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Practitioner’s Report – “IT support in Swedish county councils” (Jerlvall and Pehrsson, 2009)

This report is prepared by SLIT (IT–strategy division of county councils) annually. There is considerable interest in in-depth knowledge of health care use of IT support from authorities, suppliers, and media. Interest is particularly high for the implementation of the national IT strategy for health care services and the county council’s action plan agreed upon in 2006. The strategy highlights that the information should follow the patient over organizational boundaries as well as using IT to increase patient safety and participation in care. A prerequisite for achieving the objectives of the national IT strategy is that there is an increased local IT support to hospitals, health centres, and in private health care providers. There is currently no official statistics or summary that describes the extent to which IT support is introduced within the various counties. This report presents findings with data collected during 2009. Data relating to systems, use etc. refers to the situation in early 2009. The inventory system is based on a survey collection that has been answered by the members of SLIT. Similar inventories have been made over several years in order to provide a basis for comparison and benchmarking between councils in Sweden. The survey consists of over 100 questionnaires areas. Data was collected for each area ratio (i.e. how much is introduced in relation to goal) about system, provider, mode of operation, etc. All counties have responded survey.
The complete report shows that councils continue introduction of IT and that IT is used increasingly in the core processes of care. Notable is that IT costs as part of the trial shows a tendency to decrease (from 2.82% in 2008 to 2.77% for 2009). All IT costs for the county councils (including self- staff) is estimated at about 6.7 billion. Since last 2008, the number of counties that have IT support for all care documentation increased from 14 to 16. In other counties pending the establishment and they will be ready within the next years. The conditions for realizing the national IT strategy is starting to appear. The basic services for security (Health and Health care Address Register, Secure IT in Health and Health care) have largely been introduced. Introduction of NPÖ (National Patient Overview, based on national services) began in 2009 and planning for the introduction of all county councils is in progress. The IT support for coordinated care planning is now in 20 counties.
Each county has a comprehensive IT infrastructure for communication and a unifying National Network (SJUNET). The density of the PC / clients in health care is increasing every year and is now 1:14 staff / PC. The great common challenge of the next few years is to implement the national services (e.g., NPO) in the county councils’ IT environments. The county councils have agreed on a new common action plan and funding for the next three-year period from 2010 to 2012. This agreement and the national IT strategy (a clearer long-term coordination and an increase in the national IT infrastructure) will form the basis of the continued improvement efforts.
The need to document (write « log ») is large and central to health care. The county councils have worked for many years with the introduction of IT support care documentation. In primary health care, IT health care documentation is introduced in all counties but has been difficult in hospitals and psychiatry. There are major efforts in the county councils to consolidate and integrate the technology information for common access. There is a strong movement towards standardizing systems for hospitals, psychiatric and primary care. Strong motivation is the vision of ―one patient – one record‖, common list of drugs and common terminology and conceptual structure. Internal consolidation with only one point (a database) that facilitates achieving the vision of « a patient – one record » within a county is important. Seven counties currently have the same system at the hospital, psychiatric and primary care and 9 counties have this as a strategic direction (Figure 4.2) and within the next few years most counties are expected to have adopted the same system.
This report is prepared by SLIT (IT–strategy division of county councils) annually. There is considerable interest in in-depth knowledge of health care use of IT support from authorities, suppliers, and media. Interest is particularly high for the implementation of the national IT strategy for health care services and the county council’s action plan agreed upon in 2006. The strategy highlights that the information should follow the patient over organizational boundaries as well as using IT to increase patient safety and participation in care. A prerequisite for achieving the objectives of the national IT strategy is that there is an increased local IT support to hospitals, health centres, and in private health care providers. There is currently no official statistics or summary that describes the extent to which IT support is introduced within the various counties. This report presents findings with data collected during 2009. Data relating to systems, use etc. refers to the situation in early 2009. The inventory system is based on a survey collection that has been answered by the members of SLIT. Similar inventories have been made over several years in order to provide a basis for comparison and benchmarking between councils in Sweden. The survey consists of over 100 questionnaires areas. Data was collected for each area ratio (i.e. how much is introduced in relation to goal) about system, provider, mode of operation, etc. All counties have responded survey.
The complete report shows that councils continue introduction of IT and that IT is used increasingly in the core processes of care. Notable is that IT costs as part of the trial shows a tendency to decrease (from 2.82% in 2008 to 2.77% for 2009). All IT costs for the county councils (including self- staff) is estimated at about 6.7 billion. Since last 2008, the number of counties that have IT support for all care documentation increased from 14 to 16. In other counties pending the establishment and they will be ready within the next years. The conditions for realizing the national IT strategy is starting to appear. The basic services for security (Health and Health care Address Register, Secure IT in Health and Health care) have largely been introduced. Introduction of NPÖ (National Patient Overview, based on national services) began in 2009 and planning for the introduction of all county councils is in progress. The IT support for coordinated care planning is now in 20 counties.
Each county has a comprehensive IT infrastructure for communication and a unifying National Network (SJUNET). The density of the PC / clients in health care is increasing every year and is now 1:14 staff / PC. The great common challenge of the next few years is to implement the national services (e.g., NPO) in the county councils’ IT environments. The county councils have agreed on a new common action plan and funding for the next three-year period from 2010 to 2012. This agreement and the national IT strategy (a clearer long-term coordination and an increase in the national IT infrastructure) will form the basis of the continued improvement efforts.
The need to document (write « log ») is large and central to health care. The county councils have worked for many years with the introduction of IT support care documentation. In primary health care, IT health care documentation is introduced in all counties but has been difficult in hospitals and psychiatry. There are major efforts in the county councils to consolidate and integrate the technology information for common access. There is a strong movement towards standardizing systems for hospitals, psychiatric and primary care. Strong motivation is the vision of ―one patient – one record‖, common list of drugs and common terminology and conceptual structure. Internal consolidation with only one point (a database) that facilitates achieving the vision of « a patient – one record » within a county is important. Seven counties currently have the same system at the hospital, psychiatric and primary care and 9 counties have this as a strategic direction (Figure 4.2) and within the next few years most counties are expected to have adopted the same system.

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1 INTRODUCTION
1.1 Background
1.2 Problem .
1.4 Use of Previous Studies .
1.5 Interested Parties
1.6 Delimitations
1.7 Definition of Key Terminologies .
1.8 Disposition
2 METHOD .
2.1 Research Approach
2.1.1 Quantitative or Qualitative Research
2.1.2 Deductive and Inductive Research
2.2 Data Collection
2.3 Research Credibility
3 FRAME OF REFERENCE
3.1 eGovernment
3.2 The Swedish Health care System
3.4 Barriers to the Development of eHealth Service
3.5 User Acceptance and Adoption of eHealth Services
3.6 Summary of Theories and Concepts
4 FINDINGS FROM PREVIOUS SCIENTIFIC STUDY AND PRACTIONER’S REPORT
4.1 Scientific Study – ―Development without Strategy‖ (Wiklund and Lindh, 2004)
4.2 Practitioner‘s Report – ―IT support in Swedish county councils‖ (Jerlvall and Pehrsson, 2009)
5 EMPIRICAL FINDINGS
6 ANALYSIS AND DISCUSSION
7 CONCLUSION
8 REFLECTIONS AND FUTURE RECOMMENDATIONS
REFERENCES