Is There an App for That? Electronic Health Records (EHRs) and a New Environment of Conflict Prevention and Resolution

Katsh discusses the new problems that are a consequence of a new technological environment in healthcare, one that has an array of elements that makes the emergence of disputes likely. Novel uses of technology have already addressed both the problem and its source in other contexts, such as e-commerce, where large numbers of transactions have generated large numbers of disputes. If technology-supported healthcare is to improve the field of medicine, a similar effort at dispute prevention and resolution will be necessary

Health Status and Health Care Access of Farm and Rural Populations

Rural residents have higher rates of age-adjusted mortality, disability, and chronic disease than their urban counterparts, though mortality and disability rates vary more by region than by metro status. Contributing negatively to the health status of rural residents are their lower socioeconomic status, higher incidence of both smoking and obesity, and lower levels of physical activity. Contributing negatively to the health status of farmers are the high risks from workplace hazards, which also affect other members of farm families who live on the premises and often share in the work; contributing positively are farmers’ higher socioeconomic status, lower incidence of smoking, and more active lifestyle. Both farm and rural populations experience lower access to health care along the dimensions of affordability, proximity, and quality, compared with their nonfarm and urban counterparts.Health Economics and Policy, agriculture safety and health, electronic health records, farmer health, health, health care access, health care affordability, health care quality, health disparities, health IT, health status, mortality, rural health, telehealth, uninsured,

Needs Assessment for a Patient Centered Medical Home Model of Care at the Providence Alaska Cancer Center

Presented to the Faculty of the University of Alaska Anchorage in Partial Fulfillment of the Requirements for the Degree of MASTER OF PUBLIC HEALTHIn order to better understand the needs of cancer patients and allocate resources, the Providence Alaska Cancer Center requested a needs assessment for an oncology focused patient centered medical home (PCMH). A PCMH allows for coordinated and comprehensive care through the use of a teamwork model that centers on the primary care physician. The Providence Alaska Cancer Center staff randomly selected the records of 200 cancer patients between 2010 and 2011, using the cancer tumor registry. Data were analyzed to answer four specific questions that addressed the 1) presence of a Primary Care Physician (PCP), 2) number and type of comorbidities, 3) cancer diagnosis and 4) insurance status impacted emergency room utilization. Individuals tended to utilize the emergency room more if they 1) had a PCP, 2a) had three or more comorbidities, 2b) were diagnosed with hyperlipidemia, chronic obstructive pulmonary disease (COPD) or hypertension, 3) were diagnosed with an “other” cancer as opposed to breast, lung or gynecological cancers or 4) had federal insurance. These data in particular show expected trends such as patients who have more medical complications have higher emergency room utilization rates than patients with less complicated medical history and that certain comorbidities (hyperlipidemia, hypertension and chronic obstructive pulmonary disease) may be predictors of emergency room utilization. These trends may allow providers to create more specialized treatment and care plans for patients at greater risk of emergency room utilization.Signature Page / Title Page / Abstract / Table of Contents / List of Figures / List of Tables / List of Appendices / Introduction to Cancer and its Treatment / Introduction to the Patient Centered Medical Home Model / Treatment of Cancer in Alaska / Study Goals, Rationale, Research Questions and Hypotheses / Methods / Sample Demographics and Description / Results and Discussion / Strengths and Limitations / Future Directions / References / Appendice

Annotated Bibliography: Understanding Ambulatory Care Practices in the Context of Patient Safety and Quality Improvement.

The ambulatory care setting is an increasingly important component of the patient safety conversation. Inpatient safety is the primary focus of the vast majority of safety research and interventions, but the ambulatory setting is actually where most medical care is administered. Recent attention has shifted toward examining ambulatory care in order to implement better health care quality and safety practices. This annotated bibliography was created to analyze and augment the current literature on ambulatory care practices with regard to patient safety and quality improvement. By providing a thorough examination of current practices, potential improvement strategies in ambulatory care health care settings can be suggested. A better understanding of the myriad factors that influence delivery of patient care will catalyze future health care system development and implementation in the ambulatory setting