The Association Between Organizational Characteristics and Strategic Information Systems Planning: A Study of U.S. Hospitals

Despite the potential of Strategic Information System Planning (SISP) to reduce cost and improve quality, hospitals have been slow to have strategic plans on Information Systems. Our objective was to explore which organizational characteristics influence SISP in healthcare. Data on Information Systems plans from the HIMSS analytics database was combined with organizational characteristics data from the American Hospital Association. Logistic regression analyses on a sample of 2,495 hospitals revealed that hospitals with system membership and for profit status had a greater likelihood of selecting ‘computerized medical records’ (OR=1.88, OR=6.60 respectively, p<0.05), ‘decreasing medical errors’ (OR=7.02, p<0.05), ‘resolving integration issues’ (OR=1.36, OR=0.15 respectively, p<0.05), ‘migrating towards a paperless environment (OR=1.66, OR=8.28 respectively, p<0.05), and ‘reducing the number of software vendors’ (OR=1.78, OR=0.23 respectively, p<0.05) as their Information System plans. System membership and ownership status are associated with SISP. An understanding of the hospital characteristics that may impact Strategic Information Systems Planning, managers would assist managers in making informed decisions about planning and implementing Information Systems at their hospitals

O Serviço de documentação textual e iconografia do Museu Paulista

The essay compares the curatorship's works realized during the decade of 1990 by the actual Department of Textual and Iconographical Documentation of Museu Paulista, responsible for the MP Fund / Permanent File (Fundo MP/Arquivo Permanente), hundreds of collections and textual funds and 50.000 iconography pieces, great part of which are gathered in photographic collections. It shows how the documentation work extrapolates the limits of SVDHICO in order to integrate itself with the group activities of the museum and with other research groups. It also points towards new work methodologies which allow to perform the curatorship in an integrated way with the interdisciplinary research and the culture diffusion.O artigo faz um balanço dos trabalhos de curadoria realizados durante a década de 1990 pelo atual Serviço de Documentação Textual e Iconografia do Museu Paulista, responsável pelo Fundo MP/Arquivo Permanente, centenas de coleções e fundos textuais e 50.000 peças de iconografia, grande parte delas reunidas em coleções fotográficas. Mostra como o trabalho de documentação extrapola os limites do SVDHICO para integrar-se com as atividades de conjunto do Museu e com outros grupos de pesquisa. Aponta também para novas metodologias de trabalho com imagens que permitem realizar a curadoria de forma integrada à pesquisa interdisciplinar e à difusão cultural

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Convergence of Information and Law: A Comparative Study between I-Schools and Other ALISE Schools

This study examined the incorporation of law-related courses into information studies curricula. Data were gathered from the 59 member schools of the Association for Library and Information Science Education (ELISE) and 4 members of the i-School community, who are not ALISE members. Results indicated that schools are infusing law-related courses in their curricula, and that i-Schools seem to be early adopters in this regard, as compared to other ALISE schools

Factors Influencing Health Information System Adoption In American Hospitals

Objectives: To study the number of health information systems (HISs), applicable to administrative, clinical, and executive decision support functionalities, adopted by acute care hospitals and to examine how hospital market, organizational, and financial factors influence HIS adoption. Methods: A cross-sectional analysis was performed with 1441 hospitals selected from metropolitan statistical areas in the United States. Multiple data sources were merged. Six hypotheses were empirically tested by multiple regression analysis. Results: HIS adoption was influenced by the hospital market, organizational, and financial factors. Larger, system-affiliated, and for-profit hospitals with more preferred provider organization contracts are more likely to adopt managerial information systems than their counterparts. Operating revenue is positively associated with HIS adoption. Conclusion: The study concludes that hospital organizational and financial factors influence on hospitals\u27 strategic adoption of clinical, administrative, and managerial information systems

An integrated digital/clinical approach to smoking cessation in lung cancer screening: study protocol for a randomized controlled trial

Abstract Background Delivering effective tobacco dependence treatment that is feasible within lung cancer screening (LCS) programs is crucial for realizing the health benefits and cost savings of screening. Large-scale trials and systematic reviews have demonstrated that digital cessation interventions (i.e. web-based and text message) are effective, sustainable over the long-term, scalable, and cost-efficient. Use of digital technologies is commonplace among older adults, making this a feasible approach within LCS programs. Use of cessation treatment has been improved with models that proactively connect smokers to treatment rather than passive referrals. Proactive referral to cessation treatment has been advanced through healthcare systems changes such as modifying the electronic health record to automatically link smokers to treatment. Methods This study evaluates the impact of a proactive enrollment strategy that links LCS-eligible smokers with an evidence-based intervention comprised of a web-based (WEB) program and integrated text messaging (TXT) in a three-arm randomized trial with repeated measures at one, three, six, and 12 months post randomization. The primary outcome is biochemically confirmed abstinence at 12 months post randomization. We will randomize 1650 smokers who present for a clinical LCS to: (1) a usual care control condition (UC) which consists of Ask–Advise–Refer; (2) a digital (WEB + TXT) cessation intervention; or (3) a digital cessation intervention combined with tobacco treatment specialist (TTS) counseling (WEB + TXT + TTS). Discussion The scalability and sustainability of a digital intervention may represent the most cost-effective and feasible approach for LCS programs to proactively engage large numbers of smokers in effective cessation treatment. We will also evaluate the impact and cost-effectiveness of adding proven clinical intervention provided by a TTS. We expect that a combined digital/clinical intervention will yield higher quit rates than digital alone, but that it may not be as cost-effective or feasible for LCS programs to implement. This study is innovative in its use of interoperable, digital technologies to deliver a sustainable, scalable, high-impact cessation intervention and to facilitate its integration within clinical practice. It will add to the growing knowledge base about the overall effectiveness of digital interventions and their role in the healthcare delivery system. Trial registration ClinicalTrials.gov, NCT03084835 . Registered on 9 March 2017