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      Charting Complex Change: Application of the e-Health Implementation Toolkit (e-HIT) in ‘dallas’

      , , ,

      BCS Health Informatics Scotland (HIS) (HIS)

      BCS Health Informatics Scotland (HIS)

      2 - 3 September 2014

      eHealth, Integrated Delivery of Health Care, National Health Programs, Qualitative Research

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          The ‘dallas’ (Delivering Assisted Living Lifestyles at Scale) programme is a UK-wide digital healthcare initiative that has been designed to support independent living, enhance preventative care, and improve lifestyles by harnessing the potential of e-health technologies and digital services. This short paper presents a brief update on one strand of the University of Glasgow evaluation of the dallas programme. We have used the e-Health Implementation Toolkit (e-HIT) to investigate processes involved in the implementation of e-health tools and digital services being developed and deployed across the dallas communities and to assess ‘distance travelled’ by communities from baseline to midpoint of a three year programme. Qualitative data analysis was guided by the Normalisation Process Theory (NPT) and Framework Analysis. The e-HIT scores indicated that the dallas communities had underestimated the amount of work involved in implementing at scale. Qualitative data analysis showed that communities have successfully navigated barriers in order to make significant progress in strategic areas, including the development of new models of partnership working resulting in brand recognition and agile service design. The dallas communities are now sharing lessons learned and generating new professional knowledge, skills and understanding across several key strategic areas required for operationalising the implementation of e-health technologies and digital services at scale. The new knowledge being generated through the dallas programme will contribute to the ongoing transformation of digitally enabled healthcare based on more personalised flexible models of provision which resonates with the current e-health policy environment.

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          Systematic review: impact of health information technology on quality, efficiency, and costs of medical care.

          Experts consider health information technology key to improving efficiency and quality of health care. To systematically review evidence on the effect of health information technology on quality, efficiency, and costs of health care. The authors systematically searched the English-language literature indexed in MEDLINE (1995 to January 2004), the Cochrane Central Register of Controlled Trials, the Cochrane Database of Abstracts of Reviews of Effects, and the Periodical Abstracts Database. We also added studies identified by experts up to April 2005. Descriptive and comparative studies and systematic reviews of health information technology. Two reviewers independently extracted information on system capabilities, design, effects on quality, system acquisition, implementation context, and costs. 257 studies met the inclusion criteria. Most studies addressed decision support systems or electronic health records. Approximately 25% of the studies were from 4 academic institutions that implemented internally developed systems; only 9 studies evaluated multifunctional, commercially developed systems. Three major benefits on quality were demonstrated: increased adherence to guideline-based care, enhanced surveillance and monitoring, and decreased medication errors. The primary domain of improvement was preventive health. The major efficiency benefit shown was decreased utilization of care. Data on another efficiency measure, time utilization, were mixed. Empirical cost data were limited. Available quantitative research was limited and was done by a small number of institutions. Systems were heterogeneous and sometimes incompletely described. Available financial and contextual data were limited. Four benchmark institutions have demonstrated the efficacy of health information technologies in improving quality and efficiency. Whether and how other institutions can achieve similar benefits, and at what costs, are unclear.

            Author and article information

            September 2014
            September 2014
            : 1-3
            Institute of Health & Well-Being

            University of Glasgow
            Dept. of Computer &

            Information Science,

            University of Strathclyde
            © Alison M. Devlin et al. Published by BCS Learning and Development Ltd. BCS Health Informatics Scotland (HIS), Glasgow, UK

            This work is licensed under a Creative Commons Attribution 4.0 Unported License. To view a copy of this license, visit

            BCS Health Informatics Scotland (HIS)
            Glasgow, UK
            2 - 3 September 2014
            Electronic Workshops in Computing (eWiC)
            BCS Health Informatics Scotland (HIS)
            Product Information: 1477-9358BCS Learning & Development
            Self URI (journal page):
            Electronic Workshops in Computing


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