Information technology as a tool to improve the quality of American Indian health care

Department of Health Care Policy, Harvard Medical School, Brigham and Women's Hospital, Boston, MA 02120, USA.
American Journal of Public Health (Impact Factor: 4.23). 01/2006; 95(12):2173-9. DOI: 10.2105/AJPH.2004.052985
Source: PubMed

ABSTRACT The American Indian/Alaska Native population experiences a disproportionate burden of disease across a spectrum of conditions. While the recent National Healthcare Disparities Report highlighted differences in quality of care among racial and ethnic groups, there was only very limited information available for American Indians. The Indian Health Service (IHS) is currently enhancing its information systems to improve the measurement of health care quality as well as to support quality improvement initiatives. We summarize current knowledge regarding health care quality for American Indians, highlighting the variation in reported measures in the existing literature. We then discuss how the IHS is using information systems to produce standardized performance measures and present future directions for improving American Indian health care quality.

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    • "For example, communities are developing green energy technologies and practices (Carrasco & Acker, 2002), remote health care services and telemedicine (e.g. Becker et al., 2004; DeCourtney et al., 2003; Kokesh et al., 2011; Sequist et al., 2005), and new educational materials focused on simulations and traditional practices (Eglash, 2007; Inglebret, Banks, Pavel, Friedlander, & Stone, 2007; Neal et al., 2007; Robins, 2007). Language revitalization efforts 1 serve as a particularly robust context in which new technologies and new medias are being used toward critical community goals (Auld, 2007b; Bernard, 1992; Bowers, 1998; Hermes et al., 2012; Holton et al., 2007; Keegan, 2007; McKenny, Hughes, & Arposia, 2007; Warschauer, 1998, 1999, 2000). "
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    Urban Education 09/2013; 48(5):705-733. DOI:10.1177/0042085913490555 · 0.56 Impact Factor
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    • "Au niveau du 4 ème axe : l'axe de l'apprentissage et l'innovation, les administrateurs doivent trouver l'infrastructure de base (technologie) nécessaire pour mettre en place, améliorer, créer la valeur afin de pouvoir réaliser la mission (Sequist, Cullen et Ayanian, 2005). D'où, la technologie affecte: -la structure hospitalière et l'efficacité organisationnelle en termes de créer "l'adaptation" entre la structure, la technologie et un environnement donné (Kumar, Si Ow et Prietula, 1993; Schoonhoven, 1981; Thomson, 1967). "
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    ABSTRACT: Notre communication vise (1) à dresser un historique de l'évolution du design des systèmes de contrôle de gestion (CDG) et, essentiellement, des systèmes de pilotage de la performance (SPP) en contexte hospitalier; (2) à en inférer, dans une perspective contingente, la nature de ses principaux facteurs contingents; et (3) à synthétiser l'ensemble dans un modèle contingent conceptuel permettant de comprendre comment le système de contrôle de gestion des institutions hospitalières peut évoluer à l'avenir afin de maintenir un équilibre interne fragile de performance, ce système “hôpital” étant lui-même en permanence mis sous tension par les tensions divergentes exercées sur lui par ses 3 principaux acteurs que sont les patients, le monde professionnel médical et la collectivité au sens large.
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    ABSTRACT: As we shift from documenting health-care disparities to implementing solutions to eliminate them, health information technology will play a critical role. Health information technology can alert physicians to deviations from evidence-based guidelines, improve clinical decision-making at the point-of-care, and support population-based management of health care (Custodio et al., J Health Care Poor Underserved 20:301–7, 2009). Telemedicine applications can improve access to specialist care for patients in remote and underserved areas (Fricton and Chen, Dent Clin N Am 53:537–48, 2009). Novel devices can provide close monitoring for high-risk populations. In short, health information technology (IT) can drive our efforts to monitor and reduce health-care disparities. The 2009 American Reinvestment and Recovery Act’s (ARRA) HITECH provisions contain over 2 billion in programs and over2 billion in programs and over 20 billion in incentives to support the adoption and “meaningful use” of Health Information Technology (Blumenthal, N Engl J Med 362:382–5, 2010). The Recovery Act also includes over $7 billion in grants to improve the availability of broadband technology in underserved areas. Together, these programs will lay the foundation for America’s health IT infrastructure. They will also give us a new modality to monitor, manage, and correct health disparities. As with the diffusion of any new technology, there is always the risk that uneven access to electronic health records (EHR) by certain types of patients and providers will create new disparities in health. While the current data do not indicate that providers or patients of particular ethnic or racial groups are more or less likely to adopt or have access to electronic health records, careful attention must be paid to ensure that underserved patient populations are the beneficiaries of the clinical improvements that health information technology can enable. This chapter summarizes our current state of knowledge about health IT adoption among underservedcommunities and outlines a vision for how broad adoption and use of healthinformation technology can limit or correct health-care disparities. It describes the federal HITECH Act programs and also addresses how the federal government is working to ensure that the benefits of health IT are widely distributed to underserved populations.
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