Maass MC et al. 2008 "Usefulness of a regional health care information system in primary care - a case study."
Reference
Maass MC, Asikainen P, Maenpaa T, et al. Usefulness of a regional health care information system in primary care - a case study. Comput Methods Programs Biomed 2008;91(2):175-181.
Abstract
"The goal of this paper is to describe some benefits and possible cost consequences of computer based access to specialised health care information. A before-after activity analysis regarding 20 diabetic patients clinical appointments was performed in a Health Centre in Satakunta region in Finland. Cost data, an interview, time-and-motion studies, and flow charts based on modeling were applied. Access to up-to-date diagnostic information reduced redundant clinical re-appointments, repeated tests, and mail orders for missing data. Timely access to diagnostic information brought about several benefits regarding workflow, patient care, and disease management. These benefits resulted in theoretical net cost savings. The study results indicated that Regional Information Systems may be useful tools to support performance and improve efficiency. However, further studies are required in order to verify how the monetary savings would impact the performance of Health Care Units."
Objective
"To describe some benefits and possible cost consequences of computer based access to specialised health care information" through the networking of health care information systems in a geographic region.
Tools Used
Type Clinic
Primary care
Size
Large
Other Information
In the Satakunta region in Finland, the study was conducted at the Satakunta Central Hospital and a health center serving 20,000 people.
Type of Health IT
Health Information Exchange (HIE)
Type of Health IT Functions
The Health Information Exchange system was designed to "enable all Health Centres of the region to have access to secondary care diagnostic information regarding all patients...The [s]ystem allowed a focussed search for the precise information required...Access to medical speciality related data by computed selection was rapid and convenient."
Context or other IT in place
Electronic health records (EHR)
Workflow-Related Findings
"Access to the [HIE system] reduced the number of work processes. The time and motion study revealed that workflow was simplified and accelerated in 4 of the 20 cases followed. Availability of the latest diagnostic data assisted in concluding successfully these clinical appointments."
Patients' "treatment was shortened by one to two weeks."
"The [HIE system] allowed in situ decision-making which encouraged confidence, and increased professional performance. There was no longer confusion arising from the absence of required documents, which previously had triggered" staff to perform several sets of tasks.
Average patient appointment time increased by 4 minutes, from 22 to 26 minutes.
"The activity analysis [found that prior to the HIE implementation] 20% of the tests and clinical appointments were redundant."
"The parallel use of paper suggested that the full potential of Information Systems was not fully exploited."
Study Design
Pre-postintervention (no control group)
Study Participants
The study participants included diabetes patients from the health center receiving secondary care at Satakunta Central Hospital.