The Role of User Ownership and Positive User Attitudes in the Successful Adoption in Information Systems within NHS Community Trusts

The factors that influence the ultimate level of success or failure of systems development projects have received considerable attention in the academic literature. However, despite the existence of a ‘best practice’ literature many projects still fail. The record of the National Health Service has been particularly poor in this respect. The research reported in this paper proposes that two additional factors; user ownership and positive user attitudes warrant further development and investigation. The current study investigated these two factors in a homogenous organizational sector, Community NHS Trusts, using a common type of information system, in order to eliminate the potentially confounding influences of sector and system. A multiple case-study design incorporating five Community Healthcare Trusts was utilized. The key results from the analysis indicated that both user ownership and positive user attitudes were important mediating variables that were crucial to the success of a CIS. In addition, it was also identified that the adoption of best practice variables had a dual role, directly influencing the level of perceived success but also facilitating the development of user ownership and positive user attitudes. These results will be of particular interest to practising IM&T managers in the NHS and also to the wider academic research community.

Experiences from Health Information Systems Implementation Projects Reported in Canada Between 1991 and 1997

Canada’s Health Informatics Association has been hosting annual conferences since the 1970’s as a way of bringing information systems professionals, health practitioners, policy makers, researchers and industry together to share their ideas and experiences in the use of information systems in the health sector. This paper describes our findings on the outcome of information systems implementation projects reported at these conferences in the 1990s. Fifty implementation projects published in the conference proceedings were reviewed and the authors or designates of 24 of these projects were interviewed. The overall experiences, which are consistent with existing implementation literature, suggest the need for organizational commitment; resource support and training; managing project, change process and communication; organizational/user involvement and teams approach; system capability; information quality; and demonstrable positive consequences from computerization.

Scanning and Image Processing System (SIPS) for Medication Ordering

This chapter presents a physician order entry system in the ward (for medication prescriptions) by using scanning and image processing. Important design and operational requirements are presented. Then the scanning and imaging processing system (SIPS) is described. SIPS integrates different information technologies including scanning, bar code and other marks recognition, intelligent image capturing, server database access and retrieval, and network communication and printing. SIPS uses specially designed order forms for doctors to write orders that are then scanned into the computer that performs recognition and image processing. The resulting orders, including doctor’s handwritten images and other order information, are transmitted to the destinations electronically. SIPS reduces human effort (and errors). We observe that SIPS is an innovative use of information technology to meet the needs of a hospital that requires paper-and-pen operations. SIPS can be extended to meet other operational needs as an alternate input method.

Information System Failures in Healthcare Organizations

Preparedness for response and continued operation of a health care facility following an information systems disaster must encompass two facets: continuation of patient care delivery and continuation of business processes. This chapter reports a root cause analysis following an information system failure that compromised the organization’s ability to capture clinical documentation for a 33-hour period.

The Use of Artificial Intelligence Techniques and Applications in the Medical Domain

In recent years we have witnessed sweeping developments in information technology. Currently, the most promising and interesting domain seemed to be the artificial intelligence. Within this field we see now a growing interest in the medical applications. The purpose of this article is to present a general review of the main areas of artificial intelligence and its applications to the medical domain. The review will focus on artificial intelligence applications to radiology, robotically-operated surgical procedures and different kinds of expert systems.

Intermediation Structures in Electronic Healthcare Portals

Despite the fact that commercial intermediation accounts for over 15% of the US GDP (Spulber, 1996), it has commanded limited attention from the academic community. Moreover, popular discourse has heralded the Internet’s ability to dis-intermediate supply chains and channels, directing attention away from intermediation. In contrast, this chapter focuses upon a sector of the economy that has witnessed a surge in electronic intermediation, namely, the healthcare industry. Founded on a survey of leading healthcare portals, this paper documents and analyzes four predominant patterns of functional intermediation in this new form of IT-enabled commercial institution. Based upon an historical analysis of healthcare portals, functional, generalizable patterns of intermediation are posited.

The Quality of Medical Information on the Internet

This chapter provides an overview of some of the criteria that are currently being used to assess medical information found on the World Wide Web (WWW). Drawing from the evaluation frameworks discussed, a simple set of easy to apply criteria is proposed for evaluating on-line medical information. The criterion covers the categories of information accuracy, objectivity, privacy, currency and authority. A checklist for web page assessment and scoring is also proposed, providing an easy to use tool for medical professionals, health consumers and medical web editors.

The Knowledge Medium - A Conceptual Framework for the Design and Implementation of a Platform Supporting the Community of AIDS Researchers and Practitioners

The health care industry is essentially knowledge-based. The quality and efficiency of work performed depends on the ability to both manage internally created knowledge, e. g., about healing practices and available expertise as well as to enrich and integrate it with relevant external knowledge created world-wide by pharmacy research teams, international health organizations, etc. Efficient management of knowledge in health care requires, therefore, concepts and solutions for cooperation and sharing of knowledge within and between communities (Greiner & Rose, 1997).

The User Interface for a Computerized Patient Record System for Primary Health Care in a Third World Environment

The manual paper-based system for keeping track of patient history was replaced with a computerized system in a Primary Health Care clinic in a traditionally Black urban area. Several factors influenced the design of the user-interface. Aspects such as screen layout, data fields to be captured, mouse dependency, computer literacy of the users and adapting the system to the normal daily routine of users were considered. The study showed that special attention should be devoted to the design of the user interface for systems used primarily by third world users who do not want the computer to interfere or hinder them in their daily jobs.

CORBAMed and DHE

The healthcare organizational structure is often naturally distributed. In order to improve the quality of care, the adoption of standards to allow the effective and robust networking of the various centers for clinical, epidemiological, administrative information management purposes has been widely recognized as an urgent and strategic need in the healthcare community. This chapter analyzes the status and challenges that today’s healthcare information systems have, and introduces two middleware service frameworks for information systems, namely CORBAMed and DHE, in detail. The middleware service can address heterogeneous problems and significantly assist interoperability and integrity of information systems by providing common services and a set of standard interfaces that enable different applications to interact with each other.