IT Adoption, Diffusion and Evaluation in Healthcare

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    Enabling laboratory medicine in primary care through EMR systems use: A survey of Canadian physicians
    ( 2019-01-08) Raymond, Louis ; Paré, Guy ; Maillet, Eric
    Important problems remain with regard to the efficiency and effectiveness of laboratory testing in primary care. In view of this, a significant function of electronic medical record (EMR) systems is to enable the practice of laboratory medicine by primary care physicians (PCPs). In addressing this issue, the present study aims to deepen our understanding of the nature and effectiveness of PCPs’ use of EMR systems for patient management and care within the laboratory testing process. To achieve our main objective, a survey of 684 Canadian physicians was realized. Results confirm that the artefactual and clinical contexts of EMR use influence the extensiveness of this use for communicational and clinical purposes. In turn, it is confirmed that the more extensive the use of EMR for laboratory medicine, the greater its impacts on the PCPs’ efficiency and on the quality of care provided by these physicians. The implications of these results are discussed.
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    The Perils of Using Social Media Data to Predict the Spread of Diseases
    ( 2019-01-08) Patel, Akshay ; Amrit, Chintan ; Sundaram, David
    The data produced by social media engagement is of interest to various organizations and has been used in different applications like marketing, finance and healthcare. Though the potential of mining this data is high, standard data mining processes do not address the peculiarities of social media data. In this paper, we explore the perils of using social media data in predicting the spread of an infectious disease; perils that are mostly related to data quality, textual analysis and location information. We synthesize findings from a literature review and a data mining exercise to develop an adapted data mining process. This process has been designed to minimize the effects of the perils identified and is thus more aligned with the requirements of predicting disease spread using social media data. The process should be useful to data miners and health institutions
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    Gaining Insight and Taking Action: Engaging Adults with Persistent Pain and Opioid Use Disorder in an Online Pain Self-Management Program
    ( 2019-01-08) Wilson, Marian ; Shaw, Michele R.
    The primary purpose of this study was to evaluate participants’ perceptions after engaging in an 8-week online pain self-management program. Participants (N=31) were adults enrolled in a medication-assisted outpatient opioid treatment program who had co-existing opioid substance use disorder and persistent pain. Data were collected via secure online surveys and content analysis methods were used to analyze text from open-ended questions. Two themes were identified describing benefits of the program: gaining insight and taking action. Two themes described how participants would like to improve program experiences: feeling overwhelmed and ease of use. Survey data were also examined for relationships between level of program engagement, pain relief, and substance use to explore potential barriers to program use. Poorly managed pain and illicit drug use were associated with reduced program use (p<0.05). Understanding preferences and barriers can assist adoption of online programs for people with co-morbid pain and substance use disorder.
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    Electronic Health Records Communication among Team Members and Quality of Care and Costs for Patients with Cardiovascular Disease in Primary Care
    ( 2019-01-08) Mundt, Marlon ; Zakletskaia, Larissa
    This study determines how changes in electronic health record (EHR) communication patterns in primary care teams are related to quality of care and costs for patients with cardiovascular disease. Counts of EHR messages routed between any two team members were extracted from the EHR system, and flow betweenness, the proportion of information passed indirectly within the team, was calculated. The analysis related changes in team flow betweenness to changes in acute care visits and associated medical costs for the teams’ patients with cardiovascular disease. The results indicated that patient hospital visits increased by 7% (SE 3%) for every 1% increase in team EHR flow betweenness. Medical costs increased by $141 (SE $67) per patient for every 1% increase in team EHR flow betweenness. EHR team communication flow patterns may be an important avenue to explore for raising quality of care and lowering costs for primary care patients with cardiovascular disease.
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    Emergence of an Information Infrastructure through Integrating Waste Drug Recycling, Medication Management, and Household Drug Management in China
    ( 2019-01-08) Luo, Yumei ; Reimers, Kai
    The total amount of waste drugs is expanding significantly as populations age and societies become wealthier. Drug waste is becoming a problem for health and environment. Thus, how to reduce and effectively dispose of waste drugs is increasingly becoming an issue for society. In this paper, we analyze the current situation with regard to existing systems for expired drug recycling and disposal in China and suggest that by connecting the involved practices of waste drug recycling, medication management, and household drug management the incentives to participate in an integrated drug recycling system can be dramatically increased for all involved actors. This is important from an IS perspective because such connecting of practices could account for a novel mechanism of information infrastructure emergence, known from physics as ‘state transition’. By contrast, the current literature focuses on the development of information infrastructures through growth at the periphery, mostly driven by user activity and enabled by modular and flexible designs. Our approach could explain the de-novo emergence of an information infrastructure.
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    Understanding the Complexity of Benefits Management in an Interorganizational eHealth Effort
    ( 2019-01-08) Askedal, Kirsti
    Information and communication technology (ICT) is an intervention for the future provision of healthcare services and diverse types of technologies are being implemented. However, realizing the benefits of such efforts is challenging. Moreover, collaboration among organizations has become common, which increases the complexity level and making the benefits of ICT efforts even more challenging to realize. As benefits management (BM) practices have not been designed for complex situations, a deeper contextual understanding of BM practices is required. To address this issue, a case study was conducted in a Norwegian interorganizational eHealth effort. The results provide an overview of four central concepts describing interorganizational complexity, as well as organizational and external concepts that challenge current BM practices. The case study findings highlight the need for updated BM practices and provides three novel suggestions for improving BM practices in interorganizational eHealth efforts.
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    What They Gain Depends on What They Do: An Exploratory Empirical Research on Effective Use of Mobile Healthcare Applications
    ( 2019-01-08) Yu, Yao ; Yan, Xiangda ; Zhang, Xi ; Zhou, Shuling
    Mobile healthcare application receives widespread attention, although it has advanced technology and user-friendly design, when users don’t use it effectively, it seems worthless. Research mainly focus on technology improvement. But how to improve user behavior to match the technology is another essential factor for facilitating effective use from managerial perspective. We introduced the task technology fit theory to explain the mechanism when user using the applications. We added perceived e-health literacy as moderator variable, considering the user characteristic and medical environment. The data was collected from student samples of two schools (medical and non-medical related universities), totally 178 valid samples. Our research indicates adaptation and learning behavior have significantly positive impact on the efficiency use and effectiveness use. The perceived e-health literacy only has significant moderator effect on learning behavior. Our study provides practical implications for both software providers and users to achieve effective use of mobile healthcare applications.
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    Patients’ Characteristics Effecting the Use of a MyChart Patient Portal
    ( 2019-01-08) Ahmed, Ali ; Nasralah, Tareq ; Wahbeh, Abdullah ; Noteboom, Cherie
    In this study, we have studied the effects of patients’ characteristics on the use of an online patient portal. We have created an explanatory model to illustrate the relationship between the patient-portal use and the patients’ demographic and health characteristics. The study is conducted on a large dataset of 1 million patient records, provided by a leading national healthcare provider. Our results indicate, that a unit increase in health problems increases the odds of using the patient portal by 31.1%. Moreover, a single visit to an emergency department decreases the odds of using a patient portal by 7.1%, while a visit to an urgent care center decreases the odds of portal use by 9.2%. We also found that female patients are 58% more likely to use the patient portal as compared to the male patients. The study has practical implications for health care providers, patients and portal developers.
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    Repairing the Digital Divide Can Increase the Service Divide: The Effects of Patient Portals on Kidney Allocation
    ( 2019-01-08) Kim, Yeongin ; Ayvaci, Mehmet ; Raghunathan, Srinivasan ; Tanriover, Bekir
    The severe shortage of organs combined with increasing demand for them characterizes the outcomes for the kidney allocation process. Despite the efforts to improve the allocation of kidneys, notable inefficiencies and unequal access to available organs persist across patient populations. The goal of this study is to examine (i) whether the adoption of a patient-oriented information technology (IT), namely the patient portals, can mitigate inefficiencies in the allocation of these scarce resources (kidneys) in general; (ii) whether the adoption of patient portals magnify or alleviate the disparity issues around access to transplants. Using a rich dataset of all the kidney transplant records in the U.S. from 2011 to 2014, we show that the likelihood that the patient receives deceased donor transplant at a given point in time increases in the presence of patient portals. However, the varying impact of IT across sub-populations may indicate that the efforts to bridge the digital divide may benefit some groups of patients at the expense of other groups, leading to further disparities.
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    Natural-Setting PHR Usability Evaluation using the NASA TLX to Measure Cognitive Load of Patients
    ( 2019-01-08) Pachunka, Emily ; Windle, John ; Schuetzler, Ryan ; Fruhling, Ann
    While personal health records (PHRs) carry an array of potential benefits such as increased patient engagement, poor usability remains a significant barrier to patients’ adoption of PHRs. In this mixed methods study, we evaluate the usability of one PHR feature, an intake form called the pre-visit summary, from the perspective of cognitive load using real cardiovascular patients in a natural setting. A validated measure for cognitive load, the NASA Task Load Index, was used along with retrospective interviews to identify tasks within the pre-visit summary that increased participants’ cognitive load. We found that the medications, immunizations, active health concerns, and family history pages induced a higher cognitive load because participants struggled to recall personal health information and also due to user interface design issues. This research is significant in that it uses validated measures of cognitive load to study real patients interacting with their PHR in a natural environment.