The Implementation of Integrated Health Information Systems – Research Studies from 7 Countries Involving the InterRAI Assessment System

Abstract

Introduction:In the past years, governments from several countries have shown interest in implementing integrated health information systems. The interRAI Suite of instruments fits this concept, as it is a set of standardised, evidence-based assessments, which have been validated for different care settings. The system allows the electronic transfer of information across care settings, enabling integration of care and providing support for care planning and quality monitoring. The main purpose of this research is to describe the recent implementation process of the interRAI instruments in seven countries:

Implementation leadership of the Resident Assessment Instrument in healthcare services for older people: An interview study of specialists

“…This includes establishing the appropriate circumstances and providing sufficient resources for the implementation process. de Almeida Mello et al (2023) noted in a multinational study the importance of similar factors, such as adequate staffing, appropriate information technology and availability of hardware in RAI implementation. In addition, resource provision is centrally related to implementation leadership in general (Gifford et al, 2017).…”

“…On the other hand, thoughtful preparation (Toye, 2016) Almeida Mello et al, 2023;de Stampa et al, 2018;Kangasniemi et al, 2022;Turcotte et al, 2018;Vuorinen, 2020) provided by a technically competent and contextually knowledgeable trainer (Toye, 2016). Additionally, the role of RAI mentors has been strongly noted, and they have been perceived as partly responsible for its successful implementation (Kangasniemi et al, 2022).…”

“…The Resident Assessment Instrument (RAI) provides an individual-level versatile and structured information on older persons' functional abilities, health, quality of life, social support, service use, moods and behaviours. It also provides unit-and organizational-level information on implementation status and outcomes, care planning and resource allocation tools, and quality indicators that can be used for operational development (interRAI, 2023) and decision-making (de Almeida Mello et al, 2023). Some challenges have been identified in the implementation of the RAI (Roth et al, 2014), and they can be influenced by leadership (Boorsma et al, 2013;de Stampa et al, 2018).…”

“…In Finland, the use of RAI started in 2000 in long‐term care facilities and was extended to include home care services a few years later. Over the past two decades, its implementation has steadily grown (de Almeida Mello et al., 2023). Since April 2023, the use of RAI in healthcare services for older people has been mandated by governments (Act on Supporting the Functioning Capacity of the Elderly Population and Social and Health Services for the Elderly, 980/2012).…”

“…Despite widespread use of RAI, previous studies on the effectiveness of the instrument are inconsistent and fragmented. While some have established its benefits in terms of improving the quality of care (de Almeida Mello et al., 2023; Vuorinen, 2020), decision‐making, resource planning and benchmarking (de Almeida Mello et al., 2023), other studies have found deficiencies in its usefulness, consistency (Iduye et al., 2022) and effectiveness (Vuorinen, 2020). Some challenges have also been identified in the implementation of this instrument (Roth et al., 2014), which may affect its potential benefits.…”