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Transforming care and health through information and technology: Local Investment Programme – Interim Report

By Dr Adam Hoare

Local Government Association – Local Investment Programme

Local Government Association Local Investment Programme Interim Report

Local Investment Programme – Interim Evaluation Report

In 2017 the Local Government Association in collaboration with NHS Digital introduced the Local Investment Programme. The programme recognised that the imperative for local care services to transform has never been greater due to rising needs, citizen demands and expectations alongside sustained pressure on resources. Although technology will never be a replacement for the delivery of care it can, if used appropriately, support people to live at home for longer, enable professionals to work more effectively together and help commissioners target services where they have the greatest impact. The Local Investment Programme (LIP) supported transformation through one-off local investment funding of up to £50,000 for projects that seek to use information and technology to improve adult social care and health outcomes and deliver financial savings as well as supporting more resilient care services and in improving outcomes, including people’s experience of care.

The programme was underpinned by a number of key principles:

  • encouraging open and replicable approaches which enable other LAs to adopt digital ways of working
  • supporting innovation and new thinking within adult social care and health, assisting its digital maturity within a challenging financial environment
  • assisting cross-council or multi-agency use of information and technology
  • developing an evidence-base and tools to support ongoing local digital investment in adult social care and health.

It was expected that the outputs and learning from these projects would be reusable and replicable, enabling them to be shared and implemented widely across the sector.

Councils who were successful in their bids for funding received support from an external partner organisation to help evaluate benefits, capture learning and support dissemination to assist other local areas. Participating local authorities were required to actively support this work, over the course of the programme, including in the development of guidance and tools for the sector.

The Bayswater Institute and OPM Group (now Traverse) were successful in winning the opportunity to evaluate the 19 technology interventions funded by the programme. In April 2018 an interim report was produced capturing the learning on the ground as well as considering the programme itself.

 

Representing Socio-Technical Systems Options in the Development of New Forms of Work Organization

Abstract:

It is widely accepted that effective implementation of new technology into work organizations needs an integrative approach in which developments in both technical and social systems are considered. Furthermore, success depends upon the effective participation of significant stakeholders in this process. This article reviews the methods available for this purpose and concludes that a particular weakness is the methods that can be used to generate and review socio-technical system opportunities early in the development process. Whilst methods exist to support stakeholder participation at this stage, they need to represent future socio-technical opportunities if they are to make an effective contribution. This article presents the ORDIT (Organizational Requirements Definition for Information Technology Systems) methodology, which uses responsibility modelling as a basis for constructing socio-technical systems opportunities. The application of telemedicine in health care is presented as a case study to demonstrate how this method can be used to construct and evaluate socio-technical scenarios.

Socio-technical Systems Work Organisational Development Information Technology

Publication at Taylor and Francis Online

Eason K.D. Harker S.D.P. and Olphert C.W. (1996) Representing Socio-Technical Systems Options in the Development of New Forms of Work Organization. European Journal of Work and Organizational Psychology 5(3) 399-420

DOI Link

The National Health Service National Programme for Information Technology (NPfIT): A Socio-technical Systems Perspective

From the book ‘Integrating Healthcare with Information and Communication Technology’ addressing the National Programme for Information Technology in the NHS

The book ‘Integrating healthcare with information and communication technology’ presents a collection of essays that discusses a set of challenges that arise when attempts are made to integrate Information and Communication Technology (ICT) into health care services. By exploring the outcomes of the National Programme for Information Technology (NPfIT) in the NHS in England the book attempts to learn from experience. It recognises that interoperable information systems are paramount for efficient integrated care, and contributions to explore ICT in the ongoing transformation processes towards seamless care should be of importance for the integrated care community.

The book consists of eleven chapters and the book is organised into three parts: Transforming Health Care Services using ICT, Electronic Health Records (EHR) and Global ICT Adoption and Implementation in Health Care. This national programme offered a wealth of learning about user-centred design, action research, understanding the intent of technology development and the impact of technology interoperability. The value of such learning is that by understanding where the approach was successful and not so successful future programmes could be better designed.

Information and Communications Technology National Programme for Information Technology NPfIT

Review in the International Journal of Integrated Care

Link to Amazon Listing

EASON K.D. The National Health Service National Programme for Information Technology (NPfIT): A Socio-technical Systems Perspective. In Currie W. and Finnegan D. (eds) ‘Integrating healthcare with information and communications technology’ Radcliffe, Oxford 183-204

People and Computers: Emerging Work Practice in the Information Age

A chapter in the book ‘Psychology at Work’ reviewing the impact of information technology on work practice and the link between people and work

 

Psychology at work Ken Eason People and computers emerging work practice in the information age

Amazon Book Link

EASON K.D. People and Computers: Emerging Work Practice in the Information Age. In P.B.Warr (ed) ‘Psychology at Work’ Penguin, London, 5th Edition pp 77-99 ISBN 0-14-100010-4

Changing Perspectives on the Organizational Consequences of Information Technology

Abstract:
Early predictions of the impact of computers on organizations ranged from ‘human – computer symbiosis’ to automation and the collapse of jobs. The findings from impact research show that there was evidence for all predictions that were made. This demonstrated that the technology is very flexible and can be deployed to facilitate many different organizational outcomes. However, more recent research shows that the design process despite significant progress in the adoption of user-centred methods remains technocentric and organizational outcomes are often unplanned and unwanted. The paper concludes that current predictions about the development of virtual organizations are likely to be over simplistic and that the usage of methods to assess organizational options and design socio-technical systems are necessary if emerging forms of technology are to be effectively deployed.

EASON K.D. Changing Perspectives on the Organizational Consequences of Information Technology, Behaviour and Information Technology 20(5) pp 323-328

Understanding the Organisational Ramifications of Implementing Information Technology Systems

Handbook of Human-Computer Interaction (Second Edition)

Publisher Summary:
Information technology is a major force for organizational change. Every organization that applies the technology experiences organizational ramifications. This chapter charts the development of different models of organizational effects over a 40-year period. During the 1960s and 1970s, many studies of organizational impact were undertaken that produced conflicting results. As a result, a contingency model of computer impact emerged that accounted for the different impacts by reference to different forms of technology and application. In the last decade, it has become clear that this is also an inadequate model because it does not allow for the active nature of organizations that act to shape the impact of the technology. The chapter examines nine case studies to explore the processes by which organizational impact takes place. The active manner in which these processes operate is summarized in model three. This is an organizational assimilation model in which the three sub-systems of an enterprise interact and create outcomes in each sub-system. The chapter ends with a review of the many methods now available to support this approach and outlines the need for organizational stakeholders to play significant roles in new system developments.

Human Computer Interaction User Centred Design Organisational Impact Information Technology

Google Books Link

Science Direct Link

Eason K. D. (1997) Understanding the organisational ramifications of implementing information technology systems. In ‘Handbook of Human-computer interaction’ M.G. Hollander, T.K. Landeaur and P.V. Prabhu (eds) , Amsterdam, Elsevier

DOI Link

Early Evaluation of the Organisational Implications of CSCW Systems

Evaluation of Computer Systems which Support Cooperative Work (CSCW)

Abstract:
Computer systems which support cooperative work will undoubtedly change the way people interact with one another in a working setting. In stimulating these changes, the CSCW system will be a force for organisational change. Over the past twenty years there has been a tradition of impact research, in which investigators have studied the impact computer-based information systems implemented within organisations have had upon those organisations. The results have been many and varied. Some studies show that computer systems lead to the centralisation of power, while others show decentralisation of power. At the level of the individual job there are studies which show the empowerment of the individual and the opposite: the creation of the “white collar assembly line.” A study from 1983 demonstrated both job enrichment and deskilling from two different computer systems in the same organisation. There is widespread agreement that there can be substantial change, but very little agreement on the form that it takes. We have argued elsewhere (Eason 1988) that the reason for these diverse results is that computer systems are not deterministic, and that they can be used to achieve many different organisational effects. There is an opportunity in the design and development process to plan the organisational outcomes and to achieve the impact that is desired by the members of the organisation.

Early Evaluation of the Organisational Implications of CSCW Systems Ken Eason

Springer Link to Article

Eason K.D. and Olphert C.W. (1996) Early evaluation of the organisational implications of CSCW Systems, In Thomas P. (ed) ‘CSCW Requirements and Evaluation, Springer-Verlag, London 75-89

How to Fail When Introducing Electronic Technologies into Organisations

The challenges of large scale IT projects viewed through the National Programme for IT – NPfIT

Abstract:
The history of computer applications is littered with examples of large and expensive IT systems failing when they were implemented in organisations. This paper illustrates how this happens by describing the case of the NPfIT, the National Programme for IT, in the UK National Health Service. It was introduced with a great fanfare in 2004 to standardize electronic patient records across the NHS and was ‘dismantled’ in 2011 having cost somewhere between £12 and £20 billion.

The paper concludes this programme encountered major problems because it adopted a top down, technocentric approach that led to a ‘one size does not fit all’ response from health agencies of widely different types. A major lesson is that these developments have to be treated not just as technical developments but as sociotechnical developments, i.e. the organisational and technical changes have to be treated in parallel and as interdependent entities. The paper offers six principles for the implementation of new technology into organisations that may improve the chances of users being able to harness the potential of new technology.

IEEE Explore Link

Eason K.D. How to fail when introducing electronic technologies into organisations. Proceedings of DESE 2016 (Developments in eSystems Engineering’, Liverpool September

 

Local Sociotechnical System Development in the NHS National Programme for Information Technology

National Programme for IT Electronic Health Records – User Perspectives

Abstract:
The National Programme for IT is implementing standard electronic healthcare systems across the National Health Service Trusts in England. This paper reports the responses of the Trusts and their healthcare teams to the applications in the programme as they are being implemented. It concludes that, on the basis of the data available, it is likely that the emergent behaviour of healthcare staff will serve to minimise the impact of the systems. The paper looks at the opportunities within the programme to undertake local sociotechnical system design to help staff exploit the opportunities of the new electronic systems. It concludes that there are opportunities and offers one case study example in a Mental Health Trust. However, it concludes that there are many aspects of the technical systems themselves and also of the approach to implementation, that limit the opportunities for local sociotechnical systems design work.

Local Sociotechnical System Development in the NHS National Programme for IT Ken Eason

Springer Link

EASON K.D. Local sociotechnical system development in the NHS National Programme for Information Technology, Journal of Information Technology 22 (3) 257-264