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  Subjects -> HEALTH AND SAFETY (Total: 1288 journals)
    - CIVIL DEFENSE (18 journals)
    - DRUG ABUSE AND ALCOHOLISM (86 journals)
    - HEALTH AND SAFETY (520 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (377 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (105 journals)
    - PHYSICAL FITNESS AND HYGIENE (101 journals)
    - WOMEN'S HEALTH (81 journals)

HEALTH AND SAFETY (520 journals)                  1 2 3 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access  
A Life in the Day     Hybrid Journal   (Followers: 9)
Acta Informatica Medica     Open Access   (Followers: 1)
Acta Scientiarum. Health Sciences     Open Access  
Adultspan Journal     Hybrid Journal  
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10)
Advances in Public Health     Open Access   (Followers: 22)
African Health Sciences     Open Access   (Followers: 2)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 6)
African Journal of Health Professions Education     Open Access   (Followers: 5)
Afrimedic Journal     Open Access   (Followers: 2)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 3)
AJOB Primary Research     Partially Free   (Followers: 3)
American Journal of Family Therapy     Hybrid Journal   (Followers: 11)
American Journal of Health Economics     Full-text available via subscription   (Followers: 12)
American Journal of Health Education     Hybrid Journal   (Followers: 28)
American Journal of Health Promotion     Hybrid Journal   (Followers: 23)
American Journal of Health Studies     Full-text available via subscription   (Followers: 10)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 21)
American Journal of Public Health     Full-text available via subscription   (Followers: 188)
American Journal of Public Health Research     Open Access   (Followers: 28)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 2)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 2)
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Global Health     Open Access   (Followers: 9)
Annals of Health Law     Open Access   (Followers: 3)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 15)
Applied Biosafety     Hybrid Journal  
Applied Research In Health And Social Sciences : Interface And Interaction     Open Access   (Followers: 1)
Archives of Medicine and Health Sciences     Open Access   (Followers: 3)
Arquivos de Ciências da Saúde     Open Access  
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 8)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 2)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 8)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 3)
Association of Schools of Allied Health Professions     Full-text available via subscription   (Followers: 6)
Atención Primaria     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 2)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 6)
Autism & Developmental Language Impairments     Open Access   (Followers: 4)
Behavioral Healthcare     Full-text available via subscription   (Followers: 6)
Best Practices in Mental Health     Full-text available via subscription   (Followers: 7)
Bijzijn     Hybrid Journal   (Followers: 2)
Bijzijn XL     Hybrid Journal   (Followers: 1)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 8)
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 5)
BMC Pregnancy and Childbirth     Open Access   (Followers: 18)
BMJ Simulation & Technology Enhanced Learning     Full-text available via subscription   (Followers: 7)
Brazilian Journal of Medicine and Human Health     Open Access  
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 16)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Canadian Family Physician     Partially Free   (Followers: 12)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 11)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 1)
Canadian Journal of Public Health     Full-text available via subscription   (Followers: 19)
Case Reports in Women's Health     Open Access   (Followers: 3)
Case Studies in Fire Safety     Open Access   (Followers: 12)
Central Asian Journal of Global Health     Open Access   (Followers: 2)
Central European Journal of Public Health     Full-text available via subscription   (Followers: 4)
CES Medicina     Open Access  
Child Abuse Research in South Africa     Full-text available via subscription   (Followers: 1)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 11)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access  
Christian Journal for Global Health     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia y Cuidado     Open Access  
Ciencia, Tecnología y Salud     Open Access  
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 2)
CME     Hybrid Journal   (Followers: 1)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 2)
Conflict and Health     Open Access   (Followers: 8)
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 1)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Digital Health     Open Access  
Dramatherapy     Hybrid Journal   (Followers: 2)
Drogues, santé et société     Full-text available via subscription  
Duazary     Open Access   (Followers: 1)
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 13)
East African Journal of Public Health     Full-text available via subscription   (Followers: 3)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 16)
EcoHealth     Hybrid Journal   (Followers: 3)
Education for Health     Open Access   (Followers: 5)
electronic Journal of Health Informatics     Open Access   (Followers: 4)
ElectronicHealthcare     Full-text available via subscription   (Followers: 3)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 5)
Emergency Services SA     Full-text available via subscription   (Followers: 2)
Ensaios e Ciência: Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access  
Environmental Sciences Europe     Open Access   (Followers: 1)
Epidemics     Open Access   (Followers: 4)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 4)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 19)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 1)
Ethiopian Journal of Health Development     Open Access   (Followers: 8)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 7)
Ethnicity & Health     Hybrid Journal   (Followers: 13)
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 2)
European Medical, Health and Pharmaceutical Journal     Open Access  
Evaluation & the Health Professions     Hybrid Journal   (Followers: 9)
Evidence-based Medicine & Public Health     Open Access   (Followers: 5)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Expressa Extensão     Open Access  
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 8)
Family & Community Health     Partially Free   (Followers: 12)
Family Medicine and Community Health     Open Access   (Followers: 5)
Family Relations     Partially Free   (Followers: 11)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 1)
Food and Public Health     Open Access   (Followers: 11)
Frontiers in Public Health     Open Access   (Followers: 7)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access  
Geospatial Health     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 11)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Health : Science and Practice     Open Access   (Followers: 5)
Global Health Promotion     Hybrid Journal   (Followers: 16)
Global Journal of Health Science     Open Access   (Followers: 9)
Global Journal of Public Health     Open Access   (Followers: 12)
Global Medical & Health Communication     Open Access   (Followers: 1)
Globalization and Health     Open Access   (Followers: 5)
Hacia la Promoción de la Salud     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 3)
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 15)
Health & Justice     Open Access   (Followers: 5)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 7)
Health and Human Rights     Free   (Followers: 8)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 7)
Health and Social Work     Hybrid Journal   (Followers: 48)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 1)
Health Care Analysis     Hybrid Journal   (Followers: 14)
Health Inform     Full-text available via subscription  
Health Information Management Journal     Hybrid Journal   (Followers: 12)
Health Issues     Full-text available via subscription   (Followers: 2)
Health Policy     Hybrid Journal   (Followers: 35)
Health Policy and Technology     Hybrid Journal   (Followers: 1)
Health Professional Student Journal     Open Access   (Followers: 1)
Health Promotion International     Hybrid Journal   (Followers: 21)
Health Promotion Journal of Australia : Official Journal of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 10)
Health Promotion Practice     Hybrid Journal   (Followers: 15)
Health Prospect     Open Access   (Followers: 1)
Health Psychology     Full-text available via subscription   (Followers: 46)
Health Psychology Research     Open Access   (Followers: 18)
Health Psychology Review     Hybrid Journal   (Followers: 39)
Health Renaissance     Open Access  
Health Research Policy and Systems     Open Access   (Followers: 10)
Health SA Gesondheid     Open Access   (Followers: 2)
Health Science Reports     Open Access  
Health Sciences and Disease     Open Access   (Followers: 2)
Health Services Insights     Open Access   (Followers: 2)
Health Systems     Hybrid Journal   (Followers: 2)
Health Voices     Full-text available via subscription  
Health, Culture and Society     Open Access   (Followers: 11)
Health, Risk & Society     Hybrid Journal   (Followers: 11)
Healthcare     Open Access   (Followers: 1)
Healthcare in Low-resource Settings     Open Access   (Followers: 1)
Healthcare Quarterly     Full-text available via subscription   (Followers: 8)
HERD : Health Environments Research & Design Journal     Full-text available via subscription  
Highland Medical Research Journal     Full-text available via subscription  
Hispanic Health Care International     Full-text available via subscription  
HIV & AIDS Review     Full-text available via subscription   (Followers: 10)
Home Health Care Services Quarterly     Hybrid Journal   (Followers: 5)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 2)
Hospitals & Health Networks     Free   (Followers: 4)
IEEE Journal of Translational Engineering in Health and Medicine     Open Access   (Followers: 3)
IMTU Medical Journal     Full-text available via subscription  
Indian Journal of Health Sciences     Open Access   (Followers: 2)
Indonesian Journal for Health Sciences     Open Access   (Followers: 1)
Inmanencia. Revista del Hospital Interzonal General de Agudos (HIGA) Eva Perón     Open Access  
Innovative Journal of Medical and Health Sciences     Open Access  
Institute for Security Studies Papers     Full-text available via subscription   (Followers: 6)
interactive Journal of Medical Research     Open Access  
International Health     Hybrid Journal   (Followers: 5)
International Journal for Equity in Health     Open Access   (Followers: 7)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 33)
International Journal of Applied Behavioral Sciences     Open Access   (Followers: 2)
International Journal of Behavioural and Healthcare Research     Hybrid Journal   (Followers: 7)
International Journal of Circumpolar Health     Open Access   (Followers: 1)
International Journal of Community Medicine and Public Health     Open Access   (Followers: 5)
International Journal of E-Health and Medical Communications     Full-text available via subscription   (Followers: 2)
International Journal of Environmental Research and Public Health     Open Access   (Followers: 20)
International Journal of Evidence-Based Healthcare     Hybrid Journal   (Followers: 8)
International Journal of Food Safety, Nutrition and Public Health     Hybrid Journal   (Followers: 16)
International Journal of Health & Allied Sciences     Open Access   (Followers: 3)
International Journal of Health Care Quality Assurance     Hybrid Journal   (Followers: 9)
International Journal of Health Geographics     Open Access   (Followers: 6)
International Journal of Health Policy and Management     Open Access   (Followers: 3)
International Journal of Health Professions     Open Access   (Followers: 2)
International Journal of Health Promotion and Education     Hybrid Journal   (Followers: 13)

        1 2 3 | Last

Journal Cover ElectronicHealthcare
  [3 followers]  Follow
    
   Full-text available via subscription Subscription journal
   ISSN (Print) 1701-8439
   Published by Longwoods Publishing Homepage  [7 journals]
  • Barriers and Facilitators to Family Planning Access in Canada
    • Abstract: [This article was originally published in Healthcare Policy, 10(3)]Background: Contraceptives are underutilized in Canada, and nearly one in three Canadian women will have an abortion in her lifetime. To help delineate a national family planning research agenda, the authors interviewed healthcare providers and organizational stakeholders to explore their perspective on barriers to contraception across regions of Canada.Methods: Semi-structured interviews were conducted based on validated frameworks for assessing family planning access and quality. The authors purposefully selected 14 key stakeholders from government agencies, professional organizations and non-governmental organizations for in-person interviews. Fifty-eight healthcare providers and representatives of stakeholder organizations in reproductive health who self-selected through an online survey were also interviewed. Transcripts were analyzed for repeated and saturated themes.Results: Cost was the most important barrier to contraception. Sexual health education was reported as inconsistent, even within provinces. Regional differences were highlighted, including limited access to family physicians in rural Canada and throughout Quebec. Physician bias and outdated practices were cited as significant barriers to quality. New immigrants, youth, young adults and women in small rural, Northern and Aboriginal communities were all identified as particularly vulnerable. Informants identified multiple opportunities for health policy and system restructuring, including subsidized contraception, and enhancing public and healthcare provider education. Sexual health clinics were viewed as a highly successful model. Task-sharing and expanded scope of practice of nurses, nurse practitioners and pharmacists, alongside telephone and virtual healthcare consultations, were suggested to create multiple points of entry into the system.Conclusion: Results underscore the need for a national strategic approach to family planning health policy and health services delivery in Canada.
      PubDate: Mon, 28 Aug 2017 04:00:00 +000
       
  • In Conversation with Marilyn Emery
    • Abstract: In Conversation with Marilyn Emery
      PubDate: Mon, 28 Aug 2017 04:00:00 +000
       
  • The World’s First Virtual Cello Lesson – Perhaps with a Few
           Lessons for Healthcare
    • Abstract:  
      PubDate: Mon, 28 Aug 2017 04:00:00 +000
       
  • Improving Outcomes through Transformational Health and Social Care
           Integration – The Scottish Experience
    • Abstract: [This article was originally published in Healthcare Quarterly, 19(2)]The Scottish Parliament recently passed legislation on integrating healthcare and social care to improve the quality and outcomes of care and support for people with multiple and complex needs across Scotland. This ambitious legislation provides a national framework to accelerate progress in person-centred and integrated care and support for the growing number of people who have multiple physical and mental health conditions and complex needs. Additional investment and improvement capacity is helping to commission support and services that are designed and delivered with people in local communities and in partnership with housing, community, voluntary and independent sectors.
      PubDate: Wed, 07 Jun 2017 04:00:00 +000
       
  • A Better Prescription: Advice for a National Strategy on Pharmaceutical
           Policy in Canada
    • Abstract: [This article was originally published in Healthcare Policy, 12(1)]Canada needs a national strategy to fulfill its obligation to ensure universal access to necessary healthcare, including prescription drugs. A 2004 attempt at a national strategy for pharmaceutical policy failed because it lacked clear vision, logical planning and commitment from federal and provincial governments. The result of uncoordinated pharmaceutical policies in Canada has been more than a decade of poor system performance. In this essay, we present a framework for a renewed national strategy for pharmaceutical policy. Building on published research and international frameworks, we propose that pharmaceutical policies of federal, provincial, and territorial governments be coordinated around a core health-focused goal. We strongly suggest policy actions be taken on four core objectives that are necessary to support the overarching health goal. If implemented, the proposed strategy would offer clear benefits to all Canadians who use medicines, federal and provincial governments and to the economy as a whole. We therefore argue that political leadership is now needed to articulate and implement such a plan on behalf of Canadians.
      PubDate: Wed, 07 Jun 2017 04:00:00 +000
       
  • The Association between Health Information Technology Adoption and Family
           Physicians’ Practice Patterns in Canada: Evidence from 2007 and 2010
           National Physician Surveys
    • Abstract: [This article was originally published in Healthcare Policy, 9(1)]Objective: To describe the association between health information technology (HIT) adoption and family physicians' patient visit length in Canada after controlling for physician and practice characteristics.Method: HIT adoption is defined in terms of four types of HIT usage: no HIT use (NO), basic HIT use without electronic medical record system (HIT), basic HIT use with electronic medical record (EMR) and advanced HIT use (EMR + HIT). The outcome variable is the average time spent on a patient visit (visit length). The data for this study came from the 2007 and 2010 National Physician Surveys. A log-linear model was used to analyze our visit length outcome.Results: The average time worked per week was found to be in the neighbourhood of 36 hours in both 2007 and 2010, but users of EMR and EMR + HIT were undertaking fewer patient visits per week relative to NO users. Multivariable analysis showed that EMR and EMR + HIT were associated with longer average time spent per patient visit by about 7.7% (p<0.05) and 6.7% (p<0.01), respectively, compared to NO users in 2007. In 2010, EMR was not statistically significant and EMR + HIT was associated with a 4% (p<0.1) increased visit length. A variety of practice-related variables such as the mode of remuneration, work setting and interprofessional practice influenced visit length in the expected direction.Conclusion: Use of HIT is found to be associated with fewer patient visits and longer visit length among family physicians in Canada relative to NO users, but this association weakened in the multivariable analysis of 2010. 
      PubDate: Tue, 27 Aug 2013 04:00:00 +000
       
  • Enhancing Community Care for Ontarians (ECCO) – A Three Year Plan
    • Abstract: www.longwoods.com/product/download/code/23075 
      PubDate: Mon, 15 Oct 2012 04:00:00 +000
       
  • A Model for Measuring Industry-Wide Adoption and Capability of Healthcare
           Analytics and Data Warehousing in the USA
    • Abstract: A Model for Measuring Industry-Wide Adoption and Capability of Healthcare Analytics and Data Warehousing in the USA
      PubDate: Mon, 03 Sep 2012 04:00:00 +000
       
  • Assessing Primary Care Physicians' Attitudes toward Adoption of an
           Electronic Tool to Support Cancer Diagnosis: An Exploratory Study
    • Abstract: Background: The diagnostic phase of the cancer journey, from suspicion to diagnosis, is a complicated process for both patients and physicians. The Diagnostic Assessment Program-Electronic Pathway Solution (DAP-EPS) shows patients and their primary care providers where they are on the journey to cancer diagnosis. This tool is designed to provide a coordinated approach to patient care from referral to definitive diagnosis by centralizing information and allowing the tracking of patients throughout the diagnostic journey.Objective: The primary objective of this work was to explore primary care physicians' (PCPs) attitudes toward adoption of the DAP-EPS tool in their clinical setting. The secondary objective was to explore potential factors influencing perceived ease-of-use and usefulness of the tool.Methods: To guide this study, an integrated theoretical framework that combined the theories of the Technology Acceptance Model and Diffusion of Innovation was used. An online survey was used to collect data from PCPs across the province of Ontario.Results: Results from this study suggest a strong influence of perceived usefulness of the DAP-EPS on physicians' attitudes toward adoption of the tool. Findings also suggest that perceived usefulness is more important than perceived ease-of-use within the PCP context.Conclusion: This exploratory study, although limited, supports previous views regarding PCPs' attitudes toward adoption of technology. The main lessons learned are that the perceived usefulness is the main predictor of PCPs' attitudes and that the management and implementation teams should emphasize the usefulness of DAP-EPS to increase adoption of the tool.
      PubDate: Mon, 03 Sep 2012 04:00:00 +000
       
  • Access to Test Results "The Number One Reason" Why Patients Use a Portal
           according to Sunnybrook MyChart™ Users
    • Abstract: In 2006, Sunnybrook Health Sciences Centre created MyChart™, a personal health record solution available to all Sunnybrook patients for viewing their personal health information online. The information in MyChart™ is extracted from Sunnybrook's electronic patient record. MyChart™ has been widely adopted by patients and physicians and had 18,873 users as of October 18, 2012.The authors of this article created a survey for patients who use MyChart™ to help verify and understand the user value, usage patterns and impact of MyChart™ on patients' care. On April 12, 2012, the 11-question online survey was e-mailed to 11,348 active patient accounts. On May 22, 2012, a total of 2,096 of those patients (18%) had responded.The survey indicates an overwhelming majority of MyChart™ patients (89%) value MyChart™ and its features. Access to test results was patients' highest priority (81%), and although a large proportion wanted immediate access, the majority were comfortable with moderate delays (up to 5 days). Respondents rated access to radiology images and reports as their second-highest priority (61.2%), followed by the feature that enables them to organize and view appointments (35.7%). Survey results also indicate most MyChart™ users identify themselves as occasional users (34.9%) who do not log on daily or weekly to MyChart™. Reasons for using MyChart™ vary from the time of last doctor's visit, degree of uncertainty, sickness, and other reasons.In terms of sharing information with others, the majority of respondents do not share access to their MyChart™ account with friends or family (59.6%) - however, a slim majority do share access with physicians, providers, or care teams (51.8%). Additionally, respondents expressed minimal interest in future development of social networking and communication features within MyChart™.The results of this survey provide a better understanding of what information patients want to access and what is valued. In the next stage of research, Sunnybrook hopes to further understand what patients do with this access and whether it has any impact on their health outcomes.
      PubDate: Mon, 03 Sep 2012 04:00:00 +000
       
  • Transforming Healthcare through Better Use of Data: A Canadian Context
    • Abstract: Rhoads and Ferrara are to be commended for their understanding of the increasing need for healthcare organizations operating in a competitive environment in the United States (US) to seize the opportunities offered by technological advances in access to data and advanced analytics. Their White Paper, "Transforming Health Care through Better Use of Data," postulates that in an increasingly competitive environment, hospitals and health systems in the US that will be able to leverage their data to improve patient care, drive innovation and improve organizational performance will generate an ongoing competitive advantage. This argument is not new and had already been put forward by Davenport for the private industry in 2006 (Davenport 2006). In addition, the authors propose that most organizations have the data they need but lack the foundational practices and capabilities to get the most out of these data assets. They propose that in order to leverage their data, organizations should assess their capacity to assess their organizational capacity in six areas: data governance; data acquisition; data sharing; data standardization; data integration; and analytics. Finally, they make the point that the next generation of data will be bigger, less structured and less easily integrated.
      PubDate: Tue, 17 Jul 2012 04:00:00 +000
       
  • Defining and Evaluating Electronic Medical Record Data Quality within the
           Canadian Context
    • Abstract: Data collected by primary care providers in electronic medical record (EMR) systems can be used to support a variety of actions including provision of day-to-day care, decision support, practice reflection, research and public health surveillance. The extent to which EMR data can be relied on to support such actions is dependent on the quality of the held data. While a body of literature describing data quality assessment techniques exists, few studies speak to the challenges of evaluating data quality in the Canadian primary care setting. In response, researchers at the University of Victoria's eHealth Observatory are refining data quality definitions and developing techniques for the evaluation of EMR data quality within the Canadian primary care context.With electronic medical record (EMR) adoption programs under way in several Canadian jurisdictions, healthcare organizations, funders and the public are starting to look for evidence that the investments are having positive impact.One measure that may be used to infer how meaningfully a given EMR system is being utilized in practice is that of data quality. Varying levels of data completeness, correctness and consistency can be indicative of the overall frequency and sophistication with which a given EMR is being used.Moreover, a data quality evaluation can be used to determine the readiness of a given practice's EMR data set for reliable use with advanced EMR features. These can include chronic disease management reporting or drug-interaction decision support; submission to research and public health surveillance programs, such as the Canadian Institute for Health Information's (CIHI) Primary Care Voluntary Reporting System or the Canadian Primary Care Sentinel Surveillance Network; and safe and meaningful interaction within distributed, interoperable care networks, such as those expected to emerge with the Canadian maturation of Infoway-modelled jurisdictional electronic health record (EHR) systems.Researchers at the University of Victoria's eHealth Observatory are currently devising EMR data quality evaluation methods and engaging in early studies to test those methods against EMR data sets of participating primary care practices. The intent of this article is to share our findings regarding methods that have been used to assess data quality in published studies, how well those methods apply in the Canadian e-health context, and a framework for how to design a context-appropriate data quality evaluation.
      PubDate: Mon, 25 Jun 2012 04:00:00 +000
       
  • An Electronic Medical Record (EMR) Implementation Framework for HIV Care
           and Treatment Facilities in Ethiopia
    • Abstract: Purpose: Implementing electronic medical record (EMR) systems is a complex process that is receiving more focus in developing countries to help understaffed and overcrowded health facilities deal with the HIV/AIDS epidemic. Despite growing evidence of EMR systems implementation in various developing countries to support acute and chronic disease management, use of these systems by clinicians for patient monitoring and management is limited in many sub-Saharan African countries.Methods: We undertook an exploratory-grounded theory study to explore clinician-perceived benefits of EMRs in antiretroviral therapy (ART) clinics at four hospitals in Ethiopia. The study was designed to understand the process, technology, social and organizational challenges associated with EMR implementation in resource-limited areas.Results: The research found the attitude of ART clinicians toward the implementation of EMR systems overwhelmingly positive. Clinician-perceived benefits associated with EMR use included improved continuity of care; timely access to a complete medical record; improved efficiency of patient care; fewer medication errors; improved patient confidentiality, integration of HIV programs and decision-support timelines; and increased overall job motivation. However, clinician-identified drawbacks to EMR implementation included productivity loss and negative impacts on interactions and relationships between clinicians and their patients.Conclusion: The study adds to existing frameworks by developing an EMR implementation framework that integrates socio–organizational–technical factors addressing the complexity of healthcare institutions in developing countries. We took a bottom-up approach to understand these contextual factors in which an EMR would be embedded in order to develop a defensible conceptual framework encompassing key organizational, technological, infrastructural and user attributes essential for successful EMR implementation in a developing country context.
      PubDate: Mon, 25 Jun 2012 04:00:00 +000
       
  • Transforming Healthcare through Better Use of Data*
    • Abstract: Hospitals and health systems have more pressures and more incentives to become data-driven. Competitive pressures, changes in rules and reimbursement and opportunities to gain incentives are all making it necessary for organizations to improve their clinical quality and efficiency. Many organizations already have large data resources but they need to develop the foundational practices and capabilities to get the most out of these assets. In this paper, we indicate three areas that can be improved through the better use of data and describe six key building blocks that need to be addressed in order to approach this opportunity.
      PubDate: Mon, 25 Jun 2012 04:00:00 +000
       
  • The Virtual Hospice: An Interview with Dr. Michael Harlos
    • Abstract: The Virtual Hospice: An Interview with Dr. Michael Harlos
      PubDate: Thu, 12 Apr 2012 04:00:00 +000
       
  • Managing e-Health Change – A Pan-Canadian Collaborative Approach
    • Abstract: Following a Clinical Adoption workshop held in November 2009, Canadian change management (CM) practitioners came together to develop a common approach for addressing gaps in e-Health CM practices. Through collaborative dialogue, the group, collectively known as the Pan-Canadian CM Network, conducted a current-state analysis and environmental scan of e-Health CM activities and methodologies. As a result, a National CM Framework was developed to promote a best practice model that supports users in their adoption of e-Health solutions. This article will review the six core framework elements required in a CM process to ensure adoption and achieved return on investment, highlighted by examples of practical Canadian applications.
      PubDate: Mon, 02 Apr 2012 04:00:00 +000
       
  • C-HOBIC: Standardized Clinical Outcomes to Support Evidence-Informed
           Nursing Care
    • Abstract: C-HOBIC: Standardized Clinical Outcomes to Support Evidence-Informed Nursing Care
      PubDate: Mon, 02 Apr 2012 04:00:00 +000
       
  • Results of a New Healthcare Confidence Index
    • Abstract: Earlier work (Blendon et al.1990) has shown that most Canadians are satisfied with their healthcare system, while most Americans are not. In the current study, conducted between February 21, 2011, and September 16, 2011, a random sample of 81,417 distinct Web users – 7,174 Canadians and 74,243 Americans – responded to the question, "How do you rate your healthcare system'" Positive confidence scores ranged from 41.3% to 66.9%, with an average of 52.0% for the United States versus 63.4% for Canada. This difference is significant at the level of state versus province and at the inter-country level (p < .0001 student's t-test). The healthcare confidence score is the sum of the proportion of respondents who answered "good" or "excellent" as compared to "okay," "poor" and "terrible." The technology used in this study can track changes of public opinion as they occur in real time and, in this way, provide actionable data for decision makers.
      PubDate: Wed, 29 Feb 2012 05:00:00 +000
       
  • Online Patient Engagement: Key Factors of Trusted Health Websites
    • Abstract: Objectives: (1) To identify some of the most trusted web pages that relate to patient engagement in their own healthcare, and (2) to identify the key themes of these trusted websites that most capture the attention of participants, thereby fostering the mutual sharing of personal and factual information.Methods: Using language strings as search terms, over 1,000 patient engagement websites in English and French were "scraped." Scoring was based on a "buzz" ranking the authors had previously developed. The top selected sites were analyzed for emergent themes, and these themes were qualitatively compared with earlier literature in the field of patient engagement.Results and conclusion: Thirty-nine English and 18 French web pages received top ranking. Participation was largely from the lay public, and most information was user-generated. Recurring themes that were central factors in these healthcare websites were shared decision making, an empathic patient–health provider relationship, humour, transparency of funding, and patient-centred care. It is concluded that these key factors are important to online patient engagement.
      PubDate: Mon, 02 Jan 2012 05:00:00 +000
       
  • The Development and Change Management Strategy of Sunnybrook Health
           Sciences Centre's MyChart™*
    • Abstract: The e-Health environment has focused primarily, to date, on enabling clinicians; patients and families, on the other hand, have not been the target of focus. Across the globe, there has been mixed success in the patient-focused e-Health marketplace – including a few high-profile failures. Sunnybrook Health Sciences Centre's personal health record (PHR) MyChart™ is a true Canadian success story in patient-focused e-Health. This paper describes the development, history and change management strategy utilized in establishing a successful patient-focused e-Health solution in a Canadian setting. Our ultimate goal is to not only share the lessons learned in developing and implementing MyChart™ but also to measure and investigate the connection between patient-focused e-Health solutions and health outcomes.
      PubDate: Mon, 02 Jan 2012 05:00:00 +000
       
  • White Paper on e-Health Adoption*
    • Abstract: White Paper on e-Health Adoption*
      PubDate: Mon, 02 Jan 2012 05:00:00 +000
       
  • Commentary on the COACH White Paper on e-Health Adoption
    • Abstract: COACH: Canada's Health Informatics Association is to be commended for putting the effort into discussing and producing their White Paper on e-Health adoption, with its particular focus on the need for a robust and consistently applied adoption model. The Organisation for Economic Co-operation (OECD) and Development would agree, for they themselves are convening a workshop in late January 2012 on "Benchmarking Adoption and Use of Information and Communication Technologies in the Health Sector." The workshop is an outgrowth of a meeting sponsored by the Spanish Ministry of Health and the European Commission and chaired by the US Office of the National Coordinator for IT, held in Barcelona in March 2010. At that meeting the participants worked on an action plan to employ common measures of IT adoption. Similar to COACH's observations, they identified four categories of indicator areas of increasing complexity, namely (1) adoption, (2) modes of use/purpose of use, (3) critical success factors, and (4) outcomes/impacts. They produced a preliminary set of 14 indicators, noting that the ability to achieve consensus would best be achieved by focusing on indicators that measured only adoption and modes of use.
      PubDate: Mon, 02 Jan 2012 05:00:00 +000
       
  • Robotic Health Assistant (Feverkit) for the Rational Management of Fevers
           among Nomads in Nigeria*
    • Abstract: The innovation described in this paper was motivated by concern that in Africa, parasite resistance to antimalarial drugs is associated with irrational drug use where health facilities are inaccessible. However, advancement in digital technology, simple diagnostic devices and smart drug packaging inspire innovative strategies. The combination of communication technology, rapid diagnostic tools, and antibiotic and antimalarial medicines can increase access to evidence-based malaria management, reduce mortality and slow the development of resistance to drugs. The author initiated development of a solar-powered device (Feverkit) programmed with user-interactive capabilities and equipped with a detachable laboratory and dispensary for community management of fevers. The operational performance of 10 units of the device was evaluated among 20 nomadic Fulani communities in northeastern Nigeria. A brief introduction to its parts and functions was sufficient for community-selected nomadic caregivers to use it competently for managing 207 fever cases in eight weeks, with a 97% (p=.000) recovery rate. The Feverkit guided the nomads to distinguish between malaria and non-malaria–induced fevers, and thus selectively treat them. Camp communities accepted the device and were willing to pay between US$33 and $334 (mean, $113; mode, $67) to keep it. Public–private sector collaboration is essential for sustaining and scaling up production of the Feverkit as a commercial health device for the management of fevers among nomads.* Originally published in Canadian Journal of Nursing Leadership: http://www.longwoods.com/content/22465
      PubDate: Mon, 02 Jan 2012 05:00:00 +000
       
  • Canadian Health Informatics Awards Gala
    • Abstract: Canadian Health Informatics Awards Gala
      PubDate: Mon, 02 Jan 2012 05:00:00 +000
       
  • Québec’s e-Health Journey – Assessing the Path Forward
    • Abstract: Québec’s e-Health Journey – Assessing the Path Forward
      PubDate: Mon, 02 Jan 2012 05:00:00 +000
       
  • CPOE and eMAR Implementation Metrics at a Community Hospital
    • Abstract: Toronto East General Hospital implemented CPOE and eMAR in 2009 for all inpatients and day surgery patients. The organization undertook quantitative and qualitative to demonstrate the impact of the investment.Results on adoption/use demonstrated a high rate of adoption. In the first two weeks, all inpatients charts were converted to electronic charts. Clinician satisfaction was higher for nursing and allied staff compared to physicians, but was overall very positive. Areas for improvement included impact on workflow and the admission process for physicians. All groups agreed that quality of care and legibility of orders improved. To support evidence-based care, the number of order-sets has increased threefold. Pharmacy medication delivery turnaround time decreased 60%; documented medication incidents decreased 21%. Wrong patient, no order and omission errors have been reduced and transcription errors, illegible writing and MAR interpretation errors have decreased significantly. This benefits analysis demonstrated a positive impact on patient safety, quality of care and medication management.
      PubDate: Mon, 23 May 2011 04:00:00 +000
       
  • Measuring EMR Adoption: A Framework and Case Study
    • Abstract: Use of electronic medical records (EMRs) is being promoted and funded across Canada. There is a need to consistently assess the use of those EMRs. This paper outlines an EMR adoption framework developed by the University of Victoria's eHealth Observatory. It assesses provider adoption of an EMR in office-based practices across ten functional categories. Assessments across practices can be compared and collated across regions and jurisdictions. A case study is presented in the paper that illustrates how the EMR adoption framework has been used over time with an office to help them assess and improve their EMR use.
      PubDate: Tue, 10 May 2011 04:00:00 +000
       
  • Automating Data Capture from the Ontario Laboratories Information System
           (OLIS) for Secondary Data Uses
    • Abstract: Provincial health data repositories enable clinical data utilization for secondary data uses. This study profiles the first use of Ontario Laboratories Information System (OLIS) data and demonstrates the value of automating tumour marker data collection to enhance cancer stage information in the Ontario Cancer Registry. The study shows that automation reduces manual data abstraction while increasing data quality, completeness and timeliness. The study reveals variability in lab data standards, a concern to healthcare researchers, planners and decision makers. Variability creates challenges in data analyses, decision making and forecasting, suggesting further standardization is needed to maximize the utility of data for secondary uses.
      PubDate: Wed, 27 Apr 2011 04:00:00 +000
       
  • Ontario’s e-Health Journey – Assessing the Path Forward –
           Part One
    • Abstract: IntroductionOn Monday, May 16, 2011, at The Canadian Club in Toronto, Greg Reed, President and CEO of eHealth Ontario, delivered “Improving Front-Line Healthcare,” a long-awaited update of eHealth Ontario’s strategy for implementing a province-wide electronic health record (EHR) (The Canadian Club of Toronto 2011). The central focus of Mr. Reed’s review was his announcement of the agency’s plan to implement three regional connecting hubs covering the entire province that will allow all participating health service providers to access and send patient healthcare data. By employing health information access layer (HIAL) technology to overlay and connect electronic healthcare solutions at the region’s healthcare service providers, the three regional hubs will be the next-to-last step in eHealth Ontario’s strategy for creating a province-wide interoperable electronic health record (iEHR) in collaboration with, and employing the existing electronic systems of, the province’s healthcare delivery organizations. Once the three regional HIAL hubs are live and operational, the last step will be to connect them through a province-wide HIAL in order to implement Ontario’s iEHR.Earlier, at the end of April, HIMSS Analytics published the first results of its 2011 acute care hospital data collection efforts in the form of Q1 Hospital Electronic Medical Record Adoption Model (EMRAM) scores for Canadian acute care facilities (Figure 1). Included were EMRAM scores for 124 Ontario acute care hospitals. As a measurement of levels of electronic clinical solutions implementation, Ontario EMRAM scores offer valuable insight into the ways Ontario’s acute care facilities are prepared to participate in an iEHR. During the development phase of regional HIAL hubs by eHealth Ontario and its collaborative partners, understanding the status of electronic clinical implementation progress at the province’s acute care facilities can provide valuable information illuminating the conditions required for successful use of HIAL hubs to connect diverse hospital health information systems, which contribute to a robust EHR for all Ontarians.What follows is the first in an ongoing series of updates on HIMSS Analytics’ EMRAM scores for acute care hospitals participating in the annual Ontario Hospital Association – HIMSS Analytics Technologies and Applications Study. Ontario’s acute care hospitals are key stakeholders in the province’s e-Health strategy of developing regional HIAL hubs that connect the clinical systems of Ontario’s healthcare service providers across the continuum of care.
      PubDate: Wed, 27 Apr 2011 04:00:00 +000
       
  • Integrating Healthcare and e-Health in the Territories: The Tasks Ahead
           for Yukon, the Northwest Territories and Nunavut
    • Abstract: IntroductionIn the government's Speech from the Throne opening the Third Session of Canada's 40th Parliament, delivered on March 3, 2010, the Right Honourable Michaëlle Jean, Governor General of Canada, asserted that the current government "established the Northern Strategy to realize the potential of Canada's North for northerners and all Canadians." Specifically, the government "will continue to give northerners a greater say over their own future and take further steps toward territorial devolution" (Government of Canada 2010).
      PubDate: Sat, 16 Apr 2011 04:00:00 +000
       
  • Rethinking Our Approach to Disease Management: Technology and Information
           Flow Considerations
    • Abstract: Health information technology has been moving away from its provider-centric origins and toward sharing timely and relevant information along the care continuum in a collaborative manner. Disease Management (DM) information solutions are receiving increased attention because of their role in connecting care teams and patients to produce better care and outcomes and a more efficient use of resources. To achieve these improvements, we need an effective and efficient way for sharing information among increasingly mobile patients and clinicians that enables DM and fundamentally changes how care is managed. This article proposes three principles to guide decision makers in choosing a health information approach that will result in improved workflow across the continuum of care. The first involves a truly integrated information platform, encompassing clinical as well as administrative data to provide a full picture of health system performance and operations, without complicating the day-to-day workflow of clinicians. The second involves tailoring the solution to the needs of an increasingly mobile clinician workforce. Clinicians need the "right" information at the right time in the right context; making all information for all patients available all the time is counterproductive for successful DM enablement. Similarly, alerts must be selected judiciously; too many leads to their being ignored. The third involves "smart" use of smartphones to optimize an increasingly mobile workflow. Embedding voice, SMS, chat tools and other social media capabilities into the clinical workflow can make the Smartphone a true mobile unified communications hub and significantly enhance the time value of information.
      PubDate: Mon, 14 Feb 2011 05:00:00 +000
       
  • Funding IVF in Quebec: Mining the Web to Assess Public Support for Policy
           Change
    • Abstract: On March 12, 2010, Quebec's Minister of Health and Social Services announced that the province would be the first jurisdiction in North America to cover the costs of in vitro fertilization (IVF) treatment. Judging by the increase in Internet discussion of the topic, Quebec's decision has heightened the public discourse on allocation of taxpayer dollars. At this time, two million Quebecers are without a regular doctor.This study measured online public opinion before and after the Minister's announcement, using "sentiment analysis." This involves mining open-access content on blogs, online commentary and message boards. No individual identifiers were captured.Software collected online opinion on IVF in Quebec and, within that topic, on funding IVF, for six months before the Minister's announcement and six months after. Pre-announcement, 676 entries on IVF in Quebec were captured; 144 of these related to funding. Post-announcement, 940 entries for IVF were captured; 215 related to funding. Positive opinion outnumbered negative in both periods, but attitudes remain similarly divided: 29% of opinion was positive both pre- and post-announcement; 13% and 11% were negative, pre- and post-, respectively.The sentiment analytics approach described here is useful as a rapid assessment for policy makers, complementing literature reviews and policy options analysis.
      PubDate: Mon, 24 Jan 2011 05:00:00 +000
       
  • From Benefits Evaluation to Clinical Adoption: Making Sense of Health
           Information System Success in Canada
    • Abstract: This article proposes a Clinical Adoption Framework for making sense of health information system (HIS) success in Canada. It extends Canada Health Infoway's Benefits Evaluation Framework with contextual factors that influence HIS adoption by clinicians, which include people, organization, implementation, and the macro environment. Our hypothesis is that successful clinical adoption of an HIS requires explicit recognition, strategies and actions that address the factors described in the framework. Validation of this framework by stakeholders and literature has thus far been favourable. Its potential application with selected evaluation approaches in specific settings, the implications and work ahead are discussed.
      PubDate: Fri, 21 Jan 2011 05:00:00 +000
       
  • The Digital Hospital: Transforming Care Delivery with e-Health Records*
    • Abstract: The Digital Hospital: Transforming Care Delivery with e-Health Records*
      PubDate: Fri, 21 Jan 2011 05:00:00 +000
       
  • Re: "Apples or BlackBerrys' Clinical Use and Evaluation of the iPhone
           Platform in a BlackBerry-Dominated Hospital Environment" by Sherman Quan
           et al., ElectronicHealthcare, Vol. 9 No. 1, 2010
    • Abstract: Re: "Apples or BlackBerrys' Clinical Use and Evaluation of the iPhone Platform in a BlackBerry-Dominated Hospital Environment" by Sherman Quan et al., ElectronicHealthcare, Vol. 9 No. 1, 2010
      PubDate: Mon, 13 Dec 2010 05:00:00 +000
       
  • An Exploratory Study to Examine the Use of SNOMED CT in a Palliative Care
           Setting
    • Abstract: This paper describes a one-year pilot implementation of SNOMED CT in a Canadian palliative care setting. There were three phases: The design phase involved the creation of a palliative SNOMED CT subset, a real-time encoding system and relevant evaluation metrics. The trial phase had clinicians use the system to create SNOMED-encoded consult letters. The evaluation phase involved clinician interviews, case analysis and system review to identify usage, issues, lessons and implications. The initial palliative SNOMED CT subset had 1,939 terms covering most palliative diagnoses and problems at referral. Six clinicians used the system for ten weeks to create 164 SNOMED-encoded consult letters, which were perceived as more legible, professional looking and shareable. When compared with 20 manually prepared consult letters, the SNOMED-encoded letters had a similar number of clinical terms but a higher degree of consistency with a smaller range of terms selected. All clinicians felt the system "was the way to go."
      PubDate: Mon, 13 Dec 2010 05:00:00 +000
       
  • Disease Management and E-health: Can a Synergistic
           Partnership–Measurement Strategy Magnify the Health and Economic
           Benefits of Each Care Model'
    • Abstract: As the future unfolds, two major issues are challenging the Canadian population: progressive aging and chronic ailing (Montague et al. 2009). The burden of managing these related challenges is complicated by an already-large investment of the national treasury in healthcare that is often perceived as returning less than optimal outcomes, at a cost that constrains investments in other areas of innovation necessary for society's advance.Optimal return on healthcare investments demands a strategy that effectively and efficiently manages health and disease, particularly for older, community-based citizens with chronic illnesses. To this end, consensus has formed around partnerships of inter-professional and non-professional providers and patients, using regular measurement and feedback of data on gaps between usual and best care, to drive improvements in both clinical and economic outcomes. In this patient-centred health and disease management model, key drivers of success are clinical measurements and their communication. However, widespread adoption is impeded by lack of flexible systems to facilitate the measures of care and cost. Adoption of electronic health/medical record systems (e-health), another care improvement strategy, is also lagging at primary care and community levels, in part because of inadequate investment and user skepticism about clinical benefit and technical flexibility. To address the limitations of these promising, but largely independently deployed, care models we propose an integrated strategy in which community- and team-based, measurement-driven disease management is enhanced by e-health measurement and communication technology. This synergistic model can accelerate the capture and visibility of practical information for all stakeholders – driving improvements in care and outcomes and cultural adoption of disease management and e-health values. In short, it offers promise of the best health for the most people at the best cost.
      PubDate: Mon, 13 Dec 2010 05:00:00 +000
       
  • Does E-health Adoption Enable Improved Health Outcomes' Encouraging
           Evidence from Ontario Hospitals*
    • Abstract: To date, Canadian healthcare provider organizations, along with provincial and federal governments, have made significant financial commitments to e-health. The US government is providing billions of dollars to support the adoption of "meaningful use" of technology applications in that country's hospitals and physician practices. Canadian public and political awareness of the potential role of information technology to improve healthcare is higher than it has ever been. The claims of e-health proponents are that the use of information technology to support clinical practice will positively impact health outcomes.
      PubDate: Mon, 13 Dec 2010 05:00:00 +000
       
  • Newfoundland and Labrador's E-health Journey: Implementing Canada's First
           Interoperable Provincial Electronic Health Record
    • Abstract: The last eight years have been promising times for Newfoundland and Labrador's (NL) e-health journey. Canada Health Infoway has identified the province as an emerging leader in developing an EHR. The province's unique personal identifier could be replicated to other jurisdictions that are developing a Client Registry.To date, NL has implemented a Client Registry, Provider Registry, and all its diagnostic imaging/picture archiving and communications systems are linked to a single provincial system. As of late 2009, the Centre realized another important milestone when it executed on years of planning and development to begin deployment of the provincial drug information system – the Pharmacy Network. In the early years of the new millennium, the province's efforts to lead Newfoundland and Labrador's healthcare stakeholders, as well as the rest of Canada, can be seen in developing a fully functional interoperable EHR (iEHR), integrating the foundational components of client and provider registries, and a DI/PACS system and a drug information system. With five of six EHR components already implemented or installation in process, and the last iEHR/labs component slated for complete installation no later than 2013, the province appears within striking distance of meeting Canada Health Infoway's deadline of 2015 for all provinces to integrate their iEHR solutions in a pan-Canadian iEHR.
      PubDate: Mon, 13 Dec 2010 05:00:00 +000
       
  • Smart Card Technology: The Cornerstone of the Application of Health
           Information Technology in Lombardy, Italy
    • Abstract: The diffusion of smart cards within the health field is common in many countries and regions throughout the world. Italy's Regione Lombardia enjoys one of the more successful applications of health information technology in Europe, and the current state of its accomplishments is examined in this article. Other European countries and regions are also using health smart card programs, and some are moving beyond using the card simply for health insurance. Programs in Andalucia, Austria, Belgium, Finland, France, Germany and Slovenia are reviewed here, too.
      PubDate: Sat, 25 Sep 2010 04:00:00 +000
       
  • Is Business Intelligence (including Analytics) Having an Impact on the
           Delivery of Care'
    • Abstract: Organizations in industries outside healthcare have been able to demonstrate the successful application of Business Intelligence (BI) and analytical tools to gain a competitive advantage. Within the healthcare industry, organizations are successfully using BI and analytical tools to support their financial and operational functions. With the adoption of electronic health records and other investments in health information technology, there is potential for these tools to transform clinical care. This paper explores the degree to which BI and Analytics are having an impact on the delivery of care and presents some thoughts on where BI could have the greatest impact in the future. It also explores some of the challenges organizations are facing in maximizing return on these investments.
      PubDate: Tue, 08 Jun 2010 04:00:00 +000
       
  • The Emerging Role of Canada's Health Professional Colleges in the
           Regulation of E-health Technologies
    • Abstract: In Canada, the majority of healthcare professionals are governed by independent, profession-specific Regulatory Colleges. These Colleges regulate the conduct and practice of physicians, nurses, pharmacists and other healthcare professionals by registering them, establishing standards of practice, administering quality assurance programs, investigating complaints and, where appropriate, taking disciplinary action.Professional Colleges are not responsible for regulating health-related technologies. However, many Colleges have recognized that certain technologies will dramatically change practice environments and have taken steps to ensure these technologies are used safely and ethically.This paper starts by providing a background on e-health technologies and an overview of their regulation in Canada. It then explores the emerging role of Professional Colleges in the regulation of e-health technologies by discussing specific examples from British Columbia, Alberta and Ontario. Strategies vary, from issuing guidelines and administering information systems to proposing regulations and bylaws. Each of these approaches shares a common objective: preserving and heightening patient safety and quality of care.New developments in these provinces suggest that Colleges will play an increasingly important role in the future, particularly in terms of governing how electronic health records (EHRs) are used.
      PubDate: Tue, 08 Jun 2010 04:00:00 +000
       
  • New Brunswick's E-health Strategy and the Evolution of Regionalization
    • Abstract: New Brunswick's E-health Strategy and the Evolution of Regionalization
      PubDate: Tue, 08 Jun 2010 04:00:00 +000
       
  • Apples or BlackBerrys' Clinical Use and Evaluation of the iPhone
           Platform in a BlackBerry-Dominated Hospital Environment
    • Abstract: The University Health Network equipped the Gastroenterology consult service with Apple iPhone devices and provided access to push e-mail, phone and Internet access to clinical content and applications. We used pre-post surveys to assess the iPhone's impact on clinical communication, and we held interviews to obtain subjective user feedback, comparing it to prior experiences with Research In Motion (RIM) BlackBerrys where possible. The iPhone's phone and e-mail capabilities improved team communication, allowing more efficient coordination of patient care. Compared with the BlackBerry, it was also the preferred personal device due to its touch screen navigation and breadth of applications available. However, users felt the BlackBerry was the more productive communication device, mainly due to its physical QWERTY keyboard. The mobile device market in healthcare continues to be competitive, and the vendor who can most effectively combine a good interface with long battery life and access to practical healthcare applications will find success.
      PubDate: Thu, 29 Apr 2010 04:00:00 +000
       
  • Why Does It Take So Long to Adopt an EMR' Part 1 of 2: A Model of the
           Effects of Socio-Technical Factors on Physician Office Productivity
    • Abstract: We sought to understand the drivers and influencers that affect the time needed to adopt a health information management system in primary care offices. The results from three independent but interrelated studies were crystallized to understand how socio-technical factors affect the adoption of physician office systems. The duration of the adoption period is affected by differences between the culture and workflow of a clinic and the workflow design of its health information management software. While customized software could make adoption seamless, the cost of such systems drives physician offices to select a commercial off-the-shelf system from a list of systems pre-qualified by the jurisdictional certification organization. Jurisdictional physician office certification programs maximize the fit between physician office and health information systems by selecting a wide range of solutions to fit different practice types.
      PubDate: Thu, 29 Apr 2010 04:00:00 +000
       
  • Electronic Health Records: Examining Information Privacy
    • Abstract: Information governance considers the principles, processes and policies for protecting personal information and personal health information. In particular, information governance frameworks draw upon legal, "best practice" and quality requirements to ensure that personal information and personal health information is kept confidential and secure at all times. This article examines the role of information governance frameworks in electronic health record (EHR) systems by discussing four key factors of information governance. The authors draw on approaches to EHR information governance across Canada and define the components of information governance that provincial agencies should consider to appropriately implement and manage EHRs.
      PubDate: Thu, 01 Apr 2010 04:00:00 +000
       
  • An Evaluation of a Patient-Centred Information Technology Tool for the
           Management of Chronic Diseases by Primary Care Interdisciplinary Teams
    • Abstract: Introduction: Chronic disease management has become a major concern for healthcare systems in industrialized countries. There is a significant care gap between the best care, based on results from clinical trials, and usual care. Most patients with multiple chronic diseases are followed in primary care. Yet there are few tools to help primary care health professionals manage the complex care these patients require and even fewer systems that systematically assess the outcomes of care of these patients. The DaVinci system proposes a comprehensive clinical and technological approach to assist primary care interdisciplinary teams (PCITs) in the management of patients with multiple chronic problems. The project aims ultimately at improving the process of care as well as patients' health outcomes, thus helping close the healthcare gap.Intervention: An IT-supported health-management system (DaVinci system) that gives timely, flexible access to many functionalities relevant to management of multiple chronic diseases by PCITs. At the heart of DaVinci lies the CASE (Convince, Action, Support and Empower) clinical approach, which builds on the work of Prochaska and DiClemente (1994) on readiness to change. The CASE classification helps prioritize and coordinate actions of individual team members to reach explicit, patient-centred, guideline-consistent treatment goals. The other components of the DaVinci system are: 1) a list of the patient's active chronic problems, that is, the "patient agenda," 2) explicit patient-centred treatment-goal setting for each of these problems, 3) the reason for the care gap when the treatment goal is not achieved, 4) checklists tailored to the problems identified in the agenda in order to better monitor and coordinate the provision of preventive and chronic care, 5) a virtual library with an evidence-based knowledge database, 6) a medication prescriber, 7) decision-support tools and calculators for cardiovascular risk, renal function and body mass index, 8) regular clinical performance feedback to the group and to professionals individually, and 9) a secure communication channel between team members.Study Design: Mixed-method design. A qualitative approach using a multiple-case study design and a quantitative approach using descriptive statistics will be used to explore how the different functionalities of the DaVinci IT-supported PCIT clinical approach affect the provision and outcomes of care. Data gathered from these different approaches will be used to corroborate, validate and complement each other.Results: The scientific data on the acceptability and integration of practice changes in primary care that will emerge from this project will contribute to the knowledge base of multimorbidity management in primary care.
      PubDate: Thu, 01 Apr 2010 04:00:00 +000
       
  • Improve Office Efficiency by Putting Your Patients to Work: Patients'
           Perspectives Regarding Online Self-service Appointment Scheduling in
           Family Practice (Part 3 of 3)
    • Abstract: This case study is the third part of a three-part study examining the impact of an online appointment scheduling system on physician office scheduling. The purpose of the study was to understand patients' experiences when booking appointments through an online appointment scheduling system. A 24-question patient survey gathered perspectives from registered adult patients who had booked by either channel from August 8, 2008, to February 28, 2009. The online scheduling system was used by 128 unique patients, while 1,831 booked by telephone. Of the respondents, 186 were aware of the system but had not booked online, 107 were not aware of the system and 105 had booked online. Patients chose to book online for convenience, control and choice. Most patients found the online system to be as easy as booking by telephone, and all who booked online said they would do so again. Chi-square tests showed a dependent relationship between a patient's likelihood of using an online scheduling system and frequency of Internet use. A dependent relationship was also found between a patient's likelihood of using an online scheduling system and computer aptitude. There was no relationship between age, gender, education level or years as a patient with the physician.
      PubDate: Thu, 01 Apr 2010 04:00:00 +000
       
  • Saskatchewan's Strategy for Moving e-Health Forward: Prepared to Implement
           Patient First Review Recommendations
    • Abstract: Saskatchewan's Strategy for Moving e-Health Forward: Prepared to Implement Patient First Review Recommendations
      PubDate: Thu, 01 Apr 2010 04:00:00 +000
       
  • Evaluating the Value and Impact of an Electronic Health Record in a
           Complex Health System
    • Abstract: NetCARE is Canada's first region-wide electronic health record (EHR) (Hospital News 2004). It is a clinical, web-based, view-only record of an individual's key health information drawn from multiple sources. NetCARE is available in both hospital and community settings and is accessed by a variety of clinical users. A systematic evaluation showed that an average of 88% of respondents agreed or strongly agreed that netCARE provided valuable lab test results, event history, diagnostic imaging and transcribed reports. Seventy-six per cent indicated that it helped provide quality patient care, and 82% felt it integrated easily into their clinical workflow. A 15-fold increase in EHR use over two and a half years was accompanied by a 56% decrease in physician use of a major legacy system (p=.004) and an average decrease of 24% in requests for paper-based records (p=.03). The average time for netCARE to decrease both legacy system use and patient-chart requests to desired levels was two years.
      PubDate: Wed, 31 Mar 2010 04:00:00 +000
       
  • Improving Communication in Acute Trauma
    • Abstract: In 2008, approximately 4,500 people in Germany died in traffic accidents and around 71,000 people were badly injured. Altogether, yearly productivity loss caused by these injuries is estimated to be around 5 billion Euros. International and national studies revealed the trauma centre level of the primary hospital as the major predictor for trauma-related mortality. In 2006, the German Society for Trauma Surgery (DGU) called its members to form regionally based networks of hospitals engaged in trauma care. In April 2008, 45 hospitals in the north-west region of Germany, two hospitals from the Netherlands, and the local emergency services founded the "TraumaNetwork NorthWest (TNNW)." The major goals of these networks are: 1) To shorten the time between accident and admission to the appropriate hospital, 2) to create effective ways of communication, and 3) to implement common pre- and in-hospital standards for trauma care. In order to improve acute trauma care, we looked for new ways of communicating from hospital to hospital, as well as from emergency services to hospitals. Local emergency services will be able to locate the site of an accident on a digital map and find the next (in terms of transport time under emergency conditions) appropriate hospital with free capacity. The emergency physician at the accident site also has an overview of the nearest trauma centres on a hand-held device and can contact them if required. Hospitals can exchange diagnostic data (e.g., CT scans) securely via a fast Internet connection and view the scans either on their own radiology workstation or on an integrated web viewer. Since the necessary software is not commercially available, a team of computer and medical specialists was commissioned for developing the software for commercial use. After the software is in place, a pre- and post-analysis will be performed to study the consequences of the new communication on transport time and injury-related mortality within the region. The project is recognized as a pilot project by the DGU and – if successful – is meant to be adapted across Germany.
      PubDate: Thu, 18 Mar 2010 04:00:00 +000
       
  • Innovation in ALC – Evaluation and Lessons Learned from a Pilot of
           Electronic Resource Matching and Referral to In-patient Rehab/CCC in an
           Acute Care Organization
    • Abstract: Introduction: One of the root causes for Emergency Department (ED) overcrowding stems from challenges with patient flow from acute to post-acute care institutions. Significant improvements to the referral process can be made by moving to an electronic Resource Matching and Referral (RM&R) system, which could be used to facilitate accessing accurate and consistent data relating to referral patterns, waitlists, response times, referral efficiencies, and gaps in programs/services.Objectives: To elicit user views, identify challenges, and measure acute care providers' performance and satisfaction of the RM&R system for Rehabilitation and Complex Continuing Care.Setting: The General Internal Medicine ward at the Toronto General Hospital (TGH), part of the University Health Network (UHN), affiliated with the University of Toronto, Toronto, Canada.Method: This study included both quantitative and qualitative assessments of the electronic RM&R process. A random effects model was used to compare the mean time taken to complete the paper and electronic forms. In total, we performed 18 paper and 21 electronic RM&R trials. An exit survey allowed participants to subjectively evaluate the two processes.In response to some of our findings on the exit survey, we also completed seven interviews with other acute care providers.Results: Our study showed that electronic RM&R forms required slightly less completion time than paper referrals. However, there was no significant difference in the time it took to fill out the forms (paper vs. electronic). In the random effects model, subjects took on average 22 seconds longer to complete the paper form than the electronic form (95% CI: −26s to 70s; p=0.35). For paper forms, the average satisfaction score for the six raters was 2.6, and for electronic forms it was 4.5 (p=0.035 by signed rank test). Our surveys and interviews, indicated clinicians' satisfaction of RM&R system in terms of time efficiency of task accomplishment, time to decision-making, and confidence in decision-making. The RM&R system was easy to use and required minimal training.Conclusions: The adoption of the RM&R system to Rehab/CCC on GIM at the UHN was characterized by high satisfaction, perceived positive benefits to patient care, and minimal technical challenges.
      PubDate: Thu, 18 Mar 2010 04:00:00 +000
       
  • Improve Office Efficiency by Putting Your Patients to Work: The Financial
           Viability of an Online Self-Service Appointment Scheduling System in
           Family Practice (Part 2 of 3)
    • Abstract: This case study is the second part of a three-part study examining the impact of an online appointment scheduling system on physician office scheduling. The purpose of this case study was to develop a method for determining the financial viability of the self-serve appointment scheduling system. Pay mechanisms for selling software were examined in other industries to offer insight into a financial model used to calculate viability. The analysis produced a financial model to help physicians determine if their practice would benefit from an online scheduling system. Viability was assessed first by ensuring the physician office is busy enough to justify the ongoing costs of system operation. The model then determined the period over which savings resulting from using the system will pay back capital costs. The model compared the costs avoided to the costs incurred in implementing the system. The main costs avoided by the system are receptionist's pay. The financial model showed that an online booking system implemented in a physician office was paid off by the 6th month—significantly sooner than many other health information technology interventions.
      PubDate: Thu, 18 Mar 2010 04:00:00 +000
       
  • The e-Network Solution for Mental Health and Addictions Information
           Management
    • Abstract: ConnexOntario Health Services Information's genesis was over 18 years ago. Back then, it was known as the Drug and Alcohol Registry of Treatment (DART). At that time, it was – and remains today – an innovative initiative that acted as an e-network solution for mental health and addiction information management. Using state-of-the-art technology and professional information management standards, DART was designed to offer a form of electronic healthcare by way of resource matching and referral for those who were seeking treatment for substance abuse problems. DART was also designed as a means to help improve the alcohol and drug treatment system in Ontario by providing easily accessible, up-to-date and accurate data about the availability of those services.This paper explores the development and growth of DART through its metamorphosis into ConnexOntario. Acting as a hub to the electronic network, the computerized database housing the Registry information provides the platform upon which information is shared amongst service providers, professionals, planners, government officials and members of the general public.
      PubDate: Thu, 18 Mar 2010 04:00:00 +000
       
  • Manitoba's e-Health Strategy: A High-tech Collaboration between Primary
           and Acute Care
    • Abstract: IntroductionSince 2007, Manitoba has been committed to a unified and comprehensive e-Health strategy that relies on information and communications technology (ICT) to enable a province-wide system of connected and effective healthcare delivery and management across the full continuum of healthcare settings. Originally, the provincial government invested $150 million (CAD) in healthcare ICT. Going forward, the province is planning for expenditures of up to $40 million annually to fund ongoing and new projects that, over time, flesh out the complete e-Health Strategy (Province of Manitoba News Release 2007). Like other provinces and territories, Manitoba is employing ICT to create a paperless and seamless unified healthcare system that connects all stakeholders and overcomes the silos of legacy healthcare information existing in a sea of paper. Manitoba's e-Health approach is distinctive in that it combines a foundation of province-wide primary care delivery through collaboration with physician offices, health centres and clinics, with a tiered approach to full service in-patient delivery at 15 of the province's 65 hospitals designated as general acute care facilities.
      PubDate: Thu, 18 Mar 2010 04:00:00 +000
       
 
 
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