Health Information Technology Commons^™

A Geospatial Analysis Of Norovirus Outbreaks In California, And An Investigation Of The Impact Of Environmental Variables, Alexandra Groen

Master's Projects and Capstones

Previous studies and empirical evidence suggest norovirus outbreaks in California exhibit correlation with environmental variables and exhibit spatial spread patterns. Few studies have been done looking at what causes norovirus seasonality in temperate climates and more research is needed on the regional level. This study aims to find what relationships exist with outbreak occurrence and environmental variables in California, as well as any spatial patterns of spread or clustering of outbreaks. Spatial analysis tools were used to find any relationships between California norovirus outbreak data and environmental variables. The results showed a south to north spread of outbreaks in California …

Diabetes Type 2 Self-Management Education Program: Short Messaging From Patient Portal To Web-Enabled Device, Lynn S. Holcomb

Evidence-Based Practice Project Reports

Only one in eight adults with diabetes reaches target goals for disease management, which can lead to clinical complications, costly both economically and in quality and duration of human life. The standard of care is a quarterly 15-minute face-to-face visit-- arguably inadequate to impart self-care knowledge. The purpose of this EBP project was to deliver a 30-day diabetes self-management education program (DSMEP) utilizing widely accessible web-based technology to facilitate adults with diabetes to reach targeted goals. Using the Chronic Care Model as a framework, the DSMEP design was based on an extensive literature review of the delivery of DSMEP in …

Adapting The Standard Sir Disease Model In Order To Track And Predict The Spreading Of The Ebola Virus Using Twitter Data, Armin Smailhodzic

Masters Theses & Specialist Projects

A method has been developed to track infectious diseases by using data mining of active Twitter accounts and its efficacy was demonstrated during the West African Ebola outbreak of 2014. Using a meme based n-gram semantic usage model to search the Twitter database for indications of illness, flight and death from the spread of Ebola in Africa, principally from Guinea, Sierra Leone and Liberia. Memes of interest relate disease to location and severity and are coupled to the density of Tweets and re-Tweets. The meme spreads through the community of social users in a fashion similar to nonlinear wave propagation- …

The Importance Of A Pictorial Medical History In Assisting Medical Diagnosis Of Individuals With Intellectual Disabilities: A Telemedicine Approach, Grace Bonanno

CCAC Theses and Dissertations

When face-to-face physical medical exams are not possible, virtual physical exams, in the form of a pictorial medical exam/history, can be substituted, and telemedicine can be the means to deliver these virtual exams. The goal of this work was to determine if presence in the form of a visual and/or pictorial medical history can be of benefit to clinicians in the diagnosis of medical conditions of individuals with developmental disabilities (DDs) and/or intellectual disabilities (IDs), in particular those who cannot, because of their cognitive and/or physical disabilities, verbally relate their illness to a clinician. Virtual exams can also be useful …

An Information Privacy Examination Of The Practices Of Pharmaceutical Companies Regarding Use Of Information Collected Through Their Websites, Shonda Dellena Brown

CCAC Theses and Dissertations

Consumers have begun to take a more proactive approach to their healthcare by accessing pharmaceutical companies Websites to obtain health and drug information, support groups, rebates, coupons, as well as free drug trials. In exchange for these benefits, companies require consumers to voluntarily disclose information. However, research has shown that consumers continue to be concerned about how their information is managed, used, and distributed by companies, especially if accessed via the Web. To date, there has been limited empirical research to examine the actual online practices of companies when it comes to privacy, especially those of pharmaceutical companies. Using Delphi …

Improving Antibiotic Resistant Infection Transmission Situational Awareness In Enclosed Facilities With A Novel Interface Design For Tactical Biosurveillance, Ann L. Fruhling, Devika Ramachandran

Interdisciplinary Informatics Faculty Proceedings & Presentations

The implementation of the Electronic Health Record to substantially improve the practice of medicine has not fully reached its projected potential partly due to many barriers to its adoption. There is growing evidence that one of the reasons for the delay in the adoption of EHR has been due to the negative impact of current EHRs on the clinician-patient interaction, clinician workflow and communications. This research studies the usability of the Electronic Health Record for clinicians involved in cardiac care by evaluating various clinician-patient interaction workflows. The aim of the study is to identify inefficiencies by examining the similarities and …

Evaluation Of Patient To Provider Oriented Telemedicine In Hospitals And Physician Practices, Macklin G. Gaynor

Muskie School Capstones and Dissertations

This project explores barriers to telemedicine adoption and meaningful integration with contemporary healthcare delivery systems.

Conception To Implementation: Quality Improvement In Behavioral Health Home Organizations, Elizabeth A. Miller

Muskie School Capstones and Dissertations

This capstone project developed quality improvement tools to be used by community mental health agencies participating in the Maine Behavioral Health Homes Initiative. Providing technical assistance, analysis of feedback, and developing recommendations were the foundation of this project with a central tenet to enhance the existing Quality Improvement Project Template created by MaineCare, Maine’s Medicaid Office. These recommendations suggest the Quality Improvement Project Template may be improved by providing an additional fillable quality improvement process outline, providing a list of example projects and focus areas for quality improvement projects, and providing tools to assist in implementation of quality improvement projects. …

Telephone Usage At Mercy Hospital's Primary Care Practices, Julia C. Nason

Muskie School Capstones and Dissertations

This capstone focuses on Mercy’s primary care practices, reviews how their phone process currently works, reasons for patients calling, and then researching best practices for the telephones.

The Value Of Online Medication Rating Systems To Older Adults And Their Association With Self-Reported Outcomes, Yazed Sulaiman Alruthia

Theses and Dissertations (ETD)

The Internet is a powerful and very popular vehicle for distributing judgment-free health information to patients. Multiple studies have examined the role of online health information as well as physician-rating websites in health care. Studies have examined the value of online drug information for patients and the value of the online drug information for patients. However, no study has examined the usefulness or value of online medication rating websites in facilitating physician-patient communication or participant-reported outcomes. In this study, the value of online medication rating websites to older adults in facilitating communication with their physicians using a newly developed tool …

Emr Training Tactics: A Case Study Of Clinical Staff Training Experiences, Needs And Perceptions, Victoria Leaann Miller

Graduate Theses and Dissertations

Electronic medical record systems have become essential for giving patient care at health care institutions. The purpose of this study was to explore the training provided to staff at the University of Arkansas for Medical Sciences Northwest Family Medical Center in an effort to identify participant training experiences, needs, and perceptions. This study included qualitative, case study research. There were fourteen participants in the study. A focus group interview was conducted with eight administrative and training participants. Interviews and observations were conducted with six staff members.

The literature review of this study discussed educational theories including andragogy and training techniques. …

The Patient Portal And Abnormal Test Results: An Exploratory Study Of Patient Experiences, Traber Giardina, Varsha Modi, Danielle Parrish, Hardeep Singh

Patient Experience Journal

Many health care institutions are implementing patient portals that allow patients to track and maintain their personal health information, mostly in response to the Health Information Technology for Economic and Clinical Health Act requirements. Test results review is an area of high interest to patients and provides an opportunity to foster their involvement in preventing abnormal test results from being overlooked, a common patient safety concern. However, little is known about how patients engage with portals to review abnormal results and which strategies could facilitate that interaction in order to ensure safe follow-up on abnormalities. The objective of this qualitative …

Health Information Technology: A Key Ingredient Of The Patient Experience, Matthew Werder

Patient Experience Journal

In this exploration to understand the linkages of health information technology (HIT) and patient experience, a comprehensive literature search was conducted using the key words, “information technology, HIT, patient experience, patient satisfaction, and technology”, on the MEDLINE, PubMed, and EMBASE databases resulting in over 1,000 citations. Eventually, 35 of the most relevant articles were reviewed and 11 identified as key references to include in beginning to explore the question, as the transformation of healthcare continues, how can technology enable a positive return on investment to a patients’ perception of their care in an organization and how can technology impact the …

Model Of Cost-Effectiveness Of Mri For Women Of Average Lifetime Risk Of Breast Cancer, Mckenna L. Kimball

Scholarly and Creative Works Conference (2015 - 2021)

Background: Mammography is the current standard for breast cancer detection however magnetic resonance imaging (MRI) is a more sensitive method of breast imaging. Despite MRI’s increased sensitivity, MRI has more false positives and higher costs. The purpose of this study was to determine if MRI or MRI in conjunction with mammography was a cost-effective solution for breast cancer detection in women with average lifetime risk of breast cancer.

Methods: A mathematical model was used to compare annual mammography, annual MRI, and mammography and MRI on alternate years. The model included the natural history of breast cancer, screening by mammography …

Clinical Effectiveness Of Inr Patient Self-Testing: Adults On Warfarin Therapy In Private Practice, Anisa Munshi

Doctor of Nursing Practice Final Manuscripts

Background: Warfarin is the most commonly prescribed oral anticoagulant for the prevention and treatment of venous thromboembolism. Due to its narrow therapeutic index, warfarin requires close monitoring of the international normalized ratio (INR) to ensure proper anticoagulation control and safety. INRs outside of this range are strongly associated with an increased risk of major bleeding, thromboembolic events, and death. Patient self-testing (PST) using a point-of-care device allows patients to monitor INR results at home. Evidence shows that PST improves the clinical outcomes of warfarin therapy compared to usual care, which includes laboratory INR monitoring. Purpose: To compare the clinical effectiveness …

The Detrimental Pitfalls Of Provider Documentation, Rosalind Crook-Duckett

Applied Research Projects

Electronic Health Records hold many benefits and clearly is a cut above maintain-ing paper records. Although, over the years we have learned that there are potential drawbacks that come with having an electronic health record. This review on EHR’s, is what could be, considered detrimental pitfalls of provider documentation (copying and pasting) and how this may affect the safety and quality of the physician documentation and patient care.

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 …

Examining Faith Community Nurses’ Perception And Utilization Of Electronic Health Records, Carole N. Mattingly, M. Eve Main

International Journal of Faith Community Nursing

Abstract

The purpose of this study is to identify current faith community nurse documentation practices, explore factors impacting intention to adopt electronic health records, and identify perceived barriers and benefits to electronic health record use among faith community nurses practicing in the Midwest. The technology acceptance model is used to examine impact of perceived usefulness and perceived ease of use of electronic health records on intention to adopt.

This study is a quantitative exploratory research study utilizing a cross-sectional researcher-developed 39-item questionnaire. Surveys were distributed by mail and e-mail to faith community nurses practicing in South-Central Indiana and Western Kentucky. …

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 …

A Study Of Access Control For Electronic Health Records, Sergio Vincent Senese

All Student Theses and Dissertations

The expansion between Information Technology and Healthcare has created many new options for both disciplines, as well as challenges. One of these topics is the Electronic Health Record (EHR) and the push for a universal record. A challenge for this topic is access control: how to keep patient’s personal health information secure, but at the same time accessible to all fields of healthcare and accomplish this within the federal privacy laws made by our government. This study focuses on the idea of a single EHR containing all the different medical information for all the areas of healthcare for a patient. …

Physio@Home: Exploring Visual Guidance And Feedback Techniques For Physiotherapy Exercises, Richard Tang, Xing-Dong Yang, Scott Bateman, Joaquim Jorge, Anthony Tang

Research Collection School Of Computing and Information Systems

Physiotherapy patients exercising at home alone are at risk of re-injury since they do not have corrective guidance from a therapist. To explore solutions to this problem, we designed Physio@Home, a prototype that guides people through pre-recorded physiotherapy exercises using realtime visual guides and multi-camera views. Our design addresses several aspects of corrective guidance, including: plane and range of movement, joint positions and angles, and extent of movement. We evaluated our design, comparing how closely people could follow exercise movements under various feedback conditions. Participants were most accurate when using our visual guide and multi-views. We provide suggestions for exercise …

Formative Research On An Instructional Design Theory For Virtual Patients In Clinical Education: A Pressure Ulcer Prevention Clinical Reasoning Case, Manon Maitland Schladen

CCAC Theses and Dissertations

Despite advances in health care over the past decades, medical errors and omissions remain significant threats to patient safety and health. A large number of these mistakes are made by trainees, persons who are just beginning to build the case-based experiences that will transform them from novices to expert practitioners. Clinicians use both intuitive and deductive problem-solving skills in caring for patients and they acquire expertise in applying these skills through interaction with many and varied cases.

The contemporary heath care environment, with decreased lengths of stay for patients and reduced duty hours for trainees, makes getting optimal patient exposure …

Medical Students In Microscopic Anatomy And Pathology Laboratories: Design Of An E-Learning Histology And Histopathology Atlas As An Evolving Response To Interdisciplinary Pre-Clinical Curricular Needs, Michelle S. Davis, Alexandra Mills, Gisela Butera, Donald S. Karcher, Patricia S. Latham, Janette Krum, Rosalyn A. Jurjus

Anatomy and Regenerative Biology Faculty Publications

E-learning, also known as computer-assisted learning, successfully bridges anatomical knowledge and transferrable skills, such as critical analysis, teamwork, leadership and communication. Several institutions have already integrated histology and physiology in team based laboratory approaches, but integration of histology and pathology instruction has been done to a lesser extent. Our aim was to develop an e-learning atlas that integrates microanatomy and pathology laboratory for an interdisciplinary pre-clinical medical curriculum.

A multidisciplinary team of teaching faculty and students developed an online atlas (microanatomyatlas.com) that includes a library of histology and histopathology images. Traditional laboratory manual instructions and study objectives were added onto …

Development And Pilot Feasibility Study Of A Health Information Technology Tool To Calculate Mortality Risk For Patients With Asymptomatic Carotid Stenosis: The Carotid Risk Assessment Tool (Carat), Adrienne E. Faerber, Rebecca Horvath, Carey Stillman, Melissa L. O'Connell, Amy L. Hamilton, Karina A. Newhall, Donald S. Likosky, Philip P. Goodney

Dartmouth Scholarship

Patients with no history of stroke but with stenosis of the carotid arteries can reduce the risk of future stroke with surgery or stenting. At present, a physicians’ ability to recommend optimal treatments based on an individual’s risk profile requires estimating the likelihood that a patient will have a poor peri-operative outcomes and the likelihood that the patient will survive long enough to gain benefit from the procedure. We describe the development of the CArotid Risk Assessment Tool (CARAT) into a 2-year mortality risk calculator within the electronic medical record, integrating the tool into the clinical workflow, training the clinical …

Ms-Squared Focus Group Questions And Probes: V1.4, Philip J. Kroth

MS-Squared

This document contains the MS-Squared Study's focus group questions and probes.

Management Of Rfid Systems In Hospital Transfusion Services, Alberto Coustasse, Brian Cunningham, Stacie Deslich, Eric Wilson, Pamela Meadows

Management Faculty Research

Radio Frequency Identification Devices (RFID) technology is used by hospital supply chains to track various medical products and monitor inventories. To improve overall operations, hospitals have implemented RFID as part of their supply chain processes. Hospitals have also have begun incorporating RFID technology as part of their transfusion services processes. The purpose of this review was to analyze how healthcare organization supply chains can benefit from the utilization of RFID systems in transfusion services departments. The methodology for this study was a literature review following the steps of a systematic review with a total of 51 sources referenced.

RFID technology …

Benefits And Barriers For Adoption Of Personal Health Records, Brittany Vance, Brent Tomblin, Jena Studney, Alberto Coustasse

Management Faculty Research

A Personal Health Record (PHR) is an electronic, universally available, lifelong resource of health information maintained by individuals. There are numerous potential benefits to PHRs, including improved patient-provider relationships, increased patient empowerment, and enhanced care safety, efficiency, coordination, and quality. However, privacy, security, cost, and adoption issues have been significant barriers to implementation. The purpose of this research was to determine how the use of PHRs affects patient outcomes, as well as to analyze benefits and barriers of adoption of PHRs. The methodology for the examination of the benefits and barriers to PHR implementation was conducted following the basic principles …

Know Your Audience: Predictors Of Success For A Patient-Centered Texting App To Augment Linkage To Hiv Care In Rural Uganda, Mark J. Siedner, Data Santorino, Jessica E. Haberer, David Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Despite investments in infrastructure and evidence for high acceptability, few mHealth interventions have been implemented in sub-Saharan Africa.

Objective: We sought to (1) identify predictors of uptake of an mHealth application for a low-literacy population of people living with HIV (PLWH) in rural Uganda and (2) evaluate the efficacy of various short message service (SMS) text message formats to optimize the balance between confidentiality and accessibility.

Methods: The trial evaluated the efficacy of a SMS text messaging app to notify PLWH of their laboratory results and request return to care for those with abnormal test results. Participants with a …

Coexpression Network Analysis Of Mirna-142 Overexpression In Neuronal Cells, Ishwor Thapa, Howard S. Fox, Dhundy Raj Bastola

Interdisciplinary Informatics Faculty Publications

MicroRNAs are small noncoding RNA molecules, which are differentially expressed in diverse biological processes and are also involved in the regulation of multiple genes. A number of sites in the 3′ untranslated regions (UTRs) of different mRNAs allow complimentary binding for a microRNA, leading to their posttranscriptional regulation. The miRNA-142 is one of the microRNAs overexpressed in neurons that is found to regulate SIRT1 and MAOA genes. Differential analysis of gene expression data, which is focused on identifying up- or downregulated genes, ignores many relationships between genes affected by miRNA-142 overexpression in a cell. Thus, we applied a correlation network …