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Inadequate follow-up of ICT efforts in the health service - Document no. 3:7 (2007-2008)

Despite the focus on information and communication technology (ICT) and health during the last ten years, a great deal of the information flow in the health service is still paper-based.  So far, electronic medical records in hospitals have only made a limited contribution to improving cooperation and the utilisation of resources. ‘The Ministry of Health and Care Services has failed to fulfil its responsibility for following up the national ICT efforts,’ says Auditor General Jørgen Kosmo.
Published 5/22/2008 3:08 PM

The Office of the Auditor General’s investigation into ICT in hospitals and electronic cooperation in the health service, Document no 3:7 (2007–2008), was submitted to the Storting on 22 April 2008.

The electronic exchange of discharge summaries and referrals between hospitals and GPs has been a goal for ten years now. The Office of the Auditor General’s investigation shows that roughly half of all discharge summaries are still sent on paper only and that only eight per cent of referrals are sent electronically.

The investigation also shows that ICT has only been utilised to a small extent to improve cooperation between hospitals and municipal nursing and care services. ‘Good cooperation between the different branches of the health service is important in order to ensure that patients receive good treatment, care and follow-up,’ says Mr Kosmo. ‘It is essential to introduce new measures if the goals for electronic cooperation between hospitals, GPs and municipal nursing and care services are to be attained.’

One of the most important ICT measures in the health trusts is the introduction of electronic medical records (EMR). The investigation shows that, with one exception, the health trusts have introduced EMR, but that the electronic records have not replaced the use of paper documents. In most of the health trusts, the paper records are still important, and many manual procedures are still in use. In many health trusts, the management focuses too little on facilitating good utilisation of EMR, and so far work on planning and realising gains has received insufficient attention.

‘Both the health trusts and the regional health authorities have a responsibility for ensuring that the EMR systems that are already in place help the hospitals to perform their duties in a better manner. These are management responsibilities which the Ministry must ensure are given higher priority,’ says Mr Kosmo.

In the Office of the Auditor General’s view, the Ministry of Health and Care Services has failed to fulfil its responsibility for ensuring that ICT is used as a means of achieving a better health service and more efficient utilisation of resources. The Directorate for Health and Social Affairs has been responsible for implementing the national strategic plan Te@mwork 2007, but the means at the Directorate’s disposal have been limited. The Office of the Auditor General has raised the question of whether this discrepancy between responsibility and means is behind the failure to attain the goals. The Office of the Auditor General has also raised the question of whether the Ministry has defined sufficiently clear requirements regarding how the regional health authorities should contribute to the attainment of the goals in the strategic plan.

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