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Brief analytical summaries or syntheses #6

The role of information and communication technologies

in improving health sector efficiency

Summary

This OECD health policy study provides advice on a range of policy options, conditions and practices that policymakers can adapt to their own national circumstances to accelerate adoption and effective use of information and communication technologies (ICTs) in health care. It analyses the incentives and institutional mechanisms used to encourage the adoption of these technologies in six OECD countries (Australia, Canada, The Netherlands, Spain, Sweden, and the United States). It presents an analysis of the range of incentives and institutional mechanisms that have been applied to influence introduction and successful adoption of ICTs, examines the results of these initiatives, looks at some of the new technologies in health care and helps identify the challenges in securing cooperation from the different stakeholders involved.

Background

Policymakers in OECD countries are faced with ever-increasing demands from patients and health professionals to make health systems more responsive to needs. However, unrelenting growth in healthcare spending limits government’s ability to meet these demands. A widely recognized source of inefficiencies is the fragmentation of the care delivery process and the poor transfer of information between healthcare providers.

ICTs are expected to produce a number of benefits:

  • increase quality of care and efficiency
  • reduce operating costs of clinical services
  • reduce administrative costs
  • enable entirely new modes of care
  • increase patient security and data protection

The implementation of ICTs is being held back by concerns about privacy and confidentiality of patient information and by barriers to ICT implementation.

Analysis and results

The main measures proposed with regard to the implementation of ICTs in the health system are:

  • the electronic health record (EHR);
  • electronic prescribing;
  • programs that encourage the exchange of information between health professionals.

A number of different approaches are featured in the study:

  • Australia: Great Southern Managed Health Network
    An electronic messaging and patient management solution that facilitates collaboration between health professionals.
  • Canada (British Columbia): Chronic Disease Management Toolkit
    Web-based clinical decision support tools, accessed via the Physician Connect high-speed communication network, to help physicians manage chronic diseases.
  • United States (Massachusetts): Massachusetts e-Health Collaborative (MAeHC)
    Support for the implementation of EHRs and clinical data exchange capabilities.
  • Spain: Balearic Telestroke Program
    Use of patient EHR and PACS system to make emergency stroke care available to remote parts of the region.
  • Sweden: E-prescription
    A national system connecting all pharmacies in the country to primary care physicians and other health professionals.
  • Netherlands: Patient Summary Care Record System
    Pilot project to transfer patient health information between family doctors and other health professionals.

The main barriers to the implementation of ICTs are:

  • Financial
    Limited provider resources to implement new technologies.
    Inequitable distribution of costs and benefits.
  • Institutional
    Differences in medical terminology and compilation of patient information.
    Lack of commonly defined and consistently implemented standards to enable communication between different systems.
  • Social
    Public concerns about safeguarding the privacy and confidentiality of health information.

Conclusion

This study points to a number of practices or approaches that could usefully be employed in efforts to improve and accelerate the adoption and use of ICTs in health care. It highlights the general absence of independent, robust monitoring and evaluation of programs and projects. Measuring the impact of ICTs is difficult for a number of reasons. Moving to new technologies involves cultural transformation along with technical innovation, and organizational transformation is vital to successful uptake. Benefits of new ICT systems may, therefore, only become apparent after working practices have changed or adapted to take advantage of these new resources.

Notwithstanding these difficulties, the case studies support the potential for countries to make major progress toward key policy goals such as improving access to care in remote areas and better co-ordination for chronic disease care by implementing ICTs.

The analysis illustrates the interdependence between various stakeholders, something that must be addressed if countries are to achieve the intended efficiency gains from ICT implementation. Government action is needed to help establish reliable and coherent privacy and security frameworks and assure public confidence and trust. Incentives must be aligned with health system priorities and standardized indicators are needed to evaluate ICT implementation. High quality evaluation will minimize the costs, risks and delays involved.

Source

Improving health sector efficiency: The role of information and communication technologies. Fichier PDF.