CASE STUDY 1
According to Khalifa & Alswailem, (2021) at King Faisal Specialist Hospital and Research Center, Saudi Arabia, the implementation and upgrading of the hospital information system had been facing many challenges; among these were the resistance, acceptance and satisfaction of the Hospital Information System (HIS) by the end-users. The Health Information Technology Affairs (HITA) department decided to survey to explore HIS acceptance and satisfaction by end-users and investigate the influential factors that might increase or decrease acceptance and satisfaction levels among different healthcare professionals. The availability of computers in the hospital was one of the most influential factors, with a special emphasis on the availability of laptop computers and computers on wheels to facilitate direct and immediate data entry and information retrieval processes when healthcare professionals are at the point of care. Users believed that HIS might frequently slow down the process of care delivery and increase the time spent by patients inside the hospital, especially during the slow performance and responsiveness phases. Three main areas showed improvement potential; system performance, organizational support and users’ feedback. The availability of computers in the hospital was one of the least acceptable and satisfying groups of factors, with a special emphasis on the unavailability of laptop computers and mobile computers (computers on wheels) to facilitate the direct and immediate data entry and information retrieval processes when healthcare professionals are at the point of the care. However, users were not satisfied with the downtime procedure and they highlighted that they are not prepared for it; to switch to an alternative manual system in case the electronic system failed. They said that the HIS downtime procedure is not clear and not comprehensive, this is consistent with many studies which highlighted that minimal and clearly understood downtime can spare a lot of the unintended consequences of HIS related medical errors, especially in the areas of medications and ICU. Improving the performance of the HIS is very crucial for its success, in addition to increasing the availability of computers at the point of care. User-friendliness and new innovative methods for data entry, such as automated voice recognition, can improve the workload and enhance information quality. Organizational support is also very crucial, through providing training, and dedicated and protected time during working hours for users to learn and practice on HIS. Better and more reliable channels of communication and feedback are needed to consider users’ complaints, suggestions and contributions.
CASE STUDY 2
According to Wang et al., (2020) in Hong Kong, the Public-Private Interface–Electronic Patient Record (PPI-PR) system was introduced as a new electronic platform to help the public and private sectors collaborate more effectively. However, neither the barriers to participation nor the advantages have been thoroughly evaluated. Subjects’ awareness, acceptance, and perceptions of the PPI-ePR, perceived benefits and barriers to participation in the programme, reasons for not using the system after enrolling, and perceived areas for system service improvement were the case. More than 53.1 per cent (266/501) of enrolled patients thought the PPI-PR system would improve health care quality by reducing duplicate tests and treatments, while more than 76.8 per cent (314/409) of enrolled doctors said the most important benefit of their enrollment was timely access to patients’ medical records. Unawareness of the project was the most common barrier to enrollment in the PPI-ePR system among non-enrolled patients (483/1200, 40.3 per cent). The complicated registration process was the most difficult for non-enrolled doctors to participate in the programme (95/198, 48.0 per cent). Television, newspaper, and magazine advertisements, as well as medical profession newsletters or journals, were identified as the most effective means of encouraging programme participation among surveyed patients (1297/1701, 76.2 per cent) and doctors (428/610, 70.2 per cent). Due to a lack of clinical indication, data extraction from other hospitals was the main reason for low-level PPI-per.
CASE STUDY 3
According to Hackett et al., (2019), governments and health organizations in Canada have invested in digital health technologies such as personal health records (PHRs) and other electronic service functionalities, as well as innovation in provincial and territorial hospital information systems. This is because digital health technologies are strategies in publicly funded health systems that aim to improve the quality and safety of health care service delivery while also improving patient experiences and outcomes. Patients’ access to their information through secure, Web-based PHRs and integrated virtual care services are promising mechanisms for supporting patient engagement in health care, so they use current evidence to develop an economic model that estimates the demonstrated and potential value of these digital health initiatives. The first compiled findings from several Canadian and international studies on the outcomes for patients and service providers associated with PHRs across a range of services, from viewing information (e.g., laboratory results) on the Web to electronic prescription renewal to email or video conferencing with care teams and providers. Then, based on these demonstrated benefits and citizen use, they created a quantitative model of the estimated value (2016-2017). They used a novel application of a compensating differential approach to assessing the value (independent of costs) to society of improved health and well-being as a result of PHR use, in addition to estimating the costs saved from both the patient and system perspectives. Patients’ access to a variety of digital PHR functions added value to Canadians and healthcare systems by increasing healthcare productivity and improving access to and quality of care. The marginal value generated by utilizing PHR functionalities increased as the opportunities to interact and engage with health care providers increased. From the patient’s perspective, web-based prescription renewal generated a share of the total current value of $1 million CADs. The ability of Canadians to view their information on the Web was the highest value share in terms of health systems. The value generated by populations with chronic illnesses such as severe and persistent mental illness and diabetes could amount to $800 million CADs across Canadian health systems if PHRs were implemented with more integrated virtual care services. The PHRs with greater interactivity could provide significant potential value through wider adoption in Canada and higher adoption rates in specific target groups, namely high-frequency health system users and their caregivers.