Florida Health Information Exchange

Florida began the journey to health information connectivity in 2004 under Governor Jeb Bush. Initially these efforts were funded by grants, but due to the downturn in the economy, the state was unable to support growth in 2008. The American Recovery and Reinvestment Act of 2009 provided funding to further expand health information exchange efforts across the country. As a result, Florida is now able to move forward and make progress in information sharing. Harris Corporation was contracted to provide some basic services to the health care industry in 2011. However, challenges remain as privacy and security regulations are put in place to protect patients’ information. With two seemingly opposing mandates, sharing the information versus protecting the information, challenges continue to impede progress.

Doing and Understanding

This chapter provides an introduction to the pedagogy of using the case method particularly for instruction in the health informatics context. The thoughts and insights shared in this chapter are inspired by basic theories, published methods, and lessons learned from the authors’ collective experiences. They illustrate the case teaching experience by engaging the reader in an exercise to highlight the basic phases of the case method process and challenges of the process. The case referenced in this exercise (provided in the Appendix to this chapter) has been used on multiple occasions by authors of this chapter, and they draw on their experiences in using this case to illustrate points throughout the exercise. The authors close the chapter by providing the reader with strategies and considerations in using the case method.

Telehealth Implementation

Improving the opportunity to access care by infectious disease specialists and improve the overall quality of care received is the core mission demonstrated by this clinic through the on-going and continued development of their telehealth services program. This focus does not remove the need for the clinic to adhere to sound business practices. Instead, this case demonstrates that both focuses can be appropriately accomplished. Current regulatory issues will continue to pose challenges, but these barriers are not significant enough to shut down the enthusiasm for continuing this service or for future expansion plans. This study will discuss the benefits of telehealth not only to patients, but also to the clinic practice as a whole.

Physician Interaction with EHR

Research Medical Center is a regional medical center that meets the needs of residents of a rural area in the Midwest. It is part of a large healthcare system. The primary care hospital implemented the Electronic Health Record (EHR). The endeavor to implement Health IT applications including Computerized Physician Order Entry (CPOE), EHRs, nursing documentation, and paperless charts, adverse drug reaction alerts, and more were introduced with the corporate initiative. The core applications were clinical and revenue cycle systems, including CPOE. The planning, implementation, and training was developed by the parent operating company and efforts to engage the local physicians were minimal. There were over 300 physicians involved. The physicians were primarily not hospital employees. They had the ability to choose to adopt the EHR and adapt their social, work, and technology practices, or to avoid usage. Follow up research indicated the change management and support efforts were not successful for the physician stakeholder.

One System of Care, One Electronic Chart

Regional Health made a commitment as part of quality and patient safety initiatives to have an electronic health record before the federal government developed the concept of “meaningful use.” The “One System of Care, One Electronic Chart” concept was a long-term goal of their organization, accomplished through electronically sharing a patient’s medical record among Regional Health’s five hospitals and other area health care facilities. Implementing a hybrid electronic record using a scanning and archiving application was the first step toward the long-term goal of an electronic health record. The project was successfully achieved despite many challenges, including some limited resources and physician concerns.

Mobile Device Application in Healthcare

Clinical practitioners need to have the right information, at the right time, at the right place, which is possible with mobile healthcare information technology. This chapter will help in understanding the need for mobile device usage across six different roles in healthcare: physicians, nurses, administrative staff, pharmaceutical staff, emergency staff, and patients. Research indicates that even in this advancing digital age, there are more than 98,000 deaths because of preventable medical errors. This can be abated with proper utilization of mobile devices in the healthcare sector. Utilization of technology in the process of sharing information may help in improving the decision making, and thereby reducing the medical errors and costs involved. This chapter illustrates the implementation and the application of mobile devices in healthcare from six different user perspectives, and summarizes the advantages, challenges, and solutions associated with mobile information technology implementation in healthcare.

Application of Handheld Computing and Mobile Phones in Diabetes Self-Care

Advances in technology have accelerated self-care activities, making them more practical and possible than before using these technologies. The utilization of new Health Information Technologies (HIT) is becoming more and more apparent in self-care. Many patients incorporate the use of PDAs in diabetes self-care (Forjuoh, et al., 2007; Jones & Curry, 2006). Mobile phones are used in diabetes self-management by diabetes patients (Carroll, DiMeglio, Stein, & Marrero, 2011; Faridi, et al., 2008; Mulvaney, et al., 2012). Also, reminders based on SMS cell phone text messaging are used to support diabetes management (Hanauer, Wentzell, Laffel, & Laffel, 2009). Given the current advances in the field of health care, health care technologies, and handheld computing, this case explores the possible primary usages of mobile phones, PDAs, and handheld devices in self-care management. More specifically, the case illustrates how such technologies can be used in diabetes management by patients and health care providers.

User and Data Classification for a Secure and Practical Approach for Patient-Doctor Profiling Using an RFID Framework in Hospital

Utilization and application of the latest technologies can save lives and improve patient treatments and well-being. For this it is important to have accurate, near real-time data acquisition and evaluation. The delivery of patient’s medical data needs to be as fast and as secure as possible. Accurate almost real-time data acquisition and analysis of patient data and the ability to update such a data is a way to reduce cost and improve patient care. One possible solution to achieve this task is to use a wireless framework based on Radio Frequency Identification (RFID). This framework can integrate wireless networks for fast data acquisition and transmission, while maintaining the privacy issue. This chapter discusses the development of an intelligent multi-agent system in a framework in which RFID can be used for patient data collection. This chapter presents a framework for the knowledge acquisition of patient and doctor profiling in a hospital. The acquisition of profile data is assisted by a profiling agent that is responsible for processing the raw data obtained through RFID and database of doctors and patients. A new method for data classification and access authorization is developed, which will assist in preserving privacy and security of data.

Primary Care Patient Management and Health Information Technology

Electronic Health Records (EHR) are a system of Health Information Technology (HIT) components including clinical documentation, medication orders, laboratory and diagnostic study results, management, and evidence based clinical decision support. In this case, a patient’s care is compromised because of incomplete documentation of medical information and lack of integration among data collection systems. The patient has had over fifty years of medical care in a U.S. government health system followed by care in a private primary care setting. Effective implementation and utilization of EHRs in primary care settings, will positively affect patient safety and quality of care. Appropriate use of EHR provides challenges to clinicians, HIT developers, and healthcare administrators. Provision of quality patient care utilizing HIT is challenging to use and implement, but when patients receive healthcare from multiple sources, the challenge becomes even greater. The need for integrated EHR systems is evident in the geriatric population (Ash, et al., 2009), where the ability to provide data to new clinicians may be affected by cognitive decline in this population. Management of health and chronic conditions in the geriatric population requires an ongoing commitment to HIT implementation for safer and more effective care.

Clinical Decision Support System for Diabetes Prevention

Millions of people around the world have diabetes. It is the seventh leading cause of death in US. An advancement of technologies may serve as the backbone for controlling diseases. Computerizing healthcare is expected to be one of the powerful levers essential for significant transformation in the quality and cost of delivering healthcare. Data management and technology is essential for providing the ability to exchange data and information at the right place in the right time to the right people in the healthcare process, to enable informed decision-making, and to achieve better health outcomes. Clinical Decision Support System (CDSS) provides guidance specific to the patient, including importing/entering patient data into the CDSS application and providing relevant information like lists of possible diagnoses, drug interaction alerts, or preventive care reminders to the practitioner that assists in their decision-making. This chapter has focuses on the use of CDSS for diabetes prevention.