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(Hägglund and Scandurra, 2022)
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The following table, from Cijvat, Cornet and Hägglund, 2021 (Table 4), shows “Barriers on the local implementation level”
Category | Sweden | Netherlands |
|---|---|---|
Systems and suppliers | Technical limitations of systems High costs for connecting small EHR systems Testing prior to implementation necessary Difficult requisites for connecting to the HIE | Limitations in choice and possibilities of systems Large dependency on software suppliers Alignmentof systems necessary but difficult Systems and suppliers determine achievement of VIPP (VIPP programme is an initiative in the Netherlands designed to enhance the exchange of information between patients and healthcare professional) |
Social and organisational | Resistance and fears from physicians Changing HCPs' routines, workflows and attitudes | Physicians' reluctance, resistance and fears CHanging HCPs' political status and workflow Effects on hospitals' culture and work processes Fears for patients' confusion, questions, fears Gradual implementation necessary to keep physicians on board |
Resources | High costs for connecting to HIE Time-consuming decision making due to flexibility in NRF | VIPP requires a lot of human work Human work leads to high costs Too little time to make VIPP’s deadlines |
Policies, laws and regulations | Some VIPP goals are difficult to accomplish Strict privacy regulations not in patiants' interests Strict security rules impede user-friendliness | |
Governance | Gradual approach necessary to get all stakeholders on board Flexibility in choosing EHR systems in some countries but only one supported | Gradual implementation to keep physicians on board VIPP has no or low priority |
The following table, from Cijvat, Cornet and Hägglund, 2021 (Table 3), shows “Barriers on the national level”
Category | Sweden | The Netherlands |
|---|---|---|
Systems and suppliers | Authentication methods | Difficulties in measuring hospitals' progress |
Social and organisational | Resistance and fears from physicians | - |
Resources | Financing the development of Journalen Too little time to take precautions for physicians' resistance | - |
Policies, laws and regulations | Include electable rules to make progress Electable rules caused confusion and inequality for users Givinc patients direct on line access to record was illegal when the PAEHR Journalen was first introduced in 2002 | Challenging to define goals adequately for desired outcomes Challenging to estimate reasonable usage percentages Slow development of other national programs |
Effects of barriers | Delays Restrictions on information that is diplayed | Delays |
Published outcomes - statistics
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