Hannele Hyppönen

Organizing for a National Infrastructure Project: The Case of the Finnish Electronic Prescription

Electronic prescriptions should be a central part of a working health care and national e-government infrastructure. In Finland the pursuit to establish such a system has been up few times, and the most recent, nation-wide initiative to set up a central electronic prescription system was set up in 2001. Our article here describes the starting points of the Finnish initiative to set up the system for electronic prescriptions, and presents the organizational structure and main tasks that are set up to build the system. Our theoretical discussion focuses on the concept of national IT infrastructures, and analyses the Finnish electronic prescription system against the ramifications given for a national infrastructure. The authors of the article are members of a group assigned to evaluate the national project. It is worth noting that both the system and the evaluation tasks are at the very early stages of work.

Finnish physicians' stress related to information systems keeps increasing: a longitudinal three-wave survey study

BackgroundPoorly functioning, time-consuming, and inadequate information systems are among the most important work-related psychosocial factors causing stress in physicians. The present study examined the trend in the perceived stress that was related to information systems (SRIS) among Finnish physicians during a nine-year follow-up. In addition, we examined the associations of gender, age, employment sector, specialization status, leadership position, on-call burden, and time pressure with SRIS change and levels.MethodsA longitudinal design with three survey data collection waves (2006, 2010 and 2015) based on a random sample of Finnish physicians in 2006 was used. The study sample included 1095 physicians (62.3% women, mean age 54.4xa0years) who provided data on SRIS in every wave. GLM repeated measures analyses were used to examine the associations between independent variables and the SRIS trend during the years 2006, 2010, and 2015.ResultsSRIS increased during the study period. The estimated marginal mean of SRIS in 2006 was 2.80 (95% CIxa0=xa02.68–2.92) and the mean increase was 0.46 (95% CIxa0=xa00.30–0.61) points from 2006 to 2010 and 0.25 (95% CIxa0=xa00.11–0.39) points from 2010 to 2015. Moreover, our results show that the increase was most pronounced in primary care, whereas in hospitals SRIS did not increase between 2010 and 2015. SRIS increased more among those in a leadership position. On-call duties and high time-pressures were associated with higher SRIS levels during all waves.ConclusionsChanging, difficult, and poorly functioning information systems (IS) are a prominent source of stress among Finnish physicians and this perceived stress continues to increase. Organizations should implement arrangements to ease stress stemming from IS especially for those with a high workload and on-call or leadership duties. To decrease IS-related stress, it would be important to study in more detail the main IS factors that contribute to SRIS. Earlier studies indicate that the usability and stability of information systems as well as end-user involvement in system development and work-procedure planning may be significant factors.