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Abstract 
Health Information Managers (HIMs) are responsible for overseeing health information. The change management necessary during the transition to electronic health records (EHR) is substantial, and ongoing. Archetype-based EHRs are a core health information system component which solve many of the problems that arise during this period of change. Archetypes are models of clinical content, and they have many beneficial properties. They are interoperable, both between settings and through time. They are more amenable to change than conventional paradigms, and their design is congruent with clinical practice. This paper is an overview of the current archetype literature relevant to Health Information Managers. The literature was sourced in the English language sections of ScienceDirect, IEEE Explore, Pubmed, Google Scholar, ACM Digital library and other databases on the usage of archetypes for electronic health record storage, looking at the current areas of archetype research, appropriate usage, and future research. We also used reference lists from the cited papers, papers referenced by the openEHR website, and the recommendations from experts in the area. Criteria for inclusion were (a) if studies covered archetype research and (b) were either studies of archetype use, archetype system design, or archetype effectiveness. The 47 papers included show a wide and increasing worldwide archetype usage, in a variety of medical domains. Most of the papers noted that archetypes are an appropriate solution for future-proof and interoperable medical data storage. We conclude that archetypes are a suitable solution for the complex problem of electronic health record storage and interoperability.

Abstract 
The unimpeded functioning of hospital Health Information Services (HIS) is essential for patient care, clinical governance, organisational performance measurement, funding and research. In an investigation of hospital Health Information Services’ preparedness for internal disasters, all hospitals in the state of Victoria with the following characteristics were surveyed: they have a Health Information Service/ Department; there is a Manager of the Health Information Service/Department; and their inpatient capacity is greater than 80 beds. Fifty percent of the respondents have experienced an internal disaster within the past decade, the majority affecting the Health Information Service. The most commonly occurring internal disasters were computer system failure and floods. Two-thirds of the hospitals have internal disaster plans; the most frequently occurring scenarios provided for are computer system failure, power failure and fire. More large hospitals have established back-up systems than medium- and small-size hospitals. Fifty-three percent of hospitals have a recovery plan for internal disasters. Hospitals typically self-rate as having a ‘medium’ level of internal disaster preparedness. Overall, large hospitals are better prepared for internal disasters than medium and small hospitals, and preparation for disruption of computer systems and medical record services is relatively high on their agendas.

Abstract Mercy Medical Center – North Iowa implemented electronic health records (EHR), computerised provider order entry (CPOE) and event tracking systems in the emergency department (ED) as part of hospital-wide implementation of clinical information systems. This case study examines the changes in outcomes and processes in the ED following implementation. Although the system was designed to enhance efficiency, there was a significant increase in the mean length of stay (about 17 minutes, or 15%) in the ED after implementation. This surprising finding was examined in relationship to the multiple process-of-care changes in the ED.

Abstract Implementation of an electronic medical record (EMR) system increases efficiency of health services, quality of care and patient satisfaction. Successful implementation depends on many factors, one of which is how users respond to the new system. We studied medical receptionists’ appraisal of the newly implemented EMR system in primary healthcare centres in Kuwait. Four hundred receptionists were selected randomly from different healthcare centres and asked to complete a user interaction satisfaction questionnaire relating to their experience of the new system. The response rate was 80.5%. A large majority of the respondents considered the system to be flexible (83%), easy (89%), and satisfying (81%). However, more than one third of the respondents (36%) found the system inadequate. Bivariate and multivariate analyses found age, typing ability, ease of data entry and computer error as significant correlates with overall user response. These findings relating to users’ reactions to various aspects of the EMR should assist policymakers to recognise the causes of dissatisfaction with the EMR among medical receptionists at health centre clinics that may adversely affect its successful implementation and regular use, as well as the quality of care provided by the clinics. In addition, the findings provide information to assist the development of guidelines for future implementation of the EMR system at the secondary healthcare level.