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Implementing national EHR strategies in Europe: organisational, social and political issues. Laurence ESTERLE, MD,PhD INSERM U 750 ‘Medicine, Sciences, Health & Society’ Villejuif – France. Implementing national EHR strategies in Europe: organisational, social and political issues.

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implementing national ehr strategies in europe organisational social and political issues

Implementing national EHR strategies in Europe: organisational, social and political issues

Laurence ESTERLE, MD,PhD

INSERM U 750

‘Medicine, Sciences, Health & Society’

Villejuif – France

implementing national ehr strategies in europe organisational social and political issues2

Implementing national EHR strategies in Europe: organisational, social and political issues

1. New topics for Eurorec ?

2. Main issues and research topics

3. Next steps

implementing national ehr strategies in europe organisational social and political issues3

Implementing national EHR strategies in Europe: organisational, social and political issues

1. New topics for Eurorec ?

national ehr implementation
National EHR Implementation
  • A radical innovation facing:
    • Numerous technological issues
    • But also political, organisational and social issues
  • Possible failures because of non-technical issues
    • Social, cultural and organisational challenges at the core of EHR adoption
    • Failures due to limited knowledge or consideration for these issues
national ehr implementation5
National EHR Implementation
  • A socio-technical innovation
  • Requires management of change at all levels & dimensions
organisational social and political issues new topics for eurorec
Organisational, social and political issues: New topics for Eurorec ?
  • European dimension
    • Many European countries already engaged
    • Lack of experience sharing and best practice exchanges
  • Eurorec scope and goals
    • Dissemination of information based on European experiences
    • Organisational, cultural and social issues
  • Complementary with existing projects :
    • Q-Req project
    • RIDE roadmap
implementing national ehr strategies in europe organisational social and political issues7

Implementing national EHR strategies in Europe: organisational, social and political issues

2. Main issues and research topics

national ehr implementation political issues
National EHR implementation: Political issues
  • Strategy:
    • Political vision
    • Political decision
    • Management at the political level
  • Dynamic & very complex process
    • Introduction of a major innovation
    • Many actors involved
    • Many changes during the process
national ehr implementation research topics on political issues
National EHR implementation: Research topics on political issues
  • Governance of the system
    • Decision process
    • Institutional design
    • Actors involved
  • Funding mechanisms & financial models
  • Accompanying legal and regulatory measures
national ehr implementation organisational issues
National EHR implementation: Organisational issues
  • Impact on the National Healthcare system and its organisation
  • Changes in the healthcare practices
  • Changes in the role of the actors
national ehr implementation research topics on organisational issues
National EHR implementation: Research topics on organisational issues
  • Management of organisational change
  • Involvement and participation of users:
    • health professionals
    • citizens
national ehr implementation social issues
National EHR implementation: Social issues
  • Potential conflict with cultural or social values, eg:
    • Radical cultural change of healthcare tools
    • Change in respective roles of health professionals & patients
    • Empowerment of patients and citizens
national ehr implementation research topics on social issues
National EHR implementation: Research topics on social issues
  • Identification of controversies
  • User acceptance and/or resistance
implementation of national ehrs strategy organisational social and political issues

Implementation of national EHRs strategy: Organisational, social and political issues

3. Next steps

next steps national and european level
Next steps:National and European level
  • For decision makers:
    • Encouragement & funding of studies and projects on social aspects of EHR implementation
    • Experience sharing and benchmarking of best practices between Member states
  • For researchers
    • Development & reinforcement of a scientific community at the European level
    • Research projects and studies
    • Dissemination of expertise to decision makers
next steps eurorec level
Next steps:Eurorec level
  • Consideration and prioritization of social aspects
  • Participation to research projects
    • e.g. EHR-IMPLEMENT
  • Establishment of a working group associating technical and social researchers
conclusions
Conclusions
  • A real need exists for studying
    • social, political and organisational aspects
  • This need should not be underestimated in National EHR implementation strategies
  • A lot can be learnt from social sciences

“Adopting an innovation means adapting it”

Michel Callon

thank you
Thank you

“No success, no social acceptability without participation, without representation of actors, of innovators, of producers, of intermediaries, of political authorities and of end users”

Michel Callon