Evaluation of IT modernisation in the NHS - NETSCC

Report to SDO for NCRS ProjectSupporting LiteratureSpecific qualitative literature search terms used were:• Ethnography• Phenomenology• Grounded theory• Discourse analysis• focus group• hermeneutic• narrative analysis or narrative psychology or narrative method• human science• new paradigm• action research• co-operative inquiry• humanistic• existential• experiential &• conversation analysisThe search also included checking references in references lists of papersalready identified, identifying main researchers in the field and searching underauthor names, and searching general internet sites (Google). The articlesretrieved included 380 MEDLINE abstracts and 325 Web of Knowledge abstracts.The results of this initial search and subsequent additional sources of informationare synthesised below.2.2. Difficulties in evaluating the impact of EPRsThere is considerable evidence that the implementation of large-scale healthservice IT projects is extremely difficult to achieve. 9 The problem of achievinginteroperability, the cornerstone of any integrated record system, still appearselusive. Hospitals often have small ‘own brand’ IT systems that will not link towider networks. The issue of confidentiality and security is another IT problem inhospital medicine that has not been completely resolved 10 . These factors,amongst others, have led to IT implementation failure rates of around 30%,although this may be higher; many negative results are likely to be seen as14