Technique for improving care integration models

Recent developments in technologies and improved life style have had a positive impact on prolonging human life contributing to the increasing elderly population. As a consequence, many countries (particularly developed ones) started to experience higher proportions of elderly people (over 65). This has consequently generated the need for care for the elderly that is necessitating the integration of health and social care to accommodate their complex needs. A number of modelling methods have been employed to assist those concerned to cope with health and social care but albeit separately. The literatures so far, identified several techniques that have been employed mostly to model the care integration. However, literatures also suggest that there are some challenges still persist when modelling integrated care. It can be argued that these techniques are not capable of handling the complexities associated with the requirements of integrated systems. This paper attempts to prove the reason why despite the fact that many models of integrated care have been developed, problems are still exist. Based on the literatures, the problems exist due to the unsuitable techniques used to model the IC systems as most of the developed models are using single technique. Therefore, new technique to improve the care integration model is suggested

A socio-technical analytical framework on the EHR-organizational innovation interplay: Insights from a public hospital in Greece

The healthcare sector globally is confronted with increasing internal and external pressures that urge for a radical reform of health systems' status quo. The role of technological innovations such as Electronic Health Records (EHR) is recognized as instrumental in this transition process as it is expected to accelerate organizational innovations. This is why the widespread uptake of EHR systems is a top priority in the global healthcare agenda. The successful co-deployment though of EHR systems and organizational innovations within the context of secondary healthcare institutions is a complex and multifaceted issue. Existing research in the field has made little progress thus emphasizing the need for further research contribution that will incorporate a holistic perspective. This paper presents insights about the EHR-organizational innovation interplay from a public hospital in Greece into a socio-technical analytical framework providing a multilevel set of action points for the eHealth roadmap with worldwide relevance

The NPFIT strategy for information security of care record service

The National Programme for IT in England doesn’t have a one-document strategy for its information security of the Care Records Service, which is the national EHR system. This paper provides a comprehensive understanding of the information security strategy of England’s EHR system by presenting its different information security issues such as consent mechanisms, access control, sharing level, and related legal and regulations documents

Communication in cross-cultural consultations in primary care in Europe: the case for improvement. The rationale for the RESTORE FP 7 project

The purpose of this paper is to substantiate the importance of research about barriers and levers to the implementation of supports for cross-cultural communication in primary care settings in Europe. After an overview of migrant health issues, with the focus on communication in cross-cultural consultations in primary care and the importance of language barriers, we highlight the fact that there are serious problems in routine practice that persist over time and across different European settings. Language and cultural barriers hamper communication in consultations between doctors and migrants, with a range of negative effects including poorer compliance and a greater propensity to access emergency services. It is well established that there is a need for skilled interpreters and for professionals who are culturally competent to address this problem. A range of professional guidelines and training initiatives exist that support the communication in cross-cultural consultations in primary care. However, these are commonly not implemented in daily practice. It is as yet unknown why professionals do not accept or implement these guidelines and interventions, or under what circumstances they would do so. A new study involving six European countries, RESTORE (REsearch into implementation STrategies to support patients of different ORigins and language background in a variety of European primary care settings), aims to address these gaps in knowledge. It uses a unique combination of a contemporary social theory, normalisation process theory (NPT) and participatory learning and action (PLA) research. This should enhance understanding of the levers and barriers to implementation, as well as providing stakeholders, with the opportunity to generate creative solutions to problems experienced with the implementation of such interventions

Healthcare professionals' perspectives on mental health service provision : a pilot focus group study in six European countries

Background: The mental healthcare treatment gap (mhcGAP) in adult populations has been substantiated across Europe. This study formed part of MentALLY, a research project funded by the European Commission, which aimed to gather qualitative empirical evidence to support the provision of European mental healthcare that provides effective treatment to all adults who need it. Methods: Seven focus groups were conducted with 49 health professionals (HPs), including psychologists, psychiatrists, social workers, general practitioners, and psychiatric nurses who worked in health services in Belgium, Cyprus, Greece, the Netherlands, Norway and Sweden. The focus group discussions centered on the barriers and facilitators to providing quality care to people with mild, medium, and severe mental health problems. Analyses included deductively and inductively driven coding procedures. Cross-country consensus was obtained by summarizing findings in the form of a fact sheet which was shared for triangulation by all the MentALLY partners. Results: The results converged into two overarching themes: (1) Minding the treatment gap: the availability and accessibility of Mental Health Services (MHS). The mhcGAP gap identified is composed of different elements that constitute the barriers to care, including bridging divides in care provision, obstacles in facilitating access via referrals and creating a collaborative 'chain of care'. (2) Making therapeutic practice relevant by providing a broad-spectrum of integrated and comprehensive services that value person-centered care comprised of authenticity, flexibility and congruence. Conclusions: The mhcGAP is comprised of the following barriers: a lack of funding, insufficient capacity of human resources, inaccessibility to comprehensive services and a lack of availability of relevant treatments. The facilitators to the provision of MHC include using collaborative models of primary, secondary and prevention-oriented mental healthcare. Teamwork in providing care was considered to be a more effective and efficient use of resources. HPs believe that the use of e-mental health and emerging digital technologies can enhance care provision. Facilitating access to a relevant continuum of community-based care that is responsive coordinated and in line with people's needs throughout their lives is an essential aspect of optimal care provision

Benefits realisation for healthcare

Following the emergent importance of benefits realisation applied to healthcare infrastructure and service development programs, HaCIRIC has undertaken a research initiative targeting the development of a robust and comprehensive Benefits Realisation (BeReal©) process. The resulting model is focusing on how benefits should be elicited at the initial strategic stages, and how benefits should be deployed, managed and traced along the lifecycle of a programme so their realisation contributes to successful health outcomes. Subsequently BeReal© aspires to be an appropriate method to drive and control the programme plan; providing tools and techniques for defining specific benefits. It also allows the measurement and evaluation of the extent to which those benefits are delivered. We have set ourselves the objective of identifying current best practices and demonstrate how to improve benefits realisation in healthcare infrastructure provision. The HaCIRIC team in active collaboration with leading industry partners have undertaken various case and comparator studies not only to define a business critical process but to set out an ideology which places benefits realisation at the heart of securing wholly integrated (collective) change. We believe that to deliver consistent high quality infrastructure and services within an ever changing investment model requires a different level of thinking and understanding towards benefits realisation. The challenge of answering community needs through intelligent investment in infrastructure is complex and demands a deeper and inclusive awareness and appreciation of how to deliver benefits and effectively allocate resources. The BeReal© initiative seeks to contribute methodologically and intends to help spending money intelligently, working with programme and project related stakeholders, securing that the best possible benefits are obtained for the overall healthcare communities. This report highlights selected performed initiatives and summarises BeReal© process’s major characteristics, covering far more than the follow-up of a competitive tendering process and of the development of a traditional business case. BeReal© copes with a detailed definition of changing activities, breakdown of (needs into) benefits that drive the investment, supports decision-making, proposes the development of controlling initiatives and suggests major awareness to the implementation of corrective actions. We seek to continue innovating, stimulate learning, contributing to an increase of health and care performance that properly answers to community needs and intelligently invests public and private resources

Improving health and public safety through knowledge management

This paper reports on KM in public healthcare and public safety. It reflects the experiences of the author as a CIO (Chief Information Officer) in both industries in Australia and New Zealand. There are commonalities in goals and challenges in KM in both industries. In the case of public safety a goal of modern policing theory is to move more towards intelligence-driven practice. That means interventions based upon research and analysis of information. In healthcare the goals include investment in capacity based upon knowledge of healthcare needs, evidence-based service planning and care delivery, capture of information and provision of knowledge at the point-of-care and evaluation of outcomes. The issue of knowledge management is explored from the perspectives of the user of information and from the discipline of Information Technology and its application to healthcare and public safety. Case studies are discussed to illustrate knowledge management and limiting or enabling factors. These factors include strategy, architecture, standards, feed-back loops, training, quality processes, and social factors such as expectations, ownership of systems and politics

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Machines and machinations: The integrated care record service in the UK national health service

This paper examines the use of Actor Network Theory (ANT) as a lens to get a better understanding of the implementation of the Integrated Care Record Service (ICRS) in the UK National Health Service (NHS). Actor Network Theory has been deployed in various environments to achieve a better understanding of the roles of not only the humans but also the artifacts that constitute, in this case, healthcare networks of services and organisations. The theory is used as a means of supporting real world interventions, providing a richer understanding of complexities involved and thereby helps management to make better decisions. This study also explores Latour’s concept of machines as machinations, whose role is to translate other actors into the network. We propose ICRS as a fruitful empirical context for the use of ANT to support decision making for actors in health care provision. Actor Network Theory (ANT) is well-suited for use in the socio-technical evaluation of IS into the ICRS project because this approach treats human and non-human actors symmetrically. This approach facilitates a more thorough examination of the ways in which information technology is enabled or restricted in social processes