ROI Assessment on Using Information Technology in the Course of Admission Decisions in Myocardial Infarction Diagnosis

The healthcare sector has been investing heavily in health information technologies (HIT), with the aim of improvingdecision-making through improved medical processes, reduced costs and integration of medical data. However, the overallcontribution of HIT to the medical field is not obvious, especially, in high-stress environments such as the emergencydepartment (ED). The objective of this research is to explore whether investing in HIT in an ED is rewarding in evaluatingacute myocardial infarction diagnosis in EDs.We evaluated the overall profitability of certain integrative medical IS in a cost-effectiveness analysis using an experimentalstudy in the course of diagnosing an acute myocardial infarction. The results in the paper show that our specific medicalcases received a clear cost-effective reading since the results (ΔCosts/ΔQuality) were lower than the range of all commonthreshold values. Furthermore, the use of HIT in the ED also improved the quality of the medical care

Improving Robustness of Scale-Free Networks to Message Distortion

Vast numbers of organizations and individuals communicate every day by sending messages over social networks. These messages, however, are subject to change as they propagate through the network. This paper attempts to calculate the distortion of a message as it propagates in a social network with a scale free topology, and to establish a remedial process in which a node will correct the distortion during the diffusion process, in order to improve the robustness of scale-free networks to message distortion. We test a model that we created using a simulation of different types of scale-free networks, and we compared different sets of corrective nodes, hubs, regular (non-hubs) nodes, and a combination of hubs and regular nodes. The findings show that using hubs that correct the distorted message while it\u27s diffused, decrease a global error measurement of the distortion, and as a result improve the robustness of the network

A RETURN ON INVESTMENT ANALYSIS OF USING HEALTH INFORMATION TECHNOLOGY IN THE COURSE OF ADMISSION DECISIONS

In light of the ever-growing importance and usability of medical information systems (IS), the healthcare sector has been investing heavily in these technologies in recent years, with the aim of improving decision-making through improved medical processes, reduced costs and integration of medical data. However, these systems are extremely costly. In addition, the overall contribution of these technologies to the medical field is not obvious, especially, in high-stress environments such as emergency departments (EDs). The objective of this research is to explore whether investing in health information technology (HIT) in an ED is financially rewarding in general, and specifically the circumstances under which such an investment is more rewarding and vice versa. A cost-effectiveness analysis served as the selected tool for return on investment (ROI) estimations of certain integrative medical IS that serves seven main hospitals in Israel. We evaluated the overall profitability of this medical IS, by balancing the quality gained from information (retrieved from medical IS) against the costs of providing this information. The results of the cost-effectiveness analysis show that our specific medical cases of chest pain received a clear cost-effective reading since the results (ΔQuality/ΔCosts) were lower than the range of all common threshold values. Furthermore, the use of HIT in the ED improved the quality units per patient for each chosen admission decisions The findings of this study may also contribute to policy makers in the healthcare sector regarding the advisability of investing in such systems

Analyzing Patients’ EHR: Predicting and Explaining Admission Consequences for COPD and Liver Disease Patients

This study analyzed the admission outcomes in chronic patients (with COPD, and Liver disease) to demonstrate the feasibility of applying prediction methods on EHR records while incorporating an explainable AI technique. We predicted three target variables: 30-day readmission, Medium&Long Length of Stay and Single-day admission and analyzed the features using an explainable AI technique, the SHapley Additive exPlanations (SHAP). The results show that Readmission had higher prediction scores than all other dependent variables. Some features affected all target variables with either positive or negative influence including: Age, Charlson comorbidity index, Day-Shift, Gender, using EHR screens and Insurance cover level. These findings thus point to the value of using Machine-Learning combined with an explainable AI method to understand and assess the risks factors. The assessment of the potential factors leading to multiple complications can bolster prevention-oriented medical decisions to groups of patients but can also be tailored to the patient level

The Contribution of Information Technology to Emergency Medicine

Information systems have been adopted in many fields including the healthcare industry. Indeed, keeping abreast of theadvances of the technological age, many medical organizations have invested heavily in information technologies (IT),aiming at improving medical decision-making and increasing its efficiency. Despite their advantages, information systems donot always provide the vital medical information required for medical decision-making, and the decisions may result in adecreased level of quality of care and unnecessary costs.The objective of this research is to evaluate the contribution of IT to decision-makers (physicians) at the point of care ofemergency departments (EDs). We evaluate the contribution of the medical information to medical decisions by using twomethods: the track log-file analysis and an experimental study. Our results lead to the major conclusion that using ITcontributes to increasing the proportion of correct admission decisions

The Influence of EHR Components on Admission Decisions

Medical organizations are implementing electronic health record (EHR) systems in order to improve medical decision-making. The goal of this study was to characterize the specific data components that improve the process of medical decision-making in an emergency department (ED). The outcome measures were the decision to admit/discharge a patient, and differences in single-day admission rates with/without EHR IS. A database containing 3.2 million ED referrals from seven main Israeli hospitals was subjected to log file analysis. We found that viewing medical history via the EHR IS significantly affects admission decisions. The data show a reduction in the number of avoidable single-day admissions but an increase in the rate of prolonged admissions. Previous admissions, laboratory tests, imaging and previous surgeries were the most influential information components

THE IMPACT OF INFORMATION TECHNOLOGY ON ADMISSION DECISIONS

Information systems have been adopted in many fields, no less so in the health industry. Indeed, keeping abreast of the advances of the technological age, many medical organizations have invested heavily in information technologies (IT), aiming at improving medical decision-making and increasing its efficiency. Despite their obvious advantages, the systems do not always immediately provide the vital medical information required for critical decision-making, and the decisions that are based on this partial information may result in a decreased level of quality of care and unnecessary costs. The objective of this research is to evaluate the contribution of IT to decision-makers (physicians) at the point of care of emergency departments (EDs) by investigating whether the information systems (IS) have improved the medical outcomes, in the complex and highly stressful environment of the ED, with time constraints and overcrowding. We evaluated the contribution of the medical information to admission decisions by using two research methods: the track log-file analysis (with statistical tools) and an experimental study. The results were obtained using a unique database containing 3,219,910 referrals to the ED on seven main hospitals in Israel. Our results lead to the major conclusion that viewing medical history contributes to many clinical and admission decisions and clearly reduces the number of avoidable admissions

ADOPTION OF ELECTRONIC HEALTH RECORDS SYSTEM: DIFFERENTIATING MAIN ASSOCIATIONS

Health organizations are implementing health information technologies such as electronic health records (EHR), information systems (IS), and health information exchange (HIE) networks to improve decision-making. However, over the years, the healthcare environment has demonstrated numerous unsuccessful implementations of such technologies. One of the reasons is that physicians tend not to make use of these technologies in the healthcare environment. The various explanations put forward typically refer to patient, physician, and/or work environment-related factors. \ \ This study evaluated the factors associated with the EHR use among physicians in the complex environment of emergency departments. \ \ We used log-files retrieved from an integrative and interoperable EHR that serves Israeli hospitals. We found that EHR was primarily consulted for patients presenting with internal diagnoses, patients of older age, and it was used more by internists than by surgical specialists. Furthermore, EHR usage was larger for admitted patients than for those discharged. \ \ The findings show factors associated with EHR use and suggest that it is mostly related to case-specific features and to physician specialty. The findings strongly suggest that when planning assimilation projects for EHR systems and HIE networks, attention should be paid to those factors associated with system usage. Specifically, in order to increase the efficiency of the system, and enhance its use in the ED environment, physicians´ preferences and practice-related needs need to be taken into account. Furthermore, well-thought IT design and implementation are necessary to generate an increase in meaningful use of HIT, which can serve both physicians´ and patients´ needs