Impact Of Health Information Technology Research Articles

The Impact of Health Information Technology on Hospital Performance: A Systematic Integrative Literature Review

The Impact of Health Information Technology on Hospital Performance: A Systematic Integrative Literature Review

Возможности, проблемы и перспективы информационных технологий в сфере клинической безопасности.

The article describes the possibilities of using information technology (IT) to ensure patient safety. The role of IT is examined in three aspects of patient safety: creating a safe health care environment, safely delivering health care, and assessing patient safety. Purpose of the study is to explore the current state of information technology and environmental factors in the field of clinical safety. Materials and methods. Analyze the current capabilities of using information technology to ensure patient safety in three aspects: creating a safe environment for the provision of medical care, safe delivery of medical care and assessing patient safety. Based on the results of the analysis, determine the problems and prospects of information technologies in the field of clinical safety. Results. One of the components of a safe medical care environment is a patient’s personal account. Research examining the impact of patient privacy on health care safety is an important and promising area for future research. It is stated that today without IT it is impossible to create safe conditions for the provision of medical care. Based on the results of the analysis of the problem of the relevance of medical knowledge, the need for a transition to medical ecosystems is stated for a comprehensive solution to patient safety problems, including in relation to the use of DSS in medicine. Approaches to solving IT problems in the field of clinical safety are proposed, which are to optimally integrate compliance functions of multiple requirements and clinical data coming from different sources into complex medical technological processes, ensuring maximum patient safety with minimal complication of these processes. The assessment of compliance (certification) with safety standards is described as one of the ways to confirm the compliance of the results of activities with the requirements of not only quality, but also safety for the patient. Findings. There is a need to intensify research on the impact of health IT on patient safety, with particular attention to improving methods for identifying side effects and assessing patient safety, clinical decision support systems, adequate representation of biomedical knowledge, patient personal accounts, ecosystem solutions and support for continuity of care using IT, and also to the use of informatization criteria in the development and improvement of standards for the quality and safety of medical care.

The Role of Laboratory Information System in Improving the Delivery of Laboratory Services: A Recent Systematic Review.

Recently, laboratory information systems (LIS) have become necessary for every laboratory to improve the decision-making process and achieve better treatment and diagnostic results. By standardizing laboratory's tests, procedures, and workflows, the software enables laboratories to improve patient care, reduce human error, and constructively lower operating costs. Implementing LIS has a multidimensional impact on improving the delivery of laboratory services. This paper aims to investigate how patient services can be improved by laboratory information system. This paper is based on a review conducted by searching PubMed, Google Scholar, Saudi Digital Library and Research Gate for English language articles published from 2015 to 2021 and focused primarily on laboratory information systems. The literature searches yielded a total of 30 articles that were then initially screened based on the titles and abstracts. Seven articles were excluded because they did not primarily address LIMS for biosafety, automated verification of test results in the core clinical laboratory, clinical biochemistry, or the impact of health information technology on patient safety, or were not written in English. The remaining 23 articles were then screened in full text. Advanced laboratory information systems may eliminate diagnostic errors in the preanalytical, analytical, and postanalytical phases. In addition, they can incorporate genomic data at the analytical stage to generate useful reports for providers and patients.

The Impact of Health Information Technology for Early Detection of Patient Deterioration on Mortality and Length of Stay in the Hospital Acute Care Setting: Systematic Review and Meta-Analysis.

To evaluate the impact of health information technology (HIT) for early detection of patient deterioration on patient mortality and length of stay (LOS) in acute care hospital settings. We searched MEDLINE and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus from 1990 to January 19, 2021. We included studies that enrolled patients hospitalized on the floor, in the ICU, or admitted through the emergency department. Eligible studies compared HIT for early detection of patient deterioration with usual care and reported at least one end point of interest: hospital or ICU LOS or mortality at any time point. Study data were abstracted by two independent reviewers using a standardized data extraction form. Random-effects meta-analysis was used to pool data. Among the 30 eligible studies, seven were randomized controlled trials (RCTs) and 23 were pre-post studies. Compared with usual care, HIT for early detection of patient deterioration was not associated with a reduction in hospital mortality or LOS in the meta-analyses of RCTs. In the meta-analyses of pre-post studies, HIT interventions demonstrated a significant association with improved hospital mortality for the entire study cohort (odds ratio, 0.78 [95% CI, 0.70-0.87]) and reduced hospital LOS overall. HIT for early detection of patient deterioration in acute care settings was not significantly associated with improved mortality or LOS in the meta-analyses of RCTs. In the meta-analyses of pre-post studies, HIT was associated with improved hospital mortality and LOS; however, these results should be interpreted with caution. The differences in patient outcomes between the findings of the RCTs and pre-post studies may be secondary to confounding caused by unmeasured improvements in practice and workflow over time.

Improved efficiency of coding systems with health information technology.

This study aimed to investigate the impact of health information technology (IT) on the Case Mix Index (CMI). This study was a retrospective cohort study using hospital financial data from the Office of Statewide Health Planning and Development (OSHPD) in California. A total of 309 unique hospitals were included in the study for 7 years, from 2009 to 2015, resulting in 2,135 hospital observations. The effects of health information technology (IT) on the Case Mix Index (CMI) was evaluated using dynamic panel data analysis to control endogeneity issues. This study found that more health IT adoption could lead to a lower CMI by improving coding systems. Policy makers, researchers, and healthcare providers must be cautious when interpreting the effect of health IT on the CMI. To encourage the adoption of health IT, the cost savings and reimbursement reductions resulting from health IT adoption should be compared. If any profit loss occurs (i.e., the cost savings is less than reimbursement reduction), more incentives should be provided to healthcare providers.

Utilization of health information technology among skin cancer patients: A cross-sectional study of the National Health Interview Survey from 2011 to 2018

Utilization of health information technology among skin cancer patients: A cross-sectional study of the National Health Interview Survey from 2011 to 2018

Impact of Health Information Technologies on the Quality of Healthcare Deliveries

Through a literary review of recent research, this paper examines the mixed impact of health information technology (HIT) on patient care, medical errors, and the quality of healthcare delivery in selected hospital settings such as emergency departments. Specific technologies examined include the electronic health record (EHR), medical devices, artificial intelligence, and robotics. The paper identifies that some healthcare technologies are increasingly valuable in reducing medical errors, improving healthcare quality, and in producing better patient-centered outcomes. It also determines that technologies have complicated the delivery of quality patient care, increased the incidences of clinician burnout, and made receiving quality healthcare in America's hospital systems possibly less sure. The paper concludes with some suggestions for improving HIT's implementations and confirms the need for further evaluation of the impact of HIT in increasing patient safety and clinician well-being.

The impact of health information technology on prescribing errors in hospitals: a systematic review and behaviour change technique analysis

BackgroundHealth information technology (HIT) is known to reduce prescribing errors but may also cause new types of technology-generated errors (TGE) related to data entry, duplicate prescribing, and prescriber alert fatigue. It is unclear which component behaviour change techniques (BCTs) contribute to the effectiveness of prescribing HIT implementations and optimisation. This study aimed to (i) quantitatively assess the HIT that reduces prescribing errors in hospitals and (ii) identify the BCTs associated with effective interventions.MethodsArticles were identified using CINAHL, EMBASE, MEDLINE, and Web of Science to May 2020. Eligible studies compared prescribing HIT with paper-order entry and examined prescribing error rates. Studies were excluded if prescribing error rates could not be extracted, if HIT use was non-compulsory or designed for one class of medication. The Newcastle-Ottawa scale was used to assess study quality. The review was reported in accordance with the PRISMA and SWiM guidelines. Odds ratios (OR) with 95% confidence intervals (CI) were calculated across the studies. Descriptive statistics were used to summarise effect estimates. Two researchers examined studies for BCTs using a validated taxonomy. Effectiveness ratios (ER) were used to determine the potential impact of individual BCTs.ResultsThirty-five studies of variable risk of bias and limited intervention reporting were included. TGE were identified in 31 studies. Compared with paper-order entry, prescribing HIT of varying sophistication was associated with decreased rates of prescribing errors (median OR 0.24, IQR 0.03–0.57). Ten BCTs were present in at least two successful interventions and may be effective components of prescribing HIT implementation and optimisation including prescriber involvement in system design, clinical colleagues as trainers, modification of HIT in response to feedback, direct observation of prescriber workflow, monitoring of electronic orders to detect errors, and system alerts that prompt the prescriber.ConclusionsPrescribing HIT is associated with a reduction in prescribing errors in a variety of hospital settings. Poor reporting of intervention delivery and content limited the BCT analysis. More detailed reporting may have identified additional effective intervention components. Effective BCTs may be considered in the design and development of prescribing HIT and in the reporting and evaluation of future studies in this area.

A method for measuring the effect of certified electronic health record technology on childhood immunization status scores among Medicaid managed care network providers.

To provide a methodology for estimating the effect of U.S.-based Certified Electronic Health Records Technology (CEHRT) implemented by primary care physicians (PCPs) on a Healthcare Effectiveness Data and Information Set (HEDIS) measure for childhood immunization delivery. This study integrates multiple health care administrative data sources from 2010 through 2014, analyzed through an interrupted time series design and a hierarchical Bayesian model. We compared managed care physicians using CEHRT to propensity-score matched comparisons from network physicians who did not adopt CEHRT. Inclusion criteria for physicians using CEHRT included attesting to the Childhood Immunization Status clinical quality measure in addition to meeting "Meaningful Use" (MU) during calendar year 2013. We used a first-presence patient attribution approach to develop provider-specific immunization scores. We evaluated 147 providers using CEHRT, with 147 propensity-score matched providers selected from a pool of 1253 PCPs practicing in Maryland. The estimate for change in odds of increasing immunization rates due to CEHRT was 1.2 (95% credible set, 0.88-1.73). We created a method for estimating immunization quality scores using Bayesian modeling. Our approach required linking separate administrative data sets, constructing a propensity-score matched cohort, and using first-presence, claims-based childhood visit information for patient attribution. In the absence of integrated data sets and precise and accurate patient attribution, this is a reusable method for researchers and health system administrators to estimate the impact of health information technology on individual, provider-level, process-based, though outcomes-focused, quality measures. This research has provided evidence for using Bayesian analysis of propensity-score matched provider populations to estimate the impact of CEHRT on outcomes-based quality measures such as childhood immunization delivery.

A systematic review of the impact of health information technology on nurses' time.

ObjectiveNursing time represents one of the highest costs for most health services. We conducted a systematic review of the literature on the impact of health information technology on nurses’ time.Materials and MethodsWe followed PRISMA guidelines and searched 6 large databases for relevant articles published between Jan 2004 and December 2019. Two authors reviewed the titles, abstracts, and full texts. We included articles that included a comparison group in the design, measured the time taken to carry out documentation or medication administration, documented the quantitative estimates of time differences between the 2, had nurses as subjects, and was conducted in either a care home, hospital, or community clinic.ResultsWe identified a total of 1647 articles, of which 33 met our inclusion criteria. Twenty-one studies reported the impact of 12 different health information technology (HIT) implementations on nurses’ documentation time. Weighted averages were calculated for studies that implemented barcode medication administration (BCMA) and 2 weighted averages for those that implemented EHRs, as these studies used different sampling units; both showed an increase in the time spent in documentation (+22% and +46%). However, the time spent carrying out medication administration following BCMA implementation fell by 33% (P < .05). HIT also caused a redistribution of nurses’ time which, in some cases, was spent in more “value-adding” activities, such as delivering direct patient care as well as inter-professional communication.Discussion and ConclusionsMost of the HIT systems increased nursing documentation time, although time fell for medication administration following BCMA. Many HIT systems also resulted in nurses spending more time in direct care and “value-adding” activities.

Impact of Gender on Doctor-Patient Communication and Emotion: Exploratory Analysis

Doctor-patient communication is one of the essential precursors of patient-centered care. The quality of this communication is influenced by several factors, including providers’ communication style and the use of existing technologies. In our previous studies, we measured the impact of health information technology on doctor-patient communication. In this study, we used sentiment analysis to understand the impact of doctor-patient gender dyads on verbal communication. The findings showed a noticeable difference in the communication pattern between the same (concordance) and opposite gender dyads (discordance). The findings of this study also indicate that male doctors tend to talk more and in detail with their patients (p = 0.01 for gender concordance; p = 0.01 during gender discordance) than female doctors did with their patients (p = 0.33 for gender concordance; p = 0.41 during gender discordance), irrespective of doctor-patient gender dyads. No significant differences were observed in doctor-patient sentiments and emotions. However, we observed more trust in gender concordance (20.9% & 17.6% of the time). In contrast, gender discordance resulted in more sadness (15.5% & 19.8% of the time), anticipation (17.3%), and joy (16.1% of the time). In conclusion, our study indicates that gender influences doctor-patient verbal communication. Further research with a larger sample size is required to thoroughly understand the role of gender in overall healthcare communication.

A regulatory perspective on the influence of health information technology on organisational quality and safety in England.

Health information technology can transform and enhance the quality and safety of care, but it may also introduce new risks. This study analysed 130 healthcare regulator inspection reports and organisational digital maturity scores in order to characterise the impact of health information technology on quality and safety from a regulatory perspective. Although digital maturity and the positive use of health information technology are significantly associated with overall organisational quality, the negative effects of health information technology are frequently and more commonly identified by regulators. The poor usability of technology, lack of easy access to systems and data and the incorrect use of health information technology are the most commonly identified areas adversely affecting quality and safety. There is a need to understand the full risks and benefits of health information technology from the perspective of all stakeholders, including patients, end-users, providers and regulators in order to best inform future practice and regulation.

Using Electronic Health Records Data to Evaluate the Impact of Information Technology on Improving Health Equity: Evidence from China

This study evaluates the impact of health information technology in accessing medical resources and identifies its role in improving health equity. We used 262, 771 records from the electronic medical records and outpatient appointment systems of three clinics for logistic regression to analyze the impact of information technology on patients' access to medical care. We interviewed a few health professionals to gauge their reactions and to validate and understand our quantitative results. The proportion of inpatients affected by information technology is low, accounting for only 16.7% (N = 43, 870). The difference between rural and urban groups is statistically significant, and rural households are more susceptible to information technology. In addition, distance has a significant positive effect. We demonstrate an inverted U-shaped relationship between severity of disease and the impact of information technology. Moreover, our interview results are consistent with our quantitative results. Quantitative and interview results suggest that health information technology plays a positive role in accessing medical care for patients with rural household and those in remote areas. Meanwhile, this effect is complex for patients with different severities of illnesses. Governments and managers should vigorously promote health information technology for healthcare delivery in the future and focus their attention on patients with serious diseases.

The impact of health information technology on the management and follow-up of test results - a systematic review.

ObjectiveTo investigate the impact of health information technology (IT) systems on clinicians’ work practices and patient engagement in the management and follow-up of test results.Materials and MethodsA search for studies reporting health IT systems and clinician test results management was conducted in the following databases: MEDLINE, EMBASE, CINAHL, Web of Science, ScienceDirect, ProQuest, and Scopus from January 1999 to June 2018. Test results follow-up was defined as provider follow-up of results for tests that were sent to the laboratory and radiology services for processing or analysis.ResultsThere are some findings from controlled studies showing that health IT can improve the proportion of tests followed-up (15 percentage point change) and increase physician awareness of test results that require action (24–28 percentage point change). Taken as whole, however, the evidence of the impact of health IT on test result management and follow-up is not strong.DiscussionThe development of safe and effective test results management IT systems should pivot on several axes. These axes include 1) patient-centerd engagement (involving shared, timely, and meaningful information); 2) diagnostic processes (that involve the integration of multiple people and different clinical settings across the health care spectrum); and 3) organizational communications (the myriad of multi- transactional processes requiring feedback, iteration, and confirmation) that contribute to the patient care process.ConclusionExisting evidence indicates that health IT in and of itself does not (and most likely cannot) provide a complete solution to issues related to test results management and follow-up.

A National Assessment of Access to Technology Among Nursing Home Residents: A Secondary Analysis.

BackgroundAccording to the National Center for Health Statistics, there are over 1.7 million nursing home residents in the United States. Nursing home residents and their family members have unique needs and stand to benefit from using technology empowering them to be more informed and engaged health care consumers. Although there is growing evidence for benefits of patient-facing technologies like electronic patient portals on patient engagement in acute and outpatient settings, little is known about use of this technology in nursing homes.ObjectiveThe purpose of this study was to report findings from a secondary analysis of data from a national nursing home study of information technology (IT) adoption, called IT sophistication. We describe the extent to which nursing homes (n=815) allow residents or their representatives to access technology including electronic health records, patient portals, and health information-exchange systems as well as the ability of the residents or representatives to self-report data directly into the electronic health record.MethodsWe used descriptive statistics and regression techniques to explore relationships between information technology adoption (IT sophistication) and residents’ or their representatives’ access to technology. Covariates of location, bed size, and ownership were added to the model to understand their potential influence on the relationship between IT sophistication and resident access to technology.ResultsFindings revealed that resident access to technology was a significant predictor of the nursing home IT sophistication (P<.001). The inclusion of covariates—nursing home location, bed size, and ownership—with their interactions produced a nonsignificant effect in the model. Residents’ or their representatives’ use of electronic health records and personal health records were both significant predictors of overall IT sophistication (P<.001).ConclusionsAs nursing homes continue to progress in technological capabilities, it is important to understand how increasing IT sophistication can be leveraged to create opportunities to engage residents in their care. Understanding the impact of health information technology on outcomes and which technologies make a difference will help nursing home administrators make more informed decisions about adoption and implementation.

Physician stress and burnout: the impact of health information technology.

To quantify how stress related to use of health information technology (HIT) predicts burnout among physicians. All 4197 practicing physicians in Rhode Island were surveyed in 2017 on their HIT use. Our main outcome was self-reported burnout. The presence of HIT-related stress was defined by report of at least 1 of the following: poor/marginal time for documentation, moderately high/excessive time spent on the electronic health record (EHR) at home, and agreement that using an EHR adds to daily frustration. We used logistic regression to assess the association between each HIT-related stress measure and burnout, adjusting for respondent demographics, practice characteristics, and the other stress measures. Of the 1792 physician respondents (43% response rate), 26% reported burnout. Among EHR users (91%), 70% reported HIT-related stress, with the highest prevalence in primary care-oriented specialties. After adjustment, physicians reporting poor/marginal time for documentation had 2.8 times the odds of burnout (95% CI: 2.0-4.1; P < .0001), compared to those reporting sufficient time. Physicians reporting moderately high/excessive time on EHRs at home had 1.9 times the odds of burnout (95% CI: 1.4-2.8; P < .0001), compared to those with minimal/no EHR use at home. Those who agreed that EHRs add to their daily frustration had 2.4 times the odds of burnout (95% CI: 1.6-3.7; P < .0001), compared to those who disagreed. HIT-related stress is measurable, common (about 70% among respondents), specialty-related, and independently predictive of burnout symptoms. Identifying HIT-specific factors associated with burnout may guide healthcare organizations seeking to measure and remediate burnout among their physicians and staff.

When IT Creates Legal Vulnerability: Not Just Overutilization but Underprovisioning of Health Care Could be a Consequence

We study the potential impact of the legal vulnerability created by ubiquitous information technology (IT) and provide insights into its unintended consequences in a typical healthcare context. Informed by algorithmic predictions based on risk information, screening policies determine the level of care provision (i.e., whether to conduct a test). When such predictions are provided to physicians via IT in the testing stage, follow-up decisions could be more accurate. Yet, physicians may also observe heightened legal risk due to increased information visibility. In this context, we examine the socially optimal screening (based on risk information) and follow-up policies (based on risk and test information) in light of increased visibility of patient data due to health IT and possible litigation risks associated with it.We nd that strategic underprovisioning of health care, therefore a lower utilization of health care services, through screening policies could potentially mitigate the adverse impact of health IT. The underprovisioning of health care is aggravated if the precision of the risk factors relative to that of the medical test increases or the physician becomes more self-interested and less patient-oriented. On the other hand, limits on malpractice damage can alleviate the underprovisioning of health care.

Is HIT a hit? The impact of health information technology on inpatient hospital outcomes

ABSTRACTIn an effort to eliminate inefficiencies in the US health care sector, policymakers have made a concerted effort to encourage hospitals and physicians to adopt health information technology (HIT) systems. Using a unique data set on HIT adoption and health outcomes in New York State, we conduct a hospital-level analysis identifying the impact of adopting HIT on inpatient outcomes (rates of adverse drug events and severity-adjusted mortality). Unlike previous studies, the patient population is not restricted to Medicare patients, but covers all ages and insurance types. After controlling for unobserved hospital quality and endogenous HIT adoption, our results suggest that a hospital’s severity-adjusted mortality decreases by 0.3 percentage points. When restricted to the Medicare patients, we find HIT adoption lowers a hospital’s severity-adjusted mortality rate by 0.5 percentage points. We find HIT to have no significant effect on the rate of ADEs.

The impact of health information technology on patient safety.

Since the original Institute of Medicine (IOM) report was published there has been an accelerated development and adoption of health information technology with varying degrees of evidence about the impact of health information technology on patient safety. This article is intended to review the current available scientific evidence on the impact of different health information technologies on improving patient safety outcomes. We conclude that health information technology improves patient’s safety by reducing medication errors, reducing adverse drug reactions, and improving compliance to practice guidelines. There should be no doubt that health information technology is an important tool for improving healthcare quality and safety. Healthcare organizations need to be selective in which technology to invest in, as literature shows that some technologies have limited evidence in improving patient safety outcomes.

The impact of health information technologies on quality improvement methodologies' efficiency, throughput and financial outcomes: a retrospective observational study.

BackgroundTo evaluate whether or not the utilization of Health Information Technologies (HITs) in Quality Improvement Methodologies (QIMs) has impacts on QIMs’ efficiency, throughput and financial outcomes at healthcare organizations and physician practices in the United States.MethodsThis is a retrospective observational study that was conducted between the years of 2014 and 2015 and relied on two data sources: the Dorenfest Institute dataset and the Healthcare Information and Management Systems Society (HIMSS) Analytics data source. In addition, questionnaires were submitted to collect data about how healthcare settings in the United States had been utilizing QIMs in the last 10 years. The submitted questionnaire invitations yielded 144 responses from 134 hospitals and 10 physician practices. Descriptive statistics were used to assess the condition of the data. This involved the utilization of Box-Whisker plots to visualize the data shape, outliers and variation. The Gamma correlation analysis method was used to evaluate the statistical relationships between the QIM outcomes, efficiency, throughput and financial outcomes, and the employment of HIT systems in QIMs.ResultsThe study found that 99.3% of the healthcare organizations and physician practices had implemented at least one QIM over the last 10 years. In the QIM implementations, the total numbers of reported utilization instances of manual data collection, electronic health records, lab information systems, pharmacy information systems, computerized provider order entry and radiology information systems were 387, 352, 205, 185, 180 and 158, respectively. Based on a 95% confidence limit, the Gamma statistical test has shown an inverse correlation between the exclusive utilization of manual data collection and the overall QIM efficiency (p = 0.047, Gamma = −0.388) and throughput (p = 0.012, Gamma = −0.593) outcomes. However, the overall QIM financial outcomes were found to have a statistically insignificant correlation (p = 0.159).ConclusionsThe study has revealed statistically significant negative impacts on QIMs’ efficiency and throughput outcomes when the manual data collection is the sole method used in QIM implementations. This also indicates a positive correlation between the QIMs’ efficiency and throughput outcomes and the HIT utilization in QIMs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12911-016-0395-z) contains supplementary material, which is available to authorized users.