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Healthcare information management and operational cost performance: empirical evidence
Healthcare knowledge management systems can mitigate hospitals’ operational inefficiency. As a healthcare information technology, the electronic health record (EHR) receives much attention from medical institutions due to its considerable impact on operational cost performance. This paper focuses on EHR systems to address operational inefficiency by which patients pay more for health care services, and many U.S. hospitals are filing for bankruptcy. From the theoretical perspective of the practice-based view, this paper introduces a path to implement EHR systems for improving cost performance. The empirical investigation is archival data of 200 hospitals collected from the U.S. healthcare agencies. Findings contribute to prior work by hypothesizing moderating and mediating roles in EHR systems implementation. This paper introduces absorptive capacity and monitoring mechanisms as enablers of implementing EHR systems. The results showed that hospital monitoring strengthens the relationship between absorptive capacity and electronic health record systems implementation, which results in better operational cost performance. Theoretically, this study supports the long-term potential benefits of EHR adoption, and its findings are consistent with optimizing efficiency through data standardization and interoperability. From a practical perspective, this study supports hospitals' investments in evolving healthcare information technology systems through the development of a knowledge-based system employing EHR, particularly when hospitals are merging or need a financial strategic plan to control expenses.
Journal Article
Leadership development for interprofessional education and collaborative practice
This is an edited compilation of chapters written by international medical and health professional experts. The book provides historical and current perspectives on leadership in healthcare.
Book
Healthcare Data Breaches: Implications for Digital Forensic Readiness
While the healthcare industry is undergoing disruptive digital transformation, data breaches involving health information are not usually the result of integration of new technologies. Based on published industry reports, fundamental security safeguards are still considered to be lacking with many documented data breaches occurring as the result of device and equipment theft, human error, hacking, ransomware attacks and misuse. Health information is considered to be one of the most attractive targets for cybercriminals due to its inherent sensitivity, but digital investigations of incidents involving health information are often constrained by the lack of the necessary infrastructure forensic readiness. Following the analysis of healthcare data breach causes and threats, we describe the associated digital forensic readiness challenges in the context of the most significant incident causes. With specific focus on privilege misuse, we present a conceptual architecture for forensic audit logging to assist with capture of the relevant digital artefacts in support of possible future digital investigations.
Journal Article
Factors influencing harmonized health data collection, sharing and linkage in Denmark and Switzerland: A systematic review
The digitalization of medicine has led to a considerable growth of heterogeneous health datasets, which could improve healthcare research if integrated into the clinical life cycle. This process requires, amongst other things, the harmonization of these datasets, which is a prerequisite to improve their quality, re-usability and interoperability. However, there is a wide range of factors that either hinder or favor the harmonized collection, sharing and linkage of health data.
This systematic review aims to identify barriers and facilitators to health data harmonization-including data sharing and linkage-by a comparative analysis of studies from Denmark and Switzerland.
Publications from PubMed, Web of Science, EMBASE and CINAHL involving cross-institutional or cross-border collection, sharing or linkage of health data from Denmark or Switzerland were searched to identify the reported barriers and facilitators to data harmonization.
Of the 345 projects included, 240 were single-country and 105 were multinational studies. Regarding national projects, a Swiss study reported on average more barriers and facilitators than a Danish study. Barriers and facilitators of a technical nature were most frequently reported.
This systematic review gathered evidence from Denmark and Switzerland on barriers and facilitators concerning data harmonization, sharing and linkage. Barriers and facilitators were strictly interrelated with the national context where projects were carried out. Structural changes, such as legislation implemented at the national level, were mirrored in the projects. This underlines the impact of national strategies in the field of health data. Our findings also suggest that more openness and clarity in the reporting of both barriers and facilitators to data harmonization constitute a key element to promote the successful management of new projects using health data and the implementation of proper policies in this field. Our study findings are thus meaningful beyond these two countries.
Journal Article
DM management in HIV patients: the adoption of population health management to transform the chronic management of HIV
Abstract
Background
The success of antiretroviral therapies has made human immunodeficiency virus (HIV) a chronic disease, changing the care scenario dramatically. This study aimed to measure adherence to diabetes mellitus standards of care provided for people living with HIV (PLWH). Diabetes represents a paradigmatic case for tackling chronic care management in this target group.
Methods
This retrospective observational study was performed on administrative health data retrieved from 2014 to 2016, with a validated algorithm to identify patients with HIV using: (i) hospital discharge records (ICD9-CM codes); (ii) drug dispensing records (with ATC codes); and (iii) disease-specific exemptions from co-payments for healthcare services. HIV-related treatments, comorbidities and health service utilization were measured, as was adherence to clinical guidelines-recommended standards of care for diabetes.
Results
A population of 738 cases were identified in two Local Health Authorities in Italy, representing a prevalence of 0.14% of the general population, in line with the expected prevalence. Thirty-one cases of HIV patients diagnosed with diabetes were identified, a prevalence ratio of 4.2% compared to the 8% in the overall population. Adherence to diabetes standards of care tested within the same population was low, with the exception of those tests commonly administered for standard HIV follow-up care.
Conclusions
The use of administrative data, combined with a Population Health Management approach represents a powerful tool for evaluating system capacity to manage HIV comorbidities. Study findings prove that it is time to design new care models for PLWH, affected by one or more chronic conditions, both to prevent their onset and to manage their comorbidities.
Journal Article
Healing Together
Kaiser Permanente is the largest managed care organization in the country. It also happens to have the largest and most complex labor-management partnership ever created in the United States. This book tells the story of that partnership-how it started, how it grew, who made it happen, and the lessons to be learned from its successes and complications. With twenty-seven unions and an organization as complex as 8.6-million-member Kaiser Permanente, establishing the partnership was not a simple task and maintaining it has proven to be extraordinarily challenging.
Thomas A. Kochan, Adrienne E. Eaton, Robert B. McKersie, and Paul S. Adler are among a team of researchers who have been tracking the evolution of the partnership between Kaiser Permanente and the Coalition of Kaiser Permanente Unions ever since 2001. They review the history of health care labor relations and present a profile of Kaiser Permanente as it has developed over the years. They then delve into the partnership, discussing its achievements and struggles, including the negotiation of the most innovative collective bargaining agreements in the history of American labor relations.Healing Togetherconcludes with an assessment of the Kaiser partnership's effect on the larger health care system and its implications for labor-management relations in other industries.
eBook