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  • 1. Beställ onlineKöp publikationen >>
    Rahimi, Bahlol
    Linköpings universitet, Institutionen för datavetenskap, MDALAB - Human Computer Interfaces. Linköpings universitet, Tekniska högskolan.
    Supporting Collaborative Work through ICT: How End-users Think of and Adopt Integrated HealthInformation Systems2009Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Health Information Systems (HISs) are implemented to support individuals,organizations, and society, making work processes integrated andcontributing to increase service quality and patient safety. However, theoutcomes of many HIS implementations in both primary care and hospitalsettings have either not met yet all the expectations decision-makersidentified or have failed in their implementation. There is, therefore, agrowing interest in increasing knowledge about prerequisites to be fulfilledin order to make the implementation and adoption of HIS more effective andto improve collaboration between healthcare providers.

    The general purpose of the work presented in this thesis is to explore issuesrelated to the implementation, use, and adoption of HISs and its contributionfor improving inter- and intra-organizational collaboration in a healthcarecontext. The studies included have, however, different research objectivesand consequently used different research methods such as case study,literature review, meta-analysis, and surveys. The selection of the researchmethodology has thus depended on the aim of the studies and their expectedresults.

    In the first study performed we showed that there is no standard frameworkto evaluate effects and outputs of implementation and use of ICT-basedapplications in the healthcare setting, which makes the comparison ofinternational results not possible yet.

    Critical issues, such as techniques employed to teach the staff when usingintegrated system, involvement of the users in the implementation process,and the efficiency of the human computer interface were particularlyreported in the second study included in this thesis. The results of this studyalso indicated that the development of evidence-based implementation processes should be considered in order to diminish unexpected outputs thataffect users, patients and stakeholders.

    We learned in the third study, that merely implementing of a HIS will notautomatically increase organizational efficiency. Strategic, tactical, andoperational actions have to be taken into consideration, includingmanagement involvement, integration in healthcare workflow, establishingcompatibility between software and hardware, user involvement, andeducation and training.

    When using an Integrated Electronic Prescribing System (IEPS), pharmaciesstaff declared expedited the processing of prescriptions, increased patientsafety, and reduced the risk for prescription errors, as well as the handingover of erroneous medications to patients. However, they stated also that thesystem does not avoid all mistakes or errors and medication errors stilloccur. We documented, however, in general, positive opinions about theIEPS system in the fifth article. The results in this article indicated thatsafety of the system compared to a paper-based one has increased. Theresults showed also an impact on customer relations with the pharmacy; andprevention of errors. However, besides finding an adoption of the IEPS, weidentified a series of undesired and non planned outputs that affect theefficiency and efficacy of use of the system.

    Finally, we captured in the sixth study indications for non-optimality in thecomputer provider entry system. This is because; the system was not adaptedto the three-quarters of physicians and one-half of nurses’ specificprofessional practice. Respondents pointed out also human-computerinteraction constrains when using the system. They indicated also the factthat the system could lead to adverse drug events in some circumstances.

    The work presented in this thesis contributes to increase knowledge in thearea of health informatics on how ICT supports inter- and intraorganizationalcollaborative work in a healthcare context and to identifyfactors and prerequisites needed to be taken into consideration whenimplementing new generations of HIS.

    Delarbeten
    1. Methods to Evaluate Health information Systems in Healthcare Settings: A Literature Review
    Öppna denna publikation i ny flik eller fönster >>Methods to Evaluate Health information Systems in Healthcare Settings: A Literature Review
    2007 (Engelska)Ingår i: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 31, nr 5, s. 397-432Artikel i tidskrift (Refereegranskat) 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.

    Ort, förlag, år, upplaga, sidor
    Springer, 2007
    Nyckelord
    Evaluation studies, Medical informatics, Literature review
    Nationell ämneskategori
    Biomedicinsk laboratorievetenskap/teknologi
    Identifikatorer
    urn:nbn:se:liu:diva-15650 (URN)10.1007/s10916-007-9082-z (DOI)
    Tillgänglig från: 2008-11-26 Skapad: 2008-11-25 Senast uppdaterad: 2022-03-08Bibliografiskt granskad
    2. Implementing an integrated computerized patient record system: Towards an evidence-based information system implementation practice in healthcare
    Öppna denna publikation i ny flik eller fönster >>Implementing an integrated computerized patient record system: Towards an evidence-based information system implementation practice in healthcare
    2008 (Engelska)Ingår i: AMIA 2008 Annual Symposium, Biomedical and Health Informatics:form foundations to applications to policy. Washington DC. 8-12 November 2008, 2008, s. 616-620Konferensbidrag, Publicerat paper (Refereegranskat)
    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.

    Serie
    AMIA Annual Symposium Proceedings, ISSN 1942-597X
    Nationell ämneskategori
    Biomedicinsk laboratorievetenskap/teknologi
    Identifikatorer
    urn:nbn:se:liu:diva-15672 (URN)
    Tillgänglig från: 2008-11-26 Skapad: 2008-11-26 Senast uppdaterad: 2022-03-08Bibliografiskt granskad
    3. Health Information System Implementation: A Qualitative Meta-analysis
    Öppna denna publikation i ny flik eller fönster >>Health Information System Implementation: A Qualitative Meta-analysis
    2009 (Engelska)Ingår i: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 33, nr 5, s. 359-368Artikel i tidskrift (Refereegranskat) 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.

    Ort, förlag, år, upplaga, sidor
    Springer Netherlands, 2009
    Nyckelord
    Health information system, Implementation, Qualitative methods, Meta-analysis
    Nationell ämneskategori
    Biomedicinsk laboratorievetenskap/teknologi
    Identifikatorer
    urn:nbn:se:liu:diva-15673 (URN)10.1007/s10916-008-9198-9 (DOI)
    Anmärkning
    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/ Tillgänglig från: 2008-11-26 Skapad: 2008-11-26 Senast uppdaterad: 2022-03-08Bibliografiskt granskad
    4. Integrated electronic prescribing systems: pharmacists’ perceptions ofimpact on work performance and patient safety
    Öppna denna publikation i ny flik eller fönster >>Integrated electronic prescribing systems: pharmacists’ perceptions ofimpact on work performance and patient safety
    2009 (Engelska)Ingår i: Proceedings of the 9th WSEAS International Conference on APPLIED INFORMATICS AND COMMUNICATIONS (AIC '09), 2009, s. 299-304Konferensbidrag, Publicerat paper (Övrigt vetenskapligt)
    Abstract [en]

    Integrated electronic prescribing systems (IEPSs) are expected to improve efficiency and safety inthe management of pharmaceuticals throughout the healthcare sector. We examined the introduction of anIEPS into pharmacists’ work performance with regard to impact on efficiency and patient safety. Aquestionnaire was distributed to all pharmacists (n = 85) in a Swedish municipality (pop. 145,000) where anIEPS had recently been introduced. The response rate was 74%. We found that, in general, the IEPS wasperceived to have expedited the processing of prescriptions and reduced the risk for prescription errors, as wellas the handing over of erroneous medications to patients. Pharmacists were more cautious about the residualrisks for making mistakes than the pharmacist’s assistants. We conclude that the introduction of an IEPS waswell received by local-level pharmacy staff, but that an IEPS does not automatically reduce the need forqualified personnel in the management of pharmaceuticals.

    Nyckelord
    Electronic prescribing, pharmacist, patient safety, work performance
    Nationell ämneskategori
    Teknik och teknologier
    Identifikatorer
    urn:nbn:se:liu:diva-20568 (URN)000273271800052 ()978-960-474-107-6 (ISBN)
    Tillgänglig från: 2009-09-14 Skapad: 2009-09-14 Senast uppdaterad: 2022-03-08Bibliografiskt granskad
    5. Introduction of an Integrated ElectronicPrescribing System: The Pharmacies StaffDimension
    Öppna denna publikation i ny flik eller fönster >>Introduction of an Integrated ElectronicPrescribing System: The Pharmacies StaffDimension
    2009 (Engelska)Ingår i: The 14th International Symposium for Health Information ManagementResearch (ISHIMR), Kalmar, Sweden, 14-16 October, 2009Konferensbidrag, Publicerat paper (Övrigt vetenskapligt)
    Abstract [en]

    An integrated electronic prescribing system allows the transfer of pharmaceutical prescriptionsfrom doctors to pharmacies. Using a questionnaire, we gathered data from the pharmacies staffin a Swedish county council. We found that most of the pharmacists have positive opinions aboutthe system. The participants in the survey indicated, as important issues, the safety of the systemcompared to a paper-based one; impact on customer relations with the pharmacy; and preventionof errors. However, it was stated that errors occur due to similar drug names, codes, or due theinability of doctors to cancel the prescription once it is send to the pharmacy. Future feasibility ofthis technology will be determined by whether several obstacles can be resolved such ascorrection or cancellation of prescriptions by physicians, decreasing the computer problems, andattending different risks related to the prescriptions including confusion between different patientsand different drugs.

    Nyckelord
    Electronic prescribing, pharmacists, patient safety, work process
    Nationell ämneskategori
    Teknik och teknologier
    Identifikatorer
    urn:nbn:se:liu:diva-20570 (URN)
    Tillgänglig från: 2009-09-14 Skapad: 2009-09-14 Senast uppdaterad: 2022-03-08Bibliografiskt granskad
    6. Organization-wide adoption of computerized provider order entry systems: a study based on diffusion of innovations theory
    Öppna denna publikation i ny flik eller fönster >>Organization-wide adoption of computerized provider order entry systems: a study based on diffusion of innovations theory
    Visa övriga...
    2009 (Engelska)Ingår i: BMC Medical Informatics and Decision Making, E-ISSN 1472-6947, Vol. 9, nr 52Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background: Computerized provider order entry (CPOE) systems have been introduced to reduce medication errors, increase safety, improve work-flow efficiency, and increase medical service quality at the moment of prescription. Making the impact of CPOE systems more observable may facilitate their adoption by users. We set out to examine factors associated with the adoption of a CPOE system for inter-organizational and intra-organizational care. Methods: The diffusion of innovation theory was used to understand physicians and nurses attitudes and thoughts about implementation and use of the CPOE system. Two online survey questionnaires were distributed to all physicians and nurses using a CPOE system in county-wide healthcare organizations. The number of complete questionnaires analyzed was 134 from 200 nurses (67.0%) and 176 from 741 physicians (23.8%). Data were analyzed using descriptive-analytical statistical methods. Results: More nurses (56.7%) than physicians (31.3%) stated that the CPOE system introduction had worked well in their clinical setting (P andlt; 0.001). Similarly, more physicians (73.9%) than nurses (50.7%) reported that they found the system not adapted to their specific professional practice (P = andlt; 0.001). Also more physicians (25.0%) than nurses (13.4%) stated that they did want to return to the previous system (P = 0.041). We found that in particular the received relative advantages of the CPOE system were estimated to be significantly (P andlt; 0.001) higher among nurses (39.6%) than physicians (16.5%). However, physicians agreements with the compatibility of the CPOE and with its complexity were significantly higher than the nurses (P andlt; 0.001). Conclusions: Qualifications for CPOE adoption as defined by three attributes of diffusion of innovation theory were not satisfied in the study setting. CPOE systems are introduced as a response to the present limitations in paper-based systems. In consequence, user expectations are often high on their relative advantages as well as on a low level of complexity. Building CPOE systems therefore requires designs that can provide rather important additional advantages, e. g. by preventing prescription errors and ultimately improving patient safety and safety of clinical work. The decision-making process leading to the implementation and use of CPOE systems in healthcare therefore has to be improved. As any change in health service settings usually faces resistance, we emphasize that CPOE system designers and healthcare decision-makers should continually collect users feedback about the systems, while not forgetting that it also is necessary to inform the users about the potential benefits involved.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-53838 (URN)10.1186/1472-6947-9-52 (DOI)000273910200001 ()
    Anmärkning
    Original Publication: Bahlol Rahimi, Toomas Timpka, Vivian Vimarlund, Srinivas Uppugunduri and Mikael Svensson, Organization-wide adoption of computerized provider order entry systems: a study based on diffusion of innovations theory, 2009, BMC MEDICAL INFORMATICS AND DECISION MAKING, (9), 52, . http://dx.doi.org/10.1186/1472-6947-9-52 Licensee: BioMed Central http://www.biomedcentral.com/. On the day of the defence date the original title of this article was "Adoption of computerized provider order entry systems: An organization-wide study based on diffusion of innovations theory".Tillgänglig från: 2010-02-05 Skapad: 2010-02-05 Senast uppdaterad: 2022-05-10Bibliografiskt granskad
    Ladda ner fulltext (pdf)
    Supporting Collaborative Work through ICT : How End-users Think of and Adopt Integrated Health Information Systems
    Ladda ner (pdf)
    Cover
  • 2.
    Rahimi, Bahlol
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för datavetenskap, EISLAB - Economic Information Systems.
    What kinds of intangible are important to identify and measure?2007Ingår i: Medinfo 2007,2007, Australia: HISA ltd Australia , 2007, s. p209-Konferensbidrag (Refereegranskat)
    Abstract [en]

    Information technology has the power to increase the quality of work creating accurate and update data, but gives the organization the capacity reduce cost of coordination, communications, and information processing. In this poster we identify a number of intangible outputs that can be important to measure in medical informatics area. Three categories of outputs, namely technical, individual and organizational, are suggested to specially give attention to and to consider when discussing the intangible effects of the implementation and use of IS. 

  • 3.
    Rahimi, Bahlol
    et al.
    Linköpings universitet, Institutionen för datavetenskap, MDALAB - Human Computer Interfaces. Linköpings universitet, Tekniska högskolan.
    Moberg, Anna
    Linköpings universitet, Institutionen för datavetenskap, EISLAB - Economic Information Systems. Linköpings universitet, Tekniska högskolan.
    Timpka, Toomas
    Linköpings universitet, Institutionen för medicin och hälsa, Socialmedicin och folkhälsovetenskap. Linköpings universitet, Hälsouniversitetet.
    Vimarlund, Vivian
    Linköpings universitet, Institutionen för datavetenskap, MDALAB - Human Computer Interfaces. Linköpings universitet, Tekniska högskolan.
    Implementing an integrated computerized patient record system: Towards an evidence-based information system implementation practice in healthcare2008Ingår i: AMIA 2008 Annual Symposium, Biomedical and Health Informatics:form foundations to applications to policy. Washington DC. 8-12 November 2008, 2008, s. 616-620Konferensbidrag (Refereegranskat)
    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.

  • 4.
    Rahimi, Bahlol
    et al.
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för datavetenskap, MDALAB - Human Computer Interfaces.
    Moberg, Anna
    Vårdprocesscentrum Landstinget Östergötland.
    Timpka, Toomas
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Socialmedicin och folkhälsovetenskap. Östergötlands Läns Landsting, Folkhälsovetenskapligt centrum, Folkhälsovetenskapligt centrum.
    Vimarlund, Vivian
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för datavetenskap, MDALAB - Human Computer Interfaces.
    The voices are the same2008Ingår i: Medical Informatics Association,2008, 2008Konferensbidrag (Refereegranskat)
    Abstract [en]

       

  • 5.
    Rahimi, Bahlol
    et al.
    Linköpings universitet, Institutionen för datavetenskap, MDALAB - Human Computer Interfaces. Linköpings universitet, Tekniska högskolan.
    Timpka, Toomas
    Linköpings universitet, Institutionen för medicin och hälsa, Socialmedicin och folkhälsovetenskap. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Folkhälsovetenskapligt centrum.
    Vimarlund, Vivian
    Linköpings universitet, Institutionen för datavetenskap, MDALAB - Human Computer Interfaces. Linköpings universitet, Tekniska högskolan.
    Uppugunduri, Srinivas
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk kemi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk kemi.
    Svensson, Mikael
    Östergötland County Council, Drug and Therapeut Comm, Linkoping, Sweden .
    Organization-wide adoption of computerized provider order entry systems: a study based on diffusion of innovations theory2009Ingår i: BMC Medical Informatics and Decision Making, E-ISSN 1472-6947, Vol. 9, nr 52Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Computerized provider order entry (CPOE) systems have been introduced to reduce medication errors, increase safety, improve work-flow efficiency, and increase medical service quality at the moment of prescription. Making the impact of CPOE systems more observable may facilitate their adoption by users. We set out to examine factors associated with the adoption of a CPOE system for inter-organizational and intra-organizational care. Methods: The diffusion of innovation theory was used to understand physicians and nurses attitudes and thoughts about implementation and use of the CPOE system. Two online survey questionnaires were distributed to all physicians and nurses using a CPOE system in county-wide healthcare organizations. The number of complete questionnaires analyzed was 134 from 200 nurses (67.0%) and 176 from 741 physicians (23.8%). Data were analyzed using descriptive-analytical statistical methods. Results: More nurses (56.7%) than physicians (31.3%) stated that the CPOE system introduction had worked well in their clinical setting (P andlt; 0.001). Similarly, more physicians (73.9%) than nurses (50.7%) reported that they found the system not adapted to their specific professional practice (P = andlt; 0.001). Also more physicians (25.0%) than nurses (13.4%) stated that they did want to return to the previous system (P = 0.041). We found that in particular the received relative advantages of the CPOE system were estimated to be significantly (P andlt; 0.001) higher among nurses (39.6%) than physicians (16.5%). However, physicians agreements with the compatibility of the CPOE and with its complexity were significantly higher than the nurses (P andlt; 0.001). Conclusions: Qualifications for CPOE adoption as defined by three attributes of diffusion of innovation theory were not satisfied in the study setting. CPOE systems are introduced as a response to the present limitations in paper-based systems. In consequence, user expectations are often high on their relative advantages as well as on a low level of complexity. Building CPOE systems therefore requires designs that can provide rather important additional advantages, e. g. by preventing prescription errors and ultimately improving patient safety and safety of clinical work. The decision-making process leading to the implementation and use of CPOE systems in healthcare therefore has to be improved. As any change in health service settings usually faces resistance, we emphasize that CPOE system designers and healthcare decision-makers should continually collect users feedback about the systems, while not forgetting that it also is necessary to inform the users about the potential benefits involved.

    Ladda ner fulltext (pdf)
    FULLTEXT01
  • 6.
    Rahimi, Bahlol
    et al.
    Linköpings universitet, Institutionen för datavetenskap, MDALAB - Human Computer Interfaces. Linköpings universitet, Tekniska högskolan.
    Vimarlund, Vivian
    Linköpings universitet, Institutionen för datavetenskap, MDALAB - Human Computer Interfaces. Linköpings universitet, Tekniska högskolan.
    Introduction of an Integrated ElectronicPrescribing System: The Pharmacies StaffDimension2009Ingår i: The 14th International Symposium for Health Information ManagementResearch (ISHIMR), Kalmar, Sweden, 14-16 October, 2009Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    An integrated electronic prescribing system allows the transfer of pharmaceutical prescriptionsfrom doctors to pharmacies. Using a questionnaire, we gathered data from the pharmacies staffin a Swedish county council. We found that most of the pharmacists have positive opinions aboutthe system. The participants in the survey indicated, as important issues, the safety of the systemcompared to a paper-based one; impact on customer relations with the pharmacy; and preventionof errors. However, it was stated that errors occur due to similar drug names, codes, or due theinability of doctors to cancel the prescription once it is send to the pharmacy. Future feasibility ofthis technology will be determined by whether several obstacles can be resolved such ascorrection or cancellation of prescriptions by physicians, decreasing the computer problems, andattending different risks related to the prescriptions including confusion between different patientsand different drugs.

  • 7.
    Rahimi, Bahlol
    et al.
    Linköpings universitet, Institutionen för datavetenskap, MDALAB - Human Computer Interfaces. Linköpings universitet, Tekniska högskolan.
    Vimarlund, Vivian
    Linköpings universitet, Institutionen för datavetenskap, MDALAB - Human Computer Interfaces. Linköpings universitet, Tekniska högskolan.
    Methods to Evaluate Health information Systems in Healthcare Settings: A Literature Review2007Ingår i: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 31, nr 5, s. 397-432Artikel i tidskrift (Refereegranskat)
    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.

  • 8.
    Rahimi, Bahlol
    et al.
    Linköpings universitet, Institutionen för datavetenskap, MDALAB - Human Computer Interfaces. Linköpings universitet, Tekniska högskolan.
    Vimarlund, Vivian
    Linköpings universitet, Institutionen för datavetenskap, MDALAB - Human Computer Interfaces. Linköpings universitet, Tekniska högskolan.
    Mokhtari, Rahman
    Hospital Pharmacy, University Hospital, Linköping.
    Timpka, Toomas
    Linköpings universitet, Institutionen för medicin och hälsa, Socialmedicin och folkhälsovetenskap. Linköpings universitet, Hälsouniversitetet.
    Integrated electronic prescribing systems: pharmacists’ perceptions ofimpact on work performance and patient safety2009Ingår i: Proceedings of the 9th WSEAS International Conference on APPLIED INFORMATICS AND COMMUNICATIONS (AIC '09), 2009, s. 299-304Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    Integrated electronic prescribing systems (IEPSs) are expected to improve efficiency and safety inthe management of pharmaceuticals throughout the healthcare sector. We examined the introduction of anIEPS into pharmacists’ work performance with regard to impact on efficiency and patient safety. Aquestionnaire was distributed to all pharmacists (n = 85) in a Swedish municipality (pop. 145,000) where anIEPS had recently been introduced. The response rate was 74%. We found that, in general, the IEPS wasperceived to have expedited the processing of prescriptions and reduced the risk for prescription errors, as wellas the handing over of erroneous medications to patients. Pharmacists were more cautious about the residualrisks for making mistakes than the pharmacist’s assistants. We conclude that the introduction of an IEPS waswell received by local-level pharmacy staff, but that an IEPS does not automatically reduce the need forqualified personnel in the management of pharmaceuticals.

  • 9.
    Rahimi, Bahlol
    et al.
    Linköpings universitet, Institutionen för datavetenskap, MDALAB - Human Computer Interfaces. Linköpings universitet, Tekniska högskolan.
    Vimarlund, Vivian
    Linköpings universitet, Institutionen för datavetenskap, MDALAB - Human Computer Interfaces. Linköpings universitet, Tekniska högskolan.
    Timpka, Toomas
    Linköpings universitet, Institutionen för medicin och hälsa, Socialmedicin och folkhälsovetenskap. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Folkhälsovetenskapligt centrum.
    Health Information System Implementation: A Qualitative Meta-analysis2009Ingår i: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 33, nr 5, s. 359-368Artikel i tidskrift (Refereegranskat)
    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.

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  • 10. Beställ onlineKöp publikationen >>
    Rahimi, Bahol
    Linköpings universitet, Institutionen för datavetenskap, MDALAB - Human Computer Interfaces. Linköpings universitet, Tekniska högskolan.
    Implementation of Health Information Systems2008Licentiatavhandling, sammanläggning (Övrigt vetenskapligt)
    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.

    Delarbeten
    1. Methods to Evaluate Health information Systems in Healthcare Settings: A Literature Review
    Öppna denna publikation i ny flik eller fönster >>Methods to Evaluate Health information Systems in Healthcare Settings: A Literature Review
    2007 (Engelska)Ingår i: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 31, nr 5, s. 397-432Artikel i tidskrift (Refereegranskat) 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.

    Ort, förlag, år, upplaga, sidor
    Springer, 2007
    Nyckelord
    Evaluation studies, Medical informatics, Literature review
    Nationell ämneskategori
    Biomedicinsk laboratorievetenskap/teknologi
    Identifikatorer
    urn:nbn:se:liu:diva-15650 (URN)10.1007/s10916-007-9082-z (DOI)
    Tillgänglig från: 2008-11-26 Skapad: 2008-11-25 Senast uppdaterad: 2022-03-08Bibliografiskt granskad
    2. Implementing an integrated computerized patient record system: Towards an evidence-based information system implementation practice in healthcare
    Öppna denna publikation i ny flik eller fönster >>Implementing an integrated computerized patient record system: Towards an evidence-based information system implementation practice in healthcare
    2008 (Engelska)Ingår i: AMIA 2008 Annual Symposium, Biomedical and Health Informatics:form foundations to applications to policy. Washington DC. 8-12 November 2008, 2008, s. 616-620Konferensbidrag, Publicerat paper (Refereegranskat)
    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.

    Serie
    AMIA Annual Symposium Proceedings, ISSN 1942-597X
    Nationell ämneskategori
    Biomedicinsk laboratorievetenskap/teknologi
    Identifikatorer
    urn:nbn:se:liu:diva-15672 (URN)
    Tillgänglig från: 2008-11-26 Skapad: 2008-11-26 Senast uppdaterad: 2022-03-08Bibliografiskt granskad
    3. Health Information System Implementation: A Qualitative Meta-analysis
    Öppna denna publikation i ny flik eller fönster >>Health Information System Implementation: A Qualitative Meta-analysis
    2009 (Engelska)Ingår i: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 33, nr 5, s. 359-368Artikel i tidskrift (Refereegranskat) 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.

    Ort, förlag, år, upplaga, sidor
    Springer Netherlands, 2009
    Nyckelord
    Health information system, Implementation, Qualitative methods, Meta-analysis
    Nationell ämneskategori
    Biomedicinsk laboratorievetenskap/teknologi
    Identifikatorer
    urn:nbn:se:liu:diva-15673 (URN)10.1007/s10916-008-9198-9 (DOI)
    Anmärkning
    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/ Tillgänglig från: 2008-11-26 Skapad: 2008-11-26 Senast uppdaterad: 2022-03-08Bibliografiskt granskad
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    FULLTEXT01
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    COVER01
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