Survey on the Status of the Hospital Information Systems in Portugal

Summary

Objectives: To diagnose the hospital information systems’ situation in Portugal.

Methods: Developing a survey on HIS department heads.

Results: Several weaknesses were identified in most HIS departments, such as substantial lackof people and of qualifications to deal with HIS challenges. The Nolan and McFarlan Matrix helped assess the SNS IS maturity at stage 3, characterized by the generalized lackof IS integration.

Conclusions: The results are very relevant to explain the many delays (and conflicts) in implementing HIS and therefore the actual status of HIS in Portugal. The most successful cases of HIS implementation were recognized as related to the existence of an active CIO. Complexity theory can further define guidelines for the development of HIS that help keep the navigation towards “smart healthcare”.

Keywords

Hospital information systems - hospital information systems management - survey - CIO - complexity

• References

• 1 Berwick DM. The Double Edge of Knowledge. The Journal of the American Medical Association 1991; 266: 841-842.
• 2 Healy JC. EU-Canadae-Health Initiative. EU-Canada Meeting – Montreal. Quebec, Canada: 2000.
• 3 IOM Report. To Err is Human. Institute of Medicine; 1999.
• 4 Lenz R, Kuhn KA. Integration of Heterogeneous and Autonomous Systems in Hospitals. Data Management & Storage Technology; 2002.
• 5 IOM Report. Crossing the Quality Chasm: A New Health System for the 21st Century. Institute of Medicine; 2001.
• 6 Nolan RL. Managing the advanced stages of computer technology key research issues. The Information Systems Research Challenge. Proceedings. McFarlan FW. Boston: Harvard Business School Press; 1987.
• 7 Aylin Ε Analysis of Hospital Episode Statistics for the Bristol Royal Infirmary Inquiry. 1999.
• 8 Kuhn KA, Giuse DA. From hospital information systems to health information systems – problems, challenges, perspectives. Methods Inf Med 2001; 40 (04) 275-287.
• 9 Hamborg KC, Vehse B, Bludau HB. Questionnaire Based Usability Evaluation of Hospital Information Systems. Elect J Inform Syst Evaluation. 2004 7 (1).
• 10 Rodrigues L. Compreender os recursos humanos na saúde. Apifarma: Ediçao Colibri; 2002.
• 11 IDC. Report on IT Human Resources 2004. IDC (in Portuguese); 2004.
• 12 Duran XP. Hospital Clinic de Barcelona Information System. Portuguese Institute of Medicine.; May 2006.
• 13 Ash JS, Stavri PZ, Dykstra R, Fournier L. Implementing Computerized Physician Order Entry: the importance of special people. Int J Med Informatics 2003; 69: 235-250.
• 14 Smaltz D. Antecedents of CIO effectiveness: A role-based perspective. Information and Management Science (PhD Thesis). Florida State University; 1999.
• 15 Lenz R. Interoperability in Hospital Information Systems. DESIS 2006 – INA Report. 2006
• 16 Chittick PK, Persaud DD. Project Management: An Essential Tool for the Implementing Integrated Information Technology in Healthcare. Healthcare Management Forum. 2002 15 (2).
• 17 Lapão LV, Grilo A. Desenvolvimento de uma Metodologia para Implementação Incremental de Projectos de Sistemas de Informação para Unidades de Saúde. Proceedings of the 3rd Conference on Public Administration. Lisbon: November 2005.
• 18 Lapão LV, Tavares LV, Pereira MJ. Hospital Information Systems Integration Leadership Strategy for a Portuguese Central and University Hospital. Engelbrecht R. et al. Connecting Medical Informatics and Bio-informatics. IOS Press; 2005.
• 19 CNPD, Relatório de Avaliação da Protecção de Dados Pessoais nos Hospitais, da Comissao Nacional de Protecção de Dados Pessoais, 2004.
• 20 Broadbent M, Kitzis ES. The new CIO Leader: Setting the Agenda and Delivering Results. Harvard Business School Press; 2005.
• 21 McFarlan F. Information Technology Changes the WayYou Compete. HBR. 1984 62 (3).
• 22 Lapão LV. Smart Healthcare: The CIO and the Hospital Management Model in the context of Complexity Theory (PhD Thesis). Technical University of Lisbon.; September 2006.
• 23 Plsek P, Wilson T. Complexity scienes: Complexity, leadership, and management in healthcare organisations. BMJ 2001; 323: 746-749.
• 24 Kauffman S. At Home in the Universe: The Search for the Laws of Self-Organization and Complexity. OUP; 1998.
• 25 Nohr C. Evaluation of Electronic Health Record Systems. IMIA Yearbook of Medical Informatics 2006 (Haux R, Kulikowski C, editors). Methods Inf Med. 2006; 45 (Suppl. 01) 107-113.
• 26 Ash JS, Fournier L, Stavri PZ, Dykstra R. Principles for a Successful Computerized Physician Order Entry Implementation. AMIA 2003 Symposium Proceedings. 36-40.