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Electronic Clinical Communications Implementation (ECCI) in Scotland: a mixed-methods programme evaluation.

Claudia Pagliari1, Mhairi Gilmour, Frank Sullivan

  • 1Senior Lecturer (R&D), Department of General Practice, University of Dundee, Dundee, UK.h.c.pagliari@dundee.ac.uk

Journal of Evaluation in Clinical Practice
|January 21, 2004
PubMed
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Implementing electronic clinical communication systems across healthcare faced challenges but improved IT capabilities. Adoption varied, with lab results reporting succeeding more than electronic outpatient booking.

Area of Science:

  • Health Informatics
  • Information Management & Technology
  • Healthcare Systems Engineering

Background:

  • The Electronic Clinical Communications Implementation programme aimed to integrate electronic systems for primary-secondary care communication.
  • Focus areas included laboratory results reporting, outpatient appointment booking, referrals, correspondence, and clinical email.

Purpose of the Study:

  • To evaluate the processes and outcomes of implementing electronic systems for clinical communication.
  • To identify barriers and facilitators to system adoption.
  • To assess benefits and drawbacks for professional users.

Main Methods:

  • A mixed-methods approach was employed, including document review, surveys, stakeholder interviews, and consensus exercises.
  • Quantitative process and outcome variables were recorded monthly.

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  • A national minimum dataset was established through a consensus process.

    • Main Results:

    • Significant variation was observed in adopted technologies and implementation strategies.
    • Laboratory results reporting showed the most success; electronic outpatient booking had the least.
    • System availability, acceptance, usability, process complexity, and user engagement influenced uptake.

    Conclusions:

    • Implementing multifaceted technological and behavioral change nationally presents significant difficulties.
    • Unexpected benefits were observed, including enhanced Information Management & Technology capabilities within the Scottish health service.