This paper describes an exploratory study of networked organisations in the health care sector. Based on a review of literature on networked organisations, a theoretical framework is developed and applied to three case studies. The results indicate that networked organisations in health care services are mainly driven by socio-economic and organisational conditions, in which information and communication technology plays an increasingly important facilitative role. Furthermore, the case findings indicate that networked organisations in health care develop through different phases: from pilot practices to institutionalisation. Lessons are drawn from the case studies for practice and the applicability of the theoretical framework.

This article explores the effects of health information technologies (HIT) in operating rooms (ORs). When functioning well, HIT are a boon to mankind. However, HIT in the OR also create hazards for patients for a number of interrelated reasons. We introduce 5 interrelated components of hazard situations for medical teams operating in the OR: complexity, overload/underload, inadequate individual training, inadequate training of medical teams, and overconfidence of surgeons. These components of hazard situations in the OR may negatively impact patient safety. We discuss implications, especially in terms of individuals and medical teams in the OR, as well as work substitution as a broader aspect of the potential dark side of health IT.

This article explores the effects of health information technologies (HIT) in operating rooms (ORs). When functioning well, HIT are a boon to mankind. However, HIT in the OR also create hazards for patients for a number of interrelated reasons. We introduce 5 interrelated components of hazard situations for medical teams operating in the OR: complexity, overload/underload, inadequate individual training, inadequate training of medical teams, and overconfidence of surgeons. These components of hazard situations in the OR may negatively impact patient safety. We discuss implications, especially in terms of individuals and medical teams in the OR, as well as work substitution as a broader aspect of the potential dark side of health IT.

Applications of Information Technologies (ITs) are increasing in the healthcare domain. Recent developments in ITs towards a digital hospital address medical practitioners and patients within the walls of the hospital. Little attention has been given to crossing these walls, for example, supporting relatives of hospitalized patients. BabyMobile crosses traditional boundaries of the hospital by the use of standard ITs. It explores the potential benefit brought by applications in the connecting area of Health Informatics/Telematics. With healthcare moving towards a much more patient-orientated approach, relatively simple and low cost applications can contribute to the well-being of patients and their relatives.

Information Technology (IT) is an important enabler in supporting the growing demand for healthcare services and the growing complexity of healthcare services. IT is also a cost driver of importance in healthcare services; hospitals spend an estimated 3% of their annual revenues on IT. These factors make that IT expenditure is of strategic importance to local and national healthcare policy makers. This paper addresses the question often raised by hospital management; how much do we spend on IT and on what do we spend it? An analysis of the expenditure of IT of a Dutch hospital (1996-2005) gives an insight usable as a reference for other hospital management and Information System researchers on how to approach IT expenditure evaluation. The discussion generates important issues for further research in IT expenditure in healthcare services.

E-learning and virtual classrooms have proven to be efficient ways to discuss, to exchange information and to build shared knowledge amongst distributed participants. The paper presents the evaluation of three multimedia technologies that were developed to support e-learning for nurses (n = 84) working in shift at the hospital. The multimedia tools have been tested using the Technology Acceptance Model (TAM). The paper discusses the optimisation of e-learning in healthcare along the choice of four variables: professional culture, technology fit, content of the course and cost. It concludes that with the support of appropriated Information Communication Technologies (ICTs), e-learning improves the quality of education in a cost-effective way.

Applications of Information Technologies (ITs) are increasing in the healthcare domain. ITs have been proven to be a support for the dissemination of knowledge and training amongst specialists in the use of computer-aided surgery [2]. The development of new technologies advances care opportunities for patients, e.g., improving patient well-being by reducing pain through clinical investigation [6]. Recent developments in ITs towards a digital hospital [8] address medical practitioners and patients within the walls of the hospital. Little attention has been given to crossing these walls, for example, supporting relatives of hospitalized patients. This column presents an example of traditional boundaries of the hospital disappearing by the use of standard ITs. It explores the potential benefit brought by external system integration in the connecting area of Health Informatics/Telematics.

With the increased use of electronic patient files in Health Care Organizations (HCOs), addressing the risks related to the storage and use of patient information has become increasingly important to avoid intentional or unintentional disclosure, damage to or abuse of patients’ personal health records. This has lead governments from various countries to introduce and impose information security standards for HCOs. The Dutch government introduced the NEN 7510 national information security standard; a standard derived from the international ISO 17799 norm. Preceding the implementation phase of NEN 7510 standard at a Dutch HCO, we conducted a field study to identify the information security risks as perceived by the main stakeholder groups in the HCO. We present the differences in the perceived information security risks and threats by end users, management and suppliers, and the degree to which these identified risks will be addressed by the implementation of the NEN 7510 standard.

E-learning and virtual classrooms have proven to be efficient ways to discuss, exchange information and build shared knowledge amongst distributed participants. The paper presents 3 years of experiences gathered and the lesson learned through of an e-learning project conducted at the Catharina hospital. Results show that in such a 24-hour organization, he main advantage, of e-learning is to offer health care professionals the possibilities to engage in learning activities at a convenient time from their working place or from home. It emphasizes particularly on the importance to implement appropriated multimedia technologies. In one hand these new technologies bring a social dimension to the e-learning environment,, and in the other hand are of help to the instructors facing many electronic questions and comments. A classification grid is used to guide the complex and essential steps required deciding upon the use and the development of an electronic course in the healthcare sector. Special attention was given to the implementation of new multimedia technologies based on the expected fit between the learning strategy and the technology. With the support of appropriated multimedia tools , e-learning have been found to improve the quality of education in a cost-effective way, especially for nurses (N=84). The paper concludes that more research pilots have to be conducted in order to narrow down the classification .

The paper describes the implementation and acceptance of e-learning in a hospital environment using off-the-shelf technology. Twenty-eight nurses participated in a pilot study that was designed to support an electronic course on advanced electrocardiogram interpretation. The paper presents the procedure and the technologies used to support the e-learning activities. As a follow up of the pilot study, a survey was built and distributed amongst the caregivers of the hospital (N=203). The paper concludes first that the content of the course, a socially structured e-learning environment, as well as the available technologies are important factors to a successful implementation of an e-learning project. Secondly, the paper concludes that the acceptance of such a system to learn is widely supported amongst nurses but seems less convincing to paramedics and physicians. E-learning cannot be perceived as a substitute of a traditional face-to-face education, but when the e-learning environment is socially well structured, it becomes an efficient support to education in the hospital context.

New information technologies can be efficiently used to fill in the gaps in the human need of communication during the difficult time of hospitalization. The Telebaby® project was designed and supported by the University Medical Centre Utrecht. Telebaby® links parents from home to their newborn receiving intensive, high or medium care. The monitoring of the login behavior of the parents has shown that standard Internet technology for distributing multimedia allows parents to virtually “visit” their baby more often. The preliminary results indicate that Telebaby® offers the parents the feeling of control and principally reduced the state of anxiety associated to the mother-child separation. A simple system like Telebaby® was easily adopted by the parents and has proven to be an efficient concept. Implementing Telebaby® in a hospital environment proved to be a real challenge.

New information technologies are used to fill gaps in our need for communication. Hospitals are now starting to discover the possibilities of multimedia communication for their patients. Telebaby is a project of the University Medical Centre Utrecht that allows parents to view their newborn on the intensive care, high care or medium care unit at home. Standard Internet technology for distributing multimedia allows parents to virtually "visit" their baby more often and give parents the feeling of control. A non-complex technical system like Telebaby is easily adopted by the parents, implementing it in a closed environment like a hospital is the real challenge.

The paper describes an exploratory study of new organisational forms in hospitals. The study focuses on ICT-enabled networking in hospital organisations. Two Dutch hospitals (one general and one categorical) and a German hospital (university) were analysed. Hospitals develop through different levels of networking and phases of organisational focus. Strategic drivers and incentives are improvement of efficiency and effectiveness of the primary care process. Enabling conditions are a clear hospital strategy and an open and flexible hospital information system that supports network transactions and processes. The design and functioning of the network is conditioned by: (a) the not-for-profit market, (b) the organisational focus, and (c) the involvement of internal and external stakeholders. The measurability of performance increases as the organisational focus evolves. More research is called for to understand the complexity and dynamics of hospital network organisations.

This paper describes the design and development of electronic network organisations in health care. The strategic drivers, design and ICT infrastructure of electronic health care network are outlined. Based on an in-depth investigation of electronic health care networks, this paper summarises the main lessons learned and the critical success factors. The implications for research and directions for health care practice are discussed.