9 May 2008
In the doctoral thesis by Lauri Salmivalli, Master of Science in Economics and Business Administration, an electronic prescription feasibility pilot in Finland is evaluated. According to the study, the benefits on the social level potentially introduced by the system do not motivate individual organizations to carry out implementation; on the other hand, the benefits of the system to the organizations remain unclear. This doctoral thesis in the field of information systems science, Governing the Implementation of a Complex Inter-Organizational Information System Network – The Case of Finnish Prescription, shall be examined at Turku School of Economics on Friday, 16 May.
In the public health care field, information systems are regarded as bringing considerable benefits to their implementing organizations. The implementation of an electronic prescription (e-prescription) system has been selected in many countries as the leading project in the electronification of data transfer between organizations in the public health care field. It is hoped that e-prescription will, for example, facilitate inspection of the patient's overall medication, reduce the amount of prescription falsification, and both accelerate and improve the efficiency of the prescription process.
However, there is very little empirical research available on the advantages of public health care-related information systems. The benefits presented are either very broad or highly detailed. The research data concerning the achievement of operative advantages and their cost-utility ratio on the organizational level are still quite minimal.
Benefits for others – expenses for us
It is possible to speak of an implemented network-based data system with regard to electronic prescriptions. The situation is complex when several, mutually quite different organizations initialize the same electronic system, which should produce added value for each actor. According to the doctoral study, confusion with regard to common goals or their total absence makes the implementation of a functional network information system difficult.
“Although the advantages of the system are recognized on the broader level, the participants feel that the system brings them no benefit. It is felt, conversely, that these advantages leak away to other actors whilst the expenses and extra work fall on the shoulders of their own organization," Lauri Salmivalli explains.
In the pilot project studied, the total number of electronic prescriptions remained quite small. Approximately forty million prescriptions are delivered in Finland on an annual scale, whereas a few hundred electronic prescriptions were delivered during the entire period of the pilot.
“So that the potential benefits of an e-prescription type of system may be realized, the volume of electronic prescriptions must be substantial. Otherwise, the costs of two parallel systems are paid, but it is not possible to enjoy the advantages of the new electronic working method,” Mr Salmivalli declares.
Benefits must be critically weighed at various network levels
In this doctoral thesis, the implementation of electronic prescriptions was examined from the perspective of network management. The pilot project was extensive and the group of actors highly heterogeneous.
It began primarily as a technical experiment, and attention was not given in the project to what utility is brought to the organization by implementing the new system. The doctoral thesis presents, in fact, a critical examination of the benefits to the system to be implemented on various levels of the network.
“It must be asked what utility is obtained from the system on the social level, what benefits the system has for its implementing network, and what advantages the system offers for the individual actor on the network. A reply to these questions must be found before starting to take the system more widely into use,” Mr Salmivalli points out.
The evaluation project for e-prescription implementation was realized under the direction of STAKES National Research Centre for Welfare and Health in two consecutive projects during the years 2004 – 2006. The e-prescription pilot project was terminated in 2006 and the new project aiming at e-prescription implementation began during the first part of 2008.
The doctoral thesis can be read at:
http://info.tse.fi/julkaisut/vk/Ae3_2008.pdf
More information:
Lauri Salmivalli
+358 50 533 1434, lauri.salmivalli(a)neteffect.fi