scholarly journals Towards a framework for teaching about information technology risk in health care: Simulating threats to health data and patient safety

In this paper the author describes work towards developing an integrative framework for educating health information technology professionals about technology risk. The framework considers multiple sources of risk to health data quality and integrity that can result from the use of health information technology (HIT) and can be used to teach health professional students about these risks when using health technologies. This framework encompasses issues and problems that may arise from varied sources, including intentional alterations (e.g. resulting from hacking and security breaches) as well as unintentional breaches and corruption of data (e.g. resulting from technical problems, or from technology-induced errors). The framework that is described has several levels: the level of human factors and usability of HIT, the level of monitoring of security and accuracy, the HIT architectural level, the level of operational and physical checks, the level of healthcare quality assurance policies and the data risk management strategies level. Approaches to monitoring and simulation of risk are also discussed, including a discussion of an innovative approach to monitoring potential quality issues. This is followed by a discussion of the application (using computer simulations) to educate both students and health information technology professionals about the impact and spread of technology-induced and related types of data errors involving HIT.

2016 ◽  
Vol 25 (01) ◽  
pp. 13-29 ◽  
Author(s):  
J. Abraham ◽  
L. L. Novak ◽  
T. L. Reynolds ◽  
A. Gettinger ◽  
K. Zheng

SummaryObjective: To summarize recent research on unintended consequences associated with implementation and use of health information technology (health IT). Included in the review are original empirical investigations published in English between 2014 and 2015 that reported unintended effects introduced by adoption of digital interventions. Our analysis focuses on the trends of this steam of research, areas in which unintended consequences have continued to be reported, and common themes that emerge from the findings of these studies.Method: Most of the papers reviewed were retrieved by searching three literature databases: MEDLINE, Embase, and CINAHL. Two rounds of searches were performed: the first round used more restrictive search terms specific to unintended consequences; the second round lifted the restrictions to include more generic health IT evaluation studies. Each paper was independently screened by at least two authors; differences were resolved through consensus development.Results: The literature search identified 1,538 papers that were potentially relevant; 34 were deemed meeting our inclusion criteria after screening. Studies described in these 34 papers took place in a wide variety of care areas from emergency departments to ophthalmology clinics. Some papers reflected several previously unreported unintended consequences, such as staff attrition and patients’ withholding of information due to privacy and security concerns. A majority of these studies (71%) were quantitative investigations based on analysis of objectively recorded data. Several of them employed longitudinal or time series designs to distinguish between unintended consequences that had only transient impact, versus those that had persisting impact. Most of these unintended consequences resulted in adverse outcomes, even though instances of beneficial impact were also noted. While care areas covered were heterogeneous, over half of the studies were conducted at academic medical centers or teaching hospitals. Conclusion: Recent studies published in the past two years represent significant advancement of unintended consequences research by seeking to include more types of health IT applications and to quantify the impact using objectively recorded data and longitudinal or time series designs. However, more mixed-methods studies are needed to develop deeper insights into the observed unintended adverse outcomes, including their root causes and remedies. We also encourage future research to go beyond the paradigm of simply describing unintended consequences, and to develop and test solutions that can prevent or minimize their impact.


2019 ◽  
Vol 29 (Supp2) ◽  
pp. 377-384
Author(s):  
Tiffany Zellner Lawrence ◽  
Megan D. Douglas ◽  
Latrice Rollins ◽  
Robina Josiah Willock ◽  
Dexter L. Cooper ◽  
...  

Rulemaking is one of the most important ways the federal government makes public policy. It frequently has significant impact on individuals, communities, and organizations. Yet, few of those directly affected are familiar with the rulemaking process, and even fewer understand how it works. This article describes a case study of the Transdisciplinary Collaborative Center for Health Disparities Research Health Information Technology (TCC HIT) Policy Project’s approach to health-policy engagement using: 1) social media; and 2) a webinar to educate stakeholders on the rulemaking process and increase their level of meaningful engagement with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) proposed rule public comment submission. The webinar “Paying for Quality: What Is the Impact on Health Equity” was promoted through Twitter and held in June 2016. In total, we posted 19 tweets using two distinct hashtags (#MACRA4Equity, #MACRA2Equity) to raise awareness of the upcoming MACRA proposed rule and its possible effects on health equity. Overall, 252 individuals registered for the webinar, and more than half participated (n=133). Most (67%) registrants reported that health policy was not the primary focus of their current position. Based on information provided in the webinar, 95% agreed that their understanding of the topic improved. By the end of the webinar, 44% of participants indicated that they planned to submit public comments for MACRA, a 12% increase compared with those who planned to submit at the time of registration. The TCC health-policy engagement strategy demonstrates the feasibility of engaging a diverse audience around health policy issues, particularly those who are not typically engaged in policy work. Ethn Dis. 2019;29(Suppl 2): 377-384. doi:10.18865/ed.29.S2.377


2019 ◽  
Vol 26 (2) ◽  
pp. 897-910
Author(s):  
Guy Martin ◽  
Sonal Arora ◽  
Nisha Shah ◽  
Dominic King ◽  
Ara Darzi

Health information technology can transform and enhance the quality and safety of care, but it may also introduce new risks. This study analysed 130 healthcare regulator inspection reports and organisational digital maturity scores in order to characterise the impact of health information technology on quality and safety from a regulatory perspective. Although digital maturity and the positive use of health information technology are significantly associated with overall organisational quality, the negative effects of health information technology are frequently and more commonly identified by regulators. The poor usability of technology, lack of easy access to systems and data and the incorrect use of health information technology are the most commonly identified areas adversely affecting quality and safety. There is a need to understand the full risks and benefits of health information technology from the perspective of all stakeholders, including patients, end-users, providers and regulators in order to best inform future practice and regulation.


2020 ◽  
Vol 16 ◽  
Author(s):  
Zari Dehnavi ◽  
Haleh Ayatollahi ◽  
Morteza Hemmet ◽  
Rowshanak Abbasi

Background: Health information technology helps patients to take better care of themselves and improves health status of patients with chronic diseases, such as diabetes. Objective: This study aimed to identify factors influencing the use of health information technology in diabetes management. Methods: This was a review study conducted in 2019. To obtain the related articles, databases including Scopus, Web of Science, Proquest and PubMed were searched and the time frame was between 2010 and 2018. Initially, 1159 articles were retrieved and after screening 28 articles were selected to be included in the study. Results: Factors influencing the use of health information technology in diabetes management could be divided into the motivational and inhibitory factors and each of them could be categorized into five groups of organizational, technical, economic, individual and ethical/legal factors. The motivational factors included training, system ease of use, economic support, having computer literacy, and maintaining privacy and confidentiality. The inhibitory factors included a lack of long-term planning, technical problems, inadequate financial resources, old age, and concerns over confidentiality issues. Conclusion: Identifying motivational and inhibitory factors can help to make better use of technology for diabetes management. This approach, in turn, can improve the acceptability of the technology and saves cost, reduces long-term complications of diabetes, and improves quality of life in diabetic patients.


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