Tiina Mäenpää

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.

Family-school nurse partnership in primary school health care.

BACKGROUND The foundation of the health and well-being of a child in primary school age is the family. To promote the childs comprehensive health, we must develop the cooperation between the family and the primary school nurse. AIM The aim of the study was to develop a family nursing oriented substantive theory of cooperation between primary school nurses and families. METHOD The study used grounded theory based on Straussian principles. Data were collected from sixth-graders (N = 22) using group discussions. Interviews were conducted with parents (N = 19), and the views of school nurses (N = 20) on their cooperation with families were obtained via free form essays. FINDINGS The core concept of the theory describing cooperation between primary school nurses and families is problem-based communication. As a result of the analysis, nine-2-dimensional concepts were formed to describe this cooperation. The theory is structured further by four dimensions, which contain concepts explaining them and which also describe the relationships between the different concepts. These dimensions are the meeting between the school nurse and the family, mutual exchange of information, attending to the childs health monitoring and being at school for the child and family. The substantive theory describing cooperation between the primary school nurse and family entails the concepts formed in the analysis, their interrelationships, as well as, the core concept. CONCLUSIONS Primary school nurses can apply the resulting theory while working with families and while developing this cooperation. This theory can also be implemented in developing nursing education.

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.

Views of patient, healthcare professionals and administrative staff on flow of information and collaboration in a regional health information exchange: a qualitative study

BACKGROUND Nowadays, patients can be more involved in developing healthcare services with their healthcare professionals. Patient-centred information is a key part of improving regional health information exchange (HIE), giving patients an active role in care management. AIM The aim was to get a deeper understanding of the flow of information and collaboration in one hospital district area from the viewpoint of patients, healthcare professionals and administrative staff. METHODS The data were collected by themed interviews and analysed using both deductive and inductive content analyses. The interview themes were the flow of information and collaboration after 5 years of HIE usage in one hospital district area in Finland. FINDINGS Health information exchange usage had changed the regional flow of information after the 5-year period. The patients were satisfied that their primary care physician was able to access their special care information. The experiences of healthcare professionals and administrative staff also showed that information availability and information exchange had improved regionally. HIE usage was also found to have improved regional collaboration between different organisations in patient health care. CONCLUSIONS It was recognised that patients had taken on more responsibility for transferring their follow-up treatment information. Healthcare information exchange between professionals not only improves patient care or patient involvement in their own care, but it also requires that patient self-care or self-care management is integrated into HIE systems to share information not only among professionals, but also between patients and professionals. This information will be used in the development of healthcare systems to meet more the developing of the continuity of care the patients point of view.