The Successful Implementation of Electronic Health Records at Small Rural Hospitals

Electronic health records (EHRs) have been in use since the 1960s. U.S. rural hospital leaders and administrators face significant pressure to implement health information technology because of the American Recovery and Reinvestment Act of 2009. However, some leaders and managers of small rural hospital lack strategies to develop and implement EHRs. The focus of this descriptive phenomenological study was to explore lived experiences of hospital leaders and administrators who have used successful strategies to implement EHRs in small rural hospitals. Diffusion of innovation theory shaped the theoretical framework of this study. Data were collected through telephone interviews conducted with participants who successfully deployed EHRs at 10 hospitals in the Appalachian regions of Maryland, Virginia, and West Virginia. Data analysis occurred using a modified Husserlian approach in search of common themes from interview transcripts. The main themes were strategies to address standards and incentives, implementation, and challenges. The exploration of these strategies provides insight that small rural hospital leaders and administrators could consider for implementing EHRs. The study findings might enable small rural hospital leaders and administrators to contribute to positive social change by engaging communities in using EHRs; these findings may also expand information sharing among individuals and organizations and build social relationships with an expectation of future benefits. Results from this study are designed to inform other small rural hospital leaders and administrators to conduct further research on successful strategies for implementation of EHRs

Telemedicine: An Augmentation Strategy to Mitigate the Primary Care Shortage

According to the Association of American Medical Colleges, the primary care workforce shortage in 2025 will exceed 46,000 primary care physicians. Healthcare business leaders in Gwinnett County, Georgia have not evaluated the advantages and disadvantages of telemedicine (TM) to mitigate the workforce shortage. The purpose of this qualitative descriptive study was to determine factors primary care physician administrators consider when deciding to implement TM as a potential solution for the growing physician shortage. A purposive sample of 20 primary care physician administrators located in Gwinnett County, Georgia was drawn. The theory of disruptive technology was the conceptual framework. Data collected stemmed from semistructured interviews with each participant and review of organizational plans and workflow documents. Data were recorded, transcribed, and coded to develop themes. Three themes morphed from the study: TM awareness and education, TM cost and reimbursement, and TM implementation and utilization. Results indicated that awareness and education of leaders toward TM requires improvement, costs, and reimbursement were variables for deciding to implement or not implement TM, and TM implementation requires knowing the appropriate use of TM. The implications for positive social change include the potential for primary care physician administrators to positively influence the healthcare workforce shortage by adding flexibility to manage patient workflow with TM. Additionally, the potential for physician administrators to utilize TM for healthcare access, creating savings in transportation, energy consumption, and resource optimization, may provide better access to hard-to-reach populations

Smart and Pervasive Healthcare

Smart and pervasive healthcare aims at facilitating better healthcare access, provision, and delivery by overcoming spatial and temporal barriers. It represents a shift toward understanding what patients and clinicians really need when placed within a specific context, where traditional face-to-face encounters may not be possible or sufficient. As such, technological innovation is a necessary facilitating conduit. This book is a collection of chapters written by prominent researchers and academics worldwide that provide insights into the design and adoption of new platforms in smart and pervasive healthcare. With the COVID-19 pandemic necessitating changes to the traditional model of healthcare access and its delivery around the world, this book is a timely contribution

School-Based Health Centers Versus Telehealth Programs on Professional Quality of Life of Public School Teachers in Arkansas

This dissertation aimed to determine by type of school-based health program—schoolbased health centers (SBHCs) or telehealth programs (tSBHC)—and years of teaching experience on the effects of compassion satisfaction, burnout, and secondary traumatic stress among public school teachers in Arkansas districts. Mandates legitimize the additional mental health supports for students; however, supports for teachers who interact with those students is almost non-existent. The Professional Quality of Life survey measures compassion satisfaction, burnout, and secondary trauma in the work setting. Data were collected from novice and experienced teachers from nine Arkansas school districts and analyzed using factorial ANOVAs. SBHC and tSBHC did not affect the professional quality of life of novice and experienced teachers; however, experienced teachers had higher levels of compassion satisfaction and burnout than their novice peers. Further, school-based health programs did not affect teachers’ professional quality of life. School-based health programs and other support services, such as professional training and development focused on teachers’ professional quality of life, are imperative for ensuring the mental health supports for the teaching profession

Online Instructional Consultation (OICON) Model for Higher Education Institution

The purpose of this research is to solve the problems of the existing telementoring program which are (a) the miscommunication due to lack of nonverbal cues, (b) the need or competency in written communication and technical skills, and (c) the issue regarding recording, retrieving, and playback of consultation recorded document. The main objective of this research is to develop an appropriate online consultation model for higher education institution. The specific objectives of this research are to identify suitable multimedia components to be implemented in the online instructional consultation (OICon) model, to develop a prototype, and to test and evaluate the acceptance of online instructional consultation (OICon) prototype by students and lecturers in higher education institution. OICon model was established based on the identification of multimedia communications components and features that were adapted and adopted from the existing online financial consultation, tele-medicine consultation model as well as major e-consultation components for public policy consultation. In addition, recommendations from the IT and Educationist experts were also taken into consideration. This model was then transformed into a prototype and tested on 40 students and 8 lecturers. Eleven hypotheses are derived from 7 factors of TAM with actual system variable excluded. The hypotheses relationships among these 4 factors (Perceived Usefulness (PU), Perceived Ease of Use (PEOU), Attitude, Behavioural Intention (BI) are supported except that PEOU does not have positive relationship with attitude as predicted. Perceived Importance of Communication Components and Features have positive relationship with PEOU. Users are relatively positive towards the implementation of multimedia communication tools for consultation in higher education institution. Users perceived the communication components as important if the components are easy to use. They agreed that they will use the OICon prototype in the future in term of PU and Attitude

Comparison of the Effects of Telehealth versus N95 on Nurse-Patient Communication

Telehealth and face masks are some of the infection control measures nurses use while attending to patients. Nurses provide the most patient care in hospital settings and thus spend the most time with patients in their recovery journey. Because communication is paramount to the role nurses play as health care professionals, there is a substantial need to investigate how infection control measures affect the quality of nurse-patient communication. The purpose of this quantitative cross-sectional study was to describe the relationship of methods aimed at maintaining social distancing between nurses and patients to nurse-patient communication and to compare differences in the quality of communication when using such methods within the hospital setting. This study was grounded in the change theory and the mathematical theory of communication. These theories informed the study’s variables and research questions. The Nurse Quality of Communication with Patient Questionnaire was administered online to help collect the primary data used in the study. The data were analyzed using point bi-serial correlation coefficients and independent samples t tests (n=244). The results revealed a significant association between the two social distancing methods and the perceived quality of communication between nurses and patients (rpb = .656, p \u3c .001; rpb = -.656, p \u3c .001). The results also revealed a significant difference between the quality of nurse-patient communication when nurses use N95 masks and when nurses use telehealth devices to communicate with the patients: t (242) = -14.57, p \u3c .001. The findings of this study will facilitate improved safety in the clinical setting and help steer cooperation between nurses and patients

Comparison of the Effects of Telehealth versus N95 on Nurse-Patient Communication

Telehealth and face masks are some of the infection control measures nurses use while attending to patients. Nurses provide the most patient care in hospital settings and thus spend the most time with patients in their recovery journey. Because communication is paramount to the role nurses play as health care professionals, there is a substantial need to investigate how infection control measures affect the quality of nurse-patient communication. The purpose of this quantitative cross-sectional study was to describe the relationship of methods aimed at maintaining social distancing between nurses and patients to nurse-patient communication and to compare differences in the quality of communication when using such methods within the hospital setting. This study was grounded in the change theory and the mathematical theory of communication. These theories informed the study’s variables and research questions. The Nurse Quality of Communication with Patient Questionnaire was administered online to help collect the primary data used in the study. The data were analyzed using point bi-serial correlation coefficients and independent samples t tests (n=244). The results revealed a significant association between the two social distancing methods and the perceived quality of communication between nurses and patients (rpb = .656, p \u3c .001; rpb = -.656, p \u3c .001). The results also revealed a significant difference between the quality of nurse-patient communication when nurses use N95 masks and when nurses use telehealth devices to communicate with the patients: t (242) = -14.57, p \u3c .001. The findings of this study will facilitate improved safety in the clinical setting and help steer cooperation between nurses and patients

Usability analysis of contending electronic health record systems

In this paper, we report measured usability of two leading EHR systems during procurement. A total of 18 users participated in paired-usability testing of three scenarios: ordering and managing medications by an outpatient physician, medicine administration by an inpatient nurse and scheduling of appointments by nursing staff. Data for audio, screen capture, satisfaction rating, task success and errors made was collected during testing. We found a clear difference between the systems for percentage of successfully completed tasks, two different satisfaction measures and perceived learnability when looking at the results over all scenarios. We conclude that usability should be evaluated during procurement and the difference in usability between systems could be revealed even with fewer measures than were used in our study. © 2019 American Psychological Association Inc. All rights reserved.Peer reviewe

Environmental Pollution and Chronic Disease Management – A Prognostics Approach

No abstract available

Exploring the Potential Use of Telehealth Technology to Improve the Diagnostic Process of Autism Spectrum Disorder (ASD) in Wales, United Kingdom

There is a significant delay between parents initially seeking help and receiving a diagnosis of Autism Spectrum Disorder (ASD). Telehealth has the potential to accelerate the ASD diagnostic pathway. However, user acceptance is essential for the successful implementation of telehealth technology. This thesis therefore aims to examine whether telehealth can be used to increase access to ASD diagnostic services in Wales and reduce the time taken to receive a diagnosis. To achieve this, a multimethod approach was adopted, comprising of three studies. Initially, a scoping review (Study1) was conducted examining the use of telehealth in ASD diagnostic assessment. This identified two methods: (a) Real-Time (b) Store-and-Forward, particularly the Naturalistic Observation Diagnostic Assessment (NODA) system. Results also suggest that telehealth is feasible and acceptable to the families. However, findings indicate that no study had thus far examined the factors of telehealth acceptance, based on theoretical foundation. Therefore, Studies two and three were conducted, to explore the parental experience of the diagnostic process, and investigate the predictors of their acceptance to use NODA for ASD diagnostic assessment, using the Unified Theory of Acceptance and Use of Technology model. Data for both studies was collected via an online questionnaire, targeting parents of children with ASD in Wales. Descriptive and inferential statistics were applied to the closed-ended questions, and thematic analysis was used for open-ended questions. Study 2 findings revealed that the majority of parents were dissatisfied with the diagnostic process, with the time taken to obtain a diagnosis being a predictor of their satisfaction. Study 3 found that the majority of parents felt positively towards the NODA, with their willingness to use the system being predicted by their age, performance expectancy, social influence and comfort with using laptop and smartphone devices. Implications and recommendations are further discussed at the end of the thesis