Information technology issues in healthcare: Hospital CEO and CIO perspectives.

Healthcare Information Technology (HIT) is widely regarded as a key to improving the quality of healthcare in the United States and potentially reducing its cost. Yet, its implementation is a continuous challenge for the healthcare industry. In this article, we report the results of a survey distributed to CEOs and CIOs at 1400 U.S. hospitals regarding their perceptions of the key information technology (IT) issues in healthcare. Among the top ten issues, the implementation of electronic medical records is ranked the highest. Included in the top ten are issues related to: improving healthcare quality by the use of information technology; change management, privacy, security, and accuracy of electronic records; and decision support applications. While some differences existed, we found much similarity between the views of the CEOs and the CIOs with both groups being characterized as conservative and risk-averse in their entrepreneurial orientation. No major differences were observed between urban and rural hospitals, or large and small hospitals. Given the heightened interest in healthcare IT, these results have wide implications for many stakeholders in this burgeoning industr

Information Technology Issues in Healthcare: Hospital CEO and CIO Perspectives

Healthcare Information Technology (HIT) is widely regarded as a key to improving the quality of healthcare in the United States and potentially reducing its cost. Yet, its implementation is a continuous challenge for the healthcare industry. In this article, we report the results of a survey distributed to CEOs and CIOs at 1400 U.S. hospitals regarding their perceptions of the key information technology (IT) issues in healthcare. Among the top ten issues, the implementation of electronic medical records is ranked the highest. Included in the top ten are issues related to: improving healthcare quality by the use of information technology; change management, privacy, security, and accuracy of electronic records; and decision support applications. While some differences existed, we found much similarity between the views of the CEOs and the CIOs with both groups being characterized as conservative and risk-averse in their entrepreneurial orientation. No major differences were observed between urban and rural hospitals, or large and small hospitals. Given the heightened interest in healthcare IT, these results have wide implications for many stakeholders in this burgeoning industry

Healthcare Information Technology Issues: Hospital CEO and CIO Perspectives

Healthcare Information Technology (IT) is widely regarded as a tool for improving the quality and perhaps reducing the cost of healthcare in the United States. Yet, its implementation is a continuous challenge for the healthcare industry. In this paper, we report the results of a survey distributed to CEOs and CIOs at 1400 U.S. hospitals regarding their perceptions of the key information technology (IT) issues for healthcare. Among the top ten issues, the implementation of electronic medical records is ranked the highest. Included in the top ten are issues related to: improving healthcare quality by the use of information technology; change management, privacy, security, and accuracy of electronic records; and decision support applications. We found remarkable similarity between the views of the CEOs and the CIOs, but they were also conservative and risk-averse in their entrepreneurial orientation. These results have wide implications for many stakeholders in the healthcare domain

Outsourcing in Western Australian hospitals: Management considerations

This thesis examines Health Care Managers\u27 considerations with and experiences of outsourcing services in Western Australian hospitals. Support services such as cleaning and maintenance are some of the areas which have been targeted for outsourcing (contracting out) by the state government. These services have traditionally been delivered by permanently employed staff either on a full or part- time basis, usually with active union involvement. Core services such as nursing and medical care which involve direct patient care delivery are not included in the outsourcing debate. Firstly, this thesis reviews the literature on outsourcing and its application to the health care industry. Performance indicators and benchmarking are also explored within the context of contracted out services in a variety of settings. The implicit economic, social and legal implications are discussed. This study involved Health Care Managers in Western Australian hospitals and was conducted between June 1995 and May 1996. Their experiences with outsourcing of services together with the hospitals and the communities they served were key considerations in the final analysis. The research findings support the views of more recent studies which emphasize the importance of the context within which outsourcing is implemented, such as rural versus metropolitan hospitals. Hospital size, location, accessibility to contractors, human resource issues and funding arrangements such as those which affect teaching and non- teaching facilities were identified as major determinants affecting the degree to which outsourcing had been embraced. Finally, the implications of this research for future studies are discussed

Globalization, skilled migration and poverty alleviation: brain drains in context

The debate on the ‘brain drain’, or the emigration of skilled workers, is not new but it has taken on greater urgency in the context of a globalizing economy and ageing societies. Today, the developed world is perceived as poaching the best and the brightest from the developing world, thus prejudicing those countries of their chance of development. This paper starts with two guarded caveats: first, that any brain drain is as much internal within any country as it is among countries and, second, that the skilled migration system should not be seen in isolation from other types of migration. The paper reviews the data available for the analysis of skilled migration and identifies the main global trends. It goes on to examine the globalization of education and of health as reflected in the movement of students and health personnel. Large numbers of people from developing countries are being trained overseas and, of those trained at home, many cannot be absorbed productively into their economies of origin. The paper examines the case for a two-tiered health training system, one for global markets and the other for local markets. Retention and return of the skilled are examined through the potential for outsourcing in both education and health care. However, the association between the presence or absence of health personnel and the health status of a population is seen as simplistic. The paper concludes with an examination of policy contradictions within the global system towards skilled migration and offers pointers towards a more integrated approach

Estimating the Economic Impact of Telemedicine in a Rural Community

One commonly discussed benefit of broadband access in rural America is the potential for telemedicine visits that allow rural residents to take advantage of urbanized medical services. While the primary benefit of telemedicine is often viewed as improved health care access, the availability of these services also offers significant economic contributions to the local community. Site visits to 24 rural hospitals of varying size over a four-state area in the Midwest provide information to develop a methodology for estimating telemedicine’s economic impact. Using this technique, telemedicine services contribute between $20,000 and$1.3M annually to these local economies, with an average of $522,000.telemedicine, economic impact, teleradiology, telepsychiatry, Community/Rural/Urban Development, Health Economics and Policy,

Payments and Quality of Ante-Natal Care in Two Rural Districts of Tanzania

This paper surveys women’s experiences with payments for ante-natal care (ANC) and associated issues of quality in two rural districts of Tanzania. We draw on quantitative and qualitative data from interviews in facilities and in households in the two districts to explore these issues, and discuss some policy implications. The paper provides evidence of payments for ANC in the two rural districts. Striking differences in payments between the two districts were observed, apparently reflecting variation in charging practices in different parts of the districts. In the areas surveyed in one district, women were paying little, in both faith-based organisations (FBOs) and in the public sector. In the other district, charges were much higher in facilities that women had attended, including a district hospital and a public dispensary that seemed to have gone into business on its own account. We explore to what extent these higher charges were associated with better-quality care: The women in the higher-charging district had in general received somewhat higher levels of service than the women interviewed in the lower-charging district, with the notable exception of a low-charging FBO-owned hospital that was succeeding in combining low and predictable charges with good services. In both districts, we found few reports of abuse at the ANC level – this appears to be more a problem at birth. The main quality issues at this level are lack of basic ANC services in some of the public health facilities, and having to pay for ANC even in some of the public facilities where these services are supposed to be provided for free. However, the problem of supply shortages seems to have generated a system of informal charging in some contexts. Sale of assets and borrowing to pay for ANC means impoverishment in order to access a payment-exempted service. We also found that health insurance appears to be creating or supporting a culture of charging for ANC. ANC accessible to all women is a key requirement for improved maternal survival. The findings discussed in this paper suggest the need for a more concerted effort to implement effectively strategies that are already in place, and to come up with other alternative strategies that may result into better outcomes. Such strategies should not be considered in isolation, but should be part of effective strategies to improve all aspects of maternal health. Furthermore, an emerging problem needs to be looked into, and appropriate action taken. Health insurance, which is intended to promote access to health care for the poor, seems in this case to be creating a contrary effect by exacerbating the problem of payments for services that should be exempted from payment.\u

Outsourcing or insourcing: a case study of regional hospitals in public health within eThekwini District.

Masters Degree. University of KwaZulu-Natal, Durban.Outsourcing has been adopted by public health to improve the efficiency and quality of health care services. Essentially, outsourcing of services such as catering, believed to be a non-core function, has become vital element to afford management time to focus on improving performance on the clinical function. Traditionally, non-core services have been rendered in-house and thus the role of government as the employer and service provider has been altered. Many countries in the world, including South Africa, have come under pressure resulting from scarce financial resources, increased patient demands, high unemployment, and increased health care costs. Thus, the need to control expenditure and provision of high quality service has led hospitals to sought relief from financial pressure by outsourcing non-clinical functions. This study has cross-examined two regional hospitals including Addington and R K Khan situated in EThekwini District to investigate the advantages and disadvantages of outsourcing and insourcing as well as the impact thereof on cost saving, human resource and efficiency in service delivery, specifically in catering services. The study is qualitative in nature and a case study research design is employed to explore whether a relationship existed between outsourcing and insourcing and efficiency. Semi structured interviews were used to collect data. A total number of 14 government officials including managers and employees directly involved with catering in the hospital were interviewed. On one hand, findings from the study show that outsourcing unit displayed added advantage of offering catering services with stable monthly expenditure, improved performance, and quality of service. On the other hand, insourcing unit proved to have an advantage of being the preferred by the employer. The recommendations stemming from the study concludes that if insourcing is to be adopted as a strategy that is efficient and effective, skilled employees should be employed, and a training fund should be allocated for the existing employees and does away with single source supplier of food to allow for better negotiations. For outsourcing, improved conditions of employment should be implemented through clearly stated contract terms and stricter monitoring tools should be implemented. In its final analysis, the study concludes that public health could benefit by marrying the two strategies