Health Information Management: Integrating Information Technology ...

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STRATEGY, IMPLEMENTATION AND EVALUATION 207 objective of the implementation is clear and whether it fits with the organizational strategy. From the economic domain it is interesting to know what the costs are of buying the system, training of personnel, maintenance and so forth. From an ethical point of view it is interesting to know what the effects of electronic patient data are on for example autonomy of the patient or the doctor— patient communication. From the legal domain, finally, topics like the legal status of electronic patient data are crucial. When one simultaneously takes the domain and the phase of implementation in consideration, a whole range of potentially relevant evaluation questions emerges (see Table 11.1). The importance of the different questions is dependent on the type of technology and the focus of the evaluation. Paying attention to all these questions offers the possibility to do a comprehensive evaluation, which means one can judge the information system on all relevant aspects. Since one can ask so many questions, the relevance of the evaluation questions is dependent on the perspective that one takes. There can be as many perspectives as there are stakeholders in an evaluation project. For example, evaluation questions regarding the technical aspects of maintenance, compatibility with other systems and possibilities to upgrade are relevant for the IT department, but generally less of a priority for professionals (doctors, nurses) or the manager that is accountable for the cost-effectiveness of an information system. Patients, for Table 11.1 Different domains and moments of PCIS evaluation, with example questions Pre-implementation Implementation Post-implementation Technical domain: • compatibility with other systems? • upgradeable? • maintenance? • data consistency? • speed? • adaptability to changing requirements? Professional domain: • what are the professionals’ needs? • how much time does it take to learn the system/ work with it? does it make work easier? • what are professionals’ interests to work with the system? • user-friendliness? • possible to tailor information to specific needs of professionals? • downtime (frequency, duration)? • upgradeable? • is it easy to use? • what are the benefits compared to the old situation? • (how) does it affect the content/effectiveness of work? • does it improve patient outcomes (compliance, morbidity, mortality)? • how did the system perform on all selected features? • were there unexpected problems and were they solvable? • ‘final’ impacts on content/ effectiveness of work (changing tasks, responsibilities, routines, less errors, time saving, less ‘lost’ records)? • improved data quality? • impact on patient outcomes? • overall satisfaction? • overall use?
208 EVALUATION OF PCISS Pre-implementation Implementation Post-implementation • content of information: understandable and complete? Organizational domain: • is the organization ready? • are the different stakeholders ready? • is the objective of implementation clear? • does the investment ‘fit’ with other organizational strategies? • what kind of preparations/ adjustments have to be made in advance? • does the organization have to make adjustments (procedures, strategy, decision-making, etc.)? • are there unexpected negative effects? • impacts on work processes and organization as a whole (communication patterns, responsibilities, decision-making procedures, interactions within/between professional groups)? • impacts on waiting lists, provided services, organizational strategy? • impacts on patient satisfaction? Pre-implementation Implementation Post-implementation Economic domain: • expected costs of buying, training, maintenance, etc.? • expected benefits (return on investment)? • reliable vendor? Ethical domain: • data access, data security? • accountability for use of patient data? • possible effects of use of electronic patient data? Legal domain: • expected registration (quality, presence) improvements/benefits? Source: Stoop and Berg (2003) • unexpected costs (maintenance, upgrading, training)? • are risks being managed? • how are patient data being used (by whom, for what purposes)? • who is responsible for use of patient data? •how are patients involved in the implementation? • what role do electronic patient data play in legal matters (e.g. legal status)? • ‘final’ costs? • ‘final’ benefits? • ‘overall’ effects of use of electronic patient data (e.g. decisionmaking, autonomy, doctor-patient communication, etc.)? • consequences of use of electronic patient data? • (potential) legal (im) possibilities? example, are interested in patient outcomes, but probably less interested in the expected costs of buying or the reliability of the vendor. Independent of the reason for the evaluation, the aim of evaluation is to find answers to relevant
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Health Information Management In al
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Health Information Management Integ
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Contents List of illustrations vii
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Illustrations FIGURES 3.1 Medicatio
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Contributors Marc Berg is a physici
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Series preface In almost all Wester
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Acknowledgements I would like to th
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Chapter 1 Introduction In all Weste
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INTRODUCTION 3 touch upon the deplo
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INTRODUCTION 5 can draw upon to mai
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INTRODUCTION 7 Physician Order Entr
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Part I Starting points Understandin
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WAITING FOR GODOT 11 KEY TERMS ■
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WAITING FOR GODOT 13 Netherlands an
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WAITING FOR GODOT 15 facts to show
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WAITING FOR GODOT 17 (Lewinski-Corw
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WAITING FOR GODOT 19 In most cases,
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WAITING FOR GODOT 21 (Anonymous 191
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WAITING FOR GODOT 23 Because of the
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WAITING FOR GODOT 25 they simply sa
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WAITING FOR GODOT 27 expected. Stil
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WAITING FOR GODOT 29 organize their
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WAITING FOR GODOT 31 performance in
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WAITING FOR GODOT 33 different HIS
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WAITING FOR GODOT 35 CONCLUSION: TH
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WAITING FOR GODOT 37 assumption tha
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WAITING FOR GODOT 39 Anonymous (191
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WAITING FOR GODOT 41 Berg, M. (1997
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Chapter 3 Health care work and pati
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HEALTH CARE WORK AND INFORMATION SY
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THE CONTEXTUAL NATURE OF INFORMATIO
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Chapter 5 Meeting the challenge Int
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STARTING POINTS 81 ‘gender, race,
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STARTING POINTS 83 Now, imagine an
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STARTING POINTS 85 organization,
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STARTING POINTS 87 Figure 5.2 Incre
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STARTING POINTS 89 already overflow
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STARTING POINTS 91 responsibilities
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STARTING POINTS 93 answer the quest
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STARTING POINTS 95 Kohn, L.T., J.M.
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Chapter 6 Designing interactions En
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DESIGNING INTERACTIONS 99 the way t
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DESIGNING INTERACTIONS 101 1 Identi
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DESIGNING INTERACTIONS 103 the deve
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DESIGNING INTERACTIONS 105 communic
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DESIGNING INTERACTIONS 107 Figure 6
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DESIGNING INTERACTIONS 109 ■ Figu
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DESIGNING INTERACTIONS 111 measurem
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DESIGNING INTERACTIONS 117 Covell D
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Part II Information strategy, imple
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INFORMATION STRATEGY: AN INTRODUCTI
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Chapter 8 Developing the informatio
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STRATEGY, IMPLEMENTATION AND EVALUA
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Page 172 and 173: Guidelines for information system d
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