Use of information and communication technologies to support effective work practice innovation in the health sector: a multi-site study

Health Informatics Research & Evaluation Unit, Faculty of Health Sciences, The University of Sydney, 75 East St, Lidcombe, NSW 1825, Australia.
BMC Health Services Research (Impact Factor: 1.71). 11/2009; 9(1):201. DOI: 10.1186/1472-6963-9-201
Source: PubMed

ABSTRACT Widespread adoption of information and communication technologies (ICT) is a key strategy to meet the challenges facing health systems internationally of increasing demands, rising costs, limited resources and workforce shortages. Despite the rapid increase in ICT investment, uptake and acceptance has been slow and the benefits fewer than expected. Absent from the research literature has been a multi-site investigation of how ICT can support and drive innovative work practice. This Australian-based project will assess the factors that allow health service organisations to harness ICT, and the extent to which such systems drive the creation of new sustainable models of service delivery which increase capacity and provide rapid, safe, effective, affordable and sustainable health care.
A multi-method approach will measure current ICT impact on workforce practices and develop and test new models of ICT use which support innovations in work practice. The research will focus on three large-scale commercial ICT systems being adopted in Australia and other countries: computerised ordering systems, ambulatory electronic medical record systems, and emergency medicine information systems. We will measure and analyse each system's role in supporting five key attributes of work practice innovation: changes in professionals' roles and responsibilities; integration of best practice into routine care; safe care practices; team-based care delivery; and active involvement of consumers in care.
A socio-technical approach to the use of ICT will be adopted to examine and interpret the workforce and organisational complexities of the health sector. The project will also focus on ICT as a potentially disruptive innovation that challenges the way in which health care is delivered and consequently leads some health professionals to view it as a threat to traditional roles and responsibilities and a risk to existing models of care delivery. Such views have stifled debate as well as wider explorations of ICT's potential benefits, yet firm evidence of the effects of role changes on health service outcomes is limited. This project will provide important evidence about the role of ICT in supporting new models of care delivery across multiple healthcare organizations and about the ways in which innovative work practice change is diffused.

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    • "In this context, a challenge facing modern health care systems is to develop and implement new models of service that delivers a high-quality, more cost-effective service that significantly improves the lives of people with epilepsy (Westbrook et al., 2009). This is reflected in recent Irish health care policy, which challenges traditional models of service delivery and cost structures with a move towards models of care that require service reconfiguration, reform and greater productivity (HSE, 2011). "
    4th National Patient Safety Day, Croke Park, Dublin; 11/2014
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    • "Indeed, environmental factors such as interruptions during the process of medication administration by colleagues, patients or telephone calls have been suspected of contributing to medication administration errors [25]. This has been confirmed by Westbrook et al. [26] who reported that the occurrence and frequency of interruptions were significantly associated with the incidence of procedural failures and clinical errors. However, whereas incidents related to the omission of signatures against the administration of paper-based prescriptions were rarely quantified, PICS renders these incidents visible. "
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    ABSTRACT: Even though electronic prescribing systems are widely advocated as one of the most effective means of improving patient safety, they may also introduce new risks that are not immediately obvious. Through the study of specific incidents related to the processes involved in the administration of medication, we sought to find out if the prescribing system had unintended consequences in creating new errors. The focus of this study was a large acute hospital in the Midlands in the United Kingdom, which implemented a Prescribing, Information and Communication System (PICS). This exploratory study was based on a survey of routinely collected medication incidents over five months. Data were independently reviewed by two of the investigators with a clinical pharmacology and nursing background respectively, and grouped into broad types: sociotechnical incidents (related to human interactions with the system) and non-sociotechnical incidents. Sociotechnical incidents were distinguished from the others because they occurred at the point where the system and the professional intersected and would not have occurred in the absence of the system. The day of the week and time of day that an incident occurred were tested using univariable and multivariable analyses. We acknowledge the limitations of conducting analyses of data extracted from incident reports as it is widely recognised that most medication errors are not reported and may contain inaccurate data. Interpretation of results must therefore be tentative. Out of a total of 485 incidents, a modest 15% (n = 73) were distinguished as sociotechnical issues and thus may be unique to hospitals that have such systems in place. These incidents were further analysed and subdivided into categories in order to identify aspects of the context which gave rise to adverse situations and possible risks to patient safety. The analysis of sociotechnical incidents by time of day and day of week indicated a trend for increased proportions of these types of incidents occurring on Sundays. Introducing an electronic prescribing system has the potential to give rise to new types of risks to patient safety. Being aware of these types of errors is important to the clinical and technical implementers of such systems in order to, where possible, design out unintended problems, highlight training requirements, and revise clinical practice protocols.
    BMC Medical Informatics and Decision Making 05/2011; 11(1):29. DOI:10.1186/1472-6947-11-29 · 1.83 Impact Factor
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    • "Even after many advances in information technologies, manual reports and registers are the main methods of data collection in health sector in India[5]. As manual reporting does not facilitate any query, sorting, relating etc., there is immense need of an easy to implement information system, which can report and analyze the data in time so as to check for any outbreaks and monitoring[6]. "
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