Role Of Health Information Technology Research Articles

Building to learn: Information technology innovations to enable rapid pragmatic evaluation in a learning health system

AbstractBackgroundLearning health systems (LHSs) iteratively generate evidence that can be implemented into practice to improve care and produce generalizable knowledge. Pragmatic clinical trials fit well within LHSs as they combine real‐world data and experiences with a degree of methodological rigor which supports generalizability.ObjectivesWe established a pragmatic clinical trial unit (“RapidEval”) to support the development of an LHS. To further advance the field of LHS, we sought to further characterize the role of health information technology (HIT), including innovative solutions and challenges that occur, to improve LHS project delivery.MethodsDuring the period from December 2021 to February 2023, eight projects were selected out of 51 applications to the RapidEval program, of which five were implemented, one is currently in pilot testing, and two are in planning. We evaluated pre‐study planning, implementation, analysis, and study closure approaches across all RapidEval initiatives to summarize approaches across studies and identify key innovations and learnings by gathering data from study investigators, quality staff, and IT staff, as well as RapidEval staff and leadership.Implementation (Results)Implementation approaches spanned a range of HIT capabilities including interruptive alerts, clinical decision support integrated into order systems, patient navigators, embedded micro‐education, targeted outpatient hand‐off documentation, and patient communication. Study approaches include pre‐post with time‐concordant controls (1), randomized stepped‐wedge (1), cluster randomized across providers (1) and location (3), and simple patient level randomization (2).ConclusionsStudy selection, design, deployment, data collection, and analysis required close collaboration between data analysts, informaticists, and the RapidEval team.

Incorporating health IT into primary care transformation.

To understand the role of health information technology (IT) vendors and health IT functionality in supporting advanced primary care. We synthesized multiple rounds of surveys and interviews (2017-2022) from a mixed-methods evaluation of Comprehensive Primary Care Plus (CPC+), a multipayer model developed by CMS. CPC+ was the first federal advanced primary care reform effort that formalized health IT vendors' roles in supporting health IT implementation and specified detailed health IT requirements for practices. We conducted content analysis to identify cross-cutting themes related to health IT for both practices and vendors, comparing similarities and differences across participants and (when possible) over time. Vendors and practices reported advances in registries and dashboards for improved information management within the practice as well as strengthened relationships between vendors and practices that supported health IT implementation. However, CPC+ practices noted several gaps or challenges using existing functionalities, and both vendors and practices reported broader challenges for more transformative health IT change, particularly the lack of interoperable health information exchange needed to support care management and care coordination. Key factors constraining vendors' investment in further advances included long product development schedules, making it difficult to respond to rapidly evolving model requirements. Vendors also shared that CPC+ practices represented a small fraction of their client base, so investing in developing new functionality was not strategic unless it was more broadly relevant outside CPC+. Continued collaboration among health IT vendors, practices, policy makers, and payers could support continued technological improvements, particularly related to information exchange and communication. Aligning requirements more closely with other federal and private models could also help mitigate the risk for vendors.

Examining the Impact of Selected Sociodemographic Factors and Cancer-related Fatalistic Beliefs on Patient Engagement via Health Information Technology among Older Adults - A Cross-Sectional Analysis.

Despite the role of Health Information Technology (HIT) in patient engagement processes and government incentives for HIT development, research regarding HIT is lacking among older adults, with a high burden of chronic diseases like cancer. This study examines the role of selected sociodemographic factors and cancer-related fatalistic beliefs on patient engagement expressed through HIT usage for patient engagement in adults 65 or older. We controlled cancer diagnosis to account for its potential influence on patient engagement. This study has two aims 1- To investigate the role of sociodemographic factors of race, education, poverty index, and psychosocial factor of cancer fatalistic beliefs on accessing and utilizing HIT in older adults. 2- To examine the association of access and utilization of HIT to the self-management domain of patient activation that serves as a precursor to patient engagement. This is a secondary data analysis of a subset of the Health Information National Trend Survey (HINTS 4, Cycle 3). The subset includes individuals 65 and older with and without a cancer diagnosis. The relationships between access to and utilization of HIT to several sociodemographic variables and psychosocial factors of fatalistic beliefs were analyzed. Logistic regression and linear regression models were fit to study these associations. In this study, the total number of individuals over 65 years of age with a cancer diagnosis was 180 and without a diagnosis was 398. This analysis indicated that having less than a college education level, being nonwhite, and living in poverty were significantly associated with decreased access to HIT. Reduced HIT utilization was associated with less than a college education level and poverty. This analysis also indicated that cancer fatalistic beliefs were significantly associated with lower HIT utilization. Specifically, a one-point increase in cancer fatalistic belief score is associated with a 36% decrease in HIT utilization. We found that controlling for cancer diagnosis did not affect the outcome for sociodemographic variables. However, the self-management domain of patient activation was significantly associated with the higher utilization of HIT and patients with a prior cancer diagnosis. Sociodemographic factors (education, race, poverty, and cancer fatalistic beliefs) impact HIT access and utilization in older adults, regardless of prior cancer diagnosis. HIT users among older adults report higher self-management, essential for patient activation and engagement.

The Role of Health Information Technology on Colorectal Cancer Screening Participation Among Smokers In The United States.

Background: Despite advances in its prevention and early detection, colorectal cancer (CRC) remains a leading cause of morbidity and mortality in the United States and smokers are at an increased risk. Health information technology (HIT) has shown promise in the uptake of preventive health services, including CRC, and may prove useful among smokers. Methods: We obtained data from 7,419 adults who completed the 2018-2020 Health Information National Trends Survey. Using multivariable logistic regression models, we examined the relationship between HIT use and CRC screening participation. Results: Over 20% of current smokers had no access to HIT tools, and those with access were less likely than never smokers to use HIT in checking test results (odds ratio [OR] 0.58; 95% confidence interval [CI] [0.42-0.80]). Among former smokers, using HIT to check test results (OR 3.41; 95% CI [1.86-6.25]), look up health information online (OR 2.20; 95% CI [1.15-4.22]), and make health appointments (OR 2.86; 95% CI [1.39-5.89]) was associated with increased participation in CRC screening. Among current smokers, the use of HIT was not associated with a change in CRC screening participation. Conclusion: HIT use is associated with higher levels of CRC screening among former smokers, which is reassuring given their increased risk of CRC. The low ownership and use of HIT among current smokers of CRC screening age presents a challenge that may limit the integration of HIT into routine CRC screening services.

Clinical trial knowledge among cancer survivors in the United States: The role of health information technology.

e24039 Background: Clinical trials are essential in the evaluation of new antineoplastic therapies. However, studies have consistently reported suboptimal levels of clinical trial knowledge among adult cancer patients, and less than 5% of them participate in clinical trials. Health information technology (HIT) has shown promise in health promotion and may prove useful in bridging the knowledge gap in clinical trials among cancer survivors. Methods: We obtained data from 3,865 adults who completed the 2020 Health Information National Trends Survey of which 626 (16.2%) were cancer survivors. Using chi-squared tests, we examined the prevalence of HIT use in the general population and by cancer history. We also examined the impact of HIT use on clinical trial knowledge separately for cancer survivors and those with no cancer history using multivariable logistic regression models. Results: 63.8% of cancer survivors reported having some knowledge of clinical trials. Almost half of them used HIT to communicate with doctors (47.1%) and make health appointments (49.4%), about two-fifths (42.2%) used HIT in checking test results and 68.0% reported using HIT to look up health information online. In the adjusted models, the use of HIT in communicating with doctors [OR 2.79; 95% CI (1.41, 5.54)], checking test results [OR 2.47; 95% CI (1.12, 5.43)] and looking up health information online [OR 2.84; 95% CI (1.04, 7.77)] was associated with increased knowledge of clinical trials. Conclusions: Our findings suggest a positive association between HIT utilization and higher clinical trial knowledge levels. These results are encouraging given the rapid increase in mobile technology access globally and the increased use of HIT since the onset of the COVID-19 pandemic. There is a potential opportunity to leverage digital technology in improving clinical trial participation by increasing knowledge levels.

Provider-To-Provider Communication About Care Transitions: Considering Different Health Technology Tools.

Transitions in patient care require exchanges of information between providers. This period of transition presents a range of challenges, and inadequate transitions can have serious consequences for patients. Our objective was to understand providers' perspectives about patient care transitions, especially around communication between providers and the role of health information technology in provider-to-provider communication. Semi-structured interviews were conducted. Deductive-dominant thematic analysis was used to allow categorization of data based on general themes derived from the interview guides, as well as identification of emergent themes. We characterized three main themes involving providers' perspectives about care transitions. Themes included communication challenges, communication preferences, and suggestions for improving the care transition processes. With respect to challenges around communication, providers highlighted four main concerns. These concerns included the existence of too many methods of communication, high volume of communication, challenges with involvement of multiple providers delivering longitudinal care, and difficulty communicating with providers outside the health system. Providers noted opportunities to improve transitions including improving standardization, enhancing the specialty to primary care transition process, and increasing communication back to the referring provider. Implementation and evaluation of these improvements could be considered by health systems to enhance care transitions.

Impacts of tourists’ trust, perception and acceptance of health quick response technology on responsible pandemic travel behaviours

旅游者对健康快速反应技术的信任、感知和接受疫情大流行期间负责任旅游行为的影响研究目的本文旨在建立并实证检验一个理论框架, 以解释健康快速反应 (QR) 技术信任和接受对负责任的大流行旅行的影响。研究设计/方法/途径该研究整合了信任、信心和合作理论以及技术接受模型来解决研究目标。 采用配额抽样的方法, 在中国大陆对 1089 名受访者进行了全国在线调查。 应用结构方程模型来评估提出的假设。研究发现结果表明, 健康二维码技术信任可以提高旅行信心并减轻旅行恐惧, 这会影响游客的旅行意愿和社会疏远做法。 然而, 游客对健康二维码的接受鼓励了社会疏远行为, 而不是旅游意图。研究局限性/影响该研究说明了健康信息技术在大流行背景下提高游客信心和负责任的旅行行为方面的作用。 此外, 该研究通过调查健康相关技术的接受度与流行病旅行行为之间的关系, 支持并补充了技术接受度模型。研究实际意义这项研究帮助当地政府和旅游管理者评估健康二维码在中国大流行旅游中的有效性。 提供了提高游客信任度、技术采用和负责任行为的策略。研究独创性/价值这项研究与现有文献的不同之处在于调查了大流行旅行中的创新技术（即健康二维码）。 鉴于 COVID-19 爆发后健康二维码的流行, 它填补了知识空白并提供了改善大流行旅行安全的建议。

The Role of Health Information Technology in Improving Awareness of Human Papillomavirus and Human Papillomavirus Vaccine Among U.S. Adults.

Objective: Although human papillomavirus (HPV) vaccines prevent cancer-causing HPV infections and cervical precancers, there is suboptimal awareness and limited global accessibility of HPV and HPV vaccine. Emerging evidence suggests that health information technology (HIT) may influence HPV-related awareness and improve vaccine adoption. The objective of this study was to evaluate the link between HIT and HPV-related awareness Methods: Data were obtained from 1,866 U.S. adults aged 18-45 years who completed the 2017 and 2018 Health Information National Trends Survey. We conducted multivariable logistic regression to analyze the association between HIT utilization and HPV-related awareness. Results: Awareness of HPV and HPV vaccine were 72.7% and 67.5%, respectively. Participants who used electronic means to look up health information (adjusted odds ratio [aOR] = 3.05; p = 0.001), communicate with health care provider (aOR = 1.68; p = 0.026), look up test results (aOR = 1.94; p = 0.005), and track health costs (aOR = 1.65; p = 0.04) were more likely to report HPV awareness than those who did not. Participants who used an electronic device to look up health information (aOR = 3.10; p = 0.003), communicate with clinicians (aOR = 1.72; p = 0.008), look up test results (aOR = 1.63; p = 0.021), and track health care charges (aOR = 1.90; p = 0.006) were more likely to report HPV vaccine awareness than those who did not. Discussion and Conclusion: Our findings suggest a positive association between HIT utilization and HPV-related awareness. Given the rapid and exponential increase in mobile technology access globally, these results are encouraging and offer a potential opportunity to leverage digital technology in primary cancer prevention for HPV-related cancers, especially in low- and middle-income countries with unsophisticated health infrastructures.

Investigating the role of health information technology in the control and management of Systemic Lupus Erythematosus (SLE): a systematic review

BackgroundDespite the use of health information technology (HIT) for controlling and managing lupus, its effectiveness has not been well studied. The objective of this study was to investigate the role of HIT in controlling and managing lupus.MethodsWe searched Scopus, PubMed, Web of Science, and Embase, using "self-management", "self-care" and "Systemic Lupus Erythematosus" keywords. Two researchers selected relevant papers and extracted data using a data collection form. Disagreements were resolved in consultation with the third and fourth researchers. After extraction, the data were analyzed.ResultsTotally, 23 papers met the inclusion criteria. About 75% of the studies used web and telephone-based technologies. Most services provided with health technologies were ‘Training’ and ‘consulting’. The ‘lifestyle" and ‘Consultation and education’ axes were the most widely used HIT services to control and manage lupus. While, ‘Better management and control of the disease’, ‘Increasing knowledge and awareness of people about lupus’ and ‘Improving behaviors and attitudes toward self-management and self-care’ were also the most important outcomes. ‘Collectiing patient data and information’, 'Providing education and consultation services to patients', 'Measuring patient-reported outcomes', and 'Increasing patients' knowledge and awareness of their disease' were the most important advantages of various technologies. 'Slow internet speed' and 'Challenges and problems related to appearance and usability' and 'Patient concerns about privacy and misuse of their data' were three disadvantages of technologies.ConclusionThe findings showed that HIT can improve the management and control of lupus and facilitate self-efficacy, self-care, and self-management in patients. The axes and data elements identified in this study can be the basis for developing and implementing efficient HIT-based systems to improve, control, and manage lupus.

Health Information Technology During the COVID-19 Epidemic: A Review via Text Mining.

Due to the prevalence of the COVID-19 epidemic in all countries of the world, the need to apply health information technology is of great importance. hence, the study has identified the role of health information technology during the period of the COVID-19 epidemic. The present research is a review study by employing text mining techniques. Therefore, 941 published documents related to health information technology's role during the COVID-19 epidemic were extracted by keyword searching in the Web of Science database. In order to analyze the data and implement the text mining and topic modeling algorithms, Python programming language was applied. The results indicated that the highest number of publications related to the role of health information technology in the period of the COVID-19 epidemic was respectively on the following topics: "Models and smart systems," "Telemedicine," "Health care," "Health information technology," "Evidence-based medicine," "Big data and Statistic analysis." Health information technology has been extensively used during the COVID-19 epidemic. Therefore, different communities can apply these technologies, considering the conditions and facilities to manage the COVID-19 epidemic better.

The role of health information technology in improving awareness of HPV and HPV vaccine among U.S. adults: Insights from the health information national trends survey.

10535 Background: Despite advances in cancer prevention and wide-spread availability of Human papilloma virus (HPV) vaccines, US adults continue to have suboptimal HPV vaccination uptake with less than 50% vaccinated. Strategies aimed at enhancing HPV-related awareness are considered one of the most effective ways to improve HPV vaccine adoption and potentially eliminate HPV-related cancers. Health information technology (HIT) may influence HPV-related awareness and subsequently drive vaccine adoption. This study assessed the impact of HIT utilization on HPV and HPV vaccine awareness. Methods: Data was obtained from Health Information National Trends Survey (HINTS 5 cycles 1 and 2). Cross-sectional sample of 6,522 individuals aged 18 years or more was analyzed. The independent variables were use of smartphone, computer, or electronic means to (i) look up health information, (ii) fill a prescription online, (iii) communicate with a doctor or doctor’s office, (iv) look up test results of and (v) track health care charges. The dependent variables were HPV and HPV vaccine awareness. Chi-square analysis was used to evaluate group differences, and a multiple logistic regression was used to analyze the association between HIT utilization and HPV-related awareness controlling for sociodemographic and health-related factors. Results: Of the total sample, awareness of HPV and HPV vaccine was 62.7% and 61.8% respectively. In adjusted multivariable logistic regression analysis, those who utilized a smartphone, computer, or electronic means to look up health information (aOR 2.23; 95% CI 1.68 – 2.97, p < 0.001), communicate with healthcare provider (aOR 1.53; 95% CI 1.23 – 1.91, p < 0.001), look up test results (aOR 1.67; 95% CI 1.35 – 2.08, p < 0.001), and track health care charges (aOR 1.61; 95% CI 1.26 – 2.05, p < 0.001), were more likely to endorse HPV awareness than those who did not. Similar positive associations were observed for HIT utilization and HPV vaccine awareness. Conclusions: Our findings showed a positive association between HIT utilization and HPV-related awareness. Amid a background of sub-optimal HPV vaccination and explosion in technology, these results emphasize the potential for the role of HIT in preventive medicine. Strategies that integrate HIT into vaccine interventions and communications should be encouraged as a medium to expand HPV awareness and vaccine coverage.

The Critical Role of Health Information Technology in the Safe Integration of Behavioral Health and Primary Care to Improve Patient Care.

Integrated behavioral health and primary care is a set of related approaches to enhance care delivery, safety, and quality through closer collaboration and coordination among clinicians and care organizations in these two fields. Technology (e.g., electronic health records (EHR), telehealth, clinical decision support, and standards-based interoperability) can enable integration and improve delivery of care. Reinforcing these opportunities, virtual care and telehealth have dramatically changed care availability and delivery, especially during the COVID-19 pandemic. There are different levels of integration, ranging from minimal to full collaboration. The Partnership for Health IT Patient Safety and the HIMSS Electronic Health Record Association (EHRA) formed a workgroup to examine using information technology to facilitate integration. Taking a three-pronged approach focused on (1) screening for behavioral health issues, (2) clinician documentation, and (3) sharing data among clinicians, patients, and authorized parties, the workgroup developed action-oriented recommendations and strategies for safe use of health IT for stakeholders and policymakers seeking to advance efforts to integrate behavioral health with primary care.

The Role of Health Information Technology in Pneumococcal Vaccination Uptake Among Adults with Heart Disease

Background: Health information technology (HIT) may influence pneumococcal vaccination uptake in high-risk populations. This study assessed the association of HIT utilization on pneumococcal vaccine (PCV) uptake among adults ≥40 years with heart disease. Methods: This was a cross-sectional study of 2,134 individuals representing 16,813,593 United States adults ≥40 years with heart disease using the National Health Interview Survey data. The independent variables were use of the Internet to (1) look up health information, (2) fill a prescription, and (3) schedule a medical appointment, and use of an e-mail (4) communicate with a health care provider. The dependent variable was PCV uptake. Chi-square analysis was used to evaluate group differences, and a multiple logistic regression was used to analyze the association between HIT utilization and PCV uptake. Results: Those who use the Internet to fill up a prescription and to communicate with their health care provider were more likely to take up the PCV (adjusted odds ratio [AOR] 1.56; 95% confidence interval [CI] 1.03-2.37, p = 0.035) and (AOR 1.95; 95% CI 1.23-3.10, p = 0.005) respectively. Compared with those who did not use HIT in any form, those who used HIT in at least three or four forms had a higher PCV uptake (AORs 1.93; 95% CI 1.19-3.13, p = 0.008) and (AOR 2.33 95% CI 1.22-4.47, p = 0.011) respectively. Conclusion: Our analysis shows a positive association of HIT utilization and PCV uptake. It further stresses the importance of electronic health in preventive medicine. This implies that HIT can be used purposively in other aspects of preventive health. Larger studies should evaluate the relationship between different uses of HIT and the uptake of different vaccines.

Where Is My Money? The Interplay between Healthcare Information Technologies and Denied Claims

This study investigates the role of health information technology (HIT) in reducing uncompensated care, which has become a significant burden for healthcare providers in the U.S. Several peculiar aspects in healthcare give rise to provision of care that ends up being unpaid by payers or patients, and such loss of revenues increases the healthcare costs by every stakeholder. We theorize that the use of electronic health records (EHR) by care providers reduces the likelihood of care claims to be denied for payment by improving the accuracy and completeness of information processing. With a large-scale dataset of claim records from the State of Maryland in 2013-2016, we find that the greater use of EHR by the care providers, the less likely a claim is denied. More interestingly, this relationship between EHR and denied claims is moderated by claim characteristics – data specificity and sensitivity to claim processing errors. EHR is more effective in preventing payment declines for claims with higher data specificity (e.g. for patients with frequent hospital visits or chronic conditions) but less effective for those with higher sensitivity to claim processing errors (e.g. claims with more procedures and under ICD 10). This study provides significant theoretical insights for the information systems literature on HIT and enterprise systems by uncovering the multi-faceted roles of EHR in capabilities for information processing and compliance.

Addressing Care Continuity and Quality Challenges in the Management of Hypertension: Case Study of the Private Health Care Sector in Kenya.

BackgroundHypertension is a major risk factor of cardiovascular disease and a leading cause of morbidity and mortality globally. In Kenya, the rise of hypertension strains an already stretched health care system that has traditionally focused on the management of infectious diseases. Health care provision in this country remains fragmented, and little is known about the role of health information technology in care coordination. Furthermore, there is a dearth of literature on the experiences, challenges, and solutions for improving the management of hypertension and other noncommunicable diseases in the Kenyan private health care sector.ObjectiveThe aim of this study is to assess stakeholders’ perspectives on the challenges associated with the management of hypertension in the Kenyan private health care sector and to derive recommendations for the design and functionality of a digital health solution for addressing the care continuity and quality challenges in the management of hypertension.MethodsWe conducted a qualitative case study. We collected data using in-depth interviews with 18 care providers and 8 business leads, and direct observations at 18 private health care institutions in Nairobi, Kenya. We analyzed the data thematically to identify the key challenges and recommendations for technology-enabled solutions to support the management of hypertension in the Kenyan private health sector. We subsequently used the generated insights to derive and describe the design and range of functions of a digital health wallet platform for enabling care quality and continuity.ResultsThe management of hypertension in the Kenyan private health care sector is characterized by challenges such as high cost of care, limited health care literacy, lack of self-management support, ineffective referral systems, inadequate care provider training, and inadequate regulation. Care providers lack the tools needed to understand their patients’ care histories and effectively coordinate efforts to deliver high-quality hypertension care. The proposed digital health platform was designed to support hypertension care coordination and continuity through clinical workflow orchestration, decision support, and patient-mediated data sharing with privacy preservation, auditability, and trust enabled by blockchain technology.ConclusionsThe Kenyan private health care sector faces key challenges that require significant policy, organizational, and infrastructural changes to ensure care quality and continuity in the management of hypertension. Digital health data interoperability solutions are needed to improve hypertension care coordination in the sector. Additional studies should investigate how patients can control the sharing of their data while ensuring that care providers have a holistic view of the patient during any encounter.

Information management practices in public tertiary health-care facilities: an empirical investigation from the state of Kuwait

PurposeThis paper aims to gain insights about information management practices in public health-care organizations in Kuwait and offer recommendations to improve these practices.Design/methodology/approachThis study involves secondary analysis of quantitative and qualitative accreditation-related data pertaining to the compliance with the Information Management standard at seven public tertiary health-care facilities over two accreditation cycles.FindingsOverall, organizations improved their compliance with the Information Management standard. However, issues exist with effectively and efficiently transmitting data, aggregating clinical and administrative data and using the information for both strategic planning and quality improvement initiatives.Research limitations/implicationsThe analysed data set does not provide information about the improvements done between the accreditation cycles. Caution should be applied before assuming generalizability of the results, considering the context and social constructs around the health-care system is essential.Practical implicationsCompliance with predetermined criteria through accreditation can improve information management practices. Without proper management of information at health-care facilities, achieving safe and effective patient care is futile. The role of health information technology (IT) should not be sidelined; robust health IT solutions can help support good information management practices thereby improving care quality and aiding health-care reform.Originality/valueConcerning information management, health-care organizations providing focused services have clear advantages over organizations providing general care services. Considering the type of care organization (general vs specialized) can provide insights into how information management practices can affect the operations of the organization.

Role of Health Information Technology in the Engagement Process of Older Adults’ Cancer Treatment Decision Making

This study investigates the role of Health Information Technology (HIT) in the process of patient engagement in treatment decision making in older adults in cancer care. Despite the role of HIT in patient engagement processes and government incentives for HIT development, research regarding HIT is lacking among older adults. The following study is a secondary data analysis of a subset of the Health Information National Trend Survey (HINTS 4, Cycle 3), including individuals 65 years old and above. Chi-square tests, logistic regression, and linear regression models were fit to study several sociodemographic, socioeconomic, and psychosocial variables in this study. The results show that education, poverty status, and self-management domain of the patient activation (which is a precursor of the engagement process) were significantly associated with access to and utilization of HIT. No significant differences between access to and utilization of HIT and the diagnosis of cancer were found. However, fatalistic beliefs about the diagnosis of cancer significantly impacted the use of HIT in all models, including those controlling for cancer diagnosis and access to HIT. Specifically, a one-point increase in cancer fatalism score is associated with a 59% decrease in the utilization of HIT, giving evidence that fatalistic beliefs about cancer can drive engagement behaviors regardless of a diagnosis of cancer. Our study provides vital information for providers and policy researchers to take into account for future implementation and development strategies of HIT in cancer care for older adults.

Funding of Hispanic/Latino Health-Related Research by the National Institutes of Health: An Analysis of the Portfolio of Research Program Grants on Six Health Topic Areas.

Hispanics/Latinos are expected to constitute 25% of the U.S. population by 2060. Differences in the prevalence of health risk factors, chronic diseases, and access to and utilization of health-care services between Hispanics/Latinos and other populations in the U.S. have been documented. This study aimed to describe and analyze the landscape of Research Program Grants (RPGs) funded by the National Institutes of Health (NIH) between 2008 and 2015 involving Hispanic/Latino health research in six health condition areas—asthma, cancer, dementia, diabetes, liver/gallbladder disease, and obesity—and to identify opportunities for continued research in these areas. Using an NIH internal search engine, we identified new and renewal Hispanic/Latino health RPGs searching for specific Hispanic/Latino identifiers in the Title, , and Specific Aims. We used descriptive statistics to examine the distribution of funded RPGs by NIH disease-based classification codes for the six health condition areas of interest, and other selected characteristics. The most prominent clusters of research subtopics were identified within each health condition area, and performance sites were mapped at the city level. Within the selected time frame, 3,221 Hispanic/Latino health-related unique RPGs were funded (constituting 4.4% of all funded RPGs), and of those 625 RPGs were eligible for review and coding in the present study. Cancer and obesity were the most commonly studied health condition areas (72%), while studies on mechanisms of disease—biological and non-biological—(72.6%), behavioral research (42.1%) and epidemiological studies (38.1%) were the most common types of research. Most of the primary performance sites were in California, Texas, the northeastern U.S., and Illinois. The predominance of mechanistic, behavioral, and epidemiological studies in our analysis poses opportunities to evaluate knowledge gained and their clinical application, explore new research questions, or to update some methods or instruments. The findings of the present study suggest opportunities to expand research in understudied mechanisms of disease that could explain differences in prevalence of conditions like diabetes and cancer among different heritage groups. In addition, our findings suggest that the impact of interventions or policies designed to reduce health disparities, innovative multi-level interventions, implementation and dissemination studies, the role of health information technology on health outcomes, and the intersectionality of individual, sociocultural, geographic, and other factors on health outcomes, among others, are understudied approaches, which could potentially advance research in Hispanic/Latino health and contribute to the achievement of better health outcomes in this diverse population.

Protocol for a mixed-methods exploratory investigation into the role of health information technology for the provision of cancer care in Indonesia

Background: Cancer and its management can incur high costs, high risks and high demand. In Indonesia, there remains gap in the availability of national cancer data despite the establishment of a National Committee for Cancer Control. Multiple pilot projects have been developed by the Ministry of Health to improve the delivery of care, including interventions utilising digital health approaches and integrated referral information systems. However, it is not yet clear to what extent these approaches influence patient management or the experience of cancer patients themselves. This research aims to explore the current role of health information technology (HIT) in the provision of services and treatments for patients with cancer from primary to tertiary healthcare centres in Yogyakarta, Indonesia. Methods: The study will adopt an observational mixed-methods single case study design of health facilities involved in the delivery of cancer services in a sub-national health system. We will collect data through face-to-face interviews with a range of health professionals involved in the delivery of cancer care. Patients will be interviewed to share their views and experiences of the existing cancer referral system and communication with health facilities. Alongside interviews, we will undertake an analysis of routine data from participating health facilities to assess gaps in existing information systems. Data analysis will include framework analysis for qualitative data alongside descriptive analyses of quantitative data. Findings will be used to inform conceptual maps to be presented as part of Theory of Change workshops focused on understanding how the existing cancer referral system works, why and for whom, with a focus on future refinement and intervention development. Conclusion: Our findings will inform critical thinking around the design, implementation, adaptation, and evaluation of existing systems. Through early engagement and participation of key stakeholders and project partners, we intend that findings will have immediate utility.

Роль медицинских информационных технологий в обеспечении безопасности пациентов

Роль медицинских информационных технологий в обеспечении безопасности пациентов