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Assessing Electronic Health Records: Are Basic Assumptions in “Health Technology Assessment” Useful?

Authors:
Anne Granstrøm Ekeland

Keywords: Health Technology Assessment (HTA); challenging assumptions, approaches and methods; programs of electronic health records; assumptions in constructive assessments

Abstract:
Use of Health Technology Assessment (HTA) in the field of information and communication technologies (ICT) is limited. The Norwegian health authorities and international networks call for steps to strengthen its use to support the development of good e-health services. Randomized controlled trials (RCT) are the gold standard approach in case studies in HTA and scholars have raised questions concerning their relevance in e-health assessments. Failure of basic philosophical assumptions inherent in RCT to reflect empirical features of e-health is one explanation. In a sociotechnical perspective, this paper explores empirical features of “Common Implementation of Clinical Systems” (FIKS), a large-scale electronic health record program in North Norway. Drawing on documents, information and presentations over a 4 year period, it discusses how empirical features correspond to assumptions of RCT. Also considering scientific literature from assessments of electronic records, complimentary assumptions are presented. The objective is to contribute to a knowledge base for improving HTA of ICT. Results show that RCT assumptions of a stable world, fixed interventions and controlled implementation processes differed from empirical processes. Hence, RCT approaches fail to address important features of the program and produce knowledge that fully demonstrate (causes of) empirical benefits or pitfalls. The paper briefly considers complementary assessment perspectives. Embedding assumptions of a world in flux where social, technical and clinical entities influence each other in dynamic processes should increase the relevance of HTA of ICT, and affect real time developments. Further exploration of assumptions that encourage participatory and process assessment approaches is timely.

Pages: 36 to 41

Copyright: Copyright (c) IARIA, 2016

Publication date: April 24, 2016

Published in: conference

ISSN: 2308-4359

ISBN: 978-1-61208-470-1

Location: Venice, Italy

Dates: from April 24, 2016 to April 28, 2016