Development of a regional health care network and the effect of knowledge intensive work on personnel and organisation.
OBJECTIVE
a) To present a regional health care communication system developed in the North Karelia Hospital District with the help of two EU funded information technology projects namely the TERVE project (1) which was implemented at the national level financed by the regional subsidy 6 of the ERDF and the CHIN project (2) that was implemented at the European level. b) To present the questions and issues that arose when implementing new technologies in a regional health care environment.


RESULTS
Transformations in information technology are usually parts of other organisational transformations in health care. As a result of these issues, implementation of great information technology transformations has failed because of too strong a technology emphasis, insufficient participative touch and underestimation of social factors. Another result is that there is a cultural shock for physicians working in organisations where there are networks rather than hierarchies and relationships are predominantly contractual rather than professional.


CONCLUSIONS
The effectiveness, productivity and profitability of the hospitals will be decisively dependent on information technology as well as its regional applications. Transformations in information technology are parts of other organisational transformations in health care, and can induce cultural shocks for physicians since the networked environment has a different philosophy than the hierarchy-based environment which was the case until recently. Finally, in a taxation based system, one key requirement is to understand that the network contacts and the time spent on networks must bring additional value to health care.
Itkonen
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North Karelia Hospital District, Joensuu, Finland. pentti.itkonen@pkshp.fi
D020000:Decision Support Systems, Clinical; D005062:European Union; D005103:Expert Systems; D005387:Finland; D006801:Humans; D007256:Information Systems / Q000458:organization & administration*; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D016730:Program Development; D012041:Regional Medical Programs / Q000458:organization & administration*; D012984:Software; D017216:Telemedicine / Q000458:organization & administration*