Bottom-up or top-down?: A comparative analysis of electronic health record diffusion in Ireland and Israel

Purpose – The limited success of electronic health records (EHRs) implementation in the healthcare services in general, and a national EHR in particular, requires better understand and documentation of the current drivers and inhibitors of EHR adoption, together with a definition of a national EHR. This paper aims to address these issues.Design/methodology/approach – Factors affecting EHR adoptions are elicited from extant literature and the stakeholder/actor framework is used as the theoretical framework. The multiple case study approach is used as the research method, and data are collected in Ireland and Israel by interviews and analysed using text coding methods.Findings – Factors elicited in the literature are generally corroborated, yet the salient factor on the localized perspective appears to be the degree of centralization of the healthcare services; while different factors affect the national perspective. In summary, it seems that Israel is more ready for national EHR implementation than Ireland...

[1]  Jos van Hillegersberg,et al.  Enterprise resource planning: introduction , 2000, CACM.

[2]  Vasiliki Mantzana,et al.  Identifying healthcare actors involved in the adoption of information systems , 2007, Eur. J. Inf. Syst..

[3]  Robin C. Meili,et al.  Can electronic medical record systems transform health care? Potential health benefits, savings, and costs. , 2005, Health affairs.

[4]  Wanda J. Orlikowski,et al.  Studying Information Technology in Organizations: Research Approaches and Assumptions , 1991, Inf. Syst. Res..

[5]  L. Petersen,et al.  Barriers to proliferation of electronic medical records. , 2004, Informatics in primary care.

[6]  W. Hersh,et al.  Health care information technology: progress and barriers. , 2004, JAMA.

[7]  Andrew Abbott,et al.  From Causes to Events , 1992 .

[8]  Nir Menachemi,et al.  Reviewing the Benefits and Costs of Electronic Health Records and Associated Patient Safety Technologies , 2006, Journal of Medical Systems.

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

[10]  Michael Koenig,et al.  Knowledge management: another management fad? , 2002, Inf. Res..

[11]  D. Bates.  Physicians and ambulatory electronic health records. , 2005, Health affairs.

[12]  Alan Hassey,et al.  To opt in or opt out of electronic patient records?: Isle of Wight and Scottish projects are not opt out schemes , 2006, BMJ : British Medical Journal.

[13]  Rainu Kaushal,et al.  Bmc Medical Informatics and Decision Making Assessing the Level of Healthcare Information Technology Adoption in the United States: a Snapshot , 2005 .

[14]  J. Morse.  Qualitative data analysis (2nd ed): Mathew B. Miles and A. Michael Huberman. Thousand Oaks, CA: Sage Publications, 1994. Price: $65.00 hardback, $32.00 paperback. 238 pp , 1996 .

[15]  Eric C. Pan,et al.  The value of health care information exchange and interoperability. , 2005, Health affairs.

[16]  A. Strauss,et al.  Basics of Qualitative Research , 1992 .

[17]  Wanda J. Orlikowski,et al.  CASE Tools as Organizational Change: Investigating Incremental and Radical Changes in Systems Development , 1993, MIS Q..

[18]  Heejin Lee,et al.  District health information systems in the public sector: health centres in Korea , 2003 .

[19]  Manolis Tsiknakis,et al.  Organizational factors affecting successful adoption of innovative eHealth services: A case study employing the FITT framework , 2009, Int. J. Medical Informatics.

[20]  J. Ross,et al.  Beyond the Business Case: New Approaches to IT Investment , 2002 .

[21]  James M. Walker,et al.  Electronic medical records and health care transformation. , 2005, Health affairs.

[22]  J D Kleinke,et al.  Dot-gov: market failure and the creation of a national health information technology system. , 2005, Health affairs.

[23]  Eric Abrahamson.  Managerial Fads and Fashions: The Diffusion and Rejection of Innovations , 1991 .

[24]  Clay Shirky,et al.  Exchanging health information: local distribution, national coordination. , 2005, Health affairs.

[25]  G. Kuperman,et al.  Correlates of expected satisfaction with electronic health records in office practices by practitioners. , 2008, AMIA ... Annual Symposium proceedings. AMIA Symposium.

[26]  Graeme G. Shanks,et al.  Successfully completing case study research: combining rigour, relevance and pragmatism , 1998, Inf. Syst. J..

[27]  A. Strauss,et al.  Basics of qualitative research: Grounded theory procedures and techniques. , 1993 .

[28]  Joseph K. Tan.  E-Health Care Information Systems: An Introduction for Students and Professionals , 2005 .

[29]  Chris Sauer,et al.  Research Paper: Information Technology in Complex Health Services: Organizational Impediments to Successful Technology Transfer and Diffusion , 1997, J. Am. Medical Informatics Assoc..

[30]  John H Stone,et al.  Communication between physicians and patients in the era of E-medicine. , 2007, The New England journal of medicine.

[31]  D. Blumenthal.  Stimulating the adoption of health information technology. , 2009, The West Virginia medical journal.

[32]  Reinhold Haux,et al.  Health information systems - past, present, future , 2006, Int. J. Medical Informatics.

[33]  Clifford Goodman,et al.  Savings in electronic medical record systems? Do it for the quality. , 2005, Health affairs.

[34]  Sowmya R. Rao,et al.  Use of electronic health records in U.S. hospitals. , 2009, The New England journal of medicine.

[35]  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.

[36]  Guy G. Gable,et al.  Integrating case study and survey research methods: an example in information systems , 1994 .

[37]  Izak Benbasat,et al.  The Case Research Strategy in Studies of Information Systems , 1987, MIS Q..

[38]  R. Yin.  Case Study Research: Design and Methods , 1984 .

[39]  Fred D. Davis.  Perceived Usefulness, Perceived Ease of Use, and User Acceptance of Information Technology , 1989, MIS Q..

[40]  John Eichwald,et al.  Integrating child health information systems. , 2005, American journal of public health.

[41]  D. Bates,et al.  Functional gaps in attaining a national health information network. , 2005, Health affairs.

[42]  C. Urquhart.  An encounter with grounded theory: tackling the practical and philosophical issues , 2001 .

[43]  M. D. Myers,et al.  Qualitative Research in Business & Management , 2008 .

[44]  D. Gans,et al.  Medical groups' adoption of electronic health records and information systems. , 2005, Health affairs.

[45]  D. Bates,et al.  The Costs of a National Health Information Network , 2005, Annals of Internal Medicine.

[46]  Don E. Detmer,et al.  Building the national health information infrastructure for personal health, health care services, public health, and research , 2003, BMC Medical Informatics Decis. Mak..

[47]  Claudia Pagliari,et al.  Potential of electronic personal health records , 2007, BMJ : British Medical Journal.

[48]  Arun Vishwanath,et al.  Article Health Informatics Journal ••••• , 2022 .

[49]  Angèle L. M. Cavaye,et al.  Case study research: a multi‐faceted research approach for IS , 1996, Inf. Syst. J..

[50]  R. Steinbrook.  Personally controlled online health data--the next big thing in medical care? , 2008, The New England journal of medicine.

[51]  Paul C. Tang,et al.  Integrated Personal Health Records: Transformative Tools for Consumer-Centric Care , 2008, BMC Medical Informatics Decis. Mak..

[52]  E. Burton Swanson,et al.  Innovating Mindfully with Information Technology , 2004, MIS Q..

[53]  U. Reinhardt,et al.  Health care spending and use of information technology in OECD countries. , 2006, Health affairs.

[54]  R. Engelbrecht,et al.  Connecting medical informatics and bio-informatics : proceedings of MIE2005 : the XIXth International Congress of the European Federation for Medical Informatics , 2005 .

[55]  F. Girosi,et al.  Promoting health information technology: is there a case for more-aggressive government action? , 2005, Health affairs.

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

[57]  Cynthia LeRouge,et al.  Healthcare information systems research, revelations and visions , 2007 .

[58]  E. Cohen,et al.  Off the Record — Avoiding the Pitfalls of Going Electronic , 2009 .

[59]  K. Seers.  Qualitative data analysis , 2011, Evidence Based Nursing.

[60]  C. Delpierre,et al.  A systematic review of computer-based patient record systems and quality of care: more randomized clinical trials or a broader approach? , 2004, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[61]  Blackford Middleton,et al.  Achieving U.S. Health information technology adoption: the need for a third hand. , 2005, Health affairs.

[62]  N. Terry,et al.  Ensuring the Privacy and Confidentiality of Electronic Health Records , 2007 .

[63]  D. Roter,et al.  Electronic medical record use and physician-patient communication: an observational study of Israeli primary care encounters. , 2006, Patient education and counseling.

[64]  K. Eisenhardt.  Building theories from case study research , 1989, STUDI ORGANIZZATIVI.

[65]  Josef Ingenerf,et al.  Standardized terminological services enabling semantic interoperability between distributed and heterogeneous systems , 2001, Int. J. Medical Informatics.

[66]  Elizabeth Davidson,et al.  An organizational learning perspective on the assimilation of electronic medical records among small physician practices , 2007, Eur. J. Inf. Syst..

[67]  R. Kush,et al.  Electronic health records, medical research, and the Tower of Babel. , 2008, The New England journal of medicine.

[68]  D. Bates,et al.  Electronic health record use and the quality of ambulatory care in the United States. , 2007, Archives of internal medicine.

[69]  Joyce Sensmeier.  Advancing the state of data integration in healthcare. , 2003, Journal of healthcare information management : JHIM.

[70]  Esther Saiag.  The Israeli Virtual National Health Record: A Robust National Health Information Infrastructure Based on a Firm Foundation of Trust , 2005, MIE.

[71]  Sowmya R. Rao,et al.  Electronic health records in ambulatory care--a national survey of physicians. , 2008, The New England journal of medicine.

[72]  A. Strauss,et al.  The discovery of grounded theory: strategies for qualitative research aldine de gruyter , 1968 .

[73]  A. Strauss,et al.  The discovery of grounded theory: strategies for qualitative research aldine de gruyter , 1968 .

[74]  Nava Pliskin,et al.  Spreadsheet evaluation of computerized medical records: The impact on quality, time, and money , 1996, Journal of Medical Systems.

[75]  S. Dunne,et al.  Better informed: an overview of health informatics , 2008, BDJ.