Interpretive flexibility along the innovation decision process of the UK NHS Care Records Service (NCRS): Insights from a local implementation case study

Interpretive flexibility is a term used to describe the diverse perspectives on what a technology is and can or can not do during the process of technological development. In this article, we look at how interpretive flexibility manifests through the diverse perceptions of stakeholders involved in the diffusion and adoption of the NHS Care Records Service (NCRS). Our analysis shows that while the policy makers acting upon the application of details related to the implementation of the system, the potential users are far behind the innovation decision process, namely at the knowledge or persuasion stages. We use data from a local heath authority from a county close to London. The research explores, compares, and evaluates contrasting views on the systems implementation at the local as well as national level. We believe that our analysis is useful for NCRS implementation strategies, in particular, and technology diffusion in large organisations, in general

INFORMATION AND COMMUNICATION TECHNOLOGIES (ICTs) IN THE SERVICES OF HEALTHCARE SECTOR IN EUROPE

Information and Communication Technologies (ICTs) consists of all technical means used to handle information and aid communication, including both computer and network hardware as well as necessary software. Information and Communication Technologies tools and services are used in many sectors like development, education, e-services, policy, health and medicine and so one. This paper links the ICTs tools and services for health. ICTs has the potential to impact almost every aspect of the health sector. Information and Communication Technologies (ICTs) have an important role in service engineering, improving medical knowledge and practice, and defining new fields of research.eHealth, healthcare sector, telemedicine services, health portals, health information networks, digital health infrastructure

Summary care record early adopter programme: an independent evaluation by University College London.

Benefits The main potential benefit of the SCR is considered to be in emergency and unscheduled care settings, especially for people who are unconscious, confused, unsure of their medical details, or unable to communicate effectively in English. Other benefits may include improved efficiency of care and avoidance of hospital admission, but it is too early for potential benefits to be verified or quantified. Progress As of end April 2008, the SCR of 153,188 patients in the first two Early Adopter sites (Bolton and Bury) had been created. A total of 614,052 patients in four Early Adopter sites had been sent a letter informing them of the programme and their choices for opting out of having a SCR. Staff attitudes and usage The evaluation found that many NHS staff in Early Adopter sites (which had been selected partly for their keenness to innovate in ICT) were enthusiastic about the SCR and keen to see it up and running, but a significant minority of GPs had chosen not to participate in the programme and others had deferred participation until data quality improvement work was completed. Whilst 80 per cent of patients interviewed were either positive about the idea of having a SCR or ?did not mind?, others were strongly opposed ?on principle?. Staff who had attempted to use the SCR when caring for patients felt that the current version was technically immature (describing it as ?clunky? and ?complicated?), and were looking forward to a more definitive version of the technology. A comparable technology (the Emergency Care Summary) introduced in Scotland two years ago is now working well, and over a million records have been accessed in emergency and out-of-hours care. Patient attitudes and awareness Having a SCR is optional (people may opt out if they wish, though fewer than one per cent of people in Early Adopter sites have done so) and technical security is said to be high via a system of password protection and strict access controls. Nevertheless, the evaluation showed that recent stories about data loss by government and NHS organisations had raised concerns amongst both staff and patients that human fallibility could potentially jeopardise the operational security of the system. Despite an extensive information programme to inform the public in Early Adopter sites about the SCR, many patients interviewed by the UCL team were not aware of the programme at all. This raises important questions about the ethics of an ?implied consent? model for creating the SCR. The evaluation recommended that the developers of the SCR should consider a model in which the patient is asked for ?consent to view? whenever a member of staff wishes to access their record. Not a single patient interviewed in the evaluation was confident that the SCR would be 100 per cent secure, but they were philosophical about the risks of security breaches. Typically, people said that the potential benefit of a doctor having access to key medical details in an emergency outweighed the small but real risk of data loss due to human or technical error. Even patients whose medical record contained potentially sensitive data such as mental health problems, HIV or drug use were often (though not always) keen to have a SCR and generally trusted NHS staff to treat sensitive data appropriately. However, they and many other NHS patients wanted to be able to control which staff members were allowed to access their record at the point of care. Some doctors, nurses and receptionists, it seems, are trusted to view a person?s SCR, whereas others are not, and this is a decision which patients would like to make in real time

Pick-n-mix approaches to technology supply : XML as a standard “glue” linking universalised locals

We report on our experiences in a participatory design project to develop ICTs in a hospital ward working with deliberate self-harm patients. This project involves the creation and constant re-creation of sociotechnical ensembles in which XML-related technologies may come to play vital roles. The importance of these technologies arises from the aim underlying the project of creating systems that are shaped in locally meaningful ways but reach beyond their immediate context to gain wider importance. We argue that XML is well placed to play the role of "glue" that binds multiple such systems together. We analyse the implications of localised systems development for technology supply and argue that inscriptions that are evident in XML-related standards are and will be very important for the uptake of XML technologies

A knowledge-based taxonomy of critical factors for adopting electronic health record systems by physicians: a systematic literature review

<p>Abstract</p> <p>Background</p> <p>The health care sector is an area of social and economic interest in several countries; therefore, there have been lots of efforts in the use of electronic health records. Nevertheless, there is evidence suggesting that these systems have not been adopted as it was expected, and although there are some proposals to support their adoption, the proposed support is not by means of information and communication technology which can provide automatic tools of support. The aim of this study is to identify the critical adoption factors for electronic health records by physicians and to use them as a guide to support their adoption process automatically.</p> <p>Methods</p> <p>This paper presents, based on the PRISMA statement, a systematic literature review in electronic databases with adoption studies of electronic health records published in English. Software applications that manage and process the data in the electronic health record have been considered, i.e.: computerized physician prescription, electronic medical records, and electronic capture of clinical data. Our review was conducted with the purpose of obtaining a taxonomy of the physicians main barriers for adopting electronic health records, that can be addressed by means of information and communication technology; in particular with the information technology roles of the knowledge management processes. Which take us to the question that we want to address in this work: "What are the critical adoption factors of electronic health records that can be supported by information and communication technology?". Reports from eight databases covering electronic health records adoption studies in the medical domain, in particular those focused on physicians, were analyzed.</p> <p>Results</p> <p>The review identifies two main issues: 1) a knowledge-based classification of critical factors for adopting electronic health records by physicians; and 2) the definition of a base for the design of a conceptual framework for supporting the design of knowledge-based systems, to assist the adoption process of electronic health records in an automatic fashion. From our review, six critical adoption factors have been identified: user attitude towards information systems, workflow impact, interoperability, technical support, communication among users, and expert support. The main limitation of the taxonomy is the different impact of the adoption factors of electronic health records reported by some studies depending on the type of practice, setting, or attention level; however, these features are a determinant aspect with regard to the adoption rate for the latter rather than the presence of a specific critical adoption factor.</p> <p>Conclusions</p> <p>The critical adoption factors established here provide a sound theoretical basis for research to understand, support, and facilitate the adoption of electronic health records to physicians in benefit of patients.</p

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Electronic Medical Records: Barriers to Adoption and Diffusion

The primary goal of this paper is to explore why information technology (IT) solutions such as electronic medical records (EMR) have failed to gain a foothold in the healthcare sector. Based on a review of extant research, we propose a framework for classifying the barriers to the adoption and diffusion of EMR in the healthcare sector. We map all barriers reported in the literature onto the classification scheme to demonstrate its efficacy. We conclude by suggesting potential opportunities for applying the classification framework to research and practice

Healthcare information technology (HIT) in Saudi Arabia health care systems: an overview

In the last decade, healthcare in Saudi Arabia has been significantly improving. This has been accompanied by advancements within the field of Information and Communications Technology (ICT), more specifically Health Information Technology (HIT), whose applications in health have been a necessity for hospitals to achieve objectives such as enhancing of healthcare and reducing the time and the cost of healthcare delivery. This paper focuses on a number of research questions. These are: • What is the current status of healthcare in Saudi organizations? • What is the current status of ICT and HIT in Saudi healthcare organizations? • What are the critical factors influencing the adoption process of HIT in Saudi healthcare organizations? • What are the factors that influence organizational (technology) of HIT

A new track for technology: Can ICT take care for healthier lifestyles?

The paper takes a look on potential contribution of Information and Communication Technologies to abate public health challenges caused by demographics and lifestyle. From the current convergence of mhealth, and sport market products emerge targeting normal athletes to control their training in a quantified manner. The resulting feedback and transparency foster a healthier lifestyle. These products and services help overcome limitations to innovation typical to the health care market. The paper is based on research by the European Commission's Institute for Prospective Technological Studies on Integrated Personal Health/Care services. --eHealth,Integrated Personal Health/Care services,sport,training,lifestyle related disease,innovation