Health Services Research Commons^™

The Experience Era Is Upon Us, Jason A. Wolf Phd

Patient Experience Journal

In this moment in healthcare, the challenges for those in the system are dynamically shifting and the perspectives, desires and needs of the healthcare consumer are putting positive and lasting pressures on how healthcare works that will shift healthcare from where it has been to where it must go. At the heart of this transition are the ideas framing an experience era, where collaborative, consumer-focused and purposeful actions can and will lead to a healthcare system returning to its fundamental calling, that of human beings caring for human beings. In doing so we can change the nature of healthcare and …

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 …

Are Bay County Florida Healthcare Facilities Ready For Pama Imaging Cds Mandate?, Kelly Johnson

Applied Research Projects

The Electronic Health Record (EHR) has been a major player on the healthcare scene in recent years. Its use has ushered in a new phase of focus on quality healthcare combined with and aided by technological integration. Within this technological integration have come adjutant tools including Clinical Decision Support (CDS) tools. Among these applications are those focused on appropriate imaging by use of CDS designed according to Appropriate Use Criteria (AUC). The imaging CDS tools are available to aid the provider in selecting the appropriate imaging study for the clinical indications present. The Protecting Access to Medicare Act (PAMA) passed …

Progress Toward Eliminating Mother To Child Transmission Of Hiv In Kenya: Review Of Treatment Guideline Uptake And Pediatric Transmission At Four Government Hospitals Between 2010 And 2012., Sarah Finocchario-Kessler, Kristine F. Clark, Samoel Khamadi, Brad J. Gautney, Vincent Okoth, Kathy Goggin, Hitsystem Study Team

Manuscripts, Articles, Book Chapters and Other Papers

We analyzed prevention of mother-to-child transmission (PMTCT) data from a retrospective cohort of n = 1365 HIV+ mothers who enrolled their HIV-exposed infants in early infant diagnosis services in four Kenyan government hospitals from 2010 to 2012. Less than 15 and 20 % of mother-infant pairs were provided with regimens that met WHO Option A and B/B+ guidelines, respectively. Annually, the gestational age at treatment initiation decreased, while uptake of Option B/B+ increased (all p's < 0.001). Pediatric HIV infection was halved (8.6-4.3 %), yet varied significantly by hospital. In multivariable analyses, HIV-exposed infants who received no PMTCT (AOR 4.6 [2.49, 8.62], p < 0.001), mixed foods (AOR 5.0 [2.77, 9.02], p < 0.001), and care at one of the four hospitals (AOR 3.0 [1.51, 5.92], p = 0.002) were more likely to be HIV-infected. While the administration and uptake of WHO PMTCT guidelines is improving, an expanded focus on retention and medication adherence will further reduce pediatric HIV transmission.

Analysis Of The Efforts Of Urban And Rural Health Systems To Achieve Accountable Care Organization Target Goals For Dilated Eye Exams In Individuals With Diabetes, Michele Gilliam

Muskie School Capstones and Dissertations

This capstone project was designed to understand and analyze the completion rates for diabetic dilated eye exams within four different health systems participating in the MaineHealth Accountable Care Organizations (ACO). This research is valuable within the current US health care climate as health care providers have sought to evaluate the cost of care in terms of their value to payers. Moreover, many providers have elected to join the ACO in order to demonstrate better outcomes, improve the cost of care and to share programmatic content and tools to standardized care. Within this capstone, system level workflows and processes were evaluated …

The Interpretive Approach As A Means Of Understanding The Misunderstood, Doreen Molloy, Joyce Hendricks, Anne Williams

Research outputs 2014 to 2021

People’s experiences of health and illness are important areas of health research and practice. The interpretive process, and more significantly the biographical approach (Denzin, 1989), is an approach in which there is a focus on personal epiphanies which shape and reflect the stories people tell of their experiences. Dolby-Stahl (1985) contends stories of personal experience sit within the genre of folklore and that the reading of such stories must take into account the social, cultural, and historical contexts which influence and give meaning to experience.

Analisis Kepuasan Pasien Tni Sebelum Dan Sesudah Penerapan Jkn Di Ruang Rawat Inap Kelas Ii Rs Dik Pusdikkes Kodiklat Tni Ad, Ernawati Ernawati

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Patient satisfaction is one of indicator of health care quality measurement and can be used as a benchmark for the hospital. The purpose of this study was to describe the characteristic of TNI patients who are JKN’s based on age, sex, education and rank, determine the performance of member RS DIK PUSDIKKES Kodiklat TNI AD for TNI patients with Servqual method as well as knowing the difference of services before and after impletation of JKN. This is a quantitative study with cross sectional approach using descriptive analysis and cartesian diagram. The study was conducted for 3 months on 100 patients …

Pengendalian Persediaan Obat Kemoterapi Melalui Pendekatan Analisis Abc Indeks Kritis Di Ruang Pencampuran Instalasi Farmasi Rsup Dr. Mohammad Hoesin Palembang Tahun 2015, Layla Izzatul Khuriyati

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

One of the featured services at RSMH is integrated chemotherapy services. One of the resources in support of these services is a pharmaceutical supplies including the Chemotherapy drugs are relatively expensive. In conducting the inventory control Dr. Mohammad Hoesin Hospital not classify drugs based on user value, investment value and criticality of drugs through certain methods. So in this study aims to conduct chemotherapy drug control approach ABC Analysis Critical Index in the Cytostatica Handling Room of Pharmacy Instalation RSUP Dr. Mohammad Hoesin Palembang. This study design using operational research with quantitative and qualitative descriptive analysis. The results showed that …

Rencana Pengembangan Cssd (Central Sterile And Supplies Department) Berdasarkan Kebutuhan Di Rs Meilia Tahun 2015, Lintang Kusuma Delia

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

To meet the requirements of Peraturan Menteri Kesehatan RI number 56 2014 and JKN in 2015, RS Meilia need the planning of CSSD development that refers to the literature, regulations, guidelines and standards of the Ministry of Health of Indonesia and also refers to the analysis of internal and external factors in the RS Meilia CSSD to reach an ideal CSSD. The analytical results are RS Meilia has been preparing since the beginning of the construction of the hospital to hold a separate CSSD unit. In addition, there is a problem about the distribution flow of dirty goods and sterile …

Analisis Perbedaan Tarif Rumah Sakit Dan Tarif Ina-Cbg’S Pelayanan Rawat Jalan Di Rsud Budhi Asih Jakarta Tahun 2015, Hotma Dumaris

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

There is a fundamental change of hospital’s payment system in Indonesia since the Indonesian National Health Insurance was implemented (January 2014). The former retrospective payment system was changed into prospective payment system with Indonesia Case Base Groups (INA-CBG) as expense base. This change forced hospital to propose a new efforts to adjust the rate difference between the previous hospital based-tariff system and the latter INA-CBG-based-tariff system in order to assure the health service quality. This study aims to find out hospital’s efforts to adjust the tariff difference between the hospital-based- tariff system and INA-CBG-based-tariff-system.This is a quantitative as well as …

Analisis Biaya Layanan Diabetes Melitus Dengan Komplikasi Dan Faktor Penentu Inefisiensi Penanganan Diabetes Melitus Di Rawat Inap Rsud Banyuasin Tahun 2015, Fahrul Rahman

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Since JKN was offiacially administered in general hospital on January 1st, 2014, there has been changing in hospital administration payment from the restrospective system (free for services) to the prospective system (INA-CBG’s). It is planned in 2019 that all the people in Indonesia is registered in BPJS (Universal Heath Coverage) as one of the facilities for public healt services provided by Banyuasin general hospital (RSUD Banyuasin) which ains to provide qualified services, yet still considering effiencies due to the lach of the government subsidies. This study aimed to analyze the cost and identify determinant factor in handling Diabetes Melitus with …

Analisis Perencanaan Dan Pengendalian Persediaan Obat Antibiotik Di Rsud Cicalengka Tahun 2014, Gita Gilang Kencana

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Poor planning and controlling of drug in RSUD Cicalengka has resulted excess inventory and potential Hospital losses. This operational research was using ABC Critical Index Analysis Method, Safety Stock, Economic Order Quantity (EOQ) and Reorder Point (ROP). Stock evaluation using Inventory Turnover Ratio (ITOR) was also conducted. The result of ABC Critical Index Analysis showed that were seven antibiotics need to be prioritized. The estimation of antibiotic drug in group A for year 2015 was done using Single Exponential Smoothing Method. Safety stock for Cefadroxil Kaps 500 mg (5x10) as much as 344, EOQ as much as 1476 and ROP …

Hubungan Faktor Risiko Ergonomi Dan Keluhan Cumulative Trauma Disorders Pada Dokter Gigi Di Pt. X Tahun 2014, Hany Winihastuti

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Dentist’s works have kind of risks related with Cumulative Trauma Disorders (CTDs). This research’s aim is to explain ergonomic factors and CTDs that happens to dentist. Cross sectional method is used in this research along with 44 dentis in hospitals and cliniques X as samples. The usage of RULA and MB Ruler in this research is supported the researcher to assess the work’s postures on the upper arm, forearm, wrist, neck, torso and leg.The study found that dentists who complained of CTDs as much as 72.7%. Bivariate analysis showed a relationship between the duration and the incidence of complaints CTDs …

Chemical Reactions: Marijuana, Opioids, And Our Families, Denise A. Hines Ph.D, Staci Gruber Ph.D, John F. Kelly Ph.D, Kathleen M. Palm Reed, Hilary Smith Connery M.D., Ph.D.

Mosakowski Institute for Public Enterprise

Chemical Reactions: Marijuana, Opioids, and Our Families is the seventh Massachusetts Family Impact Seminar. This seminar was designed to emphasize a family perspective in policymaking on issues related to the legalization of marijuana and managing the opioid abuse crisis in the Commonwealth. In general, Family Impact Seminars analyze the consequences an issue, policy, or program may have for families.

Access To Health Care Services For Adults In Maine [Report], Erika C. Ziller Phd

Access / Insurance

On October 17, 2016, the Maine Health Access Foundation (MeHAF) released a new research brief developed with the University of Southern Maine that found significant inequality in the ability of people in Maine to access quality health care. The authors, Barbara Leonard from MeHAF and Erika Ziller from the USM Muskie School, found that income, age and education are all closely associated with Maine people’s ability to receive appropriate and timely health care. Specifically, they found that among Maine adults 18 and older, those with family incomes less than $25,000 a year, young adults, racial and ethnic minorities, and people …

Recruiting And Retaining Individuals With Serious Mental Illness And Diabetes In Clinical Research: Lessons Learned From A Randomized, Controlled Trial., Stephanie W. Kanuch M.Ed., Kristin A. Cassidy Ma, Neal Dawson Md, Melanie Athey Ms, Edna Fuentes-Casiano Mssw, Martha Sajatovic Md

Journal of Health Disparities Research and Practice

Abstract: Recruitment and retention of individuals with serious mental illness (SMI) and comorbid diabetes mellitus (DM) in research studies can be challenging with major impediments being difficulties reaching participants via telephone contact, logistic difficulties due to lack of transportation, ongoing psychiatric symptoms, and significant medical complications. Research staff directly involved in recruitment and retention processes of this study reviewed their experiences. The largest barriers at the macro, mediator, and micro levels identified in this study were inclement weather, transportation difficulties, and intermittent and inaccessible telephone contact. Barrier work-around practices included using the health system’s EHR to obtain current phone numbers, …

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 …

Financial Hardship From Purchasing Medications For Senior Citizens Before And After The Medicare Modernization Act Of 2003 And The Patient Protection And Affordable Care Act Of 2010: Findings From 1998, 2001, And 2015, Anthony W. Olson, Jon C. Schommer, David A. Mott, Lawrence M. Brown

Pharmacy Faculty Articles and Research

BACKGROUND: The Medicare Modernization Act of 2003 (Medicare Part D) added prescription drug coverage for senior citizens aged 65 years and older and applied managed care approaches to contain costs. The Patient Protection and Affordable Care Act of 2010 (ACA) had the goals of expanding health care insurance coverage and slowing growth in health care expenditures.

OBJECTIVES: To (a) describe the proportion of senior citizens who had prescription drug insurance coverage and the proportion who experienced financial hardship from purchasing medications in 2015, and (b) compare the findings with those collected in 1998 and 2001.

METHODS: Data were obtained in …