Integrated Health Information Research Articles

Development of an Evaluation Framework for Health Information Systems (DIPSA).

Introduction:Use of Integrated Health Information Systems (IHIS) for the provision of healthcare services benefits both healthcare professionals and patients, while requiring continuous evaluation and upgrading to fully support its role.Aim:The main purpose of the study was to develop an evaluation framework for hospitals utilizing IHIS, within the three main areas identified as Human factor, Technology and Organization.Material and methods:The questionnaire consisted of 43 questions, with 17 questions (related to categories procedures, system quality and satisfaction), 25 questions (related to categories, safety and collaboration) and 1 question related to accessibility to the system (within the category system quality). Three open questions were added to evaluate users’ perception on what was needed for the improvement of health services in their respective hospitals for all 3 variables being evaluated. The open questions were included to allow participants to express their opinion in a more detailed setting. A database was developed, and the data were processed and analyzed.Results:Factor analysis formed 5 categories for the evaluation framework. Cronbach’s alpha coefficient was found in all categories to be above > 0.85.Conclusion:Evaluation frameworks can be designed, developed and implemented by using different methodologies. For an evaluation framework to be effective it should be designed and implemented based on the aims and purpose of the research and the specific needs of the particular healthcare setting or hospital. Considering the categories satisfaction, collaboration, safety, system quality, procedures, and by using Likert scale and open questions in the current study, DIPSA can provide a holistic image of IHIS by evaluating any hospital system.

Progress and Challenges of Integrating Health Information Exchange with Telemedicine in a Rural State

Progress and Challenges of Integrating Health Information Exchange with Telemedicine in a Rural State

Evaluation on Recording and Reporting System of Maternal Child Health in SIKDA (Regional Health Information System) of Public Health Affair Surakarta

Regional Health Information System (RHIS) is an integrated Health Information System which effectively functions as data communication in a region. This system has been used since 2012. However, it has not shown best performance. Puskesmas (Community Health Centers) send their regular reports in the form of soft copy or hard copy. However, DKK has not verified the reports on the maternal child health regularly. Moreover, they retype the report to be sent to the Ministry of Health. It results in possibility of errors in its accuracy and validity. Thus, it requires further evaluation to improve the implementation of RHIS especially in recording and reporting maternal child health to the Ministry of Health. The objective of this research is to analyze the maternal child health data recording and reporting system in RHIS Surakarta.This is a qualitative research. Data were collected by deep interview and direct observation on the implementation of the RHIS. Object of this research is the recording and reporting system of Maternal Child Health in the RHIS DKK Surakarta. The main informant is the head and the staffs of SIMKES, midwifes coordinators of SIK in 6 Community Health Centers.The results of this study propose that improvement on human resources competences should be done regularly. The data of maternal child health are taken from community health centers. That is why, there should be proper policy on the reporting the data of maternal child health. The report sent should be filed in soft copy and hard copy. Nevertheless, the available data have been processed by community health centers and are accessible for public needs.This study proposes that the recording and reporting system of maternal child health data should be developed by improving the competences of human resources, decreeing operational policy, and providing standard operating procedure.

Health Information Infrastructure for People with Intellectual and Developmental Disabilities (I/DD) Living in Supported Accommodation: Communication, Co-Ordination and Integration of Health Information

ABSTRACT People with intellectual and/or developmental disability (I/DD) commonly have complex health care needs, but little is known about how their health information is managed in supported accommodation, and across health services providers. This study aimed to describe the current health information infrastructure (i.e., how data and information are collected, stored, communicated, and used) for people with I/DD living in supported accommodation in Australia. It involved a scoping review and synthesis of research, policies, and health documents relevant in this setting. Iterative database and hand searches were conducted across peer-reviewed articles internationally in English and grey literature in Australia (New South Wales) up to September 2015. Data were extracted from the selected relevant literature and analyzed for content themes. Expert stakeholders were consulted to verify the authors’ interpretations of the information and content categories. The included 286 sources (peer-reviewed n = 27; grey literature n = 259) reflect that the health information for people with I/DD in supported accommodation is poorly communicated, coordinated and integrated across isolated systems. ‘Work-as-imagined’ as outlined in policies, does not align with ‘work-as-done’ in reality. This gap threatens the quality of care and safety of people with I/DD in these settings. The effectiveness of the health information infrastructure and services for people with I/DD can be improved by integrating the information sources and placing people with I/DD and their supporters at the centre of the information exchange process.

Can ‘meso-tier’ healthcare organizations enhance health system performance? - lessons from US Accountable Care Organizations (ACOs) and a discussion of the implications for Australia

Background: USA: ACOs are becoming a prominent feature of the US healthcare system. ACOs are groups of physicians, hospitals, and other providers that agree to be held financially responsible for the total cost and quality of care for a defined patient population. There are currently over 800 ACOs covering around 28 million people. With new Medicare reforms coming into effect soon, the ACO sector may cover over 100 million people in the next five years. Despite this rapid growth, outcomes have been mixed to date and there is little knowledge of how capable these organizations are in promoting delivery system changes. Australia: Like in the US, the Australian healthcare system has historically been dominated by volume-driven, fee-for-service models and overall costs are rising. New models of primary and integrated care are evolving with bundled primary care payments for patients with chronic and complex care needs currently being implemented nationally. Meso-level primary health networks and local hospital networks are leading the implementation of these models and there may be important lessons from the US ACO experience that could inform policy in this area. Methods: Using data from a national survey and Medicare, we reviewed structures, capabilities and performance outcomes for 399 ACOs in the US from 2012 to 2015. Results: ACOs with commercial insurer contracts were significantly larger, more integrated with hospitals, and had lower benchmark expenditures and higher quality scores, compared to ACOs participating only in public (Medicare and Medicaid) payer programs. For most ACOs, there was a low uptake of quality and efficiency activities, although generally commercial ACOs reported higher rates of electronic medical record usage, disease monitoring tools, patient satisfaction data, and quality improvement methods. Few ACOs reported having high-level performance and financial monitoring capabilities. Although ACOs were making modest savings overall, there was wide variation. A small number of ACOs accounted for the majority of total savings accrued and around one third had exceeded their expenditure benchmarks thus incurring a loss. There was no correlation between total savings and quality scores. Implications for the US: ACOs are at diverse stages of development and this is possibly an important driver of the wide performance variations currently being observed. ACOs may be using public programs as a testing ground to build their capacity to succeed in risk-based contracting. Policy initiatives to support ACOs in establishing essential infrastructure could make a major contribution to supporting delivery system changes. Implications for Australia: The US findings underscore the importance of building core capabilities within meso-tier organizations to bring about system change. Factors such as building integrated health information systems, embedding quality improvement processes within health services, and robust financial and performance monitoring systems are likely to be key drivers of success. State and federal governments ought to identify those organizations that lack sufficient capacity in these areas and intervene early with appropriate supports.

Trends in acquisitions of physician practices and subsequent clinical integration: A mixed methods study.

The US health care system is marked by a high degree of fragmentation in both delivery and financing. Some evidence suggests that attempts to reduce fragmentation have led to significant provider consolidation, including hospital acquisitions of physician groups, or "vertical integration." The objective was to use time-series data to quantify trends in and characteristics of hospital acquisitions of physician practices. A secondary objective was to use case studies to determine the motivations for these acquisitions and to identify what integration results from these transactions. Data on annual hospital acquisition of physician practices was used to quantify trends and characteristics of acquiring hospitals between 2006 and 2013. Four in-depth case studies, including structured interviews with hospital leadership, were then conducted of recent hospital acquisitions of primary care practices. Acquisitions of physician practices have been increasing over the last decade and peaked in 2011. Most acquisitions were of small primary care, multi-specialty, or cardiology practices. The case studies revealed that the primary motivation for hospital acquisitions was to increase referrals and negotiate higher payment rates. These transactions resulted in very limited clinical integration, while all acquiring hospitals sought to integrate health information systems. Among 4 case-studies of hospital acquisition of physician practices, the primary motivation was financial and competitive motivations. This suggests that policymakers should be mindful of the potential negative effects of these acquisitions on health care costs, as well as the uncertainty of clinical benefits. Policymakers may need supplementary strategies to deliver the goals of reduced costs and improved quality of care.

An Old Challenge with New Promises: A Systematic Review on Comprehensive Geriatric Assessment in Long-Term Care Facilities.

Comprehensive geriatric assessment (CGA) is a multidimensional and multidisciplinary diagnostic process focused on determining the clinical profile, pathological risk, residual skills, short- and long-term prognosis, and personalized therapeutic and care plan of the functionally compromised and frail older subjects. Previous evidence suggested that the effectiveness of CGA programs may be influenced by settings where the CGA is performed [i.e., hospital, posthospital discharge/long-term care facilities (LTCFs), or community/home] as well as the specific clinical conditions of older frail individuals. In this scenario, CGA and quality of care in LTCFs have been a challenge for decades. In the present article, we systematically reviewed evidence from the last three decades of clinical research devoted to systematic implementation of CGA programs in LTCFs, that is, nursing homes, care homes, residential homes, and rehabilitation facilities. In the United States, all LTC residents must undergo a CGA on a regular basis on admission to a facility, prompting the development of the Resident Assessment Instrument (RAI) Minimum Data Set, a specific CGA-based assessment tool in this population. In the LTCF setting, the present reviewed evidence suggested that most complex older subjects may benefit from a CGA in terms of improved quality of care and reduced hospitalization events and that CGA must be standardized across healthcare settings to promote greater health system integration and coordination. In the LTCF setting, particularly in nursing homes, other new and promising CGA programs have also been proposed to develop rapid screening CGA-based tools to enhance in the future the ability of primary care physicians to recognize and treat geriatric syndromes in this setting. However, at present, the interRAI suite of instruments represented an integrated health information system that has the potential to provide person-centered information transcending healthcare settings.

Implementation of Health Information System-A Case Study of Magrabi Hospitals, KSA

Today's healthcare market has created its niche by adopting emerging technologies and ensuring minimal rate of failures. Embracing integrated Health Information System (HIS) is one such venture that not only helps the organization to excel in the market but also caters to the needs of the public. The present research paper is a case study of HIS implementation of Magrabi hospitals and centres, in Saudi Arabia. Though implementing HIS is a herculean task, with respect to the efforts as well as investment, Magrabi could achieve this task with at most care. The system could promote service efficacy across all the centres and hospitals of Magrabi. The paper analyses the procedures and strategies followed in order to prepare the entity ready for transformation. That is, the method of actualizing the health system implementation is also detailed in this study. Overall, the case research tried to know the extent of improvement took place in all the streams of operations in Magrabi group after automation. To gather this information, data is collected from all the in-charges of respective departments as well as users, who are in managerial cadre. This data is tabulated against various cycles (revenue and payroll). From the opinion of the stakeholders it can be easily understood that HIS has brought a sea change in the service flows of Magrabi group. Apart from the benefits of HIS implementation, the lacunae of the study along with the future research prospects in these lines are suggested for the possible improvements.

One for all, all for one - Establishing a corporate linkage methodology for integrated health analytics in Canada

ABSTRACTObjectivesTo describe the successes, challenges and trade-offs encountered when establishing a standard patient linkage methodology for linking pan-Canadian health data across the continuum of care.
 ApproachHealth facilities, regional health authorities and ministries of health across Canada need access to timely, integrated health information across the continuum of care in order to make effective decisions to manage and improve their health systems. To better meet these needs, our organization has embarked on an initiative to integrate our web-based analytic tools. A requirement for this integration is the establishment of a corporate linkage standard.
 The scope is to enable linkage across a dozen patient-level data holdings including data from acute care, long term care, home care, rehabilitation, mental health, pharmaceuticals and registries for joint replacements and organ transplants. In Canada, provinces and territories issue jurisdiction-specific health care numbers (HCN) to their residents.
 A working group was established to review existing methodologies and to define a standard linkage. To gain support from the various groups in our organization to adopt the proposed standard, the right balance was sought between accuracy, timeliness, ease of implementation as well as availability and quality of data elements across our data holdings. In addition, an accurate patient linkage key was manually created as a benchmark to compare false positives and false negatives of the various candidate methods.
 ResultsIn general, adding data elements to the linkage methodology increased false negatives, decreased false positives and reduced the number of records that could be included in the linkage. Data quality issues affecting linkages varied across the data holdings and by jurisdiction.
 The final standard linkage methodology is simple and deterministic: link records by jurisdiction and HCN and exclude records where HCN is used by multiple people, for example, newborns who share their HCN with their mother.
 ConclusionArriving at a methodology that balanced the need for inclusiveness, simplicity and precision required collaboration, compromise, analysis and innovation. To date, the new client linkage standard has been implemented for ad-hoc analysis as well as in the data warehouse for our new web analytics tool. The implementation of the new client linkage standard represents an important foundational step towards creating an integrated analytics tool that spans across the continuum of care.

Integrated Health Information Technology and the Quality of Patient Care: A Natural Experiment

Fragmentation of care delivery remains one of the main challenges of healthcare systems. In this study, we examine health information technology (HIT) that is electronically integrated across care physicians, specialists, hospitals, and pharmacists and its impact on quality of care. Drawing on the structure–process–outcome framework, we hypothesize that integrated HIT will have both a direct and an indirect effect on quality of care. By providing more complete information to physicians and allowing them to detect and manage health problems early in the care cycle, integrated HIT is expected to directly improve quality of care. Integrated HIT is also hypothesized to improve quality of care indirectly by increasing continuity of care and reducing the odds of therapeutic errors. We test these hypotheses through a contemporaneous natural experiment of a matched set of 15,626 outpatients receiving ambulatory care through an integrated HIT system and 15,626 outpatients in a control group. The results show that the patients treated with the integrated system had better quality of care in the follow-up period than patients of the control group. Integrated HIT also had an indirect effect on quality of care through an increase in continuity of care. Our study contributes to research by examining how an integrated HIT system—rather than specific HIT components—influences patient-related outcomes, and how this effect is mediated by two key processes: continuity of care and therapeutic duplication errors. Our work also helps decision makers to better understand the impact of HIT in a complex and highly decentralized and fragmented care delivery system.

PILOTING DHIS2 SYSTEM IN VISCERAL LEISHMANIASIS SURVEILLANCE

BackgroundThe District Health Information System 2 (DHIS2) is a tool for collection, validation, analysis and presentation of both individual (tracker) and aggregated data tailored to integrated health information management activities....

Continuity of care after percutaneous coronary intervention: The patient's perspective across secondary and primary care settings.

Background:Although patients may experience a quick recovery followed by rapid discharge after percutaneous coronary interventions (PCIs), continuity of care from hospital to home can be particularly challenging. Despite this fact, little is known about the experiences of care across the interface between secondary and primary healthcare systems in patients undergoing PCI.Aim:To explore how patients undergoing PCI experience continuity of care between secondary and primary care settings after early discharge.Methods:The study used an inductive exploratory design by performing in-depth interviews of 22 patients at 6–8 weeks after PCI. Nine were women and 13 were men; 13 were older than 67 years of age. Eight lived remotely from the PCI centre. Patients were purposively recruited from the Norwegian Registry for Invasive Cardiology. Interviews were analysed by qualitative content analysis.Findings:Patients undergoing PCI were satisfied with the technical treatment. However, patients experienced an unplanned patient journey across care boundaries. They were not receiving adequate instruction and information on how to integrate health information. Patients also needed help to facilitate connections to community-based resources and to schedule clear follow-up appointments.Conclusions and implications:As high-technology treatment dramatically expands, healthcare organisations need to be concerned about all dimensions of continuity. Patients are witnessing their own processes of healthcare delivery and therefore their voices should be taken into greater account when discussing continuity of care. Nurse-led initiatives to improve continuity of care involve a range of interventions at different levels of the healthcare system.

Integrating Health Information Technology Safety into Nursing Informatics Competencies.

Nursing informatics competencies are constantly changing in response to advances in the health information technology (HIT) industry and research emerging from the fields of nursing and health informatics. In this paper we build off the work of Staggers and colleagues in defining nursing informatics competencies at five levels: the beginning nurse, the experienced nurse, the nursing informatics specialist, the nursing informatics innovator and the nursing informatics researcher in the area of HIT safety. The work represents a significant contribution to the literature in the area of nursing informatics competency development as it extends nursing informatics competencies to include those focused on the area of technology-induced errors and HIT safety.

Helina Activities of the Pan African Health Informatics Association

A Call for Papers was sent out in November for full papers, work in progress, and case studies to be submitted for consideration for the HELINA 2017 conference. The HELINA Board appointed a scientific program committee and has been working with the Local Organising Committee (LOC) of the Burundi Health Informatics Association to organise the 10th HELINA Conference in Bujumbura, Burundi, in 2017. The conference is expected to attract about 200 – 250 people from across the world. The title of the conference is “Integrated Health Information Management Resources for Global Healthcare Strategies”. The following topics are proposed as the main themes for the conference:

Integrated Care Program for the very old adults

Introduction : The University Hospital of Getafe (HUG) is a public reference Hospital belonging to the Servicio Madrileno de Salud (SERMAS). It provides service to patients older than 65 (in most cases over 75), showing the usual features of older frail patients: multiple chronic co-morbid conditions, multi-drug intake and high risk of developing new disability when acutely stressed. Their status must be continuously assessed and they often undergo recurrent hospitalisation. The Geriatrics Service (GS) has implemented an Integrated Care Program (ICP) to fill service gaps, to prevent tasks overlapping and to assure continuum of care. HUG shifted Disease Management Processes (DMP) to new models, engaging different professionals from different units and at different levels both horizontally and vertically. Description of practice : The ICP at HUG and the research described in this paper are aligned with the World Report on Ageing and Health (WHO), which recommends the organisation of services for the older focused in function and not on disease. They also follow the ‘Consensus document on frailty and falls prevention among the elderly’ released by the Spanish Ministry of Health as a part of the ‘Prevention and health promotion strategy of the Spanish NHS’ and approved by the Inter-territorial Council of the NHS in 2014. The ICP promotes the transition from costly inpatient settings to the community. Discharge Criteria from impatient settings were modified and the Acute Care Unit collaborates with the Community Care Unit (CCU) and the General Outpatient Unit (GOC) to devise discharge plans guaranteeing assessment in the community and care delivery until stabilization. These include ICT-supported continuous follow up in the community (CCU) and visits to outpatient settings in the HUG (GOC). Besides, the GS created a Day Hospital to implement training and preventive programs for frail patients (i.e. recurrent fallers accomplish personalized physical training programs to prevent sarcopenia and are educated on action protocols to react if a fall occurs; neuropsychological rehabilitation is conducted for cognitive impaired patients and education ; education on desirable life habits and physical therapy are devised and implemented for diabetic patients). A multidisciplinary team (geriatricians, nurses and occupational therapists) devises personalized programs following a patient centered approach, in which patients are engaged and empowered to self-manage their chronic conditions. The ICP enhances the seamless delivery of care and improves patient outcomes in the GS. However, the implementation of the CGA and the new care processes enlarged the set of data harvested. Before, this information is stored on dedicated data tables that are independent from the General Health Information System (GHIS). This gap constraints information availability within the Service and with other Units and care levels, and hinders integration. An in-depth analysis of the ICP at HUG through case study research identified the barriers for its operation. We designed an innovative information management system to overcome these drawbacks and facilitate full integration, engaging finals users (healthcare professionals). This Integrated Health Information System (IHIS) has the following characteristics: (1) it is an extension of the GHIS, it avoids duplicities; (2) it structures information and make it available; (3) it enables dynamic patient evolution visualization; (4) it is interoperable (following CDA architecture) and scalable. Key findings : The average length of stay in the GS Acute Care Unit is lower than at other departments treating similar patient segments (6.8 vs 9.1 days). Moreover, mortality and re-admissions have not increased and patients’ functional status has improved thanks to the Day Hospital performance. The number of unnecessary hospitalisations has been reduced by around 400 patients/year with a direct impact of €1.5 million. Highlights : Integration must be built over the complete understanding of the environment and its requirements. Otherwise, it may not become a facilitator for integration but a burden for users. The multilevel and multidisciplinary integrated delivery of care services requires the comprehensive knowledge of patient status and care processes. In this sense ICT become an unavoidable tool enhancing information availability. User collaboration led to more effective, efficient and user-friendly system and contributed to the acceptance of the final model. After the modelling stage and validation, the HUG ICT department and the GS are working together to fully develop the IHIS. Conclusion : The GS had already built a successful ICP, but the absence of dedicated information management tools prevents complete integration. We proposed an IHIS devoted to the real requirements at GS. The functional status and frailty determine the outcome of elderly chronic patients. In this sense, IHIS provides Geriatric Teams with a tool to perform CGA, improving the availability of information and allowing the efficient follow-up of older patients.

Towards a digitized and integrated health information system in Sudan: assessment of readiness at state level

Background: A strong health information system able to generate timely and accurate information is essential to ensure effective and efficient performance. Sudan’s health information system is still paper-based and characterized by fragmentation and verticality. Efforts to overcome this have led to development of an integrated system to digitize the health information. For this to succeed the 18 states in Sudan need to be evaluated and assessed to identify the gaps in capacity and readiness for such important change. The aim of this paper is to assess the capacity and readiness of the health information system in Sudan at state level for the digitization of the health information system. Materials and Methods: This is a cross sectional institutional based study conducted in 2014 targeting the health information units in the 18 states ministries of health in Sudan. Quantitative data was collected using a pre-tested checklist and analyzed using SPSS version 20. Qualitative data was collected through semi-structured interviews with state managers and analyzed using the evaluation matrix. Results: All states ministries of health had health information units but this was believed inadequate in 27.8% and 72.2% had units at locality level. Data analysis units were not present in one third of the states. Basic statistical training was done in 15 states. Internet services was available in 14 states but was scarce at locality level (16.7%). Annual reports though produced by 17 states, one third admit not reporting to higher levels in a regular manner. Conclusion: There is a need to strengthen the health information system at state level. Challenges of ICT infrastructure, capacity building and coordination need to be addressed. This needs collaborative work and political commitment. Keywords: Health Information System, states, digitization

A Survey of Adverse Event Reporting Practices Among US Healthcare Professionals

IntroductionThe under-reporting of adverse drug events (ADEs) is an international health concern. A number of studies have assessed the root causes but, to our knowledge, little information exists relating under-reporting to practices and systems used for the recording and tracking of drug‐related adverse event observations in ambulatory settings, institutional settings, and retail pharmacies.ObjectivesOur objective was to explore the process for reporting ADEs in US hospitals, ambulatory settings, and retail pharmacies; to explore gaps and inconsistencies in the reporting process; and to identify the causes of under-reporting ADEs in these settings.MethodsThe Tufts Center for the Study of Drug Development (Tufts CSDD) interviewed 11 thought leaders and conducted a survey between May and August 2014 among US-based healthcare providers (HCPs) in diverse settings to assess their experiences with, and processes for, reporting ADEs.ResultsA total of 123 individuals completed the survey (42 % were pharmacists; 27 % were nurses; 15 % were physicians; and 16 % were classified as ‘other’). HCPs indicated that the main reasons for under-reporting were difficulty in determining the cause of the ADE, given that most patients receive multiple therapies simultaneously (66 % of respondents); that HCPs lack sufficient time to report ADEs (63 % of respondents); poor integration of ADE-reporting systems (53 % of respondents); and uncertainty about reporting procedures (52 % of respondents).DiscussionThe results of this pilot study identify that key factors contributing to the under-reporting of ADEs relate to a lack of standardized process, a lack of training and education, and a lack of integrated health information technologies.Electronic supplementary materialThe online version of this article (doi:10.1007/s40264-016-0455-4) contains supplementary material, which is available to authorized users.

Health Informatics Competencies, Workforce and the DNP: Why Connect These 'Dots'?

This panel will provide the perspectives of nurse informatics experts on the development of informatics education integrating health information technology (HIT) and immersive simulation. The panel will also address student and provider access to the electronic health record (EHR) for educational purposes. This panel examines the education and preparation of students and practicing nurses to meaningfully use EHRs. The target audience is clinicians, educators, trainers, students and those interested in the meaningful use of EHRs and achievement of the Informatics competencies defined by AACN and TIGER.

Designing User-Centric Patient Portals: Clinician and Patients' Uses and Gratifications.

Legislation mandates that clinicians make patients' medical information available digitally. This has resulted in hurriedly installing patient portals that do not fully meet the needs of patients or clinicians. This study examined a specific portal, MyPreventiveCare (MPC), a patient-centered portal designed to promote preventive care to consumers, to elicit recommendations from patients and clinicians about how it could be more beneficial by uncovering their uses and gratifications (U&G). In-depth interviews with 31 patients and two clinician focus groups were conducted. Multiple methods were utilized, such as grounded theory coding to develop themes and content analysis to classify responses according to the U&G framework. Four main categories emerged that users desire to be included in health portals: integration with technology (27%), coordination of care (27%), incorporation of lifestyle (26%), and increased control (20%). Additional analysis revealed that health portals are mainly utilized to fulfill cognitive and affective needs, with over 80% of recommendations related to the U&G categories of cognitive and affective needs. Cognitive (60%), affective (21%), social integrative (10%), personal integrative (9%), and tension release (0%). Portals will continue to evolve and become important health communication tools if they address the user's perspective and are inclusive of new technological advances. Specifically, portals must become more user centric and incorporate aspects of the patients' lifestyle and integrate health information technology.

Health informatics and analytics - building a program to integrate business analytics across clinical and administrative disciplines.

Health care organizations must develop integrated health information systems to respond to the numerous government mandates driving the movement toward reimbursement models emphasizing value-based and accountable care. Success in this transition requires integrated data analytics, supported by the combination of health informatics, interoperability, business process design, and advanced decision support tools. This case study presents the development of a master's level cross- and multidisciplinary informatics program offered through a business school. The program provides students from diverse backgrounds with the knowledge, leadership, and practical application skills of health informatics, information systems, and data analytics that bridge the interests of clinical and nonclinical professionals. This case presents the actions taken and challenges encountered in navigating intra-university politics, specifying curriculum, recruiting the requisite interdisciplinary faculty, innovating the educational format, managing students with diverse educational and professional backgrounds, and balancing multiple accreditation agencies.