Comparing New Zealand's ‘Middle Out’ health information technology strategy with other OECD nations

Bowden, Tom; Coiera, Enrico

doi:10.1016/j.ijmedinf.2012.12.002

Cited by 19 publications

(17 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…England's eHealth project, the National Programme for Health IT (NPfIT) also known as 'Connecting for Health' was discontinued in 2011 due to issues with missed deadlines and poor progress (Bowden & Coiera, 2013). The technical architecture used a centralised model based on infrastructure known as the "NHS Spine" and a nationally shared summary care record (SCR) located centrally to enable all clinicians to add or read information.…”

Section: Englandmentioning

confidence: 99%

“…However, adopting a top down approach in the specification, governance, management and implementation of a centralised system resulted in problems with the system not meeting the local needs of clinicians (Mudaly, et al, 2013). Similarly, concerns about completeness and accuracy of clinical information with fears about personal privacy erosion led to distrust in the system (Bowden & Coiera, 2013). As a result, England have since commenced moving towards decentralised architecture.…”

Section: Englandmentioning

confidence: 99%

“…As a result, England have since commenced moving towards decentralised architecture. On the other hand, Scotland and Wales are making progress in developing sustainable systems for sharing clinical information having learned from the lessons of the NpfIT (Bowden & Coiera, 2013).It is noteworthy that Singapore has also adopted a top-down approach with a centralised architecture but unlike England, is progressing to plan. In Singapore, the national eHealth record (NEHR) was created in just 18 months following changes to legislation permitting the exchange of health information between institutions (Accenture, 2012).…”

mentioning

confidence: 99%

“…The expectation is that information will eventually aggregate at the national level (Mudaly, et al, 2013). It has been reported that there are concerns with the current HIE strategy centered around the low number of HIEs with sustainable business models (Bowden & Coiera, 2013).Likewise, it is unclear how much information can be made available to participating clinicians in a patient's journey due to incompatible data models leading to data quality problems and interoperability issues (Coiera, 2009;Eason, Dent, Waterson, Tutt, Hurd, et al, 2012). …”

mentioning

confidence: 99%

mentioning

confidence: 99%

See 4 more Smart Citations

eHealth-as-a-Service: A Service Based Design Approach for Large Scale eHealth Architecture

Black¹

View full text Add to dashboard Cite

A significant challenge for the design of large scale (national) eHealth systems is the fluid nature of the Patient Journey, particularly in primary healthcare modalities.In this context, a patient's journey is predisposed to organic growth rather than intelligent design. As a result, clinical tasks requiring access to high quality information may occur as a function of known healthcare patterns or as a response to a patient's state of health. Whilst Australia's national eHealth system provides the infrastructure to accommodate the self-organizing flexibility and dynamism characteristic of complex information-based ecosystems, the system neglects certain information quality attributes. Specifically, accuracy, timeliness and completeness, which may lead to improved coordination of patient care. Based on the premise that the quality of patient information plays a significant role in the performance of health professionals, consideration must be given to these information quality dimensions as an overarching goal for eHealth architectural design activities. Framed as a problem concerning the design of large scale eHealth architecture that improves the quality of health information, this perspective presents a timely research opportunity.Within a prescriptive design science research (DSR) framework, this thesis is an example of a multi-methodological approach to create and evaluate a purposeful eHealth-as-a-Service (eHaaS) design artifact, which will improve patient information quality. This was achieved by firstly, deriving abstract meta-requirements from an ethnographic examination of care pathways to establish the technical goals of the solution space. Secondly, defining the functions, organization, and structure of an eHaaS conceptual model as an example of how service-based architectures might deliver high quality information services. Finally, by establishing the validity of the conceptual model with the development of a novel evaluation strategy to explain the predicted change produced by an eHaaS design artifact.Several original contributions emerged from the research. First and foremost, the developed eHaaS conceptual model, which encapsulates a set of design principles, service-based architectural patterns and implementation strategies represents a new class of eHealth solution. One that embodies a shift away from data-centric monolithic eHealth-as-a-Service: A Service-Based Design Approach for Large Scale eHealth Architecture iii architecture to process oriented, event-driven application services. To demonstrate the benefits of this shift, an electronic patient information system (ePIMS) was developed as an original solution for orchestrating clinical information services as personalised patient workflows. Another significant contribution of this thesis is a novel evaluation strategy for validating the utility of large scale eHealth systems at the design stage. It is innovative in its use of business process and data modelling techniques (e.g. data flow diagrams, business process modelling notatio...

show abstract

Section: Englandmentioning

confidence: 99%

Section: Englandmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

eHealth-as-a-Service: A Service Based Design Approach for Large Scale eHealth Architecture

Black¹

View full text Add to dashboard Cite

show abstract

Dynamics in Entry and Exit Registrations in a 14-Year Follow-Up of Nationwide Electronic Prescription and Patient Data Repository Services in Finland

Jormanainen

2024

Communications in Computer and Information Science

View full text Add to dashboard Cite

There exist a need to carry out further research in order to describe implementation and adoption of nationwide healthcare information systems. This research aimed to follow-up in a 14-year period (2010–2023) of public and private healthcare service organizations’ entries to and exits from the centralized electronic Prescription and Patient Data Repository Services in Finland. Our material comes from the official Social Welfare and Healthcare Organization Registry (SOTE-organisaatiorekisteri), which is part of the national Code Server and the Kanta Services. Registry data were extracted in an excel file format in 3 January 2024. Outcomes were continuous registration of services or registered exist from the services. We found profound dynamics in the registry data. In the nationwide Prescription Services, the registered organizations provided altogether 8,884 follow-up years, during which in 2010–2023 there were in total 1,530 healthcare service organization entries and 553 exits from the national services, whereas 977 organizations had the national services in production in 2023. In Patient Data Repository Services, the registered organizations provided altogether 7,692 follow-up years, during which in 2011–2023 there were totally 1,980 healthcare service organization entries and 494 exits from the national services, whereas 1,486 organizations had the national services in production in 2023. No effects of Covid-19 epidemic were observed. Permanent legislation may explain many of the peak numbers observed in this research. Effects of the structural reform to reorganize healthcare, social welfare and rescue services to wellbeing services counties starting January 2023 were observed in this registry research on public healthcare service organizations.

show abstract

Current and future vision

Hovenga¹,

Lowe²

2020

Measuring Capacity to Care Using Nursing Data

View full text Add to dashboard Cite

Comparing New Zealand's ‘Middle Out’ health information technology strategy with other OECD nations

Cited by 19 publications

References 7 publications

eHealth-as-a-Service: A Service Based Design Approach for Large Scale eHealth Architecture

eHealth-as-a-Service: A Service Based Design Approach for Large Scale eHealth Architecture

Dynamics in Entry and Exit Registrations in a 14-Year Follow-Up of Nationwide Electronic Prescription and Patient Data Repository Services in Finland

Current and future vision

Contact Info

Product

Resources

About