Health Policy and Technology最新文献

{"title":"Facilitating acceptance, trust, and ethical integration of socially assistive robots among nurses: A quasi-experimental study","authors":"Izidor Mlakar (Dr.) ,&nbsp;Igor Robert Roj ,&nbsp;Vojko Flis (Dr.) ,&nbsp;Valentino Šafran ,&nbsp;Urška Smrke (Dr.) ,&nbsp;Nejc Plohl (Dr.)","doi":"10.1016/j.hlpt.2025.101034","DOIUrl":"10.1016/j.hlpt.2025.101034","url":null,"abstract":"<div><div>Objectives: To evaluate the impact of different types of demonstrations (no demonstration, video demonstration, and face-to-face demonstration) on nurses’ acceptance, trust, and ethical considerations regarding socially assistive robots.</div><div>Methods: The study employed a quasi-experimental design involving 312 nurses: 201 with no exposure to socially assistive robots, 97 exposed via video demonstrations, and 14 exposed through live face-to-face demonstrations in a hospital room. Participants completed self-report measures assessing their perceptions of ethical acceptability, trust, and acceptance of socially assistive robots.</div><div>Results: Participants exposed to any kind of demonstration reported significantly higher perceptions of ethical acceptability compared to those with no exposure. Among demonstration types, live face-to-face demonstrations resulted in higher overall ethical acceptability, satisfaction, and acceptance compared to video demonstrations.</div><div>Conclusions: Demonstrations, particularly face-to-face interactions, play a crucial role in fostering ethical acceptability and overall acceptance of socially assistive robots. These findings highlight the importance of incorporating live demonstrations in strategies to improve healthcare professionals’ trust and acceptance of robotic technology.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 101034"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144137686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Volume-cost relationship in Pancreatic Surgery: A scoping review","authors":"Nashmil Ghadimi ,&nbsp;Alireza Olyaeemanesh ,&nbsp;Ali Akbar Fazaeli ,&nbsp;Rajabali Daroudi ,&nbsp;Sara Kaveh","doi":"10.1016/j.hlpt.2025.101020","DOIUrl":"10.1016/j.hlpt.2025.101020","url":null,"abstract":"<div><h3>Objectives</h3><div>To synthesize evidence on the volume-cost relationship (VCR) in pancreatic surgery, focusing on the impact of hospital and surgeon volumes on economic indicators.</div></div><div><h3>Methods</h3><div>A scoping review was conducted using PubMed, Web of Science, and Scopus to identify studies published from inception to November 30, 2024, to ensure a comprehensive and unbiased review of all relevant studies. The PRISMA-ScR framework guided data extraction, focusing on hospital and surgeon volumes in relation to costs, length of stay (LOS), resource utilization, and readmissions. The metrics included cost definitions, volume thresholds, and economic indicators. Studies that analyzed the economic impact of centralization in pancreatic surgery were included.</div></div><div><h3>Results</h3><div>Twenty-two studies (1996–2024), primarily from the United States, were included. Pancreaticoduodenectomy was the most studied procedure. High-volume Hospitals (HVHs) consistently demonstrated reduced costs, shorter LOS, lower resource utilization, and higher discharge-to-home rates compared to low-volume hospitals (LVHs). Cost reductions were attributed to enhanced efficiency and fewer complications. However, there was significant variability in volume thresholds and limited use of cost-effectiveness analyses (CEAs). Few studies addressed broader societal costs, such as productivity losses or caregiver burden.</div></div><div><h3>Conclusions</h3><div>Centralizing pancreatic surgeries in HVHs offers clear economic impact through improved efficiency and outcomes. Addressing gaps in standardized volume definitions, incorporating socioeconomic factors, and expanding CEAs are critical for optimizing resource allocation and ensuring equitable and cost-effective care. Future research should focus on these areas to inform better health policies.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 101020"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficiency and equity of elderly care service resource allocation in China, 2014–2022","authors":"Min Bao ,&nbsp;Rongji Ma ,&nbsp;Jianqian Chao","doi":"10.1016/j.hlpt.2025.101016","DOIUrl":"10.1016/j.hlpt.2025.101016","url":null,"abstract":"<div><h3>Backgrounds</h3><div>As the aging process in China progresses, the importance and urgency of the appropriate allocation of elderly care service resources are becoming increasingly prominent. This study aims to provide a multidimensional analysis of the efficiency and equity of elderly care resource allocation in China from 2014 to 2022.</div></div><div><h3>Methods</h3><div>Three-stage data envelopment analysis was used to measure efficiency, while Bayesian linear regression and spatial correlation tests were employed to explore the influencing factors and spatial effects of efficiency. The Dagum Gini coefficient decomposition method was applied to assess equity and examine the sources of disparities.</div></div><div><h3>Results</h3><div>From 2014 to 2022, the average efficiency of elderly care service allocation in Chinese provinces showed an increasing trend, rising from 0.469 to 0.602. Spatial correlation tests revealed a global positive spatial correlation among provincial efficiency values, with local clustering observed. The allocation of elderly welfare remained inequitable, with inter-regional differences being the main source of disparities. Conversely, the distribution of bed numbers, end-of-year employee counts and elderly care facility areas remained relatively equitable. The allocation of elderly care institutions and facility numbers transitioned from inequity to moderate equity.</div></div><div><h3>Conclusion</h3><div>From 2014 to 2022, the overall efficiency of elderly care service resource allocation in China was relatively low, with significant inter-provincial differences and evident spatial effects. The allocation of elderly welfare exhibited inequity, primarily due to regional disparities. Policymakers should address the existing regional disparities, strengthen regional cooperation, and scientifically plan the scale and structure of investment in elderly care service resources.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 101016"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting the utilization of healthcare services during COVID-19 - forecasting models based on routine data","authors":"Marco Alibone,&nbsp;Marion Ludwig,&nbsp;Christina Simantiri,&nbsp;Josephine Jacob,&nbsp;Dirk Enders","doi":"10.1016/j.hlpt.2025.101030","DOIUrl":"10.1016/j.hlpt.2025.101030","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic has significantly impacted global healthcare systems through the prioritisation of COVID-19 cases and the reallocation of resources, leading, for example, to a postponement of elective procedures. This study quantifies the impact of the COVID-19 pandemic on healthcare utilization in 2020 and 2021.</div></div><div><h3>Methods</h3><div>Forecasting models were trained using data from the pre-pandemic years 2013 to 2019. The most suitable model was used to predict a trend in healthcare utilization unaffected by the pandemic in the two pandemic years. Deviations between observed and predicted utilization were interpreted as the pandemic impact on healthcare.</div></div><div><h3>Results</h3><div>During the COVID-19 pandemic, all-cause hospitalizations declined across the first three waves. The first drop occurred in April 2020, with hospitalization rates falling to 1.7 times below expected pre-pandemic levels. A second drop began in November 2020, reaching 1.4 times below expected levels by January 2021. Hospitalizations returned to pre-pandemic levels after strict lockdown measures eased. These declines affected elective procedures but also life-threatening conditions, such as myocardial infarctions (MI). In March and April 2020, admissions for these events were 1.29 times below expected levels. By July 2020, however, MI hospitalization increased, reaching 0.87 times higher than typical pre-pandemic rates.</div></div><div><h3>Discussion</h3><div>We investigate for the first time the impact of the pandemic on healthcare in Germany using modern forecasting methods showing delayed hospitalizations for acute conditions like MI. Findings highlight the need to protect vulnerable groups and underscore the importance of further research on long-term health impacts and improved public health responses.</div></div><div><h3>Lay summary</h3><div>The COVID-19 pandemic has significantly disrupted healthcare provision by prioritising COVID-19 cases over other conditions, leading to postponement of interventions and reduced care for serious problems such as myocardial infarctions (MI). This study examined healthcare utilization in Germany in 2020–2021 by comparing observed hospitalisations with predicted values based on pre-pandemic trends from 2013–2019. The results showed a sharp decline in hospitalisations during the first three pandemic waves. In April 2020, hospital admissions fell to almost half the expected level, with a second decline at the end of 2020. Normalisation only set in when the lockdown measures were lifted. Crucially, admissions for life-threatening conditions such as MI also fell temporarily, showing a time lag in hospital admissions. This analysis emphasises the importance of ensuring access to healthcare for critical illnesses, even in times of pandemic, to reduce negative health impacts and improve the resilience of healthcare in future crises.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 101030"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Musculoskeletal complaints following hospitalization for COVID-19 infection","authors":"Mike Ruettermann ,&nbsp;Jan Peters ,&nbsp;Alexander Kaltenborn ,&nbsp;Andre Gutcke ,&nbsp;Martin Bergold ,&nbsp;Oliver Pieske","doi":"10.1016/j.hlpt.2025.101012","DOIUrl":"10.1016/j.hlpt.2025.101012","url":null,"abstract":"<div><h3>Objectives</h3><div>The term post- or long-COVID syndrome describes &gt;50 possible long-term effects on various organ systems following COVID-19 infection. The pathophysiology of most symptoms remains unclear, and the time course of symptom onset varies widely.</div></div><div><h3>Methods</h3><div>Using a telephone survey and validated questionnaires we investigated the incidence of musculoskeletal complaints after inpatient treatment for COVID-19 infection compared with patients hospitalized for a non-COVID diagnosis.</div></div><div><h3>Results</h3><div>112 patients were followed up for least 6 months after discharge (range 6–21 months). Hospitalized and ICU-treated COVID patients showed significant changes in WOMAC scores for the lower extremities (Kruskal-Wallis test, <em>p</em> = 0.005). There is also a significant change in the post-discharge question about new limb complaints (Chi-squared test, <em>p</em> = 0.005), regardless of whether the patients received intensive care or not. The majority of COVID patients with joint or muscle symptoms describe them as widespread and much less frequently as localized and restricted to one region.</div></div><div><h3>Conclusions</h3><div>In addition to the already known long-term effects, there is evidence that patients with COVID who have been treated in an inpatient setting may also suffer from long-term musculoskeletal effects. Women of working age are particularly affected by the resulting limitations.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 101012"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness, use and implementation of telehealth solutions for CHF and COPD: A systematic review using the PRISMA method","authors":"Ofir Ben-Assuli","doi":"10.1016/j.hlpt.2025.101023","DOIUrl":"10.1016/j.hlpt.2025.101023","url":null,"abstract":"<div><h3>Background</h3><div>According to leading health organizations such as the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), telehealth applications have the potential to improve patients' health, particularly for the billions of patients suffering from chronic diseases such as Congestive Heart Failure (CHF) and Chronic Obstructive Pulmonary Disease (COPD). While telehealth solutions hold promise, there is currently inadequate clinical evidence supporting their use in public health surveillance and home-based care, making it difficult to draw decisive conclusions.</div></div><div><h3>Objective</h3><div>The objective of this work was to evaluate the cost-effectiveness, use, and implementation of telehealth solutions for patients with chronic diseases, specifically CHF and COPD, through a review of the current literature. This narrative review examined studies presenting cost-effectiveness analyses, use, and implementation of telehealth for these patients.</div></div><div><h3>Methods</h3><div>This work implemented the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In order to receive recency and to examine recent and innovative telehealth solutions, articles published in English from 2010 to 2023 were included in the search. The inclusion criteria were papers on telehealth tools employed for CHF and COPD patients that assessed their cost-effectiveness.</div></div><div><h3>Results</h3><div>The majority of the studies were conducted in Europe. Approximately half had an adequate sample size and tracked patients prospectively for a sufficient duration. The most frequently used telehealth method was distance monitoring, with only a few studies incorporating home visits or phone calls. The parameters monitored included blood pressure, oxygen saturation, heart rate, and spirometry, among others. General statistical analyses and regression models were the most frequently used methods, although several studies incorporated Markov models and simulations.</div></div><div><h3>Discussion</h3><div>The majority of the papers (20 out of 26) concluded that the tools implemented led to either cost-effectiveness, cost-savings or strongly dominance. This promising result shows that telehealth is an important topic that deserves further research on its effectiveness as well as cost-effectiveness for chronic disease management.</div></div><div><h3>Limitations</h3><div>One key limitation of this PRISMA review is that the literature search was restricted to two major diseases, and the language of the publications was exclusively English. Thus, the generalizability of the findings to other chronic diseases is subject to caution.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 101023"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Young people’s perspective on technology-enabled personalised youth mental health care for depression in the UK","authors":"Vilas Sawrikar ,&nbsp;Kyle Buchan ,&nbsp;Karri Gillespie-Smith","doi":"10.1016/j.hlpt.2025.101028","DOIUrl":"10.1016/j.hlpt.2025.101028","url":null,"abstract":"<div><h3>Objectives</h3><div>While new models of youth mental health care will be introduced in the United Kingdom (UK) as part of the NHS’s Long Term Plan, little is known about how to design and implement these models for depression. This study investigated young people’s perspective on the key attributes of technology-enabled personalised youth mental health care for depression to ensure the crucial components are implemented.</div></div><div><h3>Methods</h3><div>Qualitative data of young people’s perspectives was collected over two phases. In phase 1, 37 young people participated in interviews where they were presented with two depression vignettes differentiated by clinical stage and asked to outline the key attributes of care. In phase 2, 8 young people participated in a group workshop co-designing digital care pathways. Recordings were analysed thematically to identify key service, model, and digitised care attributes.</div></div><div><h3>Results</h3><div>Key service attributes emphasised youth-friendly, welcoming environments allowing for timely access to care. Key model attributes included needs-led care, supported by youth and family engagement, personalised care planning, care coordination, monitoring, and peer support. Key attributes of digitised care included facilitating access to care, centralised assessments, patient decision aid, monitoring, and design principles of flexibility and human assistance.</div></div><div><h3>Conclusions</h3><div>The results suggest that evidence-informed methods of delivering care based on individual needs is critical to personalised care and that the implementation of this model entails specific configuration of highly personalised and measurement-based capabilities within youth mental health services. In line with this, a digitised care pathway for delivering personalised care for depression is presented.</div></div><div><h3>Public interest summary</h3><div>Personalised care reforms in the United Kingdom (UK) will see the implementation of technology-enabled, youth specific models of care supported by emerging health technologies. An analysis of young people’s perspective of these models indicated that delivery of technology-enabled personalised youth mental health care can be defined in terms of service characteristics, service model, and digitised care pathways. Young people propose that services should be youth friendly and easy to access, while care should be tailored to individual needs and preferences. Treatments should also be organised on as needed bases with youth having greater choice. Digitised care pathways were proposed to help reduce barriers to care and streamline pathways from screening to referrals, assessments and transfers between services. The results are used to prototype a digitised care pathway for delivering personalised care for depression within youth mental health services in the UK.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 101028"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appropriateness of the percutaneous coronary intervention technical fee in Japan","authors":"Satoru Hashimoto ,&nbsp;Yoshihiro Motozawa ,&nbsp;Burt Cohen ,&nbsp;Toshiki Mano","doi":"10.1016/j.hlpt.2025.101026","DOIUrl":"10.1016/j.hlpt.2025.101026","url":null,"abstract":"<div><h3>Objectives</h3><div>In Japan, reimbursements of technical fees for percutaneous coronary intervention (PCI) are not considered to reflect actual medical costs, since medical procedures frequently cost hospitals more than they make. This study evaluated the appropriateness of PCI technical fees in Japan as part of reimbursed medical fees.</div></div><div><h3>Methods</h3><div>We estimated the PCI technical fee’s validity from three approaches including 1) costing calculation, 2) survey-based cost estimation, and 3) lost profit methods.</div></div><div><h3>Results</h3><div>For the costing calculation method, we used the draft proposal that is evaluated by the Japanese Health Insurance Federation for Surgery (Gaihoren draft proposal). The proposal indicated PCI technical fees of ¥727,997 for acute myocardial infarction (AMI) and ¥596,397 for unstable angina (UA). For the survey-based cost estimation method, a survey of cardiologists showed the appropriateness of ¥814,600 and ¥554,825 for AMI-PCI and UA-PCI, respectively, while the lost profit method evaluated AMI-PCI at ¥812,210 and UA-PCI at ¥773,961. The average costs of technical fees calculated according to the three approaches were ¥772,186 for AMI-PCI and ¥566,688 for UA-PCI, which are higher than the existing reimbursements of ¥343,800 and ¥243,800, respectively.</div></div><div><h3>Conclusion</h3><div>The present study showed that technical fees for PCI did not reflect estimated costs in three approaches. The majority of hospitals in Japan are operating at a loss for medical profit, and these results call into question, the need for a review of the healthcare costs reimbursed by the government.</div></div><div><h3>Lay summary</h3><div>In Japan, reimbursement prices of percutaneous coronary intervention (PCI) technical fees are considered to be lower than the actual cost, which can translate to losses for hospitals, especially when complex PCI procedures are performed. We estimated the appropriateness of technical fees using three approaches including 1) costing calculation, 2) survey-based cost estimation, and 3) lost profit methods. The results confirmed that technical fees, which form the core of medical fees, do not reflect estimated costs. It was suggested that this discrepancy has led to a deficit in the structure of Japanese hospitals.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 101026"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143929474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overcoming vaccine hesitancy: Evidence from Italy during the COVID-19 pandemic","authors":"Alessandro Del Ponte ,&nbsp;Audrey De Dominicis ,&nbsp;Paolo Canofari","doi":"10.1016/j.hlpt.2025.100996","DOIUrl":"10.1016/j.hlpt.2025.100996","url":null,"abstract":"<div><h3>Objectives</h3><div>Here we investigate whether releasing COVID-19 vaccines at open-day events boosted Italy's vaccination campaign in 2021. This strategy exploits insights from psychology.</div></div><div><h3>Study design</h3><div>We built an original dataset covering 200 days of vaccination data in Italy, including “open day” events. Open-day events (in short: open days) are instances where COVID-19 vaccines were released only for a specific day at a specified location (usually, a large pavilion or a public building). Importantly, releasing vaccines through open days instead of the usual appointment channel leaves the supply of vaccines unaltered. Our dependent variables are the number of total and first doses administered in proportion to the eligible population. Our key independent variable is the presence of open-day events in a given region on a specific day.</div></div><div><h3>Methods</h3><div>We analyzed the data using regression with fixed effects for time and region. The analysis was robust to alternative model specifications.</div></div><div><h3>Results</h3><div>We find that when an open day event was organized, in proportion to the eligible population, there was an average 0.39–0.44 percentage point increase in total doses administered and a 0.30–0.33 percentage point increase in first doses administered. These figures correspond to an average increase of 10,455–11,796 in total doses administered and 8,043–8,847 in the first doses administered.</div></div><div><h3>Conclusions</h3><div>Releasing vaccines by organizing open-day events was associated with an increase in COVID-19 vaccinations in most Italian regions. These results call for further study of the effectiveness of open days to increase vaccinations and protect against other infectious diseases or future pandemics.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 100996"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing a clinical decision support system in an Aboriginal health service – A qualitative case study","authors":"Sophie Pascoe ,&nbsp;Debbie-Ann Gillon ,&nbsp;Paul Kamler ,&nbsp;Asanga Abeyaratne ,&nbsp;Natasha Pavlin ,&nbsp;Gillian Gorham","doi":"10.1016/j.hlpt.2025.101010","DOIUrl":"10.1016/j.hlpt.2025.101010","url":null,"abstract":"<div><h3>Objective</h3><div>This qualitative case study aims to evaluate the implementation of a clinical decision support system (CDSS) – Territory Kidney Care (TKC) – at an Aboriginal health service in the Northern Territory (NT) of Australia. This research aims to contribute understandings about the challenges clinicians face when navigating electronic systems within an Aboriginal health service setting and enablers and barriers to the implementation of CDSS.</div></div><div><h3>Methods</h3><div>Within a larger evaluation of TKC, this qualitative case study involved 13 baseline semi-structured interviews completed between October 2022 and January 2023 and seven follow up interviews conducted in June 2023. Through purposive sampling, clinicians in a range of primary care roles participated in the study. Interview transcripts were inductively and iteratively coded by two researchers using a thematic analysis approach.</div></div><div><h3>Results</h3><div>The baseline evaluation found that clinicians working in an Aboriginal health service used multiple electronic health systems, spent considerable time collating patient data across systems and faced challenges related to missing information, technological issues and limited training. The process evaluation of TKC implementation identified that adequate training, a funded Implementation Officer role and supportive leadership were central enablers, while competing clinical priorities, time limitations, staff shortages, access processes were key barriers to uptake and usage.</div></div><div><h3>Conclusions</h3><div>This case study highlights the need for integrated data tools in Aboriginal health services to bridge the gaps between primary, tertiary, government and non-government services. The evaluation emphasises the importance of embedding CDSS within workflows and ensuring there are dedicated staff and resources to facilitate implementation.</div></div><div><h3>Lay Summary</h3><div>This study focuses on how a clinical decision support system was implemented in an Aboriginal health service in the Northern Territory of Australia. Through interviews with clinicians, we identify key barriers and enablers to accessing clinical decision support, as an adjunct to electronic health records. Clinicians in Aboriginal health services must use multiple systems and spend a lot of time looking for information about their patients; a new integrated data platform called Territory Kidney Care was implemented to pull information together from different health services. This research highlights the importance of ensuring there are dedicated staff and resources to help implement new systems.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 101010"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143823224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}