Information-Enabled Decision-Making in Health Care: EHR-Enabled Standardization, Physician Profiling and Medical Home

Health care today harms too frequently and routinely fails to deliver its potential benefits. Significant evidence suggests that high quality primary care can positively affect health outcomes. I explored three related topics mentioned frequently in current United States health reform €“ Electronic Health Records (EHR), physician profiling and Medical Home. An investment in these areas is expected to significantly improve quality of care and efficiency; however, there is only a patchwork of evidence supporting such claims. To achieve EHR promises, my research employed a standardization lens to study the dynamics between EHR embedded structures and primary care processes. Using grounded theory, a standardization dynamics model was created describing the influencers, conditions and consequences of the process state. A matrix of two conditions, information exchange and patient complexity, identified four distinct pathways that require a different balance between standardization and flexibility. The value of such pathways is that they frame choices about how to use embedded IT structures to support effective delivery processes. Physician profiling is an emerging methodology used in health care quality improvement programs. Efforts to measure performance at the individual physician level face a number of challenges, including the need for sufficient sample size to support reliable measurement. A process for creating a physician profiling model was developed, and a model designed for a case study site. Results indicate that reliable physician profiling is possible across care domains using a hierarchical composite model. Patient-Centered Medical Home (PCMH) is a new care delivery approach for providing comprehensive primary care that seeks to strengthen the physician-patient relationship. This exploratory study utilizes Pearson correlation coefficients to test four hypotheses about relationships between two sources of data: (1) PPC-PCMH Survey results that measure adoption of PCMH structures and (2) patient experience data from Massachusetts Health Quality Partners (MHQP). The results showed that the PPC-PCMH structures of access and communication were negatively correlated with the related patient experience measure. This study contributes to the literature by addressing deficiencies in how EHR-enabled processes, physician profiling models and Medical Home constructs are measured, to support improved outcomes

Análisis de las barreras para la unificación de una Historia Clínica Electrónica -HCE- en Colombia

Objetivo: Identificar las barreras para la unificación de una Historia Clínica Electrónica –HCE- en Colombia. Materiales y Métodos: Se realizó un estudio cualitativo. Se realizaron entrevistas semiestructuradas a profesionales y expertos de 22 instituciones del sector salud, de Bogotá y de los departamentos de Cundinamarca, Santander, Antioquia, Caldas, Huila, Valle del Cauca. Resultados: Colombia se encuentra en una estructuración para la implementación de la Historia Clínica Electrónica Unificada -HCEU-. Actualmente, se encuentra en unificación en 42 IPSs públicas en el departamento de Cundinamarca, el desarrollo de la HCEU en el país es privado y de desarrollo propio debido a las necesidades particulares de cada IPS. Conclusiones: Se identificaron barreras humanas, financieras, legales, organizacionales, técnicas y profesionales en los departamentos entrevistados. Se identificó que la unificación de la HCE depende del acuerdo de voluntades entre las IPSs del sector público, privado, EPSs, y el Gobierno Nacional.Objective: Identify barriers to the unification of a -HER- in Colombia. Materials and Methods: A qualitative study. Semi-structured interviews were conducted with professionals and experts from 22 health institutions in Bogota and Cundinamarca, Santander, Antioquia, Caldas, Huila, Valle del Cauca. Results: Colombia is in a structure for the implementation of the Unified Electronic Health -HCEU- History. Currently, it is in unification in 42 public IPSs in the department of Cundinamarca, HCEU development in the country is private and self-development due to the particular needs of each IPS. Conclusions: New human barriers, financial, legal, organizational, technical and professional respondents departments. It was identified that the unification of HCE depends on the agreement of wills between the IPSs public and private sectors, EPSs, and the national government.CENTRO DE ESTUDIOS EMPRESARIALES PARA LA PERDURABILIDA

Why Information Matters: A Foundation for Resilience

Embracing Change: The Critical Role of Information, a research project by the Internews' Center for Innovation & Learning, supported by the Rockefeller Foundation, combines Internews' longstanding effort to highlight the important role ofinformation with Rockefeller's groundbreaking work on resilience. The project focuses on three major aspects:- Building knowledge around the role of information in empowering communities to understand and adapt to different types of change: slow onset, long-term, and rapid onset / disruptive;- Identifying strategies and techniques for strengthening information ecosystems to support behavioral adaptation to disruptive change; and- Disseminating knowledge and principles to individuals, communities, the private sector, policymakers, and other partners so that they can incorporate healthy information ecosystems as a core element of their social resilience strategies

A critical analysis of the digitization of healthcare communication in the EU: a comparison of Italy, Finland, Norway, and Spain

This article provides a critical analysis of the digitization of healthcare communication in Italy, Finland, Norway, and Spain. Particularly, we focus on organizational communication and interactions among institutions, providers, and patients. A qualitative content analysis was conducted on data collected between January and May 2019 from (a) documents and policies and (b) interviews in each country with health-related key experts. Results indicate that Finland and Norway are closer than Italy and Spain to the EU discourse concerning the digitization of healthcare communication. Despite what we see as two roads of innovation, all four countries share problems such as the transition toward patient-centered care and the standardization of e-services at different levels. Given that the COVID-19 pandemic has accelerated these practices since March 2020, this article suggests that European digitization of healthcare is undergoing rapid change that warrants broader analysis

Should ChatGPT be Banned at Schools? Organizing Visions for Generative Artificial Intelligence (AI) in Education

Several sectors, including education, have experienced rapid growth in the utilization of artificial intelligence (AI). The emergence of generative AI (GAI) models, such as GPT-4, hold the potential to transform teaching and learning. However, GAI in education presents unique challenges and risks, such as potential violation of academic integrity, negative effects on critical thinking skills, and propagation of biases and inaccuracies. This study examines organizing vision functions in the digital world to explore the opportunities and threats posed by GAI, specifically ChatGPT, in education. By identifying the main actors contributing to the early development of organizing visions of ChatGPT in education, we aim to provide valuable insights into the shared visions concerning ChatGPT in education. Understanding these implications will be crucial for educational stakeholders and society at large as they navigate the complex challenges associated with GAI in education

Attitudes and perception of healthcare workers in health facilities with regards to the 'Intention to Use' of the Road to Health Booklet (RtHB)

Introduction: That low and middle income countries (LMICs) are plagued with high burdens of disease and limited health resources is well documented in the literature. These two realities necessitate the availability of good quality and reliable information to enable the efficient distribution of recourses and services. Growing recognition of the importance of health information has seen the introduction of numerous health information systems (HIS). The goal of these HIS is to attain preventative and curative treatment for those that need them, in adequate quantities, promptly, reliably and at equitable cost. Amongst the variety of HIS is the Road-to-Health Booklet (RtHB) in South Africa. This is a paper-based, patient-held medical record given to new mothers, intended to monitor all contact children have with the healthcare system. Due to the dearth of local research and increasing need for strong HIS, more research is needed in the implementation of the HIS and its use by healthcare workers (HCWs) in the African context. Methods: The aim of this study is to explore and understand the influence HCWs' attitudes and perceptions have on the implementation of the RtHB within the Khayelitsha Sub-District of Cape Town, South Africa. A qualitative case study was conducted utilising in-depth interviews, naturalistic observations, document review and mind mapping to explore HCWs' attitudes and perceptions on the RtHB. A combination of purposive and snowball sampling was used to identify participants with insights on the RtHB

The lifecycle of a social media beauty trend: a case study of the Instagram body.

The study pursued the creation of a functional model of the typical lifecycle of a social media beauty trend. Within the fashion and consumer goods industries, lifecycle models already exist that explain the typical manifestations of products and trends, chronicling their interactions with consumers from their introduction to their exit from the market. In the last decade especially, social media has established itself as both a breeding ground for beauty trends and a cultural meeting point for interactions with these trends, which drive billions of dollars in consumer spending. This is exemplified by the Instagram body, a body type characterised by a small waist, thick thighs, and large buttocks. Despite the popularity of this social media-driven body type in the last decade, no model currently exists to explain its lifecycle. As such, the study sought to close the existing research gap by creating a model using the Instagram body as a case study. To achieve this, interviews were conducted with groups identified as stakeholders in both the social media landscape and offline beauty endeavours. These were social media content creators, fitness professionals and a cosmetic surgeon. Additionally, an analysis was conducted of the song lyrics on the U.K. Offical year-end charts from 2010 to 2019, to map out references to the Instagram body. Finally, an analysis was undertaken of YouTube video titles with the search term "big butt" from 2010 to 2019, to map out content changes during this period. The study produced a six-stage social media beauty trend lifecycle, which consists of: the emergence phase; the mainstreaming phase; the normalisation/peak phase; the criticism/fatigue phase; the discard phase; and the retrospective phase. The study also identified several stakeholders who influence the lifecycle, such as social media content creators and traditional celebrities, as well as several factors such as the social media algorithm and content fatigue. Finally, the study identified gender as a factor in the manifestation of these trends, in that they disproportionately affect women and its treatment could lead to instances of misogyny

The Diffusion of Telehealth: System-Level Conditions for Successful Adoption

Telehealth is a promising advancement in health care, though there are certain conditions under which telehealth has a greater chance of success. This research sought to further the understanding of what conditions compel the success of telehealth adoption at the systems level applying Diffusion of Innovations (DoI) theory. System-level indicators were selected to represent four components of DoI theory (relative advantage, compatibility, complexity, and observability) and regressed on 5 types of Telehealth (Teleradiology, Teledermatology, Telepathology, Telepsychology, and Remote Monitoring) using multiple logistic regression. Analyses included data from 84 states leveraging data from the World Health Organization, World Bank, ICT Index, and HDI Index. The analyses supported relative advantage and compatibility as the strongest influencers of telehealth adoption. These findings help to quantitatively clarify the factors influencing the adoption of innovation and advance the ability to make recommendations on the viability of state telehealth adoption. In addition, results indicate when DoI theory is most applicable to the understanding of telehealth diffusion. Ultimately, this research may contribute to more focused allocation of scarce health care resources through consideration of existing state conditions available to foster innovation