We found even some studies that
aimed to evaluate the effects of IT-innovations on the
quality of work performance. Studies that focus on how
to manage information systems report the po sitive effects
of the technology in use and its effects for the quality of
care, or improvements in management and work process.
Studies performed with the aim to evaluate the finan-
cial impacts of introducing IT-innovations seldom use a
systematic identification of all costs. Usually the studies
that aim to capture the contribution of IT-innovations to
health and/or social care concern user attitudes and per-
spectives, user satisfaction, and the usefulness of the
systems implemented. They normally missed the rela-
tionship between usability and economic or usefulness
and cost-effectiveness
The most common techniques that the studies have
used to capture the economic effects of IT-innovations
are current market prices or loss of income. The articles
give, however, no clear picture of how the effects have
been measured and many times only the direct effects
were included in the calculations. The studies are mostly
descriptive and indicate the difficulty in measuring
qualitative effects of changes. They are usually carried
out a priori, i.e. before an IT-innovation has been intro-
duced and used in practice and thus cannot confirm that
any anticipated effects have been realized. In some cases,
studies have been conducted a-posteriori, noting that the
promise of economic gain has not been realized. Empiri-
cal attempts to demonstrate or measure the Return on
Investment (ROI), has often failed due to the complexity
of health and social care organizations, or are of limited
use when evaluation is only conducted on prototypes
with a limited number of users.
The most common indicators used to express impacts
of IT-innovations in the reviewed articles are:
Increased incomes related to a general use of elec-
tronic journals;
Cost reductions as a consequence of reduced time for
paper-based work or for reduction of printing docu-
mentation;
Reduction of costs for medicine due a more effective
prescription pr o ce ss ;
Costs reducti ons due to effectiveness of work-routi nes;
Cost reductions for less administrative support;
Productivity improvements both at the individual and
organi zational le v el;
Quality improvement of care processes and its sub-
sequent reduction of costs due to less;
Reduction of costs due to errors both in processes,
prescriptions an d treatment.
A general reflection that we find in the studies re-
viewed is that concrete evidence of the benefits of IT-
based innovations are still few and of varying quality.
The articles give no clear picture of how the effects have
been measured and normally only the direct effects were
included in the calculations. The benefits of IT innova-
tions depend heavily on factors that may take consider-
able time to reach full power. It often means that the total
benefits are rarely identified in the short term. Although
much research has been done in this area it is still the
case that IT-innovations lead to un-expected costs and
Copyright © 2012 SciRes. IIM
V. VIMARLUND, S. KOCH
298
organiz ational cha nges.
Most of the literature indicates, however, the limita-
tions of a strictly quantified economic framework to
measure the benefits in relation to investments in IT-
innovation s in health and social care [7-143]. Most of the
studies are descriptive and indicate the difficulty in
measuring qualitative effects of changes. A significant
trend can be seen in an increased focus on systemic per-
spective that takes into account several areas such as or-
ganization, patient perspective and social consequences.
It is interesting to note that most of the studies included
in this review, did not discuss a specific theory, approach
or model to be applied when evaluating IT-innovations
and its contribution to health and social care organiza-
tional contexts, and none study generated new theories or
extended old ones. Furthermore, many studies perform
formative evaluations, and a high proportion of studies
perform summative evaluations.
Previous research shown, however, that IT is used for
different aims in different organizations, [2,5,10,11,20,
25,34,38,48,49,51,65,95,117,118,121,123,131,144 ,145 ]
consequently, it is rational to expect that in order to cap-
ture where the values of IT-innovations come from it is
necessary to first identify the context in which IT is im-
plemented. For this reason, when building the contexts’
landscape in this study, we used the principle of coher-
ence [11] and tried to reflect these organizational con-
textual differences by theoretically classifying the con-
texts in which an IT-innovation is applied into three
types:
The Micro context: Characterized by IT investments in
systems that supports exchange of information and
communication between one patient and its current
healthcare provider as well as the production of basic
services at the local organization.
The Intra- and inter-organizational context: Charac-
terized by a multiple organizational perspective and in-
cludes investments in IT-innovations that support coop-
eration, communication and work flows as well as the
production of services between several different health
and social care organizations.
Virtual networks context: Characterized by a patient
focused perspective and includes investments in IT-in-
novations where the healthcare receiver is an active actor
and influences the demand and supply of services at both
the micro and the inter- and intra-organizational level.
All propositions related to the contexts’ landscape
were discussed with senior researchers belonging to the
Swedish national e-Health research network and repre-
sentatives from The Swedish Association of Local Au-
thorities and Regions, Center for eHealth (CeHis). In a
series of iterative drafts, the effects reflected what was
considered of key importance and coherent between a
vision and what can be expected from specific IT-inno-
vations in each specific context were discussed and ana-
lyzed. Researchers and practitioners were asked to use
their experience to decide if the effects and outcomes
proposed at each specific context were coherent with the
expectations stakeholders believe IT-innovations should
bring to complex organizations such health and social
care organizations. They were also asked to deal with
each context separately, in order to be able to set bounda-
ries and see adjacent possibilities in each environment or
context.
A first report was distributed [145] for comments to all
the individuals that participated in the workshops or
seminars. The report was further discussed with national
authorities, CeHis, county councils representatives and
IT-managers. A final report was produced at the end of
2010 [144] and distributed through the Santa Anna IT-
Research Institute at a national level. During 2011 a se-
ries of case studies were performed in order to validate
the contexts and their respective effects and outcomes. A
final report in which both the contexts and the case stud-
ies’ results are presented was produced and distributed to
all participants in th e study, at the end of 2011.
Definition: An IT-innovation can be defined as “a
mayor technological ch ange resulting in the creation of a
substitute technology for a particular organization” pro-
ducts and services or processes. The emergence of digital
imaging as opposed to analog ones in healthcare can
serve as an illustrative example of an inno vation.
3. Identifying the Contributions of
IT-Innovations: From Micro-Level to
Virtual Networks
3.1. The Micro-Level Context
Investments in IT-innovations at the micro level are
mainly made to reduce costly time-consuming errors
from manual data entry, and to increase system usability.
Health and social care organ izations focus on facilitating
internal communication and stimulating a good informa-
tion management for the local work team. IT-innovations
are mainly used to improve administrative issues i.e., to
keep records, order supplies, to support the provision of
basic services (i.e. prescription renewal or cancellation of
appointments) facilitating one way communication be-
tween stakeholders (i.e. patients and practitioners) with
simple interfaces.
IT-innovations at this level, normally, do not allow
possibilities to interact or to exchange information with
the patients in real-time. There have neither any automa-
tion nor verification mechanisms to confirm the receipt
of a request. In some cases e-mail is sent to confirm re-
quests, but they are usually not sent in real-time or auto-
matically.
Main outcomes at this level are related to the possibil-
Copyright © 2012 SciRes. IIM
V. VIMARLUND, S. KOCH
Copyright © 2012 SciRes. IIM
299
ity to share information between different actors at the
micro-level, reduce unnecessary consumption of re-
sources, reduce the work-overload of frontline personnel
and improve decision making process. Economic benefits
that are generated at this level are not directly related
with net economic savings for the single organization or
for the investor. They are usually short-term returns as a
result of reductions in transaction costs when administra-
tive services can be rationalized (Table 1).
3.2. The Intra- and Inter-Organizational Context
Health and social care organizations at this level are of-
ten developing less hierarchical alternatives for organiz-
ing work and changing the way individuals (care profes-
sionals and patients) interact with and within organiza-
tions.
IT-innovations contribute at this level to create a mod-
ern and flexible information exchange along the entire
chain of care empowering end-users to actively use IT
for communication and interaction patters. New struc-
tures created by the use of an IT-innovation improve in-
ternal and external integration of actors, supporting and
enabling the creation of integrated services (i.e. the pos-
sibility to collaborate with pharmacies or social care ac-
tors). An important challenge at this level is the fact that
the benefits of the implementation and use of techno-
logical innovations do not always go to the same stake-
holder who funded the IT-initiative.
The relationship between cost and effectiveness is not
necessarily directly or linear. Main challenges are, para-
doxically, not related to the technolog y and its functional
capacities, but to the willingness and frequency of the
use of IT, and to governance. Of crucial importance is to
keep decisions about investment in IT-innovations sepa-
rated from decisions concerning the financing of the inno-
vation, and being coherent to identify the possibilities that
the IT-innovation offers to the context to reduce the time
and space of the communication and collaboration simul-
taneously to, to not be vulnerable t o changes (Table 2).
3.3. Virtual Networks’ Context
Health and social care organizations at this level are
working actively with the total integration of organiza-
tional structures. The paradox of this step is that the
benefits derived from IT-innovations become easier to
appreciate, although the technology is interwoven in all
activities. The values cannot any longer be analyzed at a
single level. This is because IT-innovations has become
powerful, complex and embedded in the organizations
and accompanied by considerable changes in structures,
work procedures and sometimes in division of labor.
The patient, at this step, is assumed to be the actor who
is best updated on his own needs and preferences and
knows best which services he/she wants to demand and
adopt an active role becoming an important factor in the
production and delivery of services. The ambition is to
enable the patient to take an active part in his/her own
care and to stimulate him/her to actively participate in the
demand of services. Examples of IT applications at this
level are: Portals, blogs, networks, social media, and bu-
siness intelligence solutions support and encourage in-
teraction with external private service providers/sup-
pliers.
Effects emerge, at this level, from an increased patient
involvement (awareness and empowerment). This pre-
supposes, however, that patients are well info rmed about
Table 1. IT-innovations, effects and outcomes at the micro-level context.
The micro level context
IT-innovation Effects Outcomes
Electronic decision support
systems (EHR, EPR) Electronic scheduling of appointments
and registration of tasks
Reduced number of missed contacts
Reallocation of time and resources
Reduce numbers of double refe rrals and/or errors due to manual
registration
Organizational learning
Increase and stimulate information and knowledge exchange
between different care givers at the same unit.
Support awareness of patient safety
Virtual logistic systems Effective and fast access to information
for joint planning and distribution of
resources
Shorter lead time for communication
Integration of the activities along the logistics value chain.
Proactive planning of resources
Shorter time for delivery of results, analysis etc
Reduce costs transaction costs due to effective and fast access to
informatio n for joint planning
E-basic services i.e. booking
systems, b irthregistration ,
renewal of pr escriptions Customization of services
Flexibility and new options for booking/outbookning of appointments
Reduction of waiting time for accessibility of services (i.e. renewal of
prescriptions, electronic birth registration)
V. VIMARLUND, S. KOCH
300
Table 2. IT-innovations, effects and outcomes at the intra and interorganizational context.
The intra and inter-organizational context
IT-innovation Effects Outcomes
Organizatio-nal
intelligente systems Integration of electronic healthcare records
and lab report systems
Tests can be taken within all healthcare organizations (HC,
hospital) and results are accessible in the system
Reduced waiting time for registration and follow-up of informatio n
on results from different te sts
Particular prescription of drugs and its motivations are accessible for
all actors in EHR
Strategies for prevention and control with the possibility to
simulate f or prognosis and redistribution of resources in real time
Pictures and opinions f rom different experts are presented and visual-
ized in the system
Integration and co ordination of vertical
and horizontal administrative and
clinical information
Reduced transaction costs for making information accessible for
all healthcare providers
Embedded sol utions for control and reduction of incorrect
prescription of drugs, lab results and diagnoses
Electronic support for documentation of deviation handling systems
improves service quality and patient safety
Prioritization and reduction of time for the selection of treatment
efforts and routines
Information about private actors for follow-up on controls of costs
and quality of efforts in real time
IT-based coll aboration and develo pment of e-based warning s ystems
Best practices at inter- and intra
organizational level
Diminish of information asymmetry leads to fewer mistakesand more
secure routines
Fast and effective access to key information in acute situations (i.e.
epidemic, p an de mic)
Better routines for follow-up acute situations
E-business models Outsourcing of specialized services i.e. X-ray,
tomography , screenings, etc.
Rationalization and specialization of services
Alternative forms of resource use
IT based economical information s ystems Individual heal th budget with possibility for follow-up
the challengers and requisites that of the use of an avail-
able IT-innovation demand, and how or if it should affect
them at the individual level. Patients taking the initiative
to active use technological innovations are those who
trust in IT and those who are willing to test alternative
communication tools bu t even those that are willing to in
parallel to take the initiativ e and invest time and efforts.
Investments in IT-innovations are seldom financially
sustainable at the short run in this context. They are a
combination of investments in a specific IT-innovation,
and investments in changing the relationship between
practitioners and patients as well as the manner to pro-
duce and up-date health and social care information. Ad-
ditional costs, not having been present at the previous
two levels of the model appear at this level. Namely costs
for producing trustfully and state-of-the art information,
costs for financing the accessibility to services to the
patient, costs for organizing the supply of information in
real-time and in a new context and costs for supporting
the new and the old system in parallel, at least for a while.
There exists at this level, consequently, a clear need for
to develop innovative and sustainable business models
that meet the economic and administrative requirements
as well as the demand for stimulating patient to being
active demanders of services (Table 3).
4. Discussion
There is today a good deal of wisdom and experience in
how to identify the values and contributions of IT-inno-
vations outside of the health informatics area (i.e. ERP-
systems). There is no shortage of writers in the IT field
who have tackled the problematic task of IT-innovation
investment appraisal. When discussing where the values
of IT-innovations migrate from in health and social care,
issues concerning process reengineering, resource alloca-
tion, organizational issues and individual behavior and its
consequences are usually discussed often as exogenous
factors related to the use of a new IT system. Evaluation
reports have, usually, shown that the introduction of IT in
health and social care leads to failures, resistance to use
ICT or to a non-optimal use of the scarce resources [2,6,
7,16,47,53,100,107,144].
Investments in IT-innovations are usually made based
Copyright © 2012 SciRes. IIM
V. VIMARLUND, S. KOCH 301
Table 3. IT-innovations, effects and outcomes at the virtual networks context.
The virtual networks context
IT-innovation Effects Outcomes
Patient portals Digitally integrated information tools
for follow-up and interaction with
health-and social care
Electronic follow-up or control of the state of services
Information on actual current questions for differen t target groups
Possibility for follow-up and support healthcare receivers in different
clusters
Services adapted to the individual preferences
Reduced number of steps for access to information
Rationalization of information supply for healthca re units
Visualization of treatment strategies, efforts, interventions, e.g. individual
care plan
Innovative work-routines
Re-design of work routines and processes and electronic access to
individual information
Possibilities to control number of visits and reallocate resources
Reduced the number of steps for dist ribution of information
Control of consumption of services
Automatic reminders or follow-up on care plans or healthcare efforts and
their effects
Post information or questions befor e an appointment or follow-up of
information during a care-process
On-line communities “Health-facebook” or such including
tools for simulation and visualization
for preventive efforts
eHealthcare teams for virtual care and to particularly support for
chronically ill individuals
The healthcare receiver is offered possibilities to participate in
specialized ”communities” with chat rooms and interaction opportunities
Faster and more effective decision making that favors the healthcare
receiver and makes administration for certain matters more cost-effectives
Telemedicine and distance healthcare within all areas: elderly, children,
chronically ill, palliative healthcare, cardio vascular etc
Follow-up in areas and of healthcare receivers with special healthcare
needs, with the possibility for cooperation between external actors
Virt ual systems for
control and
accounting
Automatic decisions for third party
(i.e. health insurance office or
insurance company)
Faster and more effective decision making that favors the healthcare
receiver and makes administration for certain matters more cost-effective
Inform a t i o n / a n s w e rs for costs/ support of different efforts between and
within different healthcare providers, including both private and publ ic
healthcare providers
Real-time interaction with external organization such as social security
offices
Cost-control and effective management of demand of services both at the
individuals and group level
Standardization with the healthcare
receiver in focus
Standardization of health and social care information about treatments and
interventions, it consequences and costs at a national level
Standardization of answers related to private life issues offers possi
b
ility to
keep anonymity if it is desirable and r e d u c e p e rsonal visits to primary
healthcare
Facilitate search services and comparison of providers for the health care
receiver
on a vision designed beforehand and in which a series of
expectations of improving organizational operations, re-
ducing costs, controlling resource allocation and achiev-
ing of a higher standard of quality are described. The
generation of evidence on the success of these initiatives
cannot be possible without a coherent relationship be-
tween the context and the specific the type of innovation
analyzed.
Many decision makers feel the need to articulate an
ideal end-state for their organizations. Striking the bal-
ance between novelty and believability of such an ideal
end-state is often tricky and they become neither satisfied
with the ideal not the visioning. Being coherent rather
than visionary contributes to identify where you are, as
an organization, and to capture effects and outcomes that
“make sense” for health and social care organizational
contexts. Health and social care organizations must find
ways to interpret effects of IT-innovations so as to make
their environments more predictable in order to under-
stand the co-evolution needs that IT-innovations demand.
Copyright © 2012 SciRes. IIM
V. VIMARLUND, S. KOCH
302
Coherence between a specific context, IT-innovation,
effects and outcomes serves as the glue, which allows
both managers and the organization to reassert identity in
the face of continues change demanded by technology.
Roles, processes and interaction s evolve continually with
each new occasion of use of IT-innovation, because new
situations, negotiations, and activities, inevitably recast it
in a new form. Change in complex organizations as
health and social care cannot longer be undertaken as
though ceteris paribus was true. It is necessary to find the
coherence between linkages from an IT-innovation at
each specific organizational context. While the impor-
tance of coherence has not yet become a common issue
to analyze where the values migrates from IT-innova-
tions in health and social care, its critical role is well
recognized in managerial contexts, and in other fields
like psychology.
Coherent organizations thrive in attainment of their
purposes. As coherence between IT-innovation and con-
text increase, a much higher level of organizational co-
herence and alignment is possible. The adjacent possi-
bilities that IT-innovations allow in the current environ-
ment become clearer and new organizational and busi-
ness opportunities evolves, but at the same time demand
investments that normally are not considered when de-
veloping a general vision to achieve.
Decision makers can benefit from using the contexts
and effects suggested in this article as a practical instru-
ment at the moment to plan investments or identify the
outcomes that IT-innovations can bring to the organiza-
tions to avoid frustration or mismatch between vision and
outcomes. The rapid pace of change in health and social
care as a consequence of the increasing use of IT-inno-
vations as substitute of manual routines, poses serious
starting problems for any large investment. If IT is to
emerge as a beneficial corporate tool, the decision to
invest needs to be examined as rigorously as with any
other large investment. To do this, it is necessary to use
tools, as the contexts suggested in this study that visual-
ize if the investment decisions will come true not just to
make food forecasts.
The economic motivation of investments in IT-inno-
vations in health and social-care cannot only be justified
by its economic benefits to the investors. The economic
risks are thus higher than the ones done at the private
sector and sometimes have to sacrifice financial return in
favor of social return. However, to motivate stakeholders
to invest in social ventures, it is necessary to identify
where the contributions of IT-innovations to specific
organizational contexts migrates from and have a clear
picture about the progression of the outcomes at different
levels. Identifying the environmental, organizational and
its correspondent outcomes can facilitate to attribute a
financial value to them and made an evaluation of the
balance between economic efficiency, organizational con-
text and potential contributions of the chosen IT-inno-
vation.
5. Acknowledgements
This work has been supported by The Swedish Associa-
tion of Local Authorities and Regions, Center for eHealth
(CeHis) in Sweden. We specially thank Lars Jerlvall for
invaluable comments to our drafts and manuscripts. We
thank also our research colleagues, from the national
eHealth network, and in particularly, Linda Askenäs,
Ph.D. and Hanna Danielsson, Ph.D., for participating in
the interactive meetings when developing the contexts
architecture and for searching complementary literature
for this study. Than k you also all the representativ es fro m
the National eHealth Research Network for participating
in the presentations of the different versions of the na-
tional reports.
REFERENCES
[1] J. Schumpeter, “The Theory of Economic Development:
An Inquiry into Profits, Capital, Credit, Interest and the
Business Cycle,” Harvard University Press, Cambridge,
1912 and 1936.
[2] V. Vimarlund and N. G. Olve, “Using ICT to Transform
Elderly Healthcare,” Proceedings of the 12th Interna-
tional Symposium on Health Information Management
Research, Sheffield, 18-20 July 2007, pp 127-135.
[3] J. Grimson, W. Grimson and W. Hasselbring, “The SI
Challenge in Healthcare,” Communications of the ACM,
Vol. 43, No. 6, 2000, pp. 49-55.
doi:10.1145/336460.336474
[4] M. Berg, “Implementing Information Systems in Health
Care Organizations: Myths and Challenges,” Interna-
tional Journal of Medical Informatics, Vol. 64, No. 2-3,
2001, pp. 143-156. doi:10.1016/S1386-5056(01)00200-3
[5] N. G. Olve and V. Vimarlund, “Locating ICT’s Benefits
in Elderly Care,” Medical Informatics and the Internet in
Medicine, Vol. 30, No. 4, 2005, pp. 297-308.
doi:10.1080/14639230500429363
[6] V. Vimarlund, N. G. Olve, I. Scandurra and S. Koch,
“Information and Communication Technology (ICT) and
Elderly Homecare—The Hudiksvall Case,” Health In-
formatics Journal, Vol. 14, No. 3, 2008, pp. 195-209.
doi:10.1177/1081180X08092830
[7] B. Rahimi, V. Vimarlund and T. Timpka, “Health Infor-
mation System Implementation: A Qualitative Meta-
Analysis,” Journal of Medical Systems, Vol. 33, No. 5,
2009, pp. 359-368. doi:10.1007/s10916-008-9198-9
[8] I. Scandurra, M. Hägglund and S. Koch, “Specific De-
mands for Developing ICT Systems for Shared Home
Care: A User Centred Approach,” Journal on Information
Technology in Healthcare, Vol. 5, No. 3, 2005, pp. 279-
285.
[9] A. Andersson, V. Vimarlund and T. Timpka, “Manage-
Copyright © 2012 SciRes. IIM
V. VIMARLUND, S. KOCH 303
ment Demands on Information and Communication
Technology in Process Oriented Healthcare Organiza-
tions,” International Journal of Management in Medicine,
Vol. 16, No. 2-3, 2002, pp. 188-198.
[10] L. Afrin, K. Courtney, G. Demiris, W. Goossen, C. Lovis,
C. Lynch, M. Sondhi, S. Speedie and V. Vimarlund, “Pa-
tient-Centered Applications and Mobile Health; Use of IT
to Promote Disease Management and Wellness,” Journal
of the American Medical Informatics Association, Vol. 15,
No. 1, 2008, pp. 8-13.
[11] M. Lissack and J. Roos, “Be Coherent not Visionary,”
Long Range Planning, Vol. 34, No. 1, 2001, pp. 53-70.
doi:10.1016/S0024-6301(00)00093-5
[12] V. P. Aggelidis and P. D. Chatzoglou, “Methods for
Evaluating Hospital Information Systems: A Literature
Review,” EuroMed Journal of Business, Vol. 3, No. 1,
2008, pp. 99-118. doi:10.1108/14502190810873849
[13] H. Alalwany and S. Alshawi, “Evaluation of E-Health
Services: User’s Perspective Criteria,” Transforming Go-
vernment: People, Process and Policy, Vol. 2, No. 4,
2008, pp. 243-255.
[14] E. Ammenwerth, S. Graber, G. Herrmann, T. Burkle and
J. Konig, “Evaluation of Health Information Systems-
Problems and Challenges,” International Journal of
Medical Informatics, Vol. 71, No. 2-3, 2003, pp. 125-135.
doi:10.1016/S1386-5056(03)00131-X
[15] E. Ammenwerth, U. Mansmann, C. Iller and R. Eichstäd-
ter, “Factors Affecting and Affected by User Acceptance
of Computer-Based Nursing Documentation: Results of a
Two-Year Study,” Journal of the American Medical In-
formatics Association, Vol. 10, No. 1, 2003, pp. 69-84.
doi:10.1197/jamia.M1118
[16] E. Balka, “Technology, Governance and Patient Safety:
Systems Issues in Technology and Patient Safety,” Inter-
national Journal of Medical Informatics, Vol. 76, No. 1,
2007, pp. 35-47. doi:10.1016/j.ijmedinf.2006.05.046
[17] P. A. Bath, “Health Informatics: Current Issues and
Challenges,” Journal of Information Science, Vol. 34, No.
4, 2008, pp. 501-518. doi:10.1177/0165551508092267
[18] A. Baum, S. Figar, J. Serveri no, D. Assale, B. Schachner,
P. Otero, et al., “Assessing the Impact of Change in the
Organization of a Technical Support System for a Health
Information Systems (HIS),” Studies in Health Technol-
ogy and Informatics, Vol. 1 0 7 , N o. 2, 2 0 0 4, p p . 1367-1370.
[19] P. Bonnabry, C. Despont-Gros, D. Grauser, P. Casez, M.
Despond, D. Pugin, et al., “A Risk Analysis Method to
Evaluate the Impact of a Computerized Provider Order
Entry Sy stem on Pa tient Sa fety,” Journal of the American
Medical Information Association, Vol. 15, No. 4, 2008,
pp. 453-460. doi:10.1197/jamia.M2677
[20] J. Bourbeau, J.-P. Collet, K. Schwartzman, T. Ducruet, D.
Nault and C. Bradley, “Economic Benefits of Self-Ma-
nagement Education in COPD,” CHEST, Vol. 130, No. 6,
2006, pp. 1704-1711. doi:10.1378/chest.130.6.1704
[21] J. Brender, “Handbook of Evaluation Methods for Health
Informatics,” Academic Press, Waltham, 2005.
[22] A. Brennan, S. E. Chick and R. Davies, “Taxonomy of
Model Structures for Economic Evaluation of Health
Technologies,” Health Economics, Vol. 15, No. 12, 2006,
pp. 1295-1310. doi:10.1002/hec.1148
[23] L. Buccoliero, S. Calciolari and M. Marsilio, “A Meth-
odological and Operative Framework for the Evaluation
of an E-Health Project,” International Journal of Health
Planning and Management, Vol. 23, No. 1, 2008, pp. 3- 20.
doi:10.1002/hpm.881
[24] R. Busse, U. Nimptsch and T. Mansky, “Measuring,
Monitoring, and Managing Quality in Germany’s Hospi-
tals,” Health Affairs, Vol. 28, No. 2, 2009, pp. 294-304.
doi:10.1377/hlthaff.28.2.w294
[25] M. J. Buxton, “Economic Evaluation and Decision Mak-
ing in the UK,” PharmacoEconomics, Vol. 24, No. 11,
2006, pp. 1133-1142.
doi:10.2165/00019053-200624110-00009
[26] H. Buysse, G. D. Moor, G. V. Maele, E. Baert, G. Thien-
pont and M. Temmerman, “Cost-Effectiveness of Tele-
monitoring for High-Risk Pregnant Women,” Interna-
tional Journal of Medical Informatics, Vol. 77, No. 10,
2008, pp. 641-714.
[27] L. M. Canady, “Implementing a Home Telemonitoring
Program,” Home Healthcare Nurse, Vol. 26, No. 4, 2008,
pp. 231-236. doi:10.1097/01.NHH.0000316701.15010.e1
[28] B. Chaudhry, J. Wang, S. Wu, M. Maglione, W. Mojica,
E. Roth, et al., “Systematic Review: Impact of Health In-
formation Technology on Quality, Efficiency, and Costs
of Medical Care,” Annals of Internal Medicine, Vol. 144,
No. 10, 2006, pp. 742-752.
[29] J. S. Clark, F. S. Mair, C. O’Donnell and J. Liu, “E-
Health: Implementation and Evaluation Research in Sco-
tland—A Scoping Exercise,” Journal of Telemedicine
and Telecare, Vol. 3, No. 14, 2008, pp, 119-121.
[30] D. C. Classen, A. J. Avery and D. W. Bates, “Evaluation
and Certification of Computerized Provider Order Entry
Systems,” Journal of the American Medical Informatics
Association, Vol. 14, No. 1, 2007, pp. 48-55.
doi:10.1197/jamia.M2248
[31] P. D. Clayton, S. P. Narus, A. Watson, I. Bowes, T. S.
Madsen, A. B. Wilcox, G. Orsmond, et al., “Physician
Use of Electronic Medical Records: Issues and Successes
with Direct Data Entry and Physician Productivity,”
AMIA Annual Symposium Proceedings, Washington, 22-
26 October 2005, pp. 141-145.
[32] S. S. Cohen, “Emerging Benefits of Integrated IT Sys-
tems,” Healthcare Executive, Vol. 20, No. 5, 2005, pp.
14-18.
[33] R. E. Connely, “If You Build It, Don’t Expect Them to
Come,” Health Management Technology, Vol. 29, No. 8,
2008, pp. 32-33.
[34] J. Corrigan and D. McNeill, “Building Organizational
Capacity: A Cornerstone of Health System Reform,”
Health Affairs, Vol. 28, No. 2, 2009, pp. 205-215.
doi:10.1377/hlthaff.28.2.w205
[35] C. M. Cusack and E. G. Poon, “Evaluation Toolkit Ver-
sion 3,” Agency for Healthcare Research and Quality,
Rockville, 2009.
[36] N. F. de Keizer and E. Ammenwerth, “The Quality of
Evidence in Health Informatics: How Did the Quality of
Copyright © 2012 SciRes. IIM
V. VIMARLUND, S. KOCH
304
Healthcare IT Evaluation Publications Develop from
1982 to 2005?” International Journal of Medical Infor-
matics, Vol. 77, No. 1, 2008, pp. 41-49.
doi:10.1016/j.ijmedinf.2006.11.009
[37] C. C. Diamond and C. Shirky, “Health Information Tech-
nology: A Few Years of Magical Thinking?” Health Af-
fairs, Vol. 27, No. 1, 2008, pp, 383-390.
[38] K. B. Eden, R. Messina, H. Li, P. Osterweil, C. R. Hen-
derson and J. M. Guise, “Examining the Value of Elec-
tronic Health Records on Labor and Delivery,” American
Journal of Obstet Gynecology, Vol. 199, No. 3, 2008, pp.
301-309. doi:10.1016/j.ajog.2008.07.004
[39] A. Dobrev, et al., “Financing eHealth,” European Com-
mission, DG INFSO & Media, 2008.
[40] C. L. Goldzweig, A. Towfigh, M. Maglione and P. G.
Shekelle, “Costs and Benefits of Health Information
Technology: New Trends from the Literature,” Health
Affairs, Vol. 28, No. 2, 2009, pp. 282-293.
doi:10.1377/hlthaff.28.2.w282
[41] J. C. Hobson, S. Khemani and A. Singh, “Prospective
Audit of the Quality of ENT Emergency Clinic Notes be-
fore and after Introduction of a Computerized Template,”
Journal of Laryngology & Otology, Vol. 119, No. 4, 2005,
pp. 264-266. doi:10.1258/0022215054020359
[42] E. W. Huang and D. M. Liou, “Performance Analysis of a
Medical Records Exchange Model,” IEEE Transactions
on Information Technology in Biomedicine, Vol. 11, No.
2, 2007, pp. 153-160. doi:10.1109/TITB.2006.875681
[43] D. Kaufman, W. D. Roberts, J. Merrill, T. Y. Lai and S.
Bakken, “Applying an Evaluation Framework for Health
Information System Design, Development, and Imple-
mentation,” Nursing Research, Vol. 55, No. 2, 2006, pp.
S37-S42. doi:10.1097/00006199-200603001-00007
[44] H. Laerum, T. H. Karlsen and A. Faxvaag, “Effects of
Scanning and Eliminating Paper-based Medical Records
on Hospital Physicians’ Clinical Work Practice,” Journa l
of the American Medical Informatics Association, Vol. 10,
No. 6, 2003, pp. 588-595. doi:10.1197/jamia.M1337
[45] H. Lærum, T. H. Karlsen and A. Faxvaag, “Use of and
Attitudes to a Hospital Information System by Medical
Secretaries, Nurses and Physicians Deprived of the Pa-
per-Based Medical Record: A Case Report,” BMC Medi-
cal Informatics and Decision Making, Vol. 4, No. 1, 2004,
p. 18. doi:10.1186/1472-6947-4-18
[46] A. Likourezos, D. B. Chalfin, D. G. Murphy, B. Sommer,
K. Darcy and S. J. Davidson, “Physician and Nurse Sat-
isfaction with an Electronic Medical Record system,” The
Journal of Emergency Medicine, Vol. 27, No. 4, 2004, pp.
419-424. doi:10.1016/j.jemermed.2004.03.019
[47] A. Lockamy III and D. L. Smith, “Telemedicine: A Proc-
ess Enabler for Enhanced Healthcare Delivery Systems,”
Business Process Management Journal, Vol. 15, No. 1,
2009, pp. 5-19. doi:10.1108/14637150910931433
[48] A. J. McLeod Jr., “Measuring Success in Inter-organi-
zational Information Systems: A Case Study,” Commu-
nications of AIS, Vol. 22, 2008, pp. 617-634.
[49] N. Menachemi and R. G. Brooks, “Reviewing the Bene-
fits and Costs of Electronic Health Records and Associ-
ated Patient Safety Technologies,” Journal of Medical
Systems, Vol. 30, No. 3, 2006, pp. 159-168.
doi:10.1007/s10916-005-7988-x
[50] T. Mettler and V. Vimarlund, “Understanding Business
Intelligence in the Context of Health Care,” Health In-
formatics Journal, Vol. 15, No. 3, 2009, pp. 1-11.
doi:10.1177/1460458209337446
[51] J. B. Metzger, E. Welebob, F. Turisco and D. C. Classen,
“The Leapfrog Group’s CPOE Standard and Evaluation
Tool,” Patient Safety and Quality Healthcare, Vol. 78,
No. S1, 2008, pp. S69-S76.
[52] M. Mitka, “Advice on Adopting New Health Care IT
Systems,” Journal of the American Medical Association,
Vol. 301, No. 6, 2009, pp. 587-589.
doi:10.1001/jama.2009.37
[53] J. R. Moehr, J. Schaafsma, C. Anglin, S. V. Pantazi, N. A.
Grimm and S. Anglin, “Success Factors for Telehealth—
A Case Study,” International Journal of Medical Infor-
mation, Vol. 75, No. 10-11, 2006, pp. 755-763.
doi:10.1016/j.ijmedinf.2005.11.001
[54] A. Mukherjee and J. McGinnis, “E-healthcare: An Analy-
sis of Key Themes in Research,” International Journal of
Pharmaceutical and Healthcare Marketing, Vol. 4, No. 1,
2007, pp. 349-363. doi:10.1108/17506120710840170
[55] K. Mäkelä, I. Virjo, J. Aho, P. Kalliola, A.-M. Koivu-
koski, H. Kurunmäki, et al., “Electronic Patient Record
Systems and the General Practitioner: An Evaluation
Study,” Journal of Telemedicince and Telecare, Vol. 11,
No. 2, 2005, pp. 66-68.
doi:10.1258/135763305775124641
[56] J. C. Niland, L. Rouse and D. C. Stahl, “An Informatics
Blueprint for Healthcare Quality Information Systems,”
Journal of the American Medical Information Association,
Vol. 13, No. 4, 2006, pp. 402-417.
doi:10.1197/jamia.M2050
[57] H. Nørreklit, “The Balanced Scorecard: What Is the Score?
A Rhetorical Analysis of the Balanced Scorecard Ac-
counting,” Organizations and Society, Vol. 28, No. 6,
2003, pp. 591-619. doi:10.1016/S0361-3682(02)00097-1
[58] C. Oroviogoicoechea, B. Elliott and R. Watson, “Review:
Evaluating Information Systems in Nursing,” Journal of
Clinical Nursing, Vol. 17, No. 5, 2008, pp, 567-575.
[59] P. R. Orszag, “Evidence on the Costs and Benefits of
Health Information Technology,” Congressional Budget
Office, Washington, 2008.
[60] C. Pagliari, “Design and Evaluation in eHealth: Chal-
lenges and Implications for an Interdisciplinary Field,”
Journal of Medical Internet Research, Vol. 9, No. 2, 2007,
p. e15. doi:10.2196/jmir.9.2.e15
[61] C. Pagliari, M. Gilmour and F. Sullivan, “Electronic Cli-
nical Communications Implementation (ECCI) in Scot-
land: A Mixed-Methods Programme Evaluation,” Journal
of Evaluation in Clinical Practice, Vol. 10, No. 1, 2004,
pp. 11-20. doi:10.1111/j.1365-2753.2004.00475.x
[62] PHII, “Towards Measuring Value: An Evaluation Frame-
work for Public Health Information Systems,” Public
Health Informatics Institute, Decatur, 2005.
[63] D. Protti, T. Bowden and I. Johansen, “Adoption of In-
Copyright © 2012 SciRes. IIM
V. VIMARLUND, S. KOCH 305
formation Technology in Primary Care Physician Offices
in New Zealand and Denmark, Part 3: Medical Record
Environment Comparisons,” Informatics in Primary Care,
Vol. 16, No. 4, 2008, pp. 285-290.
[64] B. Rahimi and V. Vimarlund, “Introduction of an Inte-
grated Electronic Prescribing System: The Pharmacies’
Staff Dimension,” Proceedings of the 14th International
Symposium on Health Information, Kalmar, 14-16 Octo-
ber 2009, pp. 5-15.
[65] B. Rahimi, V. Vimarlund and B Rahimi and V. Vimar-
lund, “Methods to Evaluate IT-Based Administrative Sys-
tems in Healthcare Setting: A Literature Review,” Jour-
nal of Medical Systems, Vol. 31, No. 5, 2007, pp. 397-
432. doi:10.1007/s10916-007-9082-z
[66] E. E. J. Raja, R. Mahal and V. B. Masih, “An Exploratory
Study to Assess the Computer Knowledge, Attitude and
Skill among Nurses in Health care Setting of a Selected
Hospital, Ludhiana, Punjab, India,” 2004.
http://ojni.org/8_1/raja.htm
[67] P. A. Reynolds, J. Harper, A. M. Jenner and S. Dunne,
“Better Informed: An Overview of Health Informatics,”
British Dental Journal, Vol. 204, No. 5, 2008, pp. 259-
264. doi:10.1038/bdj.2008.150
[68] S. V. Rojas and M.-P. Gagnon, “A Systematic Review of
the Key Indicators for Assessing Telehomecare Cost-Ef-
fectiveness,” Telemedicine and e-Health, Vol. 14, No. 9,
2008, pp. 896-904.
[69] J. K. Rotich, T. J. Hannan, F. E. Smith, J. Bii, W. W.
Odero, N. Vu, et al., “Installing and Implementing a
Computer-based Patient Record System in Sub-Saharan
Africa: The Mosoriot Medical Record System,” Journal
of the American Medical Informatics Association, Vol. 10,
No. 4, 2003, pp. 295-303. doi:10.1197/jamia.M1301
[70] C. M. Ruland and I. H. Ravn, “Usefulness and Effects on
Costs and Staff Management of a Nursing Resource
Management Information System,” Journal of Nursing
Management, Vol. 11, No. 3, 2003, pp. 208-215.
doi:10.1046/j.1365-2834.2003.00381.x
[71] M. J. Sculpher, K. Claxton, M. Drummond and C.
McCabe, “Wither Trial-Based Economic Evaluation for
Health Care Decision Making?” Health Economics, Vol.
15, No. 7, 2006, pp. 677-687. doi:10.1002/hec.1093
[72] E. R. Siegel, “Information Rx: Evaluation of a New In-
formatics Tool for Physicians, Patients, and Libraries,”
Information Services & Use, Vol. 26, No. 1, 2006, pp. 1-
10.
[73] J. Smyth, “Electronic Health Records and Practice Man-
agement Solutions: All-in-One versus Best-of-Breed,”
Managed Care Outlook, Vol. 21, No. 14, 2008, pp. 1-5.
[74] R. Spicer, “Bytes and Bites’—Using Computerized Clini-
cal Records to Improve Patient Safety in General Dental
Practice,” Dental Update, Vol. 35, No. 9, 2008, pp. 614-
661.
[75] D. Stengel, K. Bauwens, M. Walter, T. Köpfer and A.
Ekkernkamp, “Comparison of Handheld Computer-As-
sisted and Conventional Paper Chart Documentation of
Medical Records: A Randomized, Controlled Trial,” The
Journal of Bone and Joint Surgery, Vol. 86, No. 3, 2004,
pp. 553-560.
[76] Y. Teerawattananon, S. Russell and M. Mugford, “A Sys-
tematic Review of Economic Evaluation Literature in
Thailand: Are the Data Good Enough to Be Used by Pol-
icy-Makers?” PharmacoEconomics, Vol. 25, No. 6, 2007,
pp. 467-479. doi:10.2165/00019053-200725060-00003
[77] M. M. Thalanany, M. Mugford, C. Hibbert, N. J. Cooper,
A. Truesdale, S. Robinson, et al., “Methods of Data Col-
lection and Analysis for the Economic Evaluation Along-
side a National, Multi-Centre Trial in the UK: Conven-
tional Ventilation or ECMO for Severe Adult Respiratory
Failure (CESAR),” BMC Health Services, Vol. 8, No. 1,
2008, p. 94. doi:10.1186/1472-6963-8-94
[78] A. H. Tjora and G. Scambler, “Square Pegs in Round
Holes: Information Systems, Hospitals and the Signifi-
cance of Contextual Awareness,” Social Science & Medi-
cine, Vol. 68, No. 3, 2009, pp. 519-525.
doi:10.1016/j.socscimed.2008.11.005
[79] C. Tompkins, A. R. Higgins and G. A. Ritter, “Measuring
Outcomes and Efficiency in Medicare Value-Based Pur-
chasing,” Health Affairs, Vol. 28, No. 2, 2009, pp. 251-
259. doi:10.1377/hlthaff.28.2.w251
[80] J. Tsai and G. Bond, “A Comparison of Electronic Re-
cords to Paper Records in Mental Health Centers,” Inter-
national Journal for Quality in Health Care, Vol. 20, No.
2, 1008, pp. 136-143.
[81] A. Wakefield, “Patient Safety Investigations: The Need
for Interprofessional Learning,” Learning in Health &
Social Care, Vol. 8, No. 1, 2009, pp. 22-32.
doi:10.1111/j.1473-6861.2008.00192.x
[82] S. J. Wang, B. Middleton, L. A. Prosser, C. G. Bardon, C.
D. Spurr, P. J. Carchidi, et al., “A Cost-Benefit Analysis
of Electronic Medical Records in Primary Care,” Ameri-
can Journal of Medicine, Vol. 114, No. 5, 2003, pp. 397-
403. doi:10.1016/S0002-9343(03)00057-3
[83] W. P. Welch, D. Bazarko, K. Ritten, Y. Burgess, R. Har-
mon and L. G. Sandy, “Electronic Health Records in Four
Community Physician Practices: Impact on Quality and
Cost of Care,” Journal of the American Medical Informa-
tion Association, Vol. 14, No. 3, 2007, pp. 320-328.
doi:10.1197/jamia.M2125
[84] F. Verhoeven, L. V. Gemert-Pijnen, K. Dijkstra, N. Ni-
jland, E. Seydel and M. Steehouder, “The Contribution of
Teleconsultation and Videoconferencing to Diabetes Care:
A Systematic Literature Review,” Journal of Medical
Internet Research, Vol. 9, No. 5, 2007, p. e37.
doi:10.2196/jmir.9.5.e37
[85] M. Whyte, “Computerized versus Handwritten Records,”
Pediatric Nursing, Vol. 17, No. 7, 2005, pp. 15-18.
[86] A. Wilcox, S. S. Jones, D. A. Dorr, W. Cannon, L. Burns,
K. Radican, et al., “Use and Impact of a Computer-Gene-
rated Patient Summary Worksheet for Primary Care,”
AMIA Annual Symposium Proceedings, Washington, 22-
26 October 2005, pp. 824-828.
[87] F. Williams and S. A. Boren, “The Role of the Electronic
Medical Record (EMR) in Care Delivery Development in
Developing Countries: A Systematic Review,” Informa-
tics in Primary Care, Vol. 16, No. 2, 2008, pp. 139-145.
Copyright © 2012 SciRes. IIM
V. VIMARLUND, S. KOCH
306
[88] V. Vimarlund, N. G. Olve, I. Scandurra and S. Koch,
“Information and Communication Technology (IT) and
Elderly Homecare—The Hudiksvall Case,” Health Infor-
matics Journal, Vol. 14, No. 3, 2008, pp. 195-209.
doi:10.1177/1081180X08092830
[89] V. Vimarlund, “Elderly Health, Homecare and Informa-
tion Technology (IT) Healthcare IT Management,” Jour-
nal of the European Association of Healthcare IT Man-
agers, Vol. 3, No. 3, 2008, pp. 22-23.
[90] S. C. Voelpel, M. Leibold and R. A. Eckhoff, “The Ty-
ranny of the Balanced Scorecard in the Innovation
Economy,” Journal of Intellectual Capital, Vol. 7, No. 1,
2006, pp. 43-60. doi:10.1108/14691930610639769
[91] K. Yamamoto, S. Matsumoto, H. Tada, K. Yanagihara, S.
Teramukai, T. Takemura, et al., “A Data Capture System
for Outcomes Studies that Integrates with Electronic
Health Records: Development and Potential Uses,” Jour-
nal of Medical Systems, Vol. 32, No. 5, 2008, pp. 423-
427. doi:10.1007/s10916-008-9147-7
[92] M. M. Yusof, J. Kuljis, A. Papazafeiropoulou and L. K.
Stergioulas, “An Evaluation Framework for Health In-
formation Systems: Human, Organization and Technol-
ogy-Fit Factors (HOT-fit),” International Journal of
Medical Informatics, Vol. 77, No. 6, 2008, pp, 386-398.
[93] M. M. Yusof, A. Papazafeiropoulou, R. J. Paul and L. K.
Stergioulas, “Investigating Evaluation Frameworks for
Health Information Systems,” International Journal of
Medical Informatics, Vol. 77, No. 6, 2008, pp. 377-385.
doi:10.1016/j.ijmedinf.2007.08.004
[94] S. O. Zandieh, “Challenges to EHR Implementation in
Electronic- versus Paper-Based Office Practices,” Journal
of General Internal Medicine, Vol. 23, No. 6, 2008, pp.
755-761. doi:10.1007/s11606-008-0573-5
[95] W. P. Zhang, K. Yamauchi, S. Mizuno, R. Zhang and D.
M. Huang, “Analysis of Cost and Assessment of Com-
puterized Patient Record Systems in Japan Based on
Questionnaire Survey,” Informatics for Health and Social
Care, Vol. 29, No. 3-4, 2004, pp. 229-238.
doi:10.1080/14639230400005990
[96] L. Zurita and C. Nøhr, “Patient Opinion—EHR Assess-
ment from the Users Perspective,” Health Technology
and Informatics, Vol. 107, No. 2, 2004, pp. 1333-1336.
[97] J. Meredith, “Electronic Patient Record Evaluation in
Community Mental Health,” Inform Prim Care, Vol. 17,
No. 4, 2009, pp. 209-213.
[98] K. Ando, J. Koyama, Y. Abe, T. Sato, M. Shoda, Y. Soga,
M. Nobuyoshi, T. Honda, K. Nakao, K. Terata, K.
Kadowaki, A. Maeda, S. Ogawa, T. Manaka, N. Hagi-
wara and K. Doi, “Feasibility Evaluation of a Remote
Monitoring System for Implantable Cardiac Devices in
Japan,” International Heart Journal, Vol. 52, No. 1, 2001,
pp. 39-43. doi:10.1536/ihj.52.39
[99] P. Breen, K. Murphy, G. Browne , F. Molloy, V. Reid, C.
Doherty, N. Delanty, S. Connolly and M. Fitzsimons,
“Formative Evaluation of a Telemedicine Model for De-
livering Clinical Neurophysiology Services Part II: The
Referring Clinician and Patient Perspective,” BMC
Medical Informatics and Decision Making, Vol. 10, 2010,
p. 49. doi:10.1186/1472-6947-10-49
[100] T. S. Bergmo, “Economic Evaluation in Telemedicine—
Still Room for Improvement,” Journal of Telemedicine
and Telecare, Vol. 16, No. 5, 2010, pp. 229-231.
doi:10.1258/jtt.2010.009008
[101] A. W. Armstrong, C. Sanders, A. D. Farbstein, G. Z. Wu,
S. W. Lin, F. T. Liu and T. S. Nesbitt, “Evaluation and
Comparison of Store-and-Forward Teledermatology Ap-
plications,” Telemedicine and e-Health, Vol. 16, No. 4,
2010, pp. 424-438.
[102] F. Wang, “The Role of Cost in Telemedicine Evaluation,”
Telemedicine and e-Health, Vol. 10, No. 5, 2009, pp.
954-955.
[103] T. S. Bergmo, “Can Economic Evaluation in Teleme-
dicine Be Trusted? A Systematic Review of the Litera-
ture,” Cost Effectiveness and Resource Allocation, Vol.
24, No. 7, 2009, pp. 7-18.
[104] M. Le Goff-Pronost and C. Sicotte, “The Added Value of
thorough Economic Evaluation of Telemedicine Net-
works,” The European Journal of Health Economics, Vol.
11, No. 1, 2009, pp. 45-55.
doi:10.1007/s10198-009-0162-5
[105] J. B. Smith, S. R. Lacey, A. R. Williams, S. L. Teasley, A.
Olney, C. Hunt, K. S. Cox and C. Kemper, “Developing
and Testing a Clinical Information System Evaluation
Tool: Prioritizing Modifications Through End-User In-
put,” Journal of Nursing Administration, Vol. 19, No. 6,
2011, pp. 252-258. doi:10.1097/NNA.0b013e31821c4634
[106] C. Fröjd, C. L. Swenne, C. Rubertsson, L. Gunningberg
and B. Wadensten, “Patient Information and Participation
still in Need of Improvement: Evaluation of Patients’
Perceptions of Quality of Care,” Journal of Nursing Ad-
ministration, Vol. 19, No. 2, 2001, pp. 226-236.
[107] J. M. Palm, T. Dart, I. Dupuis, L. Leneveut and P. De-
goulet, “Clinical Information System Post-Adoption Eva-
luation at the Georges Pompidou University Hospital,”
AMIA Annual Symposium Proceedings, Washington, 13-
17 November 2010, pp. 582-586.
[108] F. Lau, M. Price, K. Keshavjee and Q. Health, “From
Benefits Evaluation to Clinical Adoption: Making Sense
of Health Information System Success in Canada,” Elec-
tronic Health Care, Vol. 9, No. 4, 2011, pp. e11-e17.
[109] J. S. Wu, F. Y. Shih, C. H. Chiu, Y. L. Yeh, J. J. Yan, C.
C. King and M. S. Ho, “Evaluation of an Adjustable Epi-
demiologic Information System,” PLoS One, Vol. 6, No.
1, 2001, p. e14596. doi:10.1371/journal.pone.0014596
[110] E. Ammenwerth, F. Rauchegger, F. Ehlers, B. Hirsch and
C. Schaubmayr, “Effect of a Nursing Information System
on the Quality of Information Processing in Nursing: An
Evaluation Study Using the HIS-Monitor Instrument,”
International Journal of Medical Informatics, Vol. 80, No.
1, 2011, pp. 25-38. doi:10.1016/j.ijmedinf.2010.10.010
[111] J. Y. Feng, H. Chen and S. M. Zhu, “Development and
Clinical Evaluation of an Anesthesia Information man-
agement system,” National Medical Journal of China,
Vol. 90, No. 35, 2010, pp. 2514-2517.
[112] A. Krishnan, B. Nongkynrih, K. Yadav, S. Singh and V.
Gupta, “Evaluation of Computerized Health Management
Information System for Primary Health Care in Rural In-
Copyright © 2012 SciRes. IIM
V. VIMARLUND, S. KOCH 307
dia,BMC Health Services Research, Vol. 310, No. 10,
2010, p. 41.
[113] H. Hyppönen, P. Doupi, P. Hämäläinen, J. Komulainen, P.
Nykänen and R. Suomi, “Towards a National Health In-
formation System Evaluation,” Studies in Health Tech-
nology and Informatics, Vol. 160, 2010, pp. 1216-1220.
[114] C. Oroviogoicoechea and R. A. Watson, “Quantitative
Analysis of the Impact of a Computerised Information
System on Nurses’ Clinical Practice Using a Realistic
Evaluation Framework,” International Journal of Medi-
cal Informatics, Vol. 78, No. 12, 2009, pp. 839-849.
doi:10.1016/j.ijmedinf.2009.08.008
[115] H. Hyppönen, P. Doupi, P. Hämäläinen, J. Komulainen, P.
Nykänen and R. Suomi, “Planning for National Health
Information System Evaluation,” Studies in Health Tech-
nology and Informatics, Vol. 150, 2009, pp. 972-976.
[116] S. Sivic, L. Gojkovic and S. Huseinagic, “Evaluation of
an Information System Model for Primary Health Care,”
In: K.-P. Adlassnig, et al., Eds., Medical Informatics in a
United and Healthy Europe, IOS Press, Amsterdam, 2009,
pp. 106-110.
[117] I. C. Hou, H. C. Yu, Y. J. Hwang, J. Cheng, R. S. Wu, P.
Chang. “The Evaluation of the Nurses’ Work Perform-
ance after Nursing Information System Implementation in
One Medical Center in Taiwan,” Studies in Health Tech-
nology and Informatics, Vol. 146, 2009, p. 708.
[118] F. Lau, “Extending the Infoway Benefits Evaluation Fra-
mework for Health Information Systems,” Studies in
Health Technology and Informatics, Vol. 143, 2009, pp.
406-413.
[119] Y. Y. Mei, J. Marquard, C. Jacelon and A. L. Defeo,
“Designing and Evaluating an Electronic Patient Falls
Reporting System: Perspectives for the Implementation of
Health Information Technology in Long-Term Residen-
tial Care Facilities,” International Journal of Medical In-
formatics, 2011. [Epub ahead of print]
doi:10.1016/j.ijmedinf.2011.03.008
[120] E. Cummings and P. Turner, “Patient Self-Management
and Chronic Illness: Evaluating Outcomes and Impacts of
Information Technology,” Studies in Health Technology
and Informatics, Vol. 143, 2009, pp. 229-234.
[121] M. Magnus, J. Herwehe, L. Andrews, L. Gibson, N. Dai-
grepont, J. M. De Leon, N. E. Hyslop Jr., S. Styron, R.
Wilcox, M. Kaiser and M. K. Butler, “Evaluating Health
Information Technology: Provider Satisfaction with an
HIV-Specific, Electronic Clinical Management and Re-
porting System,” AIDS Patient Care STDS, Vol. 23, No.
2, 2009, pp. 85-91. doi:10.1089/apc.2008.0053
[122] S. Hagens and A. Krose, “Evolution of a National Ap-
proach to Evaluating the Benefits of the Electronic Health
Record,” Studies in Health Technology and Informatics,
Vol. 143, 2009, pp. 389-394.
[123] S. Petter and A. Fruhling, “Evaluating the Success of an
Emergency Response Medical Information System,” In-
ternational Journal of Medical Informatics, Vol. 80, No.
7, 2011, pp. 480-489. doi:10.1016/j.ijmedinf.2011.03.010
[124] I. Masic, D. Ciric, A. Pulja, I. Kulasin and H. Pandza,
“Quality Assessment of Medical Education and Use of
Information Technology,” Studies in Health Technology
and Informatics, Vol. 150, 2009, pp. 898-902.
[125] S. Khan, C. D. Maclean and B. Littenberg, “The Effect of
the Vermont Diabetes Information System on Inpatient
and Emergency Room Use: Results from a Randomized
Trial,” Health Outcomes Research in Medicine, Vol. 1,
No. 1, 2010, pp. e61-e66.
doi:10.1016/j.ehrm.2010.03.002
[126] M. Domingo, J. Lupón, B. González, E. Crespo, R. López,
A. Ramos, A. Urrutia, G. Pera, J. M. Verdú and A.
Bayes-Genis, “Evaluation of a Telemedicine System for
Heart Failure Patients: Feasibility, Acceptance Rate, Sa-
tisfaction and Changes in Patient Behavior Results from
the CARME (CAtalan Remote Management Evaluation)
Study,” European Journal of Cardiovascular Nursing,
2011. [Epub ahead of print]
doi:10.1016/j.ejcnurse.2011.02.003
[127] K. Ando, J. Koyama, Y. Abe, T. Sato, M. Shoda, Y. Soga,
M. Nobuyoshi, T. Honda, K. Nakao, K. Terata, K. Kado-
waki, A. Maeda, S. Ogawa, T. Manaka, N. Hagiwara and
K. Doi, “Feasibility Evaluation of a Remote Monitoring
System for Implantable Cardiac Devices in Japan,” In-
ternational Heart Journal, Vol. 52, No. 1, 2001, pp. 39-
43.
[128] P. Breen, K. Murphy , G. Browne, F. Molloy, V. Reid, C.
Doherty, N. Delanty, S. Connolly and M. Fitzsimons,
“Formative Evaluation of a Telemedicine Model for De-
livering Clinical Neurophysiology Services Part II: The
Referring Clinician and Patient Perspective,” BMC
Medical Informatics and Decision Making, Vol. 10, 2010,
p. 49. doi:10.1186/1472-6947-10-49
[129] A. W. Armstrong, C. Sanders, A. D. Farbstein, G. Z. Wu,
S. W. Lin, F. T. Liu and T. S. Nesbitt, “Evaluation and
Comparison of Store-and-Forward Teledermatology Ap-
plications,” Telemedicine and eHealth, Vol. 16, No. 4,
2010, pp. 424-438.
[130] M. E. Dávalos, M. T. French, A. E. Burdick, S. C. Sim-
mons and F. Wang, “Economic Evaluation of Telemedi-
cine: Review of the Literature and Research Guidelines
for Benefit-Cost Analysis. The Role of Cost in Telemedi-
cine Evaluation,” Telemedicine and eHealth, Vol. 15, No.
10, 2009, pp. 949-953.
[131] M. Le Goff-Pronost and C. Sicotte, “The Added Value of
thorough Economic Evaluation of Telemedicine Net-
works,” The European Journal of Health Economics, Vol.
11, No. 1, 2009, pp. 45-55.
doi:10.1007/s10198-009-0162-5
[132] J. F. Lesesve and R. Garand, “Evaluation of a Tele-
medicine System for the Transmission of Morpho/Immu-
nological Data Aiming at the Inclusion of Patients in a
Therapeutic Trial,” International Journal of Telemedicine
and Applications, 2009. [Epub ahead of print]
doi:10.1155/2009/767145
[133] J. B. Smith, S. R. Lacey, A. R. Williams, S. L. Teasley, A.
Olney, C. Hunt, K. S. Cox and C. Kemper, “Developing
and Testing a Clinical Information System Evaluation
Tool: Prioritizing Modifications through End-User In-
put,” Journal of Nursing Administration, Vol. 6, No. 6,
2011, pp. 252-258. doi:10.1097/NNA.0b013e31821c4634
Copyright © 2012 SciRes. IIM
V. VIMARLUND, S. KOCH
Copyright © 2012 SciRes. IIM
308
[134] C. Fröjd, C. L. Swenne, C. Rubertsson, L. Gunningberg
and B. J. Wadensten, “Patient Information and Participa-
tion Still in Need of Improvement: Evaluation of Patients’
Perceptions of Quality of Care,” Journal of Nursing Ma-
nagement, Vol. 19, No. 2, 2011, pp. 226-236.
doi:10.1111/j.1365-2834.2010.01197.x
[135] J. M. Palm, T. Dart, I. Dupuis, L. Leneveut and P. De-
goulet, “Clinical Information System Post-Adoption Eva-
luation at the Georges Pompidou University Hospital,”
AMIA Annual Symposium Proceedings, Washington, 13-
17 November 2010, pp. 582-586.
[136] J. S. Wu, F. Y. Shih, C. H. Chiu, Y. L. Yeh, J. J. Yan, C.
C. King and M. S. Ho, “Evaluation of an Adjustable Epi-
demiologic Information System,” PLoS One, Vol. 6, No.
1, 2011, p. e14596. doi:10.1371/journal.pone.0014596
[137] A. Krishnan, B. Nongkynrih, K. Yadav, S. Singh and V.
Gupta, “Evaluation of Computerized Health Management
Information System for Primary Health Care in Rural In-
dia,” BMC Health Services Research, Vol. 10, 2010, p.
310. doi:10.1186/1472-6963-10-310
[138] S. Hagens and A. Krose, “Evolution of a National Ap-
proach to Evaluating the Benefits of the Electronic Health
Record,” Studies in Health Technology and Informatics,
Vol. 143, 2009, pp. 389-394.
[139] S. Petter and A. Fruhling, “Evaluating the Success of an
Emergency Response Medical Information System,” In-
ternational Journal of Medical Informatics, Vol. 80, No.
7, 2011, pp. 480-489.
[140] I. Masic, D. Ciric, A. Pulja, I. Kulasin and H. Pandza,
“Quality Assessment of Medical Education and Use of
Information Technology,” Studies in Health Technology
and Informatics, Vol. 150, 2009, pp. 898-902.
[141] S. Khan, C. D. Maclean and B. Littenberg, “The Effect of
the Vermont Diabetes Information System on Inpatient
and Emergency Room Use: Results from a Randomized
Trial,” Health Outcomes Research in Medicine, Vol. 1,
No. 1, 2010, pp. e61-e66.
doi:10.1016/j.ehrm.2010.03.002
[142] E. Brynjolfsson and H. Lorin, “Computing Productivity:
Firm Level Evidence,” MIT Sloan Working Paper No.
4210-01, 2003.
http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2903
25
[143] V. Vimarlund, T. Timpka and N. Hallberg, “Healthcare
Professional’s Demand for Knowledge in Informatics,”
International Journal of Medical Informatics, Vol. 53, No.
2-3, 2003, 1999, pp. 107-114.
[144] V. Vimarlund, et al., “Identifying Utility of Investments
in Large Infrastructures for Health and Social Care,” Re-
search Report, 2009. (only in Swedish)
[145] V. Vimarlund, et al., “Capturing Outcomes from Invest-
ments in ICT in Health and Social Care. An Analysis
Model to Evaluation and Control,” Research Report, 2011.
(Only in Swedish)