Health information technology implementation - impacts and policy considerations: a comparison between Israel and Portugal

Abstract

The use of Information and Communications Technology (ICT) in health systems is increasing worldwide. While it is assumed that ICT holds great potential to make health services more efficient and grant patients more empowerment, research on these trends is at an early stage. Building on a study of the impact of ICT on physicians and patients in Israel, a Short Term Scientific Mission (STSM) sponsored by COST Net in conjunction with CIES/ISCTE IUL (Portugal) facilitated a comparison of ICT in health in Israel and Portugal. The comparison focused on patient empowerment, physician behavior and the role of government in implementing ICT.The research in both countries was qualitative in nature. In-depth interviews with the Ministry of Health (MOH), the private sector, patients associations, health plans and researchers were used to collect data. Purposeful sampling was used to select respondents, and secondary sources were used for triangulation.The findings indicate that respondents in both countries feel that patient empowerment has indeed been furthered by introduction of ICT. Regarding physicians, in both countries ICT is seen as providing more information that can be used in medical decision making. Increased access of patients to web-based medical information can strengthen the role of patients in decision making and improve the physician-patient relationship, but also shift the latter in ways that may require adjustments in physician orientation. Physician uptake of ICT in both countries involves overcoming certain barriers, such as resistance to change. At the national level, important differences were found between the two countries. While in Israel, ICT was promoted and adopted by the meso level of the health system, in particular the health plans and government intervention can be found in a later stage, in Portugal the government was the main developer and national strategies were built from the beginning. These two approaches present different advantages and disadvantages. Government involvement in earlier stages could provide benefit in terms of interoperability of systems between different healthcare organizations. However, innovation could be slowed down due to government bureaucracy or lack of leadership.The work provides information in order to understand and improve ICT services. Additionally, it provides input regarding impact of ICT on the physician/patient relationship and national policies in the area.

Factors affecting compliance with use of online healthcare services among adults in Israel

“…Results of a study that compared the use of Information and Communications Technology (ICT) in health systems in Israel and Portugal showed that in both countries the increased deployment of ICT has furthered patient empowerment. The increased access of patients to web-based medical information can strengthen the role of patients in decision making and improve the physician-patient relationship [47, 48]. In addition, access and use of online health information in Israel provide an alternative/additional channel for information when e-patients consider health changes [49].…”

Relations Between the Use of Electronic Health and the Use of General Practitioner and Somatic Specialist Visits in Patients With Type 1 Diabetes: Cross-Sectional Study

“…A German study found that frequent users of health services were 73% more likely to seek health information on the internet compared with nonusers [ 12 ]. Research on the associations between the use of eHealth and provider-based health care is scarce, both in general populations and for populations with specific diseases [ 19 , 20 ].…”

Factors Impacting Clinicians’ Adoption of a Clinical Photo Documentation App and its Implications for Clinical Workflows and Quality of Care: Qualitative Case Study

“…Of course, the cost and cost-benefit play a key role. These may be perceived as facilitators when the app helps in saving costs by creating efficiencies as narrated in similar studies [ 67 , 83 , 103 , 104 ]; however, they may also be a barrier [ 56 , 105 , 106 ] considering the tool’s direct costs and the indirect costs related to creating a suitable infrastructure, such as providing handheld devices across the clinic or hospital to support the app’s usage.…”