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Shade SB, Marseille E, Kirby V, Chakravarty D, Steward WT, Koester KK, Cajina A, Myers JJ. Health information technology interventions and engagement in HIV care and achievement of viral suppression in publicly funded settings in the US: A cost-effectiveness analysis. PLoS Med 2021; 18:e1003389. [PMID: 33826617 PMCID: PMC8059802 DOI: 10.1371/journal.pmed.1003389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 04/21/2021] [Accepted: 03/25/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The US National HIV/AIDS Strategy (NHAS) emphasizes the use of technology to facilitate coordination of comprehensive care for people with HIV. We examined cost-effectiveness from the health system perspective of 6 health information technology (HIT) interventions implemented during 2008 to 2012 in a Ryan White HIV/AIDS Program (RWHAP) Special Projects of National Significance (SPNS) Program demonstration project. METHODS/FINDINGS HIT interventions were implemented at 6 sites: Bronx, New York; Durham, North Carolina; Long Beach, California; New Orleans, Louisiana; New York, New York (2 sites); and Paterson, New Jersey. These interventions included: (1) use of HIV surveillance data to identify out-of-care individuals; (2) extension of access to electronic health records (EHRs) to support service providers; (3) use of electronic laboratory ordering and prescribing; and (4) development of a patient portal. We employed standard microcosting techniques to estimate costs (in 2018 US dollars) associated with intervention implementation. Data from a sample of electronic patient records from each demonstration site were analyzed to compare prescription of antiretroviral therapy (ART), CD4 cell counts, and suppression of viral load, before and after implementation of interventions. Markov models were used to estimate additional healthcare costs and quality-adjusted life-years saved as a result of each intervention. Overall, demonstration site interventions cost $3,913,313 (range = $287,682 to $998,201) among 3,110 individuals (range = 258 to 1,181) over 3 years. Changes in the proportion of patients prescribed ART ranged from a decrease from 87.0% to 72.7% at Site 4 to an increase from 74.6% to 94.2% at Site 6; changes in the proportion of patients with 0 to 200 CD4 cells/mm3 ranged from a decrease from 20.2% to 11.0% in Site 6 to an increase from 16.7% to 30.2% in Site 2; and changes in the proportion of patients with undetectable viral load ranged from a decrease from 84.6% to 46.0% in Site 1 to an increase from 67.0% to 69.9% in Site 5. Four of the 6 interventions-including use of HIV surveillance data to identify out-of-care individuals, use of electronic laboratory ordering and prescribing, and development of a patient portal-were not only cost-effective but also cost saving ($6.87 to $14.91 saved per dollar invested). In contrast, the 2 interventions that extended access to EHRs to support service providers were not effective and, therefore, not cost-effective. Most interventions remained either cost-saving or not cost-effective under all sensitivity analysis scenarios. The intervention that used HIV surveillance data to identify out-of-care individuals was no longer cost-saving when the effect of HIV on an individual's health status was reduced and when the natural progression of HIV was increased. The results of this study are limited in that we did not have contemporaneous controls for each intervention; thus, we are only able to assess sites against themselves at baseline and not against standard of care during the same time period. CONCLUSIONS These results provide additional support for the use of HIT as a tool to enhance rapid and effective treatment of HIV to achieve sustained viral suppression. HIT has the potential to increase utilization of services, improve health outcomes, and reduce subsequent transmission of HIV.
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Affiliation(s)
- Starley B. Shade
- Institute for Global Health Sciences, Department of Epidemiology and Biostatistics, University of California, San Francisco, California, United States of America
- Center for AIDS Prevention Studies, University of California, San Francisco, California, United States of America
- * E-mail:
| | | | - Valerie Kirby
- Center for AIDS Prevention Studies, University of California, San Francisco, California, United States of America
| | - Deepalika Chakravarty
- Center for AIDS Prevention Studies, University of California, San Francisco, California, United States of America
| | - Wayne T. Steward
- Center for AIDS Prevention Studies, University of California, San Francisco, California, United States of America
| | - Kimberly K. Koester
- Center for AIDS Prevention Studies, University of California, San Francisco, California, United States of America
| | - Adan Cajina
- Demonstration and Evaluation Branch, HIV/AIDS Bureau, Health Resources and Services Administration, Rockville, Maryland, United States of America
| | - Janet J. Myers
- Center for AIDS Prevention Studies, University of California, San Francisco, California, United States of America
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Cheng Y, Mohanty AF, Ogunyemi OI, Smith CA, Leroy G, Zeng QT. 2018 Salary Survey of AMIA Members: Factors Associated with Higher Salaries. AMIA Annu Symp Proc 2020; 2019:275-284. [PMID: 32308820 PMCID: PMC7153054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Greater transparency in salaries overall and in factors associated with differing salaries can help students and professionals plan their careers, discover biases and obstacles, and help advance professional disciplines broadly. In March 2018, we conducted the first salary survey of American Medical Informatics Association members. Our goal was to summarize salary information and provide a nuanced view pertaining to the diverse biomedical informatics community. To identify factors associated with higher salaries, we reviewed average salaries for different groups (physician status, academic status, and different leadership positions) by gender. We also fitted multiple linear regression models for all participants (N = 201) and for gender, physician- and academic-status subgroup. The mean (standard deviation) salary was $181,774 ($99,566). Men earned more than women on average, and especially among professionals from academic settings. More years working in informatics and full-time employment were two factors that were consistently associated with higher salary.
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Affiliation(s)
- Yan Cheng
- Biomedical Informatics Center, George Washington University, Washington, DC
| | - April F Mohanty
- Informatics Decision-Enhancement and Analytic Sciences (IDEAS) Center, Veterans Affairs Medical Center, Salt Lake City, UT
- Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT
| | - Omolola I Ogunyemi
- Center for Biomedical Informatics, Charles R. Drew University of Medicine and Science, Los Angeles, CA
- University of California, Los Angeles, CA
| | | | - Gondy Leroy
- Management Information System Department, University of Arizona, Tucson, AZ
| | - Qing T Zeng
- Biomedical Informatics Center, George Washington University, Washington, DC
- Washington DC Veterans Affairs Medical Center, Washington, DC
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Abstract
The convergence of multiple recent developments in health care information technology and monitoring devices has made possible the creation of remote patient surveillance systems that increase the timeliness and quality of patient care. More convenient, less invasive monitoring devices, including patches, wearables, and biosensors, now allow for continuous physiological data to be gleaned from patients in a variety of care settings across the perioperative experience. These data can be bound into a single data repository, creating so-called data lakes. The high volume and diversity of data in these repositories must be processed into standard formats that can be queried in real time. These data can then be used by sophisticated prediction algorithms currently under development, enabling the early recognition of patterns of clinical deterioration otherwise undetectable to humans. Improved predictions can reduce alarm fatigue. In addition, data are now automatically queriable on a real-time basis such that they can be fed back to clinicians in a time frame that allows for meaningful intervention. These advancements are key components of successful remote surveillance systems. Anesthesiologists have the opportunity to be at the forefront of remote surveillance in the care they provide in the operating room, postanesthesia care unit, and intensive care unit, while also expanding their scope to include high-risk preoperative and postoperative patients on the general care wards. These systems hold the promise of enabling anesthesiologists to detect and intervene upon changes in the clinical status of the patient before adverse events have occurred. Importantly, however, significant barriers still exist to the effective deployment of these technologies and their study in impacting patient outcomes. Studies demonstrating the impact of remote surveillance on patient outcomes are limited. Critical to the impact of the technology are strategies of implementation, including who should receive and respond to alerts and how they should respond. Moreover, the lack of cost-effectiveness data and the uncertainty of whether clinical activities surrounding these technologies will be financially reimbursed remain significant challenges to future scale and sustainability. This narrative review will discuss the evolving technical components of remote surveillance systems, the clinical use cases relevant to the anesthesiologist's practice, the existing evidence for their impact on patients, the barriers that exist to their effective implementation and study, and important considerations regarding sustainability and cost-effectiveness.
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Affiliation(s)
- Kyan C. Safavi
- From the Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - William Driscoll
- From the Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Jeanine P. Wiener-Kronish
- From the Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts
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Affiliation(s)
- Elsa Pearson
- Policy analyst with the Boston University School of Public Health
| | - Austin Frakt
- Director of the Partnered Evidence-Based Policy Resource Center, Veterans Health Administration
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Abstract
This article is part of the Focus Theme of Methods of Information in Medicine on the German Medical Informatics Initiative. The Medical Informatics Initiative of the German Federal Ministry of Education and Research will make use of the potential of digitalization in the field of medicine in Germany. The aim is to improve the possibilities for medical research and patient care through innovative IT solutions. In an initial step, data integration centres will be set up at university hospitals to ensure the technical and organizational conditions necessary for multi-site exchange of data between health care and clinical and biomedical research. The Federal Ministry of Education and Research will provide a total of around EUR 150 million for this initiative over the next four years.
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Affiliation(s)
- Stefanie Gehring
- DLR Project Management Agency, Bonn, Germany
- Correspondence to: Stefanie Gehring, PhD DLR Project Management AgencyHeinrich-Konen-Straße 153227 BonnGermany
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Malhotra V. CTO Foresees Future of CMMS-Enabled 'True Interoperability'. Biomed Instrum Technol 2018; 52:60-62. [PMID: 29350983 DOI: 10.2345/0899-8205-52.1.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Kushniruk A, Borycki E. Low-Cost Rapid Usability Testing: Its Application in Both Product Development and System Implementation. Stud Health Technol Inform 2017; 234:195-200. [PMID: 28186040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In recent years there has been considerable discussion around the need for certification and regulation of healthcare information technology (IT). In particular, the usability of the products being developed needs to be evaluated. This has included the application of standards designed to ensure the process of system development is user-centered and takes usability into consideration while a product is being developed. In addition to this, in healthcare, organizations in the United States and Europe have also addressed the need and requirement for product certification. However, despite these efforts there are continued reports of unusable and unsafe implementations. In this paper we discuss the need to not only include (and require) usability testing in the one-time development process of health IT products (such as EHRs), but we also argue for the need to additionally develop specific usability standards and requirements for usability testing during the implementation of vendor products (i.e. post product development) in healthcare settings. It is further argued that health IT products that may have been certified regarding their development process will still require application of usability testing in the process of implementing them in real hospital settings in order to ensure usability and safety. This is needed in order to ensure that the final result of both product development and implementation processes take into account and apply the latest usability principles and methods.
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Affiliation(s)
- Andre Kushniruk
- School of Health Information Science, University of Victoria, Canada
| | - Elizabeth Borycki
- School of Health Information Science, University of Victoria, Canada
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8
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Abstract
OBJECTIVE To investigate the nature of physicians' use of research evidence in experimental conditions of open access to inform training and policy. DESIGN This qualitative study was a component of a larger mixed-methods initiative that provided 336 physicians with relatively complete access to research literature via PubMed and UpToDate, for 1 year via an online portal, with their usage recorded in web logs. Using a semistructured interview protocol, a subset of 38 physician participants were interviewed about their use of research articles in general and were probed about their reasons for accessing specific articles as identified through their web logs. Transcripts were analysed using a general inductive approach. SETTING Physician participants were recruited from and registered in the USA. PARTICIPANTS 38 physicians from 16 US states, engaged in 22 medical specialties, possessing more than 1 year of experience postresidency training participated. RESULTS 26 participants attested to the value of consulting research literature within the context of the study by making reference to their roles as clinicians, educators, researchers, learners, administrators and advocates. The physicians reported previously encountering what they experienced as a prohibitive paywall barrier to the research literature and other frustrations with the nature of information systems, such as the need for passwords. CONCLUSIONS The findings, against the backdrop of growing open access to biomedical research, indicate that a minority of physicians, at least initially, is likely to seek out and use research and do so in a variety of common roles. Physicians' use of research in these roles has not traditionally been part of their training or part of the considerations for open access policies. The findings have implications for educational and policy initiatives directed towards increasing the effectiveness of this access to and use of research in improving the quality of healthcare.
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Affiliation(s)
- Lauren A Maggio
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Laura L Moorhead
- Department of Journalism, College of Liberal and Creative Arts, San Francisco State University, San Francisco, California, USA
| | - John M Willinsky
- Graduate School of Education, Stanford University, Stanford, California, USA
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Affiliation(s)
- Kathrin Cresswell
- Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh EH8 9DX, UK
| | - David W Bates
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA
| | - Aziz Sheikh
- Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh EH8 9DX, UK.
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Luzi D, Pecoraro F, Tamburis O. Economic Evaluation of Health IT. Stud Health Technol Inform 2016; 222:165-180. [PMID: 27198101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Economic evaluation in health care supports decision makers in prioritizing interventions and maximizing the available limited resources for social benefits. Health Information Technology (health IT) constitutes a promising strategy to improve the quality and delivery of health care. However, to determine whether the appropriate health IT solution has been selected in a specific health context, its impact on the clinical and organizational process, on costs, on user satisfaction as well as on patient outcomes, a rigorous and multidimensional evaluation analysis is necessary. Starting from the principles of evaluation introduced since the mid-1980s within the Health Technology Assessment (HTA) guidelines, this contribution provides an overview of the main challenging issues related to the complex task of performing an economic evaluation of health IT. A set of necessary key principles to deliver a proper design and implementation of a multidimensional economic evaluation study is described, focusing in particular on the classification of costs and outcomes as well as on the type of economic analysis to be performed. A case study is eventually described to show how the key principles introduced are applied.
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Affiliation(s)
- Daniela Luzi
- Institute for Research on Population and Social Policies, National Research Council, Italy
| | - Fabrizio Pecoraro
- Institute for Research on Population and Social Policies, National Research Council, Italy
| | - Oscar Tamburis
- Department of Veterinary Medicine, University of Naples Federico II, Italy
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Oluoch T, de Keizer NF. Evaluation of Health IT in Low-Income Countries. Stud Health Technol Inform 2016; 222:324-335. [PMID: 27198114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Low and middle income countries (LMICs) bear a disproportionate burden of major global health challenges. Health IT could be a promising solution in these settings but LMICs have the weakest evidence of application of health IT to enhance quality of care. Various systematic reviews show significant challenges in the implementation and evaluation of health IT. Key barriers to implementation include lack of adequate infrastructure, inadequate and poorly trained health workers, lack of appropriate legislation and policies and inadequate financial 333indicating the early state of generation of evidence to demonstrate the effectiveness of health IT in improving health outcomes and processes. The implementation challenges need to be addressed. The introduction of new guidelines such as GEP-HI and STARE-HI, as well as models for evaluation such as SEIPS, and the prioritization of evaluations in eHealth strategies of LMICs provide an opportunity to focus on strategic concepts that transform the demands of a modern integrated health care system into solutions that are secure, efficient and sustainable.
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Affiliation(s)
- Tom Oluoch
- U.S. Centers for Disease Control and Prevention - Division of Global HIV & TB, Nairobi, Kenya
| | - Nicolet F de Keizer
- Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Tamba BI, Azoicăi D, Druguş D. HEALTH CARE ECONOMICS IN ROMANIA--DYNAMICS AND EVOLUTION. Rev Med Chir Soc Med Nat Iasi 2016; 120:163-172. [PMID: 27125091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Health economics refers to the analysis of medical institutions considering their economic and social efficacy, but also the regularity and the relationships that govern the phenomena and the processes from the field of health with the final purpose of achieving better results with the minimum of resources; it represents the study of health price in its complexity. The economics of the population's health needs and in particular the health needs in case of the poor groups of the population, consider health to be the main component of global human vulnerability. Health economics tries to change the simple interpretation of health price and disease cost into a wider consideration of a system administration similar to educational and social economics and the study of health in the context of the multiple specializations of the macro economy of the national group, as it is an instrument in the country's great economics symphony.
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In Conversation with Michael Green. Healthc Q 2016; 19:13-6. [PMID: 27808017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Levy DE, Munshi VN, Ashburner JM, Zai AH, Grant RW, Atlas SJ. Health IT-assisted population-based preventive cancer screening: a cost analysis. Am J Manag Care 2015; 21:885-891. [PMID: 26671700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVES Novel health information technology (IT)-based strategies harnessing patient registry data seek to improve care at a population level. We analyzed costs from a randomized trial of 2 health IT strategies to improve cancer screening compared with usual care from the perspective of a primary care network. STUDY DESIGN Monte Carlo simulations were used to compare costs across management strategies. METHODS We assessed the cost of the software, materials, and personnel for baseline usual care (BUC) compared with augmented usual care (AUC [ie, automated patient outreach]) and augmented usual care with physician input (AUCPI [ie, outreach mediated by physicians' knowledge of their patient panels]) over 1 year. RESULTS AUC and AUCPI each reduced the time physicians spent on cancer screening by 6.5 minutes per half-day clinical session compared with BUC without changing cancer screening rates. Assuming the value of this time accrues to the network, total costs of cancer screening efforts over the study year were $3.83 million for AUC, $3.88 million for AUCPI, and $4.10 million for BUC. AUC was cost-saving relative to BUC in 87.1% of simulations. AUCPI was cost-saving relative to BUC in 82.5% of simulations. Ongoing per patient costs were lower for both AUC ($35.63) and AUCPI ($35.58) relative to BUC ($39.51). CONCLUSIONS Over the course of the study year, the value of reduced physician time devoted to preventive cancer screening outweighed the costs of the interventions. Primary care networks considering similar interventions will need to capture adequate physician time savings to offset the costs of expanding IT infrastructure.
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Affiliation(s)
- Douglas E Levy
- Massachusetts General Hospital, 50 Staniford St, 9th fl, Boston, MA 02114. E-mail:
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DeSalvo K, Sanford K. Dr Karen DeSalvo of the ONC. Nurs Adm Q 2015; 39:286-290. [PMID: 26340238 DOI: 10.1097/naq.0000000000000125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Gracia-Wing V. The Cost of Technology: Facing the Challenge. Mich Med 2015; 114:10-14. [PMID: 26562951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Morrissey J. The Cost of Value-based Care. Trustee 2015; 68:13-1. [PMID: 26591231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Population health requires sophisticated systems that link payer, financial and clinical data. Prepare to spend even more on IT.
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Raman J. Mobile technology in nursing education: where do we go from here? A review of the literature. Nurse Educ Today 2015; 35:663-672. [PMID: 25665926 DOI: 10.1016/j.nedt.2015.01.018] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Revised: 01/13/2015] [Accepted: 01/19/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND The International Council of Nurses (ICN), Sigma Theta Tau International Honor Society of Nursing (STTI), and many National Nurses Associations (NNAs), have called for the integration of information technology into nursing curriculums to prepare nursing students for the current practice environment which requires access to large amounts of information to provide evidence-based patient care. Nurse educators have begun to address the integration of technology in nursing curriculum, but are the available tools, in particular, mobile devices loaded with informational applications, being maximized? Literature Review Aims The aims of this literature review are to 1) explore the literature written on the use of mobile technology in nursing education; 2) methodically discuss the benefits and concerns involved in using mobile technology in nursing education; and 3) consider strategies for enhancing the use of mobile technology in nursing education. Review Methods A search was conducted on the use of mobile technology in nursing programs in Academic Search Complete, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline with Full Text, and Medline Journals. Seventeen studies, published within the last five years in peer-reviewed journals regarding the mobile technology in nursing programs were identified. Findings Although many nursing programs have implemented the use of mobile technology in the clinical, classroom, and laboratory settings, more work needs to be done to overcome the concerns related to: cost, lack of IT support, lack of faculty acceptance and role-modeling, lack of structured assignments and/or activities designed to encourage the implementation of mobile devices; and constraints on their use in clinical settings. CONCLUSION While much has been done to incorporate the use of mobile technology in nursing curriculum, nurse educators are encouraged to develop strategies to overcome the concerns noted. Possible strategies to overcome the concerns are discussed herein.
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Affiliation(s)
- Janet Raman
- Adelphi University, College of Nursing and Public Health, One South Avenue, Garden City, NY 11530, United States.
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Gustafson DH, McTavish F, Gustafson DH, Mahoney JE, Johnson RA, Lee JD, Quanbeck A, Atwood AK, Isham A, Veeramani R, Clemson L, Shah D. The effect of an information and communication technology (ICT) on older adults' quality of life: study protocol for a randomized control trial. Trials 2015; 16:191. [PMID: 25909465 PMCID: PMC4417513 DOI: 10.1186/s13063-015-0713-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 04/08/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study investigates the use of an information and communication technology (Elder Tree) designed for older adults and their informal caregivers to improve older adult quality of life and address challenges older adults face in maintaining their independence (for example, loneliness and isolation, falling, managing medications, driving and transportation). METHODS/DESIGN This study, an unblinded randomized controlled trial, will evaluate the effectiveness and cost of Elder Tree. Older adults who are at risk for losing their independence - along with their informal caregivers, if they name them - are randomized to two groups. The intervention group has access to their usual sources of information and communication as well as to Elder Tree for 18 months while the control group uses only their usual sources of information and communication. The primary outcome of the study is older adult quality of life. Secondary outcomes are cost per Quality-Adjusted Life Year and the impact of the technology on independence, loneliness, falls, medication management, driving and transportation, and caregiver appraisal and mastery. We will also examine the mediating effect of self-determination theory. We will evaluate the effectiveness of Elder Tree by comparing intervention- and control-group participants at baseline and months 6, 12, and 18. We will use mixed-effect models to evaluate the primary and secondary outcomes, where pretest score functions as a covariate, treatment condition is a between-subjects factor, and the multivariate outcome reflects scores for a given assessment at the three time points. Separate analyses will be conducted for each outcome. Cost per Quality-Adjusted Life Year will be compared between the intervention and control groups. Additional analyses will examine the mediating effect of self-determination theory on each outcome. DISCUSSION Elder Tree is a multifaceted intervention, making it a challenge to assess which services or combinations of services account for outcomes in which subsets of older adults. If Elder Tree can improve quality of life and reduce healthcare costs among older adults, it could suggest a promising way to ease the burden that advancing age can place on older adults, their families, and the healthcare system. TRIAL REGISTRATION ClinicalTrials.gov NCT02128789 . Registered on 26 March 2014.
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Affiliation(s)
- David H Gustafson
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, 53706, USA.
| | - Fiona McTavish
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, 53706, USA.
| | - David H Gustafson
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, 53706, USA.
| | - Jane E Mahoney
- Division of Geriatrics, Department of Medicine, University of Wisconsin School of Medicine and Public Health and Executive Director, Wisconsin Institute for Health Aging, Madison, WI, 53792, USA.
| | - Roberta A Johnson
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, 53706, USA.
| | - John D Lee
- Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, WI, 53705, USA.
| | - Andrew Quanbeck
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, 53706, USA.
| | - Amy K Atwood
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, 53706, USA.
| | - Andrew Isham
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, 53706, USA.
| | - Raj Veeramani
- College of Engineering and School of Business and Executive Director, University of Wisconsin E-Business Institute, University of Wisconsin-Madison, Madison, WI, 53706, USA.
| | - Lindy Clemson
- Aging, Work & Health Research Group, Faculty of Health Sciences, University of Sydney, Sydney, Australia.
| | - Dhavan Shah
- Mass Communication Research Center, School of Journalism and Mass Communication, University of Wisconsin-Madison, Madison, WI, 53706, USA.
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Abstract
INTRODUCTION Health Information Economy (HIE) is one of the broader, more complex, and challenging and yet important topics in the field of health science that requires the identification of its dimensions for planning and policy making. The aim of this study was to determine HIE concept dimensions. METHODS This paper presents a systematic methodology for analyzing the trends of HIE. For this purpose, the main keywords of this area were identified and searched in the databases and from among 4775 retrieved sources, 12 sources were studied in the field of HIE. RESULTS Information Economy (IE) in the world has passed behind four paradigms that involve the information evaluation perspective, the information technology perspective, the asymmetric information perspective and information value perspective. In this research, the fourth perspective in the HIE was analyzed. The main findings of this research were categorized in three major groups, including the flow of information process in the field of health (production. collection, processing and dissemination), and information applications in the same field (education, research, health industry, policy, legislation, and decision-making) and the underlying fields. CONCLUSION According to the findings, HIE has already developed a theoretical and conceptual gap that due to its importance in the next decade would be one of the research approaches to health science.
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Affiliation(s)
- Kamal Ebrahimi
- School of Health Management and Information Science, Iran university of medical Science, Tehran, Iran.
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White J. Data-driven medicine requires infrastructure investment and regulatory reform. Mod Healthc 2015; 45:29. [PMID: 25823259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Conn J. Big data learning curve. ACOs make progress using health IT to improve care. Mod Healthc 2015; 45:22-25. [PMID: 25671903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Lee J. Measurement of clinical value...new partnerships with manufacturers...investment in cost-cutting IT tools. Mod Healthc 2015; 45:20. [PMID: 25826838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Simoes E. Health information technology advances health care delivery and enhances research. Mo Med 2015; 112:37-40. [PMID: 25812273 PMCID: PMC6170093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Hagens S, Zelmer J, Frazer C, Gheorghiu B, Leaver C. Valuing national effects of digital health investments: an applied method. Stud Health Technol Inform 2015; 208:165-169. [PMID: 25676967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This paper describes an approach which has been applied to value national outcomes of investments by federal, provincial and territorial governments, clinicians and healthcare organizations in digital health. Hypotheses are used to develop a model, which is revised and populated based upon the available evidence. Quantitative national estimates and qualitative findings are produced and validated through structured peer review processes. This methodology has applied in four studies since 2008.
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Abstract
Delays and spiralling costs of an IT upgrade for Scotland's NHS 24 helpline is a blow to nursing staff, the RCN says.
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Rudin RS, Jones SS, Shekelle P, Hillestad RJ, Keeler EB. The value of health information technology: filling the knowledge gap. Am J Manag Care 2014; 20:eSP1-eSP8. [PMID: 25811814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Despite rapid growth in the rate of adoption of health information technology (HIT), and in the volume of evaluation studies, the existing knowledge base for the value of HIT is not advancing at a similar rate. Most evaluation articles are limited in that they use incomplete measures of value and fail to report the important contextual and implementation characteristics that would allow for an adequate understanding of how the study results were achieved. To address these deficiencies, we present a conceptual framework for measuring HIT value and we propose a checklist of characteristics that should be considered in HIT evaluation studies. The framework consists of 3 key principles: 1) value includes both costs and benefits; 2) value accrues over time; and 3) value depends on which stakeholder's perspective is used. Through examples, we show how these principles can be used to guide and improve HIT evaluation studies. The checklist includes a list of contextual and implementation characteristics that are important for interpretation of results. These improvements will make future studies more useful for policy makers and more relevant to the current needs of the healthcare system.
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Spallek H, Johnson L, Kerr J, Rankin D. Costs of health IT: beginning to understand the financial impact of a dental school EHR. J Dent Educ 2014; 78:1542-1551. [PMID: 25362696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Health Information Technology (Health IT) constitutes an integral component of the operations of most academic dental institutions nowadays. However, the expenses associated with the acquisition and the ongoing maintenance of these complex systems have often been buried among costs for other electronic infrastructure systems, distributed across various cost centers including unmeasured central campus support, covered centrally and therefore difficult to quantify, and spread over years, denying school administrators a clear understanding of the resources that have been dedicated to Health IT. The aim of this study was to understand the financial impact of Health IT at four similar U.S. dental schools: two schools using a purchased Electronic Health Record (EHR), and two schools that developed their own EHR. For these schools, the costs of creating ($2.5 million) and sustaining ($174,000) custom EHR software were significantly higher than acquiring ($500,000) and sustaining ($121,000) purchased software. These results are based on historical data and should not be regarded as a gold standard for what a complete Health IT suite should cost. The presented data are intended to inform school administrators about the myriad of costs associated with Health IT and give them a point of reference when comparing costs or making estimates for implementation projects.
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Affiliation(s)
- Heiko Spallek
- Dr. Spallek is Associate Professor, Dental Public Health, Center for Informatics in Oral Health Translational Research and Associate Dean, Office of Faculty Affairs, School of Dental Medicine, University of Pittsburgh; Dr. Johnson is Professor of Dentistry, School of Dentistry, Associate Dean for Faculty Affairs and Institutional Effectiveness, and Clinical Professor, School of Information, University of Michigan; Mr. Kerr is Associate Dean for Administration, School of Dental Medicine, University at Buffalo; and Mr. Rankin is Director, Office of Computing and Information Systems, School of Dentistry, University of North Carolina at Chapel Hill.
| | - Lynn Johnson
- Dr. Spallek is Associate Professor, Dental Public Health, Center for Informatics in Oral Health Translational Research and Associate Dean, Office of Faculty Affairs, School of Dental Medicine, University of Pittsburgh; Dr. Johnson is Professor of Dentistry, School of Dentistry, Associate Dean for Faculty Affairs and Institutional Effectiveness, and Clinical Professor, School of Information, University of Michigan; Mr. Kerr is Associate Dean for Administration, School of Dental Medicine, University at Buffalo; and Mr. Rankin is Director, Office of Computing and Information Systems, School of Dentistry, University of North Carolina at Chapel Hill
| | - Joseph Kerr
- Dr. Spallek is Associate Professor, Dental Public Health, Center for Informatics in Oral Health Translational Research and Associate Dean, Office of Faculty Affairs, School of Dental Medicine, University of Pittsburgh; Dr. Johnson is Professor of Dentistry, School of Dentistry, Associate Dean for Faculty Affairs and Institutional Effectiveness, and Clinical Professor, School of Information, University of Michigan; Mr. Kerr is Associate Dean for Administration, School of Dental Medicine, University at Buffalo; and Mr. Rankin is Director, Office of Computing and Information Systems, School of Dentistry, University of North Carolina at Chapel Hill
| | - David Rankin
- Dr. Spallek is Associate Professor, Dental Public Health, Center for Informatics in Oral Health Translational Research and Associate Dean, Office of Faculty Affairs, School of Dental Medicine, University of Pittsburgh; Dr. Johnson is Professor of Dentistry, School of Dentistry, Associate Dean for Faculty Affairs and Institutional Effectiveness, and Clinical Professor, School of Information, University of Michigan; Mr. Kerr is Associate Dean for Administration, School of Dental Medicine, University at Buffalo; and Mr. Rankin is Director, Office of Computing and Information Systems, School of Dentistry, University of North Carolina at Chapel Hill
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Manchikanti L, Benyamin RM, Falco FJE, Hirsch JA. Metamorphosis of medicine in the United States: is information technology a white knight or killer whale? Pain Physician 2014; 17:E663-E670. [PMID: 25415781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Laxmaiah Manchikanti
- Pain Management Center of Paducah, Paducah, KY, and University of Louisville, Louisville, KY; Millennium Pain Center, Bloomington, IL, and University of Illinois, Urbana-Champaign, IL; Mid Atlantic Spine & Pain Physicians, Newark, DE, and Temple Universit
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Ayatollahi H, Mirani N, Haghani H. Electronic health records: what are the most important barriers? Perspect Health Inf Manag 2014; 11:1c. [PMID: 25593569 PMCID: PMC4272437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
INTRODUCTION The process of design and adoption of electronic health records may face a number of barriers. This study aimed to compare the importance of the main barriers from the experts' point of views in Iran. METHODS This survey study was completed in 2011. The potential participants (62 experts) included faculty members who worked in departments of health information technology and individuals who worked in the Ministry of Health in Iran and were in charge of the development and adoption of electronic health records. No sampling method was used in this study. Data were collected using a Likert-scale questionnaire ranging from 1 to 5. The validity of the questionnaire was established using content and face validity methods, and the reliability was calculated using Cronbach's alpha coefficient. RESULTS The response rate was 51.6 percent. The participants' perspectives showed that the most important barriers in the process of design and adoption of electronic health records were technical barriers (mean = 3.84). Financial and ethical-legal barriers, with the mean value of 3.80 were other important barriers, and individual and organizational barriers, with the mean values of 3.59 and 3.50 were found to be less important than other barriers from the experts' perspectives. CONCLUSION Strategic planning for the creation and adoption of electronic health records in the country, creating a team of experts to assess the potential barriers and develop strategies to eliminate them, and allocating financial resources can help to overcome most important barriers to the adoption of electronic health records.
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Affiliation(s)
- Haleh Ayatollahi
- Haleh Ayatollahi, MSc, PhD, is an assistant professor of medical informatics in the Department of Health Information Management at Iran University of Medical Sciences in Tehran, Iran
| | - Nader Mirani
- Nader Mirani, MSc, is a PhD student in the School of Health Management and Information Sciences at Iran University of Medical Sciences in Tehran, Iran
| | - Hamid Haghani
- Hamid Haghani, MSc, is a lecturer in mathematics and statistics in the Department of Mathematics and Statistics in the School of Health at Iran University of Medical Sciences in Tehran, Iran
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Kern LM, Silver M, Kaushal R. State funding for health information technology and selected ambulatory healthcare quality measures. Appl Clin Inform 2014; 5:594-602. [PMID: 25024772 PMCID: PMC4081759 DOI: 10.4338/aci-2013-12-ra-0108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 05/19/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Previous studies on the effects of health information technology (health IT) on ambulatory quality have had mixed results. New York State has invested heavily in health IT throughout the State, creating a unique opportunity to assess effects on health care quality across multiple communities. OBJECTIVE To determine any association between primary care providers' receipt of funding from New York State's Healthcare Efficiency and Affordability Law for New Yorkers Program (HEAL NY) and ambulatory quality of care. METHODS A statewide, longitudinal cohort study of primary care physicians in New York State was conducted. Data regarding which primary care physicians received funding through the HEAL NY program (Phase 5 or Phase 10) in 2008 or 2009 were obtained from the New York State Department of Health. Health care quality in 2010 was measured using claims data that had been aggregated across 7 commercial health plans across the state. Physicians were divided into 2 groups, based on receipt of HEAL funding (yes/no). Any association was measured between study group and each of 7 quality measures, all of which appear in the Stage 1 federal Meaningful Use program. Negative binomial regression was used, adjusting for provider gender and specialty. RESULTS The study included 3,988 primary care providers, of whom 863 (22%) had received HEAL NY funding. The HEAL-funded physicians provided higher quality of care on 5 of the 7 measures: breast cancer screening, eye exams in patients with diabetes, nephropathy screening in patients with diabetes, influenza vaccination and pneumococcal vaccination (p<0.0001 for all adjusted comparisons). The HEAL-funded group provided higher quality of care by an absolute 2 to 6 percentage points per measure for those 5 measures. CONCLUSION Primary care physicians who received state funding for health IT provided higher quality of care than those who did not receive such funding.
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Affiliation(s)
- L. M. Kern
- Center for Healthcare Informatics and Policy, Weill Cornell Medical College, New York, NY
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
- Health Information Technology Evaluation Collaborative, New York, NY
| | - M. Silver
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY
- Health Information Technology Evaluation Collaborative, New York, NY
| | - R. Kaushal
- Center for Healthcare Informatics and Policy, Weill Cornell Medical College, New York, NY
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
- Health Information Technology Evaluation Collaborative, New York, NY
- Department of Pediatrics, Weill Cornell Medical College, New York, NY
- New York-Presbyterian Hospital, New York, NY
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Moore KD, Eyestone KM, Coddington DC. The integration aspiration. Healthc Financ Manage 2014; 68:56-58. [PMID: 24968627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Integration is a common goal when health systems acquire medical practices, but may take various forms and continue to evolve beyond the classic model. Characteristics of the classic model of integration include strong and committed physician leadership, an emphasis on care coordination, easy access to primary care, integrated IT and business intelligence, and a willingness to accept financial risk. Leaders of integrated delivery systems continue to strive for greater levels of coordination and leveraging of collected talents and resources.
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Healthcare informatics. 100 companies by revenue. Healthc Inform 2014; 31:8-10, 12-4, 16-8 passim. [PMID: 25181858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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McCall B. Funding: MRC injects funds into medical informatics. Lancet 2014; 383:1116. [PMID: 24693548 DOI: 10.1016/s0140-6736(14)60551-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Barlow RD. Great expectations for Big Data: will the next wave of analytics lead to a great awakening or more strife? Health Manag Technol 2014; 35:18-21. [PMID: 24734390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Grantham D. The future of behavioral health: under construction. Behav Healthc 2014; 34:20-24. [PMID: 24864545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Conn J. Funding the RECs. Extension centers 'a great investment,' leaders say. Mod Healthc 2014; 44:24. [PMID: 24730154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Conn J. Organizations' IT spending expected to keep growing. Mod Healthc 2014; 44:23. [PMID: 24730152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Mul D, Veeze HJ. [Virtual paediatric medicine]. Ned Tijdschr Geneeskd 2014; 158:A8267. [PMID: 25515389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Health information technology (eHealth) can be cost-effective if it replaces existing care services. The introduction of eHealth has provided the opportunity to directly support and improve care for children with chronic diseases. We show an example of this in children with diabetes mellitus. Giving patients direct feedback on their glucose levels results in better outcomes of patient care. Accessing data from electronic patient files and using them effectively, however, is not yet possible in a number of health care institutions.
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Affiliation(s)
- Dick Mul
- Diabeter, Nationaal behandelcentrum voor diabetes bij kinderen en jongeren, Rotterdam
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Low AFH, Phillips AB, Ancker JS, Patel AR, Kern LM, Kaushal R. Financial effects of health information technology: a systematic review. Am J Manag Care 2013; 19:SP369-SP376. [PMID: 24511891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Health information technology (HIT) is widely viewed as an important lever with which to improve the quality and efficiency of the healthcare system. However, there has long been debate about its financial effects. OBJECTIVES To characterize the existing data on the financial effects of HIT and to consider the implications for the effect of HIT on healthcare spending. STUDY DESIGN Systematic literature review. METHODS We identified articles by (1) searching PubMed using the intersection of terms related to HIT applications and terms related to financial or economic effect; and (2) reviewing the reference lists of the included articles as well as additional policy articles and literature reviews. RESULTS A total of 57 articles met our inclusion criteria, including 43 articles (75%) reporting financial benefits to a stakeholder associated with HIT. These included 26 articles (46%) reporting cost savings, 6 articles (11%) reporting revenue gains, and 11 articles (19%) reporting a mixture of cost savings and revenue gains. Among articles with experimental study designs, 22 of 34 (65%) reported financial benefits; and among articles explicitly measuring costs and benefits, 19 of 21 (90%) reported financial benefits. The most prevalent mechanisms were savings on administrative goods and/or personnel, savings on pharmaceuticals, and revenue gains through improved billing. Overall there is a dearth of articles on this topic, especially ones with strong study designs and financial analyses. CONCLUSIONS HIT can have financial benefits, but more research is required, especially on HIT's effects under emerging delivery and payment reform efforts.
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Affiliation(s)
- Alexander F H Low
- Director, Strategy and Development, Center for Healthcare Informatics and Policy, Weill Cornell Medical College, 425 E 61st St, Ste 301, New York, NY 10065.
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Affiliation(s)
- Tim K Mackey
- University of California San Diego, School of Medicine, San Diego, CA 92103-8770, USA; Institute of Health Law Studies, California Western School of Law, San Diego, CA, USA.
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Goozner M. A make-or-break year for health IT. With ICD-10 looming in 2014, CIOs face tough decisions in deploying resources. Mod Healthc 2013; 43:22. [PMID: 24340705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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MacTaggart P, Thorpe JH. Long-term care and health information technology: opportunities and responsibilities for long-term and post-acute care providers. Perspect Health Inf Manag 2013; 10:1e. [PMID: 24159273 PMCID: PMC3797552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Long-term and post-acute care providers (LTPAC) need to understand the multiple aspects of health information technology (HIT) in the context of health systems transformation in order to be a viable participant. The issues with moving to HIT are not just technical and funding, but include legal and policy, technical and business operations, and very significantly, governance. There are many unanswered questions. However, changes in payment methodologies, service delivery models, consumer expectations, and regulatory requirements necessitate that LTPAC providers begin their journey.
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Affiliation(s)
- Patricia MacTaggart
- Patricia MacTaggart, MBA, MMA, is a lead research scientist in the Department of Health Policy in the School of Public Health and Health Services at the George Washington University in Washington, DC
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Cosgrove DM. A conversation with Delos M.'Toby' Cosgrove, MD. Provider-side economics. Interview by John Marcille. Manag Care 2013; 22:36-40. [PMID: 24344526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
MESH Headings
- Chief Executive Officers, Hospital/economics
- Chief Executive Officers, Hospital/standards
- Cost Control/methods
- Cost Control/standards
- Diagnostic Tests, Routine/economics
- Diagnostic Tests, Routine/standards
- Diagnostic Tests, Routine/trends
- Equipment and Supplies, Hospital/economics
- Equipment and Supplies, Hospital/standards
- Hospital-Physician Joint Ventures/economics
- Hospital-Physician Joint Ventures/organization & administration
- Hospitals, Voluntary/economics
- Hospitals, Voluntary/organization & administration
- Hospitals, Voluntary/standards
- Humans
- Insurance, Health/economics
- Insurance, Health/organization & administration
- Insurance, Health/trends
- Interinstitutional Relations
- Medical Informatics/economics
- Medical Informatics/trends
- Models, Organizational
- Multi-Institutional Systems/economics
- Multi-Institutional Systems/organization & administration
- Personnel Downsizing/economics
- Personnel Downsizing/ethics
- Personnel Downsizing/trends
- Personnel Turnover/economics
- Personnel Turnover/statistics & numerical data
- Reimbursement Mechanisms/standards
- Reimbursement Mechanisms/trends
- Risk Management
- Salaries and Fringe Benefits
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Perna G. Life after the Beacon. San Diego Beacon transitions into a regional HIE organization. Healthc Inform 2013; 30:24-25. [PMID: 24224337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Barr P. RECs complete: End of the road for IT help centers? Hosp Health Netw 2013; 87:16. [PMID: 24020165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Page D. The Most Wired Innovator Award. Hosp Health Netw 2013; 87:44-47. [PMID: 24020175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Conn J. The wave As federal EHR incentives recede, the next surge in health IT spending begins to take shape. Mod Healthc 2013; 43:6-1. [PMID: 23947264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Presbyterian Intercommunity hospital, part of PHI Health, is on the leading edge of a new surge in healthcare information technology. The hospital's plans include setting up a data warehouse for patient records and a patient portal, which is seen as key to involving patients in their own care. "It's really about patient engagement," said Dr. Davis Lee of PIH Health, left. "There are benefits to get the patients to go online and communicate with providers."
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