Starting off with a focus on national socio-technical contexts and policies

I will in this short text introduce the project’s second work package “WP 2 – National socio-technical contexts and policies”, which I am co-leading together with Isabella Scandurra. Aside from us, Gunnar Klein and Annika Bärkås are also highly involved in the work package, which was one of the work packages where work started off already at the very beginning of the project. If we consider the main aims of the NORDeHEALTH project, this work package is mostly connected to the aim of studying the current implementation and adoption of PeHS in the Nordic countries to create new knowledge and in-depth understanding of challenges and opportunities.

In this work package, which will provide valuable input to all other work packages, we will collect and analyze information about each participating country’s technical solutions (e.g. hardware and software infrastructure and content in the respective patient accessible electronic health record (PAEHR) system), important contextual factors (e.g. national rules and regulations as well as user adoption), as well as the key stakeholders and their rules and activities. The main goal of the cross-country analysis that will be performed as a last activity in this work package is to pin-point similarities and differences between the implementations in Sweden, Norway, Finland and Estonia. This will not only bring unique solutions and common features to light, but also increase our knowledge of how different factors can impact implementation and enable us to tailor the activities in other work packages to accommodate for identified similarities and differences.

The work that has been and will be performed in this work package is mainly based on the socio-technical analysis model for eHealth systems proposed by Sittig and Singh (2010). They propose 8 different dimensions that should be in focus when analyzing an eHealth solution from a socio-technical perspective; Hardware and software, Clinical content, Human-Computer Interface, People, Workflows and Communication, Internal Organizational policies, procedures & culture, External rules, regulations & pressures, System measurement and monitoring. The work of adjusting the dimensions to our specific focus, as well as drafting key data items for each dimension, began even before the project started. The team at Örebro University, in collaboration with Annika Bärkås, then spent the first couple of months in the project extending and refining the content into a form suitable for the data collection (see snapshot below). During a workshop series, where representatives from each participating country were present, the content was further revised to make sure that the questions included in the data collection instrument were relevant with respect to the different countries involved.

Just recently, the final version of the data collection instrument was made available to all project participants, meaning that data can now be collected. It will obviously take a while to fill in the form, especially since many of the involved countries have more than one national PAEHR solution (one filled out form per system). In a few months we will get the results and will be able to perform the cross-country analysis. It will be very interesting to see which conclusions can be drawn from the very rich material that will be collected. I’m also positive that we will be able to learn a lot from each other across the countries, when it comes to unique solutions as well as similarities. I, or someone else in the work package team, will of course update you as work progresses.

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