Health Information Technology Commons^™

Does The Electronic Health Record Improve The Timeliness Review And Notification Of Medical Laboratory And X-Ray Test Results?, Ruby Estes

Applied Research Projects

The medical community struggles with timeliness issues throughout the different healthcare environments in many areas of patient care. The demands of meeting patient care needs is great everywhere. One area that can lead to extreme adverse outcomes and affects patient safety is failure to review and follow-up on medical test results timely. In addition the lack of timely follow-up and treatment can lead to medico-legal implications for all healthcare professionals involved in the patients care. Some timeliness issues have been attributed to understaffed healthcare institutions, lack of trained staff, and in many instances inefficient and insufficient processes. This is an …

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

Doctoral Projects

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

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

Self-Efficacy In Situation Background Assessment And Recommendation Communication Using Information Technology In Baccalaureate Nursing, Kelly Etcheberry Espinoza

UNLV Theses, Dissertations, Professional Papers, and Capstones

Strong communication skills are essential in establishing a foundation for safe delivery of care. A report from the Institute of Medicine (IOM) titled: To Err is Human: Building a Safer Health System estimated 44,000 to 98,000 deaths occur due to medical errors annually. Communication failure was found to be the root cause in 70% of these cases of medical error. Several studies also indicate communication issues still represent up to 80% of errors and sentinel events in hospitals accredited by the Joint Commission. The IOM's report indicate improving communication in the healthcare setting is essential in reducing medical errors.

In …

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

Research Collection School Of Computing and Information Systems

The rapid ageing population is posing challenges to many countries all over the world, particularly in the provision of care to the growing number of elderly who are living alone. Allowing the elderly to age-in-place, i.e., live safely and independently in the comfort of their own homes is a model that can potentially address the resource constraint in health and community care faced by many nations. To make this model a reality and provide appropriate and timely care to the elderly, unobtrusive eldercare monitoring systems (EMS) are being deployed in real homes to continuously monitor the activity of the elderly. …

A Case Study For Integration Of Legacy Healthcare Electronic Medical Records Into A Trusted Data Warehouse Utilizing Master Data Management, Michael Greer

Theses and Dissertations

This dissertation is focused in the case study of how a large academic, medical, research centers used the principles of master data management to design, build, and implement an enterprise data warehouse. Data governance, stewardship, entity resolution, and strong supporting metadata programs are at the center of a successful enterprise data warehouse. Migrating legacy clinical and research data in structured, unstructured, text, images, signature, pictures, and multimedia format into a single trusted data warehouse is a significant task. On March 23, 2010, President Obama signed into law one of the most comprehensive revisions to our nation’s health care system in …

Obesity Due To Poor Snack Choices And Lack Of Physical Activity, Kaleb S. Adams

Scholars Week

Obesity Due to Poor Snack Choices and Lack of Physical Activity

A chronic issue in my immediate community, Murray State University, is obesity due to unhealthy diets and a generally lethargic lifestyle. The muffin picture represents the average healthiness of snacks available on campus. While students are working towards their education on campus it has become increasingly difficult to acquire snacks that are both convenient and health conscious. Places such as the T-Room cater towards less healthy foods by making them far more available and also making them much less expensive. For a student to get a quick lunch consisting …

Continuing Development Of An All Payer Health Care System In Maryland, David P. Paul Iii, Taeko Matsumoto, Alberto Coustasse, Lama Mohammed Bakhamis, Mary Lynn Harshbarger

Management Faculty Research

The state of Maryland, in collaboration with the Centers for Medicare and Medicaid, developed the first all-payer system model in the U.S. in 1971, and some 35 years later in response to financial pressures, modernized this program. The focus of the modernized program was to improve overall per capita expenditure, quality of care, and the outcome of Marylanders’ health.

This study showed positive change in moving its healthcare delivery model from volume-driven care to value-driven coordinated care. Maryland hospitals have changed their mindsets to achieve the Triple Aim of cost reduction, health improvement, and quality of care improvement for the …

Sex Ed To Go- An Analysis Of Comprehensive Sexual Education Mobile Phone Applications, Kerstin M. Kalke

Communication ETDs

The United States has one of the highest teen pregnancy rates among developed countries and the numbers of STIs have increased during the last few years. Mobile phone applications constitute a promising platform to disseminate sexual health information and to reduce adverse health outcomes, particularly among teens. In order to be effective, apps have to follow a comprehensive approach to sexuality education, include concepts of behavior change theories, and adhere to health literacy principles.

This study used a mixed-methods approach consisting of a quantitative content analysis and qualitative thematic analysis to assess the quality of sexual education apps available to …

November 2016, Randy Curry, Cindy Brooks

RURAL ROCKS

Rural Rocks, the Rural Health Network newsletter by the SWOSU College of Pharmacy

Identifying Complexity In Infectious Diseases Inpatient Settings: An Observation Study, Don Roosan, Charlene Weir, Matthew Samore, Makoto Jones, Moom Roosan, Gregory J. Stoddard, Guilherme Del Fiol

Pharmacy Faculty Articles and Research

Background
Understanding complexity in healthcare has the potential to reduce decision and treatment uncertainty. Therefore, identifying both patient and task complexity may offer better task allocation and design recommendation for next-generation health information technology system design.

Objective
To identify specific complexity-contributing factors in the infectious disease domain and the relationship with the complexity perceived by clinicians.

Method
We observed and audio recorded clinical rounds of three infectious disease teams. Thirty cases were observed for a period of four consecutive days. Transcripts were coded based on clinical complexity-contributing factors from the clinical complexity model. Ratings of complexity on day 1 for …

Is Cloud Computing In Healthcare Providing A Safe Environment For Storing Protected Health Information? A Systematic Review And Meta-Analysis, Ashley N. Hayes

Applied Research Projects

Over the past several years, cloud computing has become increasingly more popular for the use of storing, accessing, and maintaining electronic health records (EHRs). In comparison to conventional EHR management tools, such as installed software, cloud computing offers more capabilities for medical facilities and their patients. Experts claim that in addition to changing the face of health information technology, it will also advance healthcare services, and benefit medical research. As the use of cloud computing has increased, so has the amount of healthcare data breaches. This study is proposing that there is a correlation between the increase in cloud computing …

How Barriers To Using The Electronic Health Record Effects Behavioral Healthcare, Jennifer Woodard

Applied Research Projects

The healthcare scene is rapidly changing due to the introduction of the electronic health record (EHR) and advances in technology. This means more patient data is readily available for use and gives physicians and patients’ faster access to that data. With the passing of recent legislature such as the Health Information Technology for Economic and Clinical Health Act and the American Recovery and Reinvestment Act of 2009, resulting in the rapid adoption of electronic health records due to incentive payment programs. With this comes the push for use of the electronic health record to prepare for Meaningful Use and improved …

Adoption Rate Of A Certified Ehr At Medical Practices With Five Or Fewer Physicians, Nelda Onwualiaobu

Applied Research Projects

The adoption rate of a certified electronic health record (EHR) for small medical practices have been the subject of discussion because prior research shows that larger medical practices have a higher rate of adoption than small medical practices. The major reason for this disparity has been the cost of adoption and implementation as many small practices are not financially equipped to shoulder this burden. The purpose of this research was to determine the adoption rate of a certified EHR for medical practices with five or fewer physicians. Through a google search and filtering the results of the search, the office …

A Complex Systems Framework Approach Towards Multidisciplinary Tumor Boards, Rahul Salla, Robert Pahle, Ashish Amresh

Publications

Multidisciplinary tumor boards (MTBs) are universally recommended and have been used in treatment of late stage cancers. Tumor boards have the advantage of including all the stakeholders in the decision making process and improving quality of care, however several studies have pointed to their lack of efficiency and tend to be lackluster while not producing the desired benefits for the participants. In this paper we present the design of a web based immersive framework for collaborative decision making that has the potential to improve several inefficiencies in conducting tumor boards and improve overall clinical outcomes. We present the design of …

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

Journal of Health Disparities Research and Practice

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

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

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

Results: Half of participants (50%) had not previously used a computer. Post-intervention, diabetes knowledge improved significantly (p=.001). The majority of participants (86%) …

Using Electronic Health Record Data To Improve Community Health Assessment, Brian E. Dixon, Jian "Frank" Zou, Karen F. Comer, Marc Rosenman, Jennifer L. Craig, P Gibson

Frontiers in Public Health Services and Systems Research

Background: Community health assessments assist health departments in identifying health needs as well as disparities, and they enable linking of needs with available interventions. Electronic health record (EHR) systems possess growing volumes of clinical and administrative data, making them a valuable source of data for ongoing community health assessment.

Purpose: To produce population health indicators using data from EHR systems that could be combined and visually displayed alongside social determinants data, and to provide data sets at geographic levels smaller than a county.

Methods: Data from multiple EHR systems used by major health systems covering >90% of the population in …

Health It Security: An Examination Of Modern Challenges In Maintaining Hipaa And Hitech Compliance, Andrew S. Miller, Bryson R. Payne

KSU Proceedings on Cybersecurity Education, Research and Practice

This work describes an undergraduate honors research project into some of the challenges modern healthcare providers face in maintaining compliance with the Health Insurance Portability and Accountability Act (HIPAA) and HITECH (Health Information Technology for Economic and Clinical Health) Act. An overview of the pertinent sections of both the HIPAA and HITECH Acts regarding health information security is provided, along with a discussion of traditionally weak points in information security, including: people susceptible to social engineering, software that is not or cannot be regularly updated, and targeted attacks (including advanced persistent threats, or APTs). Further, the paper examines potential violations …

Microchips: Technology That Can Change Medical Services, Dale H. Shao, Ralph E. Mckinney, Lawrence P. Shao

Management Information Systems Faculty Research

Healthcare costs have increased greatly over the last few years. The result is a tremendous burden for businesses and private individuals. Experts say there is no end in sight to this increase. This situation has forced the federal government, state governments, and private industry, to investigate methods to slow down and reduce this constant increase in healthcare costs. Microchip technologies have been presented as a means to ensure better patient care while a/so reducing costs and errors resulting from the current system of healthcare. This paper presents an overview of microchip technology programs, issues with implementation, and future considerations for …

Perceived Patient Control Over Personal Health Information In The Presence Of Context-Specific Concerns, Prabhashi A. Nanayakkara

Doctoral Dissertations

Information privacy issues have plagued the world of electronic media since its inception. This research focused mainly on factors that increase or decrease perceived patient control over personal health information (CTL) in the presence of context-specific concerns. Control agency theory was used for the paper's theoretical contributions. Personal and proxy control agencies acted as the independent variables, and context-specific concerns for information privacy (CFIP) were used as the moderator between proxy control agency, healthcare provider, and CTL. Demographic data and three control variables— the desire for information control, privacy experience, and trust propensity—were also included in the model to gauge …

Design And Feasibility Of A Text Messaging Intervention To Prevent Indoor Tanning Among Young Adult Women: A Pilot Study, William Douglas Evans, Darren Mays

Prevention and Community Health Faculty Publications

Background: Although skin cancer is largely preventable, it affects nearly 1 of 5 US adults. There is a need for research on how to optimally design persuasive public health indoor tanning prevention messages.

Objective: The objective of our study was to examine whether framed messages on indoor tanning behavioral intentions delivered through short message service (SMS) text messaging would produce (1) positive responses to the messages, including message receptivity and emotional response; (2) indoor tanning efficacy beliefs, including response efficacy and self-efficacy; and (3) indoor tanning risk beliefs.

Methods: We conducted a pilot study of indoor tanning prevention messages delivered …

User-Centered Design Of Multi-Gene Sequencing Panel Reports For Clinicians., Elizabeth Cutting, Meghan Banchero, Amber L. Beitelshees, James J. Cimino, Guilherme Del Fiol, Ayse P. Gurses, Mark A. Hoffman, Linda Jo Bone Jeng, Kensaku Kawamoto, Mark Kelemen, Harold Alan Pincus, Alan R. Shuldiner, Marc S. Williams, Toni I. Pollin, Casey Lynnette Overby

Manuscripts, Articles, Book Chapters and Other Papers

The objective of this study was to develop a high-fidelity prototype for delivering multi-gene sequencing panel (GS) reports to clinicians that simulates the user experience of a final application. The delivery and use of GS reports can occur within complex and high-paced healthcare environments. We employ a user-centered software design approach in a focus group setting in order to facilitate gathering rich contextual information from a diverse group of stakeholders potentially impacted by the delivery of GS reports relevant to two precision medicine programs at the University of Maryland Medical Center. Responses from focus group sessions were transcribed, coded and …

The Development And Evaluation Of An Online Healthcare Toolkit For Autistic Adults And Their Primary Care Providers, Christina Nicolaidis, Dora Raymaker, Katherine E. Mcdonald, Steven K. Kapp, Michael Weiner, Elesia Ashkenazy, Martha Gerrity, Clarissa Kripke, Laura Platt, Amelia E.V. Baggs

School of Social Work Faculty Publications and Presentations

BACKGROUND: The healthcare system is ill-equipped to meet the needs of adults on the autism spectrum.

OBJECTIVE: Our goal was to use a community-based participatory research (CBPR) approach to develop and evaluate tools to facilitate the primary healthcare of autistic adults. DESIGN: Toolkit development included cognitive interviewing and test–retest reliability studies. Evaluation consisted of a mixed-methods, single-arm pre/postintervention comparison.

PARTICIPANTS: A total of 259 autistic adults and 51 primary care providers (PCPs) residing in the United States.

INTERVENTIONS: The AASPIRE Healthcare toolkit includes the Autism Healthcare Accommodations Tool (AHAT)—a tool that allows patients to create a personalized accommodations report for …

Implementing An Mhealth System For Substance Use Disorders In Primary Care: A Mixed Methods Study Of Clinicians’ Initial Expectations And First Year Experiences, Marie-Louise Mares, David H. Gustafson, Joseph E. Glass, Andrew Quanbeck, Helene Mcdowell, Fiona Mctavish, Amy Atwood, Lisa Marsch

Dartmouth Scholarship

Millions of Americans need but don’t receive treatment for substance use, and evidence suggests that addiction-focused interventions on smart phones could support their recovery. There is little research on implementation of addiction-related interventions in primary care, particularly in Federally Qualified Health Centers (FQHCs) that provide primary care to underserved populations. We used mixed methods to examine three FQHCs’ implementation of Seva, a smart-phone app that offers patients online support/discussion, health-tracking, and tools for coping with cravings, and offers clinicians information about patients’ health tracking and relapses. We examined (a) clinicians' initial perspectives about implementing Seva, and (b) the first year …

September 2016, Randy Curry, Cindy Brooks

RURAL ROCKS

Rural Rocks, the Rural Health Network newsletter by the SWOSU College of Pharmacy

Decreasing Patient Cost And Travel Time Through Pediatric Rheumatology Telemedicine Visits., Elizabeth A. Kessler, Ashley K. Sherman, Mara L. Becker

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: There is a critical shortage of pediatric rheumatologists in the US. Substantial travel to clinics can impose time and monetary burdens on families. The aim of this study was to evaluate the cost of in-person pediatric rheumatology visits for families and determine if telemedicine clinics resulted in time and cost savings. Factors associated with interest in telemedicine were also explored.

METHODS: Surveys were offered to parents and guardians of patients in Pediatric Rheumatology follow-up clinics in Kansas City, Missouri, the primary site of in-person care, and at a telemedicine outreach site 160 miles away, in Joplin, Missouri. Survey questions …

Cardiomems™ In Lvad Patients: A Case Series, Maya Guglin, Bennet George, Sarah Branam, Amanda Hart

The VAD Journal

Patients with a left ventricular assist device (LVAD) commonly encounter issues with volume status post-implant. Volume overload can result from incomplete compensation of left ventricular failure or from right ventricular failure. The CardioMEMS™ intracardiac hemodynamic monitoring device is an area of growing interest regarding the management of chronic congestive heart failure, however, its utility has not been serially investigated in patients with an LVAD. We present a case series of patients with ventricular assist devices care for at our institution in which the CardioMEMS™ device aided in the management of volume status and pump performance.

Changing Diagnostic Methods And Increased Detection Of Verotoxigenic Escherichia Coli, Ireland, Thomas Rice, Noreen Quinn, Roy D. Sleator, Brigid Lucey

Department of Biological Sciences Publications

The recent paradigm shift in infectious disease diagnosis from culture-based to molecular-based approaches is exemplified in the findings of a national study assessing the detection of verotoxigenic Escherichia coli infections in Ireland. The methodologic changes have been accompanied by a dramatic increase in detections of non-O157 verotoxigenic E. coli serotypes.

Using Foreign Virtual Patients With Medical Students In Germany: Are Cultural Differences Evident And Do They Impede Learning?, Jens Walldorf, Tina Jähnert, Norman B. Berman, Martin R. Fischer

Dartmouth Scholarship

Learning with virtual patients (VPs) is considered useful in medical education for fostering clinical reasoning. As the authoring of VPs is highly demanding, an international exchange of cases might be desirable. However, cultural differences in foreign VPs might hamper learning success.

Use Of Telehealth In Nhsc Grantee Sites, Patricia Pittman, Clese Erikson, Xiaoli Wu, Emily Bass

Health Workforce Research Center Publications

Telehealth has long been viewed as an important pathway for increasing access to care for underserved populations, while providing high quality care at low cost. The spread of telehealth in the United States, however, has been hampered by a range of reimbursement, equipment costs, and licensure barriers. In this study we examined the extent to which telehealth is being used in settings that are among the locations most in need: the National Health Service Corps (NHSC) approved grantee sites. Key Questions

1. To what extent and how are NHSC using telehealth and telemedicine services?
2. What are the barriers to adoption and …

August 2016, Randy Curry, Cindy Brooks

RURAL ROCKS

Rural Rocks, the Rural Health Network newsletter by the SWOSU College of Pharmacy