Health Information Technology Commons^™

The Impact Of Information Technology On Patient Engagement And Health Behavior Change: A Systematic Review Of The Literature, Suhila Sawesi, Mohamed Rashrash, Kanitha Phalakornkule, Janet S. Carpenter, Josette F. Jones

Pharmacy Faculty Articles and Research

Background: Advancements in information technology (IT) and its increasingly ubiquitous nature expand the ability to engage patients in the health care process and motivate health behavior change.

Objective: Our aim was to systematically review the (1) impact of IT platforms used to promote patients’ engagement and to effect change in health behaviors and health outcomes, (2) behavior theories or models applied as bases for developing these interventions and their impact on health outcomes, (3) different ways of measuring health outcomes, (4) usability, feasibility, and acceptability of these technologies among patients, and (5) challenges and research directions for implementing …

An Empirical Investigation Of Privacy And Security Concerns On Doctors’ And Nurses’ Behavioral Intentions To Use Rfid In Hospitals, Thomas George Winston

CCAC Theses and Dissertations

Radio frequency identification (RFID) technology is a useful technology that has myriad applications in technology, retail, manufacturing, and healthcare settings. Not dependent upon line-of-sight, RFID can scan devices in their proximity and report the information to connected (wired or other wireless) information systems. Once touted as the panacea for home healthcare, RFID devices can add benefit to patients in remote settings. RFID devices have been used to optimize systems in areas such as manufacturing and healthcare to expose inefficiencies in a system or process. Unlike manufacturing, however, RFID in healthcare settings presents security and privacy concerns to the people being …

Electronic Medical Records (Emr): An Empirical Testing Of Factors Contributing To Healthcare Professionals’ Resistance To Use Emr Systems, Emmanuel Patrick Bazile

CCAC Theses and Dissertations

The benefits of using electronic medical records (EMRs) have been well documented; however, despite numerous financial benefits and cost reductions being offered by the federal government, some healthcare professionals have been reluctant to implement EMR systems. In fact, prior research provides evidence of failed EMR implementations due to resistance on the part of physicians, nurses, and clinical administrators. In 2010, only 25% of office-based physicians have basic EMR systems and only 10% have fully functional systems. One of the hindrances believed to be responsible for the slow implementation rates of EMR systems is resistance from healthcare professionals not truly convinced …

Patient Portals: Achieving Technology Acceptance And Meaningful Use In Independent Physician-Managed Practices, Kimberly W. Bartholomew

CCAC Theses and Dissertations

As the bulk of medical health records shift from paper-based file systems to electronic formats, the promise of the transformation process called healthcare reform included adding efficiencies to medical practice workflows, lower costs, improved quality of care and most important, and the freeing of patient information from traditional propriety silos. With this incoming largess of protected health information data now viewable through online patient portals, patients can be empowered to become educated and active in their own health care decisions, but only if they have admission to their information. A digital divide currently exists in many medical practices where only …

Information Governance: An Investigation Of Interface Errors Between Source And Receiving Systems, Michelle R. Mitcheff

Applied Research Projects

The monitoring of interoperability of information in healthcare organizations is of increasing interest due to patient safety, operational and financial considerations. This monitoring is referred to as information governance (IG) and is a complex topic based on several underlying concepts. Interfacing information at the foundational, structural and semantic level is necessary for meaningful use of health information. Issues that arise range from incongruent transfer of information from source systems to receiving systems, discrepancies in the source system and receiving system and failures in interfacing information. This research project examines information governance from the perspective of failures in interfacing information from …

Clinical Educator And Student Perceptions Of Ipad™ Technology To Enhance Clinical Supervision: The Electronically-Facilitated Feedback Initiative (Effi), Suzanne J. Snodgrass, Darren Rivett, Scott Farrell, Kyle Ball, Samantha E. Ashby, Catherine L. Johnston, Kim Nguyen, Trevor Russell

Internet Journal of Allied Health Sciences and Practice

Purpose: Growing demands placed upon healthcare systems require more health professionals to be trained. Clinical placement education is an integral component of health professional training, however accommodating increasing numbers of student placements is a challenge for health services. Personal digital assistants such as iPads™ may assist in delivery of clinical education, by facilitating transfer of knowledge and skills from clinical educators to health professional students, however such an initiative has not been formally investigated. The present study sought to explore perceptions of clinical educators and allied health students regarding the impact of an iPad™-based feedback delivery system on student …

Electronic Health Records In The Academic World, Madeline Leapaldt

Williams Honors College, Honors Research Projects

Health or medical records are the backbone of the healthcare industry. They allow professions to practice patient-centered, interdisciplinary care. Electronic Health Records help accelerate the care process and allow for a smoother patient experience. However, many healthcare professionals have not used an Electronic Health Record prior to employment or internships. This can be detrimental to the process and slow down the entire team. Research shows that teaching Electronic Health Records in an academic setting allows students to safely explore the system and become comfortable with using technology for healthcare purposes. There are specific requirements that have been shown to aid …

Assessing Payer Perspectives On Health Information Exchange, Dori Cross, Sunny C. Lin, Julia Adler-Milstein

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective To identify factors that impede payer engagement in a health information exchange (HIE), along with organizational and policy strategies that might effectively address the impediments.

Materials and Methods Qualitative analysis of semi-structured interviews with leaders from 17 varied payer organizations from across the country (e.g., large, national payers; state Blues plans; local Medicaid managed care plans).

Results We found a large gap between payers’ vision of what optimal HIE should be and the current approach to HIE in the United States. Notably, payers sought to be active participants in HIE efforts – both providing claims data and accessing clinical …

Towards An Infodemiological Algorithm For Classification Of Filipino Health Tweets, Ma. Regina Justina E. Estuar, Kennedy E. Espina, Delfin Jay Sabido Ix, Raymond Josef Edward Lara, Vikki Car De Los Reyes

Department of Information Systems & Computer Science Faculty Publications

Finding innovative ICT solutions to enhance the Philippines’ health sector is part and parcel of the Philippine eHealth Strategic Framework and Plan 2020 program. This study sees the opportunity of using collected Twitter data to create a model that processes tweets to produce a dataset that may be relevant in the field of epidemiology and infodemiology. Through the collection of relevant tweets, future studies may make use of the output of this research for various purposes, such as the improvement of epidemiological systems of the Department of Health in support of the eHealth strategy. In this study, we …

Use Of High-Fidelity Simulation Training For New Cardiothoracic Intensive Care Unit Nurses, Bryan Boling

DNP Projects

Critical care nursing is one of the most challenging, high-stress fields in healthcare. This is especially true for nurses in the highly specialized environment of the cardiothoracic intensive care unit (CTICU). The experience level of nurses in critical care is positively linked with patient outcomes; however, with older nurses retiring or moving away from the bedside and younger nurses increasingly moving into advanced practice or management and leadership roles it is becoming more difficult to maintain a high degree of nursing experience in the ICU. Simulation training has been used to provide safe, effective training, and it is even possible …

Text Messaging Appointment Reminders To Reduce No-Shows: A Pilot Study, Cameron M. Stephenson

DNP Projects

Background: Hospital and outpatient clinic no-show, did not cancel or did not attend rates are a serious problem to organizations across the United States health care system. No-show appointments reduce clinic productivity, wastes clinician time and clinic resources and can be detrimental financially. Bluegrass Pediatrics and Internal Medicine (BPIM) located in Georgetown, KY experiences these problems on a daily basis.

Purpose/Methodology. This quality improvement project consisted of evaluating the effects of text messaging on appointment attendance during 3 clinic weeks of February 2016. The sample was derived from all patients enrolled at BPIM with a scheduled well, established or routine …

The Smart Heart Self-Care First Pilot Program, Samantha Mancuso

DNP Projects

Purpose: The Smart Heart Self-Care First Pilot Program (SHSCF) offers a transitional care intervention focusing on the self-care of hospitalized heart failure patients who are discharged home. It utilizes assessment, communication and education components to encourage behavior modification (improved self-care) through telehealth methodology.

Background and Significance: Heart failure related admissions, as a primary or secondary diagnosis, are among the leading causes of hospitalizations in the United States (Emory Healthcare, 2016). Surprisingly, of those patients discharged with a primary diagnosis of heart failure, 20% are readmitted to the hospital within thirty days (Feltner et. al, 2014). Heart failure related re-hospitalizations highlight …

Meaningful Use: Secure Electronic Messaging And The Use Of Mychart, Dava O. Helton

DNP Projects

Purpose: The purpose of this project was to understand providers’ views of electronic messaging through MyChart and find out the essential tools needed to comply with Stage 3 criteria of Meaningful Use. The objectives were to: 1) Discover providers’ current thoughts/opinions about electronic messaging, 2) Identify perceived benefits and barriers to using secure electronic messaging between providers and patients, and 3) Discover the perceived essential tools needed to meet Stage 3 criteria.

Methods: A needs assessment was performed through a provider survey. Providers at primary care offices with reliable Wi-Fi were approached about the project. Volunteer participants were given a …

Future Of Australia’S Etp: Script Exchange, Script Vault Or Secure Mobile Alternative, Kyaw Kyaw Htat, Patricia A. H. Williams, Vincent Mccauley

Australian Information Security Management Conference

Electronic transfer of prescriptions is an essential element of electronic medications management. Unfortunately, current manual and preliminary electronic transfer of prescription methods are not patient focussed, leading to a suboptimal solution for the patient. This is increasingly relevant in the push for more patient engagement in their own healthcare. The area is highly controlled by legislation and regulation. Through research and an analysis of the possible methods to improve and personalise electronic transfer of prescriptions, this paper provides an overview of these conclusions, and presents an alternative technical solution. The solution has been derived from a number of experiments in …

Constellation: A Tool For Rapid, Automated Phenotype Assignment Of A Highly Polymorphic Pharmacogene,, Greyson P. Twist, Andrea Gaedigk, Neil A. Miller, Emily G. Farrow, Laurel K. Willig, Darrell L. Dinwiddie, Josh E. Petrikin, Sarah E. Soden, Suzanne Herd, Margaret Gibson, Julie A. Cakici, Amanda K. Riffel, J Steven Leeder, Deendayal Dinakarpandian, Stephen F. Kingsmore

Manuscripts, Articles, Book Chapters and Other Papers

An important component of precision medicine-the use of whole-genome sequencing (WGS) to guide lifelong healthcare-is electronic decision support to inform drug choice and dosing. To achieve this, automated identification of genetic variation in genes involved in drug absorption, distribution, metabolism, excretion and response (ADMER) is required. CYP2D6 is a major enzyme for drug bioactivation and elimination. CYP2D6 activity is predominantly governed by genetic variation; however, it is technically arduous to haplotype. Not only is the nucleotide sequence of CYP2D6 highly polymorphic, but the locus also features diverse structural variations, including gene deletion, duplication, multiplication events and rearrangements with the nonfunctional, …

Design And Testing Of An Ehr-Integrated, Busulfan Pharmacokinetic Decision Support Tool For The Point-Of-Care Clinician., Susan M. Abdel-Rahman, Matthew L. Breitkreutz, Charlie Bi, Brett J. Matzuka, Jignesh Dalal, K Leigh Casey, Uttam Garg, Sara Winkle, J Steven Leeder, Jeanann Breedlove, Brian Rivera

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Busulfan demonstrates a narrow therapeutic index for which clinicians routinely employ therapeutic drug monitoring (TDM). However, operationalizing TDM can be fraught with inefficiency. We developed and tested software encoding a clinical decision support tool (DST) that is embedded into our electronic health record (EHR) and designed to streamline the TDM process for our oncology partners.

METHODS: Our development strategy was modeled based on the features associated with successful DSTs. An initial Requirements Analysis was performed to characterize tasks, information flow, user needs, and system requirements to enable push/pull from the EHR. Back-end development was coded based on the algorithm …

Challenges And Futures For Ethical Social Media Research, Casey Fiesler, Stevie Chancellor, Anna Lauren Hoffmann, Jessica Pater, Nicholas Proferes

Health Services and Informatics Research

In AAAI Conference on Web and Social Media ICWSM Workshop:

Social media and user-generated content platforms have opened up new possibilities for communication and creativity while also providing huge amounts of information about people and their online behavior. The evolution of technology and research methods presents ongoing ethical challenges to studying people and their digital traces. These challenges are a continuing source of discussion within the research community and also a topic of public discourse as social media scholarship gains greater visibility. This workshop is aimed at exploring difficult and unanswered ethical questions, touching on issues such as consent, privacy, …

#Thyghgapp: Instagram Content Moderation And Lexical Variation In Pro-Eating Disorder Communities, Stevie Chancellor, Jessica Pater, Trustin Clear, Eric Gilbert, Munmun De Choudhury

Health Services and Informatics Research

CSCW '16, FEBRUARY 27–MARCH2, 2016, SAN FRANCISCO, CA, USA

In Proceedings of the 19th ACM conference on computer-supported cooperative work & social computing.

Pro-eating disorder (pro-ED) communities on social media encourage the adoption and maintenance of disordered eating habits as acceptable alternative lifestyles rather than threats to health. In particular, the social networking site Instagram has reacted by banning searches on several proED tags and issuing content advisories on others. We present the first large-scale quantitative study investigating pro-ED communities on Instagram in the aftermath of moderation – our dataset contains 2.5M posts between 2011 and 2014. We find that …

Development & Integration Of Fhir With Open-Source Emr & Relational Databases, Timothy Van Wagner

Dissertations, Master's Theses and Master's Reports

This project looks into the development and implementation of an open source EHR software, using a FHIR interface to the system for data exchange. The EMR system used was OpenEMR, which is an open source EMR system that uses MySQL as the database backend combined with Apache and PHP to provide a user interface. The FHIR interface uses HAPI-FHIR which is an open source framework and libraries available for JAVA. Using JAVA, a RESTful API is created in order to respond to requests, and to also receive FHIR messages using the information stored in the two SQL databases, OpenEMR database …

Umls::Association - Measuring The Association Between Biomedical Terms, Keith B. Herbert

UROP Posters

UMLS::Association - A Semantic Association Framework for Biomedical Texts

Keith Herbert

Natural Language Processing Lab, Department of Computer Science

Introduction

We present UMLS::Association, a software package to explore the semantic association of biomedical terms with applications for literature-based discovery. Literature-based discovery is an endeavour to ”connect the dots” for scientists between the topics of their research and those of unexpected relevance. However, many approaches rely on the exact wording for the ideas in the research papers being analyzed. The Unified Medical Language System (UMLS) provides a way to map natural language phrases in these papers to sequences of abstract yet …

Insights From Machine-Learned Diet Success Prediction, Ingmar Weber, Palakorn Achananuparp

Research Collection School Of Computing and Information Systems

To support people trying to lose weight and stay healthy, more and more fitness apps have sprung up including the ability to track both calories intake and expenditure. Users of such apps are part of a wider “quantified self“ movement and many opt-in to publicly share their logged data. In this paper, we use public food diaries of more than 4,000 long-term active MyFitnessPal users to study the characteristics of a (un-)successful diet. Concretely, we train a machine learning model to predict repeatedly being over or under self-set daily calories goals and then look at which features contribute to the …

The Fight For Zadroga, Naeisha Rose

Capstones

The attack on the World Trade Center cost many first responders and volunteers, like Ken George, a retired highway crewmember who was part of the search and rescue, to lose their health. Ken had needs a respirator for his restricted airway disease, he is o n 33 medications and five years ago he had a heart attack. Bi- =weekly or monthly, he visits a doctor for his PTSD, his heart, his lungs and general healthcare. After seeing the devastating conditions that the responders like Ken worked in, Congresswoman C arolyn Maloney (D-12) worked tirelessly with many politicians, both Democrats and …

Factors Influencing Perceptions And Attitudes Of Nurses Towards The Use Of Ict In Patient Care In Kwazulu Natal Province, South Africa, Stephen M. Mutula

The African Journal of Information Systems

This paper presents the results of a study to determine factors influencing perceptions and attitudes of nurses towards the use of ICT in 16 hospitals in KwaZulu-Natal (KZN) province, South Africa. Data were collected through a survey questionnaire and factor analysis performed to extract relevant variables. Overall, results revealed positive dispositions of nurses towards the use of ICT. Results further revealed self-efficacy, adoption of computers to improve nursing care, confidence in using computers; usefulness; interactability and knowledgeability were major factors influencing perceptions and attitudes of nurses towards use of ICT at the work place. Findings may inform institutional and provincial …

Videoconferencing For Improved Access To Care, Alana L. Hernandez

Master's Projects and Capstones

The aim of this project is to increase the amount of education visits completed by pharmacy nurses in an outpatient infusion clinic for patients receiving 5-fluoracil chemotherapy. Two approaches have been applied: securing additional nursing staff; and implementing a telehealth delivery system that utilizes asynchronous video and videoconferencing. The intervention will employ an internet-based application to secure a videoconferencing session between patients and nurses that are 25 miles apart; and offer a patient education video that will be used and an adjunct to videoconferencing. Microsystem data obtained by auditing schedules and patient charts showed pharmacy nurses completed 0% of pharmacy-patient …

The Effect Of Education On Portal Personal Health Record Use, Imke Casey Dnp, Crna, Rhit

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Abstract

The purpose of this study was to assess the computer-use attitudes among chronically ill adult primary care practice (PCP) patients. The goal was to examine the rate of portal personal health record (PHR) use of middle-aged and older adults, to evaluate the effectiveness of an educational intervention in improving PHR adoption, and to identify patients’ thoughts about the PHR. The quasi-experimental, pre-test/post-test design with a paired matched set was performed with a convenience sample of 50 subjects from a primary care group practice in Central Florida.

Participants were recruited on the day of their provider appointment. After participant’s consent …

A New Method For Shear Wave Speed Estimation In Shear Wave Elastography, Aaron J. Engel, Gregory R. Bashford

Biomedical Imaging and Biosignal Analysis Laboratory

Visualization of mechanical properties of tissue can aid in noninvasive pathology diagnosis. Shear wave elastography (SWE) measures the elastic properties of soft tissues by estimation of local shear wave propagation speed. In this paper, a new robust method for estimation of shear wave speed is introduced which has the potential for simplifying continuous filtering and real-time elasticity processing. Shear waves were generated by external mechanical excitation and imaged at a high frame rate. Three homogeneous phantoms of varying elastic moduli and one inclusion phantom were imaged. Waves propagating in separate directions were filtered and shear wave speed was estimated by …

Measuring Quality Of Health Care In Type Ii Diabetes Mellitus Patients Using Certified Electronic Health Records, Tracey A. Hines

Applied Research Projects

Great strides have been made in health care over the past six years after the implementation of the policy known as meaningful use by the Center of Medicare and Medicaid Services. Health care subsidies and monetary incentive programs were created for eligible professionals and critical area hospitals to encourage the use of certified electronic health records in an effort to improve quality care of all acute and chronically ill patients, as well as provide routine examinations for healthy individuals.

Patients diagnosed with type II diabetes mellitus were studied using a certified electronic health record system for compliance in physician ordered …

An Automated Model Using Electronic Health Record Data To Identify Delirium Among Hospitalized Older Adults: A Pilot Project, Ariba Khan, Maharaj Singh, Hina Singh, Ayesha Maria, Michelle Simpson

Journal of Patient-Centered Research and Reviews

Background: Delirium is a serious change in mental status with adverse outcomes, but remains underrecognized. The electronic health record (EHR) may assist in the identification of delirium.

Purpose: This study was performed to generate an automated delirium identification model using data from the EHR among hospitalized older adults.

Methods: Inpatients 65 years and older were included in this cross-sectional study. The researchers used “confusion assessment method” as the gold standard to identify delirium. Four categories of variables were obtained from the EHR on the day of and the day prior to researcher assessment: 1) hypoactive delirium (any one of the …

Prognostic Indices For Hospitalized Older Adults: A Meta-Analysis And Systematic Review, Ariba Khan, Ayesha Maria, James Hocker, Maharaj Singh, Michelle Simpson

Journal of Patient-Centered Research and Reviews

Background: A prognostication predictive model incorporated into the electronic health record (EHR) may be useful in assisting the health care team in accurately predicting mortality and may be used in appropriately allocating palliative care services.

Purpose: To systematically review and summarize current medical literature regarding the factors predictive of mortality in an inpatient population above 65 years of age.

Methods: Nondisease-specific prognostication indices that predict 1-year mortality in an inpatient population of adults over age 65 were included. We excluded studies that estimated intensive care unit, disease-specific or in-hospital mortality. A MEDLINE, CINAHL, Ovid and Cochrane literature search of English-language …

Video Visits: A Closer Look At Patient Satisfaction And Quality Of Virtual Medical Care, Saddia Cheema

Applied Research Projects

Electronic medical services via video visits has revolutionized the delivery of medical care by Physicians and medical staff alike. Its steady evolution and progression towards the future of healthcare has provided insight on how to better serve patients and community members seeking care. This study will explore patient satisfaction and the quality of virtual medical care services provided by Physicians thru video visits as well as the impact of minimizing the spread of communicable diseases. Statistical data was gathered from a major U.S. healthcare company evaluating survey responses as well as feedback provided by member experience who visited with their …