Alcuni abstract di articoli che trattano argomenti relativi all'eHealth

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The Impact of Electronic Health Records on Healthcare Service Delivery, Patient Safety, and Quality

The HITECH Act has provided over $30 billion of support through the Meaningful Use program to implement Electronic Health Records (EHRs) with aims to improve healthcare service delivery, efficiency, quality, and patient safety. New healthcare models, such as pay-for-performance and value-based purchasing, were envisioned to aligning quality with reimbursement mediated with the use of EHRs. It is unclear of how EHRs and Meaningful Use have impacted health service delivery, patient safety, and quality of care. Thus, making it difficult to determine if the specific set of objectives for Meaningful Use have had a positive impact on outcomes, which ultimately is the goal of the program. The objective of this dissertation is to study the impact of EHRs on healthcare service delivery outcomes related to e-health services and productivity. Furthermore, the objectives are to study the impact of EHRs and Meaningful Use attestation on patient safety and inpatient quality of care. The results demonstrate gains in efficiency may be achieved during patient-physician interaction time with the use of fully EHRs, where physicians saved 1.53 minutes per visit in time spent with the patient, or a 6.1% gain in efficiency. EHR use significantly improved the odds of providing e-billing, e-consults, and e-prescribing. We found that fully-implemented EHRs that did not attest to Meaningful Use had a significant positive impact on 3 patient safety outcomes, and hospitals that attested to Meaningful Use had a significant positive impact on 2 patient safety outcomes. However, there were no significant differences in patient safety composite scores. Last, there were significant differences in inpatient quality composite scores. Hospitals attesting to Meaningful Use had 18% improvements in mortality for selected conditions, and 8% improvements in mortality for selected procedures. In conclusion, EHRs and the Meaningful Use program have had positive impacts on healthcare service delivery and inpatient quality of care. More efforts may be needed to improve patient safety with the use of EHRs, which may need to focus on EHR certification or Meaningful Use objectives. Future studies should determine specific EHR functionalities and Meaningful Use objectives that are associated with positive outcomes to further direct policy development

Improving the Use of Electronic Medical Records in Primary Health Care: A Systematic Review and Meta-Analysis

Electronic Medical Records were first introduced in the 1970s to organize patient information, improve coordination of care, and improve communication. The purpose of this systematic review was to identify interventions aimed at improving EMR use in primary health care settings. Of 2,098 identified studies twelve were included in the review. Results showed that interventions focused on the use of EMR functions were five times more likely to show improvements in EMR use compared to controls. Interventions focused on data quality were five and a half times more likely to show improvements in EMR use compared to controls. Individuals in primary health care settings aiming to improve EMR use would benefit from implementing interventions focused on EMR feature add-ons, and provisions of educational materials, or financial incentives targeted at improving the use of EMR functions and data quality

Information technology issues in healthcare: Hospital CEO and CIO perspectives.

Healthcare Information Technology (HIT) is widely regarded as a key to improving the quality of healthcare in the United States and potentially reducing its cost. Yet, its implementation is a continuous challenge for the healthcare industry. In this article, we report the results of a survey distributed to CEOs and CIOs at 1400 U.S. hospitals regarding their perceptions of the key information technology (IT) issues in healthcare. Among the top ten issues, the implementation of electronic medical records is ranked the highest. Included in the top ten are issues related to: improving healthcare quality by the use of information technology; change management, privacy, security, and accuracy of electronic records; and decision support applications. While some differences existed, we found much similarity between the views of the CEOs and the CIOs with both groups being characterized as conservative and risk-averse in their entrepreneurial orientation. No major differences were observed between urban and rural hospitals, or large and small hospitals. Given the heightened interest in healthcare IT, these results have wide implications for many stakeholders in this burgeoning industr

Information Technology Issues in Healthcare: Hospital CEO and CIO Perspectives

Healthcare Information Technology (HIT) is widely regarded as a key to improving the quality of healthcare in the United States and potentially reducing its cost. Yet, its implementation is a continuous challenge for the healthcare industry. In this article, we report the results of a survey distributed to CEOs and CIOs at 1400 U.S. hospitals regarding their perceptions of the key information technology (IT) issues in healthcare. Among the top ten issues, the implementation of electronic medical records is ranked the highest. Included in the top ten are issues related to: improving healthcare quality by the use of information technology; change management, privacy, security, and accuracy of electronic records; and decision support applications. While some differences existed, we found much similarity between the views of the CEOs and the CIOs with both groups being characterized as conservative and risk-averse in their entrepreneurial orientation. No major differences were observed between urban and rural hospitals, or large and small hospitals. Given the heightened interest in healthcare IT, these results have wide implications for many stakeholders in this burgeoning industry

The Business Case for Quality: Ending Business as Usual in American Health Care

Examines some of the reasons why establishing a business case for improving health care is so difficult, and considers possible solutions. Includes comments on quality provisions of the Medicare Prescription Drug Improvement and Modernization Act of 2003

Perspectives of Primary Care Physicians on Adopting Electronic Medical Records in the Atlanta, Georgia Area

Slow adoption of electronic medical records (EMR) by primary care physicians in medical office practices has not facilitated the EMR adoption process. The problem is the slow pace of EMR adoption by primary care physicians in the Atlanta, Georgia area has become a public health concern. Research regarding the lived experiences of these physicians with EMR implementation and utilization may identify reasons for the slow adoption. The purpose of this phenomenological study was to explore the lived experiences of primary care physicians, who practice in the Atlanta area, regarding their perception, successes, barriers, and urgency of adoption of EMR in their healthcare practice. Lewin\u27s change management model of health services served as the framework for the study. Data was collected during face-to-face interviews with 19 primary care physicians at Grady\u27s Ponce de Leon Clinic and Grady\u27s East Point Clinic in Atlanta, Georgia. Participants were physicians or residents and not those in authority to make decisions about the EMR at the two clinics. NVivo 10 and automatic coding was used for data analysis to develop themes from the interviews. The findings revealed that the adoption of EMR has enabled primary care physicians to spend more time with their patients, but the barriers such as a lack of interoperability and lack of training, has fostered a feeling of disinterestedness towards EMR adoption. This study supports positive social change that EMR adoption aids in improving patient safety and outcome