Emergency Physicians\u27 Perspectives on the Usability of Health Information Exchange

Emergency physicians are key users of health information exchanges (HIE). Understanding their perspectives on the usability of HIE is important if the full potential of the HIE is to be achieved. The literature identified that emergency physician experiences with HIEs are unexplored areas requiring further studies. The purpose of this study using grounded theory methods was to understand the perspectives of emergency physicians concerning the usability of HIEs. The fundamental question was how do emergency physicians use the HIE in making clinical decisions? Rich and thick data were collected from 15 emergency physicians in four urban hospitals in the mid-south using theoretical sampling and unstructured face-to face interviews. Concepts from the coded segments were developed into categories and an overarching theoretical scheme visualized in a conceptual framework. A substantive theory emerged that using the HIE among emergency physicians is the process of rationalizing non-use and reconciling challenges and benefits. The antecedent of usability was a typical day in the emergency department and why participants accessed the HIE and under what conditions. Six major themes emerged: using the HIE, influencing clinical decisions, struggling with challenges and barriers, recognizing benefits, current views, and rationalizing not using or reduced use of the HIE. Emergency physicians gave good reasons why the HIE is not being used for the majority of patients while reconciling the challenges and benefits of using the HIE to explain the role of HIEs in making clinical decisions. There was a disconnect in the necessity of using the HIE to make clinical decisions and any negative outcomes that may occur in patients from not using the HIE. Generally, emergency physicians viewed the HIE as not being user-friendly and that they probably do not use the HIE as much as they could for making clinical decisions. The perspective of the emergency physicians was the emergency environment is too busy and because the HIE is less than user-friendly as needed by physicians to practice emergency medicine, the HIE disrupts workflow and is a deterrent to consistent usage in making clinical decisions. A better understanding of how emergency physicians decided to use the HIE in making clinical decisions gives insights about how to achieve HIE usability. Satisfied end-users who view the HIE as effective and efficient should use the HIE more. However, this requires removing challenges and barriers while recognizing more benefits to using the HIE, and addressing the underlying reasons for not using the HIE. Understanding the complexities of using the HIE and providing solutions to increase usability of the HIE is necessary to influence greater use of the HIE in clinical decisions with demonstrated positive outcomes for patients

Innovative technology and change management: E-health applications in Canada.

Background Focusing on the Canadian healthcare system, this study explores factors influencing the adoption of recent specialized technology in e-health applications due to concerns about the allocation of economic resources and governmental policy formulation. This study focuses on the specific technologies of the Electronic Medical Record (EMR)-based-Personal Health Record (PHR) and their use by physicians and residents of Northern Ontario. Objectives The primary objective of this study is to understand the interdisciplinary factors that predict Northern residents’ attitude toward EMR-based-PHR innovative technology. Conducting this study also serves to increase awareness of patient-driven e-health in Northern Ontario and provides decision makers with useful quantitative data and strategies to support future initiatives. Methods/Materials Using customized data obtained from the National Physician Survey (NPS) in Canada and primary data collected through an adaptation of this survey, a comparative analysis was conducted to understand the electronic patient-physician relationship and explore interdisciplinary factors regarding perception and use of EMR-based-PHR. The data was analyzed using Descriptive Statistics, Z Test for two Population Proportions, ANOVA and Regression Analysis. Results The results indicate significant differences between Northern physicians and patients in usage and preference regarding several technological applications. More Northern patients use websites, social media and mobile applications than Northern physicians. In capturing health information, fewer physicians exclusively prefer to use electronic records than use a combination of paper charts and electronic records, and most Northern patients prefer either a combination of both methods or exclusively paper charts in their healthcare. Interdisciplinary factors related to EMR-based-PHR were significant predictors and explained 69.6% of the variance in the behavioral attitude and 74.5% of the variance in the behavioral intention to adopt this innovative technology. Conclusions. Establishing an electronic patient-physician relationship in the Canadian healthcare system requires coordinated and concerted efforts from all stakeholders involved in this process. Significant cost without benefits is evidence of a misallocation of Canadian resources and requires increased attention. New strategies must address current gaps in educational, technical, managerial, and financial supports. Physician support, however, is ultimately the key to increasing the adoption rate of EMR and fostering positive attitudes toward PHR among the Canadian people.Doctor of Philosophy (PhD) in Human Studie

Unraveling User Perceptions of Interorganizational Information Sharing

Collecting large amounts of user information is becoming an increasingly important source of value for businesses. Such data sets may be expanded through engaging in value co-creation with other organizations. Sharing user information across organizations, however, might evoke users’ privacy concerns. Existing mechanisms and concepts developed in prior information privacy research on sharing information between one user and one organization may no longer apply as multiple organizations become involved. This creates the necessity to understand more granularly how users perceive privacy situations that involve sharing their information across organizations – and how their concerns may be alleviated through control mechanisms. Employing the lens of Communication Privacy Management (CPM) theory, we conceptualize this phenomenon as Interorganizational Information Sharing (IIS) and theorize on perceived uncertainty and control to unravel user perceptions in IIS. We present our ideas for a research model, as well as our planned methodology for empirical validation

The Path to Health Information Technology Adoption: How Far Have We Reached?

Health Information Technology (HIT) is an overarching framework that describes the management of health information across various computerized systems and the secure exchange between consumers, providers, government, and insurers. It has been viewed as a promising tool for improving the overall quality, safety and efficiency of the health delivery system (Chaudhry et al., 2006). This capstone examines the problem of urban rural divide in the process of Health IT adoption especially with regard to Electronic Health Records (EHRs). This paper also tracks the progress made during years 2009 to 2013 to the process of Electronic Health Record adoption in the United States

The Second International Conference on Health Information Technology Advancement

TABLE OF CONTENTS I. Message from the Conference Co-Chairs B. Han and S. Falan …………………………....….……………. 5 II. Message from the Transactions Editor H. Lee …...………..………….......………….……….………….... 7 III. Referred Papers A. Emerging Health Information Technology and Applications The Role of Mobile Technology in Enhancing the Use of Personal Health Records Mohamed Abouzahra and Joseph Tan………………….……………. 9 Mobile Health Information Technology and Patient Care: Methods, Themes, and Research Gaps Bahae Samhan, Majid Dadgar, and K. D. Joshi…………..…. 18 A Balanced Perspective to Perioperative Process Management Jim Ryan, Barbara Doster, Sandra Daily, and Carmen Lewis…..….…………… 30 The Impact of Big Data on the Healthcare Information Systems Kuo Lane Chen and Huei Lee………….…………… 43 B. Health Care Communication, Literacy, and Patient Care Quality Digital Illness Narratives: A New Form of Health Communication Jofen Han and Jo Wiley…..….……..…. 47 Relationships, Caring, and Near Misses: Michael’s Story Sharie Falan and Bernard Han……………….…..…. 53 What is Your Informatics Skills Level? -- The Reliability of an Informatics Competency Measurement Tool Xiaomeng Sun and Sharie Falan.….….….….….….…. 61 C. Health Information Standardization and Interoperability Standardization Needs for Effective Interoperability Marilyn Skrocki…………………….…….………….… 76 Data Interoperability and Information Security in Healthcare Reid Berryman, Nathan Yost, Nicholas Dunn, and Christopher Edwards.…. 84 Michigan Health Information Network (MiHIN) Shared Services vs. the HIE Shared Services in Other States Devon O’Toole, Sean O’Toole, and Logan Steely…..……….…… 94 D. Health information Security and Regulation A Threat Table Based Approach to Telemedicine Security John C. Pendergrass, Karen Heart, C. Ranganathan, and V.N. Venkatakrishnan …. 104 Managing Government Regulatory Requirements for Security and Privacy Using Existing Standard Models Gregory Schymik and Dan Shoemaker…….…….….….… 112 Challenges of Mobile Healthcare Application Security Alan Rea………………………….……………. 118 E. Healthcare Management and Administration Analytical Methods for Planning and Scheduling Daily Work in Inpatient Care Settings: Opportunities for Research and Practice Laila Cure….….……………..….….….….… 121 Predictive Modeling in Post-reform Marketplace Wu-Chyuan Gau, Andrew France, Maria E. Moutinho, Carl D. Smith, and Morgan C. Wang…………...…. 131 A Study on Generic Prescription Substitution Policy as a Cost Containment Approach for Michigan’s Medicaid System Khandaker Nayeemul Islam…….…...……...………………….… 140 F. Health Information Technology Quality Assessment and Medical Service Delivery Theoretical, Methodological and Practical Challenges in Designing Formative Evaluations of Personal eHealth Tools Michael S. Dohan and Joseph Tan……………….……. 150 The Principles of Good Health Care in the U.S. in the 2010s Andrew Targowski…………………….……. 161 Health Information Technology in American Medicine: A Historical Perspective Kenneth A. Fisher………………….……. 171 G. Health Information Technology and Medical Practice Monitoring and Assisting Maternity-Infant Care in Rural Areas (MAMICare) Juan C. Lavariega, Gustavo Córdova, Lorena G Gómez, Alfonso Avila….… 175 An Empirical Study of Home Healthcare Robots Adoption Using the UTUAT Model Ahmad Alaiad, Lina Zhou, and Gunes Koru.…………………….….………. 185 HDQM2: Healthcare Data Quality Maturity Model Javier Mauricio Pinto-Valverde, Miguel Ángel Pérez-Guardado, Lorena Gomez-Martinez, Martha Corrales-Estrada, and Juan Carlos Lavariega-Jarquín.… 199 IV. A List of Reviewers …………………………..…….………………………208 V. WMU – IT Forum 2014 Call for Papers …..…….…………………20

The digitization of healthcare in developing countries: examining individuals’ willingness to disclose personal health information

In recent years, the increasing use of health information technologies (HITs) in support of healthcare services in developing countries has raised concerns about the privacy of digitized personal health information (PHI). However, there is little understanding of these concerns and their impact on individuals’ PHI disclosure behaviours. This study seeks to improve current understanding of the factors that influence the willingness of individuals in developing countries to disclose their PHI to receive care where the disclosed PHI is digitized. To pursue this objective, this study proposes and tests a model of antecedents to PHI privacy concerns, trust in HIT, and PHI disclosure. Drawing on the procedural and interactional dimensions of justice theory and prior research it is proposed that individuals’ characteristics, experiences, and perceptions form PHI privacy concerns and trust in HIT. Drawing on the privacy calculus, key factors that drive and inhibit individuals’ PHI disclosure are also examined. This study was conducted using a quantitative research design. The proposed model was tested using data collected from a survey of 276 individuals in Ghana, a Sub-Saharan African country. The data was analysed using the partial least squares approach to structural equation modelling (PLS-SEM). The findings of the study show trust in HIT directly influence PHI disclosure and fully mediates the influence of trust in healthcare providers. Convenience and computer experience also drive PHI disclosure. Trust in HIT is further shaped by privacy risk, government regulation, computer experience, and health concern. Perceived attitude of health workers affects trust in HIT through trust in healthcare providers. Regarding inhibitors of PHI disclosure, individuals’ perceptions of the negative consequences that may result from the exposure of their disclosed PHI decrease their willingness to disclose PHI. The results further show that individuals’ concerns about the collection of their PHI differ from concerns about the management of the collected and electronically stored PHI. For example, individuals’ express lower PHI collection concerns but greater concerns about PHI management. The results showed that PHI collection concerns decrease PHI disclosure whereas PHI management concerns increase PHI disclosure. PHI management concerns are shaped by computer experience, privacy orientation and trust in healthcare, with trust in healthcare providers mediating the influence of government regulation and perceived attitude of health workers on PHI management concerns. On the other hand, privacy risk, age, gender, and health concern form PHI collection concerns. The results also show past experience of privacy violation has different effects on PHI collection and PHI management concerns, increasing collection concerns but decreasing the management concerns. Overall, the findings of the study provide insights into the drivers and inhibitors of PHI disclosure, the dimensions of PHI privacy concerns and their antecedents, as well as the antecedents to trust in HIT. These findings provide useful contributions to the IS privacy literature and actionable insights for healthcare stakeholders especially in developing countries, as they leverage HITs in the provision of healthcare services

Technology argument frames : examining the impact of argumentation on the development of a health information exchange initiative

This dissertation applies the Technology Frames of Reference (TFR) theoretical lens to examine the implementation of a health information exchange (HIE) initiative in southeast USA. It extends the TFR lens by developing Toulminian argument maps to depict frame structure and employing the argument theories of Toulmin, Habermas and Perelman Olbrechts-Tyteca to help analyze the role that argumentation plays in the emergence and development of the technology frames that characterized this HIE endeavor. The argument maps developed in this dissertation helped to assess the level of argumentation within frames and to compare argumentation across frame domains. The argument maps were also used to structurally depict changes in frame salience over time and helped to facilitate the discovery of a prominent “perspective blindness” or “perspective indifference” which was the key finding of this dissertation. Previous TFR literature has focused on dysfunctions produced by conflict/alignment issues. This dissertation extends this research by highlighting the role that conflict avoidance or frame apathy may play in producing these dysfunctions. Perelman and Olbrechts-Tyteca’s New Rhetoric was recommended as a boundary spanning discursive framework that could help ameliorate the problems associated with both inter-frame conflict and frame indifference

Digital Transformation and Public Services

Through a series of studies, the overarching aim of this book is to investigate if and how the digitalization/digital transformation process affects various welfare services provided by the public sector, and the ensuing implications thereof. Ultimately, this book seeks to understand if it is conceivable for digital advancement to result in the creation of private/non-governmental alternatives to welfare services, possibly in a manner that transcends national boundaries. This study also investigates the possible ramifications of technological development for the public sector and the Western welfare society at large. This book takes its point of departure from the 2016 Organization for Economic Co-operation and Development (OECD) report that targets specific public service areas in which government needs to adopt new strategies not to fall behind. Specifically, this report emphasizes the focus on digitalization of health care/social care, education, and protection services, including the use of assistive technologies referred to as "digital welfare." Hence, this book explores the factors potentially leading to whether state actors could be overrun by other non-governmental actors, disrupting the current status quo of welfare services. The book seeks to provide an innovative, enriching, and controversial take on society at large and how various aspects of the public sector can be, and are, affected by the ongoing digitalization process in a way that is not covered by extant literature on the market. This book takes its point of departure in Sweden given the fact that Sweden is one of the most digitalized countries in Europe, according to the Digital Economy and Society Index (DESI), making it a pertinent research case. However, as digitalization transcends national borders, large parts of the subject matter take on an international angle. This includes cases from several other countries around Europe as well as the United States

Transparency in the Privacy Context: A Structured Literature Review

Transparency features, such as privacy policies and privacy seals, frequently offer users information about an online service’s collection and handling of personal data. While transparency is a heavily studied topic in the privacy context, the findings are equivocal, due to mixed results on the effects of transparency and heterogeneous conceptualizations of the term transparency. This is worrisome as transparency is widely recognized as a key instrument to empower users and guide their decisions, making the effects of transparency of fundamental importance for regulators, online service providers, and users. To address missing conceptual clarity and differing effects of transparency, we conducted a structured literature review on transparency in the privacy context. We extract three distinct conceptualizations of transparency and two subdimensions of privacy information, which impact user decisions. We provide a research agenda for future studies, investigating the effects of transparency in the privacy context