The outcomes of regional healthcare information systems in health care: A review of the research literature

The resulting regional healthcare information systems were expected to have effects and impacts on health care procedures, work practices and treatment outcomes. The aim is to find out how health information systems have been investigated, what has been investigated and what are the outcomes. A systematic review was carried out of the research on the regional health information systems or organizations. The literature search was conducted on four electronic Cinahl Medline, Medline/PubMed and Cochrane. The common type of study design was the survey research and case study, and the data collection was carried out via different methodologies. They found out different types of regional health information systems (RHIS). The systems were heterogeneous and were in different phases of these developments. The RHIS outcomes focused on the five main areas: flow of information, collaboration, process redesign, system usability and organization culture. The RHIS improved the clinical data access, timely information, and clinical data exchange and improvement in communication and coordination within a region between professionals but also there was inadequate access to patient relevant clinical data. There were differences in organization culture, vision and expectations of leadership and consistency of strategic plan. Nevertheless, there were widespread participation by both healthcare providers and patients.

[1]  Knut Bernstein,et al.  Shared Experience in 13 Local Danish EPR Projects: The Danish EPR Observatory , 2001, MedInfo.

[2]  G. Joshy,et al.  Diabetes information systems: a rapidly emerging support for diabetes surveillance and care. , 2006, Diabetes technology & therapeutics.

[3]  William A. Yasnoff,et al.  A framework for systematic evaluation of health information infrastructure progress in communities , 2007, J. Biomed. Informatics.

[4]  Patricia C. Dykes,et al.  National and Regional Health Information Infrastructures: Making Use of Information Technology to Promote Access to Evidence , 2004, MedInfo.

[5]  Reinhold Haux,et al.  Individualization, globalization and health - about sustainable information technologies and the aim of medical informatics , 2006, Int. J. Medical Informatics.

[6]  Robyn Tamblyn,et al.  Review Paper: The Impact of Electronic Health Records on Time Efficiency of Physicians and Nurses: A Systematic Review , 2005, J. Am. Medical Informatics Assoc..

[7]  Carole M Cotter.  Making the case for a clinical information system: the chief information officer view. , 2007, Journal of critical care.

[8]  Michael Higgins,et al.  An Electronic Health Record - Public Health (EHR-PH) System Prototype for Interoperability in 21st Century Healthcare Systems , 2005, AMIA.

[9]  Catherine C. Marshall,et al.  Designing Qualitative Research , 1996 .

[10]  K. Sackett,et al.  The Western New York regional electronic health record initiative: Healthcare informatics use from the registered nurse perspective. , 2006, Studies in health technology and informatics.

[11]  E. Ammenwerth,et al.  Evaluation of the electronic transmission of medical findings from hospitals to practitioners by triangulation. , 2006, Methods of information in medicine.

[12]  G Pangalos,et al.  Developing a Public Key Infrastructure for a secure regional e-Health environment. , 2002, Methods of information in medicine.

[13]  John Donnelly,et al.  Building an interoperable regional health information network today with IHE integration profiles. , 2006, Journal of healthcare information management : JHIM.

[14]  S. Fehrenbach,et al.  Integration of child health information systems: current state and local health department efforts. , 2004, Journal of public health management and practice : JPHMP.

[15]  T O'Dowd,et al.  Effectiveness of shared care across the interface between primary and specialty care in chronic disease management. , 2007, The Cochrane database of systematic reviews.

[16]  I. Chouvarda,et al.  Information technology can enhance quality in regional health delivery. , 2002, Methods of information in medicine.

[17]  Paula Asikainen,et al.  Usefulness of a Regional Health Care Information System in primary care: A case study , 2008, Comput. Methods Programs Biomed..

[18]  Brian E. Dixon,et al.  Pulling Back the Covers: Technical Lessons of a Real-World Health Information Exchange , 2007, MedInfo.

[19]  Lawrence P Hanrahan,et al.  Medical informatics in population health: building Wisconsin's strategic framework for health information technology. , 2006, Wisconsin Medical Journal.

[20]  Therese Hoyle,et al.  Assessing what child health information systems should be integrated: the Michigan experience. , 2004, Journal of public health management and practice : JPHMP.

[21]  Marc Cuggia,et al.  A model for a Regional Health Information Network sharing clinical information between professionals in Britanny , 2006, MIE.

[22]  J. Overhage.  Health information exchange: 'lex parsimoniae'. , 2007, Health affairs.

[23]  David W. Bates,et al.  Viewpoint Paper: E-Prescribing Collaboration in Massachusetts: Early Experiences from Regional Prescribing Projects , 2006, J. Am. Medical Informatics Assoc..

[24]  J. Roode,et al.  Modelling the effect of limited or vulnerable resources on the use of computerised hospital information systems (CHISs) in South Africa. , 2007, Studies in health technology and informatics.

[25]  W. Hammond.  The making and adoption of health data standards. , 2005, Health affairs.

[26]  Pirkko Nykänen,et al.  Evaluation during design of a regional seamless network of social and health care services--information technology perspective. , 2002, Studies in health technology and informatics.

[27]  M. Follen,et al.  Implementing health information technology to improve the process of health care delivery: a case study. , 2007, Disease management : DM.

[28]  Douglas R. Wilson,et al.  Physicians' Perceptions of Integration in Three Western Canada Health Regions , 2005, Healthcare management forum.

[29]  Reinhold Haux,et al.  An e-consent-based shared EHR system architecture for integrated healthcare networks , 2007, Int. J. Medical Informatics.

[31]  G. Kuperman,et al.  Approaches to patient health information exchange and their impact on emergency medicine. , 2006, Annals of emergency medicine.

[32]  David W. Bates,et al.  A Consensus Action Agenda for Achieving the National Health Information Infrastructure , 2004, Journal of the American Medical Informatics Association.

[33]  Dianne Koval.  Real-world RHIO. A regional health information organization blazes a trail in Upstate New York. , 2005, Journal of AHIMA.

[34]  Suzanne Austin Boren,et al.  The role of the electronic medical record (EMR) in care delivery development in developing countries: a systematic review. , 2008, Informatics in primary care.

[35]  B. Middel.  The impact of electronic health records on time efficiency of physicians and nurses: a systematic review1) , 2008 .

[36]  A. MacFarlane,et al.  Telemedicine services in the Republic of Ireland: an evolving policy context. , 2006, Health policy.

[37]  Kaija Saranto,et al.  Definition, structure, content, use and impacts of electronic health records: A review of the research literature , 2008, Int. J. Medical Informatics.

[38]  P. Shekelle,et al.  Systematic Review: Impact of Health Information Technology on Quality, Efficiency, and Costs of Medical Care , 2006, Annals of Internal Medicine.

[39]  R. Alvarez,et al.  The promise of e-Health – a Canadian perspective , 2002, Ehealth international.

[40]  P. Beynon-Davies,et al.  When health information systems fail. , 1999, Topics in health information management.

[41]  Zvisinei Sandi.  DEFINITION , 1961, A Philosopher Looks at Sport.

[42]  Arlene Fink,et al.  Implementation Brief: Identifying Organizational Capacities and Incentives for Clinical Data-sharing: The Case of a Regional Perinatal Information System , 2008, J. Am. Medical Informatics Assoc..

[43]  Shellie Kolavic Gray,et al.  NHIN, RHIOs, and Public Health. , 2007, Journal of public health management and practice : JPHMP.

[44]  Adalberto Otranto Tardelli,et al.  [Public scientific knowledge distribution in health information, communication and information technology indexed in MEDLINE and LILACS databases]. , 2007, Ciencia & saude coletiva.

[45]  Pekka Ruotsalainen,et al.  Sharable EHR systems in Finland. , 2006, Studies in health technology and informatics.

[46]  M. Bourn,et al.  A prodigious information systems failure. , 1996, Topics in health information management.

[47]  Michael R. Solomon,et al.  Regional Health Information Organizations: A Vehicle for Transforming Health Care Delivery? , 2007, Journal of Medical Systems.

[48]  A. Noblin.  Privacy Policy Analysis for Health Information Networks and Regional Health Information Organizations , 2007, The health care manager.

[49]  Manolis Tsiknakis,et al.  Delivering a Lifelong Integrated Electronic Health Record Based on a Service Oriented Architecture , 2007, IEEE Transactions on Information Technology in Biomedicine.

[50]  Manolis Tsiknakis,et al.  An open, component-based information infrastructure for integrated health information networks , 2002, Int. J. Medical Informatics.

[51]  Andrew P. McAfee,et al.  The state of regional health information organizations: current activities and financing. , 2007, Health affairs.

[52]  P Nykänen,et al.  Success and failure factors in the regional health information system design process--results from a constructive evaluation study. , 2006, Methods of information in medicine.

[53]  J. Glaser,et al.  Concepts for building inter-organizational systems in healthcare: lessons from other industries. , 2006, Journal of healthcare information management : JHIM.

[54]  Janet Marchibroda,et al.  Health information exchange policy and evaluation , 2007, J. Biomed. Informatics.

[55]  J. Marc Overhage,et al.  Viewpoint Paper: Communities' Readiness for Health Information Exchange: The National Landscape in 2004 , 2005, J. Am. Medical Informatics Assoc..

[56]  T. Roumeliotaki,et al.  Evaluation of Shared EHR Services in Primary Healthcare Centers and their Rural Community Offices: the Twister Story , 2007, Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[57]  J C Wyatt,et al.  Evaluating computerized health information systems: hardware, software and human ware: experiences from the Northern Province, South Africa. , 1999, Journal of public health medicine.