In the last decade modern information technology systems have been introduced to healthcare in order to improve it. The aim of this study is to present the impact of such information system’s adoption on patient safety and efficiency within healthcare. Interviews, observations along with literature study were conducted in order to study the impact of the adoption on patient safety and efficiency at hospital’s wards where a new information system is implemented. The conclusion of this study is that such information technology systems can improve patient safety. However it is believed that the information technology system can improve efficiency in some aspects such as the communication among medical care personnel while other aspects within efficiency can be achieved if some improvements are made. Moreover the ability to access Electronic Healthcare Records is considered to be important to improve the medical care, which can increase patient safety.

Today, the application of information and communication technologies to healthcare is on the agenda of many countries. The main aim is to make Electronic Healthcare Records (EHR) of a patient accessible anywhere at any time to all authorized users. This is even valid in the cross-border case / the European Commission has published eHealth interoperability recommendations to the EU Member States, in which the RIDE Project contributed, for the purpose of an interoperable European Health Network. Interoperable cross-border clinical data exchange is an ambitious goal with some challenges, the most obvious one being the variety of standards. This issue gets more complicated with the locally developed standards and coding systems. Each country has its own set of standards and it is not reasonable to make all possible combinations of mappings among them during multi-party EHR exchange. Instead, what needs to be done is keeping the legacy infrastructures of the participants and agreeing on a set of common EHR standards and coding systems. Then, each country shall develop &quot / Adapters&quot / transforming local EHR instances to the commonly agreed formats which will most probably be based on widely accepted standards such as HL7 CDA. This approach enables the structure level interoperability. As the second step, in order to achieve semantic interoperability, coded terms from locally defined coding systems shall be translated to international counterparts. In this thesis, our methodology is confirmed on Turkey&#039 / s National Health Information System. &quot / Transmission Schemas&quot / are automatically transformed to HL7 v3 CDA R2 and CEN EN 13606 standard formats. The local coded terms are translated by developing a mapping platform based on Unified Medical Language System (UMLS).

The Swedish National Archives are in charge of the management of Common Specifications (CS). CS are genericmetadata specifications that provides structure and markup when transferring digital information betweeninformation systems and to electronic archives. As of now there is no CS for electronic healthcare records (EHR).Organizations around Sweden have developed their own specifications for transferring healthcare information. Inaddition to that, there are comprehensive international EHR metadata standards established. The Swedish NationalArchives have commissioned a study of EHR metadata specifications and standards to aid in the development of theCS.A Delphi study was conducted, including respondents from major archiving organizations in Sweden, to identifynecessary metadata categories when exchanging EHRs. The data was analyzed considering the international EHRmetadata standards HL7 CDA2 and CEN/ISO EN13606, as well as digital preservation metadata categories. Theresults were a set of metadata categories necessary to include in a CS. In addition, a subset of suggested mandatorymetadata categories is proposed and a list of implications for practice. Clinical codes, auditing, and separatingmetadata related to different contexts are a sample size of the implications.The results were evaluated in an interview with the Swedish National Archives, as well as Sydarkivera. Three criteriafor evaluating the results were proposed, being that the results had to consider a common terminology as well as bebased on a metadata standard and Swedish metadata specifications for EHRs. The interview revealed that the resultssatisfied these criterions, except for requiring a study on one additional user environment of EHRs.