Culture change matters more than technological change, US healthcare expert tells integrated care summit

BMJ 2012; 344 doi: (Published 03 May 2012) Cite this as: BMJ 2012;344:e3178
  1. David Payne
  1. 1BMJ

Integrating health and social care more closely should be seen as a sociological rather than technological challenge, says the US doctor who deployed electronic health records for hospital and clinics serving US veterans.

When Kenneth Kizer took over as head of the Department for Veterans Affairs in 1994, the staff was demoralised by the federal bureaucracy’s risk averse and punitive culture. Patients faced long waiting times, and the service was highly hospital-centric. First established in 1946 to provide treatment for veterans with combat related injuries, Veterans Affairs is now the largest provider of healthcare services in the United States, with outposts in Guam, Samoa, and …

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