Public Health Commons^™

Health Policy & Management News, Georgia Southern University

Health Policy & Management Department News (2011-2018)

• Georgia Southern Examines Urgent Challenges for Local Public Health Informatics

Does The Electronic Health Record Improve The Timeliness Review And Notification Of Medical Laboratory And X-Ray Test Results?, Ruby Estes

Applied Research Projects

The medical community struggles with timeliness issues throughout the different healthcare environments in many areas of patient care. The demands of meeting patient care needs is great everywhere. One area that can lead to extreme adverse outcomes and affects patient safety is failure to review and follow-up on medical test results timely. In addition the lack of timely follow-up and treatment can lead to medico-legal implications for all healthcare professionals involved in the patients care. Some timeliness issues have been attributed to understaffed healthcare institutions, lack of trained staff, and in many instances inefficient and insufficient processes. This is an …

Improving Community Health Through Hospital Community Benefit Spending: Charting A Path To Reform, Sara J. Rosenbaum, Maureen Byrnes, Sara Rothenberg, Rachel Gunsalus

Health Policy and Management Faculty Publications

No abstract provided.

Volumetry Of Low-Contrast Liver Lesions With Ct: Investigation Of Estimation Uncertainties In A Phantom Study, Qin Li, Yongguang Liang, Qiao Huang, Min Zong, Benjamin Berman, Marios A. Gavrielides, Lawrence H. Schwartz, Binsheng Zhao, Nicholas Petrick

Food and Drug Administration Papers

Purpose: To evaluate the performance of lesion volumetry in hepatic CT as a function of various imaging acquisition parameters.

Methods: An anthropomorphic abdominal phantom with removable liver inserts was designed for this study. Two liver inserts, each containing 19 synthetic lesions with varying diameter (6–40 mm), shape, contrast (10–65 HU), and both homogenous and mixed-density were designed to have background and lesion CT values corresponding to arterial and portal-venous phase imaging, respectively. The two phantoms were scanned using two commercial CT scanners (GE 750 HD and Siemens Biograph mCT) across a set of imaging protocols (four slice thicknesses, …

The Economic Impact Of Changing Water Levels: A Regional Economic Analysis Of Lake Thurmond, Rob Carey, Lori A. Dickes, Elizabeth L. Crouch

Faculty Publications

This article examines the economic impact of declining lake levels on the local economy in six counties near the publically managed Thurmond Reservoir, located along the border of Georgia and South Carolina. A regression analysis of the relationship between lake level elevations and lake front real estate transactions is used in conjunction with an input-output model to estimate the median monthly economic impact of a one-foot increase in lake level in terms of employment, output, disposable income, and net local government revenue on the six counties bordering the lake. Thurmond Lake elevations have a statistically significant impact on regional economic …

“In Principle We Have Agreement, But In Practice It Is A Bit More Difficult": Obtaining Organizational Buy-In To Patient-Centered Medical Home Transformation, Janelle Applequist, Michelle Miller-Day, Peter F. Cronholm, Robert Gabbay, Deborah S. Bowen

Communication Faculty Articles and Research

The patient-centered medical home (PCMH) is a model of care that emphasizes the coordination of patient treatment among health care providers. Practice transformation to this model, however, presents a number of challenges. One of these challenges is getting the buy-in of all personnel to commit to making organizational changes in the journey to becoming a nationally recognized medical home. This study investigated internal messages of buy-in as communicated by practices transitioning to this type of care. Grounding itself in stakeholder theory, this study analyzed interviews with staff, administration, and practitioners from 20 medical practices in a mid-Atlantic state. The analysis …

Health Policy & Management News, Georgia Southern University

Health Policy & Management Department News (2011-2018)

• Georgia Southern Examines Electronic Health Records and Meaningful Use in LHDs
• Georgia Southern Examines Information Systems
• Georgia Southern Studies the Methods Behind 2015 Informatics Capacity and Needs Assessment Study

Health Policy & Management News, Georgia Southern University

Health Policy & Management Department News (2011-2018)

• Georgia Southern Assesses Skills and Capacity for Informatics
• Georgia Southern Examines Public Health Staff Development Needs in Informatics

Caution Is Needed In Designing Pharmacy Coverage., Steven A Farmer, William B Borden

Health Policy and Management Faculty Publications

Introduction

Pharmaceuticals are a critical component of modern medical care and have contributed substantially to health and quality of life. They are also expensive, accounting for ≈10% of US health care costs.1 By the end of this year, Medicare beneficiaries are expected to spend $343 billion on medications, and drug spending is projected to grow faster than both the inpatient and outpatient care categories.2Commercial and public payers use a range of mechanisms to constrain these costs, including formularies, tiered copayments, and preauthorization. These coverage policies may have potent impacts on medication usage, and their effects deserve close …

Continuing Development Of An All Payer Health Care System In Maryland, David P. Paul Iii, Taeko Matsumoto, Alberto Coustasse, Lama Mohammed Bakhamis, Mary Lynn Harshbarger

Management Faculty Research

The state of Maryland, in collaboration with the Centers for Medicare and Medicaid, developed the first all-payer system model in the U.S. in 1971, and some 35 years later in response to financial pressures, modernized this program. The focus of the modernized program was to improve overall per capita expenditure, quality of care, and the outcome of Marylanders’ health.

This study showed positive change in moving its healthcare delivery model from volume-driven care to value-driven coordinated care. Maryland hospitals have changed their mindsets to achieve the Triple Aim of cost reduction, health improvement, and quality of care improvement for the …

Health Policy & Management News, Georgia Southern University

Health Policy & Management Department News (2011-2018)

• Georgia Southern Associate Dean Serves as Guest Editor for the Special Issue on Health Informatics

Perceptions Of Peer Sexual Behavior: Do Adolescents Believe In A Sexual Double Standard?, Michael Young, Susan Cardenas, Joseph Donnelly, Mark J. Kittleson

Department of Public Health Scholarship and Creative Works

BACKGROUND

The purpose of the study was to (1) examine attitudes of adolescents toward peer models having sex or choosing abstinence, and (2) determine whether a “double standard” in perception existed concerning adolescent abstinence and sexual behavior.

METHODS

Adolescents (N = 173) completed questionnaires that included 1 of 6 randomly assigned vignettes that described male and female peer models 3 ways: (1) no information about model's sexual behavior, (2) model in love but choosing abstinence, and (3) model in love and having sex. Participants read the vignette to which they had been assigned and responded to statements about the peer …

Is Cloud Computing In Healthcare Providing A Safe Environment For Storing Protected Health Information? A Systematic Review And Meta-Analysis, Ashley N. Hayes

Applied Research Projects

Over the past several years, cloud computing has become increasingly more popular for the use of storing, accessing, and maintaining electronic health records (EHRs). In comparison to conventional EHR management tools, such as installed software, cloud computing offers more capabilities for medical facilities and their patients. Experts claim that in addition to changing the face of health information technology, it will also advance healthcare services, and benefit medical research. As the use of cloud computing has increased, so has the amount of healthcare data breaches. This study is proposing that there is a correlation between the increase in cloud computing …

Adoption Rate Of A Certified Ehr At Medical Practices With Five Or Fewer Physicians, Nelda Onwualiaobu

Applied Research Projects

The adoption rate of a certified electronic health record (EHR) for small medical practices have been the subject of discussion because prior research shows that larger medical practices have a higher rate of adoption than small medical practices. The major reason for this disparity has been the cost of adoption and implementation as many small practices are not financially equipped to shoulder this burden. The purpose of this research was to determine the adoption rate of a certified EHR for medical practices with five or fewer physicians. Through a google search and filtering the results of the search, the office …

How Barriers To Using The Electronic Health Record Effects Behavioral Healthcare, Jennifer Woodard

Applied Research Projects

The healthcare scene is rapidly changing due to the introduction of the electronic health record (EHR) and advances in technology. This means more patient data is readily available for use and gives physicians and patients’ faster access to that data. With the passing of recent legislature such as the Health Information Technology for Economic and Clinical Health Act and the American Recovery and Reinvestment Act of 2009, resulting in the rapid adoption of electronic health records due to incentive payment programs. With this comes the push for use of the electronic health record to prepare for Meaningful Use and improved …

Are Bay County Florida Healthcare Facilities Ready For Pama Imaging Cds Mandate?, Kelly Johnson

Applied Research Projects

The Electronic Health Record (EHR) has been a major player on the healthcare scene in recent years. Its use has ushered in a new phase of focus on quality healthcare combined with and aided by technological integration. Within this technological integration have come adjutant tools including Clinical Decision Support (CDS) tools. Among these applications are those focused on appropriate imaging by use of CDS designed according to Appropriate Use Criteria (AUC). The imaging CDS tools are available to aid the provider in selecting the appropriate imaging study for the clinical indications present. The Protecting Access to Medicare Act (PAMA) passed …

Public Health Staff Development Needs In Informatics: Findings From A National Survey Of Local Health Departments, Barbara L. Massoudi, Kelley Chester, Gulzar H. Shah

Health Policy and Management Faculty Publications

Context: Public health practice is information-intensive and information-driven. Public health informatics is a nascent discipline, and most public health practitioners lack necessary skills in this area.

Objective: To describe the staff development needs of local health departments (LHDs) related to informatics.

Design: Data came from the 2015 Informatics Capacity and Needs Assessment Survey, conducted by Georgia Southern University in collaboration with the National Association of County & City Health Officials.

Participants: A total of 324 LHDs from all 50 states completed the survey (response rate: 50%).

Main Outcome Measure(s): Outcome measures included LHDs' specific staff development needs related to informatics. …

Electronic Health Records And Meaningful Use In Local Health Departments: Updates From The 2015 Naccho Informatics Assessment Survey, Karmen S. Williams, Gulzar H. Shah

Health Policy and Management Faculty Publications

Background: Electronic health records (EHRs) are evolving the scope of operations, practices, and outcomes of population health in the United States. Local health departments (LHDs) need adequate health informatics capacities to handle the quantity and quality of population health data.

Purpose: The purpose of this study was to gain an updated view using the most recent data to identify the primary storage of clinical data, status of data for meaningful use, and characteristics associated with the implementation of EHRs in LHDs.

Methods: Data were drawn from the 2015 Informatics Capacity and Needs Assessment Survey, which used a stratified random sampling …

Local Health Departments' Partners And Challenges In Electronic Exchange Of Health Information, Gulzar H. Shah, Joshua Vest, Kay Lovelace, J. Mac Mccullough

Health Policy and Management Faculty Publications

Background: Unprecedented amounts of data are produced by the health care and other sectors, presenting opportunities for local health departments (LHDs) to access these data. LHDs will need to participate in health information exchange (HIE) with a number of partners in order to benefit from these data resources. LHDs' participation in HIEs with specific partners has not been studied.

Objectives: To describe the level of and challenges in LHD participation in HIE with other partners, and variation by LHD population size and governance type.

Data and Methods: This research uses data from the 2015 Informatics Capacity and Needs Assessment Survey, …

Interoperability Of Information Systems Managed And Used By The Local Health Departments, Gulzar H. Shah, Jonathon P. Leider, Huabin Luo, Ravneet Kaur

Health Policy and Management Faculty Publications

Background: In the post-Affordable Care Act era marked by interorganizational collaborations and availability of large amounts of electronic data from other community partners, it is imperative to assess the interoperability of information systems used by the local health departments (LHDs).

Objectives: To describe the level of interoperability of LHD information systems and identify factors associated with lack of interoperability.

Data and Methods: This mixed-methods research uses data from the 2015 Informatics Capacity and Needs Assessment Survey, with a target population of all LHDs in the United States. A representative sample of 650 LHDs was drawn using a stratified random sampling …

An Iterative, Low-Cost Strategy To Building Information Systems Allows A Small Jurisdiction Local Health Department To Increase Efficiencies And Expand Services, Kay Lovelace, Gulzar H. Shah

Health Policy and Management Faculty Publications

Objective and Methods: The objective of this case study was to describe the process and outcomes of a small local health department's (LHD's) strategy to build and use information systems. The case study is based on a review of documents and semi-structured interviews with key informants in the Pomperaug District Health Department. Interviews were recorded, transcribed, coded, and analyzed.

Results and Conclusions: The case study here suggests that small LHDs can use a low-resource, incremental strategy to build information systems for improving departmental effectiveness and efficiency. Specifically, we suggest that the elements for this department's success were simple information systems, …

The Methods Behind 2015 Informatics Capacity And Needs Assessment Study, Gulzar H. Shah

Health Policy and Management Faculty Publications

The 2015 Informatics Needs and Capacity of Local Health Departments (LHDs) survey is the most recent comprehensive source of quantitative data on LHD informatics. Conducted by the National Association of County & City Health Officials (NACCHO), this is the third nationally representative quantitative study of LHD informatics since 2009. The previous 2 comprehensive quantitative assessments were conducted by NACCHO in 2009-2010 and 2011. Given that public health informatics is rapidly evolving, the 2015 Informatics survey is a much-needed country-wide assessment of the current informatics needs and capacities of LHDs. This article outlines detailed methodology used in the 2015 Informatics survey, …

Assessing Skills And Capacity For Informatics: Activities Most Commonly Performed By Or For Local Health Departments, Kate Drezner, Lisa Mckeown, Gulzar H. Shah

Health Policy and Management Faculty Publications

Objective: To describe the informatics activities performed by and for local health departments.

Design: Analysis of data from the 2015 Informatics Capacity and Needs Assessment Survey of local health departments conducted by the Jiann-Ping Hsu College of Public Health at Georgia Southern University in collaboration with the National Association of County & City Health Officials.

Participants: 324 local health departments.

Main Outcome Measure(s): Informatics activities performed at or for local health departments in use and analysis of data, system design, and routine use of information systems.

Results: A majority of local health departments extract data from information systems (69.5%) and …

Urgent Challenges For Local Public Health Informatics, Joseph P. Gibson, Gulzar H. Shah, Laura C. Streichert, Linda Verchick

Health Policy and Management Faculty Publications

This editorial highlights the urgent challenges for local public health informatics and provides solutions to face these challenges.

Control Of The Public Health It Physical Infrastructure: Findings From The 2015 Informatics Capacity And Needs Assessment Survey, Kelley Chester, Barbara L. Massoudi, Gulzar H. Shah

Health Policy and Management Faculty Publications

Background: Despite improvements in information technology (IT) infrastructure in public health, there is still much that can be done to improve the adoption of IT in state and local health departments, by better understanding the impact of governance and control structures of physical infrastructure.

Objective: To report out the current status of the physical infrastructure control of local health departments (LHDs) and to determine whether there is a significant association between an LHD's governance status and control of the physical infrastructure components.

Design: Data came from the 2015 Informatics Capacity and Needs Assessment Survey, conducted by Georgia Southern University in …

Informatics As A Strategic Priority And Collaborative Processes To Build A Smarter, Forward-Looking Health Department, Kay Lovelace, Gulzar H. Shah

Health Policy and Management Faculty Publications

This article was published in the Journal of Public Health Management and Practice.

Using Information Systems To Improve A Mid-Sized Local Health Department’S Effectiveness In A Time Of Rapid Change, Kay Lovelace, Gulzar H. Shah

Health Policy and Management Faculty Publications

Background: Informatics capacity building is resource and personnel intensive. Many local health departments (LHDs) face tradeoffs between using their resources to carry out existing mandates and using resources to build their capacity, for example, through informatics, to deliver essential services in a more effective and efficient manner.

Objective: The purpose of this case study is to describe how a mid-sized LHD built and used information systems to support its strategic objectives, clinical services, and surveillance.

Methods: The mid-sized LHD described here was chosen for its “best practices” in informatics capacity building and use by NACCHO's study advisory committee. To conduct …

Health Policy & Management News, Georgia Southern University

Health Policy & Management Department News (2011-2018)

• Georgia Southern Studies LHDs Partners and Challenges in Electronic Exchange of Health Information
• Georgia Southern Studies the Interoperability of Information Systems Managed and Used by LHDs

Chemical Reactions: Marijuana, Opioids, And Our Families, Denise A. Hines Ph.D, Staci Gruber Ph.D, John F. Kelly Ph.D, Kathleen M. Palm Reed, Hilary Smith Connery M.D., Ph.D.

Mosakowski Institute for Public Enterprise

Chemical Reactions: Marijuana, Opioids, and Our Families is the seventh Massachusetts Family Impact Seminar. This seminar was designed to emphasize a family perspective in policymaking on issues related to the legalization of marijuana and managing the opioid abuse crisis in the Commonwealth. In general, Family Impact Seminars analyze the consequences an issue, policy, or program may have for families.

How Medicaid And Other Public Policies Affect Use Of Tobacco Cessation Therapy, United States, 2010-2014., Leighton Ku, Erin Brantley, Tyler Bysshe, Erika Steinmetz, Brian K. Bruen

Health Policy and Management Faculty Publications

INTRODUCTION: State Medicaid programs can cover tobacco cessation therapies for millions of low-income smokers in the United States, but use of this benefit is low and varies widely by state. This article assesses the effects of changes in Medicaid benefit policies, general tobacco policies, smoking norms, and public health programs on the use of cessation therapy among Medicaid smokers.

METHODS: We used longitudinal panel analysis, using 2-way fixed effects models, to examine the effects of changes in state policies and characteristics on state-level use of Medicaid tobacco cessation medications from 2010 through 2014.

RESULTS: Medicaid policies that require patients to …