Health Information Technology Commons^™

Electronic Health Record Documentation: Is It An Accurate Indicator Of Quality Of Care For Mechanically Ventilated Patients?, Joetta Powell

Applied Research Projects

Background: Ventilator associated pneumonia is one of the leading hospital acquired infections associated with increased mortality and lengths of stay in mechanically ventilated patients.

Hypothesis: It is hypothesized that the introduction of chlorhexidine gluconate will show reduction in the incidences of ventilator associated pneumonia and a greater reduction with tooth brushing vs oral swabbing. It is also hypothesized that the electronic health record will provide more evidence of quality of care than an external EHR sources.

Methods: The non-randomized, non-sampled population included 98 patient records that met the inclusion criteria. The external tool, Automated Vent Bundle tool provided information as …

Electronic Prescribing: Improving The Efficiency And Accuracy Of Prescribing In The Ambulatory Care Setting, Amber Porterfield, Kate Engelbert, Alberto Coustasse

Management Faculty Research

Electronic prescribing (e-prescribing) is an important part of the nation's push to enhance the safety and quality of the prescribing process. E-prescribing allows providers in the ambulatory care setting to send prescriptions electronically to the pharmacy and can be a stand-alone system or part of an integrated electronic health record system. The methodology for this study followed the basic principles of a systematic review. A total of 47 sources were referenced. Results of this research study suggest that e-prescribing reduces prescribing errors, increases efficiency, and helps to save on healthcare costs. Medication errors have been reduced to as little as …

Reduction Of Intensive Care Unit Length Of Stay: The Case Of Early Mobilization, Alex Hunter, Leslie Johnson, Alberto Coustasse

Management Faculty Research

Bed rest or immobilization is frequently part of treatment for patients in the intensive care unit (ICU) with critical illness. The average ICU length of stay (LOS) is 3.3 days, and for every day spent in an ICU bed, the average patient spends an additional 1.5 days in a non-ICU bed. The purpose of this research study was to analyze the effects of early mobilization for patients in the ICU to determine if it has an impact on the LOS, cost of care, and medical complications. The methodology for this study was a literature review. Five electronic databases were used, …

Telehealth: Into The Mainstream?, Lisa Sprague

National Health Policy Forum

Teleheath, and its subset telemedicine, extend across a range of technologies allowing patients to seek diagnosis, treatment, and other services from clinicians by electronic means. Telephone, videoconferencing, iPads, and apps are all employed. In its most established form, hospitals and medical centers use telehealth to reach patients in underserved rural areas. Proponents of telehealth suggest it can relieve medical workforce shortages; save patients time, money, and travel; reduce unnecessary hospital visits; improve the management of chronic conditions; and improve continuing medical education. But telehealth also faces ongoing challenges. States require physicians to be licensed in each state where they treat …

Clinical Information Needs Of The Allopathic Medical Practitioners In Developing Country, India: A Descriptive Analysis With Workplace., Dr.Sathivel Murugan Bomman, Dr.Ally Sornam S, Dr.Mohan Kumar V

Library Philosophy and Practice (e-journal)

Clinical Information need is an important factor for the practicing allopathic medical practitioners. This study aim is to identify the practitioners’ clinical information needs level and analysed with their experience and correlate with gender, educational qualification and workplace. Experience is classified into six categories like; 0-5years, 6-10years, 11-15years, 16-20years, 21-25years and above 25 years. Survey method is adopted and pretested questionnaire is used as a tool for data collection. Salem, Erode, Trippur, Coimbatore, and the Nilagari districts medical practitioners are used for this study. Among the 5290 samples, 10% (529) practitioners are selected by Stratified Proportionate Random …

A Case Study On Empowering A Non-Profit Organization To Better Help People With Disabilities Through M-Health, James Lawler, Hannah Moller, Robert Salloum

Wilson Center for Social Entrepreneurship

Local non-profit organizations are constrained in developing efficient methods for helping people with disabilities confined at their own homes. The cost of labor of physically serving such people is a continued issue at the organizations. This case study explores an entrepreneurial focus on best-in-class applications of m-Health devices for improving methods of home medication support furnished by a leading metropolitan non-profit organization. This study explores further the potential of hosted infrastructure-as-a-service (IaaS) m-Health remote monitoring systems technology. The findings of this study can benefit non-profit organizations considering economic entrepreneurial innovation in interactive managed care technology.

Protecting Health Privacy In An Era Of Big Data Processing And Cloud Computing, Frank A. Pasquale, Tara Adams Ragone

Faculty Scholarship

This Article examines how new technologies generate privacy challenges for both healthcare providers and patients, and how American health privacy laws may be interpreted or amended to address these challenges. Given the current implementation of Meaningful Use rules for health information technology and the Omnibus HIPAA Rule in health care generally, the stage is now set for a distinctive law of “health information” to emerge. HIPAA has come of age of late, with more aggressive enforcement efforts targeting wayward healthcare providers and entities. Nevertheless, more needs to be done to assure that health privacy and all the values it is …

Does Computerized Physician Order Entry Reduce Medical Errors?, Krista Charles, William K. Willis, Alberto Coustasse

Management Faculty Research

Introduction: Computerized Physician Order Entry (CPOE) is a system that allows physicians to electronically order patient services. The services that can be ordered, but are not limited to include: prescriptions, labs, x-rays, and referrals. Adopting CPOE will eliminate the use of paper orders with illegible hand writing. The purpose of this research project was to examine the cause of medical errors and to determine if adopting a CPOE system would be an effective solution to this problem.

Results: The results of this study show that CPOE can reduce medical errors and adverse drug events significantly. CPOE coupled with other systems …

Medical Education, Pdas And Smartphones: Welcome To The 21st Century, David P. Paul, Nicole Moussa, Sara Asad, Brad Pershing, Alberto Coustasse

Management Faculty Research

PDAs and Smartphones allow medical professionals to access medical information more easily than ever before. This literature review examines use of these devices and associated “apps” in medical education, finding widespread use by medical students, residents, and faculty. Surprisingly, little generational bias was noted.

Developing Effective Hospital Management Information Systems: A Technology Ecosystem Perspective, Christopher Bain

Theses: Doctorates and Masters

This thesis presents the results of the program of research performed in the completion of a Doctor of Philosophy (Business) entitled: Developing Effective Hospital Management Information Systems: A Technology Ecosystem Perspective.

The central contention of this thesis is that the current ecosystem models in the information technology (IT) and information systems (IS) literature can be extended and improved. In turn they can be better applied to the field of IS and the development and implementation of information systems. This research seeks to highlight an example of how these models can be extended, through an analysis of the specific context of …

The Impact Of The Electronic Medical Record On Health Information Management Staff In Two Southeastern States, Betsy W. Bradley

Applied Research Projects

Health information management (HIM) staffs in health care facilities have a long history of managing medical records in a paper format. Since 2009, with the passage of the Health Information Technology for Economic and Clinical Health Act (HITECH), health care facilities have been rapidly changing from a paper medical record system to an electronic system. The adoption of electronic record systems has reduced or eliminated paper medical record forms which consequently changed many HIM staff’s jobs. A survey of HIM professionals was conducted in two southeastern states to determine any increase or decrease in HIM staff numbers and to identify …

Adoption Of Health Information Technology In Nursing Homes, Robert Smiley

Applied Research Projects

Background: Comprehensive knowledge about the level of Health Information Technology (HIT) adoption in Nursing Homes remains subpar to 21st century healthcare standards.

Objective: This study is to determine the factors that will aid in the adoption of HIT in Nursing Homes in the New York metropolitan area.

Methods: A pilot survey was issued to employees at three Nursing Homes to collect data that would aid in the adoption of HIT in Nursing Homes in the New York metropolitan area.

Study Design: A 16 question survey was administered to twenty-one employees at three separate Nursing Homes in the New York metropolitan …

Meaningful Use: Electronic Clinical Quality Measure Reporting, Rhonda K. Denzel

Applied Research Projects

The adoption of health information technology and the meaningful use of electronic health records is a byproduct of the 2009 American Recovery and Reinvestment Act (ARRA). One measure of ARRA is the Health Information and Technology for Economic and Clinical Health (HITECH) Act which authorizes the Centers for Medicare and Medicaid Services (CMS) to provide monetary incentives to hospitals and providers who demonstrate meaningful use of certified electronic health records (EHRs).

The electronic reporting of clinical quality measures is but one requirement for demonstrating meaningful use. Reporting of clinical quality measures has been around for 25 plus years as a …

Meaningful Use – Is It Worth It?, Karen Perry Callahan

Applied Research Projects

The world of medicine has long been an ever changing environment. The advancements and progress in both knowledge and techniques has made patient care and treatment an increasingly successful endeavor. Physicians are often eager to embrace any new technology in the medical field that allows them to better care for their patients. The problem with new medical technology is that unless this technology can be shared or related to others, it is somewhat useless.

The medical profession has been somewhat reluctant to come to terms with the use of computer technology and its many benefits. Generally embedded in the use …

Implementation Plan For Emr And Beyond, Lori Katterhagen

Doctor of Nursing Practice (DNP) Projects

Change is never easy for anyone, but how we implement change can make the difference in how an innovation is accepted. Over the last two years, a small community hospital in California has introduced a new electronic medical record (EMR) to meet the requirements of meaningful use mandated by the Centers for Medicare and Medicaid (CMS) for all hospitals across the United States. EMRs are expected to improve quality in many areas, especially to improve outcomes, while safely reducing costs (U.S. Department of Health & Human Services, 2012). Adoption of EMR’s is not optional, if facilities want to avoid penalties …

The Advanced Practice Nurse And Patient-Centered Medical Home: Maintaining Patient Focus, Meeting The Institute For Healthcare Improvement Triple Aim Through The Electronic Health Record, Aileen Teresa Twomey

Seton Hall University DNP Final Projects

The Federal Government enacted the Heath Information Technology for Economic and Clinical Health Act (HITECH) in 2009, which incentivized providers to use electronic health records (EHR) for meaningful use (MU); the Patient-Centered Medical Home (PCMH) stems from the Act. Research by the National Council on Quality Assurance (NCQA) shows that primary care practices have a positive influence on the health of patients, families and communities. These positive influences are related to their ability to deliver first-contact access, and to develop long-term therapeutic relationships that focus on the person rather than the disease, improving patient health outcomes and reducing health care …

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

Management Faculty Research

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 …

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

Management Faculty Research

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 …

Rfid Technology Selection And Economic Justification For Healthcare Asset Tracking, Tyler Robert Peabody, Tali Freed

Master's Theses

Although Radio Frequency Identification (RFID) and Real-Time Location System (RTLS) technologies for inventory tracking have been growing in popularity, the healthcare industry has been reluctant to adopt these technologies. One of the primary reasons for this lack of enthusiasm has been the risk associated with electromagnetic interference between RFID/RTLS systems and medical equipment functionality. The other reason has been the substantial cost and complexity of implementing RFID/RTLS in healthcare organizations. In this study, we show that there are several ways to safely install RFID/RTLS systems to improve the inventory management processes of hospitals and clinics. We then analyze the inventory …

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

Management Faculty Research

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.

Icd-10 In The United States: Better Late Than Never, Holly Johns, Cara Havens, Danielle Robinson, Bala S. Pothakamuri, David P. Paul Iii, Alberto Coustasse

Management Faculty Research

The United States faces a revolution in the healthcare system soon, when the present coding system (ICD-9) will be replaced with what has for some years been the international standard: ICD-10. ICD-10 will provide a tremendous opportunity for better capturing the information in the increasingly complex delivery of healthcare. Although the transition to ICD-10 will undoubtedly result in substantial short-term costs, the long term benefits make the transition imperative.

Information Sources In Relation To Information Quality, Information-Seeking, And Uncertainty In The Context Of Healthcare Reform, Jennifer L. Bevan

Communication Faculty Books and Book Chapters

This exploratory study examines information-seeking about the 2010 Patient Protection and Affordable Care Act (i.e. healthcare reform) in relation to the potential barriers of uncertainty,uncertainty discrepancy, and low health self-efficacy. Adult United States participants completed an anonymous online survey about their perceptions and understanding of healthcare reform. Results confirmed recent literature, suggesting a complex relationship between information-seeking and uncertainty. Specifically, for this sample, significant positive relationships were observed between information-seeking about healthcare reform and uncertainty, uncertainty discrepancy, health self-efficacy. Further, uncertainty discrepancy was the potential barrier that accounted for the most variance in predicting information-seeking.Implications of these findings for improving …

Electronic Health Record Incentive Program Demonstrates Adoption Association With Improved Care, Keith Rosenbaum

Applied Research Projects

This study used Meaningful Use (MU) payment information as a proxy for electronic health record (EHR) adoption linked to Centers for Medicare and Medicaid (CMS) data indicating quality to demonstrate the association of EHR adoption with improved care. The CMS quality indicators used were comprised of data from the value-based purchasing (VBP) program, readmission reduction program, and hospital compare mortality data. Results showed a positive association of EHR adoption with the VBP data, which most closely aligns the MU achievement period with the quality measure period. Readmission and mortality data showed negative and neutral associations, respectively, with a less aligned …

The Role Of Is Infrastructure And Organizational Context On Implementation Of Electronic Health Records Systems, Pilar Pazos, Anjee Gorkhali, Rolando Delaguila

Engineering Management & Systems Engineering Faculty Publications

This research explores the role that Information System (IS) infrastructure and organizational context play on the implementation of Electronic Health Records (EHR) Systems. A number of indicators can be used as a proxy for IS infrastructure such as: Information System (IS) Department Budget allocation, percentage of full time IS staff and the number of technical trainings provided by the IS department to the clinical staff. Data was obtained from the Healthcare Information and Management Systems Society (HIMSS) database, a non-for profit organization that evaluates the use of information technology in the health care industry. This paper reports on the development …

Legal Issues With The Electronic Health Record, Hannah Jackson

Applied Research Projects

Introduction

The purpose of this paper is to make readers aware of the legal issues in the electronic health record (EHR) and the risks involved so they can be prepared. It is also to help provide solution to those who are already dealing with the risks. The goal of this Project is to reach out to health care facilities who are about to embark on a new chapter in health care that we call, the EHR. Everyone should know the risks of a product before purchasing and that is what my research will show.

Method

I used The Journal of …

Closing The Meaningful Use Gap Between Small And Large Practices, Crystal L. Jones

Applied Research Projects

The Lack of Meaningful Use Awareness in small practices is very prevalent. One may ask why there is such a gap in MU Awareness amongst small and large practices. The answer is quite the same across the board for small practices, “Cost”. This misfortune has resulted in many small practice physicians and staff being objective to the adoption of an electronic health record system. They are indifferent about the penalties that will be enforced soon, if they do not follow suite with the guidelines mandated by the ARRA. Essentially, this thesis will provide statistical data on the adoption rate of …

Correctional Telemedicine And Its Benefits For Female Inmates, Chelsea Oliver

Applied Research Projects

The purpose of this study is to identify health issues that are specific to the female population of correctional institutions and how telemedicine would be beneficial in providing healthcare to same. A questionnaire was developed using information from literature on the topics obtained from a variety of places. Once the questionnaire was completed, a randomly selected group of telemedicine providers received the questionnaire, along with an introduction and information on the study that was being conducted.

The barriers of this study came from telemedicine providers either not responding to the questionnaire entirely or the providers only being able to answer …

Anesthesia Information Management Systems: A Review Of The History, The Products, And The Adoption Of These Systems, Emily G. Hoffner

Applied Research Projects

Anesthesia Information Management Systems (AIMS) have been growing in popularity and use over the past decade, but widespread adoption of these systems by anesthesia groups and hospitals across the country is yet to occur. The promise of AIMS reaches beyond basic anesthesia recordkeeping into a realm of complex, integrated systems with enhanced billing, improved regulatory requirements, improved communication amongst caregivers, and reduced medical-legal exposure. In fact, AIMS have been shown to improve patient care and can increase the financial performance of a group. Despite the documented benefits of AIMS, adoption of these systems is low. This paper will review the …

Increasing Patient Engagement In The African American Community Through Personal Health Record Use, Andrea Perkins

Applied Research Projects

Personal Health records have many potential benefits to patients, caregivers and institutions. In order to meet meaningful use standards EHR systems must allow patients to be able to access and easily download their healthcare records and images for their own use. Previous studies have shown that African Americans are less likely to enroll in a personal health record than other ethnic populations. This study was done to research and identify possible barriers the have limited the utilization of personal health record use in the African American community. A preliminary survey and focus group were convened to discuss issues affecting PHR …

An Evaluation Of The Role Of The Originator Of Catastrophic Edits/Data Overwrites Within The Veteran Health Administration, Britney Braxton

Applied Research Projects

Objective: To determine which job function causes or creates a large number of Catastrophic Edit/ Data Overwrites within VHA.

Methods: The study is based on data extracted from the Catastrophic Edits Monthly Reports reported by the HC IdM Team staff on the CEs that have occurred on the MPI. Catastrophic Edits (CEs) reported by the HC IdM team between November 2011 through December 2012 are examined.

Result: Out of the 2736 Potential Identity Changes, 115 actually resulted in a CE. The number of CEs created by each job title ranged from 1% by Employee Health Clerk to 28% by Eligibility …