Adoption and non-adoption of a shared electronic summary record in England: a mixed-method case study

Publisher version: http://www.bmj.com/content/340/bmj.c3111.full?sid=fcb22308-64fe-4070-9067-15a172b3aea

A strategic roadmap for achieving the potential benefits of electronic health record system in the state of Kuwait

This research investigates the desired benefits of using an Electronic Health Record (EHR) in Kuwait Primary Health Care Centers and the perceived barriers to its successful adoption. From this, a set of key strategic capabilities are proposed, ranked for priority and urgency as a roadmap for EHR adoption in the State of Kuwait. This thesis examines the organization of the health care system in Kuwait and important issues related to primary health care, including the implementation and current use of the EHR system at Kuwait primary health care centers. International evidence of the EHR system benefits, barriers and capabilities such as interoperability, confidentiality and security were used as the basis for user surveys. The research applied domain theory and research-based improvement strategy as a means of identifying the stakeholders and the priorities area of investigation. The research utilized a quantitative research design focusing on multiple case studies as the survey methodology. Two case study surveys were conducted to identify the main benefits and barriers that affect the adoption of the EHR at international and national (Kuwaiti) levels. The first survey involved international and national decision makers. The second survey involved healthcare professionals working in Kuwait primary health care to assess their view regarding the features of the current system, the benefits and barriers of more complete EHRs. The results of first and second surveys were used to develop a list of key EHR system capabilities and adoption requirements relevant to Kuwait primary care. This list was used for the design of a third survey, for senior stakeholders at the Kuwait Ministry of Health, to identify their strategic roadmap priorities. This research, drawing on the literature of the EHR design and implementation, a study of international initiatives of the EHR adoption and outputs of three case studies, has emphasized the importance of developing a strategic roadmap for Kuwait to achieve the potential benefits of EHRs

Application of information and communication technologies for health systems in Belgium, Denmark, Spain, the United Kingdom and Sweden

Incluye BibliografíaThis document describes and analyzes implementation of eHealth in several European countries, as well as strengths and weaknesses, using this experience in order to support the management and execution of this kind of projects in other scenarios. Five EU member States evidencing different degrees of advancement in their national eHealth projects have been selected for this purpose: Belgium, Denmark, Spain, the United Kingdom and Sweden. In addition to these five cases, a brief study has been made of several international collaboration projects for the implementation of cross-border spaces for eHealth that most of these countries are currently participating in

Public strategies for improving eHealth integration and long-term sustainability in public health care systems: Findings from an Italian case study

eHealth is expected to contribute in tackling challenges for health care systems. However, it also imposes challenges. Financing strategies adopted at national as well regional levels widely affect eHealth long-term sustainability. In a public health care system, the public actor is among the main "buyers" eHealth. However, public interventions have been increasingly focused on cost containment. How to match these 2 aspects? This article explores some central issues, mainly related to financial aspects, in the development of effective and valuable eHealth strategies in a public health care system: How can the public health care system (as a "buyer") improve long-term success and sustainability of eHealth solutions? What levers are available to match in the long period different interests of different stakeholders in the eHealth field? A case study was performed in the Region of Tuscany, Italy. According to our results, win-win strategies should be followed. Investments should take into account the need to long-term finance solutions, for sustaining changes in health care organizations for obtaining benefits. To solve the interoperability issues, the concept of the "platform approach" emerged, based on collaboration within and between organizations. Private sector as well as beneficiaries and final users of the eHealth solutions should participate in their design, provision, and monitoring. For creating value for all, the evidence gap and the financial needs could be addressed with a pull mechanism of funding, aimed at paying according to the outcomes produced by the eHealth solution, on the base of an ongoing monitoring, measurement, and evaluation of the outcomes

Smart Healthcare solutions in China and Europe, an international business perspective

The thesis is part of the Marie Curie Fellowship project addressing health related challenges with IoT solutions. The author tries to address the challenge for the implementation of telehealth solutions by finding out the demand of the telehealth solution in selected European economies and in China (chapter 1), analyzing the emerging business models for telehealth solution ecosystems in China (chapter 2), how to integrate telehealth solutions with institutional stakeholders (chapter 3) and why are elderly users willing to use telehealth solutions in China. Chapter 1 and chapter 2 form the theoretical background for empirical work in chapter 3 and chapter 4. The thesis addressed four research questions, namely “Which societal and social-economics unmet needs that Internet of Healthcare Things can help to resolve?”, “What are the business model innovation for tech companies in China for the smart health industry?”, “What are the facilitators and hurdles for implementing telehealth solutions”, “Are elderly users willing to use telehealth solutions in China?”. Both qualitative study and quantitative analysis has been made based on data collected by in depth interviews with stakeholders, focus group study work with urban and rural residents in China. The digital platform framework was used in chapter 2 as the theoretical framework where as the stakeholder power mapping framework was used in chapter 3. The discretion choice experiment was used in chapter 4 to design questionnaire study while ordered logit regression was used to analyze the data. Telehealth solutions have great potential to fill in the gap for lack of community healthcare and ensuring health continuity between home care setting, community healthcare and hospitals. There is strong demand for such solutions if they can prove the medical value in managing chronic disease by raising health awareness and lowering health risks by changing the patients’ lifestyle. Analyzing how to realize the value for preventive healthcare by proving the health-economic value of digital health solutions (telehealth solutions) is the focus of research. There remain hurdles to build trust for telehealth solutions and the use of AI in healthcare. Next step of research can also be extended to addressing such challenges by analyzing how to improve the transparency of algorithms by disclosing the data source, and how the algorithms were built. Further research can be done on data interoperability between the EHR systems and telehealth solutions. The medical value of telehealth solutions can improve if doctors could interpret data collected from telehealth solutions; furthermore, if doctors could make diagnosis and provide treatment, adjust healthcare management plans based on such data, telehealth solutions then can be included in insurance packages, making them more accessible