Implementation of Electronic patient record and mobile units in Vindafjord Municipality - an evaluation study

IMPLEMENTATION OF ELECTRONIC PATIENT RECORD AND MOBILE UNITS IN VIDAFJORD MUNICIPALITY-AN EVALUATION STUDY

 

Author 1: Engeseth, Kjersti Halvorsen, Chief Consultant, Norwegian Centre for Telemedicine

 

1. Introduction Mobile units in home care services for the elderly and disabled is believed to be a measure that might contribute to simplifying cooperation within the care sector. The effects of using electronic patient records and mobile units are, however, poorly documented. Vindafjord Municipality will in April 2003 have completed implementation of electronic patient record and mobile units in the home care service. 2. The objective of this study: The objective of the study is to follow and evaluate the implementation of electronic patient records and mobile units in a typical Norwegian municipality. The study is divided into two parts: an evaluation of economic consequences, and an evaluation of the implementation process in which the main focus will be on organizational and professional change. This abstract focuses on the implementation process. 3. Method The study will be a process evaluation, which follows the implementation process from beginning to end. In the evaluation we want to measure the activities of the home care service at three different stages. We wish to document qualitative as well as quantitative changes by studying the situation before implementation, immediately after the time of implementation, and after the new system has been in use for about 6 months. The method will be semi-structured interviews combined with field studies. 4. Results and discussion NST has carried out the first phase of the evaluation study, and has so far completed the introductory measuring of the situation before implementation began. We will complete the final interviews autumn 2003. However, from the first set of the interviews we have found areas that will be very interesting to follow in the two next phases of the study. On the organizational level will the approach be changes in the organizational structure and relation between implementation versus integration of technology. What kind of changes on the organizational level will appear in the municipality reorganization process with ICT as one of the components? On the care giver level will main focus be any qualitative and structural changes that take place in report-writing routines as a consequence of the switch to electronic patient records. Will changing to a new method of record writing also affect the content of the patient records entries and the thoughts employees have about report writing in general? It will also be interesting to observe whether there are any changes in the relationship between personnel in the home care services and clients. Will the care recipient, for instance, notice that care givers have more time, and will the extra time in fact be used on clients? And finally, how does the implementation of new technology affect the working conditions?