Objective To explore the introduction of a centrally stored, shared electronic patient record (the summary care record (SCR)) in England and draw wider lessons about the implementation of large scale information technology projects in health care. Design Multi-site, mixed method case study applying utilisation focused evaluation. Setting Four early adopter sites for the SCR in Englandthree in urban areas of relative socioeconomic deprivation and the fourth in a relatively affluent rural area. Data sources and analysis Data included 250 staff interviews, 1500 hours of ethnographic observation, interviews and focus groups with 170 patients and carers, 2500 pages of correspondence and documentary evidence, and incorporation of relevant surveys and statistics produced by others. These were analysed by using a thematic approach drawing on (and extending) a theoretical model of complex change developed in a previous systematic review. Main findings The mixed fortunes of the SCR programme in its first year were largely explained by eight interacting influences. The first was the SCR's material properties (especially technical immaturity and lack of interoperability) and attributes (especially the extent to which potential adopters believed the benefits outweighed the risks). The second was adopters' concerns (especially about workload and the ethicality of sharing "confidential" information on an implied consent model). The third influence was interpersonal influence (for example, opinion leaders, champions, facilitators), and the fourth was organisational antecedents for innovation (for example past experience with information technology projects, leadership and management capacity, effective data capture systems, slack resources). The fifth was organisational readiness for the SCR (for example, innovation-system fit, tension for change, power balances between supporters and opponents, baseline data quality). The sixth was the implementation process (including the nature of the change model and the extent to which new routines associated with the SCR aligned with existing organisational routines). The seventh influence was the nature and quality of links between different parts of the system, and the final one was the wider environment (especially the political context of the programme).Conclusion Shared electronic records are not plug-in technologies. They are complex innovations that must be accepted by individual patients and staff and also embedded in organisational and inter-organisational routines. This process is heavily influenced at the microlevel by the material properties of the technology, individuals' attitudes and concerns, and interpersonal influence; at the meso-level by organisational antecedents, readiness, and operational aspects of implementation; and at the macro-level by institutional and socio-political forces. A case study approach and multi-level theoretical analysis can illuminate how contextual factors shape, enable, and constrain new, technology supported models of patient care. INT...

Background: Research has identified a clear link between clinical outcomes and patient satisfaction especially in chronic diseases like diabetes, where a wide range of needs and expectations exists. Satisfaction affects the timely, efficient, and patient-centred delivery of quality health care. Aim: To assess patients' satisfaction with type 2 diabetes care and its relation to their glycaemic control. Patients and Methods: Analytic cross sectional study with a total of 72 patients ≥18 years old with type 2 diabetes who attend Port Fouad urban family health centre, Port Said city, Egypt were invited to complete 18 items, Patient Satisfaction Questionnaire (PSQ-18) to determine their satisfaction and its relation to the degree of HbA1c control. The questionnaire contained 7 domains to identify patients, doctors and practice determinants of satisfaction. Results: 60% of type 2 diabetic patients were satisfied with the provided health care services. Doctor's communication ranked the highest satisfaction level among other factors followed by satisfaction with consultation time and appropriateness of consultation room. Meanwhile, the study revealed a proportional relationship between overall patients' satisfaction and controlled HbA1c. Conclusion: There was a clear link between patients' satisfaction with type 2 diabetes care and improvement of their glycemic control.

Objectives: This study was oriented to investigate the current situation of Syrian medical staff working in different fields and their response regarding the preventive procedures. Material and Methods: Questionnaire was designed according to the World Health Organization guidelines and recommendations, addressing the preventive measures, which must be followed by healthcare workers to protect themselves and their community against COVID-19. The participation in the study was average as 1339 participants from medical staff (596 males and 743 females) have filled the questionnaire. Results: The results displayed high percentages of commitment in general regarding preventive measures followed (health rules, personal protective equipment, and disinfection) for all healthcare workers. The proportions of responses were varied depending on job nature. In addition, the highest range of percentage of self-evaluation was 50–75% for all medical staff. Conclusion: Based on the filled information, the study showed relatively good commitment to the preventive procedures by healthcare workers to control COVID-19 and prevents its spread in the community.

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This paper is looking at electronic health record (EHR) systems and their information security strategy. It focuses on the first step of building an information security strategy which is analysing the current situation of an EHR system. This research is based on different research methods applied to different EHR systems. In this paper we define eight elements that can be used as guidelines for how best to assess the current situation of any EHR system.