Development of a Taxonomy for Health Information Technology

Taxonomies provide schemas to help classify entities and define the relationships between them. Early computing enabled the development of ontologies and Medical Subject Headings (MeSH), the first modern classification of medical terminology as applied to medical literature. Later developments, such as MEDLINE, expanded MeSH to include a number of medical informatics terms. However, a lack of specificity in MeSH and other existing informatics taxonomies for terminology used to describe the growing field of health information technology (health IT) created the need for the development of a specialized taxonomy. Experts associated with the Agency for Healthcare Research and Qualitys (AHRQs) National Resource Center for Health Information Technology (NRC) created and evaluated a taxonomy for health IT, to enable users of a public health IT Web site to efficiently identify resources within an online, searchable repository

Classification And Analysis Of Mobile Health Evaluation Through Taxonomy and Method Development

This manuscript documents the creation and evaluation of a taxonomy for mobile health (m-health) evaluation and a method for m-health evaluation. M-health as a field within IS has seen significant amounts of growth in recent years due to improvements in technology leading to more affordable and portable computing power. The application of these technologies to the healthcare domain has created many new opportunities and benefits for patients and providers alike. This research seeks to study how these m-health projects are being evaluated and to determine what the characteristics of these evaluations are. To accomplish this goal, the research process is conducted as design science and the research outputs of taxonomy and method are presented as design science artifacts. The two artifacts are evaluated during their creation and once more afterwards to determine their utility. The taxonomy is created by collecting and analyzing documentation on m-health evaluation and using that information to generate descriptive categories by following a series of guidelines for creating a classification system. After evaluation of the artifact, a method is created for conducting m-health evaluation. This method is a series of guidelines built upon constructs and relationships derived from the taxonomy. Evaluation of the artifacts consists of expert surveys, cluster analysis, and attribute analysis. After evaluation of both artifacts, a descriptive theory explaining the selection of m-health evaluation types is created and presented. Theory development is based on the idea of kernel theories and their transferability to the information systems (IS) and design science domains. Contributions of this research are as follows: a classification system for m-health evaluation, a series of guidelines for individuals working on evaluations in the field of m-health, and a descriptive theory on the selection of evaluation type in an m-health context

Taxonomy of Health IT and Medication Adherence

Background: Patients’ failure to take medication as prescribed – poor medication adherence – is a well-known issue.Health information technology (IT) presents itself as a promising approach to tackle poor medication adherence. Objectives: To deepen the understanding of what features health IT offers and how these address poor medication adherence, we examine existing health IT targeting medication adherence. Methods: Building on extant literature, we follow a systematic approach for taxonomy development in information systems to build a taxonomy of health IT focusing on medication adherence. Results: Health IT offers various promising ways to address poor medication adherence. Overall, we map 16 different types of health IT offerings on 7 different dimensions. The principal results are that health IT focusing on medication adherence should be developed in a patient-centered way because medication adherence is predominantly a matter of the patient and that mobile technologies are a seminal driver for health IT offerings focusing on medication adherence. Finally, the taxonomy identifies the core impacts of health IT on medication adherence. Conclusion: The taxonomy establishes an overview of current health IT offerings targeting Medication adherence, offers insights into untapped potential for health IT, and yields valuable insights for health policy and technology. Future efforts must, however, address how to continuously motivate patients and how to better integrate and combine health IT offerings to unfold the full potential of health IT for addressing poor medication adherence

Using Fink’s Integrated Course Design Model in Developing a Health It Course

This paper introduces how Fink’s Integrated Course Design model was used to refine a Health Information Technology (HIT) core course – Clinical Process and Workflow: Analysis and Redesign – for improving the design and enhancing student learning in this rapidly growing field. The paper describes the course design process centered on Fink’s taxonomy of significant learning – foundational knowledge, application, integration, human dimension, caring, and learning how to learn. Example case study assignment, term project and assessment rubric are provided. Student feedback shows that the course enhances student learning and prepares them to meet the needs of healthcare organizations and HIT development

Transatlantic collection of health informatics competencies

The electronic collection, processing and management of information is becoming increasingly important in healthcare. Because of the nature of the healthcare provision and delivery process, where the health, safety and quality of human lives are impacted on a daily basis, it is critical that those who work in the field are competent and able to perform all clinical, administrative, research and technology-impacted facets of their roles.The United States and the European Union have been working to encourage broader and more effective use of Information and Communications Technology (ICT) within healthcare. The development, use and governance of ICT within healthcare, often called health informatics, requires a number of competences which need to be identified and integrated into relevant skills assessment, education and training. Ultimately, this will help produce a more proficient and a more confident mobile health informatics-empowered workforce.A structured set of health information technology and eHealth implementation competences was collected in a co-operation project by voluntary experts in USA and European Union. The project took a deliberately broad starting point, seeking and reviewing an extensive range of related competencies. The skills cover the following domains of professions working with health information technology: direct patient care; administrative; engineering/information, communication, and technology (ICT); informatics; and research and biomedicine. The aggregation of over one thousand competencies was classified to a baseline set of skills and four levels of expertise in 33 focus areas according to Bloom’s taxonomy. The data set also contains definitions of 268 ‘typical’ professional roles. The use of the collection of competencies is supported by an open access web tool through which all the competencies can be searched through a query mechanism.The limitation of this work is that only the Acute Care segment of roles and competencies impacted by ICT was evaluated within the scope of this project, however, this subset of other care settings such as ambulatory, rehabilitative care, surgery, and others serves as a representative set of roles and competencies within the health care field as well as a being an important proof of concept for future usefulness of the work if extended beyond its current span. This project has made a contribution to the potential improvement of workforce mobility internationally

Integrating Taxonomies into Theory-Based Digital Health Interventions for Behavior Change: A Holistic Framework

Digital health interventions have been emerging in the last decade. Due to their interdisciplinary nature, digital health interventions are guided and influenced by theories (e.g., behavioral theories, behavior change technologies, persuasive technology) from different research communities. However, digital health interventions are always coded using various taxonomies and reported in insufficient perspectives. The inconsistency and incomprehensiveness will bring difficulty for conducting systematic reviews and sharing contributions among communities. Based on existing related work, therefore, we propose a holistic framework that embeds behavioral theories, behavior change technique (BCT) taxonomy, and persuasive system design (PSD) principles. Including four development steps, two toolboxes, and one workflow, our framework aims to guide digital health intervention developers to design, evaluate, and report their work in a formative and comprehensive way

Towards a Holistic Approach to Designing Theory-based Mobile Health Interventions

Increasing evidence has shown that theory-based health behavior change interventions are more effective than non-theory-based ones. However, only a few segments of relevant studies were theory-based, especially the studies conducted by non-psychology researchers. On the other hand, many mobile health interventions, even those based on the behavioral theories, may still fail in the absence of a user-centered design process. The gap between behavioral theories and user-centered design increases the difficulty of designing and implementing mobile health interventions. To bridge this gap, we propose a holistic approach to designing theory-based mobile health interventions built on the existing theories and frameworks of three categories: (1) behavioral theories (e.g., the Social Cognitive Theory, the Theory of Planned Behavior, and the Health Action Process Approach), (2) the technological models and frameworks (e.g., the Behavior Change Techniques, the Persuasive System Design and Behavior Change Support System, and the Just-in-Time Adaptive Interventions), and (3) the user-centered systematic approaches (e.g., the CeHRes Roadmap, the Wendel's Approach, and the IDEAS Model). This holistic approach provides researchers a lens to see the whole picture for developing mobile health interventions

Behavior change interventions: the potential of ontologies for advancing science and practice

A central goal of behavioral medicine is the creation of evidence-based interventions for promoting behavior change. Scientific knowledge about behavior change could be more effectively accumulated using "ontologies." In information science, an ontology is a systematic method for articulating a "controlled vocabulary" of agreed-upon terms and their inter-relationships. It involves three core elements: (1) a controlled vocabulary specifying and defining existing classes; (2) specification of the inter-relationships between classes; and (3) codification in a computer-readable format to enable knowledge generation, organization, reuse, integration, and analysis. This paper introduces ontologies, provides a review of current efforts to create ontologies related to behavior change interventions and suggests future work. This paper was written by behavioral medicine and information science experts and was developed in partnership between the Society of Behavioral Medicine's Technology Special Interest Group (SIG) and the Theories and Techniques of Behavior Change Interventions SIG. In recent years significant progress has been made in the foundational work needed to develop ontologies of behavior change. Ontologies of behavior change could facilitate a transformation of behavioral science from a field in which data from different experiments are siloed into one in which data across experiments could be compared and/or integrated. This could facilitate new approaches to hypothesis generation and knowledge discovery in behavioral science

Assessment and learning outcomes: the evaluation of deep learning in an on-line course

Using an online learning environment, students from European countries collaborated and communicated to carry out problem based learning in occupational therapy. The effectiveness of this approach was evaluated by means of the final assessments and published learning outcomes. In particular, transcripts from peer-to-peer sessions of synchronous communication were analysed. The SOLO taxonomy was used and the development of deep learning was studied week by week. This allowed the quality of the course to be appraised and showed, to a certain extent, the impact of this online international course on the learning strategies of the students. Results indicate that deep learning can be supported by synchronous communication and online meetings between course participants.</p

A comparison of reimbursement recommendations by European HTA agencies : Is there opportunity for further alignment?

Introduction: In Europe and beyond, the rising costs of healthcare and limited healthcare resources have resulted in the implementation of health technology assessment (HTA) to inform health policy and reimbursement decision-making. European legislation has provided a harmonized route for the regulatory process with the European Medicines Agency, but reimbursement decision-making still remains the responsibility of each country. There is a recognized need to move toward a more objective and collaborative reimbursement environment for new medicines in Europe. Therefore, the aim of this study was to objectively assess and compare the national reimbursement recommendations of 9 European jurisdictions following European Medicines Agency (EMA) recommendation for centralized marketing authorization. Methods: Using publicly available data and newly developed classification tools, this study appraised 9 European reimbursement systems by assessing HTA processes and the relationship between the regulatory, HTA and decision-making organizations. Each national HTA agency was classified according to two novel taxonomies. The System taxonomy, focuses on the position of the HTA agency within the national reimbursement system according to the relationship between the regulator, the HTA-performing agency, and the reimbursement decision-making coverage body. The HTA Process taxonomy distinguishes between the individual HTA agency's approach to economic and therapeutic evaluation and the inclusion of an independent appraisal step. The taxonomic groups were subsequently compared with national HTA recommendations. Results: This study identified European national reimbursement recommendations for 102 new active substances (NASs) approved by the EMA from 2008 to 2012. These reimbursement recommendations were compared using a novel classification tool and identified alignment between the organizational structure of reimbursement systems (System taxonomy) and HTA recommendations. However, there was less alignment between the HTA processes and recommendations. Conclusions: In order to move forward to a more harmonized HTA environment within Europe, it is first necessary to understand the variation in HTA practices within Europe. This study has identified alignment between HTA recommendations and the System taxonomy and one of the major implications of this study is that such alignment could support a more collaborative HTA environment in Europe.Peer reviewedFinal Published versio