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Mannoubi C, Kairy D, Menezes KV, Desroches S, Layani G, Vachon B. The Key Digital Tool Features of Complex Telehealth Interventions Used for Type 2 Diabetes Self-Management and Monitoring With Health Professional Involvement: Scoping Review. JMIR Med Inform 2024; 12:e46699. [PMID: 38477979 DOI: 10.2196/46699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 09/21/2023] [Accepted: 12/07/2023] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Therapeutic education and patient self-management are crucial in diabetes prevention and treatment. Improving diabetes self-management requires multidisciplinary team intervention, nutrition education that facilitates self-management, informed decision-making, and the organization and delivery of appropriate health care services. The emergence of telehealth services has provided the public with various tools for educating themselves and for evaluating, monitoring, and improving their health and nutrition-related behaviors. Combining health technologies with clinical expertise, social support, and health professional involvement could help persons living with diabetes improve their disease self-management skills and prevent its long-term consequences. OBJECTIVE This scoping review's primary objective was to identify the key digital tool features of complex telehealth interventions used for type 2 diabetes or prediabetes self-management and monitoring with health professional involvement that help improve health outcomes. A secondary objective was to identify how these key features are developed and combined. METHODS A 5-step scoping review methodology was used to map relevant literature published between January 1, 2010 and March 31, 2022. Electronic searches were performed in the MEDLINE, CINAHL, and Embase databases. The searches were limited to scientific publications in English and French that either described the conceptual development of a complex telehealth intervention that combined self-management and monitoring with health professional involvement or evaluated its effects on the therapeutic management of patients with type 2 diabetes or prediabetes. Three reviewers independently identified the articles and extracted the data. RESULTS The results of 42 studies on complex telehealth interventions combining diabetes self-management and monitoring with the involvement of at least 1 health professional were synthesized. The health professionals participating in these studies were physicians, dietitians, nurses, and psychologists. The digital tools involved were smartphone apps or web-based interfaces that could be used with medical devices. We classified the features of these technologies into eight categories, depending on the intervention objective: (1) monitoring of glycemia levels, (2) physical activity monitoring, (3) medication monitoring, (4) diet monitoring, (5) therapeutic education, (6) health professional support, (7) other health data monitoring, and (8) health care management. The patient-logged data revealed behavior patterns that should be modified to improve health outcomes. These technologies, used with health professional involvement, patient self-management, and therapeutic education, translate into better control of glycemia levels and the adoption of healthier lifestyles. Likewise, they seem to improve monitoring by health professionals and foster multidisciplinary collaboration through data sharing and the development of more concise automatically generated reports. CONCLUSIONS This scoping review synthesizes multiple studies that describe the development and evaluation of complex telehealth interventions used in combination with health professional support. It suggests that combining different digital tools that incorporate diabetes self-management and monitoring features with a health professional's advice and interaction results in more effective interventions and outcomes.
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Affiliation(s)
- Choumous Mannoubi
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
- Centre interdisciplinaire en readaptation du Montreal Métropolitain, Institut Universitaire sur la readaptation en déficience physique de Montreal, Montréal, QC, Canada
| | - Dahlia Kairy
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
- Centre interdisciplinaire en readaptation du Montreal Métropolitain, Institut Universitaire sur la readaptation en déficience physique de Montreal, Montréal, QC, Canada
| | - Karla Vanessa Menezes
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
- Centre interdisciplinaire en readaptation du Montreal Métropolitain, Institut Universitaire sur la readaptation en déficience physique de Montreal, Montréal, QC, Canada
| | - Sophie Desroches
- Institute of Nutrition and Functional Foods, Université Laval, Quebec, QC, Canada
- Centre nutrition, santé et société NUTRISS, Université Laval, Québec, QC, Canada
- School of Nutrition, Université Laval, Québec, QC, Canada
| | - Geraldine Layani
- Centre de recherche du centre hospitalier de l'universite de Montreal, Montréal, QC, Canada
- Département de médecine de famille et de médecine d'urgence, Universté de Montréal, Montreal, QC, Canada
| | - Brigitte Vachon
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Centre integre de sante et de services sociaux de l'Est-de-l'ile-de-Montreal, Montréal, QC, Canada
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Malhan A, Manuj I, Pelton L, Pavur R. Electronic health records using a resource advantage theory perspective: an interdisciplinary literature review. RECORDS MANAGEMENT JOURNAL 2022. [DOI: 10.1108/rmj-06-2021-0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Warren Buffett asserted that the greatest issue confronting American business and the economy is rising health-care costs, which have risen to 17% of gross domestic product. Public policymakers, health-care providers and other stakeholders grapple with cost-containment and increased health-care delivery efficiencies. There exists a paucity of theory-driven research addressing how information technology vis-à-vis electronic health records (EHR) may supply a managerial mechanism for increasing bottom-line hospital performance, thereby attaining competitive advantage.
Design/methodology/approach
A systematic interdisciplinary literature review motivated by resource advantage theory (RAT) offers a conceptual foundation for analyzing the financial, informational and physical workflows that are core elements of supply chain management in a hospital.
Findings
RAT links how EHR impacts profitability, competitive advantage and macromarketing factors in hospital supply chains. The literature review provides a research synthesis of the implementation and adoption of EHR to reveal its impact on a hospital’s competitive advantage. Although legislative initiatives like the 2009 Health Information Technology for Economic and Clinical Health Act and the Affordable Care Act encourage EHR adoption, there remains a reluctance for hospitals to do so.
Originality/value
The extant literature precedes the relevant legislation, has incomplete data or focuses solely on patient outcomes.
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Mishra AN, Tao Y, Keil M, Oh JH(C. Functional IT Complementarity and Hospital Performance in the United States: A Longitudinal Investigation. INFORMATION SYSTEMS RESEARCH 2022. [DOI: 10.1287/isre.2021.1064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
For healthcare practitioners and policymakers, one of the most challenging problems is understanding how to implement health information technology (HIT) applications in a way that yields the most positive impacts on quality and cost of care. We identify four clinical HIT functions which we label as order entry and management (OEM), decision support (DS), electronic clinical documentation (ECD), and results viewing (RV). We view OEM and DS as primary clinical functions and ECD and RV as support clinical functions. Our results show that no single combination of applications uniformly improves clinical and experiential quality and reduces cost for all hospitals. Thus, managers must assess which HIT interactions improve which performance metric under which conditions. Our results suggest that synergies can be realized when these systems are implemented simultaneously. Additionally, synergies can occur when support HIT is implemented before primary HIT and irrespective of the order in which primary HITs are implemented. Practitioners should also be aware that the synergistic effects of HITs and their impact on cost and quality are different for chronic and acute diseases. Our key message to top managers is to prioritize different combinations of HIT contingent on the performance variables they are targeting for their hospitals but also to realize that technology may not impact all outcomes.
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Affiliation(s)
- Abhay Nath Mishra
- Debbie and Jerry Ivy College of Business, Information Systems & Business Analytics, Iowa State University, Ames, Iowa 50011
| | - Youyou Tao
- College of Business Administration, Information Systems & Business Analytics, Loyola Marymount University, Los Angeles, California 90045
| | - Mark Keil
- J. Mack Robinson College of Business, Department of Computer Information Systems, Georgia State University, Atlanta, Georgia 30303
| | - Jeong-ha (Cath) Oh
- Department of Computer Information Systems, Georgia State University, Atlanta, Georgia 30302
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Zhai H, Yang X, Xue J, Lavender C, Ye T, Li JB, Xu L, Lin L, Cao W, Sun Y. Radiation Oncologists' Perceptions of Adopting an Artificial Intelligence-Assisted Contouring Technology: Model Development and Questionnaire Study. J Med Internet Res 2021; 23:e27122. [PMID: 34591029 PMCID: PMC8517819 DOI: 10.2196/27122] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 07/07/2021] [Accepted: 07/27/2021] [Indexed: 01/07/2023] Open
Abstract
Background An artificial intelligence (AI)–assisted contouring system benefits radiation oncologists by saving time and improving treatment accuracy. Yet, there is much hope and fear surrounding such technologies, and this fear can manifest as resistance from health care professionals, which can lead to the failure of AI projects. Objective The objective of this study was to develop and test a model for investigating the factors that drive radiation oncologists’ acceptance of AI contouring technology in a Chinese context. Methods A model of AI-assisted contouring technology acceptance was developed based on the Unified Theory of Acceptance and Use of Technology (UTAUT) model by adding the variables of perceived risk and resistance that were proposed in this study. The model included 8 constructs with 29 questionnaire items. A total of 307 respondents completed the questionnaires. Structural equation modeling was conducted to evaluate the model’s path effects, significance, and fitness. Results The overall fitness indices for the model were evaluated and showed that the model was a good fit to the data. Behavioral intention was significantly affected by performance expectancy (β=.155; P=.01), social influence (β=.365; P<.001), and facilitating conditions (β=.459; P<.001). Effort expectancy (β=.055; P=.45), perceived risk (β=−.048; P=.35), and resistance bias (β=−.020; P=.63) did not significantly affect behavioral intention. Conclusions The physicians’ overall perceptions of an AI-assisted technology for radiation contouring were high. Technology resistance among Chinese radiation oncologists was low and not related to behavioral intention. Not all of the factors in the Venkatesh UTAUT model applied to AI technology adoption among physicians in a Chinese context.
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Affiliation(s)
- Huiwen Zhai
- Office of Research Management and Education Administration, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Anthropology, School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, China
| | - Xin Yang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Jiaolong Xue
- School of Management, Sun Yat-sen University, Guangzhou, China.,School of Management, Guangdong Ocean University, Zhanjiang, China
| | - Christopher Lavender
- Office of Research Management and Education Administration, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Tiantian Ye
- School of Medicine, Southern University of Science and Technology, Shenzhen, China
| | - Ji-Bin Li
- Department of Clinical Research, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Lanyang Xu
- Department of Anthropology, School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, China
| | - Li Lin
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Weiwei Cao
- Management Office of Huangpu Campus, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Ying Sun
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
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Setia P, Menon N, Srinivasan SS. EHR application portfolio and hospital performance: Effects across hospitals with varying administrative scale and clinical complexity. INFORMATION & MANAGEMENT 2020. [DOI: 10.1016/j.im.2020.103383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Singh R, Mindel V, Mathiassen L. IT-Enabled Revenue Cycle Transformation in Resource-Constrained Hospitals: A Collaborative Digital Options Inquiry. J MANAGE INFORM SYST 2017. [DOI: 10.1080/07421222.2017.1373005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
In recent years, the potential use of mobile devices has significantly positively impacted healthcare globally. Despite global claims of widespread use of mobile devices in healthcare, its adoption in the Australian healthcare context is slow. Limited research is available on slow adoption of mobile devices in the Australian healthcare context. Therefore, this chapter is designed to investigate the factors influencing adoption of mobile devices from healthcare professionals' perspective and develop a health specific conceptual framework. The influential factors for the adoption of mobile devices in the Australian health context may be intention, individual readiness, advantages, safety issues, features, self-efficacy, complexity, training, compatibility, social influences, age and gender.
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Bani-Issa W, Al Yateem N, Al Makhzoomy IK, Ibrahim A. Satisfaction of health-care providers with electronic health records and perceived barriers to its implementation in the United Arab Emirates. Int J Nurs Pract 2016; 22:408-16. [PMID: 27481126 DOI: 10.1111/ijn.12450] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 02/29/2016] [Accepted: 04/10/2016] [Indexed: 11/29/2022]
Abstract
The integration of electronic health records (EHRs) has shown promise in improving health-care quality. In the United Arab Emirates, EHRs have been recently adopted to improve the quality and safety of patient care. A cross-sectional survey of 680 health-care providers (HCPs) was conducted to assess the satisfaction of HCPs in the United Arab Emirates with EHRs' impact on access/viewing, documentation and medication administration and to explore the barriers encountered in their use. Data were collected over 6 months from April to September 2014. High overall satisfaction with EHRs was reported by HCPs, suggesting their acceptance. Physicians reported the greatest overall satisfaction with EHRs, although nurses showed significantly higher satisfaction with the impact on medication administration compared with other HCPs. The most significant barriers reported by nurses were lack of belief in the value of EHRs for patients and lack of adequate computer skills. Given the large investment in technology, additional research is necessary to promote the full utilization of EHRs. Nurses need to be aware of the value of EHRs for patient care and be involved in all stages of EHR implementations to maximize its meaningful use for better clinical outcomes.
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Affiliation(s)
- Wegdan Bani-Issa
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Nabeel Al Yateem
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Ibtihal Khalaf Al Makhzoomy
- Nursing Program, Fatima College of Health Sciences, Abu Dhabi, United Arab Emirates.,School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia
| | - Ali Ibrahim
- College of Business Administration/Marketing Department, Griffith University, Brisbane, Queensland, Australia
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Ayatollahi H, Nazemi Z, Haghani H. Patient Accounting Systems: Are They Fit with the Users' Requirements? Healthc Inform Res 2016; 22:3-10. [PMID: 26893945 PMCID: PMC4756055 DOI: 10.4258/hir.2016.22.1.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 12/11/2015] [Accepted: 12/16/2015] [Indexed: 11/25/2022] Open
Abstract
Objectives A patient accounting system is a subsystem of a hospital information system. This system like other information systems should be carefully designed to be able to meet users' requirements. The main aim of this research was to investigate users' requirements and to determine whether current patient accounting systems meet users' needs or not. Methods This was a survey study, and the participants were the users of six patient accounting systems used in 24 teaching hospitals. A stratified sampling method was used to select the participants (n = 216). The research instruments were a questionnaire and a checklist. The mean value of ≥3 showed the importance of each data element and the capability of the system. Results Generally, the findings showed that the current patient accounting systems had some weaknesses and were able to meet between 70% and 80% of users' requirements. Conclusions The current patient accounting systems need to be improved to be able to meet users' requirements. This approach can also help to provide hospitals with more usable and reliable financial information.
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Affiliation(s)
- Haleh Ayatollahi
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Nazemi
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Haghani
- Department of Biostatistics, School of Health, Iran University of Medical Sciences, Tehran, Iran
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Bardhan I, Oh JH(C, Zheng Z(E, Kirksey K. Predictive Analytics for Readmission of Patients with Congestive Heart Failure. INFORMATION SYSTEMS RESEARCH 2015. [DOI: 10.1287/isre.2014.0553] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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11
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Karimi F, Poo DC, Tan YM. Clinical information systems end user satisfaction: The expectations and needs congruencies effects. J Biomed Inform 2015; 53:342-54. [PMID: 25542853 DOI: 10.1016/j.jbi.2014.12.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Revised: 11/27/2014] [Accepted: 12/15/2014] [Indexed: 10/24/2022]
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Information technology strategy and alignment issues in health care organizations. Health Care Manage Rev 2013; 38:188-200. [PMID: 22722318 DOI: 10.1097/hmr.0b013e31826119d7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Information technology (IT) plays a key role in public health care management because it could improve quality, efficiency, and patient care. Researchers and practitioners repeatedly contend that a health care organization's information systems strategy should be aligned with its objectives and strategies, a notion commonly known as IT alignment. PURPOSE Actor-related IT alignment issues in health care institutions were explored in this study. More specifically, it explores the possibility of moving beyond the current IT alignment perspective and, in so doing, explores whether IT alignment-as currently conceptualized in the dominant body of research-is sufficient for attaining improved quality, efficiency, and patient care in health care organizations. METHODS The findings are based on a qualitative and longitudinal study of six health care organizations in the Stockholm metropolitan area. The empirical data were gathered over the 2005-2011 period from interviews, a focus group, observations, and archival material. FINDINGS The data suggest recurrent misalignments between IT strategy and organizational strategy and operations due to the failure to deconstruct the IT artifact and to the existence of various levels of IT maturity. CONCLUSIONS A more complex picture of IT alignment in health care that goes beyond the current perspective is being offered by this study. It argues that the previously common way of handling IT as a single artifact and applying one IT strategy to the entire organizational system is obsolete. MANAGERIAL IMPLICATIONS: The article suggests that considerable benefits can be gained by assessing IT maturity and its impact on IT alignment. The article also shows that there are different kinds of IT in medical care that requires diverse decisions, investments, prioritizations, and implementation approaches.
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Papathanassopoulos F, Kounetas K, Skuras D. Medical Equipment Adoption in Greek Hospitals: The Case of CT Scanners. JOURNAL OF HEALTH MANAGEMENT 2013. [DOI: 10.1177/0972063413489002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The paper aims to unravel the elements which constitute the decision-making process concerning new medical technologies in the context of the Greek Health System, where there are more than one decision makers. Computerized tomography is used as a case study. Using a unique data setting that refers to the total number of the Greek Public Hospitals, the pattern of adoption is outlined. At the second stage, data is associated with regional and geographical characteristics as well as information related to the hospital efficiency. A probit model is used for the factor analysis and a survival function hazard model for time to adopt. Results indicate that the models used are suitable for examining the factors influencing the adoption of medical technologies as well as the time that such technologies are adopted. It was found that the size of the hospital and its plenitude positively influence not only the probability of adoption but also the time of adoption of computerized tomography. Findings are encouraging; they support the use of the model in studying the adoption of other medical technologies too and can be used also as a tool by policy makers to assist the process of investment in new health technologies.
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Olson JR, Belohlav JA, Cook LS. A Rasch model analysis of technology usage in Minnesota hospitals. Int J Med Inform 2012; 81:527-38. [DOI: 10.1016/j.ijmedinf.2012.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Revised: 01/08/2012] [Accepted: 01/23/2012] [Indexed: 11/26/2022]
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Ven K, Verelst J. A Qualitative Study on the Organizational Adoption of Open Source Server Software. INFORMATION SYSTEMS MANAGEMENT 2012. [DOI: 10.1080/10580530.2012.687305] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Shea CM, Weiner BJ, Belden CM. Using Latent Class Analysis to Identify Sophistication Categories of Electronic Medical Record Systems in U.S. Acute Care Hospitals. SOCIAL SCIENCE COMPUTER REVIEW 2012; 31:10.1177/0894439312448726. [PMID: 24244071 PMCID: PMC3826986 DOI: 10.1177/0894439312448726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Many believe that electronic medical record systems hold promise for improving the quality of health care services. The body of research on this topic is still in the early stages, however, in part because of the challenge of measuring the capabilities of electronic medical record systems. The purpose of this study was to identify classes of Electronic Medical Record (EMR) system sophistication in hospitals as well as hospital characteristics associated with the sophistication categories. The data used were from the American Hospital Association (AHA) and the Health Information Management and Systems Society (HIMSS). The sample included acute care hospitals in the United States with 50 beds or more. We used latent class analysis to identify the sophistication classes and logistic regression to identify relationships between these classes and hospital characteristics. Our study identifies cumulative categories of EMR sophistication: ancillary-based, ancillary/data aggregation, and ancillary-to-bedside. Rural hospital EMRs are likely to be ancillary-based, while hospitals in a network are likely to have either ancillary-based or ancillary-to-bedside EMRs. Future research should explore the effect of network membership on EMR system development.
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Affiliation(s)
- Christopher M Shea
- Department of Health Policy and Management, University of North Carolina-Chapel Hill
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Pynoo B, Devolder P, Duyck W, van Braak J, Sijnave B, Duyck P. Do hospital physicians' attitudes change during PACS implementation? A cross-sectional acceptance study. Int J Med Inform 2011; 81:88-97. [PMID: 22071012 DOI: 10.1016/j.ijmedinf.2011.10.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Revised: 10/13/2011] [Accepted: 10/16/2011] [Indexed: 11/19/2022]
Abstract
PURPOSE The purpose of this study is to gain a better insight into the reasons why hospital physicians accept and use a Picture Archiving and Communication System (PACS). Two research questions are put forward, pertaining to (1) factors that contribute to physicians' acceptance of PACS, and (2) whether these factors change as physicians gain experience in using PACS. METHODS Questionnaires were administered at three moments in time during the PACS implementation process in a private hospital: just before its introduction (T1), four months later (T2), and about fifteen months after the introduction of PACS (T3). The Unified Theory of Acceptance and Use of Technology was chosen as the theoretical framework for this study. Hence, the following scales were measured: performance expectancy, effort expectancy, social influence, facilitating conditions, behavioral intention, and self-reported frequency of use. RESULTS Forty-six usable responses were obtained at T1, 52 at T2 and 61 at T3. Three variables directly influenced PACS acceptance (measured as behavioral intention and use of PACS): effort expectancy, performance expectancy, and social influence; and their influence evolved over time. Effort expectancy was of particular importance at T1, whereas performance expectancy influenced acceptance at T2 and T3; social influence was the only consistent predictor of PACS acceptance at all times. Variance explained in behavioral intention ranged from .26 at T1 to .58 at T3. CONCLUSIONS In this setting, the main motivation for physicians to start using PACS is effort expectancy, whereas performance expectancy only becomes important after the physicians started using PACS. It is also very important that physicians perceive that their social environment encourages the use of PACS.
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Affiliation(s)
- Bram Pynoo
- Ghent University Hospital, Radiology and Medical Imaging, Belgium.
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Abstract
The purpose of this study was to explore the status of e-healthcare maturity in Taiwan following a nationwide investigation sponsored by the Department of Health. Based on Nolan's stage model and related studies, we propose a multidimensional model to gain a better understanding of the current status of e-healthcare maturity in hospitals. The target subjects included every hospital in Taiwan. A total of 538 hospitals were successfully interviewed, showing a high response rate of 94.4%. The results indicate that the overall e-healthcare maturity of Taiwanese hospitals is fairly high. Such a high degree of maturity is critical for formulating e-healthcare policy to stimulate the exchange of electronic medical record. This article provides a brief comparison of the situation in other countries and posits that Taiwan holds a position of relative maturity in the world of e-healthcare development.
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Affiliation(s)
- Chung-Feng Liu
- Department of Information Management, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan.
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Falan S, Han B. Moving towards efficient, safe, and meaningful healthcare: issues for automation. INTERNATIONAL JOURNAL OF ELECTRONIC HEALTHCARE 2011; 6:76-93. [PMID: 21406353 DOI: 10.1504/ijeh.2011.039060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Correcting problems in healthcare delivery has become a top priority in the USA due to skyrocketing insurance costs and fast growth in national healthcare spending. This paper is aimed at examining how Health Information Technology (HIT) could be used to help the USA move towards efficient, safe, and meaningful healthcare. Our study is focused on healthcare needs in three areas: documentation, standardisation, and design and implementation. Urgent research issues in each area are presented. Our findings maintain that unique needs in the diverse healthcare environments must be incorporated into the convergent HIT system.
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Affiliation(s)
- Sharie Falan
- Bronson School of Nursing, College of Health and Human Services, Western Michigan University, 1903 W. Michigan Avenue, Kalamazoo, MI 49008-5345, USA.
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Mäkelä K, Virjo I, Aho J, Kalliola P, Kurunmäki H, Uusitalo L, Valli M, Ylinen S. Management of Electronic Patient Record Systems in Primary Healthcare in a Finnish County. Telemed J E Health 2010; 16:1017-23. [PMID: 21058891 DOI: 10.1089/tmj.2010.0031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Kari Mäkelä
- Department of Biomedical Engineering, Tampere University of Technology, Seinäjoki, Finland
- Hospital District of South Ostrobothnia, Seinäjoki, Finland
| | - Irma Virjo
- Hospital District of South Ostrobothnia, Seinäjoki, Finland
- Medical School, University of Tampere, Tampere, Finland
| | - Juhani Aho
- Jalasjärvi Health Centre, Jalasjärvi, Finland
| | | | | | | | | | - Suvi Ylinen
- Inter-Municipal Health Centre of Kuusiokunnat, Finland
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Agarwal R, Gao G(G, DesRoches C, Jha AK. Research Commentary—The Digital Transformation of Healthcare: Current Status and the Road Ahead. INFORMATION SYSTEMS RESEARCH 2010. [DOI: 10.1287/isre.1100.0327] [Citation(s) in RCA: 465] [Impact Index Per Article: 33.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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An examination of the antecedents and consequences of organizational IT innovation in hospitals. JOURNAL OF STRATEGIC INFORMATION SYSTEMS 2010. [DOI: 10.1016/j.jsis.2010.07.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Standing S, Standing C. Mobile technology and healthcare: the adoption issues and systemic problems. ACTA ACUST UNITED AC 2009; 4:221-35. [PMID: 19174359 DOI: 10.1504/ijeh.2008.022661] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Although the benefits that are associated with mobile technology have been recognised as offering great potential in the healthcare sector, its widespread adoption has been lagging. We propose that fundamental systemic issues are likely to be the main barriers to adoption. We explain that the fragmented nature of the conservative healthcare system, the contradictory incentives and improper outcome measures conspire to make the innovative adoption of mobile technology problematic. Researchers can only gain a limited understanding of a technology's potential success by using technology adoption frameworks and need to supplement this with a 'systems' perspective that takes a more strategic view.
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Affiliation(s)
- Susan Standing
- School of Management, Edith Cowan University, 100 Joondalup Drive, Joondalup, Western Australia, Australia.
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Menachemi N, Brooks RG, Schwalenstocker E, Simpson L. Use of health information technology by children's hospitals in the United States. Pediatrics 2009; 123 Suppl 2:S80-4. [PMID: 19088234 DOI: 10.1542/peds.2008-1755f] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The purpose of this study was to examine the adoption of health information technology by children's hospitals and to document barriers and priorities as they relate to health information technology adoption. METHODS Primary data of interest were obtained through the use of a survey instrument distributed to the chief information officers of 199 children's hospitals in the United States. Data were collected on current and future use of a variety of clinical health information technology and telemedicine applications, organizational priorities, barriers to use of health information technology, and hospital and chief information officer characteristics. RESULTS Among the 109 responding hospitals (55%), common clinical applications included clinical scheduling (86.2%), transcription (85.3%), and pharmacy (81.9%) and laboratory (80.7%) information. Electronic health records (48.6%), computerized order entry (40.4%), and clinical decision support systems (35.8%) were less common. The most common barriers to health information technology adoption were vendors' inability to deliver products or services to satisfaction (85.4%), lack of staffing resources (82.3%), and difficulty in achieving end-user acceptance (80.2%). The most frequent priority for hospitals was to implement technology to reduce medical errors or to promote safety (72.5%). CONCLUSION This first national look at health information technology use by children's hospitals demonstrates the progress in health information technology adoption, current barriers, and priorities for these institutions. In addition, the findings can serve as important benchmarks for future study in this area.
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Affiliation(s)
- Nir Menachemi
- aDepartment of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
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Menachemi N, Randeree E, Burke DE, Ford EW. Planning for Hospital IT Implementation: A New Look at the Business Case. BIOMEDICAL INFORMATICS INSIGHTS 2008; 1:29-44. [PMID: 27429553 PMCID: PMC4943043 DOI: 10.4137/bii.s1035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Compared to organizations in other industries, hospitals are slow to adopt information technology (IT). Those planning for system implementation must understand the barriers to IT adoption which, in healthcare, include the relatively high acquisition and maintenance costs of sophisticated administrative and clinical information systems. Understanding the overall business case is particularly important for hospital IT planners. This paper describes the literature that examines benefits from using health IT. In addition, we focus on a series of studies conducted in Florida that provide generalizable evidence regarding the overall business case associated with hospital adoption for information systems. These studies focus broadly on the improved financial, operational, and clinical performance associated with IT.
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Affiliation(s)
- Nir Menachemi
- UAB School of Public Health, 1530 3rd Ave. South, Birmingham, AL 35294
| | - Ebrahim Randeree
- Florida State University College of Information, 101 Louis Shores Bldg, Tallahassee, FL 32306-2100
| | - Darrell E. Burke
- UAB School of Health Professions, 1530 3rd Ave. South, Birmingham, AL 35294
| | - Eric W. Ford
- Texas Tech University, Center for Health Innovation Education and Research, Box 42101, Lubbock, TX 79409-2101
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