scholarly journals Persuasion Tactics in the Implementation of Large-Scale EHR Suites in Public Healthcare

2021 ◽  
Author(s):  
Gunnar Ellingsen ◽  
Bente Christensen ◽  
Morten Hertzum
Keyword(s):  
Large Scale ◽  
Healthcare Services ◽  
Governance Structure ◽  
Public Healthcare ◽  
Technical Literature ◽  
Health Authorities ◽  
To Come ◽  
Regional Health Authorities ◽  
Entrepreneurial Role ◽  
The U.S

Large-scale electronic health record (EHR) suites have the potential to cover a broad range of use needs across various healthcare domains. However, a challenge that must be solved is the distributed governance structure of public healthcare: Regional health authorities regulate hospitals, municipalities are responsible for first-line healthcare services, and general practitioners (GPs) have an independent entrepreneurial role. In such settings, EHR program owners cannot enforce municipalities and GPs to come on board. Thus, we examine what tactics owners of large-scale EHR suite programs apply to persuade municipalities to participate, how strongly these tactics are enforced, and the consequences. Empirically, we focus on the Health Platform program in Central Norway where the goal is to implement the U.S. Epic EHR suite in 2022. Theoretically, the paper is positioned in the socio-technical literature.

The role of regional health systems on the waiting time inequalities in health care services: Evidences from Italy

2020 ◽  
pp. 095148482092830
Author(s):  
Stefano Landi ◽  
Enrico Ivaldi ◽  
Angela Testi
Keyword(s):  
Health Care ◽  
Health Systems ◽  
Waiting Time ◽  
Health Care Access ◽  
Health Care Services ◽  
Waiting Times ◽  
Healthcare Services ◽  
Regional Health ◽  
Health Authorities ◽  
Regional Health Authorities

Inequalities in effective access to healthcare are present among countries and within the same country. Despite in Italy exist the principle of equity in access to health system, there are evidence of different access rates in the form of unequal waiting time within the country. Waiting times are an instruments to ration healthcare services dealing with resource scarsity. Theoretically, it is a fair tool because waiting times should depend only on health needs and not on the ability to pay. However, a growing literature has pointed out that belonging to a particular socioeconomic status leads to waiting times inequalities for healthcare services. Many countries have socioeconomic disparities among regions, and healthcare organizations need to take into account these differences. The increasing power of Regional Health Authorities in decentralized health systems, as in the case of Italy, has generated different organizational ways to provide health care, possibly leading to different access rates in the form of unequal waiting time within the country. This paper aims to understand if the administrative area (Regional Health Authorities) in charge of health services affects waiting times lowering or strengthening health care access inequalities. Using a series of logistic regression models, this work suggests the presence of two vectors: socioeconomic inequalities and regional inequalities. Health organizations need to implement different kinds of answers for each vectors of inequalities.

scholarly journals Towards a shared service centre for telemedicine: Telemedicine in Denmark, and a possible way forward

2016 ◽  
Vol 22 (4) ◽  
pp. 815-827 ◽  
Author(s):  
Simon Bo Larsen ◽  
Nanna Skovgaard Sørensen ◽  
Matilde Grøndahl Petersen ◽  
Gitte Friis Kjeldsen
Keyword(s):  
Participatory Design ◽  
Electronic Monitoring ◽  
Healthcare Services ◽  
Service Centre ◽  
Health Authorities ◽  
Shared Service ◽  
Internet Portals ◽  
Regional Health Authorities ◽  
Multi Stakeholder ◽  
Information And Technology

Although evidence of the effectiveness of telemedicine is accumulating, knowledge of how to make best use of telemedicine is limited. This article presents results from a multi-stakeholder project that developed a new concept, a ‘shared service centre’ for telemedicine that is envisioned as working across different telemedical initiatives to support the implementation and wider adoption of telemedicine. One year of participatory design and analysis of the shared service centre concept involved stakeholders, such as clinicians, patients, technicians, policy makers, lawyers, economists and information technology architects. More than 100 people contributed to the findings. Most of the ideas generated for potential centre support for telemedicine could be categorised under four service categories. The need for such support services was verified in the cases investigated, and by agreement among stakeholders from regional health authorities, municipalities, and general practice. Therefore, it is probable that a shared service centre could help enable the wider deployment of telemedicine. Definitions In this article, we use ‘telemedicine’ as an umbrella term for all the ‘tele-’ labels that are sometimes used rather indiscriminately to denote the use of information and technology to support healthcare services, including ‘telehealth’, ‘telemonitoring’, ‘telehomecare’, ‘e-health’, and so on. As per our definition, telemedicine may be synchronous and/or asynchronous, and may apply to any information and technology-based means of connecting healthcare actors and the patient, such as video communication, e-mail, electronic monitoring equipment, and Internet portals. Furthermore, the term ‘telemedical initiative’ covers projects in which telemedicine is conducted by a temporary project organisation, as well as self-contained telemedicine services used in daily, clinical practice in existing organisations.

scholarly journals Psychiatric Nursing — Quo Vadis?

1985 ◽  
Vol 9 (4) ◽  
pp. 70-72
Author(s):  
Charles Brooker ◽  
Paul Beard
Keyword(s):  
Mental Health ◽  
Social Services ◽  
Community Care ◽  
Psychiatric Hospitals ◽  
Psychiatric Nurses ◽  
District Health ◽  
Health Authorities ◽  
Quo Vadis ◽  
To Come ◽  
Regional Health Authorities

In the last year or so the future of mental health services in this country has been intensively discussed. COHSE, MIND, and the Richmond Fellowship have produced their ‘blueprints', outlining details of the way they see services being organized. All variety of professional organizations have been busy presenting evidence to the House of Commons Social Services Committee which is specifically examining community care. The DHSS has committed more joint finance to ‘care in the community’ projects and Regional Health Authorities are examining the strategies to close large psychiatric hospitals. Consequently, District Health Authorities, in many cases, are planning the shape of a new mental health service which places increasingly less reliance on the large institution. The phrase ‘community care’ has now become so hackneyed in planning circles that for many it has lost whatever meaning it may have once had. However, despite all the rhetoric, and indeed all the planning activity, psychiatric nurses themselves have still to voice coherently their thoughts and fears about the shape of things to come.

CORPORATE GOVERNANCE IN THE 19TH CENTURY: EVIDENCE FROM THE CHESAPEAKE AND OHIO CANAL COMPANY

2009 ◽  
Vol 36 (2) ◽  
pp. 113-137 ◽  
Author(s):  
Robert W. Russ ◽  
Gary John Previts ◽  
Edward N. Coffman
Keyword(s):  
Corporate Governance ◽  
19Th Century ◽  
Annual Report ◽  
Governance Structure ◽  
Review Committee ◽  
Corporate Governance Structure ◽  
Theoretical Structure ◽  
The 19Th Century ◽  
The U.S

Presenting evidence from a 19th century corporation, the Chesapeake and Ohio Canal Company (C&O), the paper shows that issues of corporate governance have existed since the first corporations were established in the U.S. The C&O used a stockholder review committee to review the annual report of the president and directors. The paper shows how the C&O stockholders used this committee to supplement the corporate governance structure. The corporate governance structure of the C&O is also viewed from a theoretical structure as espoused by Hart [1995].

scholarly journals Public Health Workforce Burnout in the COVID-19 Response in the U.S.

2021 ◽  
Vol 18 (8) ◽  
pp. 4369
Author(s):  
Kahler W. Stone ◽  
Kristina W. Kintziger ◽  
Meredith A. Jagger ◽  
Jennifer A. Horney
Keyword(s):  
Public Health ◽  
Health Workforce ◽  
Work Experience ◽  
Large Scale ◽  
Health Workers ◽  
Public Health Workforce ◽  
Cross Sectional Survey ◽  
Public Health Response ◽  
Cross Sectional ◽  
The U.S

While the health impacts of the COVID-19 pandemic on frontline health care workers have been well described, the effects of the COVID-19 response on the U.S. public health workforce, which has been impacted by the prolonged public health response to the pandemic, has not been adequately characterized. A cross-sectional survey of public health professionals was conducted to assess mental and physical health, risk and protective factors for burnout, and short- and long-term career decisions during the pandemic response. The survey was completed online using the Qualtrics survey platform. Descriptive statistics and prevalence ratios (95% confidence intervals) were calculated. Among responses received from 23 August and 11 September 2020, 66.2% of public health workers reported burnout. Those with more work experience (1–4 vs. <1 years: prevalence ratio (PR) = 1.90, 95% confidence interval (CI) = 1.08−3.36; 5–9 vs. <1 years: PR = 1.89, CI = 1.07−3.34) or working in academic settings (vs. practice: PR = 1.31, CI = 1.08–1.58) were most likely to report burnout. As of September 2020, 23.6% fewer respondents planned to remain in the U.S. public health workforce for three or more years compared to their retrospectively reported January 2020 plans. A large-scale public health emergency response places unsustainable burdens on an already underfunded and understaffed public health workforce. Pandemic-related burnout threatens the U.S. public health workforce’s future when many challenges related to the ongoing COVID-19 response remain unaddressed.

Crystallex Int'l Corp. v. Bolivarian Rep. Venez. (3D Cir.)

2021 ◽  
pp. 1-21
Author(s):  
Kevin D. Benish
Keyword(s):  
United States Supreme Court ◽  
The United States ◽  
United States Supreme ◽  
Decision To Leave ◽  
Court Of Appeals ◽  
The Third ◽  
To Come ◽  
Alter Ego ◽  
Oil Company ◽  
The U.S

On May 18, 2020, the United States Supreme Court denied a request by the Bolivarian Republic of Venezuela and its state-owned oil company, Petróleos de Venezuela, S.A. (PDVSA), to review the merits of Crystallex Int'l Corp. v. Bolivarian Republic of Venezuela, a decision by the U.S. Court of Appeals for the Third Circuit. In Crystallex, the Third Circuit affirmed a trial court's determination that PDVSA is the “alter ego” of Venezuela itself, thus permitting Crystallex to enforce a $1.4 billion judgment against Venezuela by attaching property held in PDVSA's name. Given the Supreme Court's decision to leave the Third Circuit's opinion undisturbed, Crystallex is a significant decision that may affect parties involved in transnational litigation for years to come—especially those pursuing or defending against U.S. enforcement proceedings involving the property of foreign states.

scholarly journals Coming Vaccine Battle

Contexts ◽  
2020 ◽  
Vol 19 (4) ◽  
pp. 92-94
Author(s):  
Jennifer Reich
Keyword(s):  
To Come ◽  
The U.S

“Though small, the recent protests we've seen across the U.S. signal what is likely to come as governments grapple with how to move forward, particularly if a vaccine against SARS-CoV-2, the virus causing the pandemic becomes available.”

scholarly journals Human Enhancements and Voting: Towards a Declaration of Rights and Responsibilities of Beings

Philosophies ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 5
Author(s):  
S. J. Blodgett-Ford
Keyword(s):  
Human Rights ◽  
Voting Rights ◽  
Governance Structure ◽  
The Other ◽  
First Person ◽  
Person Perspective ◽  
First Person Perspective ◽  
To Come ◽  
Additional Option

The phenomenon and ethics of “voting” will be explored in the context of human enhancements. “Voting” will be examined for enhanced humans with moderate and extreme enhancements. Existing patterns of discrimination in voting around the globe could continue substantially “as is” for those with moderate enhancements. For extreme enhancements, voting rights could be challenged if the very humanity of the enhanced was in doubt. Humans who were not enhanced could also be disenfranchised if certain enhancements become prevalent. Voting will be examined using a theory of engagement articulated by Professor Sophie Loidolt that emphasizes the importance of legitimization and justification by “facing the appeal of the other” to determine what is “right” from a phenomenological first-person perspective. Seeking inspiration from the Universal Declaration of Human Rights (UDHR) of 1948, voting rights and responsibilities will be re-framed from a foundational working hypothesis that all enhanced and non-enhanced humans should have a right to vote directly. Representative voting will be considered as an admittedly imperfect alternative or additional option. The framework in which voting occurs, as well as the processes, temporal cadence, and role of voting, requires the participation from as diverse a group of humans as possible. Voting rights delivered by fiat to enhanced or non-enhanced humans who were excluded from participation in the design and ratification of the governance structure is not legitimate. Applying and extending Loidolt’s framework, we must recognize the urgency that demands the impossible, with openness to that universality in progress (or universality to come) that keeps being constituted from the outside.

scholarly journals Belonging in the Coronaverse: Will There Be Time?

2021 ◽  
Vol 1 (1) ◽  
pp. 100-115
Author(s):  
Kate Fischer ◽  
Malika Rakhmonova ◽  
Mike Tran
Keyword(s):  
College Experience ◽  
The United States ◽  
Limited Time ◽  
The Novel ◽  
Residential University ◽  
To Come ◽  
Novel Coronavirus ◽  
University Experience ◽  
The U.S ◽  
Older Siblings

Abstract Since the spring of 2020 SARS-CoV-2, the novel coronavirus, has upended lives and caused a rethinking of nearly all social behaviors in the United States. This paper examines the ways in which the pandemic, shutdown, and gradual move towards “normal” have laid bare and obfuscated societal pressures regarding running out of time as it pertains to the residential university experience. Promised by movies, television, and older siblings and friends as a limited-time offer, the “typical” college experience is baked into the U.S. imaginary, reinforcing a host of notions of who “belongs” on campus along lines of race, class, and age. Fed a vision of what their whole lives “should be”, students who enter a residential four-year college are already imbued with a nostalgia for what is yet to come, hailed, in Althusser’s (2006[1977]) sense, as university subjects even before their first class. The upheaval of that subjecthood during the pandemic has raised important questions about the purpose of the college experience as well as how to belong to a place that is no longer there.

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