Characteristics of patient portals developed in the context of health information exchanges: Early policy effects of incentives in the meaningful use program in the United States

__Background:__ In 2014, the Centers for Medicare & Medicaid Services in the United States launched the second stage of its Electronic Health Record (EHR) Incentive Program, providing financial incentives to providers to meaningfully use their electronic health records to engage patients online. Patient port

The organizational dynamics enabling patient portal impacts upon organizational performance and patient health: A qualitative study of Kaiser Permanente

Background: Patient portals may lead to enhanced disease management, health plan retention, changes in channel utilization, and lower environmental waste. However, despite growing research on patient portals and their effects, our understanding of the organizational dynamics that explain how effects come about is limited. Methods

Can relational coordination help inter-organizational networks overcome challenges to coordination in patient portals?

Purpose: Delivering comprehensive patient portals in fragmented delivery systems depends on coordination among a network of healthcare organizations. Inter-organizational coordination is fraught with challenges, mainly due to a lack of organizational, technological, and geographical proximity between network participants. This paper assesses the extent to which application of Relational Coordination Theory (RCT) can ameliorate these challenges. Approach: We conducted a conceptual analysis of the usefulness of RCT and the applicability of the Relational Model of Organizational Change to patient portal networks. Findings: Relational coordination can mitigate challenges caused by lack of organizational and technological proximity among participants in a patient portal network. The Relational Model of Organizational Change is useful to improve relational coordination. However, some organization redesign interventions proposed in the Model may not be directly applicable to patient portal networks due to lack of geographical proximity among network participants. Conclusion: We suggest three propositions regarding the relationships among relational coordination, organizational and technological proximity, and cost of coordination in an inter-organizational portal network. If future research provides empirical support for these propositions and identifies appropriate adaptations of the Relational Model of Organizational Change for inter-organizational contexts, portal network leaders should strive to strengthen relational coordination in their networks

Detecting violations of temporal regularities in waking and sleeping two-month-old infants

Correctly processing rapid sequences of sounds is essential for developmental milestones, such as language acquisition. We investigated the sensitivity of two-month-old infants to violations of a temporal regularity, by recording event-related brain potentials (ERP) in an auditory oddball paradigm from 36 waking and 40 sleeping infants. Standard tones were presented at a regular 300 ms inter-stimulus interval (ISI). One deviant, otherwise identical to the standard, was preceded by a 100 ms ISI. Two other deviants, presented with the standard ISI, differed from the standard in their spectral makeup. We found significant differences between ERP responses elicited by the standard and each of the deviant sounds. The results suggest that the ability to extract both temporal and spectral regularities from a sound sequence is already functional within the first few months of life. The scalp distribution of all three deviant-stimulus responses was influenced by the infants‟ state of alertness

Effect of different East Coast Fever control strategies on disease incidence in traditionally managed Sanga cattle in Central Province of Zambia

A clinical trial, comparing East Coast fever (ECF) control strategies in 5 different groups of traditionally managed Sanga cattle (44-49 animals per herd), was conducted in Zambia over 2.5 years between 1992 and 1995. Two groups were kept under intensive tick control by weekly cypermethrin (Barricade) treatment by hand spray (one group immunized by the infection-and-treatment method and one non-immunized), 2 groups were under no tick control (one immunized and one non-immunized), and a fifth, immunized group was maintained under strategic tick control (18 sprays/year). ECF-specific mortality was highest in the non-immunized and non-treated (control) group, while no difference in ECF-specific mortality could be observed between animals treated for ECF by immunization or by tick control. Acaricide treatment and/or immunization reduced the risk of clinical ECF by 92 percent . The highest incidence of ECF occurred in the adult Rhipicephalus appendiculatus season of 1993, just after immunization. The results of an artificial challenge experiment at the end of the field trial indicated that about 60 percent of the animals in the control group had become infected with Theileria parva without showing clinical signs. ECF incidence in non-vaccinated cattle declined 6 months after immunization, suggesting that the carrier state induced by immunization did not lead to a persistent high incidence, and might accelerate the progress to endemicity

An outbreak of East Coast Fever in a herd of Sanga cattle in Lutale, Central Province of Zambia

An outbreak of East Coast fever (ECF) occurred in an experimental herd of Sanga cattle maintained under a traditional rangeland grazing system at Lutale, Central Province of Zambia. Two groups of cattle had been kept under different tick-control regimes for several years prior to the introduction of the disease and epidemiological information on the outbreak were recorded. Weekly tick control was not sufficient to achieve full protection against Theileria parva infection. Systematic body temperature monitoring seems to be a good method for early detection of infection resulting in an important reduction of the case fatality rate after treatment with anti-theilerial drugs