E-Health and Society: An Empirical Study of Catalonia

Between 2005 and 2007 I worked in a research project titled Project Internet Catalunya – Technological Modernisation, Organisational Change and Service Delivery in the Catalan Public Health System (PIC Salut) directed by Prof. Castells and supported by Catalonia Government. I’m glad to announce that the English summary is already available: E-HEALTH AND SOCIETY: An Empirical Study of Catalonia (see Spanish version PIC Salud – Modernización tecnológica, cambio organizativo y servicio a los usuarios en el sistema de salud de Catalunya).

Summary

This study examines the health related uses of the Internet and information and communication technologies (ICTs) in Catalonia. It is a multilevel study that comprises the observation of the population at large, of health professionals, and of health care organizations, such as Primary Care and Hospitals.

It is based on 7,784 on-line interviews, and on 106 face to face interviews, as well as on extensive field work research and direct observation of health organizations in Barcelona, Vic, Sabadell, Palamós, and Tarragona. It was conducted between April 2005 and July 2007.

Conclusions

The different studies we have conducted show a generally positive feeling among health
care professionals, patients, and the population at large on the uses of Internet and ICTs in the health care processes. Furthermore, most professionals, doctors and nurses alike, are intensive Internet users at home. Patients are eager to consult health matters on the web.

Primary care centers and hospitals are also gradually using e-health management and service delivery systems, although the introduction of SAP-Health is still exceptional and the training of the personnel to use advanced health care systems is limited and critically perceived by the nurses and auxiliary personnel.

While the uses of Internet and Intranets for information are widespread, the uses for communication are very limited, with the exception of communication among physicians and among researchers. Patients are largely excluded from online interaction with health care professionals and their online support groups rarely receive permanent advice. While doctors are positive towards the health uses of the Internet, they distrust the use that patients could make of unguided information and prefer to maintain the traditional, personal interaction with their patients.

Thus, the uses of ICTs in the health system do not seem to yield significant increases in productivity, efficiency and quality because their introduction is rarely accompanied by the organizational, managerial, and cultural changes necessary to set up an interactive network at the heart of the health delivery system. ICTs are tools confined in specific functions, not a platform permeating the entire process of health delivery. Furthermore, the updating of the technological infrastructure of the health system would require considerable investment whose justification is not obvious in the absence of an organizational restructuring of the health care units, particularly of the large public hospitals.

Thus, cultural resistances and organizational routines present a major obstacle to the technological overhauling of the health care system, a project that appears to be indispensable to be able to simultaneously control health costs and improve health care quality.

Empirical data of chapter one and two and the results of another research project titled Citizens, Health and the Internet in Catalonia directed by Prof. Castells and based on a telephone survey (2,000 interviews) are the materials of my dissertation. So comments will be very welcome, specially those related to chapter one, chapter two and conclusions.