In accordance with the People's Republic of China's (China) National Health Reform Plan 2009, two nation's leading hospitals, located in Beijing, have implemented electronic medical record (EMR) systems from different vendors.To inform future EMR adoption and policy China, as well informatics research US, this study compared United State's Hospital Meaningful Use (MU) Objectives (phase 1) objectives to functionality early hospital adopters China.At both researchers observed a physician using...

Summary Background: Homecare is an important and effective way of managing chronic illnesses using skilled nursing care in the home. Unlike hospitals ambulatory settings, clinicians visit patients at home different times, independent each other. Twenty-nine percent 10,000 homecare agencies United States have adopted point-of-care EHRs. Yet, relatively little known about growing use Objective: Researchers compared workflow, financial billing, patient outcomes before after implementation to...

Electronic health records (EHRs), intended to improve the clinical process, are understudied in home care. The researchers assessed clinician satisfaction, informed by workflow and patient outcomes, identify EHR adoption challenges. mixed methods study setting was a Philadelphia agency with 137 clinicians. Adoption challenges included: (a) hardware problems coupled lack of field support; (b) inadequate training; (c) mismatch usability/functionality resulting decreased efficiency....

A new survey instrument was developed and validated to measure clinician (nurse) satisfaction with electronic health record impact on clinical process. The Health Information Technology Reference-Based Evaluation Framework guided the selection of evaluation dimensions for survey. Survey questions were gathered from existing information technology surveys that reflected individual concepts, such as efficiency or benefits. Decisions about data-gathering methods (e.g., item selection) made...

Background/Purpose: Adolescents from urban, socioeconomically disadvantaged communities of color encounter high rates adverse childhood experiences. To address the resulting multidimensional problems, we developed an innovative approach, Experiential Participatory and Interactive Knowledge Elicitation (EPIKE), using remote experiential needs elicitation methods to generate design content requirements for a mobile health (mHealth) psychoeducational intervention. Methods: At community-based...

Home care nurses have multiple goals at the patient admission visit. Electronic health records support some of these goals, including high-quality documentation, but may not complete electronic documentation point care. To characterize nurses' practices and lay foundation for design recommendations, this study investigates strategies with respect to entering data how nursing affect them. We conducted 10 observations home agency admissions five in rural Pennsylvania. collected screenshots...

Abstract Objective Patient transitions into home health care (HHC) often occur without the transfer of information needed for critical clinical decisions and plan care. Owing to a lack universally implemented standards, there is wide variation in transfer. We sought characterize missing at HHC admission. Materials Methods conducted mixed methods study with 3 diverse agencies. Focus groups nurses each agency identified what supports patient Thirty-six in-home admissions associated...

This multimethod study measured the impact of an electronic health record (EHR) on clinician satisfaction with clinical process. Subjects were 39 clinicians at a Program All-inclusive Care for Elders (PACE) site in Philadelphia utilizing EHR. Methods included evidence-based evaluation framework, Health Information Technology Research-Based Evaluation Framework, which guided assessment surveys, observations, follow-up interviews, and actual EHR use two points time. Mixed-methods analysis...

We assessed the Health Information Technology (HIT) Reference-based Evaluation Framework (HITREF) comprehensiveness in two HIT evaluations settings different from that which HITREF was developed. Clinician satisfaction themes emerged clinician interviews home care and hospital studies were compared to framework components. Across both studies, respondents commented on 12 of 20 components within 5 6 concepts. No new missing providing evidence is a comprehensive framework. use range by...

The re-hospitalization rate of homecare patients within 60 days hospital discharge is 30%. Enhanced care planning based on better information may reduce this rate. However, very little known about the admission and processes. research team collected data during observations three nursing visits to admit in Camden NJ, conducted thematic content analysis these data. Human factors methods helped identify nurse decision-making related selection plan problems, non-nursing resources, visit...

Background Homecare settings across the United States provide care to more than 5 million patients every year. About one in five homecare are rehospitalized during episode, with up two-thirds of these rehospitalizations occurring within first 2 weeks services. Timely allocation services might prevent a significant portion rehospitalizations. The nursing visit is most critical steps episode. This includes an assessment patient’s capacity for self-care, medication reconciliation, examination...

Effective communication between clinicians across care settings is fundamental for continuity of and decreased risk errors. The home admission often starts without important information needed formulation the plan care. We conducted a mixed methods analysis to investigate from two perspectives: qualitative regarding nurses reported they during an admission, quantitative actually available. mapped both data sets international specification transitions in information, Continuity Care Document...

Home health care (HHC) agencies face numerous challenges as they for sicker patients due to shortened hospital stays and the discharge of before are able themselves.[1] The rehospitalization penalties,[1] [2] episodes payment reform via Patient-Driven Groupings Model,[3] other pressures regarding quality efficiency.[4] More recently, increased financial reduced admissions, patient refusal services, costs personal protective equipment COVID-19 pandemic.[5] [6]

Delayed start-of-care nursing visits in home health care (HHC) can result negative outcomes, such as hospitalization. No previous studies have investigated why HHC are delayed, part because most reasons for delayed documented free-text notes.The aims of this study were to (1) develop and test a natural language processing (NLP) algorithm that automatically identifies clinical notes (2) describe large patient sample.This was conducted at the Visiting Nurse Service New York (VNSNY). We...

With the increasing adoption of interactive systems in healthcare, there is a need to ensure that benefits such are formally evaluated. Traditionally quantitative research approaches have been used gather evidence on measurable outcomes health technology. Qualitative also analyze how or why particular interventions did not work specific healthcare contexts. Mixed methods provides framework for carrying out both and qualitative within single study. In this paper an international group four...