Information Infrastructures within European Health Care: Working with the Installed Base (Health Informatics)

This book is open access under a CC BY-NC 2.5 license. The book aims to be a resource for those interested in planning and implementing large-scale information infrastructures for novel electronic services in health care. The focus of this book is on the pivotal role of the installed base (i.e. the already existing elements of an infrastructure) for ensuing infrastructural development. The book presents rich empirical cases on the design, development and implementation of core infrastructural components (e-prescription and public patient-oriented web platforms) in different national settings across Europe. Therefore, this is a book in which theoretical insights and practical experiences are tightly connected. Contributions have been sourced from a network of academics that have been working on the topic for years, and who have previously collaborated and shared a common understanding of the challenges entailed in expanding information infrastructures within healthcare. The book aims to become a reference for those seeking theoretical and empirical insights for conceptualizing and steering the evolution of information infrastructures in healthcare. The two types of systems (e-prescription and public patient-oriented web platforms) have been selected because they are widespread across Europe, because they invite comparisons, and because they are exemplary of two different types of aims. E-prescription initiatives are usually seen as opportunities to improve healthcare delivery by systematic and not dramatic change. Public patient-oriented web platforms are seen as opportunities to pursue wider and more radical innovation. This book targets researchers, practitioners and students who would benefit from a book providing a comprehensive view to contemporary approaches for the design and deployment of large-scale, inter-organizational systems within healthcare. This book is open access under a CC BY 4.0 license. This book is open access under a CC BY-NC 2.5 license. This book consolidates experiences from across Europe on the design, development, implementation and evolution of inter-organisational information infrastructures for healthcare. It provides insights with practical relevance for those involved or interested in the planning and implementation of such infrastructures and includes 11 empirical cases on the introduction of core infrastructural arrangements in different national settings: six cases investigate the use of e-prescriptions and five the public platforms for patient-oriented eHealth services. Both are linked to different types of aims. E-prescription initiatives are usually seen as opportunities to improve healthcare delivery by systematic change (controlling medication costs, improving patient safety and providing rich information for policy making and performance management). Public platforms for patient-oriented eHealth services are seen as opportunities for change and innovation, aiming to strengthen the patients' role and facilitate a shift from provider-centered healthcare towards patient-centeredness. For both types of initiatives, there is a requirement to mix novelty with pre-existing infrastructural components. The cases are analysed by leading experts in health information systems through a common theoretical framework, exploring the role of the pre-existing sociotechnical basis, i.e. the installed base, and how it fundamentally impacts the evolution of information infrastructures. The book advances an "installed base sensitivity" in decision-making both at the policy/strategy level and at the concrete eHealth design level and shows how practitioners and policy-makers can address the complexity of infrastructures that facilitate information flows across organisational boundaries. This book is open access under a CC BY 4.0 license "This book is open access under a CC BY-NC 2.5 license. This book consolidates experiences from across Europe on the design, development, implementation and evolution of inter-organisational information infrastructures for healthcare. It provides insights with practical relevance for those involved or interested in the planning and implementation of such infrastructures and includes 11 empirical cases on the introduction of core infrastructural arrangements in different national settings: six cases investigate the use of e-prescriptions and five the public platforms for patient-oriented eHealth services. Both are linked to different types of aims. E-prescription initiatives are usually seen as opportunities to improve healthcare delivery by systematic change (controlling medication costs, improving patient safety and providing rich information for policy making and performance management). Public platforms for patient-oriented eHealth services are seen as opportunities for change and innovation, aiming to strengthen the patients’ role and facilitate a shift from provider-centered healthcare towards patient-centeredness. For both types of initiatives, there is a requirement to mix novelty with pre-existing infrastructural components. The cases are analysed by leading experts in health information systems through a common theoretical framework, exploring the role of the pre-existing sociotechnical basis, i.e. the installed base, and how it fundamentally impacts the evolution of information infrastructures. The book advances an “installed base sensitivity” in decision-making both at the policy/strategy level and at the concrete eHealth design level and shows how practitioners and policy-makers can address the complexity of infrastructures that facilitate information flows across organisational boundaries."-- Prové de l'editor Front Matter....Pages i-vi Introduction....Pages 1-7 Front Matter....Pages 9-9 Information Infrastructures for eHealth....Pages 11-23 Information Infrastructures and the Challenge of the Installed Base....Pages 25-33 Strategies for Building eHealth Infrastructures....Pages 35-51 Front Matter....Pages 53-53 Maintaining the Pharmacy Model: The Catalan Electronic Prescription Infrastructure....Pages 55-72 The ePrescription Initiative and Information Infrastructure in Norway....Pages 73-87 Cultivating the Installed Base: The Introduction of e-Prescription in Greece....Pages 89-108 England’s Electronic Prescription Service....Pages 109-128 The Challenges of Implementing Packaged Hospital Electronic Prescribing and Medicine Administration Systems in UK Hospitals: Premature Purchase of Immature Solutions?....Pages 129-149 Medication Infrastructure Development in Germany....Pages 151-170 Front Matter....Pages 171-171 Navigating Towards Self-Care: The Catalan Public Patient Portal....Pages 173-192 The Norwegian eHealth Platform: Development Through Cultivation Strategies and Incremental Changes....Pages 193-208 Building National Healthcare Infrastructure: The Case of the Danish e-Health Portal....Pages 209-224 The Swedish Patient Portal and Its Relation to the National Reference Architecture and the Overall eHealth Infrastructure....Pages 225-244 The Origins of a Healthcare e-Booking System in the Municipality of Bologna....Pages 245-260 Back Matter....Pages 261-263