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The adoption of electronic health records (EHRs) and digitization of health data over the past decade is ushering in the next generation of digital health tools that leverage artificial intelligence (AI) to improve varied aspects of health system performance. The decade ahead is therefore shaping up to be one in which digital health becomes even more at the forefront of health care delivery – demanding the time, attention, and resources of health care leaders and frontline staff, and becoming inextricably linked with all dimensions of health care delivery. In this chapter, we look back and look ahead. There are substantive lessons learned from the first era of large-scale adoption of enterprise EHRs and ongoing challenges that organizations are wrestling with – particularly related to the tension between standardization and flexibility/customization of EHR systems and the processes they support. Managing this tension during efforts to implement and optimize enterprise systems is perhaps the core challenge of the past decade, and one that has impeded consistent realization of value from initial EHR investments. We describe these challenges, how they manifest, and organizational strategies to address them, with a specific focus on alignment with broader value-based care transformation. We then look ahead to the AI wave – the massive number of applications of AI to health care delivery, the expected benefits, the risks and challenges, and approaches that health systems can consider to realize the benefits while avoiding the risks.

This paper describes our experiences from a two‐year research study to introduce evidence‐based practice (EBP) through a set of electronic information tools into two Canadian health regions. The improvisational model of technological change by Orlikowski and Hofman (1997) is used to provide the conceptual foundations for understanding the pattern of evolution associated with the tools observed in these two settings over time. Key areas to consider when changing practice identified from this study are time availability, intended use, adequate training, clinical champions, work practice fit, system refinement, around‐the‐clock support and environment influence. Health organizations should also distinguish anticipated, emergent and opportunistic changes and improvise accordingly when introducing EBP information tools in a setting that is characteristically complex, dynamic and unpredictable.

The purpose of this paper is to identify the influential agents that led to the successful acceptance and diffusion of the Concerto clinical workstation at the Northern District Health Board.

The paper draws on Rogers’ diffusion of innovation theory to interpret and analyse the factors that enabled acceptance and successful implementation of the innovative Concerto clinical workstation.

The authors conclude that human factors (clinicians) and non-human factors (the software package) simultaneously influenced the ready acceptance of the innovation. The reason for the positive acceptance and full diffusion of Concerto as compared to iHealth is the increased functionality it offers and its ability to provide clinicians with comprehensive patient records over a period of time, which assists in making informed decisions regarding the treatment, discharge, hospitalisation and recommendations for the future well-being of patients.

The study focused on only one district health board (DHB); therefore, the outcomes may not be representative of all DHBs.

The study has practical implications for clinicians, DHB members and public health regulators. The outcomes illuminate the “agents” that positively influenced the diffusion of Concerto. The regulators and the DHBs can use this as a benchmark to determine how to lead the successful diffusion of information technology (IT) innovation in the public health sector.

The impact on society is evident in the paper, as the use of an innovation, such as Concerto, saves time taken by clinicians to make more informed decisions regarding their patient care.

This study contributes to new knowledge by investigating the diffusion process of IT innovation with an intention of establishing the factors that enabled this process.

While there has been substantial discussion about the potential for clinical leadership in improving quality and safety in healthcare, there has been little robust study. The purpose of this paper is to present the results of a qualitative study with clinicians and clinician managers to gather opinions on the appropriate content of an educational initiative being planned to improve clinical leadership in quality and safety among medical, nursing and allied health professionals working in primary, community and secondary care.

In total, 28 clinicians and clinician managers throughout the state of Victoria, Australia, participated in focus groups to provide advice on the development of a clinical leadership program in quality and safety. An inductive, thematic analysis was completed to enable the themes to emerge from the data.

Overwhelmingly the participants conceptualised clinical leadership in relation to organisational factors. Only four individual factors, comprising emotional intelligence, resilience, self‐awareness and understanding of other clinical disciplines, were identified as being important for clinical leaders. Conversely seven organisational factors, comprising role clarity and accountability, security and sustainability for clinical leaders, selective recruitment into clinical leadership positions, teamwork and decentralised decision making, training, information sharing, and transformational leadership, were seen as essential, but the participants indicated they were rarely addressed. The human resource management literature includes these seven components, with contingent reward, reduced status distinctions and measurement of management practices, as the essential organisational underpinnings of high performance work systems.

The results of this study propose that clinical leadership is an organisational property, suggesting that capability frameworks and educational programs for clinical leadership need a broader organisation focus.

The paper makes clear that clinical leadership was not perceived to be about vesting leadership skills in individuals, but about ensuring health care organisations were equipped to conceptualise and support a model of distributive leadership.

This paper examines existing research on the topic of personal health records (PHRs). Areas covered include PHR/patient portal, recordkeeping, preservation planning, access and provider needs for future reuse of health information. Patient and physician PHR use and functionality, as well as adoption facilitators and barriers, are also reviewed.

The paper engages in a review of relevant literature from a variety of subject domains, including personal information management, medical informatics, medical literature and archives and records management literature.

The review finds that PHRs are extensions of electronic records. In addition, it finds a lack of literature within archives and records management that may lead to a less preservation-centric examination of the new PHR technologies that are desirable for controlling the lifecycle of these important new records-type.

Although the issues presented by PHRs are issues that can best be solved with the use of techniques from records management, there is no current literature related to PHRs in the records management literature, and that offered in the medical informatics literature treats the stewardship aspects of PHRs as insurmountable. This paper offers an introduction to the aspects of PHRs that could fruitfully be examined in archives and records management.

The study aims to analyze the previous literature on government initiatives to implement health information systems (HISs).

Proknow-C (Knowledge Development Process-Constructivist) was used in the selection of the literature and in the bibliometric and systematic analysis.

The research identified a portfolio composed of 33 articles aligned with the research theme and with scientific recognition, as well as periodicals, authors, papers and keywords that stood out the most. Amongst the government initiatives in the 24 identified countries, England has been the most studied nation, and there is a certain prominence of research arising from developed countries. Electronic health records (EHRs) have been the most explored technology. Efficiency and safety of health care delivery, integration of information and among health organizations, cost reduction and economicity are the most expected benefits from government programs. The difficulties found are related to the broader context in which the system is inserted, to the management of the program, to technology itself and to individuals. The most emphasized difficulties identified in most countries were previous context marked by a lack of standardization/interoperability, acceptance of providers and users and project financing. The findings of the present article provide a theoretical framework for future studies, in addition to yielding a replicable process for future use.

This research may be considered original as it analyzes – through a constructivism-structured process (Proknow-C) – the phenomenon under investigation by gathering bibliometric and systematic review data concomitantly. The countries and technologies reported emerge from the process itself.

This paper aims to, by looking at the electronic medical record (EMR) from three points of view, bring light to the dynamics that are essential and are currently missing in the USA. The traditional paper medical record has worked for physicians, management and patients since the beginning of practice. Yet the development of the EMR did not begin with all the essential elements of the traditional record that were working, but instead shreds out important aspects of the patient.

Triangulation between three studies – medical, information technology and management studies.

An efficient EMR has to take into consideration more than just one area of study. The dynamics between departments and users of the EMR need an integrated process that includes the necessary pieces of all involved. This hole has not been addressed in academic literature.

The paper triangulates three areas – medicine, management and information management. Most research on the EMR focuses only on one or two of these areas’ concerns. Looking at the three sides of the EMR is important to get a solid understanding of the dynamics that can occur relaying a patient’s story through various departments and uses.

There is a depth, space and volume crucial to the comprehensive nature of medicine. With a perspective or dimension, necessary dialogues can be addressed and more intuitive tacit knowledge from medical expertise can be made available. A prototype, filling the holes of the observed elements in this paper, is possible by using digital objects and including more information than the data of the day. Bringing accountability to the patient, more expertise to the fingertips of the physician and available data for management purposes area are the key ingredients for an effective EMR.

With a comprehensive EMR that works more effectively for those who input the data, the patient’s story can be documented with more detailed efficiency. Filling the holes of the observed elements in this paper all support better healthcare and long-term results for the health of society.

The paper triangulates three areas – medicine, management and information management. Most research on the EMR focuses only on one or two of these areas’ concerns. Looking at the three sides of the EMR is important to get a solid understanding of the dynamics that can occur relaying a patient’s story through various departments and uses.

The purpose of this paper is to argue that monitoring of symptoms through self‐assessed data is not only a vital part of record taking in mental health care, but can also aid patients in their recovery, giving them more of a say in their healthcare, and providing a record of progress for both patients and clinicians.

A literature search was undertaken to identify ways in which self‐assessed data is used in mental health care and to examine how successful this approach may be in aiding recovery and whether patients are able and enthusiastic to participate in this approach. Ideas for effective approaches to utilising self‐assessed data into mental health care are suggested.

There were clear indications from the literature that the use of self‐assessed data improves health outcomes and that patients enjoy the process. This approach promotes greater inclusion of individuals in the management of their health care.

Self‐assessed data can be presented to doctors which may inform their decisions about their patients and be used as a reference for patients to see their progress towards recovery. It may also aid recognition of symptoms by patients.

The paper proposes that self‐assessed data should be used routinely in mental health care to complement traditional note taking by clinicians. It sets out a unique method for recording symptoms using a simple, easy to use, symptom scale. It is also proposes to measure medication dose and type, so that progress or otherwise can be compared with medication over time.

The purpose of this paper is to examine the literature published on information literacy (IL) from 2005 to 2014 and reveal the key aspects of IL publication trends.

The study analyses the literature indexed in Web of Science database on IL from 2005 to 2014 and used the required bibliometric measures to analyse specific aspects of publishing trends.

The findings of the study reveal that increase in literature on IL from 2005 to 2014 was noticed. A high amount of annual growth of literature on IL is observed for the year of 2007, 2008 and 2011. “Pinto, M” and the “University of Granada, Spain” was productive author and institute. Journal of Academic Librarianship was the most productive journal, with 97 articles being published for the period. USA was the most contributing country. “Digital divide”, “media literacy”, “pedagogy”, “higher education” and “critical thinking” were current research topics in the IL domain.

The paper is very useful for researchers to learn about trends in the literature on IL, as well as possible areas for further research, and it provides the names of the most productive authors, organizations and countries, along with the most popular IL keywords.