<p>Healthcare organizations now consider increased efficiency, reduced costs, improved patient care and quality of services, and safety when they are planning to implement new information and communication technology (ICT) based applications. However, in spite of enormous investment in health information systems (HIS), no convincing evidence of the overall benefits of HISs yet exists. The publishing of studies that capture the effects of the implementation and use of ICT-based applications in healthcare may contribute to the emergence of an evidence-based health informatics which can be used as a platform for decisions made by policy makers, executives, and clinicians. Health informatics needs further studies identifying the factors affecting successful HIS implementation and capturing the effects of HIS implementation. The purpose of the work presented in this thesis is to increase the available knowledge about the impact of the implementation and use of HISs in healthcare organizations. All the studies included in this thesis used qualitative research methods. A case study design and literature review were performed to collect data.</p><p>This thesis’s results highlight an increasing need to share knowledge, find methods to evaluate the impact of investments, and formulate indicators for success. It makes suggestions for developing or extending evaluation methods that can be applied to this area with a multi-actor perspective in order to understand the effects, consequences, and prerequisites that have to be achieved for the successful implementation and use of IT in healthcare. The results also propose that HIS, particularly integrated computer-based patient records (ICPR), be introduced to fulfill a high number of organizational, individualbased, and socio-technical goals at different levels. It is therefore necessary to link the goals that HIS systems are to fulfill in relation to short-term, middle-term, and long-term strategic goals. Another suggestion is that implementers and vendors should direct more attention to what has been published in the area to avoid future failures.</p><p>This thesis’s findings outline an updated structure for implementation planning. When implementing HISs in hospital and primary-care environments, this thesis suggests that such strategic actions as management involvement and resource allocation, such tactical action as integrating HIS with healthcare workflow, and such operational actions as user involvement, establishing compatibility between software and hardware, and education and training should be taken into consideration.</p>

Diss. (sammanfattning) Uppsala : Uppsala universitet, 2008. / Härtill 5 uppsatser.

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<p>The medical imaging system Sectra PACS from Sectra Imtec contains a 3D mode that can be used for visualising image stacks from e.g. computed tomography. Various structures of human anatomy can be visualised in the 3D mode, but visualisations of the bronchial tree of the lungs rarely become good enough to be useful. The goal of this work was to investigate ways of improving such visualisations.</p><p>Various approaches were studied, evaluated and tested. The fact that most effort was needed for small structures with sizes similar to the resolution of the images made things slightly more complicated. A method classifying neighbourhoods based on local structure emerged as most promising, and was used as foundation for a proposed algorithm. It creates a mask representing the presence of bronchi, allowing the hiding of uninteresting structures in its proximity. The algorithm was then implemented so that it could be tested together with the existing system.</p><p>The method was found to work well and was able to detect the smaller tubes of the bronchial tree and output the desired classification mask. Its usefulness was somewhat reduced by issues relating to speed, and the fact that many computed tomography image stacks lack the necessary resolution for visualising the finer details of the bronchial tree.</p>

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The medical imaging system Sectra PACS from Sectra Imtec contains a 3D mode that can be used for visualising image stacks from e.g. computed tomography. Various structures of human anatomy can be visualised in the 3D mode, but visualisations of the bronchial tree of the lungs rarely become good enough to be useful. The goal of this work was to investigate ways of improving such visualisations. Various approaches were studied, evaluated and tested. The fact that most effort was needed for small structures with sizes similar to the resolution of the images made things slightly more complicated. A method classifying neighbourhoods based on local structure emerged as most promising, and was used as foundation for a proposed algorithm. It creates a mask representing the presence of bronchi, allowing the hiding of uninteresting structures in its proximity. The algorithm was then implemented so that it could be tested together with the existing system. The method was found to work well and was able to detect the smaller tubes of the bronchial tree and output the desired classification mask. Its usefulness was somewhat reduced by issues relating to speed, and the fact that many computed tomography image stacks lack the necessary resolution for visualising the finer details of the bronchial tree.