Enabling laboratory medicine in primary care through EMR systems use: A survey of Canadian physicians

Important problems remain with regard to the efficiency and effectiveness of laboratory testing in primary care. In view of this, a significant function of electronic medical record (EMR) systems is to enable the practice of laboratory medicine by primary care physicians (PCPs). In addressing this issue, the present study aims to deepen our understanding of the nature and effectiveness of PCPs’ use of EMR systems for patient management and care within the laboratory testing process. To achieve our main objective, a survey of 684 Canadian physicians was realized. Results confirm that the artefactual and clinical contexts of EMR use influence the extensiveness of this use for communicational and clinical purposes. In turn, it is confirmed that the more extensive the use of EMR for laboratory medicine, the greater its impacts on the PCPs’ efficiency and on the quality of care provided by these physicians. The implications of these results are discussed

Advanced Use of Electronic Health Records in Patient-Centered Medical Homes

Electronic Health Records (EHRs) offer the promise of improved health outcomes through care coordination, in particular for costly and difficult to manage chronic illness. Adoption levels of EHRs in primary care have increased significantly since the recent Meaningful Use policy initiative began incentivizing EHRs in 2011; however, the full benefits of EHRs will only be realized once widespread use of advanced EHR functions is achieved. Patient-Centered Medical Homes (PCMHs) are considered the pinnacle of primary care and are expected to rely heavily on EHRs to coordinate care across settings. The goals of this dissertation are to describe and discuss overall EHR adoption and use in PCMH practices, including the practices’ progress towards meeting advanced criteria for the Meaningful Use policy, and to identify and explain the specific PCMH practice characteristics and contextual factors associated with advanced EHR use. This dissertation utilizes innovative data on PCMHs to create and evaluate an advanced EHR use index and explore the iterative differences distinguishing advanced EHR use from no advanced use in PCMHs. The EHR index is the dependent variable defining the levels of advanced EHR use by the PCMH. Four models of advanced EHR use are created and variations in the models are explored to validate the EHR index and identify the PCMH practice characteristics associated with advanced EHR use at higher levels of the EHR index. This dissertation indicates higher EHR adoption and use levels for PCMHs compared to other office-based and primary care practices in the current literature. Practice size, type, and location (rural versus non-rural) of the PCMH demonstrate unique associations with advanced EHR use. Contrary to prior studies, this dissertation indicates that larger PCMHs as well as federally-funded centers are less likely to be advanced EHR users and that practice affiliation (being part of a network) has no association with advanced use; also, smaller and non-rural PCMHs practices that are physician or hospital/system-owned are more likely to be using advanced EHR functions, which is also contrary to previous research. These findings have significant implications for future policies, practice, and research. As advanced EHR use becomes more widespread, the findings from this study provide future researchers with robust baseline data on PCMHs. The measures of EHR adoption and use levels in this study, as well as the various models tested, provide frameworks for future studies to evaluate and track advanced EHR use in primary care

Mobile Technology as an Optimal Method for Assisting in the Management of Diabetic Patients in Kenya

The burden of diabetes is no longer restricted only to high income countries. The global incidence of diabetes is rising as many low-income countries are transitioning into altered diets and increasing urbanization. Kenya has a diabetic prevalence ranging from 3.3% to 12%, depending on the population measured. This article explores the current Kenyan health sector regarding diabetes management with the objective of delivering methods to improving health outcomes, while saving money in healthcare expenditures. In 2010, only 23-30% of the non-diabetic population had a "good" understanding of diabetes. As one of the first national efforts, the Kenya's National Diabetes Program 2010-2015 was launched to strengthen diabetic care within the country through targeted categorical interventions. The interventions are working but their efficacy may be limited by low healthcare workforce capacities, short-term educational engagements, geographic distribution of care, and healthcare expenditures. Alternatively, Kenya's mobile technology marketplace is robust and growing with one of the most advanced mobile banking systems globally. Moreover, studies have confirmed telemedicine interventions work in chronic care management in Kenya. Consequently, a mobile assisted management system is proposed to aid Kenya's patients, healthcare workers, insurance providers, and the ministry of health (MOH) in diabetic management. The proposed system's core components are as follow: 1) cellular glucometers for patient blood glucose measurement, tracking, and education, 2) patient application for health information, 3) healthcare worker application for patient management and communication, 4) insurance and MOH applications for broader drug and patient management. These components, used together, can improve patient outcomes and save money in health related expenditures. It is recommended that the NHIF and MOH conduct a pilot of this system with the diabetic population to further evaluate healthcare and cost efficacy.Master of Public Healt

Nevada cancer plan 2021-2025

This publication was supported by the Nevada State Division of Public and Behavioral Health through Grant Number 5 NU58DP006306-04 from the Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Division nor the CDC.Publication date from document properties.nevada_ccc_plan-508.pdfGrant Number 5 NU58DP006306-0

Nevada cancer plan 2021-2025

This publication was supported by the Nevada State Division of Public and Behavioral Health through Grant Number 5 NU58DP006306-04 from the Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Division nor the CDC.Publication date from document properties.nevada_ccc_plan-508.pdfgrant number 5 NU58DP006306-0

Three analytics-based essays examining the use and impact of Intelligent Voice Assistants (IVA) and Health Information Technologies (HIT) in service contexts

Recent advancements in information technology (IT) innovation, such as artificial intelligence (AI) and machine learning (ML), are changing the dynamics in the service sector by driving smart reinvention of service tasks and processes. Additionally, organisations are leveraging the capabilities of emerging information systems (IS) to make their services more efficient and customer centric. However, the decision to use recent advancements in IT can be challenging for organizations since the required initial investment for implementation is often high and the economic value and impact on service performance cannot be gauged with certainty (Kwon et al. 2015). This forces many organizations to prioritise which IT functionalities may best be suited for their needs. To support the decision making process of organizations, regarding the adoption and use of innovative IT, scholars in the information systems (IS) and related fields are called to improve knowledge and understanding about various IT components and functionalities as well as their corresponding impact on individual users and organizations. Scholars are also expected to provide the means by which businesses can meaningfully predict the potential impact and economic value of innovative IT (Ravichandran 2018). In this three essay dissertation, we investigate how the use of various components and functionalities of innovative information systems can individually (or together) impact the quality of service delivered to end consumers. The essays are broadly based on the intersection of artificial intelligence (AI), machine learning(ML) and services. In the first study, we found that during encounters between eService consumers and Intelligent Voice Assistants (IVAs), typically powered by artificial intelligence, machine learning and natural language processing, the following dimensions are important for the perceived quality of service: IVA interactivity, IVA personalization, IVA flexibility, IVA assurance and IVA reliability. Among the five dimensions of IVA encounter, we found that IVA interactivity, IVA personalization and IVA reliability had positive impacts on the effective use of IVAs. In study 2, we investigated performance of hospitals in the health service sector. We proposed a smart decision support system (DSS) for predicting the performance of hospitals based on the Health Information Technology (HIT) functionalities as applied and used in these hospitals for patient care and in improving hospital performance. We found that the predictive performance of our proposed smart DSS was most accurate when HIT functionalities were used in certain bundles than in isolation. In study 3, we investigated the effect of hospital heterogeneity on the accuracy of prediction of our proposed smart DSS as we recognize that not all hospitals have the same set of context, opportunity, location and constraints. We found that the following sources of variations in hospitals had significant moderator effects on the accurate prediction of our smart DSS: hospital size, ownership, region, location (urban/rural) and complexity of cases treated. In summary, this dissertation contributes to the IS literature by providing insight into the emergent use of artificial intelligence and machine learning technologies as part of IS/IT solutions in both consumer-oriented services and the healthcare sector

The dynamics and strategic analysis of wireless communications technology in the healthcare industry

Thesis (S.M.)--Massachusetts Institute of Technology, Sloan School of Management, 2006.Includes bibliographical references (leaves 98-99).The healthcare industry like other industry is on the cross roads as a result of rising demand for healthcare delivery and service, the industry is facing declining revenues and increasing cost. As a result, one of the industry's strategic arsenal to avert the continual declines in revenue and increases operating cost is to effectively use modern technology in form of wireless computing and communications technology to change the paradigm shift to improve outcomes of clinical services, enhance physician and nurse productivity and work flow efficiency, reduce supply chain cost, improve revenue collection and practice profitability. This report presents the dynamic and strategic analysis of wireless communications technology in the healthcare industry, by first evaluating the wireless technologies, industry standards and regulations, applicable standards for the healthcare information systems and innovative healthcare technologies.(cont.) Based on an in-depth technical analysis of the wireless technology, I analyzed the market and industry by applying frameworks including Porter's 5 forces and The Delta model and system dynamics models presented to illustrate contributing factors affecting new technology adoption in the healthcare industry and a holistic view of a healthcare IT system architecture. Lastly, I analyzed emerging wireless technologies including WiMAX, UltraWide -Band and RFID, and reviewed market opportunities in the healthcare industry through 2011.by John K. Eyemaro.S.M

Carbon Emission Policies in Key Economies

The Australian Government asked the Productivity Commission to undertake a study on the ‘effective’ carbon prices that result from emissions and energy reduction policies in Australia and other key economies (the UK, USA, Germany, New Zealand, China, India, Japan and South Korea). The Commissions research report, released 9 June 2011, provides a stocktake of the large number of policy measures in the electricity generation and road transport sectors of the countries studied. And it provides estimates of the burdens associated with these policies in each country and the abatement achieved. While the results are based on a robust methodology, data limitations have meant that some estimates could only be indicative. More than 1000 carbon policy measures were identified in the nine countries studied, ranging from (limited) emissions trading schemes to policies that support particular types of abatement technology. While these disparate measures cannot be expressed as an equivalent single price on greenhouse gas emissions, all policies impose costs that someone must pay. The Commission has interpreted ‘effective’ carbon prices broadly to mean the cost of reducing greenhouse gas emissions — the ‘price’ of abatement achieved by particular policies. The estimated cost per unit of abatement achieved varied widely, both across programs within each country and in aggregate across countries. The relative cost effectiveness of price-based approaches is illustrated for Australia by stylised modelling that suggests that the abatement from existing policies for electricity could have been achieved at a fraction of the cost. The estimated price effects of supply-side policies have generally been modest, other than for electricity in Germany and the UK. Such price uplifts are of some relevance to assessing carbon leakage and competitiveness impacts, but are very preliminary and substantially more information would be required.carbon pricing; cost abatement; greenhouse gas emissions; abatement technology; carbon policy; energy reduction policy; emissions trading scheme; carbon leakage