Article

The Benefits Of Health Information Technology: A Review Of The Recent Literature Shows Predominantly Positive Results

Office of Economic Analysis, Evaluation, and Modeling, Office of National Coordinator for Health Information Technology (ONC), Department of Health and Human Services, Washington, DC, USA.
Health Affairs (Impact Factor: 4.64). 03/2011; 30(3):464-71. DOI: 10.1377/hlthaff.2011.0178
Source: PubMed

ABSTRACT An unprecedented federal effort is under way to boost the adoption of electronic health records and spur innovation in health care delivery. We reviewed the recent literature on health information technology to determine its effect on outcomes, including quality, efficiency, and provider satisfaction. We found that 92 percent of the recent articles on health information technology reached conclusions that were positive overall. We also found that the benefits of the technology are beginning to emerge in smaller practices and organizations, as well as in large organizations that were early adopters. However, dissatisfaction with electronic health records among some providers remains a problem and a barrier to achieving the potential of health information technology. These realities highlight the need for studies that document the challenging aspects of implementing health information technology more specifically and how these challenges might be addressed.

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    • "The field of clinical informatics has been expanding rapidly since its inception (McCoy et al., 2013). Evidence about improved process outcomes is consistently reported in literature (Bright et al., 2012; Buntin et al., 2011).A research group published results on a work on acute stroke care under the influence of various parameters like pregnancy, childbirth in the last month, breastfeeding, etc.(Anani et al., 2014). In their setup they used the Guideline Definition Language (GDL) Editor.Their results include 13 reused, 2 new and 1 extended archetype.Another study from the University of Porto in Portugal showed that openEHR is not sufficient to fully represent gestation related data (Silva, 2011). "
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    ABSTRACT: This work investigates, whether openEHR with its reference model, archetypes and templates is suitable for the digital representation of demographic as well as clinical data. Moreover, it elaborates openEHR as a tool for modelling Hospital Information Systems on a regional level based on a national logical infrastructure. OpenEHR is a dual model approach developed for the modelling of Hospital Information Systems enabling semantic interoperability. A holistic solution to this represents the use of dual model based Electronic Healthcare Record systems. Modelling data in the field of obstetrics is a challenge, since different regions demand locally specific information for the process of treatment. Smaller health units in developing countries like Brazil or Malaysia, which until recently handled automatable processes like the storage of sensitive patient data in paper form, start organizational reconstruction processes. This archetype proof-of-concept investigation has tried out some elements of the openEHR methodology in cooperation with a health unit in Colombo, Brazil. Two legal forms provided by the Brazilian Ministry of Health have been analyzed and classified into demographic and clinical data. LinkEHR-Ed editor was used to read, edit and create archetypes. Results show that 33 clinical and demographic concepts, which are necessary to cover data demanded by the Unified National Health System, were identified. Out of the concepts 61% were reused and 39% modified to cover domain requirements. The detailed process of reuse, modification and creation of archetypes is shown. We conclude that, although a major part of demographic and clinical patient data were already represented by existing archetypes, a significant part required major modifications. In this study openEHR proved to be a highly suitable tool in the modelling of complex health data. In combination with LinkEHR-Ed software it offers user-friendly and highly applicable tools, although the complexity built by the vast specifications requires expert networks to define generally excepted clinical models. Finally, this project has pointed out main benefits enclosing high coverage of obstetrics data on the Clinical Knowledge Manager, simple modelling, and wide network and support using openEHR. Moreover, barriers described are enclosing the allocation of clinical content to respective archetypes, as well as stagnant adaption of changes on the Clinical Knowledge Manager leading to redundant efforts in data contribution that need to be addressed in future works. Copyright © 2015. Published by Elsevier Inc.
    Journal of Biomedical Informatics 04/2015; 55. DOI:10.1016/j.jbi.2015.04.004 · 2.48 Impact Factor
    • "Despite the $2.6 trillion of expenditure , the quality and efficiency of the U.S. healthcare system ranked last when compared to Britain, Canada, Germany, the Netherlands, Australia, and New Zealand (Davis et al. 2010). As a result, a concerted national effort to reform healthcare using information technologies with a focus on reducing costs and increasing quality of service is well under way (Menon et al. 2000, Casalino et al. 2003, Aron et al. 2011, Buntin et al. 2011). The recently enacted Health Information Technology for Economic and Clinical Health Act (HITECH) requires all medical records to be in standardized digital forms by 2014 (Blumenthal and Tavenner 2010). "
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    ABSTRACT: Health Information Exchanges (HIE) are becoming integral parts of the national healthcare reform efforts, chiefly because of their potential impact on cost reduction and quality enhancement in healthcare services. However, the potential of an HIE platform can only be realized when its multiple constituent users actively participate in using its variety of services. In this research, we model HIE systems as multisided platforms that incorporate self-service technologies whose value to the users depends on both user-specific and network-specific factors. We develop a model of adoption, use, and involvement of clinical practices in the coproduction of the HIE services. This model is grounded in social network theory, service operations theory, and institutional isomorphism theory. A longitudinal study of actual adoption and use behaviors of 2,054 physicians within 430 community medical practices in Western New York over a three-year period has been carried out to evaluate the proposed model. This study has been supported by HEALTHeLINK, the Regional Health Information Organization of Western New York, which has an extensive database comprising over half a million transactions on patient records by the HIE users. We extracted panel data on adoption, use, and service coproduction behaviors from this database and carried out a detailed analysis using metrics derived from the foundational theories. Positioning practices within two distinct but interrelated networks of patients and practitioners, we show that adoption, use, and service coproduction behaviors are influenced by the topographies of the two networks, isomorphic effects of large practices on the smaller ones, and practice labor inputs in HIE use. Our findings provide a comprehensive view of the drivers of HIE adoption and use at the level of medical practices. These results have implications for marketing and revenue management of HIE platforms, as well as public health and national/regional healthcare policy making.
    Information Systems Research 03/2015; 26(1):1-18. DOI:10.1287/isre.2014.0547 · 2.15 Impact Factor
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    • "Increasingly, information technologies (IT) are being proposed as solutions to the challenges faced in health care systems, for addressing population health issues and encouraging the emergence of new modes of healthcare delivery [1]. Even though the benefits of implementing IT in healthcare have been well documented, too much variance remains in the rates of satisfaction expressed by health professionals [2]. The professional culture of nurses is generally favorable to adoption of innovations such as an Electronic Patient Record (EPR) [3], but affective response remains a critical factor that influences the decisions and behaviors of IT users [4]. "
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    ABSTRACT: Background and purpose End-user acceptance and satisfaction are considered critical factors for successful implementation of an Electronic Patient Record (EPR). The aim of this study was to explain the acceptance and actual use of an EPR and nurses’ satisfaction by testing a theoretical model adapted from the Unified Theory of Acceptance and Use of Technology (UTAUT). Methods A multicenter cross-sectional study was conducted in the medical–surgical wards of four hospitals ranked at different EPR adoption stages. A randomized stratified sampling approach was used to recruit 616 nurses. Structural equation modeling techniques were applied. Results Support was found for 13 of the model's 20 research hypotheses. The strongest effects are those between performance expectancy and actual use of the EPR (r = 0.55, p = 0.006), facilitating conditions and effort expectancy (r = 0.45, p = 0.009), compatibility and performance expectancy (r = 0.39, p = 0.002). The variables explained 33.6% of the variance of actual use, 54.9% of nurses’ satisfaction, 50.2% of performance expectancy and 52.9% of effort expectancy. Conclusions Many results of this study support the conclusions of prior research, but some take exception, such as the non-significant relationship between the effort expectancy construct and actual use of the EPR. The results highlight the importance of the mediating effects of the effort expectancy and performance expectancy constructs. Compatibility of the EPR with preferred work style, existing work practices and the values of nurses were the most important factors explaining nurses’ satisfaction. The results reveal the complexity of this change and suggest several avenues for future research and for the implementation of IT in healthcare.
    International Journal of Medical Informatics 10/2014; DOI:10.1016/j.ijmedinf.2014.09.004 · 2.72 Impact Factor
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