Adela Mesa and Pedro Martínez‐Monje
NHS Subcommittee from the Spanish Central Government, about the weight and relevance of certain groups of barriers to the development of electronic healthcare governance in Spain.
This paper is therefore going to be structured as follows:( I) setting out the issue;( II) a second section in which we will show some of the issues relating to various groups of barriers to electronic government which we have emphasised here to be relevant in terms of digital inclusion( technical and design barriers, barriers regarding access, skills and uses of the ICT, and barriers relating to e‐Government);( III) We shall also stress the concrete characteristics of these barriers in the specific case of healthcare based on the partial results from the research and the main problems which it faces;( IV) finally we shall provide some conclusions and evaluation about the progress thus far;( V) we also cite some bibliographical references on the issue.
2. The barriers to the electronic government: The approach to the issue
The studies by the Oxford Internet Institute on barriers to electronic government have been a reference for many other studies on this subject( Schwester, 2009). In our case, we have taken its definition of barriers to electronic government as:“ those legal, social, technological or institutional characteristics – real or perceived – which act against the development of the electronic administration: whether because they impede the demand, act to prevent or hinder the users of the electronic Administration, or prevent the offer or act to stop or hinder the public sector organisations when it comes to providing electronic administration services »( ibid.). Through this definition we can differentiate the two main areas where the electronic Administration is used: that corresponding to the public instances( supply), and that corresponding to the users( demand); although it must be understood in a broader manner given the fact that within the administrative organisations themselves there are relations between those supplying and those demanding electronic administration( the internal market of the Administration itself). The extension of the information culture and the exponential potential of Internet are finding very little resistance in their introduction into the public arena, however the different consequences deriving from them must be taken into account as well as their impact.
The study within which this article is situated is focused on the different types of barriers facing the implementation and development of electronic government. The classification into groups of barriers( legal, social, technological, institutional), which are also interrelated, help us to identify their nature and therefore to try to discover the factors which slow down and even prevent said development and as a result to try to find ways to overcome them. Here we shall only present some groups of barriers, i. e. those which are more related to digital inclusion( another issue we are interested in) as a group of barriers which specifically refer to that aspect.
This research is therefore aimed at establishing an assessment of the development of electronic government in Spain, particularly in the area of health and for such purpose we have concentrated in the obstacles to said development. We seek to shed light on this matter based on prior studies and methodologies( Oxford Internet Institute, 2007; Schewester, 2009) which we have used to prepare a specific questionnaire for the case in question( the intergovernmental relations between the Autonomous Regions on the matter of health through the development of electronic government).
As regards the methodology which we have followed, at the beginning we select the groups of barriers which we could face and afterwards, and taking into account the different issues deriving from each of them, we draft the different questions on the questionnaire placing special emphasis on carefully specifying the terms used.
These groups of barriers are as follows: 1) technical and design barriers, 2) administrative and organizational barriers, 3) barriers to interoperability, 4) barriers regarding access, the skills and uses of the ICT, 5) barriers relating to security and privacy, 6) barriers relating to the e‐Government policies, 7) barriers relating to the regulatory elements, 8) economic elements, 9) specific barriers in the healthcare sector. As already mentioned, from these we have selected some groups of barriers for this article.
The questionnaire was set out according to these nine groups or blocks with a total of 52 propositions on which it was necessary to assess the degree to which it could constitute a barrier to the development of e‐ Government. The response level consisted of 5 categories: 1) it is not a barrier, 2) it is a very small barrier, 3) it is a small barrier, 4) it is a big barrier, 5) it is a very big barrier.
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