1,777 research outputs found

    Understanding Physicians' Adoption Of Electronic Medical Records: Healthcare Technology Self-Efficacy, Service Level And Risk Perspectives

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    Most developed countries across the globe are deploying electronic medical record (EMR) as one of the most important initiatives in their healthcare policy. EMR can not only reduce the problems associated with managing paper medical records but also improve the accuracy of medical decisions made by physicians and increase the safety of patients. Considering that physicians are the primary users of EMR, their willingness to use EMR is a critical success factor for EMR implementation in a hospital. This study aims to extend an individual-level information technology adoption model by incorporating three additional variables to investigate whether the individual characteristics of a physician affect EMR adoption. A field survey is conducted with a total of 217 physicians from 15 different academic medical centers and metropolitan hospitals for six weeks. Then, the Structural Equation Modeling (SEM) analysis results indicate that perceived service level is an important antecedent of perceived usefulness. Healthcare technology self-efficacy, perceived risk, and perceived service level are also important antecedents of perceived ease of use. This study is concluded with implications for academics, hospital managers, governments, and medical information service providers

    Bridging the Relational-Regulatory Gap: A Pragmatic Information Policy for Patient Safety and Medical Malpractice

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    The Article distinguishes and explores three categories of information use: Helping patients understand and participate in their care; Improving patient safety, including analyzing medical errors and identifying unsafe health care providers and practices; and Assessing the performance of the medical liability system in its many dimensions including deterrence, compensation, justice, administrative efficiency, and stability. For each category, the Article comments on existing laws or programs for information reporting or disclosure, points out major tensions or ambiguities, and suggests pragmatic improvements

    Bridging the Relational-Regulatory Gap: A Pragmatic Information Policy for Patient Safety and Medical Malpractice

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    The medical malpractice crisis of the last few years has tapped a lot of scholarly energy. Time not spent on original research-adding to the store of knowledge about the medical malpractice system-is often spent communicating with policymakers and the public. These experiences have led us to think a lot about the amount and quality of information circulating within or concerning the medical malpractice system, and about public policy reforms that would improve information flow in the future. No grand theory has emerged from this meditation. Instead, we have formed definite, though not immutable, opinions about a desirable information policy for patient safety and medical malpractice. Two specific recommendations convey a sense of our view. First, the mandatory malpractice payment reporting provisions of the National Practitioner Data Bank should be repealed. Second, confidential settlements of tort claims in medical malpractice cases should be prohibited, except perhaps as to the dollar amount of the payment. But aren\u27t these inconsistent? The former would reduce available information, while the latter would increase it. Furthermore, wouldn\u27t combining the two reforms be self-defeating, with a net result of reconstructing national data simply by aggregating individual settlements? We hope to persuade readers of this Article that these recommendations should receive a more favorable descriptor: pragmatic. For reasons explained below, any seamless information policy is likely to reflect a foolish consistency-perhaps political ideology, perhaps tunnel vision regarding policy goals or regulatory silos-and should be avoided. Rather, information policy should be incremental and contextual. That is, it should be sensitive to the complicated, contentious history and psychology of health care quality oversight and medical liability. One can model malpractice information policy by envisioning a signal pathway that divides the disclosure process into segments. Beginning from a medical incident, the critical steps in conveying information are content (signal), packaging (categorization), accessing (transmission), and interpretation (processing) of malpractice-related information about health care providers. Each stage of the pathway modifies the signal as it moves forward. Therefore, significant variables at each stage can affect the end result: what content is chosen, how it is categorized, who has access to it, and the final impression it creates

    ADOPTION OF ELECTRONIC HEALTH RECORDS SYSTEM: DIFFERENTIATING MAIN ASSOCIATIONS

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    Health organizations are implementing health information technologies such as electronic health records (EHR), information systems (IS), and health information exchange (HIE) networks to improve decision-making. However, over the years, the healthcare environment has demonstrated numerous unsuccessful implementations of such technologies. One of the reasons is that physicians tend not to make use of these technologies in the healthcare environment. The various explanations put forward typically refer to patient, physician, and/or work environment-related factors. \ \ This study evaluated the factors associated with the EHR use among physicians in the complex environment of emergency departments. \ \ We used log-files retrieved from an integrative and interoperable EHR that serves Israeli hospitals. We found that EHR was primarily consulted for patients presenting with internal diagnoses, patients of older age, and it was used more by internists than by surgical specialists. Furthermore, EHR usage was larger for admitted patients than for those discharged. \ \ The findings show factors associated with EHR use and suggest that it is mostly related to case-specific features and to physician specialty. The findings strongly suggest that when planning assimilation projects for EHR systems and HIE networks, attention should be paid to those factors associated with system usage. Specifically, in order to increase the efficiency of the system, and enhance its use in the ED environment, physicians´ preferences and practice-related needs need to be taken into account. Furthermore, well-thought IT design and implementation are necessary to generate an increase in meaningful use of HIT, which can serve both physicians´ and patients´ needs

    The formation of physician patient sharing networks in medicare: Exploring the effect of hospital affiliation

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    This study explores the forces that drive the formation of physician patient sharing networks. In particular, I examine the degree to which hospital affiliation drives physicians\u27 sharing of Medicare patients. Using a revealed preference framework where observed network links are taken to be pairwise stable, I estimate the physicians\u27 pair‐specific values using a tetrad maximum score estimator that is robust to the presence of unobserved physician specific characteristics. I also control for a number of potentially confounding patient sharing channels, such as (a) common physician group or hospital system affiliation, (b) physician homophily, (c) knowledge complementarity, (d) patient side considerations related to both geographic proximity and insurance network participation, and (e) spillover from other collaborations. Focusing on the Chicago hospital referral region, I find that shared hospital affiliation accounts for 36.5% of the average pair‐specific utility from a link. Implications for reducing care fragmentation are discussed

    \u3cem\u3eHellingv. Carey\u3c/em\u3e Revisited: Physician Liability in the Age of Managed Care

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    In this article, the author proposes that the traditional custom-based standard applicable in medical malpractice cases be replaced with a reasonable, prudent physician standard that will more adequately take into account the role of the physician in rationing care. Part I of this article focuses on the heightened tension between tort and contract in managed health care. Part II of this article examines managed care cost containment techniques and their possible impact on physician decision making. Part III focuses on the widely acknowledged shortcomings of the customary standard. Part IV provides an outline of the doctrinal regime for my proposed reasonable, prudent physician standard

    \u3cem\u3eHellingv. Carey\u3c/em\u3e Revisited: Physician Liability in the Age of Managed Care

    Get PDF
    In this article, the author proposes that the traditional custom-based standard applicable in medical malpractice cases be replaced with a reasonable, prudent physician standard that will more adequately take into account the role of the physician in rationing care. Part I of this article focuses on the heightened tension between tort and contract in managed health care. Part II of this article examines managed care cost containment techniques and their possible impact on physician decision making. Part III focuses on the widely acknowledged shortcomings of the customary standard. Part IV provides an outline of the doctrinal regime for my proposed reasonable, prudent physician standard
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