The Need for a Socio-Technical Analysis in E-Health: The Case of the PCEHR

The Need for a Socio-Technical Analysis in E-Health: The Case of the PCEHR

Imran Muhammad, Say Yen Teoh, Nilmini Wickramasinghe
DOI: 10.4018/978-1-4666-6339-8.ch060
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Abstract

Healthcare systems around the globe are facing a number of challenges. Thus Increasing focus is being placed on constructing appropriate healthcare reforms which are attempting to address how to tackle these challenges. A critical enabler in these reforms is the adoption of an e-health solution. Such e-health solutions are not only expensive and complex endeavours, but also have far reaching implications. Given that the implementation and adoption of these e-health solutions is so important, not to mention also requiring a substantial investment in various resources such as time and money, it is therefore essential to ensure their success. The following proffers a socio-technical analysis as an appropriate strategy to ensure more successful outcomes. An exemplar case study of the Personally Controlled Electronic Health Record (PCEHR), the chosen e-health solution by the Australian government is provided to illustrate the benefits such an analysis might provide
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Introduction

The aim of this study is to address a significant void in the existing literature; namely, the lack of incorporating a socio-technical analysis in healthcare contexts to ensure heightened success of ICT implementations in healthcare. An evaluation of the Personally Controlled Electronic Health Record (PCEHR) a chosen e-health solution in Australia is provided as an exemplar case to illustrate the benefits of such an approach.

Motivation for the Study

Given current challenges in healthcare delivery most countries are currently investing heavily in ICT (Information Communication Technology) in general and e-health solutions more specifically. Australia, like many other countries is also investing heavily in E-health initiatives. Specifically, in the federal budget (2010-11) the Australian government has allocated Au $466.7 million over two years to develop and implement a national Personally Controlled Electronic Health Record (PCEHR) system for all Australians by 2012. This is a significant investment in the hope of transforming the healthcare delivery system in Australia. This implementation has raised many interesting questions concerning policy issues such as patient privacy, security, identification and management of consent for participation and data collection as well as technical issues concerning system complexity and user understanding of system, lack of standards and protocols, disparate health information systems and frameworks for integration as well as complex user interfaces (Currell et al., 2000; Hall, 2010; Leslie, 2011; Showell, 2011; Westbrook & Braithwaite, 2010). These issues are very important to look into for smooth and successful system implementation and sustainable adoption (Bernstein et al., 2007a; Tang, Ash, et al., 2006; Trudel, 2010; Liu et al., 2011; HFMA, 2006). These key areas of issues can be categorised as social aspects and technical aspects.

An essential aspect then becomes to provide an evaluation of such systems especially since to date no such framework exists to make substantiative critiques on PCEHR; its strengths, benefits, weaknesses as well as an examination of the social and technical aspects. Moreover, no study does this from a socio-technical perspective.

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