the international council on medical & care compunetics


December, 2014

information technology

Adoption Of Electronic Health Records Grows Rapidly, But Fewer Than Half Of US Hospitals Had At Least A Basic System In 2012

DesRoches CM et al, Health Affairs, 2013

The US health care system is in the midst of an enormous change in the way health care providers and hospitals document, monitor, and share information about health and care delivery. Part of this transition involves a wholesale, but currently uneven, shift from paper-based records to electronic health record (EHR) systems. We used the most recent longitudinal survey of US hospitals to track how they are adopting and using EHR systems. Only 44 percent of hospitals report having and using what we define as at least a basic EHR system. And although 42.2 percent meet all of the federal stage 1 “meaningful-use” criteria, only 5.1 percent could meet the broader set of stage 2 criteria.
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11 July 2013 | No Comments »
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Small Physician Practices In New York Needed Sustained Help To Realize Gains In Quality From Use Of Electronic Health Records

Ryan AM et al, Health Affairs, 32(1)

The 2009 American Recovery and Reinvestment Act spurred adoption of electronic health records (EHRs) in the United States, through such measures as financial incentives to providers through Medicare and Medicaid and regional extension centers, which provide ongoing technical assistance to practices. Yet the relationship between EHR adoption and quality of care remains poorly understood. We evaluated the early effects on quality of the Primary Care Information Project, which provides subsidized EHRs and technical assistance to primary care practices in underserved neighborhoods in New York City, using the regional extension center model.
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8 January 2013 | No Comments »
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What It Will Take To Achieve The As-Yet-Unfulfilled Promises Of Health Information Technology

Kellermann AL, Jones SS. Health Affairs, 32(1)

A team of RAND Corporation researchers projected in 2005 that rapid adoption of health information technology (IT) could save the United States more than $81 billion annually. Seven years later the empirical data on the technology’s impact on health care efficiency and safety are mixed, and annual health care expenditures in the United States have grown by $800 billion. In our view, the disappointing performance of health IT to date can be largely attributed to several factors: sluggish adoption of health IT systems, coupled with the choice of systems that are neither interoperable nor easy to use; and the failure of health care providers and institutions to reengineer care processes to reap the full benefits of health IT.
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8 January 2013 | No Comments »
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Most Physicians Were Eligible For Federal Incentives In 2011, But Few Had EHR Systems That Met Meaningful-Use Criteria

Hsiao C-J et al, Health Affairs, 2012

As more physicians adopt electronic health record systems in their practices, policy interest is focusing on whether physicians are ready to meet the federal “meaningful use” criteria—a vital threshold to qualify for financial incentives. In our analysis of a 2011 nationally representative survey of office-based physicians, we found that 91 percent of physicians were eligible for Medicare or Medicaid meaningful-use incentives. About half of all physicians intended to apply.
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25 April 2012 | No Comments »
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Small, Nonteaching, And Rural Hospitals Continue To Be Slow In Adopting Electronic Health Record Systems

DesRoches CM et al, Health Affairs, 2012

To achieve the goal of comprehensive health information record keeping and exchange among providers and patients, hospitals must have functioning electronic health record systems that contain patient demographics, care histories, lab results, and more. Using national survey data on US hospitals from 2011, the year federal incentives for the meaningful use of electronic health records began, we found that the share of hospitals with any electronic health record system increased from 15.1 percent in 2010 to 26.6 percent in 2011, and the share with a comprehensive system rose from 3.6 percent to 8.7 percent. The proportion able to meet our proxy criteria for meaningful use also rose; in 2011, 18.4 percent of hospitals had these functions in place in at least one unit and 11.2 percent had them across all clinical units.
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25 April 2012 | No Comments »
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Physicians In Nonprimary Care And Small Practices And Those Age 55 And Older Lag In Adopting Electronic Health Record Systems

Decker SL et al, Health Affairs, 2012

By 2011 more than half of all office-based physicians were using electronic health record systems, but only about one-third of those physicians had systems with basic features such as the abilities to record information on patient demographics, view laboratory and imaging results, maintain problem lists, compile clinical notes, or manage computerized prescription ordering. Basic features are considered important to realize the potential of these systems to improve health care.
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25 April 2012 | No Comments »
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There Are Important Reasons For Delaying Implementation Of The New ICD-10 Coding System

Chute CG et al, Health Affairs, 2012

Federal authorities have recently signaled that they would consider delaying some aspects of implementation of the newest version of the International Classification of Diseases, known as ICD-10-CM, a coding system used to define health care charges and diagnoses. Some industry groups have reacted with dismay, and many providers with relief. We are concerned that adopting this new classification system for reimbursement will be disruptive and costly and will offer no material improvement over the current system.
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23 March 2012 | No Comments »
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Giving office-based physicians electronic access to patients’ prior imaging and lab results did not deter ordering of tests

McCormick D et al, Health Affairs, 31(3)

Policy-based incentives for health care providers to adopt health information technology are predicated on the assumption that, among other things, electronic access to patient test results and medical records will reduce diagnostic testing and save money. To test the generalizability of findings that support this assumption, we analyzed the records of 28,741 patient visits to a nationally representative sample of 1,187 office-based physicians in 2008. Physicians’ access to computerized imaging results (sometimes, but not necessarily, through an electronic health record) was associated with a 40-70 percent greater likelihood of an imaging test being ordered.
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12 March 2012 | No Comments »
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[Health 2.0 for psychiatrists]

Hoekstra R. Tijdschrift Voor Psychiatrie, 53(10)

The internet used to be mainly ‘one-way traffic’ (1.0). Nowadays it is becoming easy for internet users to communicate with each other via the web (2.0).

To describe the concept of Health 2.0 and to explore the possibilities of 2.0-technology for psychiatry.
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17 October 2011 | No Comments »
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Meaningful use of information technology: a local perspective

Hussain AA. Annals of Internal Medicine, 154(10)

To reduce costs of care and improve quality, the federal government is stimulating adoption of health information technology through meaningful use policy. The legislation, however, is built on several assumptions that are unrealistic from a provider’s perspective-the group that is expected to purchase, use, and sustain the information technology infrastructure.
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18 May 2011 | No Comments »
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Electronic health information in use: Characteristics that support employee workflow and patient care

Russ AL et al, Health Informatics Journal, 16(4)

The aim of this investigation was to assess helpful and challenging aspects of electronic health information with respect to clinical workflow and identify a set of characteristics that support patient care processes. We conducted 20 semi-structured interviews at a Veterans Affairs Medical Center, with a fully implemented electronic health record (EHR), and elicited positive and negative examples of how information technology (IT) affects the work of healthcare employees. Responses naturally shed light on information characteristics that aid work processes. We performed a secondary analysis on interview data and inductively identified characteristics of electronic information that support healthcare workflow.
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9 January 2011 | No Comments »
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Differences between integrated and stand-alone e-prescribing systems have implications for future use

DesRoches CM, Health Affairs, 29(12)

Understanding the benefits of electronic prescribing systems has important implications for quality and efficiency in medical care. We surveyed physicians about their use of e-prescribing in outpatient practices. We found that physicians who use e-prescribing systems integrated into an electronic health record have different characteristics, usage patterns, perceived benefits, and levels of satisfaction than physicians who use stand-alone systems.
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11 December 2010 | No Comments »
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Knowledge of Computer Among Healthcare Professionals of India: A Key Toward e-Health

Gour N, Srivastava D. Telemedicine and e-Health, 16(9)

Information technology has radically changed the way that many people work and think. Over the years, technology has touched a new acme and now it is not confined to developed countries. Developing countries such as India have kept pace with the world in modern technology. Healthcare professionals can no longer ignore the application of information technology to healthcare because they are key to e-health. This study was conducted to enlighten the perspective and implications of computers among healthcare professionals, with the objective to assess the knowledge, use, and need of computers among healthcare professionals. A cross-sectional study of 240 healthcare professionals, including doctors, nurses, lab technicians, and pharmacists, was conducted. Each participant was interviewed using a pretested, semistructured format. Of 240 healthcare professionals, 57.91% were knowledgeable about computers.
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26 November 2010 | No Comments »
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Management of Electronic Patient Record Systems in Primary Healthcare in a Finnish County

Mäkelä K et al, Telemedicine and e-Health, 16(10)

We investigated factors that could govern the use and user competence of electronic patient record (EPR) systems used in Finnish primary healthcare in the county of South Ostrobothnia. A structured questionnaire was sent to 400 health center (HC) staff (general practitioner, nurse, and clerical) from eight HCs. The questions dealt with Information Technology (IT) management, use, and potential problems with EPR and user EPR training within the HC. The response rate to the questionnaire was 79%. This study shows that there are large differences in working practices and in the way EPR systems are managed and utilized in the primary care organizations studied.
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9 November 2010 | No Comments »
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Determining Patient Preferences for Remote Monitoring

Basoglu N et al, Journal of Medical Systems, 2010

This paper presents the patient preferences for an application in remote health monitoring. The data was collected through a mobile service prototype. Analytical Hierarchy Process and Conjoint Analysis were used to extract the patient preferences. The study was limited to diabetes and obesity patients in Istanbul, Turkey.
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18 October 2010 | No Comments »
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A Progress Report On Electronic Health Records In U.S. Hospitals

Jha AK et al, Health Affairs, 29(10)

Given the substantial federal financial incentives soon to be available to providers who make “meaningful use” of electronic health records, tracking the progress of this health care technology conversion is a policy priority. Using a recent survey of U.S. hospitals, we found that the share of hospitals that had adopted either basic or comprehensive electronic records has risen modestly, from 8.7 percent in 2008 to 11.9 percent in 2009.
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26 August 2010 | No Comments »
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Trends in PACS architecture

Bellon E et al, European Journal of Radiology, 2010

Radiological Picture Archiving and Communication Systems (PACS) have only relatively recently become abundant. Many hospitals have made the transition to PACS about a decade ago. During that decade requirements and available technology have changed considerably. In this paper we look at factors that influence the design of tomorrow’s systems, especially those in larger multidisciplinary hospitals. We discuss their impact on PACS architecture (a technological perspective) as well as their impact on radiology (a management perspective).
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21 June 2010 | No Comments »
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Clinical effects of home telemonitoring in the context of diabetes, asthma, heart failure and hypertension: a systematic review

Paré G et al, J Med Internet Res, 12(2)

Home telemonitoring figures among the various solutions that could help attenuate some of the problems associated with aging populations, rates of chronic illness, and shortages of health professionals.

The primary aim of this study was to further our understanding of the clinical effects associated with home telemonitoring programs in the context of chronic diseases.
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20 June 2010 | No Comments »
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Securing the National Health Service

Gold S. Computer Fraud & Security, 2010(5)

Mention IT and the healthcare industry, and you’d probably think about the increasing use of PCs and PC-driven technology in the clinical healthcare environment, as well as the gradual computerisation of medical records and the lab systems behind the scenes in many hospitals.
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18 June 2010 | No Comments »
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An Evaluation of a Patient-Centred Information Technology Tool for the Management of Chronic Diseases by Primary Care Interdisciplinary Teams

Lussier M et al, ElectronicHealthcare, 8(4)

Chronic disease management has become a major concern for healthcare systems in industrialized countries. There is a significant care gap between the best care, based on results from clinical trials, and usual care. Most patients with multiple chronic diseases are followed in primary care. Yet there are few tools to help primary care health professionals manage the complex care these patients require and even fewer systems that systematically assess the outcomes of care of these patients. The DaVinci system proposes a comprehensive clinical and technological approach to assist primary care interdisciplinary teams (PCITs) in the management of patients with multiple chronic problems. The project aims ultimately at improving the process of care as well as patients’ health outcomes, thus helping close the healthcare gap.
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12 June 2010 | No Comments »
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