Exploring the Emergence of Open Platforms in Healthcare: Design Considerations and Experiences from an Initial Case in Norwegian Primary Care

Despite significant efforts on improving interoperability of health information and lowering socio-technical cost of replacing clinical applications, healthcare organizations and professionals struggle with fragmented and non-interoperable Health Information Technologies. This paper describes the emergence of open platforms, which may alleviate challenges related to interoperability issues, weak integrations, siloed data repositories, and numerous legacy systems within healthcare. Using a proposed platform initiative in Norway, we explore the open platform phenomenon with a socio-technical lens, and highlights four key topics that have produced tension and merits consideration from the involved stakeholders: i) Procurement strategy and vendor neutrality, ii) Ability to facilitate flexible use, iii) The use of standards and separation of data and application, and iv) Strategies for development and governance of standards. We further discuss the related implications and design considerations necessary to support complex patient pathways and provide clinicians more flexible and effective systems

Layperson Perceptions and Attitudes Towards a National Electronic Health Record Introduction in Saudi Arabia

Introduction: Since patients and the general public may interact with a national electronic health record (EHR), including them during implementation of an EHR is important. Such acceptance has been documented as one of the critical areas in the development of a national EHR. However, only a few studies have considered public perceptions and attitudes regarding use of their health information in a universal EHR. This is the first study that concentrated on Saudi patients and citizens’ attitudes regarding a national EHR. . Objectives: The purpose of this quantitative study was to understand perceptions and attitudes regarding the introduction of a national EHR among the Saudi citizenry. Methodology: This study used a cross-sectional survey, which was designed based on a literature review and interviews with a small subset of the target population. The final survey was distributed by hand as well as through the internet. Analysis: The data was analyzed by conducting descriptive, bivariate and logistic regression tests. Results: Most of the Saudi citizens supported the development of a national EHR system, which might be used for several services, such as healthcare, health services planning and health research. Twelve percent of respondents reported being undecided in their view and only 2% of them would be opposed to such a system. In terms of accessing health records in a national EHR, most were in favor of accessing their complete record. The study results also highlighted that more than 70% of respondents would be concerned about the security of their health record if it were to become part of a national EHR. The results also revealed significant differences in levels of support depending on sociodemographic characteristics. Working in health related jobs and level of education were important factors related to level of support for the development of a national EHR. Furthermore, it indicated that there is no significant relationship between preferences for access to a national EHR and demographic, education and health related characteristics. Conclusion: These findings support the need for expediting the incorporation of health information technology, especially an EHR in healthcare organizations in Saudi Arabia. Making a national EHR as an optimal goal before adoption of a local EHR in each healthcare institution will help to facilitate the complex implementation. Findings of this study can be generalized and extrapolated to other societies that have similar cultural factors. Furthermore, the results potentially benefit the policy makers in Saudi Arabia