Browsing by Subject "health information technology"

Filter results by typing the first few letters
Now showing 1 - 2 of 2
  • Thumbnail Image
    ItemOpen Access
    Health Information Technology: Meaningful Use and Next Steps to Improving Electronic Facilitation of Medication Adherence.
    (JMIR medical informatics, 2016-03) Bosworth, Hayden B; Zullig, Leah L; Mendys, Phil; Ho, Michael; Trygstad, Troy; Granger, Christopher; Oakes, Megan M; Granger, Bradi B

    Background

    The use of health information technology (HIT) may improve medication adherence, but challenges for implementation remain.

    Objective

    The aim of this paper is to review the current state of HIT as it relates to medication adherence programs, acknowledge the potential barriers in light of current legislation, and provide recommendations to improve ongoing medication adherence strategies through the use of HIT.

    Methods

    We describe four potential HIT barriers that may impact interoperability and subsequent medication adherence. Legislation in the United States has incentivized the use of HIT to facilitate and enhance medication adherence. The Health Information Technology for Economic and Clinical Health (HITECH) was recently adopted and establishes federal standards for the so-called "meaningful use" of certified electronic health record (EHR) technology that can directly impact medication adherence.

    Results

    The four persistent HIT barriers to medication adherence include (1) underdevelopment of data reciprocity across clinical, community, and home settings, limiting the capture of data necessary for clinical care; (2) inconsistent data definitions and lack of harmonization of patient-focused data standards, making existing data difficult to use for patient-centered outcomes research; (3) inability to effectively use the national drug code information from the various electronic health record and claims datasets for adherence purposes; and (4) lack of data capture for medication management interventions, such as medication management therapy (MTM) in the EHR. Potential recommendations to address these issues are discussed.

    Conclusion

    To make meaningful, high quality data accessible, and subsequently improve medication adherence, these challenges will need to be addressed to fully reach the potential of HIT in impacting one of our largest public health issues.
  • Thumbnail Image
    ItemOpen Access
    Making Sense of Health Information Technology
    (2012) Kitzmiller, Rebecca Rutherford

    Background: Hospital adoption of health information technology (HIT) systems is promoted as essential to decreasing medical error and their associated 44,000 annual deaths and $17 billion in healthcare costs (Institute of Medicine, 2001; Kohn, Corrigan, & Donaldson, 1999). Leading national healthcare groups, such as the Institute of Medicine, Agency for Healthcare Research and Quality, Institute for Healthcare Improvement, and the Leap Frog Group continue to advocate for increased use of HIT (AHRQ, 2010; Beidler, 2010; Institute of Medicine, 2001; Page, 2003; The Leapfrog Group, 2009), such as provider order entry and electronic health record systems, as a way to improve healthcare quality in hospitals. Even under intense pressure to adopt HIT, however, a mere 2% of US hospitals report having a comprehensive electronic health record system. Further, more than 50% of US hospitals have only rudimentary HIT systems (Jha et al., 2009). With the ARRA HITECH Act of 2009, the pressure on hospitals to quickly adopt HIT and achieve meaningful use is mounting.

    While a large body of literature exists about HIT implementation, the majority is anecdotal case reports. The remaining studies investigated attitudes about HIT or the impact of HIT on patient care processes and outcomes. Thus, best strategies for implementing HIT in hospitals remain unknown. Study design choices, such as the use of self report data, retrospective data collection methods, subjects from single care units or single healthcare professions further limit our understanding HIT implementation in complex hospital care settings.

    Methods: This prospective, longitutdinal case study used a novel approach, sensemaking, to understanding how project teams may work to implement HIT in an academic medical center. Sensemaking, defined as the social process of establishing the meaning of events and experiences (Weick, 1995), is associated with learning and problemsolving in research studies of healthcare and nonhealthcare settings. Through direct observation and document review I observed project team social interaction and activities over the course of the 18 month preimplementation phase of an HIT implementation project in a single tertiary care hopsital.

    Conclusions: In this study, I described team actions and activities that enhanced clinician team member sensemaking including: frequent, collective interaction with HIT and focusing team members' attention on specific aspects of HIT function. Further, study findings demonstrated that team members' perceptions of HIT and care processes varied across healthcare professions, management levels, and departments. Supportive social interaction from team leaders and members encouraged team member participation and resulted in members' voicing observations, perceptions and attitudes about the HIT and hospital care processes. Sensemaking of HIT teams not only resulted in identification of needed HIT design changes, but also revealed assumptions and information which may prove critical to successful HIT implementation in hospital care environments. Based on study findings, I suggested strategies for selecting and preparing HIT team members as well as for HIT team activities. This study advanced our understanding of how project teams function and bring about change in complex hospital care environments by not only identifying HIT implementation issues within but also describing the link between team member social interaction and implementation actions.