Paula Asikainen

The outcomes of regional healthcare information systems in health care: A review of the research literature

The resulting regional healthcare information systems were expected to have effects and impacts on health care procedures, work practices and treatment outcomes. The aim is to find out how health information systems have been investigated, what has been investigated and what are the outcomes. A systematic review was carried out of the research on the regional health information systems or organizations. The literature search was conducted on four electronic Cinahl Medline, Medline/PubMed and Cochrane. The common type of study design was the survey research and case study, and the data collection was carried out via different methodologies. They found out different types of regional health information systems (RHIS). The systems were heterogeneous and were in different phases of these developments. The RHIS outcomes focused on the five main areas: flow of information, collaboration, process redesign, system usability and organization culture. The RHIS improved the clinical data access, timely information, and clinical data exchange and improvement in communication and coordination within a region between professionals but also there was inadequate access to patient relevant clinical data. There were differences in organization culture, vision and expectations of leadership and consistency of strategic plan. Nevertheless, there were widespread participation by both healthcare providers and patients.

Differentiation of organizational climate and culture in public health and social services in Finland

AimThe aim of the study was to examine the differentiation of organizational contexts within Finnish public health and social services both at the workplace and at the local governmental (municipality) level.Subject and methodsWe focused on climate, comprising individual level experience, and on culture, comprising collective level as “the way things are done in organization”. Climate, as “the way people perceive their work environment”, was interpreted to reflect personally relevant professional and moral concerns. As an exploration of antecedents of climate and culture, we compared the scale of contextual differences among workplaces with the extent of differences at the municipal level. We also examined by multilevel hierarchical linear models (HLM), the importance of observed differentiation of workplaces in terms of impacts of both climate and culture on employee morale.ResultsThere existed different organizational climates and cultures within Finnish public human service organizations both at workplace and upper organizational level. Differences in terms of climate were somewhat bigger than differences in culture.ConclusionBoth climate and culture should be highlighted in the effort to specify the characteristics of organizational social contexts, as well as their antecedents and consequences in public human services.

The utilization rate of the regional health information exchange: how it impacts on health care delivery outcomes.

UNLABELLED Interest in improving quality and effectiveness is the primary driver for health information exchange efforts across a health care system to improve the provision of public health care services. OBJECTIVE The aim here was to describe and identify the impact of a regional health information exchange (HIE) using quantitative statistics for 2004-2008 in one hospital district in Finland. DESIGN We conducted a comparative, longitudinal 5-year follow-up study to evaluate the utilization rates of HIE, and the impact on health care delivery outcomes. The selected outcomes were total laboratory tests, radiology examinations, appointments, emergency visits, and referrals. RESULTS The HIE utilization rates increased annually in all 10 federations of municipalities, and the viewing of reference information increased steadily in each professional group over the 5-year study period. In these federations, a significant connection was found to the number of laboratory tests and radiology examinations, with a statistically significant increase in the number of viewed references and use of HIE. The higher the numbers of emergency visits and appointments, the higher the numbers of emergency referrals to specialized care, viewed references, and HIE usage among the groups of different health care professionals. CONCLUSIONS There is increasing interest in HIE usage through regional health information system among health professionals to improve health care delivery regionally and bring information on the patient directly to care delivery. It will be important to study which changes in working methods in the service system are explained by RHIS. Also, the experiences of the change that has taken place should be studied among the different stakeholders, administrative representatives, and patients.