Basics of qualitative research: Grounded theory procedures and techniques

In this Chapter, we imagine a decision maker (or a group of experts) trying to establish or examine fair procedures to combine opinions about alternatives related to different points of view.

Multiple criteria decision making

Background 
There is considerable international interest in exploiting the potential of digital solutions to enhance the quality and safety of health care. Implementations of transformative eHealth technologies are underway globally, often at very considerable cost. In order to assess the impact of eHealth solutions on the quality and safety of health care, and to inform policy decisions on eHealth deployments, we undertook a systematic review of systematic reviews assessing the effectiveness and consequences of various eHealth technologies on the quality and safety of care.


Methods and Findings 
We developed novel search strategies, conceptual maps of health care quality, safety, and eHealth interventions, and then systematically identified, scrutinised, and synthesised the systematic review literature. Major biomedical databases were searched to identify systematic reviews published between 1997 and 2010. Related theoretical, methodological, and technical material was also reviewed. We identified 53 systematic reviews that focused on assessing the impact of eHealth interventions on the quality and/or safety of health care and 55 supplementary systematic reviews providing relevant supportive information. This systematic review literature was found to be generally of substandard quality with regards to methodology, reporting, and utility. We thematically categorised eHealth technologies into three main areas: (1) storing, managing, and transmission of data; (2) clinical decision support; and (3) facilitating care from a distance. We found that despite support from policymakers, there was relatively little empirical evidence to substantiate many of the claims made in relation to these technologies. Whether the success of those relatively few solutions identified to improve quality and safety would continue if these were deployed beyond the contexts in which they were originally developed, has yet to be established. Importantly, best practice guidelines in effective development and deployment strategies are lacking.


Conclusions 
There is a large gap between the postulated and empirically demonstrated benefits of eHealth technologies. In addition, there is a lack of robust research on the risks of implementing these technologies and their cost-effectiveness has yet to be demonstrated, despite being frequently promoted by policymakers and “techno-enthusiasts” as if this was a given. In the light of the paucity of evidence in relation to improvements in patient outcomes, as well as the lack of evidence on their cost-effectiveness, it is vital that future eHealth technologies are evaluated against a comprehensive set of measures, ideally throughout all stages of the technology's life cycle. Such evaluation should be characterised by careful attention to socio-technical factors to maximise the likelihood of successful implementation and adoption.



Please see later in the article for the Editors' Summary

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The impact of eHealth on the quality and safety of health care: a systematic overview.

THE NEED FOR QUALITY The first thing that we need to consider, in any organization, is that quality is the most important thing. The quality of your work defines you.  Whoever you are,  Whatever you do,  I can find the same products and services cheaper somewhere else. But your quality is your signature. Developing and delivering high quality products and services means that you are doing things correctly from the beginning. As a consequence, you are reducing the need for additional services, from verification to warranty.

Total quality management.

This article presents a review of the book “Organizations: Rational, Natural and Open Systems,” by W.R. Scott.

Organizations: Rational, Natural and Open Systems

Many eHealth initiatives are never implemented or merely end as pilot projects Previous studies report that organisational, technical and human issues need to be properly taken into consideration if such initiatives are to be successful The aim of this paper is to explore whether previously identified challenges within the area have remained in the Swedish eHealth setting or whether they have changed After interviewing experts in eHealth, we present a classification of areas of concern Recurrence of previously identified challenges was found, but also new issues were identified The results of the study indicate that there is a need to consider organisational and semantic issues on both national and international levels Legal and technical challenges still exist but it seems even more important to support eHealth initiatives financially, increase practitioners' knowledge in health informatics and manage new expectations from patients

I Got 99 Problems, and eHealth Is One.

Background. Different studies have analysed a wide range of use cases and scenarios for using IT-based services in homecare settings for elderly people. In most instances, the impact of such servic ...

The need of a multi-actor perspective to understand expectations from virtual presence : managing elderly homecare informatics

Today it is a general belief that e-health has a positive effect on costs as well as on quality of health service delivery. Nevertheless, lots of projects failed in the past to clearly demonstrate ...

Evaluation of E-Health Strategies : A Portfolio Approach

Evaluation as multi-actor trade-off - a challenge in introducing ICT innovations in the health sector

Most of the available studies into information technology (IT) have been limited to investigating specific issues, such as how IT can support decision makers distributing the information throughout health care organization, or how technology impacts organizational performance. In this study, for use in the planning of information system development projects, a theoretical model for the classification of health care organizations is proposed. We try to reflect the development in the contemporary digital economy by theoretically classifying health care organizations into three types, namely traditional, developing, and flexible. We describe traditional health care organizations as organizations with a centralized system for management and control. In developing health care organizations, IT is spread over the horizontal dimension and is used for coordinating the different parties throughout the organization. Finally, flexible health care organizations are those which work actively with the design of new health care organizational structure while they are designing the information system.

Vivian Vimarlund

Papers

I Got 99 Problems, and eHealth Is One.

The need of a multi-actor perspective to understand expectations from virtual presence : managing elderly homecare informatics

Evaluation of E-Health Strategies : A Portfolio Approach

Evaluation as multi-actor trade-off - a challenge in introducing ICT innovations in the health sector

A Theory for Classification of Health Care Organizations in the New Economy