Health Information Technology Commons^™

Patient Frailty: A Review, Lakshmi Sailaja Kodavati

Dissertations and Theses

According to Geriator (2011), frailty is a common clinical syndrome in older adults that carries an increased risk for poor health outcomes such as falls, incident disability, hospitalization, and mortality. An operational definition of frailty is the existence of at least three out of five observable criteria indicating compromised energetics: low grip strength; low energy; slowed walking speed; low physical activity; and unintentional weight loss (Fried, et al. 2001).

According to Dubois and Charpillet (2017), most transitions into frailty are due to unintentional weight loss which, in turn, impacts gait performance and subsequent general mobility. In this literature review, the …

The Effect Of Patient Reminders On Patient Engagement With Digital Preoperative Education, Christine Reger

West Chester University Doctoral Projects

Preoperative education improves surgical outcomes (Burgess et al., 2019). The current standard of care for patients undergoing endoscopic sinus surgery is verbal preoperative education at the office visit supplemented with printed material. Utilizing digital education customized to the surgical procedure is an effective way to improve patient knowledge, engagement, satisfaction, and health outcomes and should be integrated into healthcare guidelines (Golinelli et al., 2020). Our healthcare institution partnered with Independence Health’s Quil to provide patients with access to digital tools for education and preparation, with a goal for patients to have a better experience before and after surgical procedures and …

A Call Away: Investigating A Solution To Healthcare Access Barriers In Remote Communities, Tamsin Rogers

Honors Theses

This project focuses on the fact that there exist communities in the United States that are underserved in terms of healthcare. Whether this is due to the community’s geographical (remote) location, lack of education, or other factors, the members of these communities experience disproportionate levels of care. My focus with this project will be the idea that everyone deserves adequate healthcare, regardless of where they live. I focus specifically on one community: Jackman, Maine, which has recently implemented a telemedicine program called ‘FirstNet’ to aid its previously struggling clinic. The Jackman Community Health Center is the only health clinic in …

Virtual Home Visits During Covid-19 Pandemic: Mothers' And Home Visitors' Perspectives, Abdullah Al-Taiar, Michele A. Kekeh, Stephanie Ewers, Amy L. Prusinski, Kimberly J. Alombro, Nancy Welch

Community & Environmental Health Faculty Publications

Background

The experiences of mothers enrolled in Maternal, Infant and Early Childhood Home Visiting (MIECHV) program with virtual home visiting (VHV) during the pandemic remain mostly unknown. This study aimed to describe in detail the experience of home visitors and mothers with VHV during COVID-19 pandemic. This is a prerequisite for guiding future efforts to optimize MIECHV services that are provided through virtual operation.

Methods

Focus groups discussion were conducted with home visitors (n = 13) and mothers (n = 30) who were enrolled in BabyCare program in Virginia from January 2019 to June 2022. This included mothers who received …

Implementation Levels Of Electronic Health Records And Their Influence On Quality And Safety, Soumya Upadhyay

Healthcare Administration and Policy Faculty Research

Improvement in quality and patient safety outcomes have been at the forefront of the United States healthcare system. Policies advocate for implementing different electronic health records (EHR) levels to support this effort. Several studies have demonstrated mixed results on the impact of EHR on quality and safety outcomes. Our study delves deeper into gaining an understanding of this influence on hospitals that have adopted various levels of EHR, especially intermediate and comprehensive. Using a longitudinal study design for general acute care hospitals within the U.S., we examine the relationship between intermediate and comprehensive EHR on quality (readmission rates for pneumonia …

The Impact Of Telemedicine On Patient-Provider Communication At A University Student Health Center, Venkata Naga Sreelalitapriya Duvuuri

Honors Undergraduate Theses

Effective patient-provider communication (PPC) involves conveying sufficient information to a patient such that the treatment is agreed upon and implemented accurately. Furthermore, a patient must feel adequately involved in the treatment process. With the advent of the COVID-19 pandemic, many clinical visits were shifted online. Although telemedicine was successful in meeting pandemic-specific goals, such as lowering personal contact, it changes the communicative context. Both patients and providers get less input from body language (nonverbal communication) and rely more on verbal communication. Furthermore, the number of telemedicine visits conducted remains elevated over pre-pandemic levels. Much of what is known about effective …

Improving Patient Access To Gastroenterology Through A Nurse-Practitioner-Led Clinic: A Quality Improvement Project, Kayla Northam

DNP Scholarly Projects

The United States has a critical healthcare access issue for gastroenterology patients. Delays in treatment can lead to expensive complications, including emergency room visits, hospitalization, and surgery. Creating a rapid-access clinic (RAC) for gastroenterology so that patients can obtain a quick and efficient evaluation of their symptoms in a shorter appointment time can help decrease the delay in care and generate more revenue for the hospital. Over 8 weeks in 2023, Dartmouth Hitchcock Medical Center Department of Gastroenterology used a telemedicine-only RAC to see patients for 20 minutes rather than the traditional 60-minute period. As a result, the RAC saw …

Hif-1 Activation And Inflammatory Responses To Hypoxia, Shazreen Shaharuddin, Nik Mohd Afizan Nik Abd Rahman, Mas Jaffri Masarudin, Mohammedarfat N Alamassi

International Journal of Aviation, Aeronautics, and Aerospace

Acute hypoxia is a significant physiological danger during high-altitude flying and military aircraft missions. The human brain requires a constant supply of oxygen to function properly, and is susceptible to settings with low availability of air oxygen. Hypoxia can influence inflammatory signalling, and both central and systemic responses can activate HIF pathway genes. HIFs are critical molecules that regulate inflammation andhypoxia, ensuring appropriate cell function and survival. Hypoxia is the condition in which insufficient oxygen reaches the body's tissues. It can be caused by a decrease in partial oxygen pressure (PO2) in the environment, problems with breathing and/or oxygen transport, …

Architectural Design Of A Blockchain-Enabled, Federated Learning Platform For Algorithmic Fairness In Predictive Health Care: Design Science Study, Xueping Liang, Juan Zhao, Yan Chen, Eranga Bandara, Sachin Shetty

VMASC Publications

Background: Developing effective and generalizable predictive models is critical for disease prediction and clinical decision-making, often requiring diverse samples to mitigate population bias and address algorithmic fairness. However, a major challenge is to retrieve learning models across multiple institutions without bringing in local biases and inequity, while preserving individual patients' privacy at each site.

Objective: This study aims to understand the issues of bias and fairness in the machine learning process used in the predictive health care domain. We proposed a software architecture that integrates federated learning and blockchain to improve fairness, while maintaining acceptable prediction accuracy and minimizing overhead …

Athletic Training Student Core Competency Professional Behavior Implementation Between Immersive And Non-Immersive Clinical Experiences: A Report From The Association For Athletic Training Education (Aate) Research Network, Bailey Christine Jones, Julie Cavallario, Bonnie L. Van Lunen, Stacy E. Walker, Curt Bay, Cailee E. Welch Bacon

Rehabilitation Sciences Faculty Publications

Context

The Commission on Accreditation of Athletic Training Education requires athletic training programs to emphasize the use of professional behaviors that are associated with 6 core competencies, 5 of which were measured in this study: patient-centered care, interprofessional education and collaborative practice (IPECP), evidence-based practice (EBP), health information technology (HIT), and quality improvement (QI). The purpose of this study was to examine the association between clinical experience type and student implementation of behaviors associated with the core competencies.

Design

Multisite, panel design.

Setting

Twelve professional athletic training programs (7 graduate, 5 undergraduate).

Patients or Other Participants

A total of 338 …

An Efficient Lightweight Provably Secure Authentication Protocol For Patient Monitoring Using Wireless Medical Sensor Networks, Garima Thakur, Sunil Prajapat, Pankaj Kumar, Ashok Kumar Das, Sachin Shetty

VMASC Publications

The refurbishing of conventional medical network with the wireless medical sensor network has not only amplified the efficiency of the network but concurrently posed different security threats. Previously, Servati and Safkhani had suggested an Internet of Things (IoT) based authentication scheme for the healthcare environment promulgating a secure protocol in resistance to several attacks. However, the analysis demonstrates that the protocol could not withstand user, server, and gateway node impersonation attacks. Further, the protocol fails to resist offline password guessing, ephemeral secret leakage, and gateway-by-passing attacks. To address the security weaknesses, we furnish a lightweight three-factor authentication framework employing the …

A Digital Transformation Framework For Biopharma Manufacturing, Frederick K. Johnson

CGU Theses & Dissertations

In the current climate of economic uncertainty and social unrest, biopharmaceutical (biopharma) companies face the challenges of changes in consumer behavior, cyber threats, and technological advancement. At the same time, their top priorities are global market growth, strengthening R&D, and undergoing digital transformation (Dx). Given these developments, biopharma organizations must choose a Dx framework as they engage in the digital transformation of their businesses in this high-stakes environment. However, there are significant problems with existing Dx frameworks. Most models are generalized frameworks designed to sell consulting services. Some focus on the enterprise or the manufacturing operations, but not both, and …

Pict-Dpa: A Quality-Compliance Data Processing Architecture To Improve The Performance Of Integrated Emergency Care Clinical Decision Support System, Ruizhi Yu

CGU Theses & Dissertations

Emergency Care System (ECS) is a critical component of health care systems by providing acute resuscitation and life-saving care. As a time-sensitive care operation system, any delay and mistake in the decision-making of these EC functions can create additional risks of adverse events and clinical incidents. The Emergency Care Clinical Decision Support System (EC-CDSS) has proven to improve the quality of the aforementioned EC functions. However, the literature is scarce on how to implement and evaluate the EC-CDSS with regard to the improvement of PHOs, which is the ultimate goal of ECS. The reasons are twofold: 1) lack of clear …

Design Of Robust Blockchain-Envisioned Authenticated Key Management Mechanism For Smart Healthcare Applications, Siddhant Thapiyal, Mohammad Wazid, Devesh Pratap Singh, Ashok Kumar Das, Sachin Shetty

VMASC Publications

The healthcare sector is a very crucial and important sector of any society, and with the evolution of the various deployed technologies, like the Internet of Things (IoT), machine learning and blockchain it has numerous advantages. However, in this section, the data is much more vulnerable than others, because the data is strictly private and confidential, and it requires a highly secured framework for the transmission of data between entities. In this article, we aim to design a blockchain-envisioned authentication and key management mechanism for the IoMT-based smart healthcare applications (in short, we call it SBAKM-HS). We compare the various …

Commentary On Healthcare And Disruptive Innovation, Hilary Finch, Affia Abasi-Amefon, Woosub Jung, Lucas Potter, Xavier-Lewis Palmer

Electrical & Computer Engineering Faculty Publications

Exploits of technology have been an issue in healthcare for many years. Many hospital systems have a problem with “disruptive innovation” when introducing new technology. Disruptive innovation is “an innovation that creates a new market by applying a different set of values, which ultimately overtakes an existing market” (Sensmeier, 2012). Modern healthcare systems are historically slow to accept new technological advancements. This may be because patient-based, provider-based, or industry-wide decisions are tough to implement, giving way to dire consequences. One potential consequence is that healthcare providers may not be able to provide the best possible care to patients. For example, …

The Current Status And Future Prospects For Conversion Therapy In The Treatment Of Hepatocellular Carcinoma, Jinfeng Bai, Ming Huang, Bohan Song, Wei Luo, Rong Ding

Faculty, Staff and Student Publications

Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related deaths worldwide. In China, most HCC patients are diagnosed with advanced disease and in these cases surgery is challenging. Conversion therapy can be used to change unresectable HCC into resectable disease and is a potential breakthrough treatment strategy. The resection rate for unresectable advanced HCC has recently improved as a growing number of patients have benefited from conversion therapy. While conversion therapy is at an early stage of development, progress in patient selection, optimum treatment methods, and the timing of surgery have the potential to deliver significant benefits. In …

Conceptualizing Care Partners' Burden, Stress, And Support For Reintegrating Veterans: A Mixed Methods Study., Nicholas A Rattray, Mindy Flanagan, Allison Mann, Leah Danson, Ai-Nghia Do, Diana Natividad, Katrina Spontak, Gala True

Health Services and Informatics Research

BACKGROUND: People who support Veterans as they transition from their military service into civilian life may be at an increased risk of psychological distress. Existing studies focus primarily on paid family caregivers, but few studies include spouses and informal non-family "care partners." We sought to identify key challenges faced by care partners of Veterans with invisible injuries.

METHODS: Semi-structured interviews were conducted with 36 individuals involved in supporting a recently separated US military Veteran enrolled in a 2-year longitudinal study. CPs completed validated measures on perceived stress, caregiving burden, quality of their relationship, life satisfaction, and flourishing. Independent

RESULTS: Care …

Health Information Exchange Adoption And Patient Satisfaction: The Mediating Role Of Organizational Efficiency, Hsun-Ming Lee, Peiqin Zhang, Jaymeen Shah

Journal of International Technology and Information Management

Patient satisfaction is perceived as a significant benefit of hospitals’ investments in health information exchange (HIE). Successful implementation of HIE systems lead to increased organizational efficiency in hospitals and more likely to enable doctors and other staff members to better meet patient needs and expectations. This research draws upon system success theory to examine how HIE adoption affects patient satisfaction. In addition, this research investigates whether the relationship between HIE adoption and patient satisfaction is mediated by organizational efficiency. This is the first research study that draws upon system success theory to understand how HIE adoption affects patient satisfaction.

For …

Patient Characteristics And Telehealth Visits In A Hepatology Clinic, Maria E. Walters

DNP Projects

BACKGROUND: In an attempt to decrease significant no-show rates amongst telehealth patients in a Hepatology outpatient clinic, a clinic-specific intervention was executed, which was efficient in decreasing no-show rates, however could not continue to be financially supported.

PURPOSE: The purpose of this study was to evaluate correlations between demographic data and social determinants of health with patients who showed and did not show for their telehealth appointments, with an overall goal of determining if there is a need for targeted support for telehealth appointments to decrease no-show rates.

METHODS: Electronic health records of telehealth patients were reviewed in an …

Evaluating The Effect Of Electronic Health Record Patient Portal Use On Medication Adherence In Adults With Chronic Conditions, Jennifer Averbeck

DNP Projects

Background Medication non-adherence is prevalent among fifty percent of the United States population. This behavior leads to increased morbidity and mortality as well as increased healthcare costs for both the patient and the healthcare system. More than two-thirds of nonadherence exists in those aged over 65 years old who are diagnosed with Multiple Chronic Conditions (MCC). Several studies have researched and trialed interventions to improve rates of adherence, limit poor health outcomes, and decrease overall cost of care. The patient portal is an interactive tool which encourages participation of the patient in their healthcare management. Implementation of this tool has …

Dual-Task Upper Extremity Motor Performance Measured By Video Processing As Cognitive-Motor Markers For Older Adults, Changhong Wang, Mohsen Zahiri, Ashkan Vaziri, Bijan Najafi

Center on Aging Staff Publications

Introduction: The use of dual-task model such as dual-task gait has been extensively studied to assess cognitive-motor performance among older adults. However, space restriction and safety factor limit its applications in remote assessment. To address the gap, we propose a video processing-based approach to remotely quantify cognitive-motor performance using a 20-s repetitive elbow flexion-extension test with dual-task condition, called video-based motoric-cognitive meter (MCM).

Methods: Eighteen older participants (age: 78.6 ± 6.5 years) who were clinically diagnosed as having either mild cognitive impairment or dementia were included in this study. Participants were asked to perform 20-s repetitive elbow flexion-extension exercise with …

Disparities In Mental Health Technology Among African Americans: Breaking Cultural Inclusion Barriers, Nyoki Cosey-Brown

DSW Capstone Projects

Mental health technology is a healthcare delivery model of the future. The engagement in virtual healthcare was intensified when traditional healthcare methods were inaccessible during the federal restrictions implemented due to the COVID-19 pandemic. Utilizing digital apparatuses for healthcare improved the convenience, efficiency, and accessibility of various mental health services that were inoperable in past healthcare models. However, the historical constructs of stigma, discrimination, inequity, exclusion, and structural racism in mental healthcare were prevalent problems that remained present in virtual mental health platforms concerning the experiences of African-American patients and professionals who utilized the spaces.

This research explored mental health …

Developing And Pre-Testing A Digital Decision-Tree Smartphone Application For Smoking Prevention And Cessation Among Hiv Care Providers, Irene Tamí-Maury, Samuel Tundealao, Jenna Guzman, Valeri Noé-Díaz, Christine Markham, Karen Vigil

Faculty, Staff and Student Publications

OBJECTIVES: The diagnosis and continuous care of chronic conditions such as HIV infection present potential teachable moments for delivering smoking prevention and cessation interventions for patients. We designed and pre-tested a prototype of a smartphone application(app), Decision-T, specifically designed to assist healthcare providers when providing personalized smoking prevention and cessation services to their patients.

METHODS: We developed the Decision-T app based on transtheoretical algorithm for smoking prevention and cessation following the 5-A's model. We employed a mixed-methods approach among 18 HIV-care providers recruited from Houston Metropolitan Area for pre-testing the app. Each provider participated in three mock sessions, and the …

Respire: A Technological Tool To Navigate Mechanical Ventilation In Patient Care And Educational Settings, Swara Chokshi

Undergraduate Research Posters

Around the world, more than 20 million patients rely on mechanical ventilators annually; however, not enough individuals understand how to operate ventilators, posing a risk to the health of many. Moreover, it is increasingly difficult to determine optimal mechanical ventilator settings in a timely fashion, especially in low-resource countries and critical care areas. Respire is a mobile application that bridges this gap in a twofold manner: it is designed to assist healthcare workers around the world navigate and use mechanical ventilators effectively as well as educate the general public about mechanical ventilation. Respire offers a user-friendly yet educational interface that …

Advocacy Spotlight: Mda’S Legislative Priorities For 2023, Neema Katibai Jd

The Journal of the Michigan Dental Association

This article outlines the Michigan Dental Association's (MDA) legislative priorities for the year 2023. The MDA focuses on various key issues, including dental loss ratio, network leasing transparency, teledentistry policy, the state budget's impact on dental services, increasing the dental workforce, and addressing student debt relief. These priorities aim to advocate for the dental profession, enhance patient care, and ensure the dental community's well-being.

Factors Associated With Patient Portal Utilization, Preventive Services Utilization, And Health Promoting Behaviors Among Adults In The United States, Elizabeth Ayangunna

College of Graduate Studies: Theses & Dissertations

Background: Nearly 60% of adults in the United States are estimated to have one or more chronic conditions, necessitating strategies to improve the health status of persons with chronic disease. Given that health information technology (HIT) is considered highly valuable for superior disease management, it is imperative to examine how HIT use can improve health behaviors, which can in turn improve health status. This study aimed to examine if there was an association between patient portal utilization and the use of preventive services & health-promoting behaviors. Also, this study examined the influence of self-efficacy on preventive health behaviors among adults …

Enhancing Nonverbal Communication Through Virtual Human Technology: Protocol For A Mixed Methods Study, Analay Perez, Michael D. Fetters, John W. Creswell, Mark Scerbo, Frederick W. Kron, Richard Gonzalez, Lawrence An, Masahito Jimbo, Predrag Klasnja, Timothy C. Guetterman

Psychology Faculty Publications

Background: Communication is a critical component of the patient-provider relationship; however, limited research exists on the role of nonverbal communication. Virtual human training is an informatics-based educational strategy that offers various benefits in communication skill training directed at providers. Recent informatics-based interventions aimed at improving communication have mainly focused on verbal communication, yet research is needed to better understand how virtual humans can improve verbal and nonverbal communication and further elucidate the patient-provider dyad.

Objective: The purpose of this study is to enhance a conceptual model that incorporates technology to examine verbal and nonverbal components of communication and develop a …

Effect Of Relaxation Intervention On Stress Levels And Cognitive Skills In Professional Students, Sandhra Sabu, Ravikiran Kisan, . Swapnali

Digital Journal of Clinical Medicine

Background: Medical Professional training is likely to encounter a variety of hassles and stress in relation to the developmental tasks associated with transition from school life to professional college life. The vast syllabus, peer competition for academic performance, continuous evaluation, and long duration of the training makes medical education stressful. Many students feel a need to relieve stress and it is a necessity to equip students with proven techniques to reduce stress and cope up with the situation. Proper cognitive functioning has been found to be an important factor for academic performance.

Methods: The present study is a cross …

Addressing Training Gaps: A Competency-Based, Telehealth Training Initiative For Community Health Workers, Laura Porterfield, Victoria Warren, Vanessa Schick, Shannon Gulliot-Wright, Jeff R Temple, Elizabeth M Vaughan

Faculty, Staff and Student Publications

BACKGROUND: To overcome vast variations in Community Health Worker (CHW) training, investigators for the CHW Core Consensus Project (CCCP) derived three types of CHW (Category 1, 2, 3) and established competencies for each category. However, studies are needed that implement these competencies in real-world settings.

OBJECTIVE: Using the six competency domains of the CCCP as a theoretical backbone, we developed and evaluated a training for

METHODS: We developed five telehealth-based, bilingual (Spanish/English) training sessions and implemented them among

RESULTS: All (18/18) CHWs achieved at least 70% on the posttest (mean: 93.7%; range 73.3-100%). Training attendance was 98.9%. Using a six-point …

“So Many Extra Safety Layers:” Virtual Service Provision And Implementing Social Distancing In Interpersonal Violence Service Agencies During Covid-19, Rachel J Voth Schrag, Sarah Leat, Bethany Backes, Saltanat Childress, Leila Wood

Faculty, Staff and Student Publications

The coronavirus pandemic necessitated rapid shifts in approach for service providers working with survivors of interpersonal violence. To reduce the spread of the virus, providers and agencies implemented a rapid and unplanned expansion of virtual services while also developing new protocols to support safe and socially distant in-person services. To understand how these shifts have impacted victim service professionals and the survivors they serve, to provide guidance for on-going efforts, and to inform planning for future public health emergencies, this study asks the question: What approaches did the interpersonal violence workforce use to address social distancing needs during COVID-19? Semi-structured …