Predictive Relationships Between Electronic Health Records Attributes and Meaningful Use Objectives

The use of electronic health records (EHR) has the potential to improve relationships between physicians and patients and significantly improve care delivery. The purpose of this study was to analyze the relationships between hospital attributes and EHR implementation. The research design for this study was the cross-sectional approach. Secondary data from the Health Information and Management Systems Society (HIMSS) Analytics Database was utilized (n = 169) in a correlational crosssectional research design. Normalization Process Theory (NPT) and implementation theory were the theoretical underpinnings used in this study. Multiple linear regressions results showed statistically significant relationships between the 4 independent variables (region, ownership status, number of staffed beds [size], and organizational control) and the outcomes for the dependent variables of EHR software application attributes (Clinical Decision Support Systems (CDSS) components), EHR software application attributes (major systems), and successful implementation of Meaningful Use (MU) (p = .001). A statistically significant relationship (p = .001) was also found between the 2 independent variables (EHR software application attributes [CDSS components] and EHR software application attributes [major systems]) and the outcome of successful implementation of MU when combined. This evidence should provide policy makers and health practitioners support for their attempts to implement EHR systems to result in positive Meaningful Use which has been shown to be more cost effective and result in better quality of care for patients.The potential social change is improved medication prescribing and administration for hospitals and, lower cost and better quality of care for patients

CDSSs for CVD Risk Management: An Integrative Review

Cardiovascular disease (CVD) is a preventable disease affecting almost half of adults in the United States (U.S.) and can have significant negative outcomes such as stroke and myocardial infarction, which can be fatal. Utilizing clinical decision support systems (CDSSs) in the primary care and community health setting can improve primary prevention of CVD by supporting evidence-based decision making at the point of care. This integrative review synthesizes the most up-to-date literature on the use of clinical decision support (CDS) tools to support guideline-based management of CVD risk. Using Whittemore and Knafl’s framework for integrative reviews, a systematic search of CINAHL, Cochrane, and Medline and ancestry search yielded 492 results; 17 articles were included in the final review after applying inclusion and exclusion criteria. Evidence-based CDSSs for CVD prevention improved guideline-based initiation and intensification of pharmacological treatment, increased frequency and accuracy of CVD risk screening, and facilitated shared decision-making discussions with patients about CVD risk; however, they were not effective in promoting smoking cessation and only sometimes effective in improving blood pressure (BP) control. This integrative review supports future evidence-based practice projects implementing CDSSs designed to improve guideline-based primary prevention of CVD as an, albeit partial, solution to improving prevention of CVD in the U.S. and globally

Ontologies Applied in Clinical Decision Support System Rules:Systematic Review

BackgroundClinical decision support systems (CDSSs) are important for the quality and safety of health care delivery. Although CDSS rules guide CDSS behavior, they are not routinely shared and reused. ObjectiveOntologies have the potential to promote the reuse of CDSS rules. Therefore, we systematically screened the literature to elaborate on the current status of ontologies applied in CDSS rules, such as rule management, which uses captured CDSS rule usage data and user feedback data to tailor CDSS services to be more accurate, and maintenance, which updates CDSS rules. Through this systematic literature review, we aim to identify the frontiers of ontologies used in CDSS rules. MethodsThe literature search was focused on the intersection of ontologies; clinical decision support; and rules in PubMed, the Association for Computing Machinery (ACM) Digital Library, and the Nursing & Allied Health Database. Grounded theory and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines were followed. One author initiated the screening and literature review, while 2 authors validated the processes and results independently. The inclusion and exclusion criteria were developed and refined iteratively. ResultsCDSSs were primarily used to manage chronic conditions, alerts for medication prescriptions, reminders for immunizations and preventive services, diagnoses, and treatment recommendations among 81 included publications. The CDSS rules were presented in Semantic Web Rule Language, Jess, or Jena formats. Despite the fact that ontologies have been used to provide medical knowledge, CDSS rules, and terminologies, they have not been used in CDSS rule management or to facilitate the reuse of CDSS rules. ConclusionsOntologies have been used to organize and represent medical knowledge, controlled vocabularies, and the content of CDSS rules. So far, there has been little reuse of CDSS rules. More work is needed to improve the reusability and interoperability of CDSS rules. This review identified and described the ontologies that, despite their limitations, enable Semantic Web technologies and their applications in CDSS rules

The Value of Information Technology-Enabled Diabetes Management

Reviews different technologies used in diabetes disease management, as well as the costs, benefits, and quality implications of technology-enabled diabetes management programs in the United States

Closed loop medication administration using mobile nursing information system

Through this long journey of PhD study including a research on ‘Closed Loop Medication Administration Using Mobile Nursing Information System’ and the thesis writing, I obtained a lot of knowledge and experience about research method and writing. I really very appreciate the help of all my supervisors

An overview of patient acceptance of Health Information Technology in developing countries: a review and conceptual model

The potential to improve the quality, efficiency, outcomes, patient safety and reduce cost of healthcare by Health Information Technology (HIT) has been established by researchers. But unfortunately HIT systems are not properly utilized or are not widely available. This problem is even more glaring in developing countries. This article presents a review of some available HIT systems in order to assess the level of their presence and the technology used in developing them. Works related to acceptance of HIT systems were also reviewed so as to study the gaps in this area and propose a solution in order to fill the gaps identified. The problems discovered from this review include lack of availability of these systems especially in developing countries, low rate of HIT systems acceptance and insufficient works on patient acceptance of HIT systems. Studying the factors that affect the acceptance of HIT systems by patients and considering the factors while developing the systems will play a significant role in getting over the aforementioned limitations. As Technology Acceptance Model (TAM) is one of the most popular models for studying users\u27 perception and acceptance of Information System (IS)/Information Technology (IT), we proposed a conceptual model of HIT acceptance in developing countries based on TAM