scholarly journals Key Factors Affecting Ambulatory Care Providers’ Electronic Exchange of Health Information With Affiliated and Unaffiliated Partners: Web-Based Survey Study (Preprint)

2018 ◽  
Author(s):  
John C Pendergrass ◽  
Ranganathan Chandrasekaran

BACKGROUND Despite the potential benefits of electronic health information exchange (HIE) to improve the quality and efficiency of care, HIE use by ambulatory providers remains low. Ambulatory providers can greatly improve the quality of care by electronically exchanging health information with affiliated providers within their health care network as well as with unaffiliated, external providers. OBJECTIVE This study aimed to examine the extent of electronic HIE use by ambulatory clinics with affiliated providers within their health system and with external providers, as well as the key technological, organizational, and environmental factors affecting the extent of HIE use within and outside the health system. METHODS A Web-based survey of 320 ambulatory care providers was conducted in the state of Illinois. The study examined the extent of HIE usage by ambulatory providers with hospitals, clinics, and other facilities within and outside their health care system–encompassing seven kinds of health care data. Ten factors pertaining to technology (IT [information technology] Compatibility, External IT Support, Security & Privacy Safeguards), organization (Workflow Adaptability, Senior Leadership Support, Clinicians Health-IT Knowledge, Staff Health-IT Knowledge), and environment (Government Efforts & Incentives, Partner Readiness, Competitors and Peers) were assessed. A series of multivariate regressions were used to examine predictor effects. RESULTS The 6 regressions produced adjusted R-squared values ranging from 0.44 to 0.63. We found that ambulatory clinics exchanged more health information electronically with affiliated entities within their health system as compared with those outside their health system. Partner readiness emerged as the most significant predictor of HIE usage with all entities. Governmental initiatives for HIE, clinicians’ prior familiarity and knowledge of health IT systems, implementation of appropriate security, and privacy safeguards were also significant predictors. External information technology support and workflow adaptability emerged as key predictors for HIE use outside a clinic’s health system. Differences based on clinic size, ownership, and specialty were also observed. CONCLUSIONS This study provides exploratory insights into HIE use by ambulatory providers within and outside their health care system and differential predictors that impact HIE use. HIE use can be further improved by encouraging large-scale interoperability efforts, improving external IT support, and redesigning adaptable workflows.

10.2196/12000 ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. e12000
Author(s):  
John C Pendergrass ◽  
Ranganathan Chandrasekaran

Background Despite the potential benefits of electronic health information exchange (HIE) to improve the quality and efficiency of care, HIE use by ambulatory providers remains low. Ambulatory providers can greatly improve the quality of care by electronically exchanging health information with affiliated providers within their health care network as well as with unaffiliated, external providers. Objective This study aimed to examine the extent of electronic HIE use by ambulatory clinics with affiliated providers within their health system and with external providers, as well as the key technological, organizational, and environmental factors affecting the extent of HIE use within and outside the health system. Methods A Web-based survey of 320 ambulatory care providers was conducted in the state of Illinois. The study examined the extent of HIE usage by ambulatory providers with hospitals, clinics, and other facilities within and outside their health care system–encompassing seven kinds of health care data. Ten factors pertaining to technology (IT [information technology] Compatibility, External IT Support, Security & Privacy Safeguards), organization (Workflow Adaptability, Senior Leadership Support, Clinicians Health-IT Knowledge, Staff Health-IT Knowledge), and environment (Government Efforts & Incentives, Partner Readiness, Competitors and Peers) were assessed. A series of multivariate regressions were used to examine predictor effects. Results The 6 regressions produced adjusted R-squared values ranging from 0.44 to 0.63. We found that ambulatory clinics exchanged more health information electronically with affiliated entities within their health system as compared with those outside their health system. Partner readiness emerged as the most significant predictor of HIE usage with all entities. Governmental initiatives for HIE, clinicians’ prior familiarity and knowledge of health IT systems, implementation of appropriate security, and privacy safeguards were also significant predictors. External information technology support and workflow adaptability emerged as key predictors for HIE use outside a clinic’s health system. Differences based on clinic size, ownership, and specialty were also observed. Conclusions This study provides exploratory insights into HIE use by ambulatory providers within and outside their health care system and differential predictors that impact HIE use. HIE use can be further improved by encouraging large-scale interoperability efforts, improving external IT support, and redesigning adaptable workflows.


2017 ◽  
pp. 694-714
Author(s):  
Kijpokin Kasemsap

This chapter explains the perspectives on global health, the overview of health information technology (health IT), the applications of electronic health record (EHR), and the importance of health IT in global health care. Health IT is the area of IT involving the design, development, creation, utilization, and maintenance of information systems for the health care industry. Health IT makes it possible for health care providers to better manage patient care through the secure use and sharing of health information. Effective health IT can lower costs, improve efficiency, and reduce medical error, while providing better patient care and service. The chapter argues that utilizing health IT has the potential to enhance health care performance and reach strategic goals in global health care.


Author(s):  
Kijpokin Kasemsap

This chapter explains the perspectives on global health, the overview of health information technology (health IT), the applications of electronic health record (EHR), and the importance of health IT in global health care. Health IT is the area of IT involving the design, development, creation, utilization, and maintenance of information systems for the health care industry. Health IT makes it possible for health care providers to better manage patient care through the secure use and sharing of health information. Effective health IT can lower costs, improve efficiency, and reduce medical error, while providing better patient care and service. The chapter argues that utilizing health IT has the potential to enhance health care performance and reach strategic goals in global health care.


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.


2019 ◽  
Author(s):  
Olivia A Mac ◽  
Amy Thayre ◽  
Shumei Tan ◽  
Rachael H Dodd

BACKGROUND Three main changes were implemented in the Australian National Cervical Screening Program (NCSP) in December 2017: an increase in the recommended age to start screening, extended screening intervals, and change from the Papanicolaou (Pap) test to primary human papillomavirus screening (cervical screening test). The internet is a readily accessible source of information to explain the reasons for these changes to the public. It is important that web-based health information about changes to national screening programs is accessible and understandable for the general population. OBJECTIVE This study aimed to evaluate Australian web-based resources that provide information about the changes to the cervical screening program. METHODS The term <i>cervical screening</i> was searched in 3 search engines. The first 10 relevant results across the first 3 pages of each search engine were selected. Overall, 2 authors independently evaluated each website for readability (Flesch Reading Ease [FRE], Flesch-Kincaid Grade Level, and <i>Simple Measure of Gobbledygook</i> [SMOG] index), quality of information (Patient Education Materials Assessment Tool [PEMAT] for printable materials), credibility (<i>Journal of the American Medical Association</i> [JAMA] benchmark criteria and presence of Health on the Net Foundation code of conduct [HONcode] certification), website design, and usability with 5 simulation questions to assess the relevance of information. A descriptive analysis was conducted for the readability measures, PEMAT, and the JAMA benchmark criteria. RESULTS Of the 49 websites identified in the search, 15 were eligible for inclusion. The consumer-focused websites were classed as <i>fairly difficult to read</i> (mean FRE score 51.8, SD 13.3). The highest FRE score (easiest to read) was 70.4 (<i>Cancer Council Australia Cervical Screening Consumer Site</i>), and the lowest FRE score (most difficult to read) was 33.0 (<i>NCSP Clinical Guidelines</i>). A total of 9 consumer-focused websites and 4 health care provider–focused websites met the recommended threshold (sixth to eighth grade; SMOG index) for readability. The mean PEMAT understandability scores were 87.7% (SD 6.0%) for consumer-focused websites and 64.9% (SD 13.8%) for health care provider–focused websites. The mean actionability scores were 58.1% (SD 19.1%) for consumer-focused websites and 36.7% (SD 11.0%) for health care provider–focused websites. Moreover, 9 consumer-focused and 3 health care provider–focused websites scored above 70% for understandability, and 2 consumer-focused websites had an actionability score above 70%. A total of 3 websites met all 4 of the JAMA benchmark criteria, and 2 websites displayed the HONcode. CONCLUSIONS It is important for women to have access to information that is at an appropriate reading level to better understand the implications of the changes to the cervical screening program. These findings can help health care providers direct their patients toward websites that provide information on cervical screening that is written at accessible reading levels and has high understandability. CLINICALTRIAL


2017 ◽  
Vol 9 (2-3) ◽  
pp. 217 ◽  
Author(s):  
Johanna Tolonen ◽  
Alpo Värri

The European Union and the USA collaborate in developing the skills of the application of information technology in the health care workforce. A part of this activity is a project which studies the gaps in the present education and proposes methods of filling these gaps. The objective of this paper is to identify the existing IT related education to the health care work force in Finland. A secondary objective was to get an impression of the experience and attitudes of the members of this workforce about health IT education. This paper presents the results of the survey of how information technology is educated to the students of the health care professions in Finland in the year 2017. In addition to literature search including also the study guides of many major health care professional education organizations, 24 telephone interviews of health care professionals in different fields in Finland were made. The results show that although basic information technology education is often available at every level of education, it is expected that the health care professionals learn to use the health information systems during their training periods or later in working life. The interviews showed that the given education varied considerably and some of the personnel had received no or only a little education on IT during studies. As the amount and quality of on-the-job information technology education varies, many health care professionals are not able to fully benefit from the information systems if their general feeling is that they just “survive” from daily activities with them. The results lead to suggest that the health professional degrees should contain at least a minimal amount of relevant health IT education which is tested with an exam and that the present health care workforce should receive ear-marked in-service training in the use of health information technology based on the needs of the individual.


Author(s):  
Kim M Unertl ◽  
Colin G Walsh ◽  
Ellen Wright Clayton

Abstract Objective Human trafficking is a global problem taking many forms, including sex and labor exploitation. Trafficking victims can be any age, although most trafficking begins when victims are adolescents. Many trafficking victims have contact with health-care providers across various health-care contexts, both for emergency and routine care. Materials and Methods We propose 4 specific areas where medical informatics can assist with combatting trafficking: screening, clinical decision support, community-facing tools, and analytics that are both descriptive and predictive. Efforts to implement health information technology interventions focused on trafficking must be carefully integrated into existing clinical work and connected to community resources to move beyond identification to provide assistance and to support trauma-informed care. Results We lay forth a research and implementation agenda to integrate human trafficking identification and intervention into routine clinical practice, supported by health information technology. Conclusions A sociotechnical systems approach is recommended to ensure interventions address the complex issues involved in assisting victims of human trafficking.


JMIR Cancer ◽  
10.2196/17352 ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e17352
Author(s):  
Alexandra Greenberg-Worisek ◽  
Liaa Ferede ◽  
Joyce Balls-Berry ◽  
Ian Marigi ◽  
Emily Valentin Mendez ◽  
...  

Background Studies have previously shown that rural cancer patients are diagnosed at later stages of disease. This delay is felt throughout treatment and follow-up, reflected in the fact that rural patients often have poorer clinical outcomes compared with their urban counterparts. Objective Few studies have explored whether there is a difference in cancer patients’ current use of health information technology tools by residential location. Methods Data from 7 cycles of the Health Information National Trends Survey (HINTS, 2003-2017) were merged and analyzed to examine whether differences exist in managing electronic personal health information (ePHI) and emailing health care providers among rural and urban cancer patients. Geographic location was categorized using Rural-Urban Continuum Codes (RUCCs). Bivariate analyses and multivariable logistic regression were used to determine whether associations existed between rural/urban residency and use of health information technology among cancer patients. Results Of the 3031 cancer patients/survivors who responded across the 7 cycles of HINTS, 797 (26.9%) resided in rural areas. No difference was found between rural and urban cancer patients in having managed ePHI in the past 12 months (OR 0.78, 95% CI 0.43-1.40). Rural cancer patients were significantly less likely to email health care providers than their urban counterparts (OR 0.52, 95% CI 0.32-0.84). Conclusions The digital divide between rural and urban cancer residents does not extend to general ePHI management; however, electronic communication with providers is significantly lower among rural cancer patients than urban cancer patients. Further research is needed to determine whether such disparities extend to other health information technology tools that might benefit rural cancer patients as well as other chronic conditions.


2019 ◽  
Author(s):  
Tayebeh Baniasadi ◽  
Marjan Ghazisaeedi ◽  
Mehdi Hassaniazad ◽  
Sharareh R. Niakan Kalhori ◽  
Mehraban Shahi

Abstract Background: Understanding each of the factors affecting the length of hospitalization especially in surgery wards can play a major role in planning for the optimal use of hospital resources. This study aims to determine factors affecting the length of stay (LOS) in a surgical ward and then provide technology-based solutions .Methods: In this cross-sectional study, 310 records were selected by systematic random sampling from hospitalized patients in surgery ward of a general teaching hospital in Bandar Abbas, situated in sought of Iran. In order to determine the association of 26 variables (demographic, clinical, and non-clinical) with LOS, analytical and descriptive statistics were used. Then, the researchers reviewed relevant literature in PubMed, Scopus, and Google Scholar to introduce solutions based on health information technology (HIT) toward LOS optimization.Results: Mean and median of patients’ LOS in surgery ward were 3.30±3.71 and 2 days respectively. According to multivariate regression model, factors that exerted higher influence on length of stay includes number of para-clinical tests, surgeries, and consultation as well as type of referral and months of admission(p<0.05). Regarding HIT-based intervention, eleven general categories of suggestions were provided. Based on the findings, more accessible technologies such as hospital information system, picture archiving and communication system, telemedicine especially tele-consultation or tele-visit as well as electronic consultation and discharge planning tools alongside smart dashboards for institutions like the center under study in order to expedite the process of diagnosis and treatment, then optimizing LOS seem appropriate. Conclusions: It is important to move toward optimized LOS though understanding and control influential factors; standardize LOS along with continuous monitoring of performance indicators may help to utilize hospital resources more efficiently. HIT-based interventions may support health care providers and administrators to manage patients` admission, hospitalization, transfer, and discharge processes more properly. Keywords: Index; length of Stay; Hospital; Health Information Technology; Surgery_ward


2021 ◽  
Author(s):  
◽  
Bailey Deglow ◽  

The Health Information Technology for Clinical and Economic Health (HITECH) Act of 2009 encouraged the meaningful use of the electronic health record (EHR) by health care providers in the United States. “Meaningful use” monetary incentives were offered by the Center for Medicare and Medicaid Services (CMS) for health care providers who met standards of documenting in and using the EHR. While clinical pharmacists typically work in clinics and hospitals in the United States, they were not considered eligible professionals who could receive incentives for using the EHR. There is a great deal of literature regarding the use of the EHR by eligible professionals, but not by ineligible professionals like clinical pharmacists. One way that clinical pharmacists assist in meaningful use criteria is by developing computerized provider order entries (CPOEs). The purpose of this study is to assess the perception and use of CPOEs by clinical pharmacists.


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