RESUMEN
As costs for healthcare are rising in society, information systems are often seen as enablers of new cost-saving healthcare processes. But an on-going deployment of a wide range of new kinds of systems requires close attention to interoperability between new and legacy systems. Another challenge is to assure that the healthcare professions are given realistic opportunities to play an active part in designing the new ways of working that the new, integrated systems are designed to support. We argue that a feasible way to approach such a user participation in design of work processes and systems is to extend well known user-survey and strategy-mapping methods with the new value-based healthcare approach which invites health professionals to participate in strategic assessments of health outcome and costs along the care chain in which they work. We also argue that such a combination of practical research methods resonates well with Techno-Anthropology's foregrounding of ethical considerations to inform the interdisciplinary cross-fertilization of interactional competencies in health informatics research.
Asunto(s)
Antropología Cultural , Informática Médica , Evaluación de Resultado en la Atención de Salud , Conducta Cooperativa , Ahorro de Costo , Difusión de Innovaciones , Humanos , Innovación Organizacional , Suecia , Integración de Sistemas , Compra Basada en CalidadRESUMEN
The use of information and communication technology (ICT) to support integrated healthcare services in elderly homecare is becoming more established. In particular, ICT can enable information exchange, knowledge sharing and documentation at the point-of-care (POC). The aim of this study was to explore these effects using the Old@Home prototype. Old@Home was perceived to contribute in developing horizontal links for communication between individuals who work together, independent of geographical distance or organizational affiliation, and to contribute to increased work efficiency. The prototype was further seen to reduce professional isolation by providing a holistic overview of the care process. User centred design and implementation of Old@Home was considered key to facilitating acceptance of organizational changes. Participation of care professionals not only led to a better understanding of the needs of involved organizations, but also increased end-users' involvement and commitment, stimulating them to test and improve the prototype until the final version.
Asunto(s)
Servicios de Atención de Salud a Domicilio/organización & administración , Sistemas de Información/organización & administración , Telemedicina/organización & administración , Anciano , Anciano de 80 o más Años , Comunicación , Personal de Salud/organización & administración , Humanos , Sistemas de Registros Médicos Computarizados/organización & administración , Estudios de Casos Organizacionales , Grupo de Atención al Paciente/organización & administración , Sistemas de Atención de Punto/organización & administraciónRESUMEN
The impact of information and communication technology (ICT) is indirect and depends on redesign of practices and structures also outside health care. Improvements will only be realized if all parties involved can coordinate their efforts to take advantage of new technology. A 'package' of changed work practices and structures extending across organizational boundaries needs to be designed and implemented. This is very different from the common conception of introducing new ICT tools. Calls for 'evaluation of benefits' before new ICT systems are introduced need to recognize this complexity. This article investigates how analysis and economic evaluations can be used to improve decision-making when new applications are proposed. This is done by drawing parallels with experiences from other industries. We conclude that the entire 'change package' should be analysed for its consequences on the well-being of care recipients, and the requirements it presents for capital investments and changed labour inputs, in particular changed competence needs. Some concepts and structures are suggested for such evaluations.