Understanding Health Information Networks in Canada

Findings from a preliminary survey of health information networks (HINs) established in various parts of Canada lead us to suggest that buy-in and participation in development of the alliance by physicians and other providers is critical. Also, most healthcare providers are not aware of the difficulties involved in establishing connectivity in the networks we examined. Nor should they be, perhaps. We found that networks that pursued a comprehensive set of applications closely linked to providing better care for patients were more likely to be considered successful by partner organizations and providers. Alliance partners who had a history of interaction prior to the formal establishment of the health information network in question seemed to get to application development quicker than when the alliance was created only because a network was needed. Many alliances reported the positive effect that external players had in terms of helping alliance partners overcome differences, sustain momentum, and provide funds and expertise as needed.

Healthcare Information and Communication Standards Framework

Standardization in healthcare is a rapidly growing field. To prevent proliferation in standardisation, good coordination in both the development and usage of standards is necessary. In this chapter we propose a framework to analyse the fit between the proposed purpose of the standard and the perceived needs of the applications using the standard. An available standard can be characterised by the level of acceptance, the application area, the object of standardisation and the kind of user a standard is aimed at. The same aspects can be determined for the kind of standards needed for a specific application of information interchange. In a practical sense this will help in determining which standards to use. Also, it may provide a better perception of the supply and demand of healthcare information and communication standards in general.

Standardization Strategies in Practice - Examples from Healthcare

This chapter explores some of the consequences of strategies used to develop electronic standards in healthcare, especially the consequences of electronic standards for communication work. The two standardization strategies explored are the prototype strategy used to develop intranet applications and the specification strategy used to develop Picture Archiving and Communication Systems (PACS) in healthcare. It was found that computer systems based on different electronic standards intervene in work in different ways, and that they do not always intervene in the ways they were initially intended. For example, the PACS based on the DICOM standard have primarily attained a local role, although its initial aim was to support universal image communication within healthcare. On the other hand the intranet application based on the Internet standards primarily not designed for this particular purpose has come to support communication of images and reports within the heterogeneous hospital network.

Streamlining Operations in Healthcare with ICT

Health care is an information-intensive industry. Its cornerstones are a research tradition of hundreds of years, and detailed understanding of each customer, patient. As compared to other industries, say banking, the data about the customer needs to be very detailed, and must include trend data to allow analysis of the development of things. When caring for a patient, even very special knowledge and know-how is often needed, and this compels the industry into a networked mode of operation, with a lot of communication needs. With this background, it is astonishing to see how slowly the industry has adopted to new information and communication technology (ICT). Currently, however, a major revolution is under way, and the health care industry has become a key application area for ICT, and an object for both national and international programs to promote usage of ICT. We want to understand these trends better. Our research questions are: 1. Which reasons led to the late adoption of modern ICT in the healthcare sector? 2. Why is the situation now changing fast? 3. Which seem to be the main application areas? 4. Which kind of progress can we now see? To each of the research questions, we allocate one section in our chatper. This article is conceptual in nature, but argumentation is supported by concrete examples and field work done at the author’s Institute in more than 10 projects in the health care sector. The main conclusions are that:

Experiences in Strategic Information Systems Implementation in UK Healthcare

Implementing large strategic IS in the UK health sector has recently become the subject of much debate, as hospitals have undergone wide-reaching government-led institutional reforms involving the introduction of IT. Many of the developments have followed the patterns in the U.S. One such example is that of Case Mix, introduced strategically as part of the Resource Management Initiative and aimed at the facilitation of both clinical and financial audit. Moreover, Case Mix was implemented alongside significant changes in hospital structure and culture, requiring clinicians to get involved in management tasks and decision making within the structure of the hospital, supported by a new information infrastructure. Case Mix was implemented blanket-fashion throughout many UK hospitals, and the success of such systems has varied significantly. A number of lessons can be learned from the way that the implementation was approached. This chapter stems from a research project focusing longitudinally on the implementation of Case Mix in four UK hospitals. It draws a number of findings from the cases, and importantly, explicates a framework for strategic IS implementation, as generated from the cases and supported by the extant literature. Such a framework has implications for both theory and practice, and assists in the understanding of what is often a dynamic and poorly understood situation.

The Electronic Patient Record as an Organizational Artifact

The research effort on Electronic Patient Records (EPRs) has rapidly increased in the last decade. Much of this research focussed on standardisation and technical realizations. We will describe such a research effort in this chapter and evaluate its success. Our main finding is that the lack of success of this specific research effort is mainly due to its technological bias. Although standards (both conceptual and technical) are important prerequisites for the realisation of an EPR, organisational issues are decisive for success. The role played by these organisational issues will be illustrated by analysing the findings of the case study presented in the chapter. We will argue that research on EPRs should be more focussed on the role of an EPR as an organisational artefact that coordinates the work of healthcare professionals, in order to lead to successful implementations.

Strategies for Healthcare Information Systems

It is widely recognized that the healthcare industry does not use information technology to its full potential. This book uncovers many of the reasons why large-scale implementation of healthcare information systems has not come to fruition yet. The authors provide a broad coverage of the field, ranging from strategic analysis to real-life project implementation. Moreover the book provides strategies to avoid pitfalls and direct your healthcare organization to strategic use of healthcare information systems. This section of the book will introduce the five main themes of the book and will show that the healthcare organizations are realistic laboratories for the information and communication technology scientists to do research. The five main themes are: Strategy, Network Healthcare Chain, Process Management, Knowledge Management, Standardization.

Reengineering the Healthcare Supply Chain in Australia

Reengineering is about fundamentally rethinking and dramatically redesigning business processes in order to lower costs and increase quality, service and speed. Such transformation is required in many industries today, perhaps none more so than the health sector. One enabling mechanism to allow for such large-scale change is found in information systems developments, most notably that of electronic commerce (e-commerce), offering a range of solutions for improving healthcare management. This paper addresses the way in which the Australian health industry has grasped such opportunities for transforming itself through e-commerce strategies, allowing for improving cost-effective services to key stakeholders. A major achievement among a range of recent activities as outlined in the federal government’s report, From Telehealth to E-Health: The Unstoppable Rise of E-Health (Mitchell, 1999), is that of Australia’s first Internet trading community, The Project Electronic Commerce and Communication for Healthcare, otherwise known as PeCC, a key platform in transforming Australia’s health sector.