Health Information Management: Integrating Information Technology ...

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STRATEGY, IMPLEMENTATION AND EVALUATION 215 Issues ■ ■ The implementation of information technology changes both work practices and the technology itself. The phenomenon to be investigated, then, is not stable in formative PCIS evaluation. The way in which evaluation data is presented can skew the interpretation. Challenges ■ ■ ■ Ensure that evaluation results are presented in a clear and concise manner. Produce different reports for different stakeholders, reflecting their perspectives and need for detail. Show how different results link to each other. For example, a qualitative result may explain a quantitative finding. Step 6 Assess recommendations and decide on actions An important part of evaluation is the consideration of the implications of the evaluation. By doing this in the right way, continuous improvement and development of a learning culture is stimulated. If we want to learn from evaluation studies, we not only have to publish negative results, but also act on them. This is not always easy, of course. Evaluation results might lead to the conclusion that, looking at the aims of the PCIS, it is best to abort the system. For example, alerting systems that appear to be unreliable or alert too often too fast will not be accepted by personnel or management of a hospital. What is needed, therefore, is a formal documented action plan that is agreed upon by all stakeholders and allocates responsibilities for improvement and identifies timescales. In addition, it is important that there is proper communication of the actions and that necessary adjustments are made in, for example, policies in order to make the actions possible. Finally, this step should be seen as establishing a—new—baseline that is crucial for the next steps in a possible next evaluation. For the interest of the health care community, it is important that negative findings are also viewed as a basis for shared learning and action planning. Since many local—more or less identical—initiatives are undertaken, it is especially important that these experiences are documented and people are informed about systems and implementation trajectories that are successful and those that have failed. Doing this requires a thorough analysis of the reasons for success or failure of PCIS. CASE STUDY
216 EVALUATION OF PCISS In practice, however, negative results are often not published and positive results are not always acted upon. In the UK EPR study, clients were keen to see positive results and the sites that were studied did not wish their projects to be viewed in anything but the most positive light. This made it difficult to present specific examples, lending less weight to the findings. In the PDMS case, the results of the survey were positive. The evaluation of changing work practices and user satisfaction resulted in several technical improvements of the system and in better communication to the users. However, despite the positive results of the evaluation, the Board of Directors decided not to prioritize the implementation of the PDMS on three other ICU wards, the operating rooms and the Emergency Departments. Faced with a small budget, the project team could only install the system on two wards. Issues ■ ■ ■ Different stakeholders may selectively focus on specific bits of information out of the overall context of the evaluation report, to illustrate their own points. Despite positive evaluation results, further steps might be frustrated. Often it is unclear who is responsible for taking action on the evaluation results. Challenges ■ ■ Communicate clearly on the core of the evaluation results and appropriate action. Defining who is responsible for receiving and acting upon evaluation results should be done at the evaluation planning stage—not later once results appear. CONCLUSION In this chapter, we have provided an introduction to the theory and practice of evaluation. To this end, we have given the reader an appreciation of some of the major debates in this area. In addition, we have showed that conducting an evaluation is not simply about following several steps in a certain sequence. Designing and conducting an evaluation is a balancing act between identifying specific and feasible evaluation questions, utilizing the amount of resources available and specifying the sufficient ‘objectivity’ of the data. However, as elsewhere in this book, distinguishing the steps is useful since they constitute a framework through which to introduce and discuss the relevant issues. In
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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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Guidelines for information system d
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Page 180 and 181: Chapter 9 Implementing information
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Page 240 and 241: INDEX 225 satisfaction 176 patient
Page 242: INDEX 227 support 164 technology de
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