Using the Electronic Health Record Data in Real Time and Predictive Analytics to Prevent Hospital-Acquired Postoperative/Surgical Site Infections.

Of critical concern to hospitals today is the prevention of postoperative (surgical site) infections that often result in increased lengths of stays for patients, increased resource demands and costs, loss of public trust and lawsuits, and needless pain and suffering for patients and their families. While all surgical patients have the potential to develop a postoperative infection, the main challenge is to identify key risk factors (both patient centered and operational) through an electronic early-warning system to reduce the likelihood of a postoperative infection from occurring. Currently, most postoperative infection risk prevention practices encompass limited use of informatics technologies or do not maximize the potential benefits. In addition, from a research perspective, there has been more focus on extrapolating electronically housed data (eg, from progress notes, operative notes, laboratory, pharmacy, radiology) retrospectively to describe poor patient outcomes for benchmarking purposes (revealing poor results and opportunities for improvement) rather than using similar sources of real-time data to prevent poor patient outcomes from occurring. This article proposes that standardized indicators, both patient centered and operational, linked to the patient's electronic health record could allow for implementation of 24/7, "real-time" monitoring/surveillance to implement well-timed preventive interventions scaled to each patient and facility to assist caregivers in reducing the numbers of postoperative infections and improve the overall quality and costs of patient care.

Use of electronic health record documentation by healthcare workers in an acute care hospital system.

Acute care clinicians spend significant time documenting patient care information in electronic health records (EHRs). The documentation is required for many reasons, the most important being to ensure continuity of care. This study examined what information is used by clinicians, how this information is used for patient care, and the amount of time clinicians perceive they review and document information in the EHR. A survey administered at a large, multisite healthcare system was used to gather this information. Findings show that diagnostic results and physician documents are viewed more often than documentation by nurses and ancillary caregivers. Most clinicians use the information in the EHR to understand the patient's overall condition, make clinical decisions, and communicate with other caregivers. The majority of respondents reported they spend 1 to 2 hours per day reviewing information and 2 to 4 hours documenting in the EHR. Bedside nurses spend 4 hours per day documenting, with much of this time spent completing detailed forms seldom viewed by others. Various flow sheets and forms within the EHR are rarely viewed. Organizations should provide ongoing education and awareness training for hospital clinical staff on available forms and best practices for effective and efficient documentation. New forms and input fields should be added sparingly and in collaboration with informatics staff and clinical team members to determine the most useful information when developing documentation systems.

Readability and Suitability of Information Presented on a University Health Center Website.

This study evaluated the readability and suitability of a university health center public website. Readability formulas estimated the reading grade and age required for comprehension of health information. The Suitability Assessment of Materials (SAM) instrument determined adequacy of the webpages for the intended audience. Readability showed the reading grade level, representing the youngest reader able to process the material, ranged from 10.1 to 14.6, averaging 12.5 (midway through 12th grade in the US educational system). Full comprehension required higher education levels, up to postgraduate. Suitability scores for some webpages indicated deficiencies in readability, motivation to learn, and instructions for healthy behavior changes. Content on the website may be difficult for some students to comprehend based on the reading grade level, but overall suitability results are satisfactory. All webpage updates should bear these parameters in mind to ensure content is fully accessible to college students, faculty, and staff.

Electronic health record implementations: applying the principles of monitoring and controlling to achieve success.

Electronic health record systems are being implemented in physicians' offices around the country at an outstanding rate. These implementations require great skill and collaboration. This article seeks to apply 2 fundamental principles of project management, monitoring and controlling, to electronic health record implementation. Issues such as project costs, project progress, schedule controls, quality management, and controlling risks are discussed.

The use of governance tools in promotion of health care information technology adoption by physicians.

Electronic health records are important technology for health care with promises of streamlining and improving care. However, physicians have been slow to adopt the technology usually because of financial constraints. Third-party payers, including Medicare and Medicaid, are coming forward with solutions and funding. While payers have the most to gain in terms of cost savings, they have been slow to provide a solution to the financial dilemmas posed by the new technology. This article details some governance tools that are frequently used to alleviate the financial concerns. Grants, loans, and tax expenditures are some of the options available to physicians to purchase electronic health records and other types of health care information technology.

Impact of Health Literacy on Senior Citizen Engagement in Health Care IT Usage.

Objective: Patient engagement in health care information technology (IT) is required for government reimbursement programs. This research surveyed one older adult group to determine their willingness to use health information from a variety of sources. Health literacy was also measured using the Newest Vital Sign (NVS) and eHealth Literacy Scale (eHEALS) tools. Method: Regression models determined engagement in health care IT usage and impact of literacy levels based on survey data collected from the group. Results: Although most participants have adequate literacy, they are not more likely to use health care IT than those with limited literacy scores. Knowledge of how to use the Internet to answer questions about health was statistically associated with IT usage. Discussion: Health care IT usage is important for healthy aging. The ability of older adults to understand information provided to them can impact population health including medication usage and other important factors.

The impact of health literacy on a patient's decision to adopt a personal health record.

Health literacy is a concept that describes a patient's ability to understand materials provided by physicians or other providers. Several factors, including education level, income, and age, can influence health literacy. Research conducted at one medical practice in Florida indicated that in spite of the patients' relatively low education level, the majority indicated a broad acceptance of personal health record (PHR) technology. The key variable explaining patient willingness to adopt a PHR was the patient's health literacy as measured by the eHealth Literacy Scale (eHEALS). Adoption and use rates may also depend on the availability of office staff for hands-on training as well as assistance with interpretation of medical information. It is hoped that technology barriers will disappear over time, and usefulness of the information will promote increased utilization of PHRs. Patient understanding of the information remains a challenge that must be overcome to realize the full potential of PHRs.

Information sharing among health care employers: using technology to create an advantageous culture of sharing.

PURPOSE: This paper uses the theory of interagency information sharing as a lens to determine the benefits, risks, and past experiences of those involved in information sharing. DESIGN/METHODOLOGY/APPROACH: The authors analyze the current existent literature related to sharing of information between health care employers. A theory that could be useful in the creation of a policy and management framework that would facilitate information sharing is also thoroughly explored. Commentary and analysis result in strategies for health care employers to utilize when facing the challenging issues involved with hiring employees. FINDINGS: The paper details how human resource professionals can utilize technology and existing theory to properly implement information sharing techniques into their organization. ORIGINALITY/VALUE: The information technology changes that are taking place within health care organizations and systems across the country create the opportunity for these organizations and systems to proactively implement strategies that will positively affect organizational performance. By investing in information sharing techniques while utilizing the theories outlined in this paper, organizations and systems may avoid many of the issues associated with hiring problem employees.

Privacy policy analysis for health information networks and regional health information organizations.

Regional Health Information Organizations (RHIOs) are forming in response to President George W. Bush's 2004 mandate that medical information be made available electronically to facilitate continuity of care. Privacy concerns are a deterrent to widespread acceptance of RHIOs. The Health Information Portability and Accountability Act of 1996 provides some guidelines for privacy protection. However, most states have stricter guidelines, causing difficulty when RHIOs form across these jurisdictions. This article compares several RHIOs including their privacy policies where available. In addition, studies were reviewed considering privacy concerns of people in the United States and elsewhere. Surveys reveal that Americans are concerned about the privacy of their personal health information and ultimately feel it is the role of the government to provide protection. The purpose of this article is to look at the privacy issues and recommend a policy that may help to resolve some of the concerns of both providers and patients. Policy research and action are needed to move the National Health Information Network toward reality. Efforts to provide consistency in privacy laws are a necessary early step to facilitate the construction and maintenance of RHIOs and the National Health Information Network.