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<p> Due to the wide-scale adoption by the market and consumers of healthcare goods that track fitness, sleep, nutrition, and basic metabolic parameters through ubiquitous devices or mobile apps, it is vital to understand physicians&rsquo; attitudes towards consumer healthcare devices. No study had previously examined constructs related to technology acceptance and how they impacted behavioral intention for ubiquitous devices that produce SMD. A quantitative, non-experimental study was conducted to examine SMD acceptance, intent to use, and other factors important to physicians regarding SMD from ubiquitous devices. The researcher randomized the American Medical Association (AMA) membership list and sent out 5,000 invitations to physicians for participation. The final sample included 259 subjects, which consisted of 75.2% (N=194) male and 24.8% (N=64) female participants. The results from statistical analysis of the data gathered through survey methodology showed that the UTAUT2 constructs of performance expectancy, hedonic motivation, and price value were positively associated with the behavioral intention of SMD by physicians, while effort expectancy and social influence were not. Further, social influence was associated with use, while performance expectancy, effort expectancy, and hedonistic motivation were not. Major positive implications of the findings include contribution to the body of literature in the IT-healthcare arena regarding factors the influence technology acceptance and potential increase in the adoption of SMD among patients. Limitations of the study and recommendations for future research are discussed.</p>

<p> <b>Background:</b> Obesity has recently been classified by the American Medical Association (AMA) as a disease which, if unrecognized and unaddressed in childhood, causes multiple medical and psychological complications that can impact both personal and population health. Unprecedented funding is being invested in electronic health records to improve quality, safety, and delivery of healthcare and reduce healthcare costs. Scant literature has evaluated the use of aids in the electronic health record (EHR) to identify obesity. </p><p> <b>Objectives:</b> The purpose of this study was to determine to what extent the tools available in an EHR for automatic Body Mass Index (BMI) calculation based on height and weight documentation are used by pediatricians to correctly identify obesity in children. Secondary objectives were to evaluate quality of data input (discrete vs. free text) and see if there is any variation in rates of identification among patients of different socio-demographic characteristics and trainees of different levels. </p><p> <b>Methods:</b> We conducted a retrospective chart review for patients aged 2&ndash;18 years seen for a well-child visit at New York Presbyterian Hospital between January 2011 and January 2014, where it is standard practice at these visits to take height and weight measurements. The EHR automatically populates these values onto growth curves, converting them into BMI with percentiles. Standardized definitions from the Centers for Disease Control and Prevention (CDC) 2010 were used to qualify overweight and obese based on BMI. We determined the percentage of patients who were overweight or obese (based on CDC percentiles) that had the diagnosis identified by the pediatrician, and then assessed the quality of data input. We assessed laboratory follow up and referrals for all patients, and assessed for demographic differences among patients properly and not properly documented by providers as obese or overweight. </p><p> <b>Results:</b> We reviewed 700 charts in total. Inclusion criteria were all of the patients who had a BMI between 85&ndash;95% (these were grouped as overweight) and a BMI over 95% (obese). 209 patients were overweight or obese and therefore eligible for inclusion. Of the 209 clinically overweight/obese children, 72.2% had some form of documentation of this diagnosis, although the diagnosis was documented more often in the obese vs. overweight child. The diagnosis was most often captured electronically in the free text progress note. Over half of clinically overweight/obese children aged &ge;8 years did not receive follow-up standard laboratory testing, and only about one-quarter of clinically overweight/obese children had documented in-office nutrition guidance. Diagnosis of overweight was higher in females, but it was almost twice as likely that an obese male would be documented as such. Results showed no identification variation based on age or race/ethnicity. There was no difference in recognition of obesity/overweight based on postgraduate year (PGY) or nurse practitioner (NP) status. </p><p> <b>Conclusion:</b> Despite its importance as a public health priority for children, automatic calculation of BMI by use of an EHR led to documentation by a provider as a child being overweight/obese only three quarters of the time. This study suggests that despite increasing focus on using EHRs to improve individual and population health, including for obesity, clinical decision support remains underutilized.</p>

Thesis (Ph.D.)--Indiana University, School of Education, 2005. / Title from PDF t.p. (viewed Nov. 11, 2008). Source: Dissertation Abstracts International, Volume: 66-01, Section: A, page: 0148. Chair: Charles M. Reigeluth.

Thesis (Ph.D.)--Indiana University, Dept. of Instructional Systems Technology, 2006. / Source: Dissertation Abstracts International, Volume: 67-01, Section: A, page: 0157. Adviser: Thomas A. Brush. "Title from dissertation home page (viewed Dec. 11, 2006)."

<p><b>Introduction</b>: Cancer registries collect tumor-related data to monitor incident rates and support population-based research. A common concern with using population-based registry data for research is reporting timeliness. Data timeliness have been recognized as an important data characteristic by both the Centers for Disease Control and Prevention (CDC) and the Institute of Medicine (IOM). Yet, few recent studies in the United States (U.S.) have systemically measured timeliness. </p><p> The goal of this research is to evaluate the quality of cancer data and examine methods by which the reporting process can be improved. The study aims are: 1- evaluate the timeliness of cancer cases at the Indiana State Department of Health (ISDH) Cancer Registry, 2- identify the perceived barriers and facilitators to timely reporting, and 3-reengineer the current reporting process to improve turnaround time. </p><p> <b>Method</b>: For Aim 1: Using the ISDH dataset from 2000 to 2009, we evaluated the reporting timeliness and subtask within the process cycle. For Aim 2: Certified cancer registrars reporting for ISDH were invited to a semi-structured interview. The interviews were recorded and qualitatively analyzed. For Aim 3: We designed a reengineered workflow to minimize the reporting timeliness and tested it using simulation. </p><p> <b>Result</b>: The results show variation in the mean reporting time, which ranged from 426 days in 2003 to 252 days in 2009. The barriers identified were categorized into six themes and the most common barrier was accessing medical records at external facilities. </p><p> We also found that cases reside for a few months in the local hospital database while waiting for treatment data to become available. The recommended workflow focused on leveraging a health information exchange for data access and adding a notification system to inform registrars when new treatments are available. </p>

<p> Global explosion of mobile technology has engendered a new instrument to address the challenges in public health and to revolutionize the paradigm of healthcare access and delivery system. Today mobile phone coverage has increased to a significant 90% of the world&rsquo;s population. The rising ubiquity and infiltration of mobile phones has kindled the beginning of a new era in healthcare, mobile health (mHealth). mHealth is the amalgamation of mobile telecommunication and multimedia into an on the go mobile health care delivery system. </p><p> Pediatric Pal is a mHealth application targeted to care for children and help build a healthier tomorrow for them. Pediatric Pal is designed to be the &ldquo;Drive Thru&rdquo; for the pediatric healthcare system. The mhealth app focuses on giving patients access to a highly sophisticated medical diagnosis tool. By using latest searching technologies, the system can take a pattern of symptoms in everyday language and instantly compute from our vast database. The app design and development will be outsourced to a web design Hyperlink solutions agency. Database for the app will be maintained in house and test runs will be run within the house. </p><p> The main source of revenue for the app will be from user subscription and upfront cash payment. Premium downloads will bring in the extra revenue as well. </p><p> Pediatric Pal puts world&rsquo;s medical knowledge at the patients fingertips and enables them to make sense of your symptoms. It will change the way patients speak to their doctor forever.</p><p>

<p> Ambulatory care comprises a major and increasingly important part of the U.S. and other countries&rsquo; health care sectors. Every year in the U.S., about 80% of the population seeks care at a doctor&rsquo;s office, amounting to one billion visits. These visits divide almost equally between primary care and specialty clinic organizations. Diagnostic work is part of most ambulatory care, and central to over 40% of patient visits that originate due to a new problem or a flare-up of an ongoing chronic problem. Yet, the risks associated with diagnostic failures have not garnered much attention from health care leaders and policy makers until a recent National Academy of Medicine (NAM 2015) report synthesized research data with the statement that &ldquo;most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences.&rdquo; This dissertation first reviews organizational theories and measurement challenges relevant to diagnostic safety and quality in the context of ambulatory care, and then presents three papers analyzing specific organizational factors hypothesized to enable or thwart an accurate and timely diagnosis. The first paper targets delayed diagnosis from missed evidence-based monitoring in high-risk conditions (e.g., cancer) within five specialty clinics in an urban publicly funded health system. The second paper analyzes staff-reported office problems that could lead to diagnostic error (e.g., not having test results when needed) in over 900 primary and specialty clinics across the nation. The third paper examines the associations between two types of time pressure (i.e., encounter-level and practice-level), organizational factors, and patient effects including perceptions of missed diagnostic opportunities. The three primary conclusions from this work are 1) organizational vulnerabilities for missed monitoring common to the different clinics included challenges with data systems, communications handoffs, population-level tracking, and patient activities, leading to the development of &lsquo;design seeds&rsquo; for context-flexible solutions to improve diagnostic quality; 2) two organizational factors&mdash;stage of health information technology (HIT) deployment and patient safety culture are associated with diagnostic-related office problems, and 3) encounter and practice-level time stressors in primary care clinics are associated with perceptions of greater adverse effects on diagnosis and treatment, and worse patients&rsquo; experiences of chronic care from the clinic team, respectively, as well as associated with several organizational factors including HIT, patient-centered culture, relational coordination for interdependent teamwork, and leadership facilitation of changes to address frontline practice challenges. Taken together, the dissertation papers also demonstrate the applicability of the NAM Improving Diagnosis Conceptual Framework for research on ambulatory care organizations. </p><p>

<p> This study utilized a multi-case, bounded case, single-site case study research design to examine how well instructional designers perceive themselves able to practice ID in health care industries. Questions central to this study focused on how instructional designers perceive their preparation to practice, usefulness of professional development organizations or affiliations in which they participated while practicing ID, both academic and non-academic curricula, and utilization of ID practices when designing and developing ID projects in health care environments. </p><p> The site selected for this study was a teaching hospital in Southeast Metropolitan Detroit, Michigan. Sampling size was limited to five instructional designers who had been working in the health care environment. Using a case study approach, convenient sampling was utilized to obtain detailed information about the experiences of instructional designers in the health care sector. Upon completion of interviews, participants had the opportunity to show completed work projects and were provided an opportunity to reflect on ID practice via journal entries over a two week time period. The constant comparative method was utilized for data analysis whereby a within-case analysis was conducted followed by a cross case analysis. Findings of this research showed that participants felt well prepared to practice ID in their respective health care environment and offered a variety of ways in which an instructional designer can explore the field of health care, how academic program administrators can collaborate with health care organizations to provide ID opportunities for students, and ways in which health care administrators can explore additional learning opportunities for their ID employees.</p>

Made available in DSpace on 2018-06-18T13:12:08Z (GMT). No. of bitstreams: 0 Previous issue date: 2015 / Esta pesquisa analisou as concepções, expectativas e vivências dos docentes, discentes e residentes médicos, frente à proposta pedagógica da disciplina optativa Telessaúde do curso de medicina da Universidade federal do Tocantins - UFT, como uma estratégia inovadora de formação de recursos humanos em saúde. Para o alcance dos objetivos propostos utilizou-se uma metodologia quali-quantitativa por meio de estudo exploratório e descritivo, utilizando análise documental, estudo de caso e um instrumento de percepção atitudinal do tipo Likert, que foi aplicado aos docentes, preceptores e discentes dos cursos da saúde (medicina, enfermagem e nutrição), jornalismo e ciências da computação da Universidade Federal do Tocantins que cursaram a disciplina Optativa Telessaúde no período de 2011 a 2014. Foram distribuídos 30 instrumentos, com 28 asserções cada, randomizadas por cinco dimensões: A disciplina optativa Telessaúde como programa estimulador da inovação curricular; A disciplina optativa Telessaúde como ferramenta qualificadora da gestão em saúde (redes de atenção); A disciplina optativa Telessaúde como ferramenta contributiva na fixação médica no Tocantins; A disciplina optativa Telessaúde como ferramenta contributiva no fortalecimento da Educação Permanente em Saúde – EPS; A disciplina optativa Telessaúde como ferramenta de estímulo a interprofissionalidade. Nenhuma asserção foi perdida no processo de validação quanto à dispersão, evidenciando uma ótima validação de conteúdo. A confiabilidade foi testada pela fórmula de Spearman – Brown usando o método teste – reteste com R = 0,97, pelo teste de homogeneidade com p-valor de 0,032 e ANOVA com p –valor de 0,059, o que configurou excelente densidade estatística para os resultados encontrados. Todas as dimensões ficaram em zona de conforto. A análise dos dados permite a sustentação de que aspectos inovadores foram identificados na construção e desenvolvimento da referida disciplina tais como: assertividade na escolha dos conteúdos, uso adequado de metodologias ativas de ensino-aprendizagem bem como das TICs. Algumas dificuldades foram identificadas como número insuficiente de docentes, pouca participação dos preceptores apontando para a necessidade de aprimoramento da integração ensino-serviço e por último eventuais dificuldades na conectividade. Este estudo traz subsídios para avanços na referida disciplina à luz dos princípios da inovação pedagógica, aprendizagem significativa e interprofissionalidade. / This research analyzed the conceptions, expectations and experiences of the teachers, students and medical residents, forefront of the pedagogical proposal of the optional discipline Telehealth from the Medicine´s course of the Federal University of Tocantins, like an innovative strategy of training human resources in health. To reach the proposed objectives was used a methodology qualitative and quantitative through exploratory and descriptive study, using document analysis, case study and an attitudinal perception instrument like Likert, that was applied to teachers, preceptors and students of health courses (medicine, nursing and nutrition), journalism and computer science at the Federal University of Tocantins who attended the optional discipline Telehealth in the period 2011 to 2014. 30 instruments were distributed, with 28 statements each, randomized for five dimensions: the optional discipline telehealth as a stimulator of curriculum innovation program; the optional discipline telehealth as health management tool qualifying (care networks); the optional discipline telehealth as contributory tool in the medical setting in Tocantins; the optional discipline telehealth as contributory tool in the strengthening of Continuing Health Education; the optional discipline telehealth as a stimulus tool inter professionalism. No proposition had been lost in the validation process on dispersed, showing a great validation of content. The reliability was tested by the Spearman – Brown´s formula using the test-retest method with R = 0,97, by the test homogeneity with p-value 0,032 and ANOVA with p-value 0,059, which sets great statistical density for the founded results. All dimensions were in the comfort zone. The data analysis allows the support that innovative aspects have been found in the construction and development from said subject such as: assertiveness in the choice of contents, proper use of teaching and learning active methodologies well as the TIC´s. Some difficulties have been identified as insufficient number of teachers, low participation of preceptors pointing to the need to improve the teaching-service integration and lastly any difficulties in connectivity. This study provides subsidies for advances in the discipline in the light of the principles of pedagogical innovation, meaningful learning and inter professionalism.