The Promise of Health Information Technology: Ensuring that Florida's Children Benefit

Substantial policy interest in supporting the adoption of Health Information Technology (HIT) by the public and private sectors over the last 5 -- 7 years, was spurred in particular by the release of multiple Institute of Medicine reports documenting the widespread occurrence of medical errors and poor quality of care (Institute of Medicine, 1999 & 2001). However, efforts to focus on issues unique to children's health have been left out of many of initiatives. The purpose of this report is to identify strategies that can be taken by public and private entities to promote the use of HIT among providers who serve children in Florida

Use of m-Health Technology for Preventive Interventions to Tackle Cardiometabolic Conditions and Other Non-Communicable Diseases in Latin America- Challenges and Opportunities

In Latin America, cardiovascular disease (CVD) mortality rates will increase by an estimated 145% from 1990 to 2020. Several challenges related to social strains, inadequate public health infrastructure, and underfinanced healthcare systems make cardiometabolic conditions and non-communicable diseases (NCDs) difficult to prevent and control. On the other hand, the region has high mobile phone coverage, making mobile health (mHealth) particularly attractive to complement and improve strategies toward prevention and control of these conditions in low- and middle-income countries. In this article, we describe the experiences of three Centers of Excellence for prevention and control of NCDs sponsored by the National Heart, Lung, and Blood Institute with mHealth interventions to address cardiometabolic conditions and other NCDs in Argentina, Guatemala, and Peru. The nine studies described involved the design and implementation of complex interventions targeting providers, patients and the public. The rationale, design of the interventions, and evaluation of processes and outcomes of each of these studies are described, together with barriers and enabling factors associated with their implementation.Fil: Beratarrechea, Andrea Gabriela. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Diez Canseco, Francisco. Universidad Peruana Cayetano Heredia; PerúFil: Irazola, Vilma. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Miranda, Jaime. Universidad Peruana Cayetano Heredia; PerúFil: Ramirez Zea, Manuel. Institute of Nutrition of Central America and Panama; GuatemalaFil: Rubinstein, Adolfo Luis. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

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How Barriers to Using the Electronic Health Record Effects Behavioral Healthcare

The healthcare scene is rapidly changing due to the introduction of the electronic health record (EHR) and advances in technology. This means more patient data is readily available for use and gives physicians and patients’ faster access to that data. With the passing of recent legislature such as the Health Information Technology for Economic and Clinical Health Act and the American Recovery and Reinvestment Act of 2009, resulting in the rapid adoption of electronic health records due to incentive payment programs. With this comes the push for use of the electronic health record to prepare for Meaningful Use and improved quality of patient care. One field however, seems to be behind the times in regards to the use of the electronic health records, and it is the field of behavioral health. The simple reason being that behavioral health has barriers that other health fields do not. The challenge is how behavioral health can overcome these barriers in order to move forward with using the electronic health record

Development of a culturally appropriate computer-delivered tailored internet-based health literacy intervention for spanish-dominant hispanics living with HIV

Background: Low health literacy is associated with poor medication adherence in persons with human immunodeficiency virus (HIV), which can lead to poor health outcomes. As linguistic minorities, Spanish-dominant Hispanics (SDH) face challenges such as difficulties in obtaining and understanding accurate information about HIV and its treatment. Traditional health educational methods (e.g., pamphlets, talking) may not be as effective as delivering through alternate venues. Technology-based health information interventions have the potential for being readily available on desktop computers or over the Internet. The purpose of this research was to adapt a theoretically-based computer application (initially developed for English-speaking HIV-positive persons) that will provide linguistically and culturally appropriate tailored health education to Spanish-dominant Hispanics with HIV (HIV¿+¿SDH).MethodsA mixed methods approach using quantitative and qualitative interviews with 25 HIV¿+¿SDH and 5 key informants guided by the Information-Motivation-Behavioral (IMB) Skills model was used to investigate cultural factors influencing medication adherence in HIV¿+¿SDH. We used a triangulation approach to identify major themes within cultural contexts relevant to understanding factors related to motivation to adhere to treatment. From this data we adapted an automated computer-based health literacy intervention to be delivered in Spanish.ResultsCulture-specific motivational factors for treatment adherence in HIV¿+¿SDH persons that emerged from the data were stigma, familismo (family), mood, and social support. Using this data, we developed a culturally and linguistically adapted a tailored intervention that provides information about HIV infection, treatment, and medication related problem solving skills (proven effective in English-speaking populations) that can be delivered using touch-screen computers, tablets, and smartphones to be tested in a future study.ConclusionUsing a theoretically-grounded Internet-based eHealth education intervention that builds on knowledge and also targets core cultural determinants of adherence may prove a highly effective approach to improve health literacy and medication decision-making in this group

Acceptance model of electronic medical record

This paper discusses acceptance issues of Electronic Medical Record System (EMR), particularly in Malaysia. A detailed overview of EMR and its benefits are firstly discussed. A number of acceptance models are scrutinized. Then factors affecting EMR acceptance are put forward. Finally, before proposing an EMR acceptance model, an instrument formed by adapting and then finding its factors loading is presented

Fatores que afetam a adoção de análises de Big Data em empresas

With the total quantity of data doubling every two years, the low price of computing and data storage, make Big Data analytics (BDA) adoption desirable for companies, as a tool to get competitive advantage. Given the availability of free software, why have some companies failed to adopt these techniques? To answer this question, we extend the unified theory of technology adoption and use of technology model (UTAUT) adapted for the BDA context, adding two variables: resistance to use and perceived risk. We used the level of implementation of these techniques to divide companies into users and non-users of BDA. The structural models were evaluated by partial least squares (PLS). The results show the importance of good infrastructure exceeds the difficulties companies face in implementing it. While companies planning to use Big Data expect strong results, current users are more skeptical about its performance.Con la cantidad total de datos duplicándose cada dos años, el bajo precio de la informática y del almacenamiento de datos, la adopción del análisis Big Data (BDA) es altamente deseable para las empresas, como un instrumento para conseguir una ventaja competitiva. Dada la disponibilidad de software libre, ¿por qué algunas empresas no han adoptado estas técnicas? Para responder a esta pregunta, ampliamos la teoría unificada de la adopción y uso de tecnología (UTAUT) adaptado para el contexto BDA, agregando dos variables: resistencia al uso y riesgo percibido. Utilizamos el grado de implantación de estas técnicas para dividir las empresas entre: usuarias y no usuarias de BDA. Los modelos estructurales fueron evaluados con partial least squres (PLS). Los resultados muestran que la importancia de una buena infraestructura excede las dificultades que enfrentan las empresas para implementarla. Mientras que las compañías que planean usar BDA esperan muy buenos resultados, las usuarias actuales son más escépticos sobre su rendimiento.Com a quantidade total de dados duplicando a cada dois anos, o baixo preço da computação e do armazenamento de dados tornam a adoção de análises de Big Data (BDA) desejável para as empresas, como aquelas que obterão uma vantagem competitiva. Dada a disponibilidade de software livre, por que algumas empresas não adotaram essas técnicas? Para responder a essa pergunta, estendemos a teoria unificada de adoção e uso de tecnologia (UTAUT) adaptado para o contexto do BDA, adicionando duas variáveis: resistência ao uso e risco percebido. Usamos a nível da implementação da tecnologia para dividir as empresas em usuários e não usuários de técnicas de BDA. Os modelos estruturais foram avaliados por partial least squares (PLS). Os resultados mostram que a importância de uma boa infraestrutura excede as dificuldades que as empresas enfrentam para implementá-la. Enquanto as empresas que planejam usar Big Data esperam resultados fortes, os usuários atuais são mais céticos em relação ao seu desempenho

Moving towards Sustainable Electronic Health Applications

Electronic healthcare applications, both web-based and mobile health (mHealth) provide new modalities for chronic disease. These tools allow patients to track their symptoms and help them manage their condition. The sustainability of these tools is often not considered during their development. To ensure these applications can be adopted and sustainable, where policy differs amongst states and provinces, we must present the benefits of our findings to highlight the justification for its development. For technology to be sustainable it has to utilize infrastructure that is secure, stable and to be agile so that it can be deployed quickly with minimal interruption to patients, family members and healthcare professionals

An Examination of Physician Resistance Related to Electronic Medical Records Adoption

The 2009 American Recovery and Reinvestment Act, signed under the Obama administration, mandated physicians to complete certification for electronic medical records (EMRs). Despite these mandates and the increased access to information technology, slow adoption rates persist on the use of EMRs. Guided by the theory of planned behavior and the technology acceptance model, the purpose of this quantitative study was to examine the relationship between the independent variables perceived ease of use, perceived usefulness, perceived behavioral control, perceived social influence, attitudes toward EMR, and the dependent variable user acceptance. This study identified physicians in the United States as end-users of EMRs. In this study, 76 randomly selected physicians in the United States, identified as end-users of EMRs, completed an electronic survey requiring responses to a 5-point Likert Scale model. Standard multiple regression analysis served as the means used to analyze the regression model. Despite the regression model being statistically significant, none of the individual independent variables had statistical significance in predicting user acceptance. Interdependence and homoscedasticity likely contributed to this phenomenon. Social change implications include understanding of physician perceptions and beliefs--how physician perceptions and beliefs affect EMR adoption. Because adoption rates did not achieve 100% certification by end-users, another social change implication includes the necessity of examining how end-user acceptance could decrease medical errors, increase efficiencies in physician workload, and improve communication within the health care industry