Restoring clinical information system operations post data disaster: the role of IT investment, integration and interoperability

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Utkarsh Shrivastava ◽  
Bidyut Hazarika ◽  
Alan Rea

PurposeDelay in the clinical information system (CIS) restoration overseeing critical health-care operations after an unexpected data loss can be fatal for patients under care. Investment in information technology (IT) capabilities and synergy between various computerized systems has been argued as the resilient information system's enablers. The purpose of this study is to empirically quantify the influence of IT investment, integration and interoperability in recovering the CIS from a data disaster.Design/methodology/approachAn archival dataset sourced from a European Commission-sponsored survey of 773 hospitals across 30 countries in Europe is utilized to study the relationships. The study adopts a quasi-experimental research design approach where sample observations are weighted based on their propensity to be selected in treatment groups. The artificial weighing allows attaining a pseudo-random sample to counter the effects of selection bias.FindingsThe study finds that hospitals with more than 5% of the budget dedicated to IT have 100% higher odds of recovering immediately from a critical data loss in comparison to those that have less than 1% investment in IT. The greater extent of IT integration significantly reduces the time to recover the CIS, while interoperability problems at the organizational level lessen the odds of immediate recovery by 19%. Interoperability problems at the technical and semantic levels do not significantly impact recovery times of the CIS.Originality/valueThe study proposes several empirically quantified and scientifically tested recommendations for health-care providers for faster restoration of critical CIS operations post data loss. The differential impact of the interoperability problems at the technical, semantic and organizational levels has also been highlighted.

2021 ◽  
Vol 3 (2) ◽  
pp. 444-453
Author(s):  
Arturo Cervantes Trejo ◽  
Sophie Domenge Treuille ◽  
Isaac Castañeda Alcántara

AbstractThe Institute for Security and Social Services for State Workers (ISSSTE) is a large public provider of health care services that serve around 13.2 million Mexican government workers and their families. To attain process efficiencies, cost reductions, and improvement of the quality of diagnostic and imaging services, ISSSTE was set out in 2019 to create a digital filmless medical image and report management system. A large-scale clinical information system (CIS), including radiology information system (RIS), picture archiving and communication system (PACS), and clinical data warehouse (CDW) components, was implemented at ISSSTE’s network of forty secondary- and tertiary-level public hospitals, applying global HL-7 and Digital Imaging and Communications in Medicine (DICOM) standards. In just 5 months, 40 hospitals had their endoscopy, radiology, and pathology services functionally interconnected within a national CIS and RIS/PACS on secure private local area networks (LANs) and a secure national wide area network (WAN). More than 2 million yearly studies and reports are now in digital form in a CDW, securely stored and always available. Benefits include increased productivity, reduced turnaround times, reduced need for duplicate exams, and reduced costs. Functional IT solutions allow ISSSTE hospitals to leave behind the use of radiographic film and printed medical reports with important cost reductions, as well as social and environmental impacts, leading to direct improvement in the quality of health care services rendered.


2020 ◽  
Vol 25 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Brianne Redquest ◽  
Yona Lunsky

Purpose There has been an increase in research exploring the area of intellectual and developmental disabilities (IDD) and diabetes. Despite being described as instrumental to diabetes care for people with IDD, the role and experiences of family carers, such as parents and siblings, are often neglected in this research. However, it is clear that family carers do not feel that they have sufficient knowledge about diabetes. The purpose of this commentary is to extend the content from “Diabetes and people with learning disabilities: Issues for policy, practice, and education (Maine et al., 2020)” and discuss how family carers can feel better supported when caring for someone with IDD and diabetes. Design/methodology/approach This commentary discusses specific efforts such as STOP diabetes, DESMOND-ID and OK-diabetes for people with IDD including family carers. Encouragement is given for health care providers to recommend such programmes to people with IDD and their family carers. It is also suggested that health care providers involve family carers in diabetes care planning and implementation for people with IDD. Findings It is hoped that if changes are made to current diabetes practices and more research with family carers is conducted, diabetes prevention and management for people with IDD will be more successful and family carers can feel more confident in providing support to their loved ones. Originality/value Research exploring the role of family carers in diabetes care for people with IDD and diabetes is very limited. This commentary makes recommendations to help family carers feel better supported in their role. It also provides areas for future research.


2020 ◽  
Vol 16 (3) ◽  
pp. 279-292
Author(s):  
Sarah Marshall

Purpose Ideas of health-related deservingness in theory and practise have largely been attached to humanitarian notions of compassion and care for vulnerable persons, in contrast to rights-based approaches involving a moral-legal obligation to care based on universal citizenship principles. This paper aims to provide an alternative to these frames, seeking to explore ideas of a human rights-based deservingness framework to understand health care access and entitlement amongst precarious status persons in Canada. Design/methodology/approach Drawing from theoretical conceptualizations of deservingness, this paper aims to bring deservingness frameworks into the language of human rights discourses as these ideas relate to inequalities based on noncitizenship. Findings Deservingness frameworks have been used in public discourses to both perpetuate and diminish health-related inequalities around access and entitlement. Although, movements based on human rights have the potential to be co-opted and used to re-frame precarious status migrants as “undeserving”, movements driven by frames of human rights-based deservingness can subvert these dominant, negative discourses. Originality/value To date, deservingness theory has primarily been used to speak to issues relating to deservingness to welfare services. In relation to deservingness and precarious status migrants, much of the literature focuses on humanitarian notions of the “deserving” migrant. Health-related deservingness based on human rights has been under-theorized in the literature and the authors can learn from activist movements, precarious status migrants and health care providers that have taken on this approach to mobilize for rights based on being “human”.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Hossein Motahari-Nezhad ◽  
Maryam Shekofteh ◽  
Maryam Andalib-Kondori

Purpose This study aims to investigate the characteristics, as well as the purpose and posts of the COVID-19 Facebook groups. Design/methodology/approach A systematic search for COVID-19 Facebook groups was conducted on June 1, 2020. Characteristics of the groups were examined using descriptive statistics. Mann-Whitney test was used to study the differences between groups. The study of the most popular groups’ posts was also carried out using the content analysis method. Findings The groups had a combined membership of 2,729,061 users. A total of 147,885 posts were received. There were about approximately 60% public groups. A high percentage of the groups (86.5%) had descriptions. The results showed a significant relationship between the groups’ description status and the number of members (p-value = 0.016). The majority of COVID-19 Facebook groups (56%) were created to meet their members’ information needs. The highest number of studied posts were related to vaccination (35.2%), followed by curfew rules (19.6%) and symptoms (10.6%). Originality/value Translating these insights into policies and practices will put policymakers and health-care providers in a stronger position to make better use of Facebook groups to support and enhance public knowledge about COVID-19.


2018 ◽  
Vol 12 (2) ◽  
pp. 135-145 ◽  
Author(s):  
Ik-Whan Kwon ◽  
Sung-Ho Kim

Purpose This paper aims to explore avenue where suppliers and manufacturers are aligned with health-care providers to improve supply chain visibility. Supply chain finance is explored to link suppliers/manufacturers with health-care providers. Design/methodology/approach Existing literature on supply chain visibility in health care forms a basis to achieve the study purpose. Alignment calls also for financial health where supply chain partners’ working capital is readily available to execute joint supply chain plan. Findings There is a disjoint in supply chain alliance between suppliers/manufacturers and providers where providers are unable to trace the origin of supplies. Quality care suffers and cost of care rises as providers search for supplies on an emergency basis. This paper provides a framework where solution can be formulated. Research limitations/implications Suppliers/manufactures form a direct strategic alliance with providers where product visibility enables health-care providers with a better patient management with lower cost of supplies. Inventory management and logistics cost will be lowered as better planning/forecasting is in place. This paper does not call for testing any hypothesis. Perhaps, next move along this line will be to investigate financial health of supply chain partners based on supplier relationship management practices. Originality/value This paper proposes health-care supply chain as an alternative solution to achieve the following twin purposes: controlling the cost while improving quality of care through supply chain finance. As far as we know, this study is the first attempt to achieve the goals.


2018 ◽  
Vol 7 (1) ◽  
pp. 2-21 ◽  
Author(s):  
Shahidul Islam

Purpose The purpose of this paper is to clarify and explain patient-centered health choices, facilitating health-care providers’ service orientation. Design/methodology/approach Extensive literature review has been done to extract seven constructs (five dimensions of SERVQUAL, perceived service cost (PSC), and reference) and their underlying 28 items to be quantified. A survey of 201 health consumers was conducted to rate those variables and their constructs. Descriptive statistics and structural equation modeling are utilized to delineate and explicate factors. Findings The confirmatory factor analysis demonstrated that responsiveness has the highest predictive power in explaining hospital choice intention. However, PSC, the only construct, is not statistically significant. The models are considered to have satisfactory reliability, validity, and acceptable fit. Research limitations/implications Since the study was administered in Comilla city, the generalizations should be exploited carefully. Future studies can be carried out on the behavioral patterns of patients and attitudes of health-care providers with respect to the discussed factors and variables. Practical implications The result highlights patients’ service expectations that can be carefully and creatively applied in the service marketing program, improving doctors’ and nurses’ service orientation, developing physical evidence, and managing references to communicate service value to patients. Originality/value What health consumers emphasize and how they incorporate service quality dimensions into hospital choice intention has stayed almost unexplored in the existing literature in Bangladesh. This study provides valuable insights into the meaning of patients’ choices, which will help practitioners and researchers to formulate marketing strategies that improve health-care outcomes and are acceptable to patients.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Kathy Kornas ◽  
Meghan O'Neill ◽  
Catherine Y. Liang ◽  
Lori Diemert ◽  
Tsoleen Ayanian ◽  
...  

PurposeThe purpose of this study is to understand health care providers' experiences with delivering a novel Integrated Care (IC) Program that co-ordinates hospital-based clinical services and home care for thoracic surgery patients, including perceptions on the provision of person-centred care and quality of work life.Design/methodology/approachThe authors conducted a process evaluation using qualitative methods to understand provider experiences in the Integrated Care (IC) Program and to identify areas for programme improvement. Study data were collected using a focus group with thoracic surgeons, open-ended survey with home care providers, and semi-structured interviews with lead thoracic surgeons and IC leads, who are nurses serving as the primary point of contact for one consistent care team. Data were analysed using thematic analysis.FindingsThe IC Program was successful in supporting a partnership between health care providers and patients and caregivers to deliver a comprehensive and person-centred care experience. Informational continuity between providers was facilitated by IC leads and improved over time with greater professional integration and adaptation to the new care delivery processes. Differential impacts were found on quality of work life for providers in the IC Program.Originality/valueThis study describes provider experiences with delivering integrated and person-centred care across the hospital to home continuum, which can inform future integrated care initiatives.


2019 ◽  
Vol 33 (7/8) ◽  
pp. 929-948 ◽  
Author(s):  
Jodyn Platt ◽  
Minakshi Raj ◽  
Sharon L.R. Kardia

Purpose Nations such as the USA are investing in technologies such as electronic health records in order to collect, store and transfer information across boundaries of health care, public health and research. Health information brokers such as health care providers, public health departments and university researchers function as “access points” to manage relationships between the public and the health system. The relationship between the public and health information brokers is influenced by trust; and this relationship may predict the trust that the public has in the health system as a whole, which has implications for public trust in the system, and consequently, legitimacy of involved institutions, under circumstances of health information data sharing in the future. This paper aims to discuss these issues. Design/methodology/approach In this study, the authors aimed to examine characteristics of trustors (i.e. the public) that predict trust in health information brokers; and further, to identify the factors that influence trust in brokers that also predict system trust. The authors developed a survey that was administered to US respondents in 2014 using GfK’s nationally representative sample, with a final sample of 1,011 participants and conducted ordinary least squares regression for data analyses. Findings Results suggest that health care providers are the most trusted information brokers of those examined. Beliefs about medical deceptive behavior were negatively associated with trust in each of the information brokers examined; however, psychosocial factors were significantly associated with trust in brokers, suggesting that individual attitudes and beliefs are influential on trust in brokers. Positive views of information sharing and the expectation of benefits of information sharing for health outcomes and health care quality are associated with system trust. Originality/value This study suggests that demonstrating the benefits and value of information sharing could be beneficial for building public trust in the health system; however, trust in brokers of information are variable across the public; that is, knowledge, attitudes and beliefs are associated with the level of trust different individuals have in various health information brokers – suggesting that the need for a personalized approach to building trust.


2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Nicole F. Stowell ◽  
Carl Pacini ◽  
Martina K. Schmidt ◽  
Nathan Wadlinger

Purpose This study aims to increase awareness and educate the reader about health-care fraud targeting seniors in the USA to help stakeholders better understand, recognize and prevent this type of fraud. Design/methodology/approach This paper collects statistics on the current state of health care frauds committed against seniors, and examines related cases and laws. Findings The authors find this type of fraud is highly prevalent and expected to increase. Current laws preventing this fraud from occurring are multifold and complex. While prevention strategies through law enforcement have been somewhat successful, a reduction in resources may put seniors at an increased risk in the years to come. Research limitations/implications Without additional prevention strategies, the problem will likely escalate with a growing population of older adults. This study encourages further research into effective prevention strategies and methods to fight health-care fraud against seniors. Practical implications Health-care fraud and its associated costs pose a significant threat to the society and economy of the USA. Reducing this fraud will not only reduce the costs to the US economy but also improve the physical and mental well-being of senior victims, reduce their mortality and hospitalization rates and improve the public trust placed to health-care providers. Originality/value This study highlights how health-care fraud is committed against seniors. With the projected trend of an aging US population, educating stakeholders, increasing awareness and applying tools to protect seniors will be important to reduce the absolute scope of this problem in the future.


2010 ◽  
Vol 01 (02) ◽  
pp. 116-131 ◽  
Author(s):  
V. Herasevich ◽  
A. Ahmed ◽  
O. Gajic ◽  
B.W. Pickering

SummaryThe introduction of electronic medical records (EMR) and computerized physician order entry (CPOE) into the intensive care unit (ICU) is transforming the way health care providers currently work. The challenge facing developers of EMR’s is to create products which add value to systems of health care delivery. As EMR’s become more prevalent, the potential impact they have on the quality and safety, both negative and positive, will be amplified. In this paper we outline the key barriers to effective use of EMR and describe the methodology, using a worked example of the output. AWARE (Ambient Warning and Response Evaluation), is a physician led, electronic-environment enhancement program in an academic, tertiary care institution’s ICU. The development process is focused on reducing information overload, improving efficiency and eliminating medical error in the ICU. Citation: Pickering BW, Herasevich V, Ahmed A, Gajic O. Novel representation of clinical information in the ICU – developing user interfaces which reduce information overload. Appl Clin Inf 2010; 1: 116–131 http://dx.doi.org/10.4338/ACI-2009-12-CR-0027


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