Boundaries and e-health implementation in health and social care

Gerry King, Catherine O'Donnell, David Boddy, Fiona Smith, David Heaney, Frances S. Mair

Research output: Contribution to journalArticle

Abstract

Background
The major problem facing health and social care systems globally today is the growing challenge of an elderly population with complex health and social care needs. A longstanding challenge to the provision of high quality, effectively coordinated care for those with complex needs has been the historical separation of health and social care. Access to timely and accurate data about patients and their treatments has the potential to deliver better care at less cost.

Methods
To explore the way in which structural, professional and geographical boundaries have affected e-health implementation in health and social care, through an empirical study of the implementation 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 the presence of established structural boundaries, which lead to competing priorities, incompatible IT systems and infrastructure, and poor cooperation. A second cause was the presence of established professional boundaries, which affect staffs’ understanding and acceptance of data sharing and their information requirements. Geographical boundaries featured but less prominently and contrasting perspectives were found with regard to issues such 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 that we develop integrated approaches to care delivery. Successful integration needs practices such as good project management and governance, ensuring system interoperability, leadership, good training and support, together with clear efforts to improve working relations across professional boundaries and communication of a clear project vision. This study shows that while technological developments make integration possible, long-standing boundaries constitute substantial risks to IT implementations across the health and social care interface which those initiating major changes would do well to consider before committing to the investment.
Original languageEnglish
Article number100
JournalBMC Medical Informatics and Decision Making
Volume12
DOIs
Publication statusPublished - 1 Mar 2012
Externally publishedYes

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Delivery of Health Care
Health
Information Dissemination
Training Support
Scotland
Communication
Costs and Cost Analysis
Population
Therapeutics

Cite this

King, Gerry ; O'Donnell, Catherine ; Boddy, David ; Smith, Fiona ; Heaney, David ; Mair, Frances S. / Boundaries and e-health implementation in health and social care. In: BMC Medical Informatics and Decision Making. 2012 ; Vol. 12.
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Boundaries and e-health implementation in health and social care. / King, Gerry; O'Donnell, Catherine; Boddy, David ; Smith, Fiona; Heaney, David; Mair, Frances S.

In: BMC Medical Informatics and Decision Making, Vol. 12, 100, 01.03.2012.

Research output: Contribution to journalArticle

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AU - Boddy, David

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AU - Mair, Frances S.

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