More Than Just Sex: The Social Implications of HIV/AIDS in Lusaka, Zambia

The thesis research examines the implications of the HIV/AIDS epidemic on people living in Lusaka, Zambia with a particular focus on women. This study incorporates a literature review, qualitative semi-structured interviews and is grounded in anthropological and feminist theories concerning gender. It explores the intersections of the economic situation, cultural norms and education as well as the gendered nature of socialization to provide further insight into the multifaceted and overlapping factors that may influence the propagation of HIV/AIDS within this society. Through ethnographic accounts, individual lived experiences are explored and highlight the variability in women’s conditions in Lusaka, particularly when these women are living with HIV

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

Effectiveness of local support for the adoption of a national programme – a descriptive study

Background Change management in health care is a complex and time-consuming endeavour, and no less so in implementing technological systems. In deploying a nationwide programme, the personally controlled electronic health record (PCEHR), the Australian Government employed a number of national and local change management programmes.Objective This article describes the processes undertaken and the experiences of introducing the PCEHR into 74 general practices across a specific area of metropolitan Melbourne.Method An online survey was developed by an independent evaluator and offered to all participating practices. The response rate was 82%.Results The deployment and testing of the eHealth infrastructure and the roll- out of the PCEHR were deeply supported through face-to-face, locally contextualised support processes. The area Medicare Local (ML), an organisation that provides support services to general practice and allied health in the community, provided support and programme coordination. This support occurred in the environment of a number of other initiatives to improve adoption.Conclusion The impact and value of this support in the registration and adoption process was explored in an online survey and found to be the key factor in practice engagement and success. ML support was seen as instrumental in improving adoption and was more effective than other activities. This article highlights the role of local support, in this case, MLs, in the effective implementation of eHealth programmes across a range of stakeholder groups, in particular, general practice, and the potential for the lessons learned from the engagement model of such an entity to be more generally applied

Electronic prescribing systems in hospitals to improve medication safety: a multimethods research programme.

Electronic prescribing (ePrescribing) systems allow health-care professionals to enter prescriptions and manage medicines using a computer. We set out to find out how these ePrescribing systems are chosen, set up and used in English hospitals. Given that these systems are designed to improve medication safety, we looked at whether or not these systems affected the number of prescribing errors made (mistakes such as ordering the wrong dose of medication). We also tried to see whether or not the systems were good value for money (or more cost-effective). Finally, we made recommendations to help hospitals choose, set up and use ePrescribing systems. We found that setting up ePrescribing systems was very difficult because there is a need to take into consideration how different pharmacists, nurses and doctors work, and the different work that needs to be carried out for different diseases and medical conditions. We recorded a link between the implementation of ePrescribing systems and a reduction in some high-risk prescribing errors in two out of three study sites. Given that the error reductions corresponded to the warnings triggered by the system, we concluded that the system is likely to have caused the error reduction. Prescribing errors may lead to adverse events that lead to death, impaired quality of life and longer hospital stays. The cost of an ePrescribing system increased in proportion to reduced errors, reaching £4.31 per patient per year for the site that experienced the greatest reduction in prescribing errors (i.e. site S). This estimate is based on assumptions in the model and how much a health service is willing to pay for a unit of health benefit. To help professionals choose, set up and use ePrescribing systems in the future, we produced an online ePrescribing Toolkit (www.eprescribingtoolkit.com/; accessed 21 December 2019) that, with support from NHS England, is becoming widely used internationally

Implementing and Evaluating a Clinical Information Interface between an Electronic Medical Record and a Patient Classification System

As a result of the Affordable Care Act and the Institute of Medicine’s initiatives, hospitals are challenged to improve outcomes as efficiently as possible. How does the national initiative of RNs partnering with other healthcare professionals to improve the quality of patient care at a lower cost, cascade down to individual organizations? One answer may come by focusing on nurse staffing in acute care hospitals. Considering the impact RNs have on patient quality outcomes and the bottom line of hospitals, appropriate management of the RN workforce is one of the most important areas hospitals can focus on in order to meet the goals of ACA and the IOM. The aim of the project is to create and implement a clinical information interface between two software solutions, by different vendors, that allows electronic medical record (EMR) data to provide source data for the patient classification system (PCS). The end result will be a classification system that is fully automated. The creation and implementation of a clinical interface between software solutions from different industry partners is a very new and innovative approach for advancing the use of software. No template for this work is available. This computerized information interface (CII) will allow Nurse Managers to use timely, accurate and consistent data to make informed decisions to manage the nursing workforce in the in-patient setting

Creating and Applying an Evaluation Framework for the National Decision Support Programme in Scotland

Context: The Scottish Government recognises the importance of decision support to improve knowledge management in health and care settings as a strategic priority. To this end, they funded the 2015 National Decision Support Roadmap. This laid out a plan for procuring and building a Decision Support Platform delivering a range of small-scale demonstrators (including several mobile platforms for specific user groups e.g. polypharmacy and diabetes), and building clinician and policy engagement for further funding. Aims: We were commissioned to undertake a formative evaluation of the National Decision Support Programme to help facilitate the effective roll-out of systems included in the Roadmap more widely. Methods: We collected qualitative data through a series of in-depth interviews and observations of workshops demonstrating technological systems. Participants included policy makers and clinical leads involved in the National Decision Support Programme. As the Programme was in the early stages of strategy development and system implementation at the time of data collection, we focused on exploring expectations and drivers of Cambio (a pilot platform) being tested in primary care. This system delivers an open standards based algorithm editor and engine which is linked with bespoke decision support applications delivered as web and mobile products and integrated into primary care electronic health record systems. The web and mobile solutions linked to the Cambio algorithms platform were developed by Scottish partners (Tactuum and University of West of Scotland). Employing a flexible methodological approach tailored to changing circumstances and need offered important opportunities for realising true impact through ongoing formative feedback to policymakers and active engagement of key clinical stakeholders. Our work was informed by sociotechnical principles and a health information infrastructure perspective. Qualitative data were coded with the help of NVivo software and analysed through a combination of inductive and deductive approaches. Findings: We collected data through 30 interviews and eight non-participant ethnographic observations of early stakeholder engagement workshops. We developed and applied a theoretically-informed evaluation framework, which we refined throughout our analysis. Overall, we observed a strong sense of support from all stakeholders for Cambio as an exemplar of an open standards based, customisable decision support platform, and proposals to roll this model out across NHS Scotland. Strategic drivers included facilitating integration of care, preventative care, patient self-management, shared decision-making, patient engagement, and the availability of information. However, in order to achieve desired benefits, participants highlighted the need for strong national leadership, system usability (which was perceived to be negatively affected by alert fatigue and integration with existing systems), and ongoing monitoring of potential unintended consequences emerging from implementations (e.g. clinical workloads). Conclusions and implications: In order to address potential tensions between national leadership and local usability as well as unintended consequences, there is a need to have overall national ownership to support the implementation of the Roadmap, whilst the implementation of individual applications needs to be devolved. This could be achieved through allowing a degree of local customisation of systems and tailoring of alerts, ongoing system development with continuing stakeholder engagement including “hands-on” experience for clinicians, a limited number of pilots that are carefully evaluated to mitigate emerging risks early, and development of a nuanced benefits realisation framework that combines smaller and locally relevant measures determined by implementing sites with national progress measures

The Second International Conference on Health Information Technology Advancement

TABLE OF CONTENTS I. Message from the Conference Co-Chairs B. Han and S. Falan …………………………....….……………. 5 II. Message from the Transactions Editor H. Lee …...………..………….......………….……….………….... 7 III. Referred Papers A. Emerging Health Information Technology and Applications The Role of Mobile Technology in Enhancing the Use of Personal Health Records Mohamed Abouzahra and Joseph Tan………………….……………. 9 Mobile Health Information Technology and Patient Care: Methods, Themes, and Research Gaps Bahae Samhan, Majid Dadgar, and K. D. Joshi…………..…. 18 A Balanced Perspective to Perioperative Process Management Jim Ryan, Barbara Doster, Sandra Daily, and Carmen Lewis…..….…………… 30 The Impact of Big Data on the Healthcare Information Systems Kuo Lane Chen and Huei Lee………….…………… 43 B. Health Care Communication, Literacy, and Patient Care Quality Digital Illness Narratives: A New Form of Health Communication Jofen Han and Jo Wiley…..….……..…. 47 Relationships, Caring, and Near Misses: Michael’s Story Sharie Falan and Bernard Han……………….…..…. 53 What is Your Informatics Skills Level? -- The Reliability of an Informatics Competency Measurement Tool Xiaomeng Sun and Sharie Falan.….….….….….….…. 61 C. Health Information Standardization and Interoperability Standardization Needs for Effective Interoperability Marilyn Skrocki…………………….…….………….… 76 Data Interoperability and Information Security in Healthcare Reid Berryman, Nathan Yost, Nicholas Dunn, and Christopher Edwards.…. 84 Michigan Health Information Network (MiHIN) Shared Services vs. the HIE Shared Services in Other States Devon O’Toole, Sean O’Toole, and Logan Steely…..……….…… 94 D. Health information Security and Regulation A Threat Table Based Approach to Telemedicine Security John C. Pendergrass, Karen Heart, C. Ranganathan, and V.N. Venkatakrishnan …. 104 Managing Government Regulatory Requirements for Security and Privacy Using Existing Standard Models Gregory Schymik and Dan Shoemaker…….…….….….… 112 Challenges of Mobile Healthcare Application Security Alan Rea………………………….……………. 118 E. Healthcare Management and Administration Analytical Methods for Planning and Scheduling Daily Work in Inpatient Care Settings: Opportunities for Research and Practice Laila Cure….….……………..….….….….… 121 Predictive Modeling in Post-reform Marketplace Wu-Chyuan Gau, Andrew France, Maria E. Moutinho, Carl D. Smith, and Morgan C. Wang…………...…. 131 A Study on Generic Prescription Substitution Policy as a Cost Containment Approach for Michigan’s Medicaid System Khandaker Nayeemul Islam…….…...……...………………….… 140 F. Health Information Technology Quality Assessment and Medical Service Delivery Theoretical, Methodological and Practical Challenges in Designing Formative Evaluations of Personal eHealth Tools Michael S. Dohan and Joseph Tan……………….……. 150 The Principles of Good Health Care in the U.S. in the 2010s Andrew Targowski…………………….……. 161 Health Information Technology in American Medicine: A Historical Perspective Kenneth A. Fisher………………….……. 171 G. Health Information Technology and Medical Practice Monitoring and Assisting Maternity-Infant Care in Rural Areas (MAMICare) Juan C. Lavariega, Gustavo Córdova, Lorena G Gómez, Alfonso Avila….… 175 An Empirical Study of Home Healthcare Robots Adoption Using the UTUAT Model Ahmad Alaiad, Lina Zhou, and Gunes Koru.…………………….….………. 185 HDQM2: Healthcare Data Quality Maturity Model Javier Mauricio Pinto-Valverde, Miguel Ángel Pérez-Guardado, Lorena Gomez-Martinez, Martha Corrales-Estrada, and Juan Carlos Lavariega-Jarquín.… 199 IV. A List of Reviewers …………………………..…….………………………208 V. WMU – IT Forum 2014 Call for Papers …..…….…………………20

ACUTA Journal of Telecommunications in Higher Education

In This Issue Current Legislative and Regulatory lssues The Broadband Stimulus: What We Can Learn from the Notice of Funds Availability The Top 10 Cloud Computing lssues for Higher Education 9-1-1. What ls Your Emergency? Shelter from the Storm Interview President\u27s Message From the Executive Director Q&A from the CI

The Intersection of Healthcare Marketing Communications and Patient Experience: A Qualitative Study

Providing a positive experience to patients at healthcare organizations is a complex undertaking and a continuous process due to staff turnover and the ever-changing industry. Positive patient experiences are an important part of the healing process as they relate to better outcomes in quality assessments. The purpose of this case study was to examine the nature of collaboration between clinical and marketing communications teams working to improve patient experience. To uncover lived experience, semi-structured interviews were conducted with 18 participants–nine clinicians and nine marketing communications professionals–from 10 organizations. The study sought to understand how marketing communications teams collaborated with clinicians, how they described barriers to collaboration, and what metrics they used to measure patient experience. Four themes related to the research questions arose: a lack of understanding of each other’s roles persists, a standard definition of patient experience has not yet been adopted, healthcare organizations seek third-party help in developing patient experience programs, and rewards, recognition, and ongoing education are the key ways healthcare organizations keep their staff focused on delivering care that will lead to positive patient experiences. Future research opportunities should include considering marketing communications role in patient experience programs from additional perspectives, especially executive leaders, whose influence is critical to promoting collaboration among team members