England’s Electronic Prescription Service: Infrastructure in an Institutional Setting

We describe the development of the Electronic Prescription Service (EPS), the solution for the electronic transmission of prescriptions adopted by the English NHS for primary care. The chapter is based on both an analysis of data collected as part of a nationally commissioned evaluation of EPS, and on reports of contemporary developments in the service. Drawing on the notion of an installed infrastructural base, we illustrate how EPS has been assembled within a rich institutional and organizational context including causal pasts, contemporary practices and policy visions. This process of assembly is traced using three perspectives; as the realization and negotiation of constraints found in the wider NHS context, as a response to inertia arising from limited resources and weak incentive structures, and as a purposive fidelity to the existing institutional cultures of the NHS. The chapter concludes by reflecting on the significance of this analysis for notions of an installed base

The evaluation of the electronic prescription service in primary care: final report on the findings from the evaluation in early implementer sites

This report presents the findings from The Evaluation of the Electronic Prescription Service in Primary Care, a Connecting for Health Evaluation Programme commissioned project. The projects aim, as stated in the proposal, was to evaluate Phase 3 (Release 2) of the Electronic Prescription Service (hereafter EPS R2) to determine effects on patient safety, satisfaction with care, work processes and economics. The methods used were a blend of ethnographically informed quantitative and qualitative approaches

Pharmacies and medication information system in Jeddah City, Saudi Arabia

It is acknowledged that the introduction of Health Information Systems (HIS) have contributed to the reorganization of the methods used in health services for Health Information Management. Managers in the health services benefit from Health Information Systems provision both strategically and operationally, for example in the planning of new services and more routinely in assisting health professionals in making informed medical decisions. Health services in developed countries already have Health Information Systems (HIS) in place but their adoption in developing countries has been less widespread. In Jeddah, KSA there is a lack of a unified HIS. Health service provision in Jeddah is spread between a wide range of governmental and private health services. The lack of unification of these services and a bespoke HIS has led to problems for both patients and healthcare professionals. This research focuses on the methods of prescribing medication, provision of supplies and the dispensing of medication within pharmacies. [Continues.

An exploration of ehealth and digital literacy in pharmacy practice.

The aim of this research programme was to explore ehealth technology in pharmacy practice in Scotland and, by doing so, contribute original knowledge to this area. Strategists worldwide believe technology has the potential to promote quality, safety and efficiency in healthcare. This has been reflected in national ehealth policies designed to support collaborative working between medical and non-medical healthcare practitioners and, more recently, the whole health and social care team. A meta-narrative systematic review was conducted to explore and contextualise research related to healthcare professionals views of the adoption of ehealth technologies to support shared care. Findings indicate the importance of organisational development and training for core and optional ehealth services with pharmacists particularly under-represented in ehealth research. Socio-technical systems theory and the computer supported cooperative working framework were adopted to explore healthcare practitioners perceptions of ehealth in relation to integrated care. Findings from the review indicate ehealth research continues to focus on doctors and nurses. No ehealth application was perceived to be an unqualified success with the socio-technical gap still evident. Multiple case studies were conducted to develop explanatory theory around the digital literacy experiences, education and training related needs of pharmacy staff in the NHS Grampian area. Digital literacy levels were self-reported as basic with mixed views on the need for formal education and training. Findings indicate organisational and social factors may act as restraining forces against implementation of technology in pharmacy and associated digital literacy training. A final theory testing, systematic review was conducted into digital literacy training experiences of pharmacy staff applying Kirkpatricks four level model. It found a lack of evidence of specific, measurable digital literacy levels but indications that suggest digital literacy should be included in pharmacy education at all levels and career stages. This research provides novel insight into ehealth and digital literacy in pharmacy practice. Combined ehealth, education and pharmacy research has been demonstrated to be an under-researched area therefore these findings contribute original knowledge

Federal Register

Daily publication of the U.S. Office of the Federal Register contains rules and regulations, proposed legislation and rule changes, and other notices, including "Presidential proclamations and Executive Orders, Federal agency documents having general applicability and legal effect, documents required to be published by act of Congress, and other Federal agency documents of public interest" (p. ii). Table of Contents starts on page iii

Assessing the potential of national strategies for electronic health records for population health monitoring and research

"Initiated in October 2004, this project builds upon two previous reports that portray a new landscape for health statistics: Shaping a Health Statistics Vision for the 21st Century: The Final Report, a joint report developed by the National Committee on Vital and Health Statistics, the Centers for Disease Control and Prevention's National Center for Health Statistics, and the U.S. Department of Health and Human Services' Data Council (Friedman, Hunter, Parrish 2002); and Information for Health: A Strategy for Building the National Health Information Infrastructure, a report released by the National Committee on Vital and Health Statistics (2001)." - p. 1"The purpose of this report is to assess the potential of national strategies for electronic health records for population health monitoring and research. The emphasis in this report is upon those types of population health monitoring typically used to develop health statistics, such as population-based registries, population-based surveys, and administrative health data, rather than those types of population health monitoring used to detect health events and diseases for the purposes of immediate public health interventions. More specifically, this report has a fourfold purpose: first, to describe the current status of national strategies for electronic health records and their supporting national health information infrastructures in Australia, Canada, England, and New Zealand, especially as those national strategies relate to population health monitoring to produce health statistics and research employing health statistics; second, to summarize themes about the potential contributions, and barriers to those contributions, of national strategies for electronic health records for population health monitoring and research and barriers that emerged from key informant interviews with experts in the same four countries; third to summarize themes emerging from key informant interviews with U.S. experts; and fourth, to delineate major fundamental issues in the relationship between national strategies for electronic health records and population health and monitoring." -.p. 1-21. Introduction -- 2. Methods -- 3. Factors impacting on national strategies for electronic health records -- 4. Nation snapshots: Australia, Canada, England, and New Zealand -- 5. Common themes in interviews with expert informants in Australia, Canada, England, and New Zealand -- 6. Common themes in interviews with expert informants in the U.S. -- 7. Fundamental issues in the relationship of national strategies for electronic health records to population health monitoring and research -- References -- Acronyms and glossary -- Tables -- Figures -- Appendix 1. Structured search criteria -- Appendix 2. Journals and newsletters reviewed -- Appendix 3.Typical interview guide (English expert) -- Appendix 4. Key informants"January 2006."Author: Daniel J. Friedman, Population and Public Health Information Services.Also available via the World Wide Web.Includes bibliographical references (p. 61-70)

Health Technology Scenarios and Implications for Spectrum

Supporting Informatio

Communications in general practice and the domestication of ICT

The NHS is currently being transformed by the implementation of the National Programme for Information Technology (NPfIT). This thesis examines the use of Information Communications Technology (ICT) and its consequences for communications in general practice. While drawing on a range of social scientific approaches to ICT, this research explores the particular utility of the 'domestication' framework advanced by Silverstone and Sorensen. It considers how users in general practice 'tame' and use technology by incorporating its affordances into their work roles and communication practices.Drawing on previous survey work, this research adopts a comparative, ethnographic approach, analyzing patterns of talk and writing in two general practices in London. Empirical work involved analysis of local and national policy documentation and two ethnographic studies that were designed to identify changes in attitudes and behaviours across a defined set of actors over time. Interviews generated preliminary evidence as to how multiple users in general practice communicated by a variety of means, including the problems/concerns they encountered or created in doing so. Observation was used to gather further direct evidence of those problems as they were negotiated and resolved.Although the two cases were both of practices that had been identified in an earlier survey as 'paper-light' which might therefore have been assumed to make effective use of ICT, usage was uneven and sharp differences were noted in the way in which broadly similar technologies were domesticated by specific user groups. Analysis of these differences produced three key findings. Firstly, domestication of ICT in general practice is difficult. To be successfully domesticated, ICTs have to be locally negotiated both horizontally and vertically in order to connect with working practices of the individual users. Secondly, the struggle to 'tame' ICTs is shaped by the extent to which different groups of users perceive ICT as assisting or compromising their roles and responsibilities. This, in turn, increases the diversity between user groups. Thirdly, the research indicated the importance of local context and workplace cultures which facilitate or inhibit the negotiations or 'communications about communications' required to domesticate ICTs.A concluding discussion reflects on the changing relationship between ICTs and communications in general practice and, in particular, the impact of ICT on faceto-face communications. The key contribution of the study lies in offering a theoretically-sophisticated framework in which to examine and explicate detailed patterns of communications in general practice. By addressing both electronic and paper-based communication as well as face-to-face interaction, it provides a basis for future research in this area as NPfIT develops

Administrative data as a research resource: a selected audit

The term ‘administrative data’ describes information which arises via the operation of a transaction, registration or as a record of service delivery. Such data relates specifically to the administration of a system or process and are not primarily generated as research resources. While administrative data are not necessarily the preserve of government, most government departments keep records of the variety of services they deliver and the processes they register in considerable detail, often storing this information as electronic records that relate to individuals and/or organisations and summarising these data for statistical purposes

Federal Register

Daily publication of the U.S. Office of the Federal Register contains rules and regulations, proposed legislation and rule changes, and other notices, including "Presidential proclamations and Executive Orders, Federal agency documents having general applicability and legal effect, documents required to be published by act of Congress, and other Federal agency documents of public interest" (p. ii). Table of Contents starts on page iii