“Four years into the Department of Health and Human Services’ “decade of health care information technology,” little progress has been made in achieving the current president’s goal of every American having a secure electronic health record by 2014. In fact, health care leaders are still arguing about the overall effectiveness of the EHR; some are preaching its powers while others are shaking their heads in disbelief. What effect does the EHR have on the Institute of Medicine’s Aims of safety, timeliness, effectiveness, efficiency, equity and patient centeredness?”
Article
Jennifer Towne, HHNMostWired, 11 June 2008
Tagged: adoption and effectiveness
; posted on Friday, June 13th, 2008 at 12:44 pm
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“The return on investment of health care information technology isn’t uniformly positive, according to a recent analysis from the Congressional Budget Office titled, Evidence on the Costs and Benefits of Health Information Technology.
The underlying rationale for the report, which was requested by the Senate Budget Committee, is to sort out the federal government’s role in health IT. The report asks, “Whether — and if the answer is yes, how — the federal government should stimulate and guide the adoption of health IT.”
Article
Jane Sarasohn-Kahn, The Health Care Blog, 30 May 2008
Tagged: benefits, effectiveness, Health Information Technology and secondary data use
; posted on Saturday, May 31st, 2008 at 10:12 am
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Abstract:
Clinical decision support systems (CDSS) integrated within Electronic Medical Records (EMR) hold the promise of improving healthcare quality. To date the effectiveness of CDSS has been less than expected, especially concerning the ambulatory management of chronic diseases. This is due in part because clinicians do not use CDSS fully. Barriers to clinicians’ use of CDSS have included lack of integration into workflow, software usability issues, and relevance of the content to the patient at hand. At Partners HealthCare, we are developing “Smart Forms” to facilitate documentation-based clinical decision support. Rather than being interruptive in nature, the Smart Form enables writing a multi-problem visit note while capturing coded information and providing sophisticated decision support in the form of tailored recommendations for care. The current version of the Smart Form is designed around two chronic diseases: coronary artery disease and diabetes mellitus. The Smart Form has potential to improve the care of patients with both acute and chronic conditions.
Abstract
Jeffrey L. Schnipper, Jeffrey A. Linder, Matvey B. Palchuk, Jonathan S. Einbinder, Qi Li, Anatoly Postilnik, and Blackford Middleton, Journal of the American Medical Informatics Association, April 24, 2008 as JAMIA PrePrint; doi:10.1197/jamia.M2501
Tagged: chronic diseases, decision support, effectiveness and emr
; posted on Tuesday, May 6th, 2008 at 12:43 pm
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Abstract:
Diverse stakeholders—clinicians, researchers, business leaders, policy makers, and the public—have good reason to believe that the effective use of electronic health care records (EHRs) is essential to meaningful advances in health care quality and patient safety. However, several reports have documented the potential of EHRs to contribute to health care system flaws and patient harm. As organizations (including small hospitals and physician practices) with limited resources for care-process transformation, human-factors engineering, software safety, and project management begin to use EHRs, the chance of EHR-associated harm may increase. The authors propose a coordinated set of steps to advance the practice and theory of safe EHR design, implementation, and continuous improvement. These include setting EHR implementation in the context of health care process improvement, building safety into the specification and design of EHRs, safety testing and reporting, and rapid communication of EHR-related safety flaws and incidents.
Abstract
James M. Walker, Pascale Carayon, Nancy Leveson, Ronald A. Paulus, John Tooker, Homer Chin, Albert Bothe, Jr., and Walter F. Stewart, J Am Med Inform Assoc. 2008;15:272-277. DOI 10.1197/jamia.M2618
Tagged: effectiveness and safety
; posted on Sunday, May 4th, 2008 at 5:40 pm
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“Introduction
Many hospitals are currently in the process of developing and implementing electronic medical records (EMR) systems. This is a critical time for developing a framework that can measure and allow for comparison the effectiveness of EMR systems across hospitals that have implemented these systems. The motivation for this study comes from the realization that there is limited research on the understanding of the effectiveness of EMR systems, and a lack of appropriate reference theoretical framework for measuring the effectiveness of EMR systems. In this paper, we propose a conceptual framework for generating a composite index (CI) for measuring the effectiveness of EMR systems in hospitals.
Methods
Data used to test the framework and associated research objectives were derived from a cross-sectional survey of five stakeholders of EMR systems including chief medical officers, chief nursing officers, chief information officers, doctors and nurses in 20 Japanese hospitals. Using statistical means of standardization and principal component analysis (PCA) procedure, CI was developed by summing up the scores of four dimensions—system quality, information quality, use and user satisfaction. The process included formulating items for each dimension, condensing the data into factors relevant to the dimension and calculating the CI by summing up the product of each dimension with its respective principal component score coefficient.
Conclusions
CI has provided a standard way, through quantitative means, of measuring, comparing and categorizing the effectiveness of EMR systems in hospitals. CI can be a powerful tool for benchmarking the effectiveness of EMR systems in hospitals in ways that can guide hospitals in computerization process as well as benchmark their systems against other hospitals.”
Abstract
George Ochieng Otieno, Toyama Hinako, Asonuma Motohiro, Koide Daisuke and Naitoh Keiko, International Journal of Medical Informatics, In Press, Corrected Proof, Available online 4 March 2008, doi:10.1016/j.ijmedinf.2008.01.002
Tagged: effectiveness, emr and hospitals
; posted on Friday, March 7th, 2008 at 10:28 am
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