Robert A Stegwee

Transformational Consulting in eHealth

The International Patient Summary (IPS) provides a standardized set of essential clinical data, designed to ensure safe and effective healthcare delivery during unscheduled or emergency medical situations. Despite its potential benefits, the practical value and opportunities for improvement remain underexplored. This study evaluates the clinical re...

The UNICOM Test Lab enhances patient safety and healthcare efficiency by implementing ISO’s IDMP standards across the EU. Funded by the EU’s HORIZON Programme, this initiative unites diverse stakeholders to enable the seamless exchange of medicinal product information. This paper details the interoperability challenges and methodologies employed, h...

This systematic review examines the impact of the International Patient Summary (IPS) in healthcare based on twelve studies. Key findings highlight its value, including enhanced care quality, improved communication, and cost-effectiveness. Sufficient financial resources and adequate funding emerge as significant facilitators, while barriers such as...

The ISO standards for the Identification of Medicinal Products (IDMP) prove to be difficult to implement. Guidance needs to be provided to those using and further developing IDMP-related standards and terminologies. Providing fitting and structured education would be a step forward. This article describes research of current education and certifica...

Background: The lack of an international standard for assessing and communicating health app quality and even of consensus about what makes a high-quality health app negatively affects uptake of such apps. At the request of the European Commission, international Standard Development Organizations (SDOs) CEN-CENELEC, ISO, and IEC have joined forces...

IDMP in a capsule helps promote greater understanding about how IDMP standards “work” throughout the life-cycle stages of a medicinal product. In each stage - from the initial stage of Development and Production through the final stage of Utilisation and Outcome Assessment - IDMP standards’ concepts and theory are explained as part of two stories:...

The eStandards methodology stressed the importance of trust and flow for health data as a key characteristic of well-functioning health systems. A digital health compass, leveraging perspectives of health systems, digital health markets, citizens, and workforce, drives a process of co-creation, governance and alignment in eStandards. A repository o...

Clinical data interoperability requires shared specifications of meaning. This is the rationale for clinical data standards. Up until now, the adoption of such standards has been varied, although they are increasingly advocated in an area where proprietary specifications prevail, and semantic resources are geared to specific purposes and limited by...

Healthcare systems increasingly rely on digital technologies to sustain costs and improve access to quality care. Data drive a wave of automation aspiring to improve productivity by forging connections between health and wellness, medical research, and clinical decision support. Mobile apps and patient-generated data combined with provider recordin...

The objective of this study was to evaluate a decade of Electronic Patient Record development. During the study a second question was added: How to take the next step in the Netherlands? This paper describes the developments but the main results create a framework for the future situation. The USE IT method was used, which is derived from DOI and T...

We present a ten-year-update of the EPR-orientation-model for success of Electronic Patient Records (EPR's), based on our research. An EPR is seen as a way to make healthcare more efficient and effective. Many initiatives lead to the implementation of EPR's, but also regional infrastructures for information- and network services are realized. The l...

The CareRabbit has been introduced as a technological innovation in the care for children, enabling family and friends to stay in touch while the child is hospitalized. This study addresses influence of this innovation on the wellbeing of the children, and uses the validated KINDL questionnaire, eliciting information from children and parents at th...

The CareRabbit (ZorgKonijn) is an e-health device that can be used to play messages (e.g. text, MP3) sent through the Internet. It is used in children's departments in hospitals. Its aim is to make children feel comfortable and make their stay more pleasant. Research approach -- During the study, we will conduct a pilot study in five hospital paedi...

Growing cost of health care, the gradual reorganization of health care on a free-market basis and patients evolving into health care consumers all prompt hospitals to gain competitive advantage by improving efficiency, quality of care, and customer friendliness. An electronic health record system (EHR) is one of the tools to achieve these goals. Ho...

Short consultations and a large and growing amount of available medical information make searching for suitable information difficult for general practitioners. Thus information is often not searched for or not found, diminishing the quality of care. We propose a system that offers decision support by combining medical information sources with data...

The workshop is organized by HL7 and its affiliates to present and to discuss HL7's activities for providing international standards and specifications to enable advanced semantically interoperable eHealth and pHealth solutions, adaptable to national health systems through localization. The workshop especially focuses on the multi-disciplinary stru...

Little specific research has been conducted to date on the adaptation of agile information systems development (ISD) methods. This chapter presents the work practice in dealing with the adaptation of such a method in the ISD department of one of the leading financial institutes in Europe. The chapter introduces the idea of method adaptation as an u...

Little specific research has been conducted to date on the adaptation of agile information systems development (ISD) methods. This chapter presents the work practice in dealing with the adaptation of such a method in the ISD department of one of the leading financial institutes in Europe. The chapter introduces the idea of method adaptation as an u...

In a business-to-business setting there is a growing need for organizations to be interoperable. Computer systems involved in automating parts of a business process need to become an integral part of the business process. Before automation is achieved, the part of the business process to be automated needs to be made explicit and then operationaliz...

When a company decides to merge with or to acquire another company, a major question is to what extent to integrate the information technologies and the organization. Interpreting merger objectives to proper IT integration strategies is a complex and time-consuming process, due to a lack of explicit understanding of the problems involved. The curre...

The developments in the ICT led companies to strive to make parts of the business transaction electronic and raised again the issue of interoperability. Although interoperability between computer systems has been widely addressed in literature, the concept of interoperability between organizations is still to a large extent unexplored. Standards ar...

Purpose – In recent years, large engineering consultancy firms in the Netherlands have implemented enterprise resource planning (ERP) systems. The purpose of this study is to shed light on the changing role of information technology (IT) in these firms after implementing ERP. Design/methodology/approach – This change is analysed by focusing on the...

Information systems involved in automating parts of a business process need to be process-aware, in order to become an integral part of it. Before automation is achieved, the part of the business process to be automated needs to be made explicit and then operationalized. Business process models could be used to make the process explicit. Domain sta...

A web based system is described for the delivery of evidence-based behavioral interventions in the home for a variety of mental health problems in children. The goal of the interventions is to teach parents and/or children new skills to enable them to ...

This paper compares a traditional requirements study with 22 interviews for the design of an electronic patient record (EPR) and a USE IT analysis with 17 interviews trying to understand the end- user of an EPR. Developing, implementing and using information technology in organizations is a complex social activity. It is often characterized by ill-...

The developments in the ICT led companies to strive to make parts of the business transaction electronic and raised again the issue of interoperability. Although interoperability between computer systems has been widely addressed in literature, the concept of interoperability between organizations is still to a large extent unexplored. Standards ar...

Communication is at the core of society, and a networked society needs to adopt standards to achieve effective communication. However, from a practical point of view, it is often hard to find out what a particular standard actually has to offer. This problem becomes even more serious when it comes to domain specific standards. To what extent differ...

The use of standards to support the electronic execution of parts of a business transaction could provide substantial benefit. However, underestimating the need to evaluate the fit between the business requirements and the capabilities of a standard to meet these requirements (at an early stage of a standard implementation project) can lead to prob...

The management of healthcare organizations is starting to recognize the relevance of the definition of care products in relation to management information. In the turmoil between costs, care results and patient satisfaction, the right balance is needed, and it can be found in upcoming information and communication technologies (ICT). The ICT develo...

It is widely recognized that the healthcare industry does not use information technology to its full potential. This book uncovers many of the reasons why large-scale implementation of healthcare information systems has not come to fruition yet. The authors provide a broad coverage of the field, ranging from strategic analysis to real-life project...

A fundamental approach to setting up an e-business initiative is needed to fully utilise the capabilities of Internet technology in a specific business setting. Such an initiative has to build on the strengths of the organisation and take full advantage of the opportunities in the market, meanwhile identifying costly unsuccessful projects and preve...

Health care is an information-intensive industry. Its cornerstones are a research tradition of hundreds of years, and detailed understanding of each customer, patient. As compared to other industries, say banking, the data about the customer needs to be very detailed, and must include trend data to allow analysis of the development of things. When...

Findings from a preliminary survey of health information networks (HINs) established in various parts of Canada lead us to suggest that buy-in and participation in development of the alliance by physicians and other providers is critical. Also, most healthcare providers are not aware of the difficulties involved in establishing connectivity in the...

The research effort on Electronic Patient Records (EPRs) has rapidly increased in the last decade. Much of this research focussed on standardisation and technical realizations. We will describe such a research effort in this chapter and evaluate its success. Our main finding is that the lack of success of this specific research effort is mainly due...

It is widely recognized that the healthcare industry does not use information technology to its full potential. This book uncovers many of the reasons why large-scale implementation of healthcare information systems has not come to fruition yet. The authors provide a broad coverage of the field, ranging from strategic analysis to real-life project...

Reengineering is about fundamentally rethinking and dramatically redesigning business processes in order to lower costs and increase quality, service and speed. Such transformation is required in many industries today, perhaps none more so than the health sector. One enabling mechanism to allow for such large-scale change is found in information sy...

This chapter explores some of the consequences of strategies used to develop electronic standards in healthcare, especially the consequences of electronic standards for communication work. The two standardization strategies explored are the prototype strategy used to develop intranet applications and the specification strategy used to develop Pictu...

Standardization in healthcare is a rapidly growing field. To prevent proliferation in standardisation, good coordination in both the development and usage of standards is necessary. In this chapter we propose a framework to analyse the fit between the proposed purpose of the standard and the perceived needs of the applications using the standard. A...

Contingency theory provides a theoretical framework for analysing the implementation differences in the configuration of Information Systems for Continuous Replenishment in the retail sector. The configuration can be broken down into three arrangements: data processing and sharing arrangement, technical arrangement, and information management arra...

It is widely recognized that the healthcare industry does not use information technology to its full potential. This book uncovers many of the reasons why large-scale implementation of healthcare information systems has not come to fruition yet. The authors provide a broad coverage of the field, ranging from strategic analysis to real-life project...

Information Technology (IT) has always been the playground of technical specialists. In this paper we argue no changes in this respect, but rather that the management of an organisation becomes aware of what the technical specialists are actually doing. This cannot be achieved by teaching tomorrow’s managers a few of the technical skills. We see th...

This contribution summarises the findings of the conference discussion group on the changing role of management. The discussions have taken place according to a quite broad format: i) exchange experiences ii) find and discuss key themes iii) identify educational issues for further studies.

This paper introduces a general, formal treatment of dynamic constraints, i.e., constraints on the state changes that are allowed in a given state space. Such dynamic constraints can be seen as representations of "real world" constraints in a managerial context. The notions of transition, reversible and irreversible transition, and transition relat...

In this paper a comparison is given of dutch methodologies for information planning and policy. This is done on the basis of three frameworks: Galliers, Stegwee and Van Waes, and Theeuwes. Galliers is used to give an overview, the other two frameworks are used to give a more detailed picture. The frameworks are joined, to be useful as a tool for po...

Information systems planning has developed rapidly over the past decades. However, practical experience indicates we have yet to reach maturity. Many organizations have yet gained some experience with ISP. The evaluations available show a mixed picture. We seem to have reached a stage in which the development and implementation of ISP has lost mome...

Health Level 7 (HL7) is een familie van internationale standaarden die de betekenisvolle uitwisseling van informatie in de zorg ondersteunt. Om ondersteuning aan de verschillende vormen van informatie-uitwisseling in de zorg zelf te kunnen vormgeven, zijn ook verschillende standaarden binnen de HL7 familie ontstaan. In deze bijdrage zal de auteur i...