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Implementation of Health Information Systems
Linköping University, Department of Computer and Information Science, MDA - Human Computer Interfaces. Linköping University, The Institute of Technology.
2008 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Healthcare organizations now consider increased efficiency, reduced costs, improved patient care and quality of services, and safety when they are planning to implement new information and communication technology (ICT) based applications. However, in spite of enormous investment in health information systems (HIS), no convincing evidence of the overall benefits of HISs yet exists. The publishing of studies that capture the effects of the implementation and use of ICT-based applications in healthcare may contribute to the emergence of an evidence-based health informatics which can be used as a platform for decisions made by policy makers, executives, and clinicians. Health informatics needs further studies identifying the factors affecting successful HIS implementation and capturing the effects of HIS implementation. The purpose of the work presented in this thesis is to increase the available knowledge about the impact of the implementation and use of HISs in healthcare organizations. All the studies included in this thesis used qualitative research methods. A case study design and literature review were performed to collect data.

This thesis’s results highlight an increasing need to share knowledge, find methods to evaluate the impact of investments, and formulate indicators for success. It makes suggestions for developing or extending evaluation methods that can be applied to this area with a multi-actor perspective in order to understand the effects, consequences, and prerequisites that have to be achieved for the successful implementation and use of IT in healthcare. The results also propose that HIS, particularly integrated computer-based patient records (ICPR), be introduced to fulfill a high number of organizational, individualbased, and socio-technical goals at different levels. It is therefore necessary to link the goals that HIS systems are to fulfill in relation to short-term, middle-term, and long-term strategic goals. Another suggestion is that implementers and vendors should direct more attention to what has been published in the area to avoid future failures.

This thesis’s findings outline an updated structure for implementation planning. When implementing HISs in hospital and primary-care environments, this thesis suggests that such strategic actions as management involvement and resource allocation, such tactical action as integrating HIS with healthcare workflow, and such operational actions as user involvement, establishing compatibility between software and hardware, and education and training should be taken into consideration.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press , 2008. , 17 p.
Series
Linköping Studies in Science and Technology. Thesis, ISSN 0280-7971 ; 1387
National Category
Biomedical Laboratory Science/Technology
Identifiers
URN: urn:nbn:se:liu:diva-15677Local ID: LiU-Tek-Lic-2008:45ISBN: 978-91-7393-745-0 (print)OAI: oai:DiVA.org:liu-15677DiVA: diva2:126921
Presentation
2008-12-15, Alan Turing, hus E, Campus Valla, Linköpings universitet, Linköping, 10:15 (English)
Opponent
Supervisors
Available from: 2008-11-26 Created: 2008-11-26 Last updated: 2013-09-05Bibliographically approved
List of papers
1. Methods to Evaluate Health information Systems in Healthcare Settings: A Literature Review
Open this publication in new window or tab >>Methods to Evaluate Health information Systems in Healthcare Settings: A Literature Review
2007 (English)In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 31, no 5, 397-432 p.Article in journal (Refereed) Published
Abstract [en]

Although information technology (IT)-based applications in healthcare have existed for more than three decades, methods to evaluate outputs and outcomes of the use of IT-based systems in medical informatics is still a challenge for decision makers, as well as to those who want to measure the effects of ICT in healthcare settings. The aim of this paper is to review published articles in the area evaluations of IT-based systems in order to gain knowledge about methodologies used and findings obtained from the evaluation of IT-based systems applied in healthcare settings. The literature review includes studies of IT-based systems between 2003 and 2005. The findings show that economic and organizational aspects dominate evaluation studies in this area. However, the results focus mostly on positive outputs such as user satisfaction, financial benefits and improved organizational work. This review shows that there is no standard framework for evaluation effects and outputs of implementation and use of IT in the healthcare setting and that until today no studies explore the impact of IT on the healthcare system’ productivity and effectiveness.

Place, publisher, year, edition, pages
Springer, 2007
Keyword
Evaluation studies, Medical informatics, Literature review
National Category
Biomedical Laboratory Science/Technology
Identifiers
urn:nbn:se:liu:diva-15650 (URN)10.1007/s10916-007-9082-z (DOI)
Available from: 2008-11-26 Created: 2008-11-25 Last updated: 2017-12-14Bibliographically approved
2. Implementing an integrated computerized patient record system: Towards an evidence-based information system implementation practice in healthcare
Open this publication in new window or tab >>Implementing an integrated computerized patient record system: Towards an evidence-based information system implementation practice in healthcare
2008 (English)In: AMIA 2008 Annual Symposium, Biomedical and Health Informatics:form foundations to applications to policy. Washington DC. 8-12 November 2008, 2008, 616-620 p.Conference paper, Published paper (Refereed)
Abstract [en]

A large number of health information system (HIS) implementations fail due to insufficient organizational harmonization. The aim of this study is to examine whether these problems remain when implementing technically integrated and more advanced generations of HIS. In a case study, data from observations, interviews, and organizational documents were analyzed using qualitative methods. We found that critical issues in the case study implementation process were the techniques employed to teach the staff to use the integrated system, involvement of the users in the implementation process, and the efficiency of the human computer interface. Comparisons with a literature review showed both recurrence of previously reported implementation problems and new issues specific to the integrated system context. The results indicate that the development of evidence-based implementation processes should be considered.

Series
AMIA Annual Symposium Proceedings, ISSN 1942-597X
National Category
Biomedical Laboratory Science/Technology
Identifiers
urn:nbn:se:liu:diva-15672 (URN)
Available from: 2008-11-26 Created: 2008-11-26 Last updated: 2015-05-28Bibliographically approved
3. Health Information System Implementation: A Qualitative Meta-analysis
Open this publication in new window or tab >>Health Information System Implementation: A Qualitative Meta-analysis
2009 (English)In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 33, no 5, 359-368 p.Article in journal (Refereed) Published
Abstract [en]

Healthcare information systems (HISs) are often implemented to enhance the quality of care and the degree to which it is patient-centered, as well as to improve the efficiency and safety of services. However, the outcomes of HIS implementations have not met expectations. We set out to organize the knowledge gained in qualitative studies performed in association with HIS implementations and to use this knowledge to outline an updated structure for implementation planning. A multi-disciplinary team performed the analyses in order to cover as many aspects of the primary studies as possible. We found that merely implementing an HIS will not automatically increase organizational efficiency. Strategic, tactical, and operational actions have to be taken into consideration, including management involvement, integration in healthcare workflow, establishing compatibility between software and hardware and, most importantly, user involvement, education and training. The results should be interpreted as a high-order scheme, and not a predictive theory.

Place, publisher, year, edition, pages
Springer Netherlands, 2009
Keyword
Health information system, Implementation, Qualitative methods, Meta-analysis
National Category
Biomedical Laboratory Science/Technology
Identifiers
urn:nbn:se:liu:diva-15673 (URN)10.1007/s10916-008-9198-9 (DOI)
Note
The original publication is available at www.springerlink.com: Bahlol Rahimi, Vivian Vimarlund and Toomas Timpka, Health Information System Implementation: A Qualitative Meta-analysis, 2009, Journal of medical systems, (33), 5, 359-368. http://dx.doi.org/10.1007/s10916-008-9198-9 Copyright: Springer Science Business Media http://www.springerlink.com/ Available from: 2008-11-26 Created: 2008-11-26 Last updated: 2017-12-14Bibliographically approved

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