Boundaries and e-health implementation in health and social care

BMC Medical Informatics and Decision Making

Research Article

Gerry King¹  David Heaney¹  David Boddy²  Catherine O’Donnell³  Fiona Smith³  Frances S Mair³ 

[1] Centre for Rural Health, University of Aberdeen, Centre for Health Sciences, Inverness, UK;Department of Management, University of Glasgow, Glasgow, UK;General Practice and Primary Care, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK;

关键词: Local Authority;    Social Care;    Geographical Boundary;    Health Board;    Professional Boundary;   

DOI  :  10.1186/1472-6947-12-100

 received in 2012-04-05, accepted in 2012-08-27,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundThe major problem facing health and social care systems globally today is the growing challenge of an elderly population with complex health and social care needs. A longstanding challenge to the provision of high quality, effectively coordinated care for those with complex needs has been the historical separation of health and social care. Access to timely and accurate data about patients and their treatments has the potential to deliver better care at less cost.MethodsTo explore the way in which structural, professional and geographical boundaries have affected e-health implementation in health and social care, through an empirical study of the implementation of an electronic version of Single Shared Assessment (SSA) in Scotland, using three retrospective, qualitative case studies in three different health board locations.ResultsProgress in effectively sharing electronic data had been slow and uneven. One cause was the presence of established structural boundaries, which lead to competing priorities, incompatible IT systems and infrastructure, and poor cooperation. A second cause was the presence of established professional boundaries, which affect staffs’ understanding and acceptance of data sharing and their information requirements. Geographical boundaries featured but less prominently and contrasting perspectives were found with regard to issues such as co-location of health and social care professionals.ConclusionsTo provide holistic care to those with complex health and social care needs, it is essential that we develop integrated approaches to care delivery. Successful integration needs practices such as good project management and governance, ensuring system interoperability, leadership, good training and support, together with clear efforts to improve working relations across professional boundaries and communication of a clear project vision. This study shows that while technological developments make integration possible, long-standing boundaries constitute substantial risks to IT implementations across the health and social care interface which those initiating major changes would do well to consider before committing to the investment.

【 授权许可】

Unknown   
© King et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.