Organizational Culture Differences in Incorporation of Health Information Technology (HIT) across Healthcare Providers

2018 ◽  
Vol 25 (1) ◽  
pp. 7-13 ◽  
Author(s):  
Mark A. Sujan

Health information technology (IT) offers exciting opportunities for providing novel services to patients, and for improving the quality and safety of care. Many healthcare professionals are already improving services through the development of numerous bottom-up local health IT innovations. Such innovations from the ground up are to be welcomed, but healthcare providers are struggling to develop processes for managing the risks that come with the introduction of health IT into clinical processes. I argue that too often the main strategy appears to be one of organisational ignorance. This puts patients at risk, and it threatens the successful adoption of health IT. I recommend that healthcare providers focus on strengthening their processes for organisational learning, promoting proactive risk management strategies, and making risk management decisions transparent and explicit.


Author(s):  
Chenzhang Bao ◽  
Indranil R. Bardhan

Under a traditional fee-for-service payment model, healthcare providers typically compromise the quality of care in order to reduce costs. Drawing on data from a national sample of accountable care organizations (ACOs), we study whether financial incentives offered under the Affordable Care Act led to fundamental changes in care delivery. Our research suggests that effective use of health information technology (IT) by ACO providers is critical in balancing competing goals of quality and efficiency. Unlike hospitals that did not participate in value-based care initiatives, ACOs were able to generate better quality outcomes while also improving overall efficiency. Furthermore, ACO providers that used health IT effectively demonstrated better patient health outcomes due to greater information integration with other providers. In other words, ACOs created value by not only reducing the cost of care but also improving patient outcomes simultaneously. Our research provides a roadmap for practitioners to succeed in a value-based healthcare environment and for policy makers to design better incentives to promote interorganizational information sharing across providers. Our findings suggest that healthcare policy needs to incorporate appropriate incentives to foster effective IT use for care coordination between healthcare providers.


Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 306
Author(s):  
Clemens Scott Kruse ◽  
Brady Kindred ◽  
Shaneel Brar ◽  
Guillermo Gutierrez ◽  
Kaleigh Cormier

Doctor shopping is the practice of visiting multiple physicians to obtain multiple prescriptions. Health information technology (HIT) allows healthcare providers and patients to leverage records or shared information to improve effective care. Our research objective was to determine how HIT is being leveraged to control for doctor shopping. We analyzed articles that covered a 10-year time period from four databases and reported using preferred reporting items for systematic reviews and meta-analysis (PRISMA). We compared intervention, study design, and bias, in addition to showing intervention interactions with facilitators, barriers, and medical outcomes. From 42 articles published from six countries, we identified seven interventions, five facilitator themes with two individual observations, three barrier themes with six individual observations, and two medical outcome themes with four individual observations. Multiple HIT mechanisms exist to control for doctor shopping. Some are associated with a decrease in overdose mortality, but access is not universal or compulsory, and data sharing is sporadic. Because shoppers travel hundreds of miles in pursuit of prescription drugs, data sharing should be an imperative. Research supports leveraging HIT to control doctor shopping, yet without robust data sharing agreements, the efforts of the system are limited to the efforts of the entity with the least number of barriers to their goal. Shoppers will seek out and exploit that organization that does not require participation or checking of prescription drug monitoring programs (PDMP), and the research shows that they will drive great distances to exploit this weakest link.


JAMIA Open ◽  
2018 ◽  
Vol 2 (1) ◽  
pp. 179-186 ◽  
Author(s):  
Hong Kang ◽  
Ju Wang ◽  
Bin Yao ◽  
Sicheng Zhou ◽  
Yang Gong

Abstract Introduction Health information technology (HIT) is intended to provide safer and better care to patients. However, poorly designed or implemented HIT poses a key risk to patient safety. It is essential for healthcare providers and researchers to investigate the HIT-related events. Unfortunately, the lack of HIT-related event databases in the community hinders the analysis and management of HIT-related events. Objectives Develop a standardized process for identifying HIT-related events from a Federal Drug Administration (FDA) database in order to create an HIT exclusive database for analysis and learning. Methods The FDA Manufacturer and User Facility Device Experience (MAUDE) database, containing over 7-million reports about medical device malfunctions and problems leading to serious injury or death, was considered as a potential resource to identify HIT-related events. We developed a strategy of identifying and categorizing HIT-related events from the FDA reports through the application of a keyword filter and standardized expert review. Ten percent identified reports were reviewed to measure the consistency among experts and to initialize a database for HIT-related events. Results With the proposed strategy, we initialized an HIT-related event database with over 3500 reports, and updated the estimation of the HIT-related event proportion in the FDA MAUDE database to 0.46∼0.69%, up to 50,000 HIT-related events. Conclusion The proposed strategy for HIT-related event identification holds promise in aiding the understanding, characterization, discovery, and reporting of HIT-related events toward improved patient safety. The analysis of contributing factors under the 8-dimensional sociotechnical model shows that hardware and software, clinical content, and human–computer interface were identified more frequently than the other dimensions.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jinhyung Lee ◽  
Jae-Young Choi

AbstractThis study aimed to investigate the impact of health information technology (IT) on the Case Mix Index (CMI). This study was a retrospective cohort study using hospital financial data from the Office of Statewide Health Planning and Development (OSHPD) in California. A total of 309 unique hospitals were included in the study for 7 years, from 2009 to 2015, resulting in 2,135 hospital observations. The effects of health information technology (IT) on the Case Mix Index (CMI) was evaluated using dynamic panel data analysis to control endogeneity issues. This study found that more health IT adoption could lead to a lower CMI by improving coding systems. Policy makers, researchers, and healthcare providers must be cautious when interpreting the effect of health IT on the CMI. To encourage the adoption of health IT, the cost savings and reimbursement reductions resulting from health IT adoption should be compared. If any profit loss occurs (i.e., the cost savings is less than reimbursement reduction), more incentives should be provided to healthcare providers.


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