Health Information Technology Innovations Research Articles

Advancements in health information technology and their role in enhancing cancer care: Innovations in early detection, treatment, and data privacy

The rapid advancement of Health Information Technology (HIT) has revolutionized cancer care, introducing new capabilities in early detection, individualized treatment, and data security. This paper reviews the key HIT innovations that have reshaped oncology, including the widespread adoption of Electronic Health Records (EHRs), the use of artificial intelligence (AI) in diagnostic processes, and the application of telemedicine and predictive analytics to improve treatment planning. These technologies have enabled earlier and more accurate diagnoses, expanded access to care, and facilitated data-driven, personalized treatment strategies. In parallel, this review addresses the importance of safeguarding sensitive patient data, focusing on encryption, anonymization techniques, and the regulatory frameworks like HIPAA and GDPR that ensure data privacy. Finally, the paper discusses future directions for HIT, particularly the potential of AI-driven decision support systems, real-time data analytics, and privacy-enhancing algorithms to further advance cancer care, creating a more secure, efficient, and patient-centered healthcare system.

Artificial Intelligence in Nursing: Perspectives from Norwegian Nurses.

Nurses continue to face challenges in leading health information technology innovations such as Artificial Intelligence (AI). There is an acknowledged need to explore the attitude of nurses towards AI and nurses' acceptance of AI in clinical settings. We sought to address this gap in knowledge about the perceptions of AI by nursing-related professionals in their work and as a content area in the education of nursing students. Norwegian nurses and healthcare personnel interested in the topic met in a seminar in Oslo in 2023 to explore their perspectives on AI. Following a lecture on AI, audience members offered their insights in a recorded discussion. Data analysis consisted of inductive coding of concepts in the transcribed recording. Three major themes emerged: Expectations, Identified needs and related recommendations; and Policy to guard safety; as well as recommendations new to the literature.

Implementation of an EHR-integrated web-based depression assessment in primary care: PORTAL-Depression.

To integrate a computerized adaptive test for depression into the electronic health record (EHR) and establish systems for administering assessments in-clinic and via a patient portal to improve depression care. This article reports the adoption, implementation, and maintenance of a health information technology (IT) quality improvement (QI) project, Patient Outcomes Reporting for Timely Assessment of Life with Depression (PORTAL-Depression). The project was conducted in a hospital-based primary care clinic that serves a medically underserved metropolitan community. A 30-month (July 2017-March 2021) QI project was designed to create an EHR-embedded system to administer adaptive depression assessments in-clinic and via a patient portal. A multi-disciplinary team integrated 5 major health IT innovations into the EHR: (1) use of a computerized adaptive test for depression assessment, (2) 2-way secure communication between cloud-based software and the EHR, (3) improved accessibility of depression assessment results, (4) enhanced awareness and documentation of positive depression results, and (5) sending assessments via the portal. Throughout the 30-month observational period, we collected administrative, survey, and outcome data. Attending and resident physicians who participated in the project were trained in depression assessment workflows through presentations at clinic meetings, self-guided online materials, and individual support. Developing stakeholder relationships, using an evaluative and iterative process, and ongoing training were key implementation strategies. The PORTAL-Depression project was a complex and labor-intensive intervention. Despite quick adoption by the clinic, only certain aspects of the intervention were sustained in the long term due to financial and personnel constraints.

Real-World Evidence for Equality.

As stakeholders in the transformative medical research ecosystem, real-world evidence researchers must conduct observational research with an awareness of racism. Advancements in understanding of the impact of racism on health outcomes, the abundance of health care data, and innovations in health information technology provide tools that create opportunities to conduct more focused research that illustrates how racism in health care deters the advancement of equity.

The Case of Organizational Innovation Capability and Health Information Technology Implementation Success As You Sow, So You Reap?

Organizational innovation capability is defined as the ability to continuously transform knowledge and ideas into new products, processes and systems for the benefit of an organization and its stakeholders. This study examines the relationship between the innovation capability of healthcare organizations and their ability to successfully implement electronic medical records (EMR), a health information technology (HIT) innovation. Data was collected using a cross-sectional survey and structural equation modeling (SEM) method was used to analyze the data. Results demonstrate that organizational product innovation capability positively affects EMR implementation success. A positive relationship also exists between organizational process innovation capability and EMR implementation success. This study is one of the first to empirically validate the relationship between healthcare organization’s innovation capability and HIT innovation implementation success, in the context of EMRs. Implications of the study for the academic and industry practitioner are discussed.

The Case of Organizational Innovation Capability and Health Information Technology Implementation Success

Organizational innovation capability is defined as the ability to continuously transform knowledge and ideas into new products, processes and systems for the benefit of an organization and its stakeholders. This study examines the relationship between the innovation capability of healthcare organizations and their ability to successfully implement electronic medical records (EMR), a health information technology (HIT) innovation. Data was collected using a cross-sectional survey and structural equation modeling (SEM) method was used to analyze the data. Results demonstrate that organizational product innovation capability positively affects EMR implementation success. A positive relationship also exists between organizational process innovation capability and EMR implementation success. This study is one of the first to empirically validate the relationship between healthcare organization’s innovation capability and HIT innovation implementation success, in the context of EMRs. Implications of the study for the academic and industry practitioner are discussed.

Automated Interactive Patient History-Taking System

The process of history-taking has been challenging for India due to its booming population and severe scarcity of doctors. Inadequate patient history could lead to medication errors, adverse drug reactions, and medication noncompliance. Innovations in health information technology have great potential for improving the practice of medicine. Automated patient history is collected with the help of a computer. Physicians can use artificial intelligence to help with documentation, analysis of patient data while increasing the precision, productivity, and efficacy of the physician. Health-care providers are looking for regulatory compliant and efficient software for automated patient history taking. In telemedicine, automated history taking before the consultation can save physician‘s time, have more accurate history which will improve the telemedicine experience for the patient, especially in times of a pandemic like coronavirus disease 2019.

The Effect of Innovation Capabilities of Health Care Organizations on the Quality of Health Information Technology: Model Development With Cross-sectional Data

BackgroundLarge health organizations often struggle to build complex health information technology (HIT) solutions and are faced with ever-growing pressure to continuously innovate their information systems. Limited research has been conducted that explores the relationship between organizations’ innovative capabilities and HIT quality in the sense of achieving high-quality support for patient care processes.ObjectiveThe aim of this study is to explain how core constructs of organizational innovation capabilities are linked to HIT quality based on a conceptual sociotechnical model on innovation and quality of HIT, called the IQHIT model, to help determine how better information provision in health organizations can be achieved.MethodsWe designed a survey to assess various domains of HIT quality, innovation capabilities of health organizations, and context variables and administered it to hospital chief information officers across Austria, Germany, and Switzerland. Data from 232 hospitals were used to empirically fit the model using partial least squares structural equation modeling to reveal associations and mediating and moderating effects.ResultsThe resulting empirical IQHIT model reveals several associations between the analyzed constructs, which can be summarized in 2 main insights. First, it illustrates the linkage between the constructs measuring HIT quality by showing that the professionalism of information management explains the degree of HIT workflow support (R²=0.56), which in turn explains the perceived HIT quality (R²=0.53). Second, the model shows that HIT quality was positively influenced by innovation capabilities related to the top management team, the information technology department, and the organization at large. The assessment of the model’s statistical quality criteria indicated valid model specifications, including sufficient convergent and discriminant validity for measuring the latent constructs that underlie the measures of HIT quality and innovation capabilities.ConclusionsThe proposed sociotechnical IQHIT model points to the key role of professional information management for HIT workflow support in patient care and perceived HIT quality from the viewpoint of hospital chief information officers. Furthermore, it highlights that organizational innovation capabilities, particularly with respect to the top management team, facilitate HIT quality and suggests that health organizations establish this link by applying professional information management practices. The model may serve to stimulate further scientific work in the field of HIT adoption and diffusion and to provide practical guidance to managers, policy makers, and educators on how to achieve better patient care using HIT.

The Role of Frontline Leaders in Building Health Professional Support for a New Patient Portal: Survey Study.

BackgroundEffective leadership and change management are thought to contribute to the successful implementation of health information technology innovations. However, limited attention has been paid to the role of frontline leaders in building health professional support for new technical innovations.ObjectiveFirst, we examined whether frontline leaders’ positive expectations of a patient portal and perceptions of its implementation were associated with their support for the portal. Second, we explored whether leaders’ positive perceptions influenced the same unit’s health professional support for the portal.MethodsData were collected through an online survey of 2067 health professionals and 401 frontline leaders working in 44 units from 14 health organizations in Finland. The participating organizations run a joint self-care and digital value services project developing a new patient portal for self-management. The survey was conducted before the piloting and implementation of the patient portal.ResultsThe frontline leaders’ perception of vision clarity had the strongest association with their own support for the portal (ß=.40, P<.001). Results also showed an association between leaders’ view of organizational readiness and their support (ß=.15, P=.04). The leaders’ positive perceptions of the quality of informing about the patient portal was associated with both leaders’ own (ß=.16, P=.02) and subordinate health professionals’ support for the portal (ß=.08, P<.001). Furthermore, professional participation in the planning of the portal was positively associated with their support (ß=.57, P<.001).ConclusionsFindings suggest that assuring good informing, communicating a clear vision to frontline leaders, and acknowledging organizational readiness for change can increase health professional support for electronic health (eHealth) services in the pre-implementation phase. Results highlight the role of frontline leaders in engaging professionals in the planning and implementation of eHealth services and in building health professionals’ positive attitudes toward the implementation of eHealth services.

An Adaptation of Grounded Theory Using a Modified Convergent Interviewing Technique

Grounded Theory (GT) researchers have been using adaptations of this methodology to serve theory building purposes, following different theoretical frameworks. However, there is a lack of enough information on the variation of GT used, or their epistemological assumptions in some studies. The purpose of this paper is to provide our experience in a GT study using a modified convergent interviewing technique to help guide other researchers on using this method and build their own research design. We have combined a decision-making technique, called Delphi, with convergent interviewing and provided a clear explanation of the steps required to apply this method in a GT research study. To help other researchers, justifications made to choose convergent interviewing in this GT study, and the proposed adaptation are explained in detail. The method used resulted in a more efficient data collection and analysis stage in the main author’s PhD study, that aimed to find main issues in a Health Information Technology innovation development by interviewing key informants. The case for this study was about using Information Technology in health care (e.g., computerised medical records for sharing patient care among clinicians in different services). The GT methodology and the proposed interviewing method can be used in the development processes of other innovations where the main issues or events need to be determined and generate relevant theory. There is potential in the proposed method to improve theory building studies by providing explicit theoretical and methodological decisions of this study.

Should Government Subsidize Electronic Health Records?

Health information technology (HIT) innovation focuses on electronic health records (EHRs) that can collect, store, and transmit health information within electronic health information exchanges. HIT innovation holds great promise not only for improving public health, but also for controlling what many believe is out-of-control healthcare spending in the United States. These benefits, along with the perception that providers were too slow in adopting HIT, motivated passage of the Health Information Technology for Economic and Clinical Health Act in 2009. That act authorized government subsidies to encourage the adoption and use of EHRs. This paper examines whether recent government investments in EHR adoption were wise. Theories that market failure in EHR innovation and adoption is caused by network externalities, lack of information, and free-rider problems are found to be not entirely convincing, especially given that the government case for subsidies mistakenly assumed that interoperable mature technologies were mostly in place and that healthcare providers would voluntarily share data among themselves. Government subsidies have thus likely “locked in” immature technology rather than spurred HIT innovations that would otherwise have evolved over time. Lost opportunities for better patient care at lower expense are one major cost of the government subsidy program. The paper concludes with recommendations for government policies that are more likely to promote HIT innovation that will improve public health.

Innovative Use Of Electronic Consultations In Preoperative Anesthesiology Evaluation At VA Medical Centers In New England.

Electronic consultations (e-consults) improve access to specialty care without requiring face-to-face patient visits. We conducted a mixed-methods descriptive study to understand the variability in e-consult use across anesthesiology departments in the Veterans Affairs New England Healthcare System (VANEHS). In the period 2012-15, the system experienced a rapid increase in the use of anesthesiology e-consults: 5,023 were sent in 2015, compared with 103 in 2012. Uptake across sites varied from near-universal use of e-consults for preoperative assessment to use for only selected low-risk patients or no use. Interviews with stakeholders revealed considerable differences in the perceived impact of e-consults on workflow and patient-centeredness. Clinicians at sites with high use of e-consults noted that they improved workflow efficiency. In comparison, clinicians at sites with low use preferentially valued face-to-face visits for some or all patients. The adoption of a health information technology innovation can alter the process of care delivery, depending on perceptions of its value by key stakeholders.

Managing the patient safety risks of bottom-up health information technology innovations: Recommendations for healthcare providers

Health information technology (IT) offers exciting opportunities for providing novel services to patients, and for improving the quality and safety of care. Many healthcare professionals are already improving services through...

An Approach for All in Pharmacy Informatics Education

Computerization is transforming health care. All clinicians are users of health information technology (HIT). Understanding fundamental principles of informatics, the field focused on information needs and uses, is essential if HIT is going to support improved patient outcomes. Informatics education for clinicians is a national priority. Additionally, some informatics experts are needed to bring about innovations in HIT. A common approach to pharmacy informatics education has been slow to develop. Meanwhile, accreditation standards for informatics in pharmacy education continue to evolve. A gap remains in the implementation of informatics education for all pharmacy students and it is unclear what expert informatics training should cover. In this article, we propose the first of two complementary approaches to informatics education in pharmacy: to incorporate fundamental informatics education into pharmacy curricula for all students. The second approach, to train those students interested in becoming informatics experts to design, develop, implement, and evaluate HIT, will be presented in a subsequent issue of the Journal.

Catalysing health information technology innovation in the National Health Service.

Catalysing health information technology innovation in the National Health Service.

Celebrating Morris F. Collen (1913-2014)

Celebrating Morris F. Collen (1913-2014)

Health care transformation initiatives in type 2 diabetes care: a qualitative study in the cincinnati beacon community.

The Beacon Community Program is part of a larger federal strategy to use health information technology (IT) as an enabling foundation for improving the nation’s health care system (1). It was funded by the Health Information Technology for Economic and Clinical Health Act under the American Recovery and Reinvestment Act, which also provided significant funding to drive adoption and “meaningful use” of electronic health records (EHRs) (2,3). Beacon Communities were encouraged to draw not only from health IT innovations, but also from other spheres, including quality improvement, payment reform, and consumer engagement (4,5). Thus, the focus in the Cincinnati, Ohio, Beacon Community was not only on technology, but also on the implementation of innovative strategies to transform care and improve outcomes. The Cincinnati program used the infrastructure of the Patient-Centered Medical Home (PCMH) model as a guide to realize the benefits of meaningful use (2,6), improve clinical outcomes, and redesign practice interactions and workflows (7). Similar to other Beacon Communities, Cincinnati targeted type 2 diabetes for its improvement efforts (8). Specific aims included increasing the proportion of people with diabetes in compliance with the “D5,” a National Quality Forum–endorsed composite measure indicative of diabetes control. The composite goals include an A1C <8%, blood pressure <140/90 mmHg, LDL cholesterol <100 mg/dL, 1 aspirin per day as appropriate, and self-reported nonsmoking status. Adherence requires all five goals to be met (9,10). Although project faculty enlisted basic improvement science methods that could be expanded to support work on any disease or condition, in this case, the interventions were tailored specifically to diabetes. Additionally, the project enlisted the PCMH framework as a marker of successful clinical and operational redesign and set a goal of 100% of practices recognized at a rating of Level 2 …

Patient innovation: an analysis of patients' designs of digital technology support for everyday living with diabetes.

The aim of this paper is to identify characteristics of patients' contributions to innovation in health information technology (HIT). The paper outlines a theoretical definition of patient innovation and presents an analysis of four digital prototypes and 22 low-fidelity mock-ups designed by people affected by the chronic illness diabetes mellitus. Seventeen families (a total of 60 people) with one or more diabetic family members participated in design activities in a four-year research project focused on the design of digital support for everyday living with diabetes. Our analysis documented the originality of the analysed patient designs and identified three characteristics of patients' designs: socio-technical networks, objects with associated personal meanings and technology supporting the expression of identity. The paper concludes that patient innovation is defined by what is perceived as new by patients and/or others within the social system of adaptation. The analysed patient designs are original (as distinct from replications of or improvements on known products), and their characteristics are innovative contributions to the social system of everyday living with diabetes (i.e. they are perceived as new to the patients in the research study). The results of the analysis contribute to the credentials of patients as key actors in HIT innovation and call for participatory approaches in health informatics.

Addressing Barriers in Health Equity through Innovations in Health Information Technology: A Health Center‘s Experiences in Implementing a Chinese Language Patient Portal

Patient portals have the potential to empower patients to be more knowledgeable and proactive about their health. Implementation of patient portals has become increasingly critical at primary care sites that serve underserved communities, where there is a growing need for linguistically appropriate electronic access. The Charles B. Wang Community Health Center has recently developed a linguistically appropriate patient portal with the goal of providing increased access to its majority Chinese American patient population with low English proficiency and literacy levels. This article will discuss experiences learned from implementing a Chinese Language Patient Portal that addresses socioeconomic barriers and disparities in health care access.

The digital health divide: evaluating online health information access and use among older adults.

Innovations in health information technology (HIT) provide opportunities to reduce health care spending, improve quality of care, and improve health outcomes for older adults. However, concerns relating to older adults' limited access and use of HIT, including use of the Internet for health information, fuel the digital health divide debate. This study evaluated the potential digital health divide in relation to characteristic and belief differences between older adult users and nonusers of online health information sources. A cross-sectional survey design was conducted using a random sample of older adults. A total of 225 older adults (age range = 50-92 years, M = 68.9 years, SD = 10.4) participated in the study. Seventy-six percent of all respondents had Internet access. Users and nonusers of online health information differed significantly on age (M = 66.29 vs. M = 71.13), education, and previous experience with the health care system. Users and nonusers of online health information also differed significantly on Internet and technology access, however, a large percentage of nonusers had Internet access (56.3%), desktop computers (55.9%), and laptop computers or netbooks (43.2%). Users of online health information had higher mean scores on the Computer Self-Efficacy Measure than nonusers, t(159) = -7.29, p < .0001. This study found significant differences between older adult users and nonusers of online health information. Findings suggest strategies for reducing this divide and implications for health education programs to promote HIT use among older adults.