Health Information Technology Commons^™

Ideas For A Healthy Baby--Reducing Disparities In Use Of Publicly Reported Quality Data: Study Protocol For A Randomized Controlled Trial, Sarah L. Goff, Penelope S. Pekow, Katharine O. White, Tara Lagu, Kathleen M. Mazor, Peter K. Lindenauer

Peter Lindenauer MD

BACKGROUND: Publicly reported performance on quality measures is intended to enable patients to make more informed choices. Despite the growing availability of these reports, patients' use remains limited and disparities exist. Low health literacy and numeracy are two barriers that may contribute to these disparities. Patient navigators have helped patients overcome barriers such as these in other areas, such as cancer care and may prove useful for overcoming barriers to using publicly reported quality data. METHODS/DESIGN: The goals of this study are: to determine the efficacy of a patient navigator intervention to assist low-income pregnant women in the use of …

New Portable Tool To Screen Vestibular And Visual Function—National Institutes Of Health Toolbox Initiative, Rose Marie Rine, Dale Roberts, Bree A. Corbin, Roberta Mckean-Cowdin, Rohit Varma, Jennifer Beaumont, Jerry Slotkin, Michael C. Schubert

Rose Marie Rine P.T., Ph.D.

As part of the National Institutes of Health Toolbox initiative, we developed a low-cost, easy-to-administer, and time-efficient test of vestibular and visual function. A computerized test of dynamic visual acuity (cDVA) was used to measure the difference in visual acuity between head still and moving in yaw. Participants included 318 individuals, aged 3 to 85 years (301 without and 17 with vestibular pathology). Adults used Early Treatment of Diabetic Retinopathy Study (ETDRS) optotypes; children used ETDRS, Lea, and HOTV optotypes. Bithermal calorics, rotational chair, and light box testing were used to validate the cDVA. Analysis revealed that the cDVA test …

Systematic Review Of The Use Of Online Questionnaires Of Older Adults, Meegan Remillard, Kathleen Mazor, Sarah Cutrona, Jerry Gurwitz, Jennifer Tjia

Jennifer Tjia

OBJECTIVES: To describe methodological approaches to population targeting and sampling and to summarize limitations of Internet-based questionnaires in older adults.

DESIGN: Systematic literature review.

SETTING: Studies using online questionnaires in older adult populations.

PARTICIPANTS: English-language articles using search terms for geriatric, age 65 and over, Internet survey, online survey, Internet questionnaire, and online questionnaire in PubMed and EBSCO host between 1984 and July 2012. Inclusion criteria were study population mean age 65 and older and use of an online questionnaire for research. Review of 336 abstracts yielded 14 articles for full review by two investigators; 11 articles met inclusion criteria. …

Use Of A Subcutaneous Insulin Computerized Glucostabilizer™ Program On Glycemic Control In The Intensive Care Setting: A Retrospective Data Analysis., Sarah A. Nisly, Serena Harris, Laura Aykroyd, Joni Carrol, Brian Ulmer, Michael Waddell, Samuel Flanders, Rattan Juneja

Sarah A. Nisly

Background: Despite guidelines that recommend strongly against Sliding Scale Insulin (SSI) it continues to be the most commonly insulin regimen used in hospitals to treat hyperglycemia. In addition to being reactionary to a glucose that has already increased, SSI offers practical challenges in the randomness of the doses of insulin prescribed and often a disconnect with glucose testing that should be occurring in congruence to the insulin dosing. While many clinical trials have shown improved glycemic control in critical care patients receiving intravenous insulin; few studies have demonstrated the efficacy of subcutaneous (SQ) insulin in this setting. In this study, …

Technology Enhancement - A Full Role For The Elderly (Pdf Of The Powerpoint), Marcus R. Wigan

Marcus R Wigan

Predicting Patients’ Use Of Provider-Delivered E-Health: The Role Of Facilitating Conditions, E. Vance Wilson, Nancy K. Lankton

Nancy K. Lankton

This chapter presents a new rational-objective (R-O) model of e-health use that accounts for effects of facilitating conditions as well as patients’ behavioral intention. An online questionnaire measured patients’ behavioral intention to use a new e-health application as well as proxy measures of facilitating conditions that assess prior use of and structural need for health services. A second questionnaire administered three months later collected patients’ self-reported use of e-health during the intervening period. The new model increased predictions of patients’ e-health use (measured in R2) by more than 300% over predictions based upon behavioral intention alone, and all measured factors …

The Ehealth Behavior Management Model: A Stage-Based Approach To Behavior Change And Management, Robert Bensley, Nelda Mercer, John Brusk, Ric Underhile, Jason Rivas, Judith Anderson, Deanne Kelleher, Melissa Lupella, André De Jager

Robert J Bensley

Although the Internet has become an important avenue for disseminating health information, theory-driven strategies for aiding individuals in changing or managing health behaviors are lacking. The eHealth Behavior Management Model combines the Transtheoretical Model, the behavioral intent aspect of the Theory of Planned Behavior, and persuasive communication to assist individuals in negotiating the Web toward stage-specific information. It is here — at the point of stage-specific information — that behavioral intent in moving toward more active stages of change occurs.

The eHealth Behavior Management Model is applied in three demonstration projects that focus on behavior management issues: parent-child nutrition education …

An Electronic Health Record-Based Intervention To Increase Follow-Up Office Visits And Decrease Rehospitalization In Older Adults, Jerry Gurwitz, Terry Field, Jessica Ogarek, Jennifer Tjia, Sarah Cutrona, Leslie Harrold, Shawn Gagne, Peggy Preusse, Jennifer Donovan, Abir Kanaan, George Reed, Lawrence Garber

Jennifer Tjia

OBJECTIVES: To assess the effect of an electronic health record-based transitional care intervention involving automated alerts to primary care providers and staff when older adults were discharged from the hospital.

DESIGN: Randomized controlled trial.

SETTING: Large multispecialty group practice.

PARTICIPANTS: Individuals aged 65 and older discharged from hospital to home.

INTERVENTION: In addition to notifying primary care providers about the individual's recent discharge, the system provided information about new drugs added during the inpatient stay, warnings about drug-drug interactions, recommendations for dose changes and laboratory monitoring of high-risk medications, and alerts to the primary care provider's support staff to schedule …

Introduction Of Evidence-Based Diagnostic Order Sets In An Electronic Medical Record Is Associated With An Increase In Laboratory Orders, Bryan G. Kane Md, Justin Arnold Do, Joshua Morrison Do, Ryan Southworth Do, William Greenhut Do, Will Russell Do, Jeremy Selley Do, Michael Stanley Do

Bryan G Kane MD

No abstract provided.

Electronic Health Record (Ehr) Adoption: Failure Or Success?, Madison Ngafeeson

Madison Ngafeeson

Electronic Health Record (EHR) is hailed as a health information technology with great potential to significantly boost healthcare outcomes, reduce medical errors, increase legibility and minimize healthcare costs. The implementation of EHRs is expected to be completely mandatory in the United States by 2015. While evidence of EHR system implementation in research goes back over fifteen years ago, and is continually increasingly being adopted, it would seem be a good time to pause and take critical look down the years. Can it be said that EHR implementation has been a success, or, perhaps a failure? This study explores the subject …

Examining Success In Health Information Technology Implementation Research, Madison Ngafeeson

Madison Ngafeeson

The implementation of health information systems (IS) is rapidly increasing. In the United States, $70 billion will be invested by the government to facilitate the adoption of the electronic health record over a ten-year period. However, IS acceptance is not success. We use content analysis to investigate the success component.

Meaningful Use And Meaningful Curricula: A Survey Of Health Informatics Programs In The U.S., Kai Koong, Madison Ngafeeson, Lai Lui

Madison Ngafeeson

The introduction of the US government’s Meaningful Use criteria carries with it many implications including the training curriculum of healthcare personnel. This study examines 108 health informatics degree programmes across the USA. First, the courses offered are identified and classified into generic classes. Next, these generic groupings are mapped to two important frameworks: the Learning to Manage Health Information (LMHI) academic framework; and the Meaningful Use criteria policy framework. Results suggest that while current curricula seemed acceptable in addressing Meaningful Use Stage 1 objective, there was insufficient evidence that these curricula could support Meaningful Use Stage 2 and Stage 3. …

An Exploratory Study Of User Resistance In Healthcare It, Madison Ngafeeson, Vishal Midha

Madison Ngafeeson

The US healthcare system is clearly experiencing a major transition. By 2015, the healthcare sector is expected to have migrated from a paper record system to a completely electronic health record (EHR) system. The adoption and use of these systems are expected to increase legibility, reduce costs, limit medical errors and improve the overall quality of healthcare. Hence, the US government is investing $70 billion over a 10-year period to facilitate the transition to an electronic system. However, early reports show that physicians and nurses among other health professionals continue to resist the full use of the system. This paper …

Collecting Real-Time Data From Substance Users Raises Unique Legal And Ethical Issues: Reply To Kuntsche & Labhart., Carla Meurk, Wayne Hall, Adrian Carter, Helen Chenery

Helen Chenery

Comment on The future is now--using personal cellphones to gather data on substance use and related factors.

Adoption Of The Icd-10 Standard In The United States: The Time Is Now, Alberto Coustasse, David P. Paul Iii

Alberto Coustasse, DrPH, MD, MBA, MPH

The United States is facing a revolution in the health care system soon when the present coding system (International Classification of Diseases, Ninth Revision) will be replaced with what has for some years been the international standard: International Statistical Classification of Diseases, 10th Revision (ICD-10). The ICD-10 system will provide a tremendous opportunity for better capturing information in the increasingly complex delivery of health care. Although the transition to ICD-10 will undoubtedly result in substantial short-term costs, the long-term benefits make the transition imperative.

Physicians, Patients, And Facebook: Could You? Would You? Should You?, Joy Peluchette, Katherine Karl, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

This paper investigates the opinions of physicians and patients regarding the use of Facebook to communicate with one another about health-related issues. We analyzed 290 comments posted on online discussion boards and found that most (51.7%) were opposed to physicians being Facebook “friends” with patients and many (42%) were opposed to physicians having any kind of Facebook presence. The primary reasons for this opposition were concerns about privacy and the need to maintain professional boundaries in the physician-patient relationship. Others expressed concerns about HIPAA violations. Some believed it was acceptable for physicians to use Facebook as long as they were …

Expanding Technology In The Icu: The Case For The Utilization Of Telemedicine, Stacie Deslich, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Introduction: Telemedicine has been utilized in various healthcare areas to achieve better patient outcomes, lower costs of providing services, and increase patient access to care. Tele-intensive care unit (ICU) technology has been introduced as a way to provide effective ICU services to patients with reduced access, as well as to decrease costs and improve patient care. Materials and Methods: The methodology for this qualitative study was a literature search and review of case studies. The search was limited to sources published in the last 10 years (2003–2013) in the English language. In total, 55 references were used for this research …

Telepsychiatry In The 21st Century: Transforming Healthcare With Technology, Stacie Deslich, Bruce Stec, Shane Tomblin, Alberto Coustasse

Shane Tomblin

This article describes the benefits and constraints of telemedicine, focusing primarily on the field of psychiatry in the United States with the current system of healthcare. Telepsychiatry is believed to provide better access and higher-quality care to patients who need psychiatric care and cost savings to providers of such care. Telemedicine has been successfully integrated into psychiatric facilities reaching rural areas, prisons, and urban facilities. It has increased the volume of patients that physicians can reach and diagnose, as well as allowing them to treat patients with limitations in mobility. While telepsychiatry has been shown to be beneficial, this technology …

Impact Of Radio-Frequency Identification (Rfid) Technologies On The Hospital Supply Chain: A Literature Review, Alberto Coustasse, Shane Tomblin, Chelsea Slack

Shane Tomblin

Supply costs account for more than one-third of the average operating budget and constitute the second largest expenditure in hospitals. As hospitals have sought to reduce these costs, radio-frequency identification (RFID) technology has emerged as a solution. This study reviews existing literature to gauge the recent and potential impact and direction of the implementation of RFID in the hospital supply chain to determine current benefits and barriers of adoption. Findings show that the application of RFID to medical equipment and supplies tracking has resulted in efficiency increases in hospitals with lower costs and increased service quality. RFID technology can reduce …

Electronic Health Records And Change Management, Wm. Marty Martin, Sergey Voynov

William Marty Martin

Abstract— Electronic health records (EHRs) offer many potential opportunities for patients, payers, physicians, and other healthcare providers. These opportunities are only realized if healthcare organizations commit to investing in EHRs and providers adopt the new technology for the benefit of patient care, higher quality, fewer errors, and greater efficiency. This paper focuses on increasing the probability those healthcare organizations in general but physicians and providers in particular adopt EHRs as a valuable tool to prevent and manage disease and illness. The adoption of EHRs often has less to do with the technology and more to do with the underlying changes …

Telepsychiatry In The 21st Century: Transforming Healthcare With Technology, Stacie Deslich, Bruce Stec, Shane Tomblin, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

This article describes the benefits and constraints of telemedicine, focusing primarily on the field of psychiatry in the United States with the current system of healthcare. Telepsychiatry is believed to provide better access and higher-quality care to patients who need psychiatric care and cost savings to providers of such care. Telemedicine has been successfully integrated into psychiatric facilities reaching rural areas, prisons, and urban facilities. It has increased the volume of patients that physicians can reach and diagnose, as well as allowing them to treat patients with limitations in mobility. While telepsychiatry has been shown to be beneficial, this technology …

Impact Of Radio-Frequency Identification (Rfid) Technologies On The Hospital Supply Chain: A Literature Review, Alberto Coustasse, Shane Tomblin, Chelsea Slack

Alberto Coustasse, DrPH, MD, MBA, MPH

Supply costs account for more than one-third of the average operating budget and constitute the second largest expenditure in hospitals. As hospitals have sought to reduce these costs, radio-frequency identification (RFID) technology has emerged as a solution. This study reviews existing literature to gauge the recent and potential impact and direction of the implementation of RFID in the hospital supply chain to determine current benefits and barriers of adoption. Findings show that the application of RFID to medical equipment and supplies tracking has resulted in efficiency increases in hospitals with lower costs and increased service quality. RFID technology can reduce …

Analytical Methods For Planning And Scheduling Daily Work In Inpatient Care Settings: Opportunities For Research And Practice, Laila Cure

Laila Cure

This article identifies current challenges in the planning and execution of daily work in inpatient care settings. Inadequate planning of the processes and resources associated with inpatient care services may negatively affect their effectiveness. It may also lead to burnout of healthcare workers when the resulting work plan is unknowingly infeasible or does not incorporate the necessary human factors considerations. This paper provides with an overview of current research on inpatient care workflow planning, as well as with directions for researchers and practitioners to advance this problem using a combination of human factors engineering and analytical methods.

The Framework Of An It-Enhanced System Designed To Improve Quality Of Patients’ Care, Alireza Lari, Nasim Lari, Dothang Truong

Dothang Truong, Ph.D.

The scope of ambulatory care has increased over the past decade as the volume and complexity of interventions has burgeoned. The opportunity to turn the potential of health information technology (IT) towards improving safety and quality in emergency department (ED) settings will form the cornerstone of this paper. The purpose of this paper is to discuss the conceptual framework of a health IT system, which is capable of using a Brief Negotiated Interview (BNI) process as an intervention tool in the ED system for patients with alcohol-related problems. This system, when implemented, is expected to improve the quality of the …

Measuring The Lifespace Of People With Parkinson's Disease Using Smartphones: Proof Of Principle., Jacki Liddle, David Ireland, Simon Mcbride, Sandra Brauer, Leanne Hall, Hang Ding, Mohan Karunanithi, Paul Hodges, Deborah Theodoros, Peter Silburn, Helen Chenery

Helen Chenery

BACKGROUND: Lifespace is a multidimensional construct that describes the geographic area in which a person lives and conducts their activities, and reflects mobility, health, and well-being. Traditionally, it has been measured by asking older people to self-report the length and frequency of trips taken and assistance required. Global Positioning System (GPS) sensors on smartphones have been used to measure Lifespace of older people, but not with people with Parkinson's disease (PD). OBJECTIVE: The objective of this study was to investigate whether GPS data collected via smartphones could be used to indicate the Lifespace of people with PD. METHODS: The dataset …

A Review Of Radio Frequency Identification Technologies And Impacts On The Hospital Supply Chain: 2002–2012, Alberto Coustasse, Shane Tomblin, Chelsea Slack

Shane Tomblin

Supply costs are the second largest expenditure in hospitals, accounting for more than one third of the average operating budget. RFID technology can reduce these costs, improve patient safety, and supply chain management by increasing the ability to track and locate equipment, as well as monitoring theft prevention, distribution management, and patient billing. Findings of this study have shown that the application of RFID on medical equipment and supplies have resulted in efficiency increase in healthcare with lower costs and increased quality services. Even though the cost of RFID implementation is decreasing, the total expenditures are still significant and the …

Information Systems And Health Care Viii-Using Paper-Based Scenarios To Examine Perceptions Of Interactive Health Communication Systems, Nancy Lankton, Robert St. Louis

Nancy K. Lankton

While information and communication technologies can increase the health care provided to underserved populations, research concerning these technologies often involves only those patients who possess access to technology or who are otherwise willing and able to use it. This issue is important for both researchers and practitioners because non-users' beliefs may not only be different from users' beliefs, they may become more important to understand as access to technology increases. To address this problem: 1. We develop a model of the antecedents to perceived usefulness of an interactive health communication (IHC) system. While our research model combines health-related beliefs with …

Interdisciplinary Research And Publication Opportunites In Information Systems And Health Care, E. Vance Wilson, Nancy K. Lankton

Nancy K. Lankton

Healthcare is a large and growing industry that is experiencing major transformation in its information technology base. IS confronted similar transformations in other industries and developed theories and methods that should prove useful in healthcare applications. In turn, IS may benefit from incorporating knowledge from health informatics, a discipline that studies IT within medical and healthcare contexts. Despite the benefits, it is often a struggle for interdisciplinary researchers in IS and healthcare to publish their work, especially in journals directed toward IS audiences. In this paper, we outline strategies and resources to help ease this publication bottleneck. As a part …

Information Flow And Clinical Outcomes In A Fully Functional Perinatal Continuum Of Care, Donald Levick Md, Michael Sheinberg Md, Chad Meyerhoefer Phd, Mary Deily, Shin-Yi Chou Phd, Susan Sherer Phd

Donald Levick MD

No abstract provided.

Importance Of New Technologies For Diabetes Monitoring, David P. Paul Iii, Joey Preast, Zach Garrett, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Diabetes and its ramifications and treatments are presented, followed by discussion of the importance of communication between patient and clinician. Improved communication approaches, including telephone consultations, blood glucose communications to a provider with feedback, and active electronic diaries on smartphones for both type 1 and type 2 diabetes mellitus, are reviewed.