67 research outputs found
Value of Electronic Health Records since HITECH: A Literature Review
No full textValue of Electronic Health Records since HITECH: A Literature Review \ TREO Talk Paper \ Shikha S. Modi, MBA \ University of Alabama at Birmingham \ [email protected] \ Sue S. Feldman, RN, MEd, PhD \ University of Alabama at Birmingham \ [email protected] \ Abstract \ Electronic health records (EHR) have become an integral part of the modern health system as a result of government regulations, technology advancements, health care challenges, and market conditions. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 was a large-scale federal effort to increase the adoption of EHRs. The ultimate goal was to reduce healthcare costs, improve care quality and safety, and increase patient satisfaction through incentives for providers and organizations that exhibited meaningful use of a certified EHR system. Approximately $27 billion in incentives were awarded to physicians and hospitals that attested to the federally defined “meaningful use†(MU) criteria. Considering the cost and complexity of an EHR system, a positive return is expected. The goal of this study is to perform a value analysis of EHR for hospitals after HITECH Act was enacted. \ \ \ This study utilizes Atlas.ti to perform qualitative analysis for the literature review for value analysis of EHRs. First, we searched the bibliographic databases of PubMed, Scopus, and CINAHL in order to identify empirical, peer reviewed studies in the area of value analysis of EHR in the period from January 2009 to March 2018. Second, we added final 23 articles into Atlas.ti document list (Figure 1). We then performed a full text review for each article and identified recurring topics. Depending on the recurring topics, we identified 25 different codes and assigned topics to its most relevant code. The process included multiple revisions and refining of codes in order to confirm the codes reflected the purpose of the research, were exhaustive, mutually exclusive, sensitizing and conceptually congruent. Preliminary findings of our literature review suggest that value can be defined in terms of financial, clinical, and social outcomes and an integration of all three outcomes may provide a more holistic view of value of the EHR. \ References \ Adler-Milstein, J., Furukawa, M. F., King, J., and Jha, A. K. 2013. “Early results from the hospital electronic health record incentive programs,â€American Journal of Managed Care (19:7), e273-e284. \ \ Collum, T. H., Menachemi, N., and Sen, B. 2016. “Does electronic health record use improve hospital financial performance? Evidence from panel data,†Health Care Management Review, (41:3), 267-274. \ \ McAlearney, A. S., Sieck, C., Hefner, J., Robbins, J., and Huerta, T. R. 2013. “Facilitating ambulatory electronic health record system implementation: Evidence from a qualitative study,â€BioMed Research International, 2013. \ \ Redd, T. K., Read-Brown, S., Choi, D., Yackel, T. R., Tu, D. C., and Chiang, M. F. 2014. “Electronic health record impact on productivity and efficiency in an academic pediatric ophthalmology practice,†Journal of AAPOS, (18:6), 584-589.
Unruly landscapes: politics of biodiversity, energy and livelihoods in India
Get PDFGlobal concerns on climate change mitigation and reduction in emissions are influencing sustainable projects worldwide. The global discourse on sustainability is manifested locally in various forms that re-arrange human-environment relationships. Such ‘green geographies’ are inevitably rooted in territoriality and are operationalized through controlling access to natural resources. The re-working of the spatial arrangements demarcating control over access to natural resources can pose a threat to local livelihoods that depend on nature. For projects located next to areas of conservation concern, it necessitates a political process of prioritization between conservation, development and livelihoods. In this dissertation, I focus on the re-working of these green geographies.
I examine cases of local opposition against renewable power projects that are located in or around areas of prime conservation. The case sites are located in the Western Ghats and near the Great Himalayan National Park in India. I argue that these green geographies are inherently dynamic and democracy provides the context within which these landscapes are contested and re-defined. Further, I argue that the introduction of renewable energy projects in pre-territorialized landscapes reorients spatial arrangements, resulting in a re-territorialization of these geographies. Further, I position this re-territorialization as an outcome of intense political wrangling that traverses multiple scales and is influenced by the larger politics of environment and development at higher scales. This study contributes to an understanding of how low-carbon geographies are operationalized.Submission published under a 24 month embargo labeled 'Closed Access', the embargo will last until 2018-12-01The student, Shikha Lakhanpal, accepted the attached license on 2016-11-22 at 13:22.The student, Shikha Lakhanpal, submitted this Dissertation for approval on 2016-11-22 at 13:28.This Dissertation was approved for publication on 2016-11-28 at 08:53.DSpace SAF Submission Ingestion Package generated from Vireo submission #10299 on 2017-02-28 at 14:41:58Made available in DSpace on 2017-03-01T17:01:30Z (GMT). No. of bitstreams: 3
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The Impact of Social Determinants of Health on Stimulant Use Disorders in the United States
No full textElectronic Thesis or DissertationUsing a three-article format, this dissertation examines the influence of social determinants of health on stimulant use within the United States. The first article investigates the background of stimulant use while simultaneously exploring various environmental factors and interventions related to stimulant use in the United States. This represents the first comprehensive literature review to examine the relationship between social determinants of health (SDOH) and stimulant use disorders (StUD). The second article presents a concept analysis of ADHD stimulants, guided by Walker and Avant’s eight-step method, to offer a comprehensive structural approach to analyzing ADHD stimulants. Consequently, this concept analysis facilitated the development of a conceptual framework to guide treatment and interventions specifically tailored for stimulant use. The third article is a comprehensive investigation of the influence of SDOH on stimulant use in the United States, utilizing secondary data provided by the National Institutes of Health's All of Us Research Program. The findings underscore the necessity for comprehensive screening tools and interventions that address both individual and community-level factors to mitigate the risk of stimulant use in vulnerable populations
The Value of Electronic Health Records Since the Health Information Technology for Economic and Clinical Health Act: Systematic Review
No full textBACKGROUND: Electronic health records (EHRs) are the electronic records of patient health information created during ≥1 encounter in any health care setting. The Health Information Technology Act of 2009 has been a major driver of the adoption and implementation of EHRs in the United States. Given that the adoption of EHRs is a complex and expensive investment, a return on this investment is expected. OBJECTIVE: This literature review aims to focus on how the value of EHRs as an intervention is defined in relation to the elaboration of value into 2 different value outcome categories, financial and clinical outcomes, and to understand how EHRs contribute to these 2 value outcome categories. METHODS: This literature review was conducted using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The initial search of key terms, EHRs, values, financial outcomes, and clinical outcomes in 3 different databases yielded 971 articles, of which, after removing 410 (42.2%) duplicates, 561 (57.8%) were incorporated in the title and abstract screening. During the title and abstract screening phase, articles were excluded from further review phases if they met any of the following criteria: not relevant to the outcomes of interest, not relevant to EHRs, nonempirical, and non–peer reviewed. After the application of the exclusion criteria, 80 studies remained for a full-text review. After evaluating the full text of the residual 80 studies, 26 (33%) studies were excluded as they did not address the impact of EHR adoption on the outcomes of interest. Furthermore, 4 additional studies were discovered through manual reference searches and were added to the total, resulting in 58 studies for analysis. A qualitative analysis tool, ATLAS.ti. (version 8.2), was used to categorize and code the final 58 studies. RESULTS: The findings from the literature review indicated a combination of positive and negative impacts of EHRs on financial and clinical outcomes. Of the 58 studies surveyed for this review of the literature, 5 (9%) reported on the intersection of financial and clinical outcomes. To investigate this intersection further, the category “Value–Intersection of Financial and Clinical Outcomes” was generated. Approximately 80% (4/5) of these studies specified a positive association between EHR adoption and financial and clinical outcomes. CONCLUSIONS: This review of the literature reports on the individual and collective value of EHRs from a financial and clinical outcomes perspective. The collective perspective examined the intersection of financial and clinical outcomes, suggesting a reversal of the current understanding of how IT investments could generate improvements in productivity, and prompted a new question to be asked about whether an increase in productivity could potentially lead to more IT investments
Inclusion in general education: Training and support for teachers
No full textMy paper is based on my professional experience in India and the United States, as well as my academic experiences at Thompson Rivers University. This paper argues that general education teachers will feel more comfortable providing inclusion if they receive the proper training and adequate support from the administration and colleagues. It is the responsibility of teachers to ensure that students with specific needs receive quality education, in accordance with Article 24 of the United Nations Convention on the Rights of Persons with disabilities. General education teachers should consider the importance of inclusion. Current research has shown that general education teachers feel underprepared to teach inclusive classrooms. Some factors influencing hesitation among general education teachers to provide inclusion include lack of support, collaboration, and adequate resources. Pre-service programs and professional development opportunities provided by administrators must not assume that general education teachers already know about inclusion. I advocate for pre-service training and professional learning opportunities for general education teachers to make a successful inclusion program.Not peer reviewedcapstonegeneral education teachersinclusionNo Child Left Behindtrainingsupportstrategies for inclusio
Value Analysis Of Electronic Health Records
No full textThe Electronic Health Record (EHR) is defined as “a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting” (HIMSS, 2011). EHRs have become an important part of the current health system as a result of government regulations, technology advancements, health care challenges, and market conditions. EHRs are considered an expensive investment; however, the complexity of adopting and implementing EHRs also demands attention. Given the complexity of health information technology (HIT) systems and the hefty investment that is required in the adoption of EHRs, a return on investment is expected, and it is essential to analyze return on investment (ROI) from more than just the financial perspective. This study analyzes the ROI of EHR adoption investment in terms of value. For the purpose of this study, value is broken down in two measures: financial and clinical. The objective of this study was to determine how EHR adoption (levels of EHR adoption) contributes to financial (operating margins, total margins) and clinical outcomes (readmission rate, length of stay) for acute care hospitals. To do this, a fixed effects and fixed effects moderation analysis was conducted. The findings from this study provided statistically-significant evidence indicating that there is a relationship between EHR adoption and operating margins when this relationship is moderated by readmission rates
Assessing Posttraumatic Growth Following Miscarriage in Women with a Pre-Miscarriage Mental Health Condition
No full textElectronic Thesis or DissertationMiscarriage occurs in 10-20% of clinically recognized pregnancies and may leave lasting impacts on maternal mental health (MH). Mental health conditions (MHC) following miscarriage are common, with anxiety, depression, and posttraumatic stress (PTS) symptoms being the most frequently reported clinical conditions associated with this type of fetal loss. Social support plays a vital role in the MH of women following miscarriage and has been associated with higher levels of posttraumatic growth (PTG). However, less is known about how pre-miscarriage characteristics, such as sociodemographic factors and MH status, may influence the relationship between social support and PTG.This study aimed to characterize sociodemographic factors, pre-miscarriage MHCs, social support, and PTG in women following miscarriage. Additionally, it examined relationships among sociodemographic variables, pre-miscarriage MH, social support, and PTG, and analyzed the moderating effect of a pre-miscarriage MHC on the relationship between social support and PTG. Survey data from 146 women across the United States were analyzed and revealed significant correlations between social support and PTG and age and PTG. Pre-miscarriage MHC was not significantly associated with PTG, and the interaction of pre-miscarriage MHC on social support and PTG was not statistically significant, indicating no moderation effect. These findings suggest that while social support and age are important predictors of PTG, the presence of a pre-miscarriage MHC does not alter the relationship between social support and PTG. Implications include the importance of fostering social support after miscarriage regardless of prior MH history
"Merits and Demerits of different technologies of defluoridation for drinking water"
No full textANALYSIS OF DIFFERENT ENCRYPTION STANDARDS ON GSM NETWORK Author
No full textGSM (Global System for Mobile Communications, originally Groupe Spécial Mobile), is a standard set developed by the European Telecommunications Standards Institute (ETSI) to describe protocols for second generation (2G) digital cellular networks used by mobile phones. It became the de facto global standard for mobile communications with over 80% market share.It IJSER is a digital mobile telephony system that is widely used in Europe and other parts of the world. GSM is a cellular network, which means that cell phones connect to it by searching for cells in the immediate vicinity. There are five different cell sizes in a GSM network—macro, micro, pico, femto, and umbrella cells. The coverage area of each cell varies according to the implementation environment. GSM was designed with a moderate level of service security. The system was designed to authenticate the subscriber using a preshared key and challenge-response. Communications between the subscriber and the base station can be encrypted. The development of UMTS introduces an optional Universa
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