Electronic Medical Record Implementation Challenges for the National Health System in Greece

2018 ◽  
Vol 7 (1) ◽  
pp. 16-30 ◽  
Author(s):  
Dimitrios G. Katehakis
Keyword(s):  
Health System ◽  
Medical Record ◽  
Electronic Medical Record ◽  
National Health ◽  
National Health System ◽  
Public Hospitals ◽  
Medical Decision ◽  
Significant Information ◽  
Implementation Challenges ◽  
Clinically Significant

The purpose of this work is to expose challenges related to the implementation of quality electronic medical record (EMR) systems in public hospitals in Greece, a country where the national health system (NHS) has already acquired electronic medical records (EMRs). The level of EMR implementation, together with organizational maturity at a hospital level, are explored. What is discovered is that there are different adoption levels, not recorded in a systematic manner. The majority of physicians are either reluctant to implement EMRs or do not know options available to them. Implications include not continuous flow of events, cut off of critical information, lower quality of health services, patients not empowered to carry with them clinically significant information, unnecessary repetition of medical procedures and higher costs. It is concluded that focus should be paid on enabling the use of quality, interoperable and secure EMRs to better support medical decision, in an effort to improve the health of the population and to better control costs.

Electronic Medical Record Implementation Challenges for the National Health System in Greece

2020 ◽  
pp. 1450-1466
Author(s):  
Dimitrios G. Katehakis
Keyword(s):  
Health System ◽  
Medical Record ◽  
Electronic Medical Record ◽  
National Health ◽  
National Health System ◽  
Public Hospitals ◽  
Medical Decision ◽  
Implementation Challenges ◽  
Organizational Maturity ◽  
Clinically Significant

The purpose of this work is to expose challenges related to the implementation of quality electronic medical record (EMR) systems in public hospitals in Greece, a country where the national health system (NHS) has already acquired electronic medical records (EMRs). The level of EMR implementation, together with organizational maturity at a hospital level, are explored. What is discovered is that there are different adoption levels, not recorded in a systematic manner. The majority of physicians are either reluctant to implement EMRs or do not know options available to them. Implications include not continuous flow of events, cut off of critical information, lower quality of health services, patients not empowered to carry with them clinically significant information, unnecessary repetition of medical procedures and higher costs. It is concluded that focus should be paid on enabling the use of quality, interoperable and secure EMRs to better support medical decision, in an effort to improve the health of the population and to better control costs.

scholarly journals The Trials and Tribulations of the National Health System (ESY) in Greece: A Chronicle of Unfulfilled Promises

2021 ◽  
Vol 17 ◽  
pp. 115
Author(s):  
Anastas Philalithis
Keyword(s):  
Health Care ◽  
World War Ii ◽  
Primary Health Care ◽  
Health System ◽  
National Health ◽  
National Health System ◽  
Public Hospitals ◽  
Primary Health ◽  
Vested Interests ◽  
The Creation

The creation of the National Health System (ESY) in the 1980s is a majorlandmark in the development of the welfare state in Greece during the metapolitefsi (regime change) period. An ambitious effort to reform the fragmented, ineffective health services of the post-World War II period, it achieved a major reorganisation of public hospitals and the establishment of rural health centres providing primary health care. Yet its promise of high-quality services for all was not fulfilled, since vested interests blocked its full implementation. While the fiscal crisis of the 2010s was the catalyst for theunification of the health insurance funds, the creation of integrated primary health care intowns failed once again. This article examines the achievements and failures of the reform in light of the political and social factors that shaped this era.

scholarly journals Risk-adjustment models for clean and colorectal surgery surgical site infection for the Spanish health system

2020 ◽  
Vol 32 (9) ◽  
pp. 599-608
Author(s):  
Daniel Angel García ◽  
Ismael Martínez Nicolás ◽  
José Andrés García Marín ◽  
Victoriano Soria Aledo
Keyword(s):  
Colorectal Surgery ◽  
Literature Review ◽  
Surgical Site Infection ◽  
Health System ◽  
National Health ◽  
Risk Adjustment ◽  
National Health System ◽  
Public Hospitals ◽  
Site Infection ◽  
Spanish National Health System

Abstract Objective To develop risk-adjusted models for two quality indicators addressing surgical site infection (SSI) in clean and colorectal surgery, to be used for benchmarking and quality improvement in the Spanish National Health System. Study design A literature review was undertaken to identify candidate adjustment variables. The candidate variables were revised by clinical experts to confirm their clinical relevance to SSI; experts also offered additional candidate variables that were not identified in the literature review. Two risk-adjustment models were developed using multiple logistic regression thus allowing calculation of the adjusted indicator rates. Data source The two SSI indicators, with their corresponding risk-adjustment models, were calculated from administrative databases obtained from nine public hospitals. A dataset was obtained from a 10-year period (2006–2015), and it included data from 21 571 clean surgery patients and 6325 colorectal surgery patients. Analysis methods Risk-adjustment regression models were constructed using Spanish National Health System data. Models were analysed so as to prevent overfitting, then tested for calibration and discrimination and finally bootstrapped. Results Ten adjustment variables were identified for clean surgery SSI, and 23 for colorectal surgery SSI. The final adjustment models showed fair calibration (Hosmer–Lemeshow: clean surgery χ2 = 6.56, P = 0.58; colorectal surgery χ2 = 6.69, P = 0.57) and discrimination (area under receiver operating characteristic [ROC] curve: clean surgery 0.72, 95% confidence interval [CI] 0.67–0.77; colorectal surgery 0.62, 95% CI 0.60–0.65). Conclusions The proposed risk-adjustment models can be used to explain patient-based differences among healthcare providers. They can be used to adjust the two proposed SSI indicators.

scholarly journals Multilevel Analysis of the Relationship between Ownership Structure and Technical Efficiency Frontier in the Spanish National Health System Hospitals

2020 ◽  
Vol 17 (16) ◽  
pp. 5905 ◽  
Author(s):  
Mª Isabel Ortega-Díaz ◽  
Ricardo Ocaña-Riola ◽  
Carmen Pérez-Romero ◽  
José Jesús Martín-Martín
Keyword(s):  
Health System ◽  
Technical Efficiency ◽  
National Health ◽  
Ownership Structure ◽  
National Health System ◽  
Public Hospitals ◽  
Efficiency Frontier ◽  
Spanish National Health System ◽  
Generalised Linear Mixed Model ◽  
The Relationship

Objective: To evaluate the relationship between the ownership structure of hospitals and the possibility of their being positioned on the frontier of technical efficiency in the economic crisis period 2010–2012, adjusting for hospital variables and regional characteristics in the areas where the Spanish National Health System (SNHS) hospitals are located. Methods: 230 National Health System hospitals were studied over the two-year period 2010–2012 according to their ownership structure—public hospitals, private hospitals and public–private partnership (PPP)—data envelopment analysis orientated to inputs was used to measure the overall technical efficiency, pure efficiency and efficiency of scale. A generalised linear mixed model (GLMM) with binomial distribution and logit link function was used to analyse the hospital and regional variables associated with positioning on the frontier. Results: There are substantial differences between the average pure technical efficiency of public, private and PPP hospitals, as well as a greater number of PPP models being positioned on the efficiency frontier (91.67% in 2012). The odds of being positioned on the frontier are 41.7 times higher in PPP models than in public hospitals. The average annual household income per region is related to the greater odds of hospitals being positioned on the frontier of efficiency. Conclusions: During the most acute period of recession in the Spanish economy, PPP formulas favoured hospital efficiency, by increasing the odds of being positioned on the frontier of efficiency when compared to private and public hospitals. The position on the frontier of efficiency of a hospital is related to the wealth of its region.

Experience in applying the effectiveness audit methodology in order to save budget funds for the purchase of medicines in the UK

2020 ◽  
pp. 82-87
Author(s):  
S. S. Budarin ◽  
N. V. Yurgel
Keyword(s):  
United Kingdom ◽  
Health System ◽  
National Health ◽  
Sharp Increase ◽  
National Health System ◽  
Pharmaceutical Market ◽  
National Audit ◽  
Drug Pricing ◽  
The United Kingdom ◽  
The Uk

The article examines the experience of the national audit office of the United Kingdom in conducting an audit of the effectiveness of budget funds aimed at providing medicines to English citizens. The reasons for the sharp increase in budget expenditures for providing the population with reproduced medicines in 2017—2018 are described in detail.The article analyzes the shortcomings of the system of regulation of drug pricing procedures and the resulting risks to the budget of the national health system in United Kingdom.It is concluded that the effectiveness audit has allowed us to identify not only the reasons for significant overspending of the NHS budget to provide the population with medicines, but also to assess the actions of organizations authorized by the UK Government to address issues of regulation of the pharmaceutical market.

I limiti del tempo in un tempo di limiti

2009 ◽  
pp. 55-62
Author(s):  
Fabrizio Rizzi
Keyword(s):  
Health System ◽  
Key Words ◽  
Community Service ◽  
National Health ◽  
National Health System ◽  
Short Term ◽  
Intellectual Honesty ◽  
Life Itself ◽  
Environmental Limits

- This article recounts the doubts and fears of an experienced analyst who is now an apprentice acrobat. He is forced to keep himself tiredly balanced between psychological and physical limits imposed by age, restrictions introduced by the National Health System and categories of patients who have precedence over others. He cannot receive all of the patients who ask for him and even those who he does receive will have to be discharged in the short term. Explaining to them, with intellectual honesty, that the community service has rules that limit his wishes as well. What can this be if not acrobatics? In the end it means combining the contradictory but perhaps also the most real aspects of life itself. [KEY WORDS: desires, personal and environmental limits, truth of the therapist]

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