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Introduction
There are several implementa/ons
iden/fying what we call Electronic Health
Record (EHR) as well as recent legisla/on
and technical requirements that lead to
different approaches. Most of them are
based on a top-‐down logic so that the EHRs
are defined by means of central-‐based
models that oDen forget to involve
territorial healthcare structures such as
Local Health Authori/es (LHA) and Hospital
Trusts (HT).
In the case of the EHR project of the Veneto
Region we considered a new point of view.
Aims and objectives • Mul/discipl inary organiza/on
represen/ng all the EHR players;
• defini/on of theme-‐related working
groups a iming at producing
guidelines to be shared among
healthcare professionals, and
introduced inside healthcare
organiza/ons;
Results Thanks to the innova/ve organiza/on, the
boNom-‐up approach implementa/on is
effec/ve with contribu/ons of each element
taking part into the en/re EHR:
• more than 5.000 healthcare professionals
par/cipants;
• 40 working groups on 20 technical issues;
• about 200 mee/ngs;
• over 15 output specifica/ons documents.
These achievements display that new approaches based on involvement can overcome technical
deficiencies, leading to actual innova/on processes. In the Veneto Region fully endorsing such a
boNom-‐up approach has allowed to enhance the level of collabora/on, the awareness, and
enabled a deep engagement among professionals, and ci/zens. Since every service in the EHR is
the outcome of shared efforts, it will be easier that they will be used daily to provide and receive
digital healthcare.
Img. 5: Example of result : ePrescrip/on infrastructure diagram
Conclusions
TOP DOWN GOVERNANCE
HEALTHCARE
PROFESSIONAL
TECHNICAL BARRIERS
HEALTHCARE
PROFESSIONAL
PSYCHOLOGICAL AND SOCIAL
BARRIERS
HEALTHCARE
PROFESSIONAL
LEGAL BARRIERS
HEALTHCARE
PROFESSIONAL
ORGANIZATIONAL BARRIERS
Top-‐down governance
COOPERATION
BoNom-‐up approach: LHA, HT
NEW
ORG
ANISAT
ION
MODE
L
ENGAGING HEALTHCARE ACTORS: A NEW GOVERNANCE STRATEGY TO SUCCESSFULLY INTRODUCE THE REGIONAL EHR
Authors: F. Sandri, F. Vanzo, C. Saccavini, L. Gubian and C. Dario
Img. 2: Coopera/on with healthcare professionals
Img. 3: Project chart Img. 6: Healthcare professionals involved
• the documents defined
inside workgroups are
subdued to public
comment, before being
submiNed to the regional
steering commiNee;
The model was built first of taking into account an organiza/onal model based on
wide-‐ranging governance involving each healthcare actor into the changing process.
Arsenàl.IT – the eHealth in-‐house organiza/on appointed by the Regional Authority of
the technical, administra/ve, and management coordina/on of 23 public LHAs and HTs
in the EHR project – decided to adopt a boNom-‐up approach based on involvement.
• each professional, depending on func/on and tasks, is included in one or more
workgroups;
• thanks to a co-‐crea/on EHR ini/a/ve ci/zens have the chance to be involved in the process
as a key to their empowerment and the democra/za/on of services.
Img. 4.1: Example of coopera/on tool
Img. 1: Comparison of different governance model
Img. 4.2: Example of coopera/on tool
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