Alcuni abstract di articoli che trattano argomenti relativi all'eHealth

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Creating Technology-enhanced Practice: A University-Home Care-Corporate Alliance

Insuring full benefit of consumer health informatics innovations requires integrating the technology into nursing practice, yet many valuable innovations are developed in research projects and never reach full integration. To avoid this outcome, a team of researchers partnered with a home care agency’s staff and patients and their corporate parent’s Information Systems and Research group to create a Technology-Enhanced Practice (TEP) designed to enhance care of home bound patients and their family care givers. The technology core of TEP, the HeartCare2 web site, was built in a collaborative process and deployed within the existing patient portal of the clinical partner. This paper describes the innovation and the experience of bringing it into full operation

Workflow Management for Multiple Sclerosis Patients: IT and Organization

Patients with Multiple Sclerosis (MS) visit various healthcare providers during the course of their disease. It was suggested that IT might help to\ud orchestrate their care provision. We have applied the USE IT-tool to get insight in the relevant problems, solutions and constraints of the MS-care and the MS care providers both in the organizational and the information technological area. There is hardly a chain of healthcare, but rather, a network in which informal communication plays an important role. This informal network worked reasonably effective, but inefficient and slow. The patient himself plays a keyrole in information exchange between care-providers. Many providers were unaware of the services that other healthcare providers could give in general or did provide to a specific patient. MS patients-count is only small for most care providers. None of the interviewed patients mentioned a lack of contacts between careproviders as a problem. They thought that lack of\ud experience caused their major problems: insufficient and inadequate care. To improve care, we proposed a solution that combines a “short MS-protocol”, the\ud introduction of a central coordinator of care and a Patient Relation Management (PRM) System. This is a simple web-based application that is based on agreement by the caregivers that supports routing, tracking and tracing of a MS patient and supplies the caregivers with professional guidelines, as written down in the protocol. It is likely that we would have suggested a far more complicated ICT solution if we had only analyzed the MS-care process as such, without specific consideration of the USE IT dimensions

Developing a Business Case for the Care Coordination and Transition Management Model: Need, Metrics, and Measures

In this descriptive qualitative study, nurse and healthcare leaders\u27 experiences, perceptions of care coordination and transition management (CCTM®), and insights as to how to foster adoption of the CCTM RN role in nursing education, practice across the continuum, and policy were explored. Twenty-five barriers to recognition and adoption of CCTM RN practice across the continuum were identified and categorized. Implications of these findings, recommendations for adoption of CCTM RN practice across the care continuum, and strategies for reimbursement policies are discussed

Addressing the Health Needs of an Aging America: New Opportunities for Evidence-Based Policy Solutions

This report systematically maps research findings to policy proposals intended to improve the health of the elderly. The study identified promising evidence-based policies, like those supporting prevention and care coordination, as well as areas where the research evidence is strong but policy activity is low, such as patient self-management and palliative care. Future work of the Stern Center will focus on these topics as well as long-term care financing, the health care workforce, and the role of family caregivers

INFORMATICS AND FACULTY INTRAPROFESSIONAL ASSESSMENT AND GAP ANALYSIS OF CURRENT INTEGRATION OF INFORMATICS COMPETENCIES IN A BACCALAUREATE NURSING PROGRAM

Abstract Background: In its effort to improve patient safety and quality in the U.S. healthcare system, the Institute of Medicine (IOM) called for the integration of health information technology and informatics in the education of healthcare professionals, especially nurses (IOM, 2001, 2003, 2012; National League for Nursing, 2008). Despite this recommendation, the integration of clinical informatics in nursing education has been slow and inconsistent, leaving gaps in the knowledge and skills that future nurses need to use clinical informatics competencies effectively in a variety of healthcare settings. Purpose: This quality improvement project had three aims: (1) to assess the current state of informatics competency integration in the baccalaureate program; (2) to identify gaps in teaching informatics competencies in the curriculum; and (3) to present the gap analysis and clinical informatics coverage gap/needs assessment related to informatics competencies of the American Association of Colleges of Nursing (AACN) Essentials of Baccalaureate Education for Professional Nursing Practice, Quality and Safety Education for Nurses (QSEN), and Technology Informatics Guiding Education Reform (TIGER). Method: A nursing informatics competency checklist worksheet was created based on the competencies outlined by the AACN, QSEN, and TIGER. This worksheet was completed by faculty and an informatician to assess the current state of integration of informatics competencies in the curriculum. Gaps between the two assessments were analyzed. Results: The informatician survey showed coverage of 94% of the competencies, while the faculty member survey showed coverage of 82%. There were three major findings: (1) coverage of informatics competencies related to basic computer literacy, clinical information literacy, and health information literacy was adequate; (2) competencies associated with the history and evolution of nursing informatics were underdeveloped in the curriculum; and (3) there were inadequate opportunities to develop and have students apply informatics competencies explicitly in most of the courses. Conclusions: Based on evidence, the nursing informatics competency checklist can be used as a guide in assessing and evaluating current undergraduate curricula and determining how nursing informatics competencies are integrated in nursing programs. The gap analysis helped faculty highlight areas of strength and identified deficiencies in informatics competency development within the program. The project lays the foundation for further work on applied assignments in the baccalaureate program. Additionally, a next phase of a curricular quality improvement project can include developing and integrating a comparable set of informatics competencies in other prelicensure nursing undergraduate, such as the associate degree program, RN to BSN completion and graduate programs. Results suggest that further education is required in the field of teaching informatics through additional training workshops and continuing education opportunities for faculty

Towards an evaluation framework for medical web applications

Copyright @ 2013 EMCIS.The main aim of this study is to review and analyse various evaluation frameworks used to assess the operational effectiveness of various Information Technology (IT) processes/applications and identify their strengths in order to form a new holistic framework for economic evaluation of web applications. This research aims to address the need for a new holistic evaluation framework for the purpose of the evaluation of the medical web applications. Over the last decade more and more, companies used accountancy techniques such as the frameworks analysed in this research. This new holistic framework that was developed will include also steps regarding the indirect and intangible costs and benefits identification and their incorporation in the evaluation process. Moreover the new emerging market of the medical websites and the embedded on them web applications requires also a new evaluation framework that will provide accurate results in the estimation of the efficiency of an investment on them. The paper first presents an introduction about why economic evaluation is important when evaluating the Information Technology in organizations. Various studies are reviewed, which highlight the ever increasing importance of integrating economic evaluation processes, such as Cost Benefit Analysis (CBA) and Return on Investment (ROI), into systems and processes of organizations and economic organizations, and analyse the factors that govern their role. Finally, the evaluation frameworks and methods that are found in these studies should be used as a part of a proactive systematic action plan that the organizations could use to avoid budget reduction due to incorrect planning. The next part of this study includes a comprehensive presentation and review of past frameworks used to evaluate Information Technology. The frameworks that are reviewed are the Framework for evaluation of information systems, the Information Technology Adoption Model (ITAM), the Total Evaluation and Acceptance Methodology (TEAM) framework, the ROI Process Model and HOT-fit evaluation framework for Health Information Systems

Exploring Challenges in Conducting E-Mental Health Research Among Asian American Women

In this discussion paper, we explore the challenges of conducting e-mental health intervention research among Asian American women and propose a model for addressing these barriers. Based on an extensive literature review, we identify two main types of barriers to conducting e-mental health intervention research among Asian American women: recruitment barriers and adherence barriers. Recruitment barriers are further subcategorized into those related to (1) stigmatized cultural beliefs about mental illness and mental health services; (2) lack of awareness about mental health services; and (3) language barrier. As to adherence barriers, the two identified subtypes concern (1) acuity and severity of mental health condition; and (2) lack of time. In order to enhance recruitment and adherence in e-mental health intervention research among the studied population, we formulate the following three main research strategies, namely: (1) considering the cultural and social contexts of Asian American women in the development of e-mental health interventions; (2) determining appropriate program length; and (3) conducting feasibility studies to test e-mental health interventions. We suggest that nurse researchers integrate our proposed model in conducting e-mental health interventions among Asian American women. Our proposed model also implies that nurses play an important role in encouraging Asian American women’s acceptance of and adherence to e-mental health interventions. In order to overcome the obstacles to conducting e-mental health research among Asian American women, we recommend that nurses familiarize themselves with credible, relevant, and evidence-based e-mental health resources and integrate online mental health services and information within their nursing practice

The Use of Clinical Decision Support to Improve Nursing Practice

Healthcare information technology is solidly entrenched in most acute care hospitals but the need to demonstrate its positive impact on patient outcomes persists. Clinical decision support (CDS) is an informatics tool that is highly customizable to promote patient improvement activities. Despite its high potential, studies have had mixed results regarding the impact of CDS and it has not been widely studied in the realm of nursing practice. One aim of this dissertation was to analyze the concept of CDS in order to inform the examination of the relationships between CDS implementation and nursing interventions. The determining factors of nurses use and acceptance of CDS was also described within the context of the CDS concept schematic developed. Data from 4718 pediatric hospital admissions were analyzed to examine if there was a relationship between the implementation of CDS and the implementation of sequential compression devices (SCD) for the purpose of preventing VTE and the placement of chart notifications of VTE risk. Admissions with patients who were identified as at risk for VTE had SCDs placed almost two and one-half times more often after the CDS was implemented (RR = 2.32; 95% CI (1.9 – 2.83)) and 33 times more likely to have chart notifications placed. In order to describe the determining factors of use, the unified theory of acceptance and use of technology (UTAUT) was adapted to create an electronic survey. Two multivariate regression models were built to describe the UTAUT model from previous literature. Results demonstrated that the model as described explains the majority of the data but also highlighted some weaknesses in the realm of the construct voluntary use. The results of this dissertation contribute to the limited literature regarding CDS use in nursing practice