National health Information Management/Information Technology priorities: an international comparative study

Abstract

This thesis research contributes to national health Information Management/Information Technology (IM/IT) planning and therefore strategy development and implementation research, as well as to health information science. An examination into the national health IM/IT plans of several countries provides knowledge into identifying the typical IM/IT priorities that selected countries are focusing upon for healthcare improvement. Second, a systematic literature review of the current challenges, barriers and/or issues (referred to as ‘challenges’ hereafter) facing IM/IT priority implementation in healthcare settings provides insight on where nations should perhaps be focusing their attention, in order to enable more successful healthcare IM/IT implementations. Lastly, a study on national health IM/IT priorities contributes to the body of evidence that national level IM/IT direction is necessary for better patient care and health system reform across the world. In this investigation, the national health IM/IT priorities, which are reflected in the national health IM/IT strategic plans of five countries were assessed. To this end, the study: 1) Developed a set of measures to select four countries to study in addition to Canada; 2) Described the national health IM/IT priorities of Canada and four other countries; 3) Performed a systematic literature review of the challenges to overcome for successful implementation of IM/IT into healthcare settings; 4) Developed and administered a questionnaire where participants were asked to give their opinions on the progress their country has achieved in dealing with such challenges; and 5) Performed an analysis of the questionnaire results with respect to the countries’ national health IM/IT priorities. The systematic literature review uncovered a large number of challenges that the health informatics and healthcare community face when attempting to implement IM/IT into healthcare settings. iii The priority comparison highlighted that there is no right or wrong answer for what countries should focus their national health IM/IT energies upon. The findings indicate that nations focus their resources (time, money, personnel etc.) on the priorities they feel they should, whether those stem from needs analyses or politics. However, by learning about what other nations are prioritizing, a country can use that knowledge to help focus their own national health IM/IT priorities. The questionnaire results drew attention to the most frequently encountered challenges the five countries face in moving their national health IM/IT agendas forward. The feedback from the respondents provided individual reflections on how IM/IT implementations are actually progressing in their country, where problems are being encountered, including the nature of those problems, and in some cases, respondents offered insight on how to better deal with the challenges they face. The findings indicate that nations encounter similar problems in implementing IM/IT into healthcare settings. Currently, the world is facing many of the same healthcare system issues: shortages of healthcare processionals, long surgical and diagnostic imaging waitlists, ‘skyrocketing’ pharmaceutical drug pricing, healthcare funding practices, and challenges with implementing healthcare IM/IT priorities to name a few. If countries are facing similar health system problems, then it would be logical to assume that solutions to deal with such problems would be similar across nations. Thus, it is recommended that international fora and conferences be held to further discuss the types of health system IM/IT priorities that countries are implementing at a nation scale, the kinds of challenges they face and the solutions or conclusions that they have formulated in response to these challenges.