Electronic health information exchange in underserved settings: examining initiatives in small physician practices & community health centers.

BackgroundHealth information exchange (HIE) is an important tool for improving efficiency and quality and is required for providers to meet Meaningful Use certification from the United States Centers for Medicare and Medicaid Services. However widespread adoption and use of HIE has been difficult to achieve, especially in settings such as smaller-sized physician practices and federally qualified health centers (FQHCs). We assess electronic data exchange activities and identify barriers and benefits to HIE participation in two underserved settings.MethodsWe conducted key-informant interviews with stakeholders at physician practices and health centers. Interviews were recorded, transcribed, and then coded in two waves: first using an open-coding approach and second using selective coding to identify themes that emerged across interviews, including barriers and facilitators to HIE adoption and use.ResultsWe interviewed 24 providers, administrators and office staff from 16 locations in two states. They identified barriers to HIE use at three levels-regional (e.g., lack of area-level exchanges; partner organizations), inter-organizational (e.g., strong relationships with exchange partners; achieving a critical mass of users), and intra-organizational (e.g., type of electronic medical record used; integration into organization's workflow). A major perceived benefit of HIE use was the improved care-coordination clinicians could provide to patients as a direct result of the HIE information. Utilization and perceived benefit of the exchange systems differed based on several practice- and clinic-level factors.ConclusionsThe adoption and use of HIE in underserved settings appears to be impeded by regional, inter-organizational, and intra-organizational factors and facilitated by perceived benefits largely at the intra-organizational level. Stakeholders should consider factors both internal and external to their organization, focusing efforts in changing modifiable factors and tailoring HIE efforts based on all three categories of factors. Collective action between organizations may be needed to address inter-organizational and regional barriers. In the interest of facilitating HIE adoption and use, the impact of interventions at various levels on improving the use of electronic health data exchange should be tested

Applying Theoretical Frameworks to Explicate Physician Acceptance of Computerized Physician Order Entry (CPOE)

This paper reports the findings of a pilot study undertaken to ascertain the feasibility of incorporating the Theory of Planned Behavior and the Taxonomy of Work Values into the explanation of physician technology acceptance of a new organizational technology – Computerized Physician Order Entry (CPOE). While Davis’s Technology Acceptance Model has received much empirical support, we posit that certain complexities associated with the physician population and the hospital environment warrant the inclusion of other theoretical models as a means of furthering our understanding of technology acceptance. Although preliminary in nature, this study finds support for the inclusion of both the Theory of Planned Behavior and the Taxonomy of Work Values in further research examining this complex phenomenon

Smartphones

Many of the research approaches to smartphones actually regard them as more or less transparent points of access to other kinds of communication experiences. That is, rather than considering the smartphone as something in itself, the researchers look at how individuals use the smartphone for their communicative purposes, whether these be talking, surfing the web, using on-line data access for off-site data sources, downloading or uploading materials, or any kind of interaction with social media. They focus not so much on the smartphone itself but on the activities that people engage in with their smartphones

UNDERSTANDING THE DRIVERS AND CONSEQUENCES OF INTERACTIVE INNOVATION ADOPTION IN HEALTH AND MEDICINE

Providing technologies and services to enable collaboration and communication is a vital concern for information scientists and organizational leaders supporting communities of professionals in research-intensive health care environments. Innovative information practices and technologies—which may include mobile and social-media based technologies, new electronic records systems, new data management practices, and new communication procedures—are developed and introduced, often at considerable cost, with the goal of supporting and enhancing information sharing. However, at times these innovations fail to be adopted by their intended user communities, or adoption leads to unforeseen negative consequences for information sharing within the social environment. The health care sector in particular, while often characterized as generally innovative, has at times been slow to adopt new information innovations. This is a seeming paradox for innovation adoption studies, in which innovativeness is typically treated as synonymous with being among the first to adopt an innovation. This research was conducted in order to better understand the factors that influence or impede interactive innovation adoption in research-intensive health care environments. A four quadrant model, the Pollock Model of Interactive Innovation Adoption (PMIIA) was created and tested in a study of innovation adoption among physicians in training at an academic medical center in the southern United States. Factors from all four quadrants of the model were found to be related to either adoption decisions or perceptions of innovations. Additionally, both personal and professional values were found to play a role in participants\u27 adoption and use of the innovations

Examining Rural Adoption Of Broadband – Critical Realist Perspectives

Broadband infrastructure is currently being implemented throughout Australia as part of a government funded National Broadband Network (NBN). Ultimately successful universal provision will require that metropolitan installations subsidize rural adoption. It is important for the success of the project that rural adoption is maximized. This will require an understanding of the complex social, political and technical aspects affecting the adoption process for rural regions. The paper argues that critical realism can provide a useful meta-theoretical position to examine the important social and physical aspects of the adoption process. Drawing on the work of Raduescu and Vessey (2008) on critical realist explanatory frameworks, it supports using 3 commonly used critical realist frameworks to guide the examination process – that of Pawson and Tilley (2007) and Danermark et al. (2002), together with Archer’s (1995, 1998) morphogenetic model as the meta theory that underpins the examination. The frameworks and model are introduced briefly and examples provided as to how they can contribute to the examination of the rural broadband adoption process

Instant Messaging and Employee\u27s Performance: A Text Mining Approach

The adoption of Instant Messaging (IM) applications in the workplace remains contentious due to difficulties in adequately quantifying organizational benefits and how it affects individual performance. Previous research on the impact of IM usage on employee performance has been limited to analyzing primary data (i.e., survey methods), making it difficult to extrapolate the findings to a constantly changing workplace. In contrast, we investigate the relationships between these individuals\u27 IM usage at the workplace and their primary assessment metric in their organization, performance evaluation, using longitudinal data of employees\u27 IM activities and their performance evaluation collected from a US Fortune 500 financial company. Using cutting-edge text-mining techniques, we identify the primary purposes of IM utilization in organizations and assess the impact of those attributes on employee performance. Our findings show that IM in the workplace can improve team communication, knowledge-sharing experience, and social networking among employees, but it can also be disruptive. However, the combined effect of team communication and knowledge sharing on employee performance can overshadow the negative impact of IM interruption on employee performance

An evaluation study of the core courses of the master's degree in training and development with alignment of globalization

Includes bibliographical references

Relationship of Transformational Leadership and Organizational Change During Enterprise Agile and DevOps Initiatives In Financial Service Firms

The rate of organizations adopting Agile and DevOps methodologies has grown in recent years, with researchers observing the impact of leadership styles and methodology adoption, presenting challenges with sustaining and scaling change initiatives. Where organizations within the marketplace today reveal the significance of leadership in influencing change, while findings signal deficiencies with having leaders who are ready. The purpose of this quantitative correlational research examines the increased probability of failure organizations face when engaging in enterprise Agile and DevOps transformational change initiatives. Through investigating the relationship between transformational leadership behaviors, readiness for change, and organizational citizenship behavior exhibited by management and employees engaging in Agile and DevOps initiatives within regional financial services companies with a presence in the South Eastern United States. The resulting study surveyed 390 anonymous participants with varying backgrounds and organizational roles based upon predetermined quota constraints aligning with the Bureau of Labor Statistics, U.S. Census, and FDIC data. Utilizing three principal instruments to measure transformational leadership, change readiness, and organizational citizenship behavior; conducting statistical analysis for construct reliability, descriptive properties, and hypothesis testing, concluding the existence of influential correlation of change readiness and organizational citizenship behaviors having a relationship with transformational leadership. The research findings identify the association of organizational readiness and employee social citizenship responsibility with applicability to transformational leadership, bringing light to the significance of grooming and sustaining leaders at all levels of the organization