Health Information Technology Commons^™

Can Electronic Health Records Systems Support New Payment Methods For Health Centers?, Peter Shin, Feygele Jacobs, Jeffrey Barnes, James B. Welsh, Lisa Perry, Scott D. Morgan

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This study assessed the feasibility and usefulness of combining electronic health record (EHR) data with federal cost report data for the purposes of: 1) quantifying the provision of enabling services; and 2) for use as the basis of community health center payment rate-setting. The study used EHR data derived from the Center for Primary Care Informatics to isolate enabling services and perform the end-to-end analysis that might be required to develop or evaluate reimbursement rates. The study revealed that data extracted from federal cost reports combined with data from the EHR fall short of providing the information required to reasonably …

Image Enhancement Of Cancerous Tissue In Mammography Images, Richard Thomas Richardson

CCAC Theses and Dissertations

This research presents a framework for enhancing and analyzing time-sequenced mammographic images for detection of cancerous tissue, specifically designed to assist radiologists and physicians with the detection of breast cancer. By using computer aided diagnosis (CAD) systems as a tool to help in the detection of breast cancer in computed tomography (CT) mammography images, previous CT mammography images will enhance the interpretation of the next series of images. The first stage of this dissertation applies image subtraction to images from the same patient over time. Image types are defined as temporal subtraction, dual-energy subtraction, and Digital Database for Screening Mammography …

Evaluating The Effectiveness Of Current Types Of Patient Portal Education Efforts, Jennifer L. Cooper

Applied Research Projects

Hospitals and providers participating in Meaningful Use are required to show 5% enrollment rate in their patient portals in order to receive incentive payments. The challenge with this is determining how to effectively market the portal in order to educate patients that the portal exists that also results in patients enrolling in the portal. A survey of patients was conducted at Hunt Regional Medical Center in Greenville Texas to identify how they are hearing about the patient portal and if they are signing-up as a result. While the response rate was low, the survey results did indicate what form of …

Is Administrative Discharge An Archaic Or Synchronic Program Practice? The Empirical Side Of The Debate, Izaak Williams

Journal of Health Ethics

No abstract provided.

The Role Of Occupational Therapy In Primary Care, Priti Patel

Occupational Therapy Doctorate Capstone Projects

The Capstone Project is focused on communicating, influencing and educating other health care professionals regarding the role of occupational therapy in the future model of primary care delivery initiated by the adoption of the Affordable Care Act and the Triple Aim Initiative. Currently, primary care, the largest health care platform in United States, is not inclusive of occupational therapy services. Occupational therapists have the scope, knowledge and understanding to be part of the redesigned team model of primary care. Educating those currently working in primary care about adding occupational therapy services can have a significant impact on the profession of …

The Impact Of Patient Portals On Release Of Information Requests, April Insco

Applied Research Projects

Patient portals are no longer a thing of the past. The government has issued a mandate that all covered entities who are reimbursed under Medicare payments must implement patient portals as a part of the Meaningful Use initiative or suffer penalties. The objective of this study is to review the data to see if there is a decrease in the number of release of information (ROI) requests at facilities that have implemented patient portals. A survey was conducted to determine if there was any change in the number of ROI requests that facilities received prior to implementation of patient portal …

Managing Copy And Paste Functionality In The Electronic Health Record, Tricia Urquhart-Jones

Applied Research Projects

The increased adoption of Electronic Health Records (EHR) has identified a significant need to develop tools to help providers maximize time spent documenting in the EHR. Copy and paste functionality, also known as carrying forward, cut and paste, and cloning, is one of many tools that can help providers save time and has been around longer than computers. A survey of thirteen Health Information Management (HIM) professionals responsible for HIMS functions within an acute care hospital in North Carolina was conducted. The survey response rate was 53%. The data gathered in this research study will add to HIM body of …

Health Information Exchanges And Patient Portals In Behavioral Health, Christine Peterson

Applied Research Projects

We live in an electronic world. Technology is everywhere, including in our healthcare system. With the advent on the electronic health record and the push to meet Meaningful Use, many healthcare organizations have already started using patient portals and sharing information among providers via health information exchanges. There have been roadblocks to successful implantation of patient portals and health information exchanges, one of which is how to handle behavioral health information and would these new technologies be accepted by patients with mental health diagnoses

The Challenges Of Establishing Partners In Health Information Exchange (Hie), Torian Tate

Applied Research Projects

Health information exchange (HIE) has become a focus of the health care industry. The ability to share information electronically between multiple health care providers is thought to be a key ingredient in the creation of a more efficient global health care system. VA Hospital Memphis has significant challenges in regard to HIE. The Virtual Lifetime Electronic Record (VLER) coordinator at the facility has been charged with establishing an HIE system. This requires the coordinator to identify partners to share health information with electronically, obtain buy-in from patients and providers through education, and to promote/market the VLER program facility-wide. The VA …

‘‘We Can Wipe An Entire Culture’’: Fears And Promises Of Dna Biobanking Among Native Americans, Roberto Abadie, Kathleen Heaney

Department of Sociology: Faculty Publications

This paper explores Native American perceptions on DNA biobanking. A qualitative study was conducted among self-declared Native Americans living off reservation in two Midwest cities. Findings demonstrate a paradox: Informants maintain strong hopes for the transformative power of gene-based research while voicing very particular social anxieties. Emerging genomic technologies elicit concerns over the potential for genetic stigmatization or discrimination based on race, preventing access to health insurance or employment. Frequently, social anxieties adopt the narrative form of conspiracy theories which portray powerful agents exploiting or abusing a disenfranchised population. We argue that while Native Americans do not have a monopoly …

H.E.A.P.S. In Advances Towards A Healthier Samoa The Health Education And Promotions Section’S Role In Combating Non-Communicable Diseases, Kara Le

Independent Study Project (ISP) Collection

With an increase in the number of health issues within Samoa, specifically in relation to non-communicable diseases (NCDs), it is important to examine the efforts being made by government health officials to improve Samoa’s overall health status. This study explores the role of the Health Education and Promotion Section (H.E.A.P.S.) of the Ministry of Health in establishing and promoting healthier standards within the Samoan community. The current efforts of H.E.A.P.S. in combating NCDs through recently introduced projects and programs were explored in-depth. Further analysis of the design and effectiveness of these programs in changing the unhealthy habits of Samoan people …

Exploration Of Preterm Birth Rates Using The Public Health Exposome Database And Computational Analysis Methods, Anne D. Kershenbaum, Michael A. Langston, Robert S. Levine, Arnold M. Saxton, Tonny J. Oyana, Barbara J. Kilbourne, Gary L. Rogers, Lisaann S. Gittner, Suzanne H. Baktash, Patricia Matthews-Juarez, Paul D. Juarez

Sociology Faculty Research

Recent advances in informatics technology has made it possible to integrate, manipulate, and analyze variables from a wide range of scientific disciplines allowing for the examination of complex social problems such as health disparities. This study used 589 county-level variables to identify and compare geographical variation of high and low preterm birth rates. Data were collected from a number of publically available sources, bringing together natality outcomes with attributes of the natural, built, social, and policy environments. Singleton early premature county birth rate, in counties with population size over 100,000 persons provided the dependent variable. Graph theoretical techniques were used …

Assessing Technologies For Information-Seeking On Prostate Cancer Screening By Low-Income Men, Susan W. Mcroy, Emily M. Cramer, Hayeon Song

Journal of Patient-Centered Research and Reviews

Purpose: This paper presents a multipart investigation of the benefits and challenges in deploying automated question-answering as an alternative to web-based searching to provide information about prostate cancer screening for low-income men age 40 years and older.

Methods: The study comprised: 1) a survey assessing current use of the Internet, mobile phones and texting; 2) a controlled observational study of both web-based searching and automated question-answering for information about prostate cancer; and 3) a formative field study in which subjects interacted with a health department nurse using text messages.

Results: Survey results suggest the target population has greater access to, …

Discordant Documentation Of Obesity Body Mass Index And Obesity Diagnosis In Electronic Medical Records, Jennifer T. Fink, George L. Morris Iii, Maharaj Singh, David A. Nelson, Renee E. Walker, Ron A. Cisler

Journal of Patient-Centered Research and Reviews

Purpose: This study examined concordance between presence of obesity body mass index (BMI), defined as BMI ≥ 30, in the patient’s electronic medical record (EMR) and a documented diagnosis of obesity.

Methods: We conducted a retrospective review of the EMR in a large health care system for a 1-year period (2012). A total of 397,313 patients met the study criteria of having at least one physician visit, being at least 18 years of age, and not being pregnant. Of those, 158,327 (40%) had a recorded BMI ≥ 30. We examined the EMR of these obese patients to determine whether a …

Quality Of Cancer Registry Data, Alicia Noel Richardson

Applied Research Projects

Cancer registry is a growing field and with data being collected year round the data needs to be of good quality standing. Quality of cancer care is measurable per standards when met within the time frame allotted per care regimen. Cancer programs are evaluating and implementing new process to make their data valid and complete through information technology and connection among hospital-based and community-based practices. The aim of this study is to review the available validity, barriers and utilization related to quality of cancer care data. The studies were consistent among each other in that a concurrent review of data, …

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 …

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 …

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 …

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 …

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 …

Grappling With Gatekeepers: Addressing Gender Hindrances To Mhealth, Jack O’Rourke

Independent Study Project (ISP) Collection

This study was conducted in order to understand the social and economic problems associated with Ugandan women’s usage of mobile phones and the ways in which different mHealth groups are approaching these problems. Seeing how these different groups approach this issue added new information and analysis to a relatively unexplored topic

The qualitative methodology undertaken was two pronged. First, single sex focus groups in rural Mukono District were assembled. Men, women without phones and women and with phones were all talked to in Luganda with the use of a translator. In addition to these focus groups in rural Mukono District, …

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 …

The Identity Of The Heart Patient In The Context Of The Gift Economy: Heartnet And Media Framing, Lynsey Uridge

Theses: Doctorates and Masters

This health communication research examines the identity levels of the heart patient on a therapeutic website HeartNET through an empirical investigation of site interactions as manifestations of a gift economy. The thesis also explores the media’s representation of heart health in both television and print.

This research utilised a longitudinal qualitative ethnographic and netnographic approach involving twenty-six participants who completed two in-depth interviews. The first one-on-one interview occurred during the early stages of the participants’ heart journey, explored their heart story and use of interactive technology for heart health support. The second interview occurred six to twelve months later, and …

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 …

Comparison Of Body Composition Measures In Older Adult Males, Cody Smith

Honors Projects

Body Mass Index (BMI) is a measure created to assess population wide staistics of obesity and stratify health risk. However, there are large differences in health risk when comparing BMI with measures of body composition. BMI is not a measure of body composition. Body composition measures are used to distinguish between fat mass, fat-free mass. This percent body fat is more significantly correlated with health risk.

This study analyzed various body composition methodologies including waist circumference at the umbilicus and at the narrowest point of the abdomen, sagittal abdominal diameter, bioelectrical impedance analysis, and air displacement plethysmography. The study’s purpose …

Dr. Who?: The Science And Culture Of Medical Wear Design, Patricia Duignan

Theses and Dissertations

The multi-million-dollar medical uniform industry has not utilized advancements in garment and textile technology that could positively impact the protection of healthcare professionals and patients. In most cases the uniforms meet basic requirements – they clothe the professional in a recognizable way. Little innovation in design, function and performance, has been applied to these garments. This is particularly evident in the case of the stereotypical white lab coat worn by many physicians, despite evidence indicating that these lab coats may carry contamination and play a role in the spread of deadly bacteria. Healthcare Associated Infections (HAIs) are among the most …

Situational Awareness/Triage Tool For Use In A Chemical, Biological, Radiological Nuclear Explosive (Cbrne) Environment, John N. Scarlett, Heather L. Gallup, David A. Smith

AFIT Patents

A method of managing patient care and emergency response following a Chemical, Biological, Radiological, or Nuclear Explosive (CBRNE) attack and maintaining compliance with the Health Insurance Portability and Accountability Act (HIPAA). The method including identifying each patient with a unique patient identifier, the identifier based upon the geospatial location of the patient, the geospatial location including at least the latitude and longitude of the patient when first treated, the unique patient identifier being part of patient data. Providing a collection point of patient data to form a patient data database where in the patient location data may be used to …