Use Of Health Information Technology Research Articles

Differences by Race in Outcomes of an In-Person Training Intervention on Use of an Inpatient Portal

Differences in patient use of health information technologies by race can adversely impact equitable access to health care services. While this digital divide is well documented, there is limited evidence of how health care systems have used interventions to narrow the gap. To compare differences in the effectiveness of patient training and portal functionality interventions implemented to increase portal use among racial groups. This secondary analysis used data from a randomized clinical trial conducted from December 15, 2016, to August 31, 2019. Data were from a single health care system and included 6 noncancer hospitals. Participants were patients who were at least 18 years of age, identified English as their preferred language, were not involuntarily confined or detained, and agreed to be provided a tablet to access the inpatient portal during their stay. Data were analyzed from September 1, 2022, to October 31, 2023. A 2 × 2 factorial design was used to compare the inpatient portal training intervention (touch, in-person [high] vs built-in video tutorial [low]) and the portal functionality intervention (technology, full functionality [full] vs a limited subset of functions [lite]). Primary outcomes were inpatient portal use, measured by frequency and comprehensiveness of use, and use of specific portal functions. A logistic regression model was used to test the association of the estimators with the comprehensiveness use measure. Outcomes are reported as incidence rate ratios (IRRs) for the frequency outcomes or odds ratios (ORs) for the comprehensiveness outcomes with corresponding 95% CIs. Of 2892 participants, 550 (19.0%) were Black individuals, 2221 (76.8%) were White individuals, and 121 (4.2%) were categorized as other race (including African, American Indian or Alaska Native, Asian or Asian American, multiple races or ethnicities, and unknown race or ethnicity). Black participants had a significantly lower frequency (IRR, 0.80 [95% CI, 0.72-0.89]) of inpatient portal use compared with White participants. Interaction effects were not observed between technology, touch, and race. Among participants who received the full technology intervention, Black participants had lower odds of being comprehensive users (OR, 0.76 [95% CI, 0.62-0.91), but interaction effects were not observed between touch and race. In this study, providing in-person training or robust portal functionality did not narrow the divide between Black participants and White participants with respect to their inpatient portal use. Health systems looking to narrow the digital divide may need to consider intentional interventions that address underlying issues contributing to this inequity. ClinicalTrials.gov Identifier: NCT02943109.

Characteristics of Veterans Experiencing Homelessness using Telehealth for Primary Care Before and After COVID-19 Pandemic Onset

BackgroundThe COVID-19 pandemic expanded telehealth use across healthcare systems, including the Veterans Health Administration (VA). Little is known about how large-scale telehealth rollout affected access to primary care for patients experiencing homelessness.ObjectiveTo examine the extent to which homeless-experienced veterans used telehealth services in primary care and to characterize users before and after the onset of the COVID-19 pandemic.DesignRetrospective cohort study, 3/16/2019–3/15/2022.Participants394,731 veterans with homelessness diagnoses nationally using 4,068,109 primary care visits.Main MeasuresThe outcomes were use of 1 + telehealth visits (video, phone, secure messaging) for primary care during each year. Through multivariable regression models, we examined associations between telehealth use, patient characteristics (e.g., age, sex, race-ethnicity, comorbidity), and VA homeless services use (e.g., homeless-tailored primary care (HPACT), permanent supportive housing).Key ResultsCompared to pre-pandemic, telehealth in primary care among homeless-experienced veterans increased substantially 2 years post-pandemic (video: 1.37% versus 20.56%, phone: 60.74% versus 76.58%). Secure messaging was low over time (1.57–2.63%). In adjusted models, video users were more likely to be young (65 + years: OR = 0.43, CI: 0.42–0.44), women (OR = 1.74, CI: 1.70–1.78), Black (OR = 1.14, CI: 1.12–1.16), Hispanic (OR = 1.34, CI: 1.30–1.38), and with more comorbidities (2 + on the Charlson Comorbidity Index; OR = 1.16, CI: 1.14–1.19), compared to video non-users. HPACT patients were less likely to use video (OR = 0.68, CI: 0.66–0.71) than other primary care patients. This was not observed among users of other VA homeless services.ConclusionsDespite decreased access to health information technology and low pre-pandemic telehealth use, veterans experiencing homelessness still sustained high use of telehealth in primary care post-pandemic. Women and racial-ethnic minorities had higher video uptake proportionately, suggesting that telehealth may address access disparities among these homeless-experienced patient groups. Identifying and targeting organizational characteristics (e.g., HPACT users) that predict telehealth use for improvement may be key to increasing adoption among VA primary care patients experiencing homelessness.

CATALYZING DEMENTIA CARE THROUGH THE LEARNING HEALTH SYSTEM AND CONSUMER HEALTH INFORMATION TECHNOLOGY

Abstract To advance care for persons with Alzheimer’s disease and related dementias (ADRD), real-world health system effectiveness research must actively engage those affected to understand what works, for whom, in what setting, and for how long – an agenda central to Learning Health System principles. The spread of consumer health information technology affords new opportunities to support ADRD caregivers within health care delivery. Patient portals allow patients to view test results and sections of their electronic medical record, perform health management tasks (e.g., scheduling visits, billing, filling prescriptions), access educational materials, and communicate with clinicians using secure messaging. Many care delivery organizations allow patients to share access to their portal account by registering a “care partner” to have their own identity credentials (login/password). Through shared access, patients may select whether and who electronically interacts with clinicians on their behalf, thus, respecting patient preferences while supporting care partners with timely information about patient health and treatments, and a mechanism to electronically navigate health system demands. Little is now known about electronic information sharing preferences and practices of persons with ADRD and their caregivers, the feasibility of deploying novel interventions, or existing initiatives through consumer health information technologies to better support ADRD care and management. This symposium presents early results from projects seeking to increase evidence regarding the role and use of consumer health information technology in ADRD care and management by examining the existing landscape of patient portal use in the context of dementia care from a large integrated academic health system.

CancelRx case study: implications for clinic and community pharmacy work systems

BackgroundMedication prescribing and discontinuation processes are complex and involve the patient, numerous health care professionals, organizations, health information technology (IT). CancelRx is a health IT that automatically communicates medication discontinuations from the clinic electronic health record to the community pharmacy dispensing platform, theoretically improving communication. CancelRx was implemented across a Midwest academic health system in October 2017. The health system also operates 15 outpatient community pharmacies.ObjectiveThe goal of this qualitative study was to describe how both the clinic and community pharmacy work systems change and interact over time regarding medication discontinuations, before and after CancelRx implantation.ApproachMedical Assistants (n = 9), Community Pharmacists (n = 12), and Pharmacy Administrators (n = 3), employed by the health system were interviewed across 3-time periods between 2017 and 2018— 3-months prior to CancelRx implementation, 3-months after CancelRx implementation, and 9-months after CancelRx implementation. Interviews were audio recorded, transcribed, and conducted a hybrid analysis with deductive content analysis following the Systems Engineering Initiative for Patient Safety (SEIPS) framework and inductive analysis to capture additional codes and themes.Key resultsCancelRx changed the medication discontinuation process at both clinics and community pharmacies. In the clinics, the workflows and medication discontinuation tasks changed over time while MA roles and clinic staff communication practices remained variable. In the pharmacy, CancelRx automated and streamlined how medication discontinuation messages were received and processed, but also increased workload for the pharmacists and introduced new errors.ConclusionsThis study utilizes a systems approach to assess disparate systems within a patient network. Future studies may consider health IT implications for systems that are not in the same health system as well as assessing the role of implementation decisions on health IT use and dissemination.

Identifying factors that affect the use of health information technology in the treatment and management of hypertension

BackgroundWe conducted this study with the aim of identifying factors that affect the use of health information technology in the treatment and management of hypertension.MethodsThis paper is a descriptive-analytic study conducted in 2022. To obtain relevant articles, databases including Scopus, Web of Science, IEEE, and PubMed were searched and the time period was between 2013 and 2022. Based on the review of similar articles, a five-point Likert scale checklist was developed in the second phase. The statistical population of the present study was specialist physicians (N = 40) and patients (N = 384). In order to analyze the data, SPSS Statistics 24 was used. To analyze the data obtained from the checklist, we used summary statistics (mean and standard deviation).ResultsAs a result of the review literature process, 50 papers were screened, that based we can distinguish motivational and inhibitory factors affecting the use of health information technology in hypertension management. Indeed, Motivational factors and inhibitory factors can be classified into five groups: organizational, economic, technical, personal, and legal/moral factors. Based on the results of the checklist, the factors that were identified as most influential on motivation and inhibitory patients and specialist physicians’ to use of health information technology to manage and treat hypertension.ConclusionUtilizing technologies for hypertension, its management can be improved by identifying motivating and inhibiting factors. Our approach can improve the acceptability of these technologies, save costs, reduce long-term complications of hypertension, and improve patient quality of life.

UTILISATION OF HEALTH INFORMATION TECHNOLOGY AMONG DIETITIANS IN THE WORKPLACE: A QUALITATIVE STUDY

Dietitians play an important role in advocating lifestyle changes, such as dietary modifications and physical activity, to effectively prevent chronic diseases and avoid complications. The use of information technologies (IT) helps dietitians to engage with their patients. This paper explores the use health information technology among dietitians in the workplace. Four focus group sessions involving fifteen dietitians from hospitals and universities were conducted using an online platform. Participants were recruited using purposive and snowball sampling. A semi-structured questionnaire was used to facilitate the interview to understand better dietitians' health IT practices. Interviews were videotaped, verbatim transcribed, and emerging themes and subthemes were thematically analysed. Inductive and deductive content analysis were used. Four themes emerged from the data: 1. utility of health IT tools, 2. factors that influence the use of health IT, 3. frequency of use, and 4. perceived barriers to adoption of health IT. Participants used health IT through health-related mobile applications, web-based platforms, and social media applications. Participants cited self-motivation, advertisement, training, peers, patients, content, ease of use, developers, quality, and functionality as factors in their use of health IT. Some barriers to utilising health IT included not disease-specific tools, inappropriate for all age groups, inaccurate information, inconvenient, required a paid version, and being overloaded with information. This study demonstrates how dietitians make use of health information technology in their practice. Support is required to overcome information technology barriers to be applied successfully in practice. It is important for dietitians to stay current with technological advancements. Dietitians will be able to stay relevant and continue to support evidence-based practice if they do so now and in the future.

Information Technology and Quality of Service during COVID-19 in a Health Center, ICA 2022

The use of health information technology allows  improving health care that could not be performed during the pandemic, in addition to controlling patients whose diagnoses are chronic can be treated remotely, so the research objective is to determine the Information Technology and quality of service during COVID-19 in a health center,  Ica 2022. It is a quantitative correlational study, with a total population of 206 workers who filled out a questionnaire with sociodemographic data and information and communication technology instruments; and the scale of quality of care of health services. In the results, 92.2% (n=190) of the participants always frequently use information and communication technologies; and 7.8% (n=16) sometimes use information and communication technologies. In conclusion, workshops should be held to promote the importance of the use of information and communication technologies, in order to improve care processes in the establishment.

The willingness and barriers to collaborate in the care of frail older adults: perspectives of primary care professionals

BackgroundThis study investigated the perspectives of primary care professionals, in particular general practitioners, registered nurses, physiotherapists and occupational therapists, on inter-professional collaboration, the barriers and the facilitators they perceive in the care of the frail older population.MethodsWe conducted a qualitative study. In-depth interviews with healthcare professionals were performed, using open-ended questions about their perceptions on the care of frail older adults and inter-professional collaboration. Data was analyzed following the Basic Logical Model of Abduction and Creswell’s coding method.ResultsHealthcare professionals indicated that when they explored problems complementary to the reasons for older people to contact a healthcare professional, these additional problems often seemed to be the main problem. They also stated that there was too little inter-professional collaboration in the care of complex chronic issues and lack of a shared vision on collaboration. Collaboration is still limited too much to contacting established professions. Health information technology can support both, inter-professional collaboration and working on an evidence-based manner. It can also be a facilitator to inform patients. The availability and use of health information technology differs between the professions. Success factors and barriers for sustainable collaboration were identified on several levels, namely innovation, individual, professional, patient, social context, context of the organization, economic and political context.ConclusionsOur study shed light on the willingness and barriers in collaboration of healthcare professionals in primary care for older adults. There is little inter-professional collaboration, despite the willingness of the healthcare professionals to collaborate.

Does Accelerated Digitization Widen Racial Digital Divide in Healthcare? Longitudinal Observational Study of Patient Portal Usage During COVID-19.

Prior research on the digital divide has documented substantial racial inequality in using online health resources. The recent COVID-19 pandemic led to accelerated mass digitization, raising alarms that underprivileged racial minorities (URMs) are left further behind. However, lacking empirical evidence, it is unclear to what extent URMs' use of health information and communications technology is impacted. We consider the COVID-19 disruption as a rare exogenous shock and estimate the impact of the accelerated digitization on the quantity and variety of patient portal usage. In this study, we study two key research questions: 1) Did patients alter their use of health ICT due to COVID-induced digital acceleration? 2) Does the effect differ along racial lines? We use a longitudinal patient portal usage dataset gathered from a large urban academic medical center to explore the effect of accelerated digitization on the racial digital gap in healthcare. We limit the sample period of our study to two same periods (March 11 - August 30) in 2019 and 2020. Our final sample consists of 25,612 patients belonging to one of the three races: Black or African American (20%), Hispanic (1%), and White or Caucasian (79%). We estimate panel data regression using three different models: pooled OLS, random effect (RE), and fixed effect (FE). Our study offers four findings. First, we confirm that the racial digital divide remains a significant issue for telehealth; URM patients have lower patient portal usage compared to White patients before the pandemic (β of Minority = -0.158/-0.168 for OLS/RE, P<.001/.001). Second, we find that the digital gap regarding patient portal use frequency between URMs and White patients is shrinking rather than widening after the COVID pandemic started (β of COVID_Period×Minority = 0.028/0.037/0.043 for OLS/RE/FE, P=.002/.000/.000). Third, the shrinking gap is foremost driven by access through mobile (vs. desktop) devices (β of COVID_Period×Minority is -0.020/0.037 for the web/mobile, P=.017/.000). Lastly, and further contributing to the narrowing of the racial digital divide under accelerated digitalization, the URMs expanded their use of a variety of portal functionalities faster than those of White patients during the pandemic (For functionality, β of COVID_Period×Minority is -0.004/-0.004/-0.003 for OLS/RE/FE, P=.000/.000/.001). Using the COVID pandemic as a natural experiment, we offer empirical evidence that accelerated digitization has shrunk the racial digital divide in telehealth, and the trend is mostly driven by mobile devices. These findings provide new insights into the digital behaviors among the URMs during accelerated digitization. They also offer policymakers an opportunity to identify new strategies to help close the racial digital gap in the post-pandemic world and call for "knowledge gap" research for improving personal health literacy known to improve healthcare quality.

Development and Validation of SafeHIT: An Instrument to Assess the Self-Reported Safe Use of Health Information Technology.

Implementing health information technology (HIT) may cause unintended consequences and safety risks when incorrectly designed and used. Yet, the tools to assess self-reported safe use of HIT are not well established. This study aims to develop and validate SafeHIT, an instrument to assess self-reported safe use of HIT among health care practitioners. Systematic literature review and a semistructured interview with 31 experts were adopted to generate SafeHIT instrument items. In total, 450 physicians from various departments at three Malaysian public hospitals participated in the questionnaire survey to validate SafeHIT. Exploratory factor analysis and confirmatory factor analysis (CFA) were undertaken to explore the items that best represent a specific construct and to confirm the reliability and validity of the SafeHIT, respectively. The final SafeHIT consisted of 14 constructs and 58 items in total. The result of the CFA confirmed that all constructs demonstrated adequate convergent and discriminant validity. A reliable and valid theoretically underpinned measure of determinants of safe HIT use behavior has been developed. Understanding external factors that influence safe HIT use is useful for developing targeted interventions that favor the quality and safety of health care.

Perceptions of COVID-19 and the Use of Health Information Technology Among People Who Are Uninsured: Multimethod Survey Study.

As of May 2023, the novel SARS-CoV-2 has claimed nearly 7 million lives globally and >1.1 million lives in the United States. Low-income populations are often disproportionately affected by risk factors such as lifestyle, employment, and limited health literacy. These populations may lack the knowledge of appropriate infection precautions or have reduced access to care during illness, particularly in countries without universal health care. We aimed to explore the perceptions and experiences of COVID-19, including symptoms and risk factors among uninsured individuals seeking care at a free medical clinic, and to obtain respondents' perceptions of and suggestions for adapting a mobile health (mHealth) app to an uninsured population known to have low health literacy. We conducted a prospective multimethod survey study with a convenience sample of uninsured adults seeking care at 3 free clinics in the United States. Respondents were questioned about their risk for and awareness of COVID-19 symptoms, COVID-19 testing, current technology use, and the use of technology to facilitate their health regarding COVID-19. Data were analyzed using descriptive statistics (eg, frequencies and mean differences). In addition, a small subset of respondents from one of the clinics (n=10) participated in interviews to provide feedback about the design of a COVID-19 web-based smartphone (mHealth) app. The survey respondents (N=240) were 53.8% (n=129) female, were primarily White (n=113, 47.1%), and had a mean age of 50.0 (SD 11.67; range 19-72) years. Most respondents (162/222, 73%) did not think that they were at risk for COVID-19. Although respondents reported only moderate confidence in their knowledge of the short- and long-term symptoms of COVID-19, their knowledge of the symptoms aligned well with reports published by the Centers for Disease Control and Prevention of the most common acute (590/610, 96.7%) and long-term (217/271, 80.1%) symptoms. Most respondents (159/224, 71%) reported an interest in using the mHealth app to gain additional information regarding COVID-19 and available community resources. Respondents who were interviewed provided suggestions to improve the mHealth app but had overall positive perceptions about the potential usefulness and usability of the app. It was encouraging that the knowledge of COVID-19 symptoms aligned well with the reports published by the Centers for Disease Control and Prevention and that respondents were enthusiastic about using an mHealth app to monitor symptoms. However, it was concerning that most respondents did not think they were at a risk of contracting COVID-19.

The Polarization of Clinician and Service Staff Perspectives After the Use of Health Information Technology in Youth Mental Health Services: Implementation and Evaluation Study.

Highly personalized care is substantially improved by technology platforms that assess and track patient outcomes. However, evidence regarding how to successfully implement technology in real-world mental health settings is limited. This study aimed to naturalistically monitor how a health information technology (HIT) platform was used within 2 real-world mental health service settings to gain practical insights into how HIT can be implemented and sustained to improve mental health service delivery. An HIT (The Innowell Platform) was naturally implemented in 2 youth mental health services in Sydney, Australia. Web-based surveys (n=19) and implementation logs were used to investigate staff attitudes toward technology before and after implementation. Descriptive statistics were used to track staff attitudes over time, whereas qualitative thematic analysis was used to explore implementation log data to gain practical insights into useful implementation strategies in real-world settings. After the implementation, the staff were nearly 3 times more likely to agree that the HIT would improve care for their clients (3/12, 25% agreed before the implementation compared with 7/10, 70% after the implementation). Despite this, there was also an increase in the number of staff who disagreed that the HIT would improve care (from 1/12, 8% to 2/10, 20%). There was also decreased uncertainty (from 6/12, 50% to 3/10, 30%) about the willingness of the service to implement the technology for its intended purpose, with similar increases in the number of staff who agreed and disagreed with this statement. Staff were more likely to be uncertain about whether colleagues in my service are receptive to changes in clinical processes (not sure rose from 5/12, 42% to 7/10, 70%). They were also more likely to report that their service already provides the best mental health care (agreement rose from 7/12, 58% to 8/10, 80%). After the implementation, a greater proportion of participants reported that the HIT enabled shared or collaborative decision-making with young people (2/10, 20%, compared with 1/12, 8%), enabled clients to proactively work on their mental health care through digital technologies (3/10, 30%, compared with 2/12, 16%), and improved their response to suicidal risk (4/10, 40% compared with 3/12, 25%). This study raises important questions about why clinicians, who have the same training and support in using technology, develop more polarized opinions on its usefulness after implementation. It seems that the uptake of HIT is heavily influenced by a clinician's underlying beliefs and attitudes toward clinical practice in general as well as the role of technology, rather than their knowledge or the ease of use of the HIT in question.

Engaging and informing patients: Health information technology use in community health centers

ObjectiveThis paper aims to address the relationship between the community health center (CHC) patient mix and the level of patient engagement health information technology (HIT) comprehensiveness. ParticipantsThe study was conducted on sample CHCs (n = 3,592 CHC-years) active between 2016 and 2018. MethodsPatient engagement HIT comprehensiveness was measured based on a framework of patient engagement through HIT that includes a two-part dichotomy of patient engagement and patient informing. Univariate analysis was used to describe CHC characteristics and multivariable ordered logistic regression analysis was used to test hypothesized relationships. ResultsThe study identified four levels of patient engagement HIT comprehensiveness: 1) to neither engage nor inform, 2) to primarily inform, 3) to primarily engage, and 4) to engage and inform. It was found that CHCs serving disproportionate shares of patients with disadvantageous socioeconomic characteristics are less likely to incorporate more comprehensive patient engagement HIT. ConclusionThe results highlight the different levels of patient engagement HIT use among CHCs and a negative association between CHC’s higher proportion of patients with a disadvantageous sociodemographic background and patient engagement HIT comprehensiveness.

Factors associated with health information technology use in adults recently diagnosed with cancer: NHIS 2012-2017.

e18673 Background: Electronic health information technology (HIT) usage among U.S. adults nearly doubled between 2007 and 2014. HIT utilization has been associated with improvement in health literacy, care coordination, provider access, and quality of care. Despite the positive influence of HIT, disparities regarding its usage exist. Individuals more likely to seek cancer prevention information online are younger, Non-Hispanic White, and highly educated. While individuals diagnosed with cancer are likely to research health information online, limited attention has focused on factors associated with HIT use among adults with cancer. The purpose of this study was to identify sociodemographic, behavioral, and health factors associated with HIT use among adults recently diagnosed with cancer. Methods: A cross-sectional analysis using the National Health Interview Survey (NHIS) 2012-2017 was conducted. Adults diagnosed with cancer within 12 months of taking the survey and reported a response to all five HIT variables (using the internet for health information, scheduling an appointment, using chat rooms for health information, filling a prescription online, and emailing a medical provider) were included (N = 3136). Survey-weighted proportions and 95% confidence intervals (CIs) were estimated for all categorical variables, and survey-weighted means and 95% CIs were estimated for continuous variables. Multiple logistic regression models were used to estimate factors associated with overall and individual HIT use. Results: Among U.S. adults with cancer utilizing HIT (51%), the highest usage was looking up health information online (53.37%) and the lowest usage was seen in using online chat groups to learn about health topics (3.04%). There was a higher prevalence in Non-Hispanic Whites looking up health information on the internet and scheduling an appointment; Asians filling a prescription online; and Non-Hispanic Blacks using online chat groups. For a one-unit increase in the number of non-cancer chronic conditions, the odds of using any HIT decreased by a factor of 0.15; p-value=&lt; 0.0001. After adjusting for covariates, significant factors related to any HIT use were identified in patients that were younger; female; Asian and Non-Hispanic White; and had health insurance, higher education, and higher income. Conclusions: Adults recently diagnosed with cancer are increasingly utilizing the internet to find health information but use varies across subgroups. These data could be utilized to direct future research investigating the influence of certain types of HIT interventions on access to health care.

Assessing the Relationship Between Health Information Technology Use and Self-Rated Health Among Adults with Chronic Low Back Painin the United States.

To assess the use of health information technology (HIT) among adults with chronic low back pain (CLBP) in the United States and to evaluate the relationship between HIT use and self-rated health. The independent variable was the use of the internet to (1) fill prescriptions, (2) communicate with a healthcare provider, (3) look up health information, and (4) schedule a medical appointment. Respondents rated their health in the last 12 months as worse, about the same, or better. A Chi-square analysis was used to assess the use of HIT among those with CLBP; a logistic regression was used to determine predictors of HIT use; and an ordinal logistic regression was used to assess the relationship between HIT and self-rated health. As compared to those without CLBP, those with CLBP are more likely to use the internet to look up health information (58.9 vs. 53.8%, p-value<.001), refill prescriptions (13.9% vs. 10.5%, p-value<.001), and communicate with a healthcare provider (19.8% vs.15.3%, p-value<.001). Being employed and having a higher level of education were positive predictors of HIT use. As compared to other uses of the internet, using the internet to communicate with a healthcare provider was associated with higher odds of rating health as better compared to worse or about the same within the last 12 months. Among adults with CLBP, a more affluent social status is associated with the use of HIT. Also, HIT is associated with a better health rating as compared to not using it at all. Further studies should assess the longitudinal relationship between HIT use and how adults with CLBP rate their health.

Personal Health Libraries for People Returning From Incarceration: Protocol for a Qualitative Study.

Individuals released from carceral facilities have high rates of hospitalization and death, especially in the weeks immediately after their return to community settings. During this transitional process, individuals leaving incarceration are expected to engage with multiple providers working in separate, complex systems, including health care clinics, social service agencies, community-based organizations, and probation and parole services. This navigation is often complicated by individuals' physical and mental health, literacy and fluency, and socioeconomic status. Personal health information technology, which can help people access and organize their health information, could improve the transition from carceral systems to the community and mitigate health risks upon release. Yet, personal health information technologies have not been designed to meet the needs and preferences of this population nor tested for acceptability or use. The objective of our study is to develop a mobile app to create personal health libraries for individuals returning from incarceration to help bridge the transition from carceral settings to community living. Participants were recruited through Transitions Clinic Network clinic encounters and professional networking with justice-involved organizations. We used qualitative research methods to assess the facilitators and barriers to developing and using personal health information technology for individuals returning from incarceration. We conducted individual interviews with people just released from carceral facilities (n=~20) and providers (n=~10) from the local community and carceral facilities involved with the transition for returning community members. We used rigorous rapid qualitative analysis to generate thematic output characterizing the unique circumstances impacting the development and use of personal health information technology for individuals returning from incarceration and to identify content and features for the mobile app based on the preferences and needs of our participants. As of February 2023, we have completed 27 qualitative interviews with individuals recently released from carceral systems (n=20) and stakeholders (n=7) who support justice-involved individuals from various organizations in the community. We anticipate that the study will characterize the experiences of people transitioning from prison and jails to community settings; describe the information, technology resources, and needs upon reentry to the community; and create potential pathways for fostering engagement with personal health information technology. DERR1-10.2196/44748.

Health Information Technologies in a Resource-Limited Setting: Knowledge, Attitude, and Practice of Health Professionals.

The use of health information technology significantly enhances patient outcomes. As a result, policymakers from developing countries have placed strong emphasis on formulating eHealth policies and initiatives. However, there have not been many successful deployments to show for. The role of individual factors in the successful implementation of these technologies is indispensable. Therefore, this study assesses healthcare professionals' knowledge, attitudes, and practice of health information technology. An institution-based cross-sectional study was conducted at the University of Gondar Comprehensive Specialized Hospital from November 15 to December 29, 2020. A structured, self-administered questionnaire was used to collect data. Student's t-test was used to learn if there were any significant differences in practice habits between participants with and without previous information technology-related training. In addition, first-order partial correlation was conducted to identify the relationship of knowledge and attitude with practice. A total of 347 health professionals responded to the questionnaire, yielding an 87.2% response rate. Most health professionals are not aware of how to use health information technologies. Notably, practice levels were low and needed prompt action from responsible authorities. Previous training did not work very well to improve the practice levels of health professionals. However, the positive attitude of these professionals encourages policymakers and implementers to engage closely.

Association of multimorbidity with the use of health information technology.

To examine the association of multimorbidity with health information technology use among adults in the USA. We used cross-sectional study design and data from the Health Information National Trends Survey 5 Cycle 4. Health information technology use was measured with ten variables comprising access, recent use, and healthcare management. Unadjusted and adjusted logistic and multinomial logistic regressions were used to model the associations of multimorbidity with health information technology use. Among adults with multimorbidity, health information technology use for specific purposes ranged from 37.8% for helping make medical decisions to 51.7% for communicating with healthcare providers. In multivariable regressions, individuals with multimorbidity were more likely to report general use of health information technology (adjusted odds ratios  =  1.48, 95% confidence intervals  =  1.01-2.15) and more likely to use health information technology to check test results (adjusted odds ratios  =  1.85, 95% confidence intervals  =  1.33-2.58) compared to adults with only one chronic condition, however, there were no significant differences in other forms of health information technology use. We also observed interactive associations of multimorbidity and age on various components of health information technology use. Compared to younger adults with multimorbidity, older adults (≥ 65 years of age) with multimorbidity were less likely to use almost all aspects of health information technology. Health information technology use disparities by age and multimorbidity were observed. Education and interventions are needed to promote health information technology use among older adults in general and specifically among older adults with multimorbidity.

Using information technology to integrate tobacco use treatment in routine oncology care: Lessons learned from the U.S. Cancer Center Cessation Initiative Cancer Centers.

Cancer patients who receive evidence-based tobacco-dependence treatment are more likely to quit and remain abstinent, but tobacco treatment programs (TTPs) are not consistently offered. In 2017, the U.S. National Cancer Institute, through the Cancer Moonshot, funded the Cancer Center Cessation Initiative (C3I). C3I supports 52 cancer centers to implement and expand evidence-based tobacco treatment in routine oncology care. Integration into routine care involves the use of health information technology (IT), including modifying electronic health records and clinical workflows. Here, we examine C3I cancer centers' IT leadership involvement and experiences in tobacco-dependence treatment implementation. This qualitative study of C3I-funded cancer centers integrated data from online surveys and in-person, semistructured interviews with IT leaders. We calculated descriptive statistics of survey data and applied content analysis to interview transcripts. Themes regarding IT personnel included suggestions to involve IT early, communicate regularly, understand the roles and influence of the IT team, and match program design with IT funding and resources. Themes regarding electronic health record (EHR) modifications included beginning modifications early to account for long lead time to make changes, working with IT to identify and adapt existing EHR tools for TTP or designing tools that will support a desired workflow developed with end-users, and working with IT personnel to make sure TTPs comply with system and state policies (e.g., privacy laws). The experiences of C3I cancer centers regarding the use of health IT to enhance tobacco-dependence treatment program implementation can guide cancer centers and community oncology practices to potentially enhance TTP implementation and patient outcomes.

Validation and prioritisation of health informatics competencies for Australian nursing and midwifery leaders: A modified Delphi study

BackgroundHealth informatics competency standards for nurses are required to ensure the use and management of health information technologies contributes to the delivery and management of safe, quality care delivery. Historically, these competencies have been identified for nurses as a general group and specifically for undergraduate nursing students but not to the same extent for nurse leaders. AimThe aim of this study was to validate and prioritise health informatics competencies for Australian nurse leaders. MethodThis study utilised a modified Delphi technique to validate and prioritise 26 health informatics competencies for the Australian setting. The competencies were previously developed for Canadian nurses through literature review and consulation with experts. This modified Delphi study included invitations to 20 Australian Chief Nursing Information Officers who were then asked to extend the invitation to nurse leaders in their corresponding organisations. ResultsEleven Chief Nursing Information Officers and seven Nurse Leaders completed the study including 3 rounds of informatics competencies consensus surveys. As a result, 22 revised competency statements were agreed to by the study participants. The top priority competency (Nursing and Midwifery leaders support clinicians to adopt and use information and communication technologies that support safe, quality care delivery) was also the highest ranked in the Canadian team’s initial work. This reflects a common objective of nurses’ need to ensure technology is fit for purpose, not only for nurses and midwives, but for patient safety and quality of care. ConclusionKnowledge is required in the digital health landscape in order for nursing leaders to increase their capability in decision-making in the current and future digital healthcare environments. Differences in the competencies validated and prioritised by Australian nurse leaders and previous work by Canadian nurse leaders support the need to examine context-specific factors for nurse leaders to utilise these competencies.