Strategic Value of an Unbound, Interoperable PHR Platform for Rights–Managed Care Coordination

Health care reform requires an information-system paradigm shift. We present an innovative implementation involving an unbound, interoperable PHR platform that enforces patient permissions while exchanging structured data via Web services with certified EHRs. We draw on a strategic health information technology framework and a disruptive-innovation argument for the underlying conceptual basis. We describe how the platform’s three-tier architecture supports rights–managed care coordination. Finally, we discuss future observational and experimental research on the platform’s cost-effectiveness

The Relationship Between Information and Communication Technologies and Country Governance: An Exploratory Study

In this exploratory study we investigate the relationship between information and communication technologies (ICTs) and country-level governance. We include in our framework the five factors of ICTs: access, quality, affordability, applications and institutional efficiency & sustainability. Governance indicators include voice and accountability, political stability and absence of violence, government effectiveness, regulatory quality, rule of law, and control of corruption. Using secondary data on ICTs and governance indicators for countries from the World Bank, and controlling for the wealth effect, our main multivariate result indicates that ICTs—with the exception of the institutional efficiency and sustainability factor—have a positive relationship with governance indicators. ICTs therefore, have the potential to promote good governance. We also find that accessibility is the most important ICTs’ factor to enhance governance. Our results are useful in shaping policy decisions involving the nature and extent of investment in ICT infrastructure at the country level

The Relationship Between Information and Communication Technologies and the Delivery of Public Health: A Country-level Study

We empirically investigate the relationship between information and communication technologies (ICTs) and the delivery of country-level public health. Our underlying hypothesis is that ICTs can improve the efficiency and effectiveness of public health delivery mechanisms. In our framework, we include the ICT factors of accessibility, quality, affordability, applications, and institutional efficiency and sustainability. The public health delivery is represented by the changes in the indicators of immunization coverage, TB infection, sanitation, undernourishment, life expectancy, mortality rate, and health care expenses. Results indicate in most cases ICT factors have a significant correlation to a country’s delivery of public health over and above a country’s income level. The “Accessibility” ICT factor contributes to improved delivery for nearly all of the public health indicators. This is followed by “ICT Applications.” Increased ICTs usage leads to increased health care expenditure. Our findings are useful at the country level for informing policy decisions regarding the nature and extent of investment in ICT infrastructure for the delivery of public health. We do caution that merely investing in more ICTs does not imply an automatic improvement in public health. Rather, ICTs have the potential to improve the delivery process

Information Systems and Healthcare XXX: Charting a Strategic Path for Health Information Technology

Despite both the slow diffusion of information technology (IT) throughout health organizations and the high cost of implementation, organizations must focus on key strategic applications that deliver high quality care at lower costs. Identifying the strategic applications that support important healthcare processes is challenging. In this article we propose a framework for developing this high level perspective of strategic health information technology (HIT) applications. We then classify into the components of the framework numerous HIT applications and initiatives reported in the media. Based on an existing framework, we identify two critical dimensions that capture two important characteristics of a healthcare delivery process, namely, the degree of mediation and the degree of collaboration. A healthcare process with a high degree of mediation involves a large series of activities in a sequential manner. Processes with a low degree of mediation “understand” that most participants in care delivery contribute directly, often simultaneously, to the final result. The underlying principle for this dimension is the level of functionality of the application. The degree of collaboration refers to the extent to which information is exchanged among the participants in a process. Depending on the degree of exchange, one can identify processes as having higher or lower degrees of collaboration. The underlying principle for this dimension is the degree of interoperability among the applications. Strategic HIT applications lie on a continuum path from a low-high degree of mediation to a low-high degree of collaboration. Our examples show that healthcare delivery organizations evolve their HIT from ad-hoc isolated systems to interoperable, integrated digital health systems. The strategic framework provides a high level perspective of HIT while assisting in the evaluation of potential HIT candidates for implementation

Editorial : special section on healthcare information systems

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