IT-supported skill-mix change and standardisation in integrated eyecare: lessons from two screening projects in The Netherlands
DOI:
https://doi.org/10.5334/ijic.189Keywords:
skill-mix, information technology, standardisation, integrated care, eyecareAbstract
Introduction: Information Technology (IT) has the potential to significantly support skill-mix change and, thereby, to improve the efficiency and effectiveness of integrated care.Theory and methods: IT and skill-mix change share an important precondition: the standardisation of work processes. Standardisation plays a crucial role in IT-supported skill-mix change. It is not a matter of more or less standardisation than in the ‘old’ situation, but about creating an optimal fit. We used qualitative data from our evaluation of two integrated-care projects in Dutch eyecare to identify domains where this fit is important.
Results: While standardisation was needed to delegate screening tasks from physicians to non-physicians, and to assure the quality of the integrated-care process as a whole, tensions arose in three domains: the performance of clinical tasks, the documentation, and the communication between professionals. Unfunctional standardisation led to dissatisfaction and distrust between the professionals involved in screening.
Discussion and conclusion: Although the integration seems promising, much work is needed to ensure a synergistic relationship between skill-mix change and IT. Developing IT-supported skill-mix change by means of standardisation is a matter of tailoring standardisation to fit the situation at hand, while dealing with the local constraints of available technology and organisational context.
Published
Issue
Section
License
Copyright (c) 2007 The Author(s)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors
Starting in 2009 the International Journal of Integrated Care applies the Creative Commons Attribution 4.0 Internaltional License (CC-BY, http://creativecommons.org/licenses/by/4.0/) to all articles, submitted in or after January 2009, that are published in IJIC. Authors retain ownership of the copyright for their articles, but they permit anyone unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. After it has appeared in IJIC authors may republish their text in any way they wish (electronic or print) as long as they clearly acknowledge IJIC as its original publisher with the correct citation details and copyright notice, independent of whether the article is used in whole or in part.
- Authors of accepted manuscripts assign IJIC the right to publish and distribute their text electronically and to archive it permanently retrievable electronically.
- Authors retain the copyright of the article. After it has appeared in IJIC authors may republish their text in any way they wish (electronic or print) as long as they clearly acknowledge IJIC as its original publisher with the correct citation details and copyright notice (see below), independent whether the article is used in whole or in part.
- IJIC may change the appearance of the article, both layout and technical format, to ensure consistency and readability. Under no circumstance will the content of the article be altered.
- The author warrants to IJIC that the article is original, does not infringe any existing copyright, and does not infringe the rights of any third party. This warrant concerns the entire manuscript, text as well as pictures, sound, video, data sets etc. The author also warrants to us that he has full authority to enter into this agreement and that the rights he is granting to IJIC are done so without breaching any obligations he may have.
- Acceptation:
Readers
Starting 2009 Utrecht the International Journal of Integrated Care applies the Creative Commons Attribution 4.0 International License (CC-by) to all articles, submitted in or after January 2009, that are published in the IJIC. Under the CC-by, authors retain ownership of the copyright for their article, but authors allow anyone unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. No permission is required from the authors or the publishers.
- Persons using http://www.ijic.org may view, reproduce or store copies of articles of the journal provided that they are used only for their personal, non-commercial use (especially for educational purposes). Articles with the CC-by logo are published under the CC-by license and can be used without restrictions, provided the article is properly cited. Any uses or copies of this Journal in whole or in part must include the citation details and copyright notice (see below) of IJIC. The URL (= uniform resource locator) of a document in IJIC (from this server) may be used in another electronic document freely.
- Linking: IJIC encourages and appreciates links in your own Web pages to IJIC-webpages. Permission is expressly granted to any person who wishes to place a link in his or her own Web page to IJIC's homepage http://www.ijic.org. As a courtesy, if you link to, or include IJIC in an index, please let us know.
- Privacy statement: On the IJIC site we may collect some anonymous information about you when you visit this site. IJIC may also include information for its own use about your visit in collective or aggregated data that does not identify you specifically.
Citation details and copyright notice
When referring to International Journal of Integrated Care either for re-publication by the author or permitted usage by third parties, the following information should be added:
Citation details:
Customary bibliographic citation, including author name(s), volume number and date of publication, article title, International Journal of Integrated Care (or abbreviation Int J of Integr Care), and the DOI (for instance http://doi.org/10.5334/sta.433).
Copyright notice for papers submitted in or after January 2009: "This work is licensed under a Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited "
Copyright notice for papers submitted in or before 2008:
"Readers are reminded that this work is protected by copyright. While they are free to use the ideas expressed in it, they are not allowed to copy, distribute or publish the work or part of it, in any form, printed, electronic or otherwise, except for reasonable quoting, clearly indicating the source. Readers are permitted to make copies, electronically or printed, for non-commercial use, particularly personal or classroom use."
The authors retain copyright of their article.