Adoption Of Health Information Technology Research Articles

The impact of trust, comfortability, usability and technophobia factors on acceptance of health information technology

In the contemporary landscape of healthcare, the rapid integration of digital technologies is reshaping traditional practices. As healthcare systems increasingly embrace digitalization, there arises a critical need to comprehend the dynamic and ever-evolving role played by Information and Communication Technologies (ICTs). Amidst the rapid digitization of healthcare systems, understanding the evolving role of Information and Communication Technologies (ICTs) is paramount. This study explores the impact of Information and Communication Technologies (ICTs) on healthcare, with a focus on Health Information Technology (HIT) and its role in enhancing patient-centered care. Specifically, the research centers on Personal Health Records (PHRs), which empower patients to control their health information securely. The study aims to identify key features influencing patients’ behavioral intention to adopt HIT, utilizing a structured questionnaire and a conceptual framework based on the Technology Acceptance Model (TAM). Feature selection analysis, conducted using the Weka tool, employed various classifiers to predict users’ perceptions and behavioral intentions towards HIT adoption. Results highlight the significance of trust, comfort, usefulness, and technophobia in shaping patients’ acceptance of HIT, with Random Forest and Bayes Net classifiers emerging as key predictors. This research provides valuable insights into the critical factors driving patients’ acceptance of HIT, contributing to the ongoing discourse on the adoption of healthcare technologies.

Data Lake, Data Warehouse, Datamart, and Feature Store: Their Contributions to the Complete Data Reuse Pipeline.

The growing adoption and use of health information technology has generated a wealth of clinical data in electronic format, offering opportunities for data reuse beyond direct patient care. However, as data are distributed across multiple software, it becomes challenging to cross-reference information between sources due to differences in formats, vocabularies, and technologies and the absence of common identifiers among software. To address these challenges, hospitals have adopted data warehouses to consolidate and standardize these data for research. Additionally, as a complement or alternative, data lakes store both source data and metadata in a detailed and unprocessed format, empowering exploration, manipulation, and adaptation of the data to meet specific analytical needs. Subsequently, datamarts are used to further refine data into usable information tailored to specific research questions. However, for efficient analysis, a feature store is essential to pivot and denormalize the data, simplifying queries. In conclusion, while data warehouses are crucial, data lakes, datamarts, and feature stores play essential and complementary roles in facilitating data reuse for research and analysis in health care.

Leadership style, change management and job performance of health information management practitioners in tertiary hospitals in South-East, Nigeria

PurposeManaging patients’ health information is one of the building blocks of the health system and the adoption of health information technologies like electronic health records (EHRs) is expected to reduce the various challenges in keeping and accessing quality health-care data that aid decision-making among medical practitioners. This study aims to investigate how leadership styles and change management affected the job performance of health information management practitioners on their adoption of EHRs in tertiary hospitals in Nigeria.Design/methodology/approachThe study used primary data collected using a Likert scale questionnaire from 117 health information management officers and health information technicians in selected tertiary hospitals in South-Eastern Nigeria. The data were analysed using bivariate correlation and multiple regression techniques of inferential statistics.FindingsThe analyses revealed that transformational leadership style, transactional leadership style and change management had significant positive influence on the job performance of health information management practitioners. However, laissez-faire leadership style did not show any significant positive influence. A further analysis showed that the combined effects of leadership styles and change management were also affirmed to significantly influence the adoption of EHRs for quality health-care delivery in Nigerian tertiary hospitals.Originality/valueThe study contributes to health information management and the need to understand how leadership styles and change management can influence the adoption of EHRs. However, there is no adequate research that examined the role of leadership style and change management in influencing the job performance of Nigerian HIM practitioners regarding their usage of EHRs in tertiary hospitals in Nigeria.

User acceptance of health information technologies (HIT): an application of the theory of planned behavior

Health Information Technologies (HIT) has a significant chance of enhancing the standard of medical treatment, but their acceptance faces major obstacles including low adoption rates and professional hesitancy. Limited research on HIT adoption, especially in poor nations, adds to this problem and clearly challenges health care managers and researchers. It emphasizes the need of knowing the elements influencing acceptance, choice, and usage of healthcare technology to improve user adoption willingness. Using past studies from several nations, this paper investigates the elements driving HIT adoption within the prism of the Theory of Planned Behavior (TPB). Using a Systematic Literature Review (SLR) under direction from the PRISMA framework guaranteed an open and exhaustive study. With eight publications compared to six from wealthy countries, the results expose a notable trend: emerging countries help more to promote HIT adoption research. Furthermore, the combination of TPB with other theories like the Technology Acceptance Model (TAM) provides a whole framework for grasp the elements influencing HIT uptake. Core TPB components include subjective norms, attitude, and perceived behavioral control are well known in industrialized nations and supported by TAM's perceived utility and simplicity of use, along with demographic elements, therefore stressing a user-centric approach. Research on emerging nations, particularly China, shows, on the other hand, a wide spectrum of variables on HIT adoption including personal, technical, social, and institutional ones. The results greatly improve our knowledge of HIT adoption seen from the TPB perspective and provide insightful analysis for legislators developing sensible plans for HIT implementation

Comparing "Meaningful Use" of Health Information Technology in Pennsylvania: Electronic Prescription Rates of Metropolitan and Rural Counties.

The Health Information Technology for Economic and Clinical Health Act incentivized the adoption of electronic health records (EHRs). Health systems looked to leverage technology to assist in serving populations in health professional shortage areas. Qualitative research points to EHR usability as a source of health inequities in rural settings, making the challenges of EHR usage a subject of interest. Pennsylvania offers a model for investigating rural health infrastructure with it having the third largest rural population in the United States. This study analyzed the adoption of Electronic Prescribing in the 67 Pennsylvania (PA) counties. Physician adoption and usage data for PA and the United States were compared using a t-test to establish a basis for comparison. PA counties were categorized using the United States Department of Agriculture (USDA)'s Rural-Urban Commuting Areas (RUCAs) system. Surescript use percentages were plotted against the RUCA scores of each PA county to create a polynomial regression model. PA office-based physicians, on average, utilize e-prescription tools at the same rate as the national average with 59% of practices utilizing Surescripts as of 2013. There was no significant correlation between Surescript usage and the rural/urban classification of counties in Pennsylvania (R-squared value of 0.06). Pennsylvania was able to adopt health information technology (HIT) infrastructure at the same rate as the national average. Rural and metropolitan definitions do not correlate to meaningful use of HIT, thus usability of HIT cannot be tied to health outcomes. Future studies looking at specific forms of HIT and their ability to decrease the burden of administrative work for clinicians.

Evaluating the Relationship Between Information Technology Adoption and Healthcare Outcomes in Sub-Saharan Africa

Purpose: The aim of the study was to investigate evaluating the relationship between information technology adoption and healthcare outcomes in Sub-Saharan Africa
 Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries.
 Findings: The study found that IT adoption in Sub-Saharan Africa's healthcare varied by country and played a positive role in improving healthcare outcomes when effectively implemented. However, challenges like infrastructure limitations and financial constraints hindered adoption. Tailored strategies and policy interventions are needed to overcome these barriers and harness the potential benefits of IT adoption in the region's healthcare systems.
 Unique Contribution to Theory, Practice and Policy: Technology Acceptance Model, Diffusion of Innovations Theory & Health Information Technology Adoption Model may be used to anchor future studies on evaluating the relationship between information technology adoption and healthcare outcomes in Sub-Saharan Africa. Advocate for capacity building initiatives to enhance digital literacy and IT skills among healthcare providers, administrators, and policymakers. Engage with policymakers at the national and regional levels to influence the formulation of healthcare IT adoption policies.

THE MOVING FORWARD NURSING HOME COALITION: A CALL TO ACTION TO SUPPORT NURSING HOME REFORM

Abstract The Moving Forward Nursing Home Quality Coalition advances the goals outlined by the 2022 National Academies of Sciences, Engineering, and Medicine (NASEM) report aimed at improving nursing home (NH) quality. Over two years, Coalition committee members – along with a network of national leaders, nursing home residents, and the general public – will develop, test and promote action plans that will improve the way the United States finances, delivers, and regulates care in Nursing Homes. The Coalition is comprised of a steering committee and working committees that align with and advance the seven NASEM goals including; 1) advancing delivery of person-centered care; 2) ensuring a well-prepared and compensated workforce; 3) increasing financial transparency and accountability; 4) creating a rational and robust financing system; 5) designing more effective and responsive quality assurance; 6) expanding quality measurement and continuous quality improvement; and 7) adopting health information technology. Coalition committees have engaged in three of four phases of their two-year work plan including convening stakeholders to prioritize and develop action plans to test and promote change. Throughout the work, committee collaboration has ensured action plans are refined and expanded in synergistic ways to shape state and national policy. This presentation will provide an overview of the broader Coalition work and give context for the other presentations which provide an example of collaborative work leading to proposed recommendations for critical policy and regulatory change around person-centered care planning.

Facilitators of and barriers to the use of a computer-based self-monitoring system by type 2 diabetic and/or hypertensive patients

BackgroundConsumer health information technologies (IT) are being increasingly applied to improve access to self-care resources for individuals with chronic illnesses. Thus, it is important to identify the factors influencing the patients’ adoption or rejection of these technologies. ObjectiveThis study contributes to the literature on consumer health IT adoption by identifying the facilitators and barriers to the use of a computer-based chronic disease self-monitoring system by patients with type 2 diabetes mellitus and/or hypertension. MethodsSemi-structured interviews nested within a 3-month randomized controlled trial were conducted with 38 patients. Guided by the home care health IT implementation framework described in Or et al. (2009), their data were contented analyzed. ResultsThe facilitators and barriers identified were organized around the six variable categories of the Health IT implementation framework, including patient attributes, technological characteristics, patient–technology interaction, home environment, organizational factors (e.g., influences, resources, and support), and patient outcomes. ConclusionsOur study provides a holistic insight into the conceptualization of consumer health IT adoption by patients. When creating and implementing consumer health IT, taking into account the identified facilitators and barriers might boost the likelihood of technology adoption.

A Survey of Technology Abandonment in US Nursing Homes

ObjectiveAdoption of health information technology (HIT) in nursing homes (NHs) improves quality of care. Although there is a robust body of research on HIT adoption, the closely related process of technology abandonment is not well understood. As NHs grow more reliant on HIT, problems of technology abandonment, defined as failure to scale up, spread, and sustain HIT need to be studied. Our objective is to describe HIT abandonment and its associations with organizational characteristics among a national sample of US NHs. DesignLongitudinal, retrospective analysis of data from 2 sources: HIT Maturity Survey and Staging model and public data from the Care Compare database. Setting and ParticipantsRandom sample of NHs (n = 299) representing each US state that completed the HIT maturity survey in 2 consecutive years: year 1 (Y1) was June 2019–August 2020 and year 2 (Y2) was June 2020–August 2021. MethodsThe primary dependent variable was technology abandonment, operationalized by using total HIT maturity score, HIT maturity stage, and subscale scores within each dimension/domain. Independent variables were NH organizational characteristics including bed size, type of ownership, urbanicity, Centers for Medicare & Medicaid Services Five-Star Overall Rating and Staffing Rating. ResultsOver the 2-year period, HIT abandonment occurred in 28% (n = 85) of NHs compared with 44% (n = 133) that experienced growth in HIT systems. HIT capabilities in resident care were abandoned most frequently. Using multivariable multinomial logistic regression, we found that large NHs (bed size greater than 120) were more likely to experience technology abandonment in administrative activities. Conclusions and ImplicationsTechnology abandonment can increase strain on scarce resources and may impact administrators’ ability to oversee clinical operations, especially in large NHs. This study contributes to the limited understanding of technology abandonment and can serve as a building block for others working to ensure limited resources are used effectively to improve care for NH residents.

UTILISATION OF HEALTH INFORMATION TECHNOLOGY AMONG DIETITIANS IN THE WORKPLACE: A QUALITATIVE STUDY

Dietitians play an important role in advocating lifestyle changes, such as dietary modifications and physical activity, to effectively prevent chronic diseases and avoid complications. The use of information technologies (IT) helps dietitians to engage with their patients. This paper explores the use health information technology among dietitians in the workplace. Four focus group sessions involving fifteen dietitians from hospitals and universities were conducted using an online platform. Participants were recruited using purposive and snowball sampling. A semi-structured questionnaire was used to facilitate the interview to understand better dietitians' health IT practices. Interviews were videotaped, verbatim transcribed, and emerging themes and subthemes were thematically analysed. Inductive and deductive content analysis were used. Four themes emerged from the data: 1. utility of health IT tools, 2. factors that influence the use of health IT, 3. frequency of use, and 4. perceived barriers to adoption of health IT. Participants used health IT through health-related mobile applications, web-based platforms, and social media applications. Participants cited self-motivation, advertisement, training, peers, patients, content, ease of use, developers, quality, and functionality as factors in their use of health IT. Some barriers to utilising health IT included not disease-specific tools, inappropriate for all age groups, inaccurate information, inconvenient, required a paid version, and being overloaded with information. This study demonstrates how dietitians make use of health information technology in their practice. Support is required to overcome information technology barriers to be applied successfully in practice. It is important for dietitians to stay current with technological advancements. Dietitians will be able to stay relevant and continue to support evidence-based practice if they do so now and in the future.

Strategic Complements or Substitutes? The Case of Adopting Health Information Technology by U.S. Hospitals

Abstract This paper explores the adoption choice of electronic medical records by U.S. hospitals, which could exhibit strategic complements or substitutes. I find complementarities in adoption through a reduced-form analysis with instruments for unobserved market characteristics. I further develop a dynamic oligopoly model to allow for strategic timing incentives that are missing in the static model. Adopting a dominant local vendor could increase per period profits from adoption by 9.2% over choosing a marginal vendor. A counterfactual analysis suggests that an incentive program rewarding coordination, not just adoption, is more effective in achieving interoperability, especially before the widespread adoption of the technology.

The digital divide: Racial disparities in adoption and utilization of health information technology among patients with lymphoid cancers.

Health information technology (HIT) has the potential to improve healthcare delivery and engagement. Studying racial-ethnic disparities in HIT engagement will help understand and overcome challenges to healthcare utilization. We undertook a patient-reported survey among patients with lymphoid malignancies at two campuses of Mayo Clinic, Florida to explore HIT-related disparities. Variables between Whites and non-Whites, and non-Whites from the two campuses were compared. The survey was completed by 1004 respondents, with 71% whites, 27% non-Whites (race-ethnicity not reported by 2%). Non-Whites included 30% responders at the main campus and 64% at an inner-city campus. Whites were significantly older and had higher education, while non-Whites had lesser access to a computer. Only 51% of non-Whites were registered to use electronic medical records (EMR) as compared to 72% Whites (p < 0.001) and significantly lesser number of non-Whites even knew that EMR existed (81% vs. 92%, p < 0.001). Encouragingly, a higher number of non-Whites wanted to engage in EMR. Non-Whites from the main campus were older, more educated and had more access to a computer as compared to those from the inner-city campus. Similar disparate factors were noted among minorities from the two campuses, suggesting impact of socioeconomic backgrounds on EMR usage among non-Whites. Linguistic barriers were more striking among inner-city campus non-Whites. Non-Whites continue to struggle with suboptimal utilization of the healthcare system and barriers related to integration in HIT, including disparities representing socioeconomic differences. Efforts need to be made at several levels to help racial-ethnic minorities overcome awareness, access, and linguistic barriers to HIT utilization.

Health Systems Need to Transform Data Collection to Advance Health Equity.

Health Systems Need to Transform Data Collection to Advance Health Equity.

Probing into Federal Policies and National Academies’ Recommendations to Adopt Health Information Technology in All U.S. Nursing Homes

Probing into Federal Policies and National Academies’ Recommendations to Adopt Health Information Technology in All U.S. Nursing Homes

What is the level of information technology maturity in Ontario’s long-term care homes? A cross-sectional survey study protocol

IntroductionThe number of Canadians 75 years and older is expected to double over the next 20 years, putting continuing care systems such as long-term care (LTC) homes under increasing pressure....

Probing into Federal Policies and National Academies' Recommendations to Adopt Health Information Technology in All U.S. Nursing Homes.

Probing into Federal Policies and National Academies' Recommendations to Adopt Health Information Technology in All U.S. Nursing Homes.

Opportunities and Challenges to Advance Health Equity Using Digital Health Tools in Underserved Communities in Southeast US: A Mixed Methods Study.

Over the last 30 years, the adoption of health information technology and digital health tools (DHTs) into the US health system has been instrumental to improving access to care, especially for people living in rural, underserved, and underrepresented communities. Despite widespread adoption of DHTs by primary care clinicians, documented challenges have contributed to inequitable use and benefit. The COVID-19 pandemic necessitated rapid adoption of DHTs, accelerated by state and federal policy changes, in order to meet patient needs and ensure access to care. The Digital Health Tools Study employed a mixed methods approach to assess adoption and use of DHTs by primary care clinicians in southeastern states and identify individual- and practice-level barriers and facilitators to DHT implementation. A survey was conducted using a multi-modal recruitment strategy: newsletters, meeting/conference presentations, social media, and emails/calls. Focus groups were conducted to assess priorities, barriers, and facilitators and were recorded/transcribed verbatim. Descriptive statistics were calculated for survey results, produced for the whole sample, and stratified by state. Thematic analysis was conducted of focus group transcripts. There were 1215 survey respondents. About 55 participants who had missing demographic information were excluded from the analysis. About 99% of clinicians used DHTs in the last 5 years, modalities included: telehealth (66%), electronic health records (EHRs; 66%), patient portals (49%), health information exchange (HIE; 41%), prescription drug monitoring programs (39%), remote/home monitoring (27%), and wearable devices (22%). Time (53%) and cost (51%) were identified as barriers. About 61% and 75% of clinicians reported being "satisfied" to "very satisfied" with telemedicine and EHRs, respectively. Seven focus groups with 25 clinicians were conducted and indicated COVID-19 and the use of supplemental tools/apps to connect patients to resources as major motivators for adopting DHTs. Challenges included incomplete and difficult-to-utilize HIE interfaces for providers and internet/broadband access and poor connectivity for patients. This study describes the impact adopting DHTs by primary care clinicians has on expanded access to healthcare and reducing health disparities in regions with longstanding health and social inequities. The findings identify opportunities to leverage DHTs to advance health equity and highlight opportunities for policy improvement.

Health Information Technology Adoption at U.S. Home Health Care Agencies: Results from a Multi-Methods Study.

Health information technology (HIT) holds potential to transform Home Health Care (HHC), yet, little is known about its adoption in this setting. In the context of infection prevention and control, we aimed to: (1) describe challenges associated with the adoption of HIT, for example, electronic health records (EHR) and telehealth and (2) examine HHC agency characteristics associated with HIT adoption. We conducted in-depth interviews with 41 staff from 13 U.S. HHC agencies (May-October 2018), then surveyed a stratified random sample of 1506 agencies (November 2018-December 2019), of which 35.6% participated (N = 536 HHC agencies). We applied analytic weights, generating nationally-representative estimates, and computed descriptive statistics, bivariate and multivariable analyses. Four themes were identified: (1) Reflections on providing HHC without EHR; (2) Benefits of EHR; (3) Benefits of other HIT; (4) Challenges with HIT and EHR. Overall, 10% of the agencies did not have an EHR; an additional 2% were in the process of acquiring one. Sixteen percent offered telehealth, and another 4% were in the process of acquiring telehealth services. In multivariable analysis, EHR use varied significantly by geographic location and ownership, and telehealth use varied by geographic location, ownership, and size. Although HIT use has increased, our results indicate that many HHC agencies still lack the HIT needed to implement technological solutions to improve workflow and quality of care. Future research should examine the impact of HIT on patient outcomes and the impact of the COVID-19 pandemic on HIT use in HHC.

IMPACT OF EHR IMPLEMENTATION IN NURSING HOMES ON FINANCIAL PERFORMANCE

Abstract Nursing homes (NHs) are a critical part of the US healthcare system providing care to the sick and fragile elderly, and research suggests that they can benefit from the implementation of health information technology (HIT). However, for multiple reasons—exclusion from HITECH incentives; limited financial wherewithal; hazy return on investments (ROI), they have lagged in HIT implementation compared to other significant components of the US healthcare system. Utilizing the resource-based view (RBV) of the firm, the purpose of this study was to examine the longitudinal impact of HIT on NH financial performance potentially building a sustainable economic argument for its implementation. To examine this relationship, we merged data from five different sources between the years 2009-2013-: Health Information and Management Systems Society, LTCFocus, Online Survey Certification and Reporting/Certification and Survey Provider Enhanced Reporting, Area Health Resource Files, and Medicare Cost Reports. The outcome variable was financial performance which was measured in four ways: operating cost and revenue, operating margin, and total margin. The independent variable of interest was HIT implementation and was measured using a novel HIT Adoption Score (HAS) reflecting NH implementation of five different HIT applications. Four separate multivariate linear regression models were estimated, and we included a series of organizational and market characteristics in the analyses. We report a positive association between NH implementation and improved profitability (operating margin) (p≤0.01), and lower operating cost (p≤0.05). Our results, suggesting a potential business case for EHR implementation within NHs, have important policy and managerial implications that are discussed.

Transition to a new nursing information system embedded with clinical decision support: a mixed-method study using the HOT-fit framework

BackgroundNursing information systems embedded with standardized nursing language and clinical decision support have been increasingly introduced in health care settings. User experience is key to the adoption of health information technologies. Despite extensive research into the user experience with nursing information systems, few studies have focused on the interaction between user, technology and organizational attributes during its implementation. Guided by the human, organization and technology-fit framework, this study aimed to investigate nurses’ perceptions and experiences with transition to a new nursing information system (Care Direct) 2 years after its first introduction.MethodsThis is a mixed-method study using an embedded design. An online survey was launched to collect nurses’ self-reported use of the new system, perceived system effectiveness and experience of participation in system optimization. Twenty-two semi structured interviews were conducted with twenty nurses with clinical or administrative roles. The quantitative and qualitative data were merged using the Pillar Integration Process.ResultsThe average score of system use behavior was 3.76 ± 0.79. Regarding perceived system effectiveness, the score of each dimension ranged 3.07–3.34 out of 5. Despite large variations in approaches to participating in system optimization, nurses had generally positive experiences with management and technical support. Eight main categories emerged from the integrated findings, which were further condensed into three themes: perceptions on system content, structure, and functionality; perceptions on interdisciplinary and cross-level cooperation; and embracing and accepting the change.ConclusionsEffective collaboration between clinicians, administrators and technical staff is required during system promotion to enhance system usability and user experience. Clear communication of organizational missions to staff and support from top management is needed to smooth the system implementation process and achieve broader system adoption.