126,289 research outputs found

    Electronic health information exchange in underserved settings: examining initiatives in small physician practices & community health centers.

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    BackgroundHealth information exchange (HIE) is an important tool for improving efficiency and quality and is required for providers to meet Meaningful Use certification from the United States Centers for Medicare and Medicaid Services. However widespread adoption and use of HIE has been difficult to achieve, especially in settings such as smaller-sized physician practices and federally qualified health centers (FQHCs). We assess electronic data exchange activities and identify barriers and benefits to HIE participation in two underserved settings.MethodsWe conducted key-informant interviews with stakeholders at physician practices and health centers. Interviews were recorded, transcribed, and then coded in two waves: first using an open-coding approach and second using selective coding to identify themes that emerged across interviews, including barriers and facilitators to HIE adoption and use.ResultsWe interviewed 24 providers, administrators and office staff from 16 locations in two states. They identified barriers to HIE use at three levels-regional (e.g., lack of area-level exchanges; partner organizations), inter-organizational (e.g., strong relationships with exchange partners; achieving a critical mass of users), and intra-organizational (e.g., type of electronic medical record used; integration into organization's workflow). A major perceived benefit of HIE use was the improved care-coordination clinicians could provide to patients as a direct result of the HIE information. Utilization and perceived benefit of the exchange systems differed based on several practice- and clinic-level factors.ConclusionsThe adoption and use of HIE in underserved settings appears to be impeded by regional, inter-organizational, and intra-organizational factors and facilitated by perceived benefits largely at the intra-organizational level. Stakeholders should consider factors both internal and external to their organization, focusing efforts in changing modifiable factors and tailoring HIE efforts based on all three categories of factors. Collective action between organizations may be needed to address inter-organizational and regional barriers. In the interest of facilitating HIE adoption and use, the impact of interventions at various levels on improving the use of electronic health data exchange should be tested

    Feasibility study of an Integrated Program for Aerospace vehicle Design (IPAD). Volume 1B: Concise review

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    Reports on the design process, support of the design process, IPAD System design catalog of IPAD technical program elements, IPAD System development and operation, and IPAD benefits and impact are concisely reviewed. The approach used to define the design is described. Major activities performed during the product development cycle are identified. The computer system requirements necessary to support the design process are given as computational requirements of the host system, technical program elements and system features. The IPAD computer system design is presented as concepts, a functional description and an organizational diagram of its major components. The cost and schedules and a three phase plan for IPAD implementation are presented. The benefits and impact of IPAD technology are discussed

    Feasibility study of an Integrated Program for Aerospace-vehicle Design (IPAD) system. Volume 2: Characterization of the IPAD system, phase 1, task 1

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    The aircraft design process is discussed along with the degree of participation of the various engineering disciplines considered in this feasibility study

    Investigation of selected disk systems

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    The large disk systems offered by IBM, UNIVAC, Digital Equipment Corporation, and Data General were examined. In particular, these disk systems were analyzed in terms of how well available operating systems take advantage of the respective disk controller's transfer rates, and to what degree all available data for optimizing disk usage is effectively employed. In the course of this analysis, generic functions and components of disk systems were defined and the capabilities of the surveyed disk system were investigated

    Earth observing system. Data and information system. Volume 2A: Report of the EOS Data Panel

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    The purpose of this report is to provide NASA with a rationale and recommendations for planning, implementing, and operating an Earth Observing System data and information system that can evolve to meet the Earth Observing System's needs in the 1990s. The Earth Observing System (Eos), defined by the Eos Science and Mission Requirements Working Group, consists of a suite of instruments in low Earth orbit acquiring measurements of the Earth's atmosphere, surface, and interior; an information system to support scientific research; and a vigorous program of scientific research, stressing study of global-scale processes that shape and influence the Earth as a system. The Eos data and information system is conceived as a complete research information system that would transcend the traditional mission data system, and include additional capabilties such as maintaining long-term, time-series data bases and providing access by Eos researchers to relevant non-Eos data. The Working Group recommends that the Eos data and information system be initiated now, with existing data, and that the system evolve into one that can meet the intensive research and data needs that will exist when Eos spacecraft are returning data in the 1990s

    Apollo applications program data archives

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    Apollo applications program data archives to collect, store, retrieve, and distribute experiments-related dat

    Innovation attributes and managers' decisions about the adoption of innovations in organizations: A meta-analytical review

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    The adop­tion of in­no­va­tions has emerged as a dom­i­nant re­search topic in the man­age­ment of in­no­va­tion in or­ga­ni­za­tions, al­though in­ves­ti­ga­tions of­ten yield mixed re­sults. To help man­agers and re­searchers im­prove their ef­fec­tive­ness, the au­thors em­ployed a meta-analy­sis in­te­grated with struc­tural equa­tion mod­el­ing to an­a­lyze the as­so­ci­a­tions be­tween the at­trib­utes of in­no­va­tions, man­agers' be­hav­ioral pref­er­ences, and or­ga­ni­za­tions' in­no­va­tion adop­tion de­ci­sions in a me­di­ated-mod­er­ated frame­work. Our find­ings of­fer ev­i­dence that at­trib­utes of in­no­va­tions in­flu­ence man­agers' be­hav­ioral pref­er­ences and, con­se­quently, adop­tion de­ci­sions in or­ga­ni­za­tions. We also ob­serve the sig­nif­i­cance of the con­text in which the adop­tion de­ci­sion oc­curs as well as the re­search set­tings em­ployed by schol­ars. Fi­nally, we dis­cuss the the­o­ret­i­cal con­tri­bu­tion and prac­ti­cal im­pli­ca­tions of our meta-an­a­lyt­i­cal re­sults

    Semantic discovery and reuse of business process patterns

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    Patterns currently play an important role in modern information systems (IS) development and their use has mainly been restricted to the design and implementation phases of the development lifecycle. Given the increasing significance of business modelling in IS development, patterns have the potential of providing a viable solution for promoting reusability of recurrent generalized models in the very early stages of development. As a statement of research-in-progress this paper focuses on business process patterns and proposes an initial methodological framework for the discovery and reuse of business process patterns within the IS development lifecycle. The framework borrows ideas from the domain engineering literature and proposes the use of semantics to drive both the discovery of patterns as well as their reuse

    Survey and Analysis of Production Distributed Computing Infrastructures

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    This report has two objectives. First, we describe a set of the production distributed infrastructures currently available, so that the reader has a basic understanding of them. This includes explaining why each infrastructure was created and made available and how it has succeeded and failed. The set is not complete, but we believe it is representative. Second, we describe the infrastructures in terms of their use, which is a combination of how they were designed to be used and how users have found ways to use them. Applications are often designed and created with specific infrastructures in mind, with both an appreciation of the existing capabilities provided by those infrastructures and an anticipation of their future capabilities. Here, the infrastructures we discuss were often designed and created with specific applications in mind, or at least specific types of applications. The reader should understand how the interplay between the infrastructure providers and the users leads to such usages, which we call usage modalities. These usage modalities are really abstractions that exist between the infrastructures and the applications; they influence the infrastructures by representing the applications, and they influence the ap- plications by representing the infrastructures

    The role of the host in a cooperating mainframe and workstation environment, volumes 1 and 2

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    In recent years, advancements made in computer systems have prompted a move from centralized computing based on timesharing a large mainframe computer to distributed computing based on a connected set of engineering workstations. A major factor in this advancement is the increased performance and lower cost of engineering workstations. The shift to distributed computing from centralized computing has led to challenges associated with the residency of application programs within the system. In a combined system of multiple engineering workstations attached to a mainframe host, the question arises as to how does a system designer assign applications between the larger mainframe host and the smaller, yet powerful, workstation. The concepts related to real time data processing are analyzed and systems are displayed which use a host mainframe and a number of engineering workstations interconnected by a local area network. In most cases, distributed systems can be classified as having a single function or multiple functions and as executing programs in real time or nonreal time. In a system of multiple computers, the degree of autonomy of the computers is important; a system with one master control computer generally differs in reliability, performance, and complexity from a system in which all computers share the control. This research is concerned with generating general criteria principles for software residency decisions (host or workstation) for a diverse yet coupled group of users (the clustered workstations) which may need the use of a shared resource (the mainframe) to perform their functions
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