Health Policy Commons^™

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 …

Variations In The Patients’ Hospital Care Experience By States’ Strategy For Medicaid Expansion: 2009-2013, Edmund Becker, Kenton Johnston Phd, Jaeyong Bae, Jason M. Hockenberry Phd, Ariel C. Avgar, Sandra Liu, Ira Wilson, Arnold Milstein Md, Mph

Patient Experience Journal

Our investigation evaluates the extent of differences in the patient’s hospital experience due to variations among state strategies to adopt, or not adopt, their Medicaid plans to the 2010 ACA legislation. Using ten HCAHPS measures, we analyze patient hospital experience data for the 2009 - 2013 period for all 50 states and the District of Columbia grouped by those states that (1) did not expand, (2) expanded Medicaid through Section 1115 waivers, (3) expanders early, and (4) expanded Medicaid concurrent with the new ACA legislation.

Our findings reveal that those states that opted out of Medicaid expansion typically started with …

Building National Consensus On Experiences Of Care, Anna Baranski, Neil Churchill, Sophie Staniszewska

Patient Experience Journal

The NHS in England is measured against specific indicators that focus on ‘ensuring that people have a positive experience of care,’ yet there was a lack of organisational alignment across the new national health and care organisations regarding their understanding of what constitutes a positive experience of care. This represents a major barrier to achieving an aligned and consistent system-wide approach to improving experiences. To address the need to create national alignment in definition and approach, we worked with the Patient Experience Sub-group of the National Quality Board to develop consensus on how national organisations define ‘experience of care’ and …

Cancer Patients’ Experiences Of Error And Consequences During Diagnosis And Treatment, Henriette Lipczak, Liv H. Dørflinger, Christine Enevoldsen, Mette M. Vinter, Jeanne L. Knudsen

Patient Experience Journal

The study objective was to investigate patient experienced error during diagnosis and treatment of cancer. The design included a nationwide patient survey on quality and safety in Danish cancer care. Responses regarding patient experienced error were separately analyzed, quantitative responses using descriptive statistics and qualitative responses using systematic text analysis. Study participants included 6,720 adult patients with a first time diagnosis of cancer registered between May 1st and August 31st 2010. The patients received a questionnaire concerning their experiences of care received by general practitioners, specialist practitioners and at the hospital. A response rate of 65% was achieved. 10 – …

Patient Complaints As Predictors Of Patient Safety Incidents, Helen L. Kroening, Bronwyn Kerr, James Bruce, Iain Yardley

Patient Experience Journal

Patients remain an underused resource in efforts to improve quality and safety in healthcare, despite evidence that they can provide valuable insights into the care they receive. This study aimed to establish whether high-level patient safety incidents (HLIs) were predictable from preceding complaints, enabling complaints to be used to prevent HLIs. For this study complaints received from November 2011 through June 2012 and HLI incident reports from April through September 2012 were examined. Complaints and HLIs were categorised according to location or specialty and the themes they included. Data were analysed to look for correlations between number of complaints and …

Weighting Patient Satisfaction Factors To Inform Health Care Providers Of The Patient Experience In The Age Of Social Media Consumer Sentiment, Blaine Parrish, Amita N. Vyas, Grace Douglass

Patient Experience Journal

The researchers explored the possibility that patients would go beyond simple ranking and could give weight to previously validated and reliable patient satisfaction factors, while also describing their online habits related to the patient experience and health seeking information in order to inform medical providers on what patients say matters most when evaluating satisfaction with their provider. One thousand one hundred and sixty-four adults completed a 13- item web-based quantitative survey, developed by public health researchers, to weight patient satisfaction factors and describe online health seeking habits of patients across the United States. Proportional weights for each of the patient …

Patient Satisfaction Reported By In-Visit And After-Visit Surveys, Rukiya Wongus, Nicholas H. Schluterman, Sharon Feinstein, Nihkolle Mcgirt, Deborah R. Greenberg, David B. Schwartz

Patient Experience Journal

Patient experience measurement has become a basic requirement for every healthcare provider organization. Yet, when the timing and mode of survey administration are considered, there is skepticism about the usefulness of ‘after- visit’ patient experience surveys to measure satisfaction and identify opportunities to improve service or health care quality. The aim of this observational study was to compare patient satisfaction among those who rated the patient experience at the conclusion of their outpatient appointment while still in the office, to that among those who rated the patient experience up to one month after their outpatient appointment via a mailed survey. …

Considering Shared Power And Responsibility: Diabetic Patients’ Experience With The Pcmh Care Model, Olena Mazurenko Md, Phd, Sheila Bock Phd, Catherine Prato, Margarita Bondarenko

Patient Experience Journal

The patient-centered medical home (PCMH), an innovative primary care model that fosters a stronger, more personal patient-doctor relationship than traditional health care models, should be particularly well suited for the treatment of chronic conditions such as diabetes that require ongoing management by both patients and providers. Despite growing research on the effectiveness of PCMHs in diabetes care, relatively little attention has been given to diabetic patients’ experiences. This qualitative study examines diabetic patients’ experiences at one PCMH setting, using in-depth interviews to understand patients’ perspectives of the shared power and responsibility between patient and provider in their diabetes care. Our …

The Children’S Hospital Of Philadelphia Family Partners Program: Promoting Child And Family-Centered Care In Pediatrics, Amy Kratchman, Ba, Darlene Barkman, Ma, Kathy Conaboy, Ba, Anna De La Motte, Msed, Rachel Biblow, Msw, Katherine Bevans, Phd

Patient Experience Journal

Involving Family Advisory Councils in decisions that impact pediatric healthcare demonstrates hospitals’ commitment to child- and family-centered care. Yet, reliance on advisors as the sole source of family input has several limitations: infrequent meetings impedes the council’s capacity to address emerging concerns in a timely manner; feedback obtained from a small number of highly-engaged family members may not represent the perspectives of “typical” patients and families; advisors provide feedback in a reactive manner and are generally not equitably involved in problem identification or the initial development of solutions. In recognition of the need to strengthen and advance family partnerships, the …

So Much More Than A “Pair Of Brown Shoes”: Triumphs Of Patient And Other Stakeholder Engagement In Patient-Centered Outcomes Research, Amanda Brodt, M.P.P., Christine K. Norton, M.A., Amy Kratchman

Patient Experience Journal

This piece illustrates the “real world” experiences of patients and other stakeholder partners in research to help inform and inspire future patient-centered outcomes research (PCOR) efforts. The Patient-Centered Outcomes Research Institute (PCORI) was created in 2010 to fund research that helps patients, clinicians, and other healthcare stakeholders make informed health decisions. The first 50 funded PCORI Pilot Projects engaged patients, caregivers, parents, patient advocates, clinicians, and other non-traditional research stakeholders to serve in advisory and leadership positions on their research teams, many for the first time. In interviews with seven patients and other stakeholders, several lessons learned emerged, including how …

Patient Partnership In Quality Improvement Of Healthcare Services: Patients’ Inputs And Challenges Faced, Marie-Pascale Pomey, Hassiba Hihat, May Khalifa, Paule Lebel, André Néron, Vincent Dumez

Patient Experience Journal

This research focuses on the perception of patients who participated in Continuous Quality Improvement Committees (CIC) regarding their contribution, lessons learned, and challenges encountered. The committees are engaged in a care partnership approach where patients are recognized for their experiential knowledge and treated as full members of the clinical team. Based on patient interviews, we conclude that they bring a structured and thoughtful vision of their experience. They identify themselves as real partners in the care process and are grateful for the opportunity to improve the care provided to other patients by using their own experience and by bringing changes …

Meaningful And Effective Patient Engagement: What Matters Most To Stakeholders, Mandy Bellows, Katharina Kovacs Burns, Karen Jackson, Brae Surgeoner, Jennifer Gallivan

Patient Experience Journal

To determine what resources, preparation, and support are needed for patients, providers, and leaders to meaningfully and appropriately engage in patient-centred health system redesign, researchers sought to learn what really matters to these three stakeholder groups. A qualitative descriptive design was selected using purposive participant sampling, focusing on ‘who’, ‘what’ and ‘why’ questions pertaining to stakeholder perceptions about patient engagement in their specific context as patients, providers or leaders. Four project groups were selected; each group was responsible for a strategic initiative within Alberta Health Services and represented one of three different levels of the healthcare system (i.e. program, site …

The Power Of Patient Ownership: The Path From Engagement To Equity, Zal Press, Dawn Richards

Patient Experience Journal

Understanding patient engagement from the lens of a person who is suffering, who is in pain and anguish, who is wracked with fear of the impact of this pain on their body, their family, their career, and their mortality, is a complex undertaking. The authors provide an important patient perspective in acknowledging and highlighting efforts to shift the conversation on experience from one about patients and families to one with patients and families. They challenge us to consider the power that can be found in creating ownership for patients and suggest it may be the one true path to moving …

Reframing The Work On Patient Experience Improvement, Jocelyn Cornwell

Patient Experience Journal

In reframing the work on patient experience improvement Dr. Jocelyn Cornwell, chief executive of The Point of Care Foundation, challenges us to broaden our view on what is necessary to impact patient experience efforts. From a defined need to reduce avoidable suffering associated with health care delivery dysfunction, she suggests we extend the discussion in two ways: First, to include a concern for staff engagement, experience and well-being, and second, to position patient experience improvement as one type of quality improvement (QI) in healthcare, and urge practitioners to pay more attention to the lessons from QI in other domains. High …

Patient Experience Established: One Year Later, Geoffrey A. Silvera, Jason A. Wolf Phd

Patient Experience Journal

Scholars and administrators have long dedicated themselves to centering healthcare conversations and debates on the experiences of patients and their families. Patient experience advocates view these experiences as critical to evaluations of healthcare quality. There have been a great multitude of important contributions, yet, for decades, these calls for patient-centric care experiences and healthcare systems have been confined to the fringes of disparate health policy and reform debates. This bygone reality created a diaspora of scholars and administrators dedicated to understanding, evaluating, and improving the patient experience. This article begins to explore a coalescing around patient experience research efforts citing …

The Patient Experience Movement Moves On, Jason A. Wolf Phd

Patient Experience Journal

As we present Volume 2 of Patient Experience Journal (PXJ) we both recognize the contributions that helped launch this publication and acknowledge the work that helped build the foundation of the broader research exploration in the emerging field of patient experience. On this base of knowledge we have worked to establish a new home for expanding the exploration of new ideas and practices through this publication. The importance of building, supporting and sustaining an outlet for research in patient experience is grounded in the belief that positive patient experience is good for healthcare, it is good for the people who …

A Community Needs Assessment To Improve Lung Health Within Substandard Housing Units, Stephanie M. Goble

Scholarly and Creative Works Conference (2015 - 2021)

The Census Bureau states “more than 45 million people, or 14.5 percent of all Americans, lived below the poverty line last year [2013].” Many of these individuals are living in substandard housing conditions, which are causing preventable poor lung health among the population. The CDC reported that asthma was linked to 3,404 deaths in 2010. The link between poor health and living conditions is a hypothesis that has been contemplated for a long time now. Florence Nightingale speculated, “The connection between health and the dwelling of the population is one of the most important that exists...” (Jacobs) Based on this …

Assessing Changes In Safety Net Providers Since The Passage Of The Affordable Care Act, Arlesia Mathis, Julia Burke, Gulzar H. Shah

Health Policy & Management: Faculty Presentations (2008-2022)

The passage of the Affordable Care Act presented opportunities and challenges for safety net providers. Significant investments in provider capacity promised much needed expansion of services; and in 2014, the law extended coverage to millions of previously uninsured Americans. However, safety net providers are concerned that changes to financing brought about by changes in the ACA may threaten their ability to provide services to millions more who still lack insurance. This is a preliminary study of changes occurring with maternal and child health services among safety-net providers.

Use Of Facebook By Local Health Departments: Activity And Focus Areas, Rakhi Trivedi, Gulzar H. Shah

Health Policy & Management: Faculty Presentations (2008-2022)

This presentation was given at the Keeneland Conference for Public Health Systems and Services Research.

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 …

Water Poverty In Disadvantaged Communities In California, Alyssa J. Galik

Seaver College Research And Scholarly Achievement Symposium

California, the eighth largest economy in the world, has nearly one million residents that lack daily access to clean drinking water, yet it recently became the first state in the US to declare water a human right through the passage of 2013 Assembly Bill 685. The majority of water quality violations take place in the rural San Joaquin Valley in unincorporated, low-income communities, which have difficulties accessing clean, drinking water due to issues including quality, affordability, and physical availability. The role of community participation in improving water poverty has been studied extensively in developing countries but its impact is infrequently …

Impact Of A State Evidence-Based Practice Legislative Mandate On County Practice Implementation Patterns And Inpatient Behavioral Health Discharge, Carl William Foreman

Dissertations and Theses

Evidence-based practices and comparative effectiveness research are salient topics in public policy. Empirical validation of agency operating processes provides agencies and policy-makers the opportunity to address uncertainty surrounding effectiveness. While this is an increasingly accepted rational approach to public policy, the exact mechanism for how this operates is less known. In order to evaluate several theoretical assumptions and normative rational expectations inherent in this approach, the implementation of a state legislative mandate stating policy expectations for behavioral health evidence-based practices is assessed. This study sought to assess whether implementation patterns and associated outcomes reflect "rational mechanism" policy expectations. While the …

Improving Police Officer Responses To Persons With Mental Illnesses: A Review Of The Literature, Portland State University. Criminology And Criminal Justice Senior Capstone

Criminology and Criminal Justice Senior Capstone Project

Addressing mental illness in the American criminal justice system is necessary in order to ensure both citizens and officers are safe. According to Centers for Disease Control and Prevention (2011), published studies show approximately 25 percent of all adults in the U.S. have a mental illness and nearly 50 percent of adults in the U.S. will develop at least one mental illness during their lifetimes. The U.S. Department of Justice’s Bureau of Justice Statistics also indicates nearly 25 percent of state prisoners and jail inmates with a mental health problem have three or more prior incarcerations (as cited in Glaze …

Barriers And Motivations In Mental Health Legislative Advocacy In Oregon, Bethany Webb

Doctor of Psychology (PsyD)

Compared to other allied health fields, psychology continuously lags behind in representation on the state, national, and local level. The percentage of advocacy involvement by psychologists is very low compared with other professions. There is a great need for all psychologists to become advocates. Unfortunately, there has been limited research into the reasons why few psychologists actually engage in this process. The purpose of this study was to explore the differences in state psychological membership and primary place of practice among Oregon psychologists and students with regard to participation in mental health legislation and to identify barriers and motivations to …

Deconstructing Unmade Examining The Capacity Of Ayurveda To Address India’S Mental Health Crisis, Cassie Sutten Coats

Independent Study Project (ISP) Collection

Though India does not have a credible, widespread system in place to recognize and focus on issues of mental health, especially in allopathic treatments, it is imperative to evaluate the existing practices and approaches in regards to mental health alongside the impact that these approaches may have on Indian society. In contrast to Westernized systems of medicine, the traditional Indian system of Ayurveda inherently addresses issues in mental health due to the holistic approach through mind-body medicine. This study evaluates the enormous potential that exists within Ayurvedic philosophy to provide adequate, culturally congruent, treatments and care in mental health, and …

Investigating Barriers To Early Cancer Detection For Rural Indian Women: A Qualitative Analysis Of Cancer Outreach In Dehradun, Uttarakhand, Blair Burnett

Independent Study Project (ISP) Collection

This study examines barriers to early detection for women’s specific cancers in rural India in and around Dehradun, Uttarakhand, within the framework of existing health outreach programs from tertiary hospitals in the state. The burden of cancer mortality within India is disproportionately affecting women living in rural populations considering the current health education and health care infrastructure in place. Barriers of knowledge, access to knowledge, economic condition, geography, and cultural norms are all examined within this study in the context of early cancer detection. National Indian health policy is currently framed to address the burden of cancer within India; however, …

Confronting Cultural Challenges For Migrant Healthcare In Switzerland, Rebecca Weiss

Independent Study Project (ISP) Collection

Switzerland is home to many migrants, and migration exacerbates health risks. In addition to physical health problems, migrants are more likely than Swiss nationals to face mental health challenges and cultural barriers, which complicate their experiences seeking healthcare. Similarly, clinicians encounter numerous challenges related to the special circumstances of migrant patients. As a response to the specific health needs of migrants, hospital networks and migrant support organizations promote the migrant health situation. However, these services are not ubiquitous in Switzerland, partly due to the partial freedoms of each canton to create its own health policy. This paper explores the barriers …

Levels And Predictors Of Lhds' Engagement In Community Health Assessment, 2002-2013, Gulzar H. Shah, Kay Lovelace, Daniel F. Linder

Health Policy & Management: Faculty Presentations (2008-2022)

This presentation was given at the Keeneland Conference for Public Health Systems and Services Research.

Characteristics Of Local Health Departments Associated With Their Implementation Of Electronic Health Records And Other Informatics System, Gulzar H. Shah, Jonathon P. Leider, Brian C. Castrucci, Karmen S. Williams, Huabin Luo

Health Policy & Management: Faculty Presentations (2008-2022)

Background: Information technology and information systems (IT/IS) play a critical role in the daily operation of local health departments (LHDs). Assessing LHDs’ informatics capacities is important, especially within the context of broader, system-level health reform efforts.

Research Objective: This study assesses a nationally representative sample of LHDs’ level of adoption of information systems, technology, and the factors associated with adoption/implementation. Specifically, five areas of public health informatics were examined: electronic health records (EHRs), health information exchange (HIE), immunization registry (IR), electronic disease reporting system (EDRS), and electronic lab reporting (ELR).

Data Sets and Sources: Data from NACCHO’s 2013 National Profile …

Factors Driving Local Health Department’S Collaboration With Other Organizations In The Provision Of Personal Healthcare Services, Huabin Luo, Nancy L. Winterbauer, Ashley Tucker, Gulzar H. Shah

Health Policy & Management: Faculty Presentations (2008-2022)

Background: Recent work has highlighted the necessity of integrating primary care services and public health to improve quality and reduce the cost of healthcare.

Research Objectives: To describe levels of partnership between local health departments (LHD) and other organizations in the community in the provision of personal healthcare services; and to assess LHD organizational characteristics and community factors that contribute to partnerships.

Data Sets and Sources: Data were drawn from the 2013 NACCHO Profile Study (Module 1) and the Area Health Resource File. A total of 490 LHDs responded to Module 1, where LHDs were asked to describe the level …