Health Information Technology Commons^™

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 …

Scalable Combinatorial Tools For Health Disparities Research, Michael A. Langston, Robert S. Levine, Barbara J. Kilbourne, Gary L. Rogers Jr., Anne D. Kershenbaum, Suzanne H. Baktash, Steven S. Coughlin, Arnold M. Saxton, Vincent K. Agboto, Darryl B. Hood, Maureen Y. Litchveld, Tonny J. Oyana, Patricia Matthews-Juarez, Paul D. Juarez

Sociology Faculty Research

Despite staggering investments made in unraveling the human genome, current estimates suggest that as much as 90% of the variance in cancer and chronic diseases can be attributed to factors outside an individual’s genetic endowment, particularly to environmental exposures experienced across his or her life course. New analytical approaches are clearly required as investigators turn to complicated systems theory and ecological, place-based and life-history perspectives in order to understand more clearly the relationships between social determinants, environmental exposures and health disparities. While traditional data analysis techniques remain foundational to health disparities research, they are easily overwhelmed by the ever-increasing size …

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 …

African Starchy Foods, Gastric Emptying, And Starch Digestion In Malian Stunted Children, Fatimata Cisse

Open Access Dissertations

Starch serves as the main energy source in cereal and tuber-rich diets, and its glycemic response profile has been associated with health-related conditions. Sorghum and millet are known to have relatively low starch digestibility, a potentially desirable property for controlling blood glucose response and providing sustained energy. Gastric emptying rates of traditional sorghum and millet-based African foods of the Sahelian region (couscous, thick and thin porridges made from millet and/or sorghum) were compared to those of non-traditional "modern" foods that are mostly consumed in urban areas using a non-invasive 13C-labelled octanoic acid breath test in healthy volunteers. The obtained results …

Chess Improves Cancer Caregivers' Burden And Mood: Results Of An Ehealth Rct, Lori L. Dubenske, David H. Gustafson, Kang Namkoong, Robert P. Hawkins, Amy K. Atwood, Roger L. Brown, Ming-Yuan Chih, Fiona Mctavish, Cindy L. Carmack, Mary K. Buss, Ramaswamy Govindan, James F. Cleary

Community & Leadership Development Faculty Publications

OBJECTIVE: Informal caregivers (family and friends) of people with cancer are often unprepared for their caregiving role, leading to increased burden or distress. Comprehensive Health Enhancement Support System (CHESS) is a Web-based lung cancer information, communication, and coaching system for caregivers. This randomized trial reports the impact on caregiver burden, disruptiveness, and mood of providing caregivers access to CHESS versus the Internet with a list of recommended lung cancer websites.

METHODS: A total of 285 informal caregivers of patients with advanced nonsmall cell lung cancer were randomly assigned to a comparison group that received Internet or a treatment group that …

Can Utilizing A Computerized Provider Order Entry (Cpoe) System Prevent Hospital Medical Errors And Adverse Drug Events?, Krista Charles Ms, Margaret Cannon Ms, Robert Hall Ms, Alberto Coustasse Drph, Md, Mba, Mph

Management Faculty Research

Computerized provider order entry (CPOE) systems allow physicians to prescribe patient services electronically. In hospitals, CPOE essentially eliminates the need for handwritten paper orders and achieves cost savings through increased efficiency. The purpose of this research study was to examine the benefits of and barriers to CPOE adoption in hospitals to determine the effects on medical errors and adverse drug events (ADEs) and examine cost and savings associated with the implementation of this newly mandated technology. This study followed a methodology using the basic principles of a systematic review and referenced 50 sources. CPOE systems in hospitals were found to …

A Business Case For Tele-Intensive Care Units, Alberto Coustasse, Stacie Deslich, Deanna Bailey, Alesia Hairston, David Paul

Management Faculty Research

Objectives: A tele-intensive care unit (tele-ICU) uses telemedicine in an intensive care unit (ICU) setting, applying technology to provide care to critically ill patients by off-site clinical resources. The purpose of this review was to examine the implementation, adoption, and utilization of tele-ICU systems by hospitals to determine their efficiency and efficacy as identified by cost savings and patient outcomes.

Methods: This literature review examined a large number of studies of implementa­tion of tele-ICU systems in hospitals.

Results: The evidence supporting cost savings was mixed. Implementation of a tele- ICU system was associated with cost savings, shorter lengths of stay, …

Applying Novel Tree-Based Frameworks To Big Data For Classification Of Heart Failure Patients And Prediction Of Clinical Responses, Yan Zhang, Nicholas Downing, Emily Bucholz, Suganthi Balasubramanian, Shu-Xia Li, Tara Liptak, Harlan Krumholz, Mark Gerstein

Yale Day of Data

Over 5 million Americans suffer from heart failure, a condition with a 5-year survival that eclipses all cancers apart from that of lung cancer. Conventional understanding of heart failure is simplistic: it is viewed as a single syndrome, despite real heterogeneity. In addition, models predicting outcomes focus on dichotomous results, like 30-day readmission. A novel approach to classification of heart failure may improve our ability to target interventions, improve patient experiences, and predict outcomes.

The Healthcare Cost and Utilization Project is a family of administrative claims databases that describes patient demographics, comorbidities, procedures, acute care utilization and outcomes, such as …

Ms-Squared Focus Group Survey Instrument, Philip J. Kroth

MS-Squared

No abstract provided.

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.

The Capus Project-Innovative Solutions For Hiv/Aids Linkage To Care, Melanie Gwynn, Jamila Ealey, Kate Racoff Musgrove

9th Annual Rural HIV Research and Training Conference (2014-2019)

“The CAPUS Project-Innovative Solutions for HIV/AIDS Linkage to Care”

Objectives: 1) Expand knowledge of the current linkage to care landscape within Georgia; 2) Identify essential components of the Resource Hub to enhance linkage to care efforts throughout Georgia; and 3)Promote effective use of the Resource Hub to facilitate HIV/AIDS linkage to care within highly impacted communities

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. …

The Government Of Kenya Cash Transfer For Orphaned And Vulnerable Children: Cross-Sectional Comparison Of Household And Individual Characteristics Of Those With And Without, Lukoye Atwoli, Lonnie Embleton, Julius Koech, Paula Braitstein, Allan Kamanda

Internal Medicine, East Africa

Background: The ‘Cash Transfer to Orphans and Vulnerable Children’ (CT-OVC) in Kenya is a government-supported program intended to provide regular and predictable cash transfers (CT) to poor households taking care of OVC. CT programs can be an effective means of alleviating poverty and facilitating the attainment of an adequate standard of living for people’s health and well-being and other international human rights. The objective of this analysis was to compare the household socioeconomic status, school enrolment, nutritional status, and future outlook of orphaned and separated children receiving the CT compared to those not receiving a CT.

Methods: This project analyzes …

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

Journal Articles

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 …

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 …

An Investigation Of The Relationship Between Plantar Weight Distribution And The Condition Of Osteoarthritic Knees During Quiet Standing, Brian Joseph Sutterer

Graduate Theses - Biology & Biomedical Engineering

Osteoarthritis (OA) is a damaging disease that commonly affects the knee and can impact function of the lower limb. This study examined how plantar weight distribution is related to the changes in knee alignment and various types of joint damage in patients with OA. A force mat was used to measure plantar weight distribution on 37 patients with knee OA, and the internal condition of the knee was evaluated during surgery. Analysis showed a relationship between medial plantar weight distribution and an increase in knee alignment angle (0.20, p < 0.001). For the damage models, an indirect relationship was found between medial weight distribution and ACL damage (-0.14, p=0.029). No relationship was found for the other types of OA damage. It is reasonable to believe they do exist, however. This study found a connection between weight distribution and alignment, and previous research has shown one between alignment and OA.

Gpu-Accelerated Influenza Simulations For Operational Modeling, Peter Holvenstot

Masters Theses

Simulations of influenza spread are useful for decision-making during public-health emergencies. Policy-makers use models to predict disease spread and estimate the effects of various intervention strategies. Effective modeling of targeted intervention strategies requires accurate modeling of individual-level behavior and transmission. However, this greatly increases the computational costs of these agent-based models. In addition, if the models are used as an outbreak progresses, some operational decisions must occur rapidly in order to contain the spread of the disease.

Graphics Processing Units (GPUs) are a type of specialized processor used to drive graphical displays. Many recent devices also allow users to write …

Automated Prediction Of Glasgow Outcome Scale For Traumatic Brain Injury, Bolan Su, Thien Anh Dinh, A. K. Ambastha, Tianxia Gong, Tomi Silander, Shijian Lu, C. C. Tchoyoson Lim, Boon Chuan Pang, Cheng Kiang Lee, Tze-Yun Leong, Chew Lim Tan

Research Collection School Of Computing and Information Systems

Clinical features found in brain CT scan images are widely used in traumatic brain injury (TBI) as indicators for Glasgow Outcome Scale (GOS) prediction. However, due to the lack of automated methods to measure and quantify the CT scan image features, the computerized prediction of GOS in TBI has not been well studied. This paper introduces an automated GOS prediction system for traumatic brain CT images. Different from most existing systems that perform the prognosis based on pre-processed data, our system directly works on brain CT scan images based on the image features. Our system can also be extended to …

A Comparison Of Fatigue During Cardiocerebral Resuscitation With Different Compression Rates Among Layperson And Professional Rescuers, Christopher Cassidy

Master's Theses

Quality chest compressions during Cardiopulmonary Resuscitation (CPR) are vital to maintaining adequate perfusion of oxygenated blood to the organs of the body to sustain life. Over the years, the compression rate recommended in Basic Life Support (BLS)/ Advanced Cardiac Life Support (ACLS) protocols for the best possible outcome has risen, and with that increase there are questions regarding rescuer fatigue and the effectiveness of compressions. Layperson and professional rescuers, answering to an emergency, both maintain continuous chest compressions until advanced life support arrives. Depending on the location, this arrival time would most likely be longer than the two minute standard …

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.

Personal Health Records: Is Rapid Adpoption Hindering Interoperability?, Jana Studeny, Alberto Coustasse

Management Faculty Research

The establishment of Meaningful Use criteria has created a critical need for robust interoperability. A universal definition for a Personal Health Records (PHRs) has not been agreed upon. Standardized code sets have been built for specific entities but integration between them has not been supported. The purpose of this research study was to explore the hindrance and promotion of interoperability standards in relationship to PHRs to describe interoperability progress in this area. The methodology for this study was conducted following the basic principles of a systematic review, with 61 articles used for this research study. Lagging interoperability has been stemmed …

Web-Based Objective Structured Clinical Examination With Remote Standardized Patients And Skype: Resident Experience, Erik E. Langenau, Elizabeth Kachur, Dot Horber

PCOM Scholarly Papers

OBJECTIVE: Using Skype and remote standardized patients (RSPs), investigators sought to evaluate user acceptance of a web-based objective structured clinical examination (OSCE) among resident physicians.

METHODS: After participating in four web-based clinical encounters addressing pain with RSPs, 59 residents from different training programs, disciplines and geographic locations completed a 52-item questionnaire regarding their experience with Skype and RSPs. Open-ended responses were solicited as well.

RESULTS: The majority of participants (97%) agreed or strongly agreed the web-based format was convenient and a practical learning exercise, and 90% agreed or strongly agreed the format was effective in teaching communication …

Novel Rejection Methods And Fusion Approaches For Multi-Biometric Verification, Md Shafaeat Hossain

Doctoral Dissertations

This dissertation proposes methods and algorithms to improve the performance of biometric verification systems. It introduces a new rejection method, "symmetric rejection method," for multi-stage biometric verification. The symmetric rejection method significantly improves the performance over the state of the art rejection methods and controls the genuine reject rate which has not been specifically addressed in earlier studies. The dissertation also proposes a new fusion framework for multi-biometric verification systems, which achieves accuracy higher than parallel fusion framework, and provides convenience to genuine users. In addition, it proposes a framework consisting of impostor score based normalization, impostor score based rejection, …

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 …