 questionnaires have been distributed and 100% answered questionnaires were received. However, only 245 reliable ones were analysed. For this study, minimum total number of sample size that has been suggested [7] is 204, while our cleaned respondents is 245 with precision of ±7% and confidence level 95% and P=.5. Data were analyzed using SPSS 18.0, and SmartPLS was used to analyze the hypothesized model. 5. Findings and Discussion Path analysis was used to test the four hypotheses as illustrated in Figure 1. SmartPLS was utilised to generate this figure. The R2 value was 0.038 suggesting that 3.8% of the variance in Socialization can be explained by Internalization which is weak. There was a positive relationship (ß = 0.195, p < 0.05) between Internalization and Socialization. The R2 value was 0.253 suggesting that 25.3 % of the variance in Externalization can be explained by Socialization which is moderate. According to Cohen (1988), R2 values are substantial (0.26), moderate (0.13) and weak (0.02). The regression weight from Socialization to Externalization was positively significant (ß = 0.503, p < 0.05). The R2 value was 0.293 suggesting that 29.3 % of the variance in Combination can be explained by Externalization which is substantial. The coefficient value of Externalization to Combination was also positively significant (ß = 0.542, p < 0.05). However, there was no relationship between Combination and Internalization which result R2 value was 0.00 suggesting that 0% of the variance in Internalization can be explained by Combination. Thus H1, H2 and H3 of this study were supported whereas H4 was not. Table 2 summarizes the findings.

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Figure 1. Hypothesized model Table 2. Path coefficients an hypothesis testing Hypotheses

Relationship

H1 H2 H3 H4

Internalization →Socialization Socialization →Externalization Externalization →Combination Combination →Internalization

Coefficient β 0.195 0.503 0.541 -

t-value 2.728343 9.838769 10.80706 -

Supported Yes Yes Yes -

6. Conclusion Overall, knowledge transfer process between medical professionals and patient in rural area covers each process in SECI model. Patients strongly rely on social interaction with medical professionals in gaining healthcare information. This finding is supported [9] who concludes that the involvement of experts in the socialization process is high in delivering knowledge to the novice. There are many wireless applications for healthcare information in Malaysia that match rural communities’ requirements. Online consultation is one of the main applications where rural community can get medical professionals expertise / consults on relevant healthcare’s necessities. Our research reveals that currently online interactions are done by using online email or forum discussion in posted website. Acknowledgement Authors would like to acknowledge ITU-CoE and Center of Research and Innovation Management (RIMC) of Universiti Utara Malaysia for the management and financial support. This work is a part of ITU-UUM Grant (S/O Code 21110).

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