If You Build It, Will They Use It? Challenges in Adoption and Use of Patient-centered E-health

Preventive healthcare services require consumers to coordinate and manage several healthcare activities with multiple service providers. In this paper, we explore the adoption and use of a patient-centered e-health system for managing personal healthcare requirements. Specifically, using the patient-centered e-health (PCEH) framework, we analyzed the data we collected from a qualitative study of consumers who participated in a preventive care program called the Health Enhancement Program (HEP) in Connecticut in the United States and the accompanying e-health service the program offered. Data from the interviews of 15 participants revealed that users found several challenges in adopting and using the e-health system when examined in the context of their lifestyle even though the system had a patient-centric design. These findings provide implications for designing and assessing patient-centered e-health to ensure that users effectively adopt and continue to use them and insights for expanding PCEH theory and practice

HITECH Revisited

Assesses the 2009 Health Information Technology for Economic and Clinical Health Act, which offers incentives to adopt and meaningfully use electronic health records. Recommendations include revised criteria, incremental approaches, and targeted policies

Addressing Childhood Adversity and Social Determinants inPediatric Primary Care:Recommendations for New Hampshire

Research has clearly demonstrated the significant short- and long-term impacts of adverse childhood experiences (ACEs) and the social determinants of health (SDOH) on child health and well-being.1 Identifying and addressing ACEs and SDOH will require a coordinated and systems-based approach. Pediatric primary care* plays a critical role in this system, and there is a growing emphasis on these issues that may be impacting a family. As awareness of ACEs and SDOH grows, so too does the response effort within the State of New Hampshire. Efforts to address ACEs and the SDOH have been initiated by a variety of stakeholders, including non-profit organizations, community-based providers, and school districts. In late 2017, the Endowment for Health and SPARK NH funded the NH Pediatric Improvement Partnership (NHPIP) to develop a set of recommendations to address identifying and responding to ACEs and SDOH in NH primary care settings caring for children. Methods included conducting a review of literature and Key Informant Interviews (KII). Themes from these were identified and the findings are summarized in this report

Innovative Medicaid Initiatives to Improve Service Delivery and Quality of Care: A Look at Five State Initiatives

Outlines initiatives in Alabama, Oklahoma, Oregon, Pennsylvania, and Washington to implement patient-centered medical home models designed to coordinate and improve quality of care; strategies; key lessons; and new opportunities under healthcare reform

The Electronic Health Record Scorecard: A Measure of Utilization and Communication Skills

As the adoption rate of electronic health records (EHRs) in the United States continues to grow, both providers and patients will need to adapt to the reality of a third actor being present during the visit encounter. The purpose of this project is to provide insight on “best” practice patterns for effective communication and efficient use of the EHR in the clinical practice setting. Through the development of a comprehensive scorecard, this project assessed current status of EHR use and communication skills among health care providers in various clinical practice settings. Anticipated benefits of this project are increased comfortability in interfacing with the EHR and increased satisfaction on the part of the provider as well as the patient. Serving as a benchmark, this assessment has the potential to help guide future health information technology development, training, and education for both students and health care providers

Driving Value in Medicaid Primary Care: The Role of Shared Support Networks for Physician Practices

Examines the challenges of transforming small primary care practices under healthcare reform and options for Medicaid to drive changes through practice supports to help implement and sustain new models of care or catalyze investments in new systems

Is There an App for That? Electronic Health Records (EHRs) and a New Environment of Conflict Prevention and Resolution

Katsh discusses the new problems that are a consequence of a new technological environment in healthcare, one that has an array of elements that makes the emergence of disputes likely. Novel uses of technology have already addressed both the problem and its source in other contexts, such as e-commerce, where large numbers of transactions have generated large numbers of disputes. If technology-supported healthcare is to improve the field of medicine, a similar effort at dispute prevention and resolution will be necessary

Breaking the Barriers to Specialty Care: Practical Ideas to Improve Health Equity and Reduce Cost - Striving for Equity in Specialty Care Full Report

Tremendous health outcome inequities remain in the U.S. across race and ethnicity, gender and sexual orientation, socio-economic status, and geography—particularly for those with serious conditions such as lung or skin cancer, HIV/AIDS, or cardiovascular disease.These inequities are driven by a complex set of factors—including distance to a specialist, insurance coverage, provider bias, and a patient's housing and healthy food access. These inequities not only harm patients, resulting in avoidable illness and death, they also drive unnecessary health systems costs.This 5-part series highlights the urgent need to address these issues, providing resources such as case studies, data, and recommendations to help the health care sector make meaningful strides toward achieving equity in specialty care.Top TakeawaysThere are vast inequalities in access to and outcomes from specialty health care in the U.S. These inequalities are worst for minority patients, low-income patients, patients with limited English language proficiency, and patients in rural areas.A number of solutions have emerged to improve health outcomes for minority and medically underserved patients. These solutions fall into three main categories: increasing specialty care availability, ensuring high-quality care, and helping patients engage in care.As these inequities are also significant drivers of health costs, payers, health care provider organizations, and policy makers have a strong incentive to invest in solutions that will both improve outcomes and reduce unnecessary costs. These actors play a critical role in ensuring that equity is embedded into core care delivery at scale.

Will the Patient-Centered Medical Home Transform the Delivery of Health Care?

Explores various definitions of the medical home model, its components, rationale, effect on primary care, issues for implementation such as costs and payment methods, evidence of effectiveness, and healthcare reform provisions promoting it

Healthcare Robotics

Robots have the potential to be a game changer in healthcare: improving health and well-being, filling care gaps, supporting care givers, and aiding health care workers. However, before robots are able to be widely deployed, it is crucial that both the research and industrial communities work together to establish a strong evidence-base for healthcare robotics, and surmount likely adoption barriers. This article presents a broad contextualization of robots in healthcare by identifying key stakeholders, care settings, and tasks; reviewing recent advances in healthcare robotics; and outlining major challenges and opportunities to their adoption.Comment: 8 pages, Communications of the ACM, 201