Abstract
Primary care involves collaboration by diverse, geographically dispersed health professionals, and presents unique challenges for IT. In Ireland, cross-disciplinary primary care teams are being established and extensive IT support is planned, including shared electronic patient records. To uncover factors that affect the implementation and use of IT in primary care, in-depth interviews were conducted with Irish primary care practitioners and IT specialists. The results suggest a widespread belief in the potential of IT to transform service delivery. However, substantial business change will also be needed to address longstanding process problems, barriers to information sharing, and a lack of integration. At present, health practitioners lack the time, knowledge, and resources to make best use of new IT. While progress at the national level has been slow, a regional or local approach to IT provision, with appropriate standards to facilitate information sharing, may offer better chances of success.
TopBackground
In healthcare, IT is generally viewed as infrastructure that can improve clinical processes and outcomes (Parker, 2006). However, low levels of IT investment (approximately 2% of budget on average, compared with 5–10% in manufacturing industries) can hinder innovation (Protti, 2005). Failures in health IT projects often stem from human factors including communication issues, cultural differences, under-estimation of complexity, scope creep, organisational inertia, lack of IT skills, insufficient training, high workload and weak leadership (Kaplan & Harris-Salamone, 2009). These causes reflect “the cognitive complexity, socio-cultural aspects, and labour-intensive nature of modern medicine” (Sistrom, 2005:440). Healthcare work is complex; many of its primary tasks are cognitive rather than physical, and personal interaction is integral (Khudair & Cooke, 2008). Success in healthcare IT projects is subjective and multi-faceted (Marc Berg, 2001). Risk management is important when making IT-led changes, since positive outcomes are not guaranteed. For example, computerising physician order entry can decrease adverse drug events but also facilitate prescribing errors, leading to increased mortality (Mills et al., 2009).
Key Terms in this Chapter
Primary Care: The provision of health services within the community; first point of contact.
Primary Care: The provision of health services within the community; first point of contact.
HIS: Healthcare Information System.
HIS: Healthcare Information System.
Primary Care Team: Team of health practitioners involved in delivering primary care in a particular geographic area, including GPs, health care assistants, home helps, nurses, midwives, occupational therapists, physiotherapists, social workers and administrative staff.
Secondary Care: Hospital-based healthcare.
ICT: Information and Communications Technology.
HSE: Health Service Executive.
Primary Care Team: Team of health practitioners involved in delivering primary care in a particular geographic area, including GPs, health care assistants, home helps, nurses, midwives, occupational therapists, physiotherapists, social workers and administrative staff.
Secondary Care: Hospital-based healthcare.
ICT: Information and Communications Technology.
HSE: Health Service Executive.
IT: Information Technology.
IT: Information Technology.