Yasnoff WA et al, JAMA, 309(10)
The promise of health information technology (HIT) is comprehensive electronic patient records when and where needed, leading to improved quality of care at reduced cost. However, physician experience and other available evidence suggest that this promise is largely unfulfilled.
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Lee Y-Y et al,
Objectives
Obtaining an accurate medication history upon admission to the hospital can be challenging and time-consuming. This study evaluated the efficacy of a medication reconciliation program, conducted by pharmacists, with the assistance of medication usage data from the Taiwan National Health Insurance (NHI). Characteristics of patients at high risk for drug discrepancies were also determined.
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Chen LM et al, New England Journal of Medicine, 2013
The patient had not yet coded but was spiraling downward, prompting a request for a bed in the intensive care unit (ICU). But the ICU had no available beds. Hours passed before the decision was made that another patient could safely be “bumped” out of the unit to accommodate our patient.
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Fenton SH et al, ACI, 3(4)
Objective:
To evaluate the health information technology (HIT) workforce knowledge and skills needed by HIT employers.
Methods:
Statewide face-to-face and online focus groups of identified HIT employer groups in Austin, Brownsville, College Station, Dallas, El Paso, Houston, Lubbock, San Antonio, and webinars for rural health and nursing informatics.
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Toll E. JAMA, 307(23)
No one was more surprised than the physician himself. The drawing was unmistakable. It showed the artist—a 7-year-old girl—on the examining table. Her older sister was seated nearby in a chair, as was her mother, cradling her baby sister. The doctor sat staring at the computer, his back to the patient—and everyone else.
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Nusbaum NJ. Online Journal of Public Health Informatics, 3(11)
Background
One goal in EMR development should be to facilitate a patient-centered clinical encounter.
Methods
Qualitative analysis and suggestions are offered for how the EMR can individualize patient care, in support of a patient-centered approach.
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Anders SH et al, Applied Clinical Informatics, 3(2)
Objective:
Longitudinal studies exploring the evolution of health information technology functions provide valuable information about how technology systems are integrated and exploited in situ. This study reports changes in the distribution of functions for a specific health information technology, the tele-ICU, over time. The studied tele-ICU provided care to six remote ICUs within a local geographic region in the same state and had nursing staff around the clock.
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Ammenwerth E et al, The HIM journal, 41(2)
It is essential for new health information technologies (IT) to undergo rigorous evaluations to ensure they are effective and safe for use in real-world situations. However, evaluation of new health IT is challenging, as field studies are often not feasible when the technology being evaluated is not sufficiently mature. Laboratory-based evaluations have also been shown to have insufficient external validity. Simulation studies seem to be a way to bridge this gap. The aim of this study was to evaluate, using a simulation methodology, the impact of a new prototype of an electronic medication management system on the appropriateness of prescriptions and drugrelated activities, including laboratory test ordering or medication changes. This article presents the results of a controlled simulation study with 50 simulation runs, including ten doctors and five simulation patients, and discusses experiences and lessons learnt while conducting the study.
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Protti D et al, ElectronicHealthcare, 8(1)
This article follows on from part 1 on the history of medical computing in Alberta and Denmark (Protti et al. 2007). It provides background to the driving forces for automation in primary care physician offices in Denmark and Alberta. It also summarizes the functionality of electronic medical records (EMRs) in both jurisdictions and compares the status of primary care physician office computing in Alberta to that of Denmark.
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Weiner JP et al, International Journal for Quality in Health Care, 24(3)
Measures of provider success are the centerpiece of quality improvement and pay-for-performance programs around the globe. In most nations, these measures are derived from administrative records, paper charts and consumer surveys; increasingly, electronic patient record systems are also being used. We use the term ‘e-QMs’ to describe quality measures that are based on data found within electronic health records and other related health information technology (HIT).
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Lewis T et al, Bulletin of the World Health Organization, 90(5)
Health systems in low- and middle-income countries continue to face considerable challenges in providing high-quality, affordable and universally accessible care. In response, policy-makers, donors and programme implementers are searching for innovative approaches to eliminate the geographic and financial barriers to health.
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Objectives:
To identify the factors and strategies that were associated with successful implementation of hospital-based information technology (IT) systems in US Department of Veterans Affairs (VA) hospitals, and how these might apply to other hospitals.
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King D et al, Health and Technology, 2012
Health information technology has great potential to promote efficiency in patient care and increase patient-provider communication, and patient engagement in their treatment. This paper explored qualitatively what patients with type 2 diabetes want from electronic resources that are designed to support their diabetes self-management. Data were collected via interviews and focus groups from managed care patients who had completed participation in either a web-based (MyPath) or in-person group-based (¡Viva Bien!) longitudinal diabetes self-management study. Content analysis identified common themes that highlighted participant interest in virtual and electronic programs to support diabetes self-management goals, and their desired content and features. Eighteen ¡Viva Bien! participants completed telephone interviews and 30 MyPath participants attended seven focus groups in 2010-2011.
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BACKGROUND:
Due to the strained financial situation in the healthcare sector, hospitals and other healthcare providers are facing an increasing pressure to improve their efficiency and to reduce costs. These trends challenge health care organizations to introduce innovative information technology (IT) based supportive processes. To guarantee that IT supports the clinical processes perfectly, IT must be managed proactively. However, until now, there is only very few research on IT service management especially on ITIL(R) implementations in the health care context.
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Vedel I et al, International Journal of Medical Informatics, 2011
Given the increasing prevalence of multimorbidity in primary care (PC), interdisciplinary PC teams supported by appropriate clinical information systems (CIS) are needed in order to deal with the complexity of multimorbid patients’ care. Our team has developed such a system, called the Da Vinci system. However, despite the expected benefits, evidence suggests generally low rates of CIS adoption. To optimize adoption in PC settings, a better understanding of the implementation process of such systems is crucial.
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Blumenthal D. N Engl J Med, 365(25)
In the spring of 2009, the Department of Health and Human Services (DHHS) faced a daunting project: to lead the creation of a nationwide, interoperable, private, and secure electronic health information system. The DHHS and its two key agencies that were responsible for this task — the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) — were in many ways unprepared to undertake it.
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Blumenthal D. N Engl J Med, 365(24)
In February 2009, the U.S. government launched an unprecedented effort to reengineer the way the country collects, stores, and uses health information. This effort was embodied in the Health Information Technology for Economic and Clinical Health (HITECH) Act, which was part of a much larger piece of legislation, the so-called stimulus bill. The purpose of the stimulus bill, also known as the American Recovery and Reinvestment Act of 2009 (ARRA), was to stimulate the economy and prevent one of the worst economic recessions in modern history from becoming a full-fledged depression.
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McKibbon KA et al, J Am Med Inform Assoc, 19(1)
Objective
The US Agency for Healthcare Research and Quality funded an evidence report to address seven questions on multiple aspects of the effectiveness of medication management information technology (MMIT) and its components (prescribing, order communication, dispensing, administering, and monitoring).
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Hsiao C-J et al, NCHS Data Brief, 79
The 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act authorized incentive payments through Medicare and Medicaid to increase physician adoption of electronic health record (EHR) systems. Eligible Medicare and Medicaid physicians may receive incentive payments over 5 years if they demonstrate 15 Stage 1 Core Set objectives and 5 of 10 Menu Set objectives, using certified EHR systems.
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Kesselheim AS et al, Health Affairs, 30(12)
Clinical decision support systems—interactive computer systems that help doctors make clinical choices—can reduce errors in drug prescribing by offering real-time alerts about possible adverse reactions. But physicians and other users often suffer “alert fatigue” caused by excessive numbers of warnings about items such as potentially dangerous drug interactions. As a result, they may pay less attention to or even ignore some vital alerts, thus limiting these systems’ effectiveness.
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