The worldwide trend in healthcare has been to look to healthcare information technology (HCIT) for solutions to prominent challenges such as process improvement, patient satisfaction, cost reduction and labour market shortages. Yet recent reviews of the electronic health record (EHR) literature show that all is not well especially with respect to the alignment of organizational design and the engineered artifact.
Niazkhani et al (2009, p. 546) concluded "When put in practice, the formal, predefined, stepwise, and role-based models of workflow underlying CPOE systems may show a fragile compatibility with the contingent, pragmatic, and co-constructive nature of workflow.” Two of the findings of Greenhalgh et al (2009, p. 767) were “While secondary work (audit, research, billing) may be made more efficient by the EPR, primary clinical work is often made less efficient” and “The EPR may support, but will not drive, changes in the social order of the workplace”. In addition, Fontaine et al (2010) concluded from a systematic literature review in primary care that “The potential for HIE to reduce costs and improve the quality of healthcare in ambulatory primary care practices is well recognized but needs further empiric substantiation.”
Just as in enterprise resource planning (ERP) adoption, healthcare organisations (HCOs) expect HCIT to shape their organization design through the embedded workflow engineered most often from a mechanistic worldview. Often, the contingencies and exceptions are not accounted for, leaving the blame to fall upon the usual reasons for HCIT failure (e.g., poor implementation, lack of training, resistance). Organisational design and engineering (ODE) takes the position that the “either-or” mindset must be replaced with an integrated and more holistic view of designing the organisation and artifact. The complex interplay between organisation and engineering, often intangible, requires a multi-disciplinary approach to solve the challenge of the social and technological world of healthcare being inextricably linked to healthcare policy.
This special issue seeks contributions from the spectrum of disciplines that are involved directly in HCIT or broader healthcare fields that implicitly rely on HCIT (e.g., policies for care coordination). These contributions must have both the elements of organisational design and an engineered artifact regardless of research discipline. These might address theoretical, empirical and design-based studies on medical- technical infrastructures, tools and applications, health information behaviour, or cost/benefits, policy, as well as social implications. HCITs are broadly defined to include technologies in clinical informatics, e-health, m-health, consumer health, public health, and health policy.
Suitable topics include but are not limited to:
- Adoption, implementation and deployment healthcare information technology (HICT)
- Social-organisational consequences of HCIT
- Electronic medical records
- Electronic patient records
- Electronic nurse records
- Picture archive and communication systems (PACS)
- Hospital information systems
- Pharmacy information systems
- Family practice information systems
- HCIT for hospital strategies
- E-procurement and healthcare
- E-payments and e-healthcare
- End-user computing in e-healthcare and HCIT
- Organisational implications of national health information infrastructure
- Reengineering hospital processes via HCIT and e-healthcare
- E-healthcare and HCIT in primary care
- E-healthcare and HCIT in chronic care
- E-healthcare and HCIT in elderly care
- Information architecture in HCIT e-healthcare
- Mobile health
- Social media and health information
- Policy-driven HCIT
- Cloud computing in healthcare
- Web services in healthcare
Deadline for submission: 15 June 2011
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