The everyday ethics of field work research with vulnerable patients.

Patients are increasingly involved in health informatics research. Researchers are always aware of the ethical dimensions of their research, but studies in the field with patients--especially among the frail, elderly, cognitively impaired--present specific additional 'everyday moral dilemmas'. Reflecting on experiences of a hospital study of patients with dementia, this paper draws attention on the type and constant presence of this situated ethics, the immediacy of decision-making, and the importance of everyday ethics for health informatics

Preemptive restorying as a means of mitigating costly conflict : the case of the Anglican Mission in American and the Anglican Church of Rwanda

https://place.asburyseminary.edu/ecommonsatsdissertations/1910/thumbnail.jp

A Delphi Study Analysis of Best Practices for Data Quality and Management in Healthcare Information Systems

Healthcare in the US continues to suffer from the poor data quality practices processes that would ensure accuracy of patient health care records and information. A lack of current scholarly research on best practices in data quality and records management has failed to identify potential flaws within the relatively new electronic health records environment that affect not only patient safety but also cost, reimbursements, services, and most importantly, patient safety. The focus of this study was to current best practices using a panel of 25 health care industry data quality experts. The conceptual lens was developed from the International Monetary Fund\u27s Data Quality Management model. The key research question asked how practices contribute to identifying improvements healthcare data, data quality, and integrity. The study consisted of 3 Delphi rounds. Each round was analyzed to identify consensus on proposed data quality strategies from previous rounds that met or exceeded the acceptance threshold to construct subsequent round questions. The 2 best practices identified to improve data collection were user training and clear processes. One significant and unanticipated finding was that the previous gold standard practices have become outdated with technological advances, leading to a higher potential for flawed or inaccurate patient healthcare data. There is an urgent need for health care leaders to maintain heightened awareness of the need to continually evaluate data collection and management policies, particularly as technology advances such as artificial intelligence matures. Developing national standards to address accurate and timely management of patient care data is critical for appropriate health care delivery decisions by health care providers

RESEARCH ETHICS AND CONSENT ON THE COLLECTION AND USE OF HUMAN BIOLOGICAL MATERIALS: A SINGAPORE PERSPECTIVE

Ph.DDOCTOR OF PHILOSOPH

Strategies Among Health Care Business Professionals to Increase Productivity and Revenue

Health care business professionals have been slow to implement electronic medical records (EMRs), although this is a federal requirement tied to reimbursement from Medicare and Medicaid. Guided by the conceptual framework of the technology acceptance model (TAM), the purpose of this single-case study was to explore EMR strategies that health care business professionals use to increase productivity and revenue. The target population was comprised of health care business professionals with EMR strategies in Orange County, New York. Methodological triangulation included analysis of semistructured interviews with 7 health care business professionals and review of organizational documents consisting of emails, meeting minutes, and a handbook. The recruitment strategy used was random sampling and snowball sampling. Analysis included compiling data, coding the data by disassembling into categories, and reassembling the data into emergent themes. The findings of the study included 5 themes or strategies focused on EMR implementation, leaders\u27 efforts to support and sustain the EMR, helping users accept the EMR, communication and efficiency for increasing productivity and revenue, and helping users improve health care safety. Health care business organizations can benefit by knowing where to focus their resources, maximizing return on investment. The findings could effect social change by enumerating strategies that businesses can use to improve performance, and productivity for health care business professionals and improve quality, care coordination, and management of population health and safety of health care for patients

Best Practices to Minimize Data Security Breaches for Increased Business Performance

In the United States, businesses have reported over 2,800 data compromises of an estimated 543 million records, with security breaches costing firms approximately $7.2 million annually. Scholars and industry practitioners have indicated a significant impact of security breaches on consumers and organizations. However, there are limited data on the best practices for minimizing the impact of security breaches on organizational performance. The purpose of this qualitative multicase study was to explore best practices technology leaders use to minimize data security breaches for increased business performance. Systems theory served as the conceptual framework for this study. Fourteen participants were interviewed, including 2 technology executives and 5 technical staff, each from a banking firm in the Northcentral United States and a local government agency in the Southcentral United States. Data from semistructured interviews, in addition to security and privacy policy statements, were analyzed for methodological triangulation. Four major themes emerged: a need for implementation of security awareness education and training to mitigate insider threats, the necessity of consistent organization security policies and procedures, an organizational culture promoting data security awareness, and an organizational commitment to adopt new technologies and innovative processes. The findings may contribute to the body of knowledge regarding best practices technology leaders can use for securing organizational data and contribute to social change since secure organizational data might reduce consumer identity theft

Assessing Clinical Software User Needs for Improved Clinical Decision Support Tools

Consolidating patient and clinical data to support better-informed clinical decisions remains a primary function of electronic health records (EHRs). In the United States, nearly 6 million patients receive care from an accountable care organization (ACO). Knowledge of clinical decision support (CDS) tool design for use by physicians participating in ACOs remains limited. The purpose of this quantitative study was to examine whether a significant correlation exists between characteristics of alert content and alert timing (the independent variables) and physician perceptions of improved ACO quality measure adherence during electronic ordering (the dependent variable). Sociotechnical theory supported the theoretical framework for this research. Sixty-nine physician executives using either a Cerner Incorporated or Epic Systems EHR in a hospital or health system affiliated ACO participated in the online survey. The results of the regression analysis were statistically significant, R2 = .108, F(2,66) = 3.99, p = .023, indicating that characteristics of alert content and timing affect physician perceptions for improving their adherence to ACO quality measures. However, analysis of each independent variable showed alert content highly correlated with the dependent variable (p = .007) with no significant correlation found between workflow timing and the dependent variable (p = .724). Understanding the factors that support physician acceptance of alerts is essential to third-party software developers and health care organizations designing CDS tools. Providing physicians with improved EHR-integrated CDS tools supports the population health goal of ACOs in delivering better patient care

The Role of Professional Identity into Explaining Saudi Arabian Healthcare Professional Resistance to Electronic Health Records’ Stratigic Change in Public Hospitals

Electronic Health Record (EHR) is an application that captures patients’ information and promises to improve healthcare services. Hence, many countries, including the developing country, such as Saudi Arabia, invested heavily to implement the system and improve healthcare service delivery. Yet, the system's adoption is slow, and failure is high, which could be related to healthcare professionals’ resistance to change to the EHR applications. Further, despite the importance of the topic of EHR resistance, little research has been conducted in Saudi Arabia regarding healthcare professionals’ resistance to change to EHR. Motivated thus, this research suggested that resistance to EHR in Saudi Arabia results from cultural and professional identity factors, which guide healthcare professionals’ behaviour. Therefore, this research investigated how the professional identity of Saudi healthcare professionals can explain their resistance tousing EHR applications. The study used identity theory as our main theoretical lens along with Hofstede cultural dimension theory and in-depth qualitative interviews to understand the EHR resistance to change phenomenon. Our study has revealed similarities between Saudi and Western healthcare professionals’ factors that could contribute to EHR resistance. However, interestingly, cultural, and religious norms were also found to be one of the leading causes of Saudi healthcare professionals’ resistance to the EHR change. Our theoretical contributions helped us understand the role of identity in EHR use in a place where professionals with a strong professional and cultural identity are the system's main users. In addition, our practical contributions aimed to help the Ministry of Health in Saudi Arabia to understand what healthcare professional needs before adapting an EHR system, or improve the current once. Further, it could help hospital managers address, understand, and solve the challenges facing healthcare professionals as they use the EHR system