Routine Health Information Systems in the European Context: A Systematic Review of Systematic Reviews

Saigí-Rubió, Francesc; Pereyra‐Rodriguez, José Juan; Torrent‐Sellens, Joan; Eguia, Hans; Azzopardi-Muscat, Natasha; Novillo-Ortiz, David

doi:10.3390/ijerph18094622

Cited by 19 publications

(23 citation statements)

References 63 publications

(187 reference statements)

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“…Routine HIS interventions in the European region were identified to be promising; however, different areas of improvement, such as technical, organizational, and behavioral elements, were identified [ 49 ]. In Japan, the areas of improvement in health care information technology include the necessity for leadership and IT knowledge in medical communities, provider incentives, legislation regarding accountability, security, privacy and confidentiality, inclusion of stakeholders in solution development, and creation of sustainable business models [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

Health Information Systems for Older Persons in Select Government Tertiary Hospitals and Health Centers in the Philippines: Cross-sectional Study

Garcia¹,

Vega²,

Mercado³

2022

J Med Internet Res

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Background The rapid aging of the world’s population requires systems that support health facilities’ provision of integrated care at multiple levels of the health care system. The use of health information systems (HISs) at the point of care has shown positive effects on clinical processes and patient health in several settings of care. Objective We sought to describe HISs for older persons (OPs) in select government tertiary hospitals and health centers in the Philippines. Specifically, we aimed to review the existing policies and guidelines related to HISs for OPs in the country, determine the proportion of select government hospitals and health centers with existing health information specific for OPs, and describe the challenges related to HISs in select health facilities. Methods We utilized the data derived from the findings of the Focused Interventions for Frail Older Adults Research and Development Project (FITforFrail), a cross-sectional and ethics committee–approved study. A facility-based listing of services and human resources specific to geriatric patients was conducted in purposively sampled 27 tertiary government hospitals identified as geriatric centers and 16 health centers across all regions in the Philippines. We also reviewed the existing policies and guidelines related to HISs for OPs in the country. Results Based on the existing guidelines, multiple agencies were involved in the provision of services for OPs, with several records containing health information of OPs. However, there is no existing HIS specific for OPs in the country. Only 14 (52%) of the 27 hospitals and 4 (25%) of the 16 health centers conduct comprehensive geriatric assessment (CGA). All tertiary hospitals and health centers are able to maintain medical records of their patients, and almost all (26/27, 96%) hospitals and all (16/16, 100%) health centers have data on top causes of morbidity and mortality. Meanwhile, the presence of specific disease registries varied per hospitals and health centers. Challenges to HISs include the inability to update databases due to inadequately trained personnel, use of an offline facility–based HIS, an unstable internet connection, and technical issues and nonuniform reporting of categories for age group classification. Conclusions Current HISs for OPs are characterized by fragmentation, multiple sources, and inaccessibility. Barriers to achieving appropriate HISs for OPs include the inability to update HISs in hospitals and health centers and a lack of standardization by age group and disease classification. Thus, we recommend a 1-person, 1-record electronic medical record system for OPs and the disaggregation and analysis across demographic and socioeconomic parameters to inform policies and programs that address the complex needs of OPs. CGA as a required routine procedure for all OPs and its integration with the existing HISs in the country are also recommended.

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Section: Discussionmentioning

confidence: 99%

Health Information Systems for Older Persons in Select Government Tertiary Hospitals and Health Centers in the Philippines: Cross-sectional Study

Garcia¹,

Vega²,

Mercado³

2022

J Med Internet Res

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“…47 48 Our findings regarding challenges to link available data sources are consistent with recent reporting on the Dutch health information system in general 17 and ultimately, common to many European routine healthcare information systems. [48][49][50] Importantly, while often justified as a legal constraint, regulations like GDPR in fact leave much room for national legislation. 51 Recent Dutch initiatives like the 'Electronic Data Exchange in Health Care Bill' 52 and national quality and information standards for the exchange of medication data 53 54 are important steps being taken for more integrated data at the point of care.…”

Section: Discussionmentioning

confidence: 99%

Optimising the secondary use of primary care prescribing data to improve quality of care: a qualitative analysis

et al. 2022

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ObjectivesTo explore available data sources, secondary uses and key considerations for optimising the actionability of primary care prescribing data to improve quality of care in the Dutch context.DesignAn exploratory qualitative study was undertaken based on semi-structured interviews. We anchored our investigation around three tracer prescription types: antibiotics; benzodiazepines and opioids. Descriptive and explanatory themes were derived from interview data using thematic analysis.SettingStakeholders were sampled from across the micro (clinical), meso (organisational) and macro (policy) contexts of the Dutch primary care system.ParticipantsThe study involved 28 informants representing general practitioners (GPs), community pharmacists, regional chronic care networks (care groups), academia and research institutes, insurers, professional associations, electronic health record (EHR) vendors and national authorities.ResultsIn the Netherlands, three main sources of data for improving prescribing in primary care are in use: clinical data in the EHRs of GP practices; pharmacy data in community pharmacy databases and claims data of insurers. While the secondary use of pharmacy and claims data is well-established across levels, the use of these data together with EHR data is limited. Important differences in the types of prescribing information needed by micro-meso-macro context are found, though the extent to which current indicators address these varies by prescription type. Five main themes were identified as areas for optimising data use: (1) measuring what matters, (2) increasing data linkages, (3) improving data quality, (4) facilitating data sharing and (5) optimising fit for use analysis.ConclusionsTo make primary care prescribing data useful for improving quality, consolidated patient-specific data on the indication for a prescription and dispensed medicine, over time, is needed. In the Netherlands, the selection of indicators requires further prioritisation to better signal the appropriateness and long-term use of prescription drugs. Prioritising data linkages is critical towards more actionable use.

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“…The research literature provides examples of studies assessing the behavioral dimension of hospital’s non-financial performance, in which the main emphasis is placed on the assessment of meeting the individual needs of hospital staff [ 27 , 28 ]. It is also argued that among all hospital stakeholders, healthcare professionals should be particularly strongly involved in designing and shaping the assessments of how performance indicators are measured [ 29 ].…”

Section: Literaturementioning

confidence: 99%

Evaluating Organizational Performance of Public Hospitals using the McKinsey 7-S Framework

Chmielewska

Stokwiszewski

Markowska

et al. 2022

BMC Health Serv Res

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Background This study examined non-financial aspects of the organizational performance of public hospitals from the perspective of hospital physicians; the obtained results were analyzed to identify the necessary improvements in organizational performance. Methods This was a cross-sectional study of multidisciplinary public hospitals on a group of 249 randomly selected physicians from 22 in-patient departments or clinics operating in the Warsaw region. The study data was collected using the structured World Health Organization questionnaires (to be filled out by respondents) assessing the hospital’s organizational performance variables qualified according to the McKinsey 7-S Framework. Epidata software version 3.1 was used for data entry, and the analysis was carried out in the SPSS software, version 19. The results of the organization evaluation are presented in the McKinsey 7-S Framework diagram. Key elements of the performance factors were grouped into ‘stens’, and the sten values were expressed as arithmetic means. Normal distribution of the stens was validated with the Kolmogorov–Smirnov test. 95% confidence intervals were calculated. The significance of differences between the analyzed stens was compared with the paired Student t-test. The interdependence of the variables was determined using the Pearson’s correlation coefficient. Results The results revealed a significant difference (p <0.05) in the respondents’ assessment of social (a mean score of 2.58) and technical (a mean score of 2.80) organizational aspects of the hospital operation. Scores for all variables were low. The social elements of an organization with the lowest score included ‘staff’, and in it the aspect – ‘efforts are made to inspire employees at the lowest levels of the organization’, ‘skills’ involving the learning style followed by the management/managerial staff, and ‘management style’ (average scores of 2.38, 2.56, 2.61, respectively). Conclusion Consistently with the existing literature, social factors were shown to play a more significant role in the management and they therefore deserve careful attention and more recognition when identifying and improving the key aspects affecting the organizational performance of public hospitals. Technical elements (strategy, structure, system) are important, but were demonstrated to have limited effect on the organizational operations geared towards ensuring effective functioning of a public hospital.

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Routine Health Information Systems in the European Context: A Systematic Review of Systematic Reviews

Cited by 19 publications

References 63 publications

Health Information Systems for Older Persons in Select Government Tertiary Hospitals and Health Centers in the Philippines: Cross-sectional Study

Health Information Systems for Older Persons in Select Government Tertiary Hospitals and Health Centers in the Philippines: Cross-sectional Study

Optimising the secondary use of primary care prescribing data to improve quality of care: a qualitative analysis

Evaluating Organizational Performance of Public Hospitals using the McKinsey 7-S Framework

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