Research Article | Open Access
Dimitrios G. Katehakis, Stelios Halkiotis, Angelina Kouroubali, "Materialization of Regional Health Information Networks in Greece: Electronic Health Record Barriers & Enablers", Journal of Healthcare Engineering, vol. 2, Article ID 749634, 16 pages, 2011. https://doi.org/10.1260/2040-22188.8.131.529
Materialization of Regional Health Information Networks in Greece: Electronic Health Record Barriers & Enablers
This paper draws upon the experience of production level implementations, initiated through public procurement, of four regional health information networks (RHINs). The RHINs are being implemented in four regional health authorities (RHAs) in Greece to support patient-centred services. This paper focuses on three key areas: (i) engineering issues related to the deployment of an integrated electronic health record (EHR) system, (ii) management issues regarding implementation and planning, and (iii) socio-organizational issues influencing the outcome of large scale EHR implementations. The complexity of the health sector is also presented focusing on EHR barriers and enablers at institutional and regional levels. Reasons why EHR system implementations have not progressed as expected are also discussed.
- Commission of the European Communities, e-Health - making healthcare better for European citizens: An action plan for a European e-Health Area, Communication from the Commision to the Council, The European Parliament, The European Economic and Social Committee and the Committee of the Regions, COM 356 final, 2004.
- National Committee for Quality Health Care, CEO survival guide(tm) to electronic health record systems, National Quality Forum, 2006.
- J. G. Anderson, “Clearing the way for physicians' use of clinical information systems,” Communications of the ACM, vol. 40, no. 8, pp. 83–90, 1997.
- J. S. Ash and D. W. Bates, “Factors and forces affecting EHR system adoption: Report of a 2004 ACMI discussion,” Journal of the American Medical Informatics Association, vol. 12, no. 1, pp. 8–12, 2005.
- N. M. Lorenzi, R. T. Riley et al., “Antecedents of the people and organizational aspects of medical informatics: Review of the literature,” Journal of the American Medical Informatics Association, vol. 4, no. 2, pp. 79–93, 1997.
- J. S. Ash, P. N. Gorman, V. Seshadri, and W. R. Hersh, “Perspectives on CPOE and Patient Care Information Systems: Research Paper: Computerized Physician Order Entry in U. S. Hospitals: Results of a 2002 Survey,” JAMIA, vol. 11, pp. 95–99, 2004.
- S. H. Fenton, O. K. Giannangel, and M. Stanfill, “Essential people skills for EHR implementation success,” Journal of AHIMA, vol. 77, no. 6, pp. 60A–60D, 2006.
- D. Gruber, G. G. Cummings, L. Leblanc, and D. L. Smith, “Factors influencing outcomes of clinical information systems implementation: A systematic review,” CIN - Computers Informatics Nursing, vol. 27, no. 3, pp. 151–163, 2009.
- A. Poulymenakou and A. Holmes, “Acontingency framework for the investigation of information systems failure,” European Journal of Information Systems, vol. 5, no. 1, pp. 34–47, 1996.
- D. A. Ludwick and J. Doucette, “Adopting electronic medical records in primary care: Lessons learned from health information systems implementation experience in seven countries,” International Journal of Medical Informatics, vol. 78, no. 1, pp. 22–31, 2009.
- M. J. Van Der Meijden, H. J. Tange et al., “Determinants of success of inpatient clinical information systems: A literature review,” Journal of the American Medical Informatics Association, vol. 10, no. 3, pp. 235–243, 2003.
- N. M. Lorenzi, L. L. Novak et al., “Crossing the implementation chasm: A proposal for bold action,” Journal of the American Medical Informatics Association, vol. 15, no. 3, pp. 290–296, 2008.
- S. A. Brown, N. L. Chervany et al., “What matters when introducing new information technology,” Communications of the ACM, vol. 50, no. 9, pp. 91–96, 2007.
- R. Heeks, “Health information systems: Failure, success, and improvisation,” International Journal of Medical Informatics, vol. 75, pp. 125–137, 2006.
- N. M. Lorenzi and R. T. Riley, “Managing Change: An Overview,” Journal of the American Medical Informatics Association, vol. 7, pp. 116–24, 2000.
- C. Westrup, “What's in information technology?” in Implementation and evaluation of information systems in developing countries, C. Avgerou, Ed., pp. 77–91, Asian Institute of Technology, 1998.
- R. Heeks, D. Mundy, and A. Salazar, “Understanding success and failure of health care information systems,” in Healthcare Information Systems: Challenges of the New Millennium, A. Armoni, Ed., pp. 96–128, Idea Group Publishing, USA, 2000.
- K. H. Dansky, L. D. Gamm et al., “Electronic medical records: Are physicians ready?” Journal of Healthcare Management, vol. 44, no. 6, pp. 440–455, 1999.
- Greece in the Information Society, Strategy and Actions, 1 February 1999, http://www.epractice.eu/node/281163, accessed December 6, 2010.
- Greece in the Information Society, Strategy and Actions, 24 January 2002, http://www.epractice.eu/en/library/281110, accessed December 6, 2010.
- Operational Programme, “Information Society,” (REGIO/2001/00227–00–00), http://www.infosoc.gr/NR/rdonlyres/2A49C506-BF24–46D0-A933–1CD3B122F389/409/InformationSociety_program.doc, accessed December 6, 2010.
- D. G. Katehakis, M. Tsiknakis, and S. C. Orphanoudakis, “Enabling components of HYGEIAnet,” in Proceedings of the 17th Annual Towards an Electronic Patient Record Conference and Exhibition (TEPR, 2001), Your Connection to Electronic Healthcare, pp. 146–153, Boston, Massachusetts, USA, 2001.
- M. Tsiknakis, C. E. Chronaki, S. Kostomanolakis, and S. C. Orphanoudakis, “The regional health telematics system of Crete,” in Proceedings of the Health Telematics '95 Conference, pp. 553–558, Naples, Italy, 1995.
- A. Kouroubali, V. Sakkalis, C. E. Chronaki, and M. Tsiknakis, “eChallenges in the implementation of eHealth services over a hybrid network architecture: The case of eLearning,” in Exploiting the Knowledge Economy: Issues, Applications and Case Studies, vol. 3, pp. 997–1004, IOS Press, 2006.
- eHealth 2003 High Level Conference, http://ec.europa.eu/information_society/eeurope/ehealth/conference/2003/index_en.htm, accessed December 6, 2010.
- D. G. Katehakis, S. G. Sfakianakis, D. Anthoulakis et al., “A holistic approach for the delivery of the integrated electronic health record within a regional health information network,” FORTH-ICS/TR-350, 2005, http://www.ics.forth.gr/~katehaki/publications/tr350.pdf, accessed December 6, 2010.
- “Health informatics, Electronic health record, definition, scope and context,” ISO/TR 20514:2005.
- M. Miles and A. Huberman, Qualitative data analysis, Sage, London, 1994.
- J. A. Effken, “Different lenses, improved outcomes: a new approach to the analysis and design of health information systems,” International Journal of Medical Informatics, vol. 65, pp. 59–74, 2002.
- M. J. Wheatley, Leadership and the new science: Learning about organization from an orderly universe, Berrett–Kohler, San Francisco, 1992.
- M. Tsiknakis, D. G. Katehakis, and S. C. Orphanoudakis, “An Open, Component-based information infrastructure for integrated health information networks,” International Journal of Medical Informatics, vol. 68, no. 1–3, pp. 3–26, 2002.
- P. Constantinides and M. Barrett, “Large-scale ICT innovation, power, and organizational change,” The Journal of Applied Behavioral Science, vol. 42, no. 1, pp. 76–90, 2006.
- T. Mäenpääa, T. Suominena, P. Asikainen, M. Maass, and I. Rostila, “The outcomes of regional healthcare information systems in health care: Areview of the research literature,” International Journal of Medical Informatics, vol. 78, no. 11, pp. 757–771, 2009.
- Health Level Seven, http://www.hl7.org, accessed December 6, 2010.
- SYZEFXIS National Public Administration Network, http://www.syzefxis.gov.gr, accessed December 6, 2010.
- J. Oates and B. H. Jensen, Eds., Building Regional Health Care Networks in Europe, vol. 67 of Studies in Health Technology and Informatics, IOS press, Amsterdam, 2000.
- N. M. Lorenzi, A. Kouroubali, D. E. Detmer, and M. Bloomrosen, “How to successfully select and implement electronic health records (EHR) in small ambulatory practice settings,” BMC Medical Informatics & Decision Making, vol. 9, no. 15, 2009, http://www.biomedcentral.com/1472-6947/9/15, accessed December 6, 2010.
- D. G. Katehakis, “The PICNIC Story,” in Regional Health Economies and ICT Services: The PICNIC Experience, vol. 115 of Studies in Health Technology and Informatics, pp. 4–36, IOS Press, 2005.
- M. Tsiknakis and A. Kouroubali, “Organizational factors affecting successful adoption of innovative eHealth services: a case study employing the FITT framework,” International Journal of Medical Informatics, vol. 78, no. 1, pp. 39–52, 2009.
- A. Kouroubali, D. E. Detmer, M. Tsiknakis, and S. A. Orphanoudakis, “Health Care Information System in Greece: Key Factors, Self-Organization and Take-Home Lessons,” in Understanding Health Communications Technologies: A Case Study Approach, P. Whitten and D. Cook, Eds., pp. 69–79, Jossey-Bass, San Francisco, 2004.
- J. T. Scott, T. G. Rundall, T. M. Vogt, and J. Hsu, “Kaiser Permanente's Experience of Implementing an Electronic Medical Record: A Qualitative Study,” BMJ, vol. 331, no. 7528, pp. 1313–1316, 2005.
- B. Kaplan, “Addressing organizational issues into the evaluation of medical systems,” Journal of the American Medical Informatics Association, vol. 4, pp. 94–101, 1997.
- M. Berg, “Implementing information systems in health care, organizations: Myths and challenges,” International Journal of Medical Informatics, vol. 64, no. 2-3, pp. 143–56, 2001.
- L. Esterle and A. Kouroubali, Political and organisational factors influencing large scale implementation of electronic health records: Recommendations for a Realistic Implementation Plan, EHR-Implement project, 2010, http://www.ehr-implement.eu, accessed December, 6, 2010.
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