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Physician Service Attribution Methods For Examining Provision Of Low-Value Care, Eva Chang PhD, MPH, Diana SM Buist PhD, MPH, Matthew Handley MD, Roy Pardee JD, MA, Gabrielle Gundersen MPH, Robert J. Reid MD, PhD 2017 echang@rti.org

Physician Service Attribution Methods For Examining Provision Of Low-Value Care, Eva Chang Phd, Mph, Diana Sm Buist Phd, Mph, Matthew Handley Md, Roy Pardee Jd, Ma, Gabrielle Gundersen Mph, Robert J. Reid Md, Phd

eGEMs (Generating Evidence & Methods to improve patient outcomes)

Objectives: There has been significant research on provider attribution for quality and cost. Low-value care is an area of heightened focus, with little of the focus being on measurement; a key methodological decision is how to attribute delivered services and procedures. We illustrate the difference in relative and absolute physician- and panel-attributed services and procedures using overuse in cervical cancer screening.

Study Design: A retrospective, cross-sectional study in an integrated health care system.

Methods: We used 2013 physician-level data from Group Health Cooperative to calculate two utilization attributions: (1) panel attribution with the procedure assigned to the physician’s predetermined ...


The Effect Of A Culturally Tailored Web-Based Physical Activity Promotion Program On Asian American Midlife Women’S Depressive Symptoms, Wonshik Chee, Sangmi Kim, Xiaopeng Ji, Sooyoung Park, Eunice Chee, Hsiu-Min Tsai, Eun-Ok Im 2016 Duke University

The Effect Of A Culturally Tailored Web-Based Physical Activity Promotion Program On Asian American Midlife Women’S Depressive Symptoms, Wonshik Chee, Sangmi Kim, Xiaopeng Ji, Sooyoung Park, Eunice Chee, Hsiu-Min Tsai, Eun-Ok Im

Asian/Pacific Island Nursing Journal

The benefits of physical activities on depressive symptoms have increasingly been reported in the literature, but the effect through which a Web-based physical activity promotion program alleviates depressive symptoms is not clearly known, especially among ethnic minority midlife women. The purpose of this pilot randomized control study is to examine the preliminary efficacy of the Web-based physical activity promotion program in enhancing the depressive symptoms of Asian American midlife women through increasing physical activity. This study adopted a randomized repeated measures pretest/posttest control group design. This study consisted of two groups of research participants: 18 in an intervention group ...


Implementation Of A Computerized Screening Inventory: Improved Usability Through Iterative Testing And Modification, Edwin D. Boudreaux, Andrew Christopher Fischer, Brianna Haskins, Zubair Saeed Zafar, Guanling Chen, Sneha A. Chinai 2016 University of Massachusetts Medical School

Implementation Of A Computerized Screening Inventory: Improved Usability Through Iterative Testing And Modification, Edwin D. Boudreaux, Andrew Christopher Fischer, Brianna Haskins, Zubair Saeed Zafar, Guanling Chen, Sneha A. Chinai

Edwin D. Boudreaux

BACKGROUND: The administration of health screeners in a hospital setting has traditionally required (1) clinicians to ask questions and log answers, which can be time consuming and susceptible to error, or (2) patients to complete paper-and-pencil surveys, which require third-party entry of information into the electronic health record and can be vulnerable to error and misinterpretation. A highly promising method that avoids these limitations and bypasses third-party interpretation is direct entry via a computerized inventory.

OBJECTIVE: To (1) computerize medical and behavioral health screening for use in general medical settings, (2) optimize patient acceptability and feasibility through iterative usability testing ...


Health Communication, Information Technology And The Public’S Attitude Toward Periodic General Health Examination, Quan-Hoang Vuong 2016 Universite Libre de Bruxelles

Health Communication, Information Technology And The Public’S Attitude Toward Periodic General Health Examination, Quan-Hoang Vuong

Quan-Hoang Vuong

Periodic general health examinations (GHEs) are gradually becoming more popular as they employ
subclinical screenings as a means of early detection. This study considers the effect of information
technology (IT), health communications and the public’s attitude towards GHEs in Vietnam. A total of
2,068 valid observations were obtained from a survey in Hanoi and its surrounding areas, out of which
42.12% said they were willing to use IT applications to recognise illness symptoms, nearly 2/3 of them
rated the healthcare quality at average level or below. The data, which is processed by the BCL model,
has ...


Leveraging A Statewide Clinical Data Warehouse To Expand Boundaries Of The Learning Health System, Christine B. Turley 2016 Health Sciences South Carolina

Leveraging A Statewide Clinical Data Warehouse To Expand Boundaries Of The Learning Health System, Christine B. Turley

eGEMs (Generating Evidence & Methods to improve patient outcomes)

Learning Health Systems (LHS) require accessible, usable health data and a culture of collaboration—a challenge for any single system, let alone disparate organizations, with macro- and micro-systems. Recently, the National Science Foundation described this important setting as a cyber-social ecosystem. In 2004, in an effort to create a platform for transforming health in South Carolina, Health Sciences South Carolina (HSSC) was established as a research collaboration of the largest health systems, academic medical centers and research intensive universities in South Carolina. With work beginning in 2010, HSSC unveiled an integrated Clinical Data Warehouse (CDW) in 2013 as a crucial ...


Assessing The Performance Differences Between Hospitals With And Without Meaningful Use Of Electronic Health Records On Care Outcomes, Joseph G. Conte 2016 Seton Hall School Health Sciences

Assessing The Performance Differences Between Hospitals With And Without Meaningful Use Of Electronic Health Records On Care Outcomes, Joseph G. Conte

Seton Hall University Dissertations and Theses (ETDs)

Background and Purpose of the Study: The U.S. healthcare system at $3 trillion, is the sixth largest economy in the world. The federal government is the largest purchaser of healthcare in the country. In the past decade it has been on a quest to refocus its purchasing from volume to value. While spending nearly double per capita than every other industrialized nation, U.S. healthcare outcomes are consistently in the lowest quartile for every major indicator from life expectancy to ambulatory sensitive conditions. The Crossing the Quality Chasm Report (IOM) focused a lens on the dearth of electronic health ...


Submitting Uds Reports In Athenanet: Assisting Clinics In Meeting Federal Requirements, Daniel Richard Eident 2016 University of Massachusetts Boston

Submitting Uds Reports In Athenanet: Assisting Clinics In Meeting Federal Requirements, Daniel Richard Eident

Instructional Design Capstones Collection

Athenahealth, Inc. is an electronic medical record company that provides services to medical care providers throughout the industry. In order to fully serve all of its clients, training is offered through hands-on coaching and training, and asynchronous e-learning. This paper explores the training developed to support one of athenahealth’s more unique clients, the Federally Qualified Healthcare Clinic, a type of clinic that serves underserved communities including the homeless, migrant-workers, and minorities. Through the process of a needs analysis and developing the instructional strategy, a curriculum was designed with the goal of increasing productivity of FQHCs through reducing calls for ...


Incidence Of Student Registered Nurse Anesthetists In The United States Who Own And Use Smartphone As Supplemental Learning Tools, Ruoyu Zhao 2016 University of Southern Mississippi

Incidence Of Student Registered Nurse Anesthetists In The United States Who Own And Use Smartphone As Supplemental Learning Tools, Ruoyu Zhao

Doctoral Nursing Capstone Projects

Background: Smartphones have a great potential for students to learn more efficiently. Students now have the ability to download applications with pertinent information in the palm of their hand for both educational and clinical duties. This descriptive correlational quantitative research examines whether student registered nurse anesthetists own and use smartphones as supplementary learning tools.

Methods: An online survey was sent through AANA to Masters and DNP student registered nurse anesthetists (SRNAs) in the United States. Respondents were asked if they owned smartphones and how often they used smartphones for educational and clinical duties. Data Analysis was conducted using a Chi-square ...


Electronic Communication Among Anesthesia Providers, Joseph K. Wells 2016 University of Southern Mississippi

Electronic Communication Among Anesthesia Providers, Joseph K. Wells

Doctoral Nursing Capstone Projects

Facilities in the United States are utilizing electronic communication devices (ECDs) for their nursing staff on intensive care units, general medical-surgical floors, and chemotherapy floors, but it is underutilized in the operating room where seconds truly matter (Wu et al., 2012). Situations arise daily within operating rooms that require quick and decisive communication to avoid poor patient outcomes. The ultimate goal is to prevent poor patient outcomes by enhancing communication among anesthesia providers.

This doctoral project evaluated an anesthesia group in southeast Mississippi regarding their satisfaction with current devices used for communication. This anesthesia group utilized smart phones and public ...


Online Detection Of Behavioral Change Using Unobtrusive Eldercare Monitoring System, Thanh Tam LA, Alvin Cerdena VALERA, Hwee-Pink TAN, Li Fang, Cheryl (XU Lifang, Cheryl) KOH 2016 Singapore Management University

Online Detection Of Behavioral Change Using Unobtrusive Eldercare Monitoring System, Thanh Tam La, Alvin Cerdena Valera, Hwee-Pink Tan, Li Fang, Cheryl (Xu Lifang, Cheryl) Koh

Research Collection School Of Information Systems

The rapid ageing population is posing challenges to manycountries all over the world, particularly in the provision ofcare to the growing number of elderly who are living alone.Allowing the elderly to age-in-place, i.e., live safely and inde-pendently in the comfort of their own homes is a model thatcan potentially address the resource constraint in health andcommunity care faced by many nations. To make this modela reality and provide appropriate and timely care to the el-derly, unobtrusive eldercare monitoring systems (EMS) arebeing deployed in real homes to continuously monitor theactivity of the elderly. In this paper, we study the ...


Hidden Surveillance On Consumer Health Information Websites, Jacquelyn A. Burkell, Alexandre Fortier 2016 Faculty of Information and Media Studies, UWO

Hidden Surveillance On Consumer Health Information Websites, Jacquelyn A. Burkell, Alexandre Fortier

Jacquelyn Burkell

Behavioural tracking presents a significant privacy risk to Canadians, particularly when their online behaviours reveal sensitive information that could be used to discriminate against them. This concern is particularly relevant in the context of online health information seeking, since searches can reveal details about health conditions and concerns that the individual may wish to keep private. The privacy threats are exacerbated because behavioural tracking mechanisms are large invisible to users, and many are unaware of the strategies and mechanisms available to track online behaviour. In this project, we seek to document the behavioural tracking practices of consumer health websites, and ...


Hidden Surveillance On Consumer Health Information Websites, Jacquelyn A. Burkell, Alexandre Fortier 2016 Faculty of Information and Media Studies, UWO

Hidden Surveillance On Consumer Health Information Websites, Jacquelyn A. Burkell, Alexandre Fortier

Jacquelyn Burkell

Behavioural tracking presents a significant privacy risk to Canadians, particularly when their online behaviours reveal sensitive information that could be used to discriminate against them. This concern is particularly relevant in the context of online health information seeking, since searches can reveal details about health conditions and concerns that the individual may wish to keep private. The privacy threats are exacerbated because behavioural tracking mechanisms are large invisible to users, and many are unaware of the strategies and mechanisms available to track online behaviour. In this project, we seek to document the behavioural tracking practices of consumer health websites, and ...


Impact Of A Collective Intelligence Tailored Messaging System On Smoking Cessation: The Perspect Randomized Experiment, Rajani S. Sadasivam, Erin M. Borglund, Roy Adams, Benjamin M. Marlin, Thomas K. Houston 2016 University of Massachusetts Medical School

Impact Of A Collective Intelligence Tailored Messaging System On Smoking Cessation: The Perspect Randomized Experiment, Rajani S. Sadasivam, Erin M. Borglund, Roy Adams, Benjamin M. Marlin, Thomas K. Houston

UMass Center for Clinical and Translational Science Supported Publications

BACKGROUND: Outside health care, content tailoring is driven algorithmically using machine learning compared to the rule-based approach used in current implementations of computer-tailored health communication (CTHC) systems. A special class of machine learning systems ("recommender systems") are used to select messages by combining the collective intelligence of their users (ie, the observed and inferred preferences of users as they interact with the system) and their user profiles. However, this approach has not been adequately tested for CTHC.

OBJECTIVE: Our aim was to compare, in a randomized experiment, a standard, evidence-based, rule-based CTHC (standard CTHC) to a novel machine learning CTHC ...


A Study On Situational Awareness Security And Privacy Of Wearable Health Monitoring Devices, xavier bellekens 2016 Abertay University

A Study On Situational Awareness Security And Privacy Of Wearable Health Monitoring Devices, Xavier Bellekens

xavier bellekens

Situational Awareness provides a user centric approach to security and privacy. The human factor is often recognised as the weakest link in security, therefore situational perception and risk awareness play a leading role in the adoption and implementation of security mechanisms. In this study we assess the understanding of security and privacy of users in possession of wearable devices. The findings demonstrate privacy complacency, as the majority of users trust the application and the wearable device manufacturer. Moreover the survey findings demonstrate a lack of understanding of security and privacy by the sample population. Finally the theoretical implications of the ...


Patient Portals In Pharmacist-Run Ambulatory Care Clinics: Is There “Meaningful Use”?, H. Paige Erdeljac, Melissa J. Snider, Kelly Bartsch, Raul Weiss 2016 The Arthur G. James Comprehensive Cancer Center

Patient Portals In Pharmacist-Run Ambulatory Care Clinics: Is There “Meaningful Use”?, H. Paige Erdeljac, Melissa J. Snider, Kelly Bartsch, Raul Weiss

Excerpts in Pharmacy Research Journal

Objective

The purpose of this study is to describe patient portal utilization within pharmacist-managed clinics at an academic medical center from the perspectives of the institution, healthcare team, and patient. This study measures the progress toward meeting requirements for meaningful use per the Centers for Medicare and Medicaid Services (CMS).

Methods

The study included patients in pharmacist-managed clinics and consisted of a retrospective chart review and patient survey. Primary endpoints consisted of: 1) report progress toward meeting CMS criteria for meaningful use in subset of patients seen in the pharmacy-managed clinics, 2) describe utilization of patient portal across the healthcare ...


Clinical Educator And Student Perceptions Of Ipad™ Technology To Enhance Clinical Supervision: The Electronically-Facilitated Feedback Initiative (Effi), Suzanne J. Snodgrass, Darren Rivett, Scott Farrell, Kyle Ball, Samantha E. Ashby, Catherine L. Johnston, Kim Nguyen, Trevor Russell 2016 The University of Newcastle

Clinical Educator And Student Perceptions Of Ipad™ Technology To Enhance Clinical Supervision: The Electronically-Facilitated Feedback Initiative (Effi), Suzanne J. Snodgrass, Darren Rivett, Scott Farrell, Kyle Ball, Samantha E. Ashby, Catherine L. Johnston, Kim Nguyen, Trevor Russell

Internet Journal of Allied Health Sciences and Practice

Purpose: Growing demands placed upon healthcare systems require more health professionals to be trained. Clinical placement education is an integral component of health professional training, however accommodating increasing numbers of student placements is a challenge for health services. Personal digital assistants such as iPads™ may assist in delivery of clinical education, by facilitating transfer of knowledge and skills from clinical educators to health professional students, however such an initiative has not been formally investigated. The present study sought to explore perceptions of clinical educators and allied health students regarding the impact of an iPad™-based feedback delivery system on student ...


Impact Of Electronic Health Records On Patient Outcomes, Lilian Ndifon, Jude E. Edwards, Leila Halawi 2016 Washington Adventist University

Impact Of Electronic Health Records On Patient Outcomes, Lilian Ndifon, Jude E. Edwards, Leila Halawi

Leila A. Halawi

With the passing of the HITECH Act, EHRs have come into prominence and sharper focus, due to efforts by the government to push for a national adoption of EHRs into our healthcare system. This push for a national adoption of EHRs is based on the premise that it will help improve the quality delivery of health care services and reduce costs. However, this push for a “national adoption” has experienced mixed results. This study was designed to assess the impact of EHRs post-2009, the year of the HITECH Act, to review some of the key contributing factors to this mixed ...


Information Expensiveness Perceived By Vietnamese Patients With Respect To Healthcare Provider’S Choice, Quan-Hoang Vuong 2016 Universite Libre de Bruxelles

Information Expensiveness Perceived By Vietnamese Patients With Respect To Healthcare Provider’S Choice, Quan-Hoang Vuong

Quan-Hoang Vuong

Background: Patients have to acquire information to support their decision on choosing a suitable healthcare provider. But in developing countries like Vietnam, accessibility issues remain an obstacle, thus adversely affect both quality and costliness of healthcare information. Vietnamese use both sources from health professionals and friends/relatives, especially when quality of the Internet-based cheaper sources appear to be still questionable. The search of information from both professionals and friends/relatives incurs some cost, which can be viewed as low or high depending low or high accessibility to the sources. These views potentially affect their choices. Aim and Objectives: To investigate ...


Evaluating Acceptability, Feasibility And Efficacy Of A Diabetes Care Support Program Facilitated By Cellular-Enabled Glucose Meters: A Dissertation, Daniel J. Amante 2016 University of Massachusetts Medical School

Evaluating Acceptability, Feasibility And Efficacy Of A Diabetes Care Support Program Facilitated By Cellular-Enabled Glucose Meters: A Dissertation, Daniel J. Amante

GSBS Dissertations and Theses

Background. Diabetes requires significant disease management, patient-provider communication, and interaction between patients, family members, caregivers, and care teams. Emerging patient-facing technologies, such as cellular-enabled glucose meters, can facilitate additional care support and improve diabetes self-management. This study evaluated patient acceptability, feasibility, and efficacy of a diabetes care support program facilitated by cellular-enabled glucose meters.

Methods. A two-phase study approach was taken. Get In Touch – Phase 1 (GIT-1) was a 1-month pilot involving patients with type 1 and type 2 diabetes. Get In Touch – Phase 2 (GIT-2) was a 12-month randomized controlled crossover trial involving patients with poorly-controlled type 2 diabetes ...


Acceptability And Feasibility Of Web-Based Diabetes Instruction For Latinos With Limited Education And Computer Experience, Sharon A. Fitzgerald, Victor E. Martinez-Zavala, Kenia Yazmin Reyna Blanco, A Paula Cupertino, Mugur V. Geana, Edward F. Ellerbeck 2016 University of Kansas Medical Center

Acceptability And Feasibility Of Web-Based Diabetes Instruction For Latinos With Limited Education And Computer Experience, Sharon A. Fitzgerald, Victor E. Martinez-Zavala, Kenia Yazmin Reyna Blanco, A Paula Cupertino, Mugur V. Geana, Edward F. Ellerbeck

Journal of Health Disparities Research and Practice

Introduction: The internet offers an important avenue for developing diabetes self-management skills, but many Latinos have limited experience with computer-based instruction.

Objective: To evaluate the feasibility and acceptability of delivering a web-based diabetes education program in a computer classroom for Spanish-speaking Latinos.

Methods: Spanish-speaking Latinos (n=26) attended two classroom sessions to learn computer skills while navigating a web-based diabetes education platform. Diabetes knowledge was assessed before and after the intervention; structured interviews were completed to assess program acceptability.

Results: Half of participants (50%) had not previously used a computer. Post-intervention, diabetes knowledge improved significantly (p=.001). The majority of ...


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