Assessing the impact of electronic health record technology adoption on hospital labor efficiency

Information technology (IT) in the hospital organization is fast becoming a key asset, particularly in light of recent reform legislation in the United States calling for expanding the role of IT in our health care system. Future payment reductions to hospitals included in current health reform are based on expected improvements in hospital operating efficiency. Since over half of hospital expenses are for labor, improved efficiency in use of labor resources can be critical in meeting this challenge. Policy makers have touted the value of IT investments to improve efficiency in response to payment reductions. ^ This study was the first to directly examine the relationship between electronic health record (EHR) technology and staffing efficiency in hospitals. As the hospital has a myriad of outputs for inpatient and outpatient care, efficiency was measured using an industry standard performance metric – full time equivalent employees per adjusted occupied bed (FTE/AOB). Three hypotheses were tested in this study.^ To operationalize EHR technology adoption, we developed three constructs to model adoption, each of which was tested by separate hypotheses. The first hypothesis that a larger number of EHR applications used by a hospital would be associated with greater staffing efficiency (or lower values of FTE/AOB) was not accepted. Association between staffing efficiency and specific EHR applications was the second hypothesis tested and accepted with some applications showing significant impacts on observed values for FTE/AOB. Finally, the hypothesis that the longer an EHR application was used in a hospital would be associated with greater labor efficiency was not accepted as the model showed few statistically significant relationships to FTE/AOB performance. Generally, there does not appear a strong relationship between EHR usage and improved labor efficiency in hospitals.^ While returns on investment from EHR usage may not come from labor efficiencies, they may be better sought using measures of quality, contribution to an efficient and effective local health care system, and improved customer satisfaction through greater patient throughput.^

Biomedical informatics applications for epilepsy management: A systematic review

Epilepsy is a very complex disease which can have a variety of etiologies, co-morbidities, and a long list of psychosocial factors4. Clinical management of epilepsy patients typically includes serological tests, EEG's, and imaging studies to determine the single best antiepileptic drug (AED). Self-management is a vital component of achieving optimal health when living with a chronic disease. For patients with epilepsy self-management includes any necessary actions to control seizures and cope with any subsequent effects of the condition9; including aspects of treatment, seizure, and lifestyle. The use of computer-based applications can allow for more effective use of clinic visits and ultimately enhance the patient-provider relationship through focused discussion of determinants affecting self-management. ^ The purpose of this study is to conduct a systematic literature review on informatics application in epilepsy self-management in an effort to describe current evidence for informatics applications and decision support as an adjunct to successful clinical management of epilepsy. Each publication was analyzed for the type of study design utilized. ^ A total of 68 publications were included and categorized by the study design used, development stage, and clinical domain. Descriptive study designs comprised of three-fourths of the publications and indicate an underwhelming use of prospective studies. The vast majority of prospective studies also focused on clinician use to increase knowledge in treating patients with epilepsy. ^ Due to the chronic nature of epilepsy and the difficulty that both clinicians and patients can experience in managing epilepsy, more prospective studies are needed to evaluate applications that can effectively increase management activities. Within the last two decades of epilepsy research, management studies have employed the use of biomedical informatics applications. While the use of computer applications to manage epilepsy has increased, more progress is needed.^

Efficiency from pharmacy inventory technology: A means to improving quality in non-profit hospitals

Hospitals, like all organizations, have both a mission and a finite supply of resources with which to accomplish that mission. Because the inventory of therapeutic drugs is among the more expensive resources needed by a hospital to achieve its mission, a conceptual model of structure plus process equals outcome posits that adequate emphasis should be placed on optimization of the organization's investment in this important structural resource to provide highest quality outcomes. Therefore emphasis should be placed on the optimization of pharmacy inventory because lowering the financial investment in drug inventory and associated costs increases productive efficiency, a key element of quality. ^ In this study, a post-intervention analysis of a hospital pharmacy inventory management technology implementation at The University of Texas M.D. Anderson Cancer Center was conducted to determine if an intervention which reduced a hospital's financial investment in pharmaceutical inventory provided an opportunity to incrementally optimize the organization's mix of structural resources thereby improving quality of care. The results suggest that hospital pharmacies currently lacking technology to support automated purchasing logistics and perpetual, real-time inventory management for drugs may achieve measurable benefits from the careful implementation of such technology, enabling the hospital to lower its investment in on-hand inventory and, potentially, to reduce overall purchasing expenditures. ^ The importance of these savings to the hospital and potentially to the patient should not be underestimated for their ability to generate funding for previously unfunded public health programs or in their ability to provide financial relief to patients in the form of lower drug costs given the current climate of escalating healthcare costs and tightening reimbursements.^

Agile it project management professional

La gestión de las tecnologías de la información tiene cada vez más importancia dentro de un mundo totalmente digitalizado y donde la capacidad de respuesta al cambio puede marcar el devenir de una compañía, y resulta cada vez más evidente que los modelos de gestión tradicionales utilizados en la mayoría de las compañías no son capaces de dar respuesta por si solos a estas nuevas necesidades. Aun teniendo identificado este área de mejora, son muchas las empresas reacias a abordar estos cambios, principalmente por el cambio rupturista que significa a nivel interno. De cara a facilitar esta transformación, se propone en este documento un modelo de transición controlada donde las grandes compañías puedan incorporar nuevas alternativas y herramientas ágiles de forma paulatina y asegurando que el proceso de cambio es seguro y efectivo. Mediante una modificación del ciclo de vida de proyecto dentro de la compañía, se incorporan en las áreas, equipos o dominios de la empresa que se identifiquen los nuevos modelos de gestión ágil, permitiendo así una transición gradual y controlada, y pudiendo además analizar los detalles sobre todo en etapas tempranas de la transformación. Una vez seleccionada el área o dominio objeto de la transformación, se realiza un análisis a nivel de Portfolio de proyectos, identificando aquellos que cumplen una serie de condiciones que les permiten ser gestionados utilizando modelos de gestión ágil. Para ello, se plantea una matriz de decisión con las principales variables a tener en cuenta a la hora de tomar una decisión. Una vez seleccionado y consensuado con los interesados el modelo de gestión utilizando la matriz de decisión, se plantean una serie de herramientas y métricas asociadas para que la gestión ágil del proyecto dé una visibilidad completa y detallada del estado en cada momento, asegurando un correcto proceso de gestión de proyectos para proveer visibilidad regular del progreso, riesgos, planes de contingencia y problemas, con las alertas y escalaciones adecuadas. Además de proponerse una serie de herramientas y métricas para la gestión ágil del proyecto, se plantean las modificaciones necesarias sobre las tipologías habituales de contrato y se propone un nuevo modelo de contrato: el Contrato Agile. La principal diferencia entre este nuevo modelo de contrato y los habituales es que, al igual que las metodologías ágiles, es ejecutado en segmentos o iteraciones. En definitiva, el objetivo de este documento es proveer un mecanismo que facilite la inclusión de nuevos modelos ágiles de gestión en grandes organizaciones, llevando a cabo una transición controlada, con herramientas y métricas adaptadas para tener visibilidad completa sobre los proyectos en todo momento.---ABSTRACT---The information technology management is every time more important in a totally digitized world, where the capacity to response the change could mark the future of a company, and results every time more evident that the traditional management models used in the most of the companies are not able to respond by themselves to these new necessities. Even having identified this improvement area, many companies are reluctant to address these changes, mainly due to the disruptive change that it means internally in the companies. In order to facilitate this transformation, this document proposed a controlled transition model to help the big companies to incorporate new alternatives and agile tools gradually and ensuring that the change process is safe and effective. Through a modification the project life cycle inside the company, the new agile management models are incorporated in the selected areas, teams or domains, permitting a gradual and controlled transition, and enabling further analyze the details above all in the early phases of the transformation. Once is selected the area or domain object of the transformation, a portfolio level analysis is performed, identifying those projects that meet a some conditions that allow them to be managed using agile management models. For that, a decision matrix is proposed with the principal variables to have into account at the time of decision making. Once the management model is selected using the decision matrix and it is agreed with the different stakeholders, a group of tools and metrics associated with the agile management projects are proposed to provide a regular visibility of the project progress, risks, contingency plans and problems, with proper alerts and escalations. Besides the group of tools and metrics proposed for agile project management, the necessary modifications over the traditional contract models and a new contract model are proposed: the Agile Contract. The main difference between this new contract model and the traditional ones is that, as the agile methodologies, it is executed in segments or iterations. To sum up, the objective of this document is to provide a mechanism that facilitates the inclusion of new agile management models in big companies, with a controlled transition and proposing adapted tools and metrics to have a full visibility over the project in all the phases of the project life cycle.

Information systems offshore outsourcing: managerial conclusions from academic research

In the light of the growing interest raised by Information Systems Offshore Outsourcing both in the managerial world and in the academic arena, the present work carries out a revision of the research in this area. We have analysed 89 research articles on this topic published in 17 prestigious journals. The analysis deals with aspects such as research methodologies, level of analysis in the studies, data perspective, economic theories used or location of vendors and clients of these services; and it additionally identifies the most frequent topics in this field as well as the most prolific authors and countries. Although other reviews about the research in this area have been published, the present paper achieves a greater level of detail than previous works. The review of the literature in the area could have interesting implications not only for academics but also for business practice.

Automated management information systems for mental health agencies : a planning and acquisition guide /

Mode of access: Internet.

Expert survey on priorities for the information society in the Caribbean

An on-line survey of experts was conducted to solicit their views on policy priorities in the area of information and communication technologies (ICT) in the Caribbean. The experts considered the goal to “promote teacher training in the use of ICTs in the classroom” to be the highest priority, followed by goals to “reduce the cost of broadband services” and “promote the use of ICT in emergency and disaster prevention, preparedness and response.” Goals in the areas of cybercrime, e-commerce, egovernment, universal service funds, consumer protection, and on-line privacy rounded out the top 10. Some of the lowest ranked goals were those related to coordinating the management of infrastructure changes. These included the switchover for digital terrestrial television (DTT) and digital FM radio, cloud computing for government ICT, the introduction of satellite-based internet services, and the installation of content distribution networks (CDNs). Initiatives aimed at using ICT to promote specific industries, or specific means of promoting the digital economy, tended toward the centre of the rankings. Thus, a general pattern emerged which elevated the importance of focusing on how ICT is integrated into the broader society, with economic issues a lower priority, and concerns about coordination on infrastructure issues lower still.

Essays on the Issue of Piracy in the Market of Information Goods

Thesis (Ph.D.)--University of Washington, 2016-06

Electronic patient records: Achieving best practice in information transfer between hospital and community providers - an integration success story

Effective healthcare integration is underpinned by clinical information transfer that is timely, legible and relevant. The aim of this study was to describe and evaluate a method for best practice information exchange. This was achieved based on the generic Mater integration methodology. Using this model the Mater Health Services have increased effective community fax discharge from 34% in 1999 to 86% in 2002. These results were predicated on applied information technology excellence involving the development of the Mater Electronic Health Referral Summary and effective change management methodology, which included addressing issues around patient consent, engaging clinicians, provision of timely and appropriate education and training, executive leadership and commitment and adequate resourcing. The challenge in achieving best practice information transfer is not solely in the technology but also in implementing the change process and engaging clinicians. General practitioners valued the intervention highly. Hospital and community providers now have an inexpensive, effective product for critical information exchange in a timely and relevant manner, enhancing the quality and safety of patient care.

Outsourcing and inter-intra supply chain dynamics: Strategic management issues

This article analyzes the outsourcing of information technology services, using an action inquiry methodology. Research spanned the disengagement and beginning of IT service functions transferred from work groups in the parent company to outsource teams. Results identified the importance of addressing strategic issues and inter/intra relationships between parent company team members and their outsource-counterparts. Conclusions indicate that behavioral issues such as psychological contracts within inter/intra work groups, power and trust are highly significant managerial issues in the success or failure of an outsourcing strategy.

Gendered dichotomies and segregation patterns in computing jobs in Australia

Sex segregation in employment is a phenomenon that can be observed and analysed at different levels, ranging from comparisons between broad classifications by industry or occupation through to finely defined jobs within such classifications. From an aggregate perspective, the contribution of information technology (IT) employment to sex segregation is clear--it remains a highly male-dominated field apparently imbued with the ongoing masculinity of science and technology. While this situation is clearly contrary to hopes of a new industry freed from traditional distinctions between 'men's' and 'women's' work, it comes as little surprise to most feminist and labour studies analysts. An extensive literature documents the persistently masculine culture of IT employment and education (see, among many, Margolis and Fisher 2002; Wajcman 1991; Webster 1996; Wright 1996, 1997), and the idea that new occupations might escape sexism by sidestepping 'old traditions' has been effectively critiqued by writers such as Adam, who notes the fallacy of assuming a spontaneous emergence of equality in new settings (2005: 140).

When electronic management tools work - and don't work - in social-based distribution channels:a study of IT manufacturers and resellers

Electronic information tools have become increasingly popular with channel manufacturers in their efforts to manage resellers. Although these tools have been found to increase the efficiency of communications, researchers and practitioners alike have questioned their effectiveness. To investigate how top-down electronic information affects social channel relationships we consider the use of such tools in information technology distribution channels. Using electronic communications theory and channel governance theory we hypothesize that the usefulness of the tools is a function of the type of information inherent in each tool (demand creation information or supply fulfillment information) and the particular communications characteristics of this information.