Assessing the impact of health information technology on community health administration
Keywords:
health information technology, test result management, patient engagement, electronic health records, systematic reviewAbstract
Background: Health Information Technology (HIT) plays a crucial role in patient care, especially in managing laboratory test results. Inadequate follow-up of these results is a significant patient safety concern globally. This systematic review aims to synthesize existing quantitative and qualitative research on the impact of HIT on test result management and patient engagement, highlighting the effectiveness of various HIT systems and identifying gaps in current practices. Aim: The review seeks to assess how HIT improves follow-up and management of test results, enhances patient engagement, and identifies challenges associated with its implementation. Methods: A systematic review methodology was employed, incorporating 57 studies published primarily between 2006 and 2018. The studies included randomized controlled trials, observational studies, mixed-methods studies, and qualitative studies, focusing on HIT interventions such as electronic alerts, electronic health records (EHRs), and patient portals. Results: The review revealed that HIT systems, particularly electronic alerts and patient portals, significantly improve clinician awareness of test results and reduce missed follow-ups. However, the evidence quality varied, with many studies indicating an increased clinician workload due to alert fatigue and the complexity of hybrid paper/electronic systems.
Downloads
References
Wolcott J , Schwartz A, Goodman C. Laboratory Medicine: A National Status Report;2008. Available at:https://stacks.cdc.gov/view/cdc/30726.
World Health Organization, World Alliance for Patient Safety, Research Priority Setting Working Group. World Alliance for Patient Safety - Summary of the Evidence on Patient Safety: Implications for Research. Geneva: World Health Organization; 2008.
ECRI Institute. Top 10 Patient Safety Concerns for Healthcare Organizations; 2017. www.ecri.org/PatientSafetyTop10. Accessed July 2017.
Poon EG , Gandhi TK, Sequist TD, et al. . “ I wish I had seen this test result earlier!”: dissatisfaction with test result management systems in primary care. Arch Intern Med2004; 16420: 2223–8. DOI: https://doi.org/10.1001/archinte.164.20.2223
Callen J , Georgiou A, Li J, et al. . The safety implications of missed test results for hospitalized patients: a systematic review. BMJ Qual Saf2011; 202: 194–9. DOI: https://doi.org/10.1136/bmjqs.2010.044339
Slovis BH , Nahass TA, Salmasian H, et al. . Asynchronous automated electronic laboratory result notifications: a systematic review. J Am Med Inform Assoc2017; 246: 1173–83. DOI: https://doi.org/10.1093/jamia/ocx047
Hanna D , Griswold P, Leape L, et al. . Communicating critical test results: safe practice recommendations. Jt Comm J Qual Patient Saf2005; 312: 68–80. DOI: https://doi.org/10.1016/S1553-7250(05)31011-7
Ash J , Singh H, Sittig D. Test Results Reporting and Follow-Up SAFER Guide; 2014. Available at: https://www.healthit.gov/sites/default/files/safer_test_results_reporting.pdf.
Singh H , Sittig DF. Measuring and improving patient safety through health information technology: The Health IT Safety Framework. BMJ Qual Saf2016; 254: 226–32. DOI: https://doi.org/10.1136/bmjqs-2015-004486
Schiff GD , Reyes Nieva H, Griswold P, et al. . Randomized trial of reducing ambulatory malpractice and safety risk: results of the Massachusetts PROMISES Project. Med Care2017; 558: 797–805. DOI: https://doi.org/10.1097/MLR.0000000000000759
Agency for Healthcare Research and Quality. Improving Your Laboratory Testing Process: A Step-by-Step Guide for Rapid-Cycle Patient Safety and Quality Improvement; 2018. Available at:https://www.ahrq.gov/news/improving-lab-testing.html
Partnership for Health IT Patient Safety. Closing the Loop: Using Health IT to Mitigate Delayed, Missed, and Incorrect Diagnoses Related to Diagnostic Testing and Medication Changes. ECRI Institute; 2018. Available at: https://www.ecri.org/Resources/HIT/Closing_Loop/Closing_the_Loop_Toolkit.pdf.
The National Patient Safety Foundation. Safety Is Personal; Partnering with Patients and Families for the Safest Care; 2014. http://www.npsf.org/about-us/lucian-leape-institute-at-npsf/lli-reports-and-statements/safety-is-personal-partnering-with-patients-and-families-for-the-safest-care/.
Australian Commission on Safety and Quality in Health Care (ACSQHC). National Safety and Quality Health Service Standards. Sydney, Australia: Commonwealth of Australia; 2012.
Bolton P. A doctor's duty to follow up preventable conditions: Young v Central Australian Aboriginal Congress - a bridge too far? NTLJ 2012; 2(3): 154.
Ammenwerth E , Schnell-Inderst P, Hoerbst A. The impact of electronic patient portals on patient care: a systematic review of controlled trials. J Med Internet Res2012; 14: e162. DOI: https://doi.org/10.2196/jmir.2238
Committee on Patient Safety and Health Information Technology; Institute of Medicine. Health IT and Patient Safety: Building Safer Systems for Better Care. Washington, DC: National Academies Press; 2011.
Carr S. Health IT and diagnostic safety: promise and peril. Improve Diagnosis2015; 2: 1–4.
Sittig DF , Murphy DR, Smith MW, et al. . Graphical display of diagnostic test results in electronic health records: a comparison of 8 systems. J Am Med Inform Assoc 2015; 22(4): 900–904. DOI: https://doi.org/10.1093/jamia/ocv013
Whitehead N , Williams L, Meleth S, et al. . Interventions to improve follow-up of laboratory test results pending at discharge: a systematic review. J Hosp Med2018. doi: 10.12788/jhm.2944. (Epub ahead of print). DOI: https://doi.org/10.12788/jhm.2944
Darragh PJ , Bodley T, Orchanian-Cheff A, et al. . A systematic review of interventions to follow-up test results pending at discharge. J Gen Intern Med 2018; 33(5): 750–758. DOI: https://doi.org/10.1007/s11606-017-4290-9
Moher D , Liberati A, Tetzlaff J, et al. . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med2009; 67: e1000097. DOI: https://doi.org/10.1371/journal.pmed.1000097
Graber ML , Franklin N, Gordon R. Diagnostic error in internal medicine. Arch Intern Med2005; 16513: 1493–9. DOI: https://doi.org/10.1001/archinte.165.13.1493
Critical Appraisal Skills Progam. CASP Qualitative Checklist. https://casp-uk.net/casp-tools-checklists/. Accessed June 2018.
National Heart Lung and Blood Institute. Study Quality Assessment Tools: US Department of Health and Human Services. https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools.
Chen TC , Lin WR, Lu PL, et al. . Computer laboratory notification system via short message service to reduce health care delays in management of tuberculosis in Taiwan. Am J Infect Control2011; 395: 426–30. DOI: https://doi.org/10.1016/j.ajic.2010.08.019
Etchells E , Adhikari NK, Cheung C, et al. . Real-time clinical alerting: effect of an automated paging system on response time to critical laboratory values—a randomised controlled trial. Qual Saf Health Care2010; 192: 99–102. DOI: https://doi.org/10.1136/qshc.2008.028407
Humphrey LL , Shannon J, Partin MR, et al. . Improving the follow-up of positive hemoccult screening tests: an electronic intervention. J Gen Intern Med2011; 267: 691–7. DOI: https://doi.org/10.1007/s11606-011-1639-3
Dalal AK , Roy CL, Poon EG, et al. . Impact of an automated email notification system for results of tests pending at discharge: a cluster-randomized controlled trial. J Am Med Inform Assoc2014; 213: 473–80. DOI: https://doi.org/10.1136/amiajnl-2013-002030
Laxmisan A , Sittig DF, Pietz K, et al. . Effectiveness of an electronic health record-based intervention to improve follow-up of abnormal pathology results: a retrospective record analysis. Medical Care2012; 5010: 898–904. DOI: https://doi.org/10.1097/MLR.0b013e31825f6619
Staes CJ , Evans RS, Rocha BH, et al. . Computerized alerts improve outpatient laboratory monitoring of transplant patients. J Am Med Inform Assoc2008; 153: 324. [Erratum appears in J Am Med Inform Assoc 2008; 15 (5): 708]. DOI: https://doi.org/10.1197/jamia.M2608
Singh H , Arora HS, Vij MS, et al. . Communication outcomes of critical imaging results in a computerized notification system. J Am Med Inform Assoc2007; 144: 459–66. DOI: https://doi.org/10.1197/jamia.M2280
Singh H , Thomas EJ, Mani S, et al. . Timely follow-up of abnormal diagnostic imaging test results in an outpatient setting: are electronic medical records achieving their potential?Arch Intern Med2009; 169: 1578–86. DOI: https://doi.org/10.1001/archinternmed.2009.263
Singh H , Wilson L, Petersen LA, et al. . Improving follow-up of abnormal cancer screens using electronic health records: trust but verify test result communication. BMC Med Inform Decis Mak2009; 9(1): 49. DOI: https://doi.org/10.1186/1472-6947-9-49
Singh H , Thomas EJ, Sittig DF, et al. . Notification of abnormal lab test results in an electronic medical record: do any safety concerns remain?American Journal of Medicine2010; 1233: 238–44. DOI: https://doi.org/10.1016/j.amjmed.2009.07.027
Hysong SJ , Sawhney MK, Wilson L, et al. . Provider management strategies of abnormal test result alerts: a cognitive task analysis. J Am Med Inform Assoc2010; 171: 71–7. DOI: https://doi.org/10.1197/jamia.M3200
Hysong SJ , Sawhney MK, Wilson L, et al. . Understanding the management of electronic test result notifications in the outpatient setting. BMC Med Inform Decis Mak2011; 11: 22. DOI: https://doi.org/10.1186/1472-6947-11-22
Wahls T , Haugen T, Cram P. The continuing problem of missed test results in an integrated health system with an advanced electronic medical record. Jt Comm J Qual Patient Saf2007; 338: 485–92. DOI: https://doi.org/10.1016/S1553-7250(07)33052-3
Wahls TL , Cram PM. The frequency of missed test results and associated treatment delays in a highly computerized health system. BMC Fam Pract2007; 8(1): 32. DOI: https://doi.org/10.1186/1471-2296-8-32
El-Kareh R , Roy C, Williams DH, et al. . Impact of automated alerts on follow-up of post-discharge microbiology results: a cluster randomized controlled trial. J Gen Intern Med2012; 2710: 1243–50. DOI: https://doi.org/10.1007/s11606-012-1986-8
Kuperman GJ , Teich JM, Tanasijevic MJ, et al. . Improving response to critical laboratory results with automation: results of a randomized controlled trial. J Am Med Inform Assoc1999; 66: 512–22. DOI: https://doi.org/10.1136/jamia.1999.0060512
Park H-I , Min W-K, Lee W, et al. . Evaluating the short message service alerting system for critical value notification via PDA telephones. Ann Clin Lab Sci2008; 382: 149–56.
Hayes SA , Breen M, McLaughlin PD, et al. . Communication of unexpected and significant findings on chest radiographs with an automated PACS alert system. J Am Coll Radiol2014; 118: 791–5. DOI: https://doi.org/10.1016/j.jacr.2014.01.017
Browning T , Kasper J, Rofsky NM, et al. . Quality improvement initiative: enhanced communication of newly identified, suspected GI malignancies with direct critical results messaging to surgical specialist. BMJ Qual Saf2013; 222: 168–75. DOI: https://doi.org/10.1136/bmjqs-2012-001069
Dalal AK , Schaffer A, Gershanik EF, et al. . The impact of automated notification on follow-up of actionable tests pending at discharge: a cluster-randomized controlled trial. J Gen Intern Med 2018; 33(7): 1043–1051. DOI: https://doi.org/10.1007/s11606-018-4393-y
WorldCat
Callen J , Georgiou A, Prgomet M, et al. . A qualitative analysis of emergency department physicians’ practices and perceptions in relation to test result follow-up. Stud Health Technol Inform2010; 160 (Pt 2): 1241–5.
Callen J , Paoloni R, Georgiou A, et al. . The rate of missed test results in an emergency department: an evaluation using an electronic test order and results viewing system. Methods Inf Med2010; 49: 37–43. DOI: https://doi.org/10.3414/ME09-01-0011
Kilpatrick ES , Holding S. Use of computer terminals on wards to access emergency test results: a retrospective audit. BMJ2001; 3227294: 1101–3. DOI: https://doi.org/10.1136/bmj.322.7294.1101
Topol P , Porat N, Zelker R, et al. . Quality improvement program to assure the delivery of pathology test results: a systemic intervention in a large general hospital. Dermatol Nurs2007; 19: 253–7.
Rodriguez-Borja E , Villalba-Martinez C, Barba-Serrano E, et al. . Failure to review STAT clinical laboratory requests and its economical impact. Biochem Med2016; 26: 61–7. DOI: https://doi.org/10.11613/BM.2016.005
Kern LM , Callahan MA, Brillon DJ, et al. . Glucose testing and insufficient follow-up of abnormal results: a cohort study. BMC Health Serv Res2006; 6: 87. DOI: https://doi.org/10.1186/1472-6963-6-87
Roy CL , Poon EG, Karson AS, et al. . Patient safety concerns arising from test results that return after hospital discharge. Ann Intern Med2005; 1432: 121–8. DOI: https://doi.org/10.7326/0003-4819-143-2-200507190-00011
Menon S , Smith MW, Sittig DF, et al. . How context affects electronic health record-based test result follow-up: a mixed-methods evaluation. BMJ Open2014; 411: e005985. DOI: https://doi.org/10.1136/bmjopen-2014-005985
Singh H , Spitzmueller C, Petersen NJ, et al. . Primary care practitioners’ views on test result management in EHR-enabled health systems: a national survey. J Am Med Inform Assoc2013; 204: 727–35. DOI: https://doi.org/10.1136/amiajnl-2012-001267
Elder NC , McEwen TR, Flach JM, et al. . Management of test results in family medicine offices. Ann Fam Med2009; 74: 343–51. DOI: https://doi.org/10.1370/afm.961
Menon S , Murphy DR, Singh H, et al. . Workarounds and test results follow-up in electronic health record-based primary care. Appl Clin Inform2016; 0702: 543–59. DOI: https://doi.org/10.4338/ACI-2015-10-RA-0135
Bhise V , Meyer AND, Singh H, et al. . Errors in diagnosis of spinal epidural abscesses in the era of electronic health records. Am J Med2017; 1308: 975–81. DOI: https://doi.org/10.1016/j.amjmed.2017.03.009
Ferris TG , Johnson SA, Co JPT, et al. . Electronic results management in pediatric ambulatory care: qualitative assessment. Pediatrics2009; 123 (Suppl 2): S85–91. DOI: https://doi.org/10.1542/peds.2008-1755G
Georgiou A , Lymer S, Forster M, et al. . Lessons learned from the introduction of an electronic safety net to enhance test result management in an Australian mothers’ hospital. J Am Med Inform Assoc2014; 216: 1104–8. DOI: https://doi.org/10.1136/amiajnl-2013-002466
Dalal AK , Pesterev BM, Eibensteiner K, et al. . Linking acknowledgment to action: closing the loop on non-urgent, clinically significant test results in the electronic health record. J Am Med Inform Assoc2015; 224: 905–8. DOI: https://doi.org/10.1093/jamia/ocv007
Georgiou A , McCaughey EJ, Tariq A, et al. . What is the impact of an electronic test result acknowledgement system on emergency department physicians’ work processes? A mixed-method pre-post observational study. Int J Med Inform2017; 99: 29–36. DOI: https://doi.org/10.1016/j.ijmedinf.2016.12.006
Li J , Callen J, Westbrook JI, et al. . What factors determine the use of an electronic test result acknowledgment system? A qualitative study across two EDs. In: Ryan A, Schaper L, Whetton S, eds. Studies in Health Technology & Informatics. Vol 239. Amsterdam:IOS Press; 2017: 70–6.
Dalal AK , Poon EG, Karson AS, et al. . Lessons learned from implementation of a computerized application for pending tests at hospital discharge. J Hosp Med2011; 61: 16–21. DOI: https://doi.org/10.1002/jhm.794
Lin JJ , Moore C. Impact of an electronic health record on follow-up time for markedly elevated serum potassium results. Am J Med Qual2011; 264: 308–14. DOI: https://doi.org/10.1177/1062860610385333
Murphy DR , Wu L, Thomas EJ, et al. . Electronic trigger-based intervention to reduce delays in diagnostic evaluation for cancer: a cluster randomized controlled trial. JCO2015; 3331: 3560–7. DOI: https://doi.org/10.1200/JCO.2015.61.1301
Choksi VR , Marn CS, Bell Y, et al. . Efficiency of a semiautomated coding and review process for notification of critical findings in diagnostic imaging. AJR Am J Roentgenol2006; 1864: 933–6. DOI: https://doi.org/10.2214/AJR.04.1913
Dupuis EA , White HF, Newman D, et al. . Tracking abnormal cervical cancer screening: evaluation of an EMR-based intervention. J Gen Intern Med2010; 256: 575–80. DOI: https://doi.org/10.1007/s11606-010-1287-z
Giardina TM , Varsha P, Danielle Singh H. The patient portal and abnormal test results: An exploratory study of patient experiences. Patient Exp J2015; 2: 148–54. DOI: https://doi.org/10.35680/2372-0247.1055
Hazara AM , Bhandari S. Barriers to patient participation in a self-management and education website Renal PatientView: a questionnaire-based study of inactive users. Int J Med Inform2016; 87: 10–4. DOI: https://doi.org/10.1016/j.ijmedinf.2015.12.004
Ling SB , Richardson DB, Mettenbrink CJ, et al. . Evaluating a web-based test results system at an urban STI clinic. Sex Transm Dis2010; 374: 259–63. DOI: https://doi.org/10.1097/OLQ.0b013e3181d3d037
Mak G , Smith Fowler H, Leaver C, et al. . The effects of web-based patient access to laboratory results in British Columbia: a patient survey on comprehension and anxiety. J Med Internet Res2015; 17: e191. DOI: https://doi.org/10.2196/jmir.4350
Miles RC , Hippe DS, Elmore JG, et al. . Patient access to online radiology reports: frequency and sociodemographic characteristics associated with use. Acad Radiol2016; 239: 1162–9. DOI: https://doi.org/10.1016/j.acra.2016.05.005
Mukoro F , Sweeney G, Mathews B, editors. Providing patients online access to their live test results: an evaluation of usage and usefulness. In: IADIS International Conference e-Health, Lisbon; 2012.
Wiljer D , Urowitz S, Apatu E, et al. . Understanding the support needs of patients accessing test results online. PHRs offer great promise, but support issues must be addressed to ensure appropriate access. J Healthc Inf Manag2010; 24: 57–63.
Winget M , Haji-Sheikhi F, Brown-Johnson C, et al. . Electronic release of pathology and radiology results to patients: opinions and experiences of oncologists. JOP2016; 128: e792–9. DOI: https://doi.org/10.1200/JOP.2016.011098
Woywodt A , Vythelingum K, Rayner S, et al. . Single-centre experience with Renal PatientView, a web-based system that provides patients with access to their laboratory results. J Nephrol2014; 275: 521–7. DOI: https://doi.org/10.1007/s40620-014-0060-5
Rodriguez ES , Thom B, Schneider SM. Nurse and physician perspectives on patients with cancer having online access to their laboratory results. Oncol Nurs Forum2011; 384: 476–82. DOI: https://doi.org/10.1188/11.ONF.476-482
Okawa G , Ching K, Qian H, et al. . Automatic release of radiology reports via an online patient portal. J Am Coll Radiol2017; 149: 1219–21. DOI: https://doi.org/10.1016/j.jacr.2017.04.037
Giardina TD , Baldwin J, Nystrom DT, et al. . Patient perceptions of receiving test results via online portals: a mixed-methods study. J Am Med Inform Assoc2018; 254: 440–6. DOI: https://doi.org/10.1093/jamia/ocx140
Office of the National Coordinator for Health Information Technology. What is a patient portal? https://www.healthit.gov/providers-professionals/faqs/what-patient-portal.
Christensen KS. Viewing laboratory test results online: patients’ actions and reactions. J Participat Med2013; 5: e38.
Cimino JJ , Patel VL, Kushniruk AW. The patient clinical information system (PatCIS): technical solutions for and experience with giving patients access to their electronic medical records. Int J Med Inform2002; 68 (1–3): 113–27. DOI: https://doi.org/10.1016/S1386-5056(02)00070-9
Henshaw D , Okawa G, Ching K, Garrido T, Qian H, Tsai J. Access to radiology reports via an online patient portal: experiences of referring physicians and patients. J Am Coll Radiol2015; 126: 582–6. e1. DOI: https://doi.org/10.1016/j.jacr.2015.01.015
Institute of Medicine. Health IT and Patient Safety: Building Safer Systems for Better Care. Washington DC: Institute of Medicine of the National Academies; 2011.
Office of the National Coordinator for Health Information Technology. Are there different types of personal health records (PHRs)? https://www.healthit.gov/faq/are-there-different-types-personal-health-records-phrs.
Georgiou A , Westbrook JI, Braithwaite J. Time matters - a theoretical and empirical examination of the temporal landscape of a hospital pathology service and the impact of e-health. Soc Sci Med2011; 7210: 1603. DOI: https://doi.org/10.1016/j.socscimed.2011.03.020
Georgiou A , Westbrook JI, Braithwaite J. An empirically-derived approach for investigating health information technology: the elementally entangled organisational communication (EEOC) framework. BMC Med Inform Decis Mak2012; 12(1): 68. DOI: https://doi.org/10.1186/1472-6947-12-68
Kuziemsky CE , Borycki EM, Purkis ME. An interdisciplinary team communication framework and its application to healthcare ‘e-teams’ systems design. BMC Med Inform Decis Mak2009; 9(1): 43. DOI: https://doi.org/10.1186/1472-6947-9-43
Schiff GD , Bates DW. Can electronic clinical documentation help prevent diagnostic errors?. N Engl J Med2010; 36212: 1066–9. DOI: https://doi.org/10.1056/NEJMp0911734
National Academies Of Science Engineering and Medicine. Improving Diagnosis in Health Care. Washington, DC: The National Acadamies Press; 2015.
Georgiou A , Prgomet M, Paoloni R, et al. . The impact of computerized provider order entry systems on clinical care and work processes in emergency departments: a systematic review of the quantitative literature. Ann Emerg Med2013; 616: 644–53. DOI: https://doi.org/10.1016/j.annemergmed.2013.01.028
Scott P , Rigby M, Ammenwerth E, et al. . Evaluation considerations for secondary uses of clinical data: principles for an evidence-based approach to policy and implementation of secondary analysis. IMIA Yearbook 2017; 26(1): 59–67. DOI: https://doi.org/10.15265/IY-2017-010
Giardina TD , Callen J, Georgiou A, et al. . Releasing test results directly to patients: a multisite survey of physician perspectives. Patient Educ Couns2015; 986: 788–96. DOI: https://doi.org/10.1016/j.pec.2015.02.011
Rigby M , Georgiou A, Hyppönen H, et al. . Patient portals as a means of information and communication technology support to patient-centric care coordination–the missing evidence and the challenges of evaluation: a joint contribution of IMIA WG EVAL and EFMI WG EVAL. Yearb Med Inform2015; 10: 148. DOI: https://doi.org/10.15265/IY-2015-007
Hordern A , Georgiou A, Whetton S, et al. . Consumer eHealth - an overview of the research evidence and the implications for future policy. Health Inf Manag2011; 402: 6–14. DOI: https://doi.org/10.1177/183335831104000202
Otte-Trojel T , de Bont A, Rundall TG, et al. . How outcomes are achieved through patient portals: a realist review. J Am Med Inform Assoc2014; 214: 751–7. DOI: https://doi.org/10.1136/amiajnl-2013-002501
Sterne JA , Egger M, Moher D. Addressing reporting biases In: Higgins J, Green S, eds. Cochrane Handbook for Systematic Reviews. New York: Wiley; 2008: 297–333. DOI: https://doi.org/10.1002/9780470712184.ch10
Carayon P , Karsh BT, Cartmill R, et al. . Incorporating Health IT into Workflow Redesign: Request for Information Summary Report (Publication No. 10-0098-EF). Rockville, MD: Agency for Healthcare Research and Quality; 2010.
Published
How to Cite
Issue
Section
Copyright (c) 2019 International journal of health sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.
