Health Information Technology Quality Research Articles

Patient-Engagement Health Information Technology and Quality Process Outcomes in Federally Qualified Health Centers.

Health information technology (HIT) for patient-engagement can positively influence the quality and efficiency of health care delivery. Although this topic is of significant importance, it has not been fully addressed in the federally qualified health center (FQHC) context. This research investigates the relationship between the level of patient-engagement HIT and FQHC preventive health care quality outcomes. Based on the Uniform Data System (UDS), this study employed multivariable regression analysis to investigate the association between the level of patient-engagement HIT and FQHC preventive health care quality outcomes. FQHCs were placed in 4 mutually exclusive groups based on the level of FQHC use of patient-engagement HIT. The results indicate that compared with the most comprehensive patient-engagement HIT at FQHCs, less comprehensive patient-engagement HIT was associated with lower rates of preventive care provision. Comprehensive patient-engagement HIT across FQHCs may improve preventive health care quality outcomes. The results support policy incentives for FQHCs with less comprehensive levels of patient-engagement HIT to foster improved preventive care for their patients.

Health IT use outcomes in small physician practices

ABSTRACT Even though Small Physician Practices (SPP) make up 60% of healthcare providers, there have been very few studies on Health Information Technology (HIT) and its impact within SPP. The goal of this study is to answer the following question: How does HIT quality and HIT use influence organizational outcomes of small physician practices? To answer this question, we use a modified IS success model as our framework and analyzed data from multiple case studies. To be more thorough, we include outcomes such as Quality of Care, Operational Outcomes, Financial, and Internal Work Flow. This study found that communication and collaboration with the system has an impact on these outcomes.

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.

Assessment of monitoring and online payment system (Asha Soft) in Rajasthan using benefit evaluation (BE) framework.

Context:e-Health programs are implemented assuming that e-health/digital health can prove beneficial but pieces of evidence for assessing the actual benefits of e-health programs are lacking.Aims:To utilize the benefit evaluation (BE) framework to assess Asha Soft, which is an online payment and performance monitoring system initiative taken by Rajasthan.Settings and Design:BE of Asha Soft in Rajasthan.Methods and Materials:BE of ASHA Soft was done using scoping review with consultation exercise. The rationale behind using this methodological framework is to contextualize knowledge of the current state of understanding within BE framework practice contexts. The themes used for data compilation and analysis were based on three broad dimensions of BE framework namely, health information technology quality, use, and net benefits.Results:The state of Rajasthan has been the first in the country to start an online system of payment and monitoring of ASHA workers, through Asha Soft. It has administrative and supportive functions. Its simple and easy to use graphical user interference helps users to make accurate data entries and obtain desired monitoring and analytical reports. It has attributed to the availability of data on various parameters which help decision-maker to decide about the performance of ASHA worker and has brought a positive impact on the work performance of ASHAs. This online payment and monitoring mechanism has argumented motivational level and intention of use. The program has optimally utilized available human resources and no apparent monetary cost was involved in developing this software.Conclusions:This scoping study using the BE framework has provided evidence on the potential benefits of Asha Soft adoption in Rajasthan. It is recommended that future in-depth assessment of other e-health initiatives could be undertaken to guide the decision making.

The Impact of Information Technology and Communication on Medical Malpractice Lawsuits

Health care organizations have substantially invested in Health Information Technology (HIT) as part of an effort to improve quality. However, many hospitals fail to generate positive returns on this significant investment, based on reimbursements for quality measures through the Affordable Care Act (ACA). Given the high cost of lawsuits, we investigate if HIT adoption reduces lawsuits, and their attendant costs, as another consideration in HIT payoffs. We use operational transparency theory to develop hypotheses on the individual and joint impact of HIT and communication quality in influencing patients’ likelihood to file a lawsuit. We combine data on 168 hospitals in the state of Florida from 2007 to 2011 in order to investigate these relationships. Analysis using a fractional response model indicates that HIT has a direct impact in reducing the number of lawsuits, this effect being higher for hospitals with higher communication quality scores. These results remain consistent irrespective of the type of caregiver (physician vs nurse) communicating with the patient or the severity of injury resulting in the lawsuit. Our results also remain robust under different operationalization of key independent variables and alternate model specifications. These results provide a better understanding of the mechanisms that reduce lawsuits.

The association between patient engagement HIT functionalities and quality of care: Does more mean better?

ObjectiveTo explore the relationship between the number (breadth) of patient engagement functionalities offered through health information technology (HIT) by hospitals and the hospitals’ quality of care. MethodsData on hospital adoption of patient engagement functionalities were combined with quality data obtained from the Centers for Medicare and Medicaid Services (CMS) Hospital Compare. Fixed effects regression models were used to analyze a panel data consisting 1,463 hospitals from 2012 to 2014. ResultsThis study revealed a significant positive relationship between the breadth of patient engagement functionalities and patient satisfaction (β = 0.126, p < 0.05). The number of functionalities was also found to be negatively associated with 30-day readmission rates for myocardial infarction (β= −0.085, p < 0.05), heart failure (β= −0.109, p < 0.05), and pneumonia (β= −0.048, p < 0.05). DiscussionThe breadth of functionalities offered by hospitals to engage patients was a significant factor in decreasing hospital 30-day readmission rates for pneumonia, acute myocardial infarction, and heart failure, and also influenced patients’ perception of the hospital. Conclusions: The findings suggest that hospitals with more patient engagement HIT functionalities are likely to have higher patient satisfaction and lower readmission rates for infarction, heart failure, and pneumonia. This study will potentially assist hospital administrators to justify their strategic deployment of HIT resources to improve both perceived and actual care quality.

Using Health IT to Coordinate Care and Improve Quality in Safety-Net Clinics

BackgroundHealth centers provide care to vulnerable and high-need populations. Recent investments have promoted use of health information technology (HIT) capabilities for improving care coordination and quality of care in health centers. This study examined factors associated with use of these HIT capabilities and the association between these capabilities and quality of care in a census of health centers in the United States. MethodsCross-sectional secondary data from the 2015 Health Resources and Services Administration's Uniform Data System was used to examine 6 measures of HIT capability related to care coordination and clinical decision support and 16 measures of quality (12 process measures, 3 outcome measures, 1 composite measure) for health centers in the United States. Adjusted logistic regressions were used to examine health center characteristics associated with use of HIT capabilities, and adjusted linear regressions were used to examine associations between HIT capabilities and quality of care. ResultsMany health centers reported using HIT for care coordination activities, including coordinating enabling services (67.3%) or engaging patients (81.0%). Health center size and medical home recognition were associated with significantly greater odds of using HIT for enabling services and engaging patients. These HIT capabilities were associated with higher overall quality and higher rates of six process measures (adult screening and maternal and child health) and hemoglobin A1c control. ConclusionUse of HIT for such activities as arranging enabling services and engaging patients are underleveraged tools for care coordination. There may be opportunities to further improve quality of care for vulnerable patients by promoting health centers’ use of these HIT capabilities.