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Align, share responsibility and collaborate: potential considerations to aid in e-health policy development.

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  • 1School of Population Health, University of Auckland, New Zealand.



Policies that support strategic development and implementation are related to health ICT implementation successes. This research aimed to explore the question, 'Why have we not seen more successful ICT implementation in healthcare, and what does policy have to do with success?'


Healthcare systems are faced with rising costs, increased prevalence of chronic diseases and diminishing resources. E-health initiatives have gained acceptance in addressing these crucial health sector issues. National governments and healthcare organisations are finding it necessary to have health Information and Communications Technology (ICT) systems in place. However, poorly developed health information policies, lack of a clear business plan and ineffective leadership contribute to failure of ICT implementation in healthcare.


This study uses a Grounded Theory approach, in which a series of data gathering activities will be completed. The first author attended the Health Information Management & Systems Society (HIMSS) Policy Summit in the USA in 2011. Five Summit participants were approached individually and informally discussed the 'meaningful use' policy and how it influences ICT implementation in healthcare. Field notes were made and analysed for themes relating to the research question.


There were three overlapping concepts that all of the participants indicated as primary considerations for policymakers. The alignment aspect stresses the need to align e-health initiatives with overall health policy, ensuring that e-health is incorporated with other healthcare investments. The shared responsibility theme involves the need for e-health initiatives to be recognised as a priority along all levels of government, i.e. local, state, federal, and national. This stresses the importance of health ICT development and implementation in a joint government direction. The last theme is collaboration with stakeholders, including clear division of tasks and clarity about technical and non-technical expectations. Engaging and working with stakeholders in a collaborative and consensus-driven way can help realise common goals.


The concepts of alignment, shared responsibility and collaboration regarding e-health policy are not new; the fact that they are still being raised in discussion and addressed in recent literature indicates that they are still an issue today. An examination of policy tools to help aid in more cohesive practice can possibly help inform and influence future e-health initiatives.


E-health policy development and implementation varies due to differing health system infrastructure, funding and interests. Artefacts such as the summary of the 'meaningful use' policy could be used to leverage the effects of alignment, shared responsibility and collaboration. The next step from this research will be to examine the New Zealand National Health IT Plan's summary diagram (an artefact itself) and what role it plays in aspects of e-health policy development.

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