TY - JOUR
KW - Decision Support Systems, Clinical
KW - Diffusion of Innovation
KW - Humans
KW - Medical Records Systems, Computerized/organization & administration
KW - Mental Health Services
KW - Models, Organizational
KW - Substance Abuse Treatment Centers
KW - Systems Integration
AU - K. A. Moselle
A1 - 
AB - This paper responds to a commonly expressed belief, or perhaps hope, that full implementation of the electronic health record (EHR) will promote a "paradigm shift" in the delivery of health services, enhancing both service system efficiency and effectiveness in ways that would not have otherwise been possible. A model is proposed that defines stages in the development of the EHR in terms of two sets of functional components: 1) information management tools used to support the delivery of care; and 2) decision support tools that use information drawn from the EHR to promote functional integration among the components of complex service systems. "Paradigm shift" is defined operationally within this framework in terms of evolution of the EHR through these stages. The concept of "clinical interoperability" (anchored in a semantically interoperable EHR) is elaborated upon and presented as the sine qua non for a distinctive form of paradigm change that centres on support for care delivery within any given location in the system, and on EHR-based support for client movement through the system. The Vancouver Island Health Authority/Infoway Bridges, now deployed across the full array of hospital and community-based mental health and addiction services, is an example of an EHR that leverages the semantically interoperable components of an EHR to support a paradigm shift in clinical interoperability for the mental health and addictions service system.
BT - Studies in health technology and informatics
C5 - HIT & Telehealth
CY - Netherlands
JF - Studies in health technology and informatics
N2 - This paper responds to a commonly expressed belief, or perhaps hope, that full implementation of the electronic health record (EHR) will promote a "paradigm shift" in the delivery of health services, enhancing both service system efficiency and effectiveness in ways that would not have otherwise been possible. A model is proposed that defines stages in the development of the EHR in terms of two sets of functional components: 1) information management tools used to support the delivery of care; and 2) decision support tools that use information drawn from the EHR to promote functional integration among the components of complex service systems. "Paradigm shift" is defined operationally within this framework in terms of evolution of the EHR through these stages. The concept of "clinical interoperability" (anchored in a semantically interoperable EHR) is elaborated upon and presented as the sine qua non for a distinctive form of paradigm change that centres on support for care delivery within any given location in the system, and on EHR-based support for client movement through the system. The Vancouver Island Health Authority/Infoway Bridges, now deployed across the full array of hospital and community-based mental health and addiction services, is an example of an EHR that leverages the semantically interoperable components of an EHR to support a paradigm shift in clinical interoperability for the mental health and addictions service system.
PP - Netherlands
PY - 2009
SN - 0926-9630; 0926-9630
SP - 248
EP - 257
EP - 
T1 - An EHR-based paradigm shift in the operation of mental health and addiction services
T2 - Studies in health technology and informatics
TI - An EHR-based paradigm shift in the operation of mental health and addiction services
U1 - HIT & Telehealth
U2 - 19380944
VL - 143
VO - 0926-9630; 0926-9630
Y1 - 2009
ER -