Publication Date:
2012-09-08
Description:
Background: The major problem facing health and social care systems globally today is the growingchallenge of an elderly population with complex health and social care needs. A longstandingchallenge to the provision of high quality, effectively coordinated care for those withcomplex needs has been the historical separation of health and social care. Access to timelyand accurate data about patients and their treatments has the potential to deliver better care atless cost. Methods: To explore the way in which structural, professional and geographical boundaries haveaffected e-health implementation in health and social care, through an empirical study of theimplementation of an electronic version of Single Shared Assessment (SSA) in Scotland,using three retrospective, qualitative case studies in three different health board locations. Results: Progress in effectively sharing electronic data had been slow and uneven. One cause was thepresence of established structural boundaries, which lead to competing priorities,incompatible IT systems and infrastructure, and poor cooperation. A second cause was thepresence of established professional boundaries, which affect staffs understanding andacceptance of data sharing and their information requirements. Geographical boundariesfeatured but less prominently and contrasting perspectives were found with regard to issuessuch as co-location of health and social care professionals. Conclusions: To provide holistic care to those with complex health and social care needs, it is essential thatwe develop integrated approaches to care delivery. Successful integration needs practicessuch as good project management and governance, ensuring system interoperability,leadership, good training and support, together with clear efforts to improve workingrelations across professional boundaries and communication of a clear project vision. Thisstudy shows that while technological developments make integration possible, long-standingboundaries constitute substantial risks to IT implementations across the health and social careinterface which those initiating major changes would do well to consider before committingto the investment.
Electronic ISSN:
1472-6947
Topics:
Computer Science
,
Medicine
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