Investigation of the use of ICT in the modernization of the health care sector : a comparative analysis

This Ph.D project started from a broad analysis aiming at investigating the key issues in the development of Information and Communication Technologies (ICT) in the health care sector, with the aim of making an in depth investigation to evaluate the effects of Electronic Medical Record (EMR) implementation on the organizations adopting them. Furthermore the study examined two study settings which have adopted the same EMR system produced by the same provider. This comparative study aims, in particular, to analyse how EMR systems are adopted by different health organizations focusing on the antecedents of the EMR project, on the implementation processes used and on the impacts produced. Diffusion theory, through the lens of socio-technical approach, represents the theoretical framework of the analysis. The research results are based on policy evaluation and case studies. The two hospitals selected for the case study analysis are the Regional Hospital of Local Health Authority in Aosta, Italy and the Royal Infirmary of Edinburgh, Scotland. In conducting the data collection several strategies have been used: documentary analysis, interviews and observations have been carried out. This work provides an overview of the key issues arising over e-health policy development through a comparative analysis of the UK and Italy and provides an insight into how EMR systems are adopted, implemented and evaluated within acute care organizations. The thesis is a comparative international research about the development of e-health and the use of ICT in health care sector. This approach makes a both a theoretical and methodological contribution. By focusing, in particular, on EMR systems, it offers to practitioners and policy makers a better basis of analysing ICT usage and its impacts on health care service delivery