A stimulus to define informatics and health information technology

<p>Abstract</p> <p>Background</p> <p>Despite the growing interest by leaders, policy makers, and others, the terminology of health information technology as well as biomedical and health informatics is poorly understood and not even agreed upon by academics and professionals in the field.</p> <p>Discussion</p> <p>The paper, presented as a Debate to encourage further discussion and disagreement, provides definitions of the major terminology used in biomedical and health informatics and health information technology. For informatics, it focuses on the words that modify the term as well as individuals who practice the discipline. Other categories of related terms are covered as well, from the associated disciplines of computer science, information technolog and health information management to the major application categories of applications used. The discussion closes with a classification of individuals who work in the largest segment of the field, namely clinical informatics.</p> <p>Summary</p> <p>The goal of presenting in Debate format is to provide a starting point for discussion to reach a documented consensus on the definition and use of these terms.</p

Is Canada ready for patient accessible electronic health records? A national scan

<p>Abstract</p> <p>Background</p> <p>Access to personal health information through the electronic health record (EHR) is an innovative means to enable people to be active participants in their own health care. Currently this is not an available option for consumers of health. The absence of a key technology, the EHR, is a significant obstacle to providing patient accessible electronic records. To assess the readiness for the implementation and adoption of EHRs in Canada, a national scan was conducted to determine organizational readiness and willingness for patient accessible electronic records.</p> <p>Methods</p> <p>A survey was conducted of Chief Executive Officers (CEOs) of Canadian public and acute care hospitals.</p> <p>Results</p> <p>Two hundred thirteen emails were sent to CEOs of Canadian general and acute care hospitals, with a 39% response rate. Over half (54.2%) of hospitals had some sort of EHR, but few had a record that was predominately electronic. Financial resources were identified as the most important barrier to providing patients access to their EHR and there was a divergence in perceptions from healthcare providers and what they thought patients would want in terms of access to the EHR, with providers being less willing to provide access and patients desire for greater access to the full record.</p> <p>Conclusion</p> <p>As the use of EHRs becomes more commonplace, organizations should explore the possibility of responding to patient needs for clinical information by providing access to their EHR. The best way to achieve this is still being debated.</p

Publication trends in the medical informatics literature: 20 years of "Medical Informatics" in MeSH

<p>Abstract</p> <p>Background</p> <p>The purpose of this study is to identify publication output, and research areas, as well as descriptively and quantitatively characterize the field of medical informatics through publication trend analysis over a twenty year period (1987–2006).</p> <p>Methods</p> <p>A bibliometric analysis of medical informatics citations indexed in Medline was performed using publication trends, journal frequency, impact factors, MeSH term frequencies and characteristics of citations.</p> <p>Results</p> <p>There were 77,023 medical informatics articles published during this 20 year period in 4,644 unique journals. The average annual article publication growth rate was 12%. The 50 identified medical informatics MeSH terms are rarely assigned together to the same document and are almost exclusively paired with a non-medical informatics MeSH term, suggesting a strong interdisciplinary trend. Trends in citations, journals, and MeSH categories of medical informatics output for the 20-year period are summarized. Average impact factor scores and weighted average impact factor scores increased over the 20-year period with two notable growth periods.</p> <p>Conclusion</p> <p>There is a steadily growing presence and increasing visibility of medical informatics literature over the years. Patterns in research output that seem to characterize the historic trends and current components of the field of medical informatics suggest it may be a maturing discipline, and highlight specific journals in which the medical informatics literature appears most frequently, including general medical journals as well as informatics-specific journals.</p

The Chicago School, Human Ecology, and Neighborhood Effects: A Reappraisal. Paper presented at the 2012 American Sociological Association Annual Meeting.

Marxist, field theoretic, and feminist approaches are three viable alternatives to the ideas of human ecology. Since the neighborhood effects literature has grown from the traditions of the Chicago School and human ecology, it may be time to reassess the paradigm and look to improve its theoretical grounding. And without too much exaggeration, I would hasten to add that it is a critical moment to begin this project. In their review of the extant literature, Sampson, Morenoff, and Gannon-Rowley (2002, 444) drew a graph of the number of articles with “Neighborhood Effects” in the title for each year from 1960-2000. The most visible feature is the doubling of publications between 1990 and 2000. Along with the shear number of publications, the neighborhood effects literature is also important because it touches upon a number of current public policy debates. Without questioning the assumptions of the paradigm, we, as social scientists, will be constricted in our ability to explore alternative policy options in a number of fields like health, education, crime, job markets, and the built environment. Thus, the time is now to begin explicitly (re-)theorizing the neighborhood effects literature

Long Term Effects of Job Displacement. Paper presented at the 2010 American Sociological Association Annual Meeting.

This paper replicates and extends Stevens’s (1997) analysis of the long-term effects of job displacements. Using data from the 1968-2005 waves of the Panel Study of Income Dynamics, I estimate fixed-effects models which show that there are long term decreases in earnings after displacements. The decreases are mediated when longer follow up data is used for individuals. Changes in the labor market have also shifted the relationship between displacements and individual worker characteristics. Specifically, education and experience have become more important then displacements. Conclusions are based on an analysis of the different people in the 40 years of PSID data and the structural changes in the labor market over that time. This article suggests that longitudinal data and fixed-effects models are one of many ways to conceptualize labor market changes

Economic restructuring: The effects on migration and poverty rates in the U.S. during the 1990s. Paper presented at the 2007 Rural Sociological Society Annual Meeting.

The popular media and academic sphere has been filled with claims about a “new” economy since the early 1990s. A common theme of the new economy is the change of production in terms of industrial sector and in terms of geographic location. The purpose of this study is to model the effects of economic restructuring during the 1990s on the migration and poverty rates of U.S. counties. According to neoclassical economic theories, wages and net migration should flow in opposite directions as employers and employees attempt to maximize their profits. I find this theory to be lacking in explanatory power, so I develop alternatives which allow reciprocal effects between migration and poverty, and simultaneously incorporate spatial spill-over effects near growing suburban counties. I conclude that many sectors typical of the new economy – for instance Finance, Insurance, and Real Estate – actually have no beneficial effect on migration or poverty