Management of laboratory data and information exchange in the electronic health record.

Science.gov (United States)

Wilkerson, Myra L; Henricks, Walter H; Castellani, William J; Whitsitt, Mark S; Sinard, John H

2015-03-01

In the era of the electronic health record, the success of laboratories and pathologists will depend on effective presentation and management of laboratory information, including test orders and results, and effective exchange of data between the laboratory information system and the electronic health record. In this third paper of a series that explores empowerment of pathology in the era of the electronic health record, we review key elements of managing laboratory information within the electronic health record and examine functional issues pertinent to pathologists and laboratories in the exchange of laboratory information between electronic health records and both anatomic and clinical pathology laboratory information systems. Issues with electronic order-entry and results-reporting interfaces are described, and considerations for setting up these interfaces are detailed in tables. The role of the laboratory medical director as mandated by the Clinical Laboratory Improvement Amendments of 1988 and the impacts of discordance between laboratory results and their display in the electronic health record are also discussed.

Consumer-Mediated Health Information Exchanges: The 2012 ACMI Debate

Science.gov (United States)

Cimino, James J.; Frisse, Mark; Halamka, John; Sweeney, Latanya; Yasnoff, William

2017-01-01

The American College of Medical Informatics (ACMI) sponsors periodic debates during the American Medical Informatics Fall Symposium to highlight important informatics issues of broad interest. In 2012, a panel debated the following topic: “Resolved: Health Information Exchange Organizations Should Shift Their Principal Focus to Consumer-Mediated Exchange in Order to Facilitate the Rapid Development of Effective, Scalable, and Sustainable Health Information Infrastructure.” Those supporting the proposition emphasized the need for consumer-controlled community repositories of electronic health records (health record banks) to address privacy, stakeholder cooperation, scalability, and sustainability. Those opposing the proposition emphasized that the current healthcare environment is so complex that development of consumer control will take time and that even then, consumers may not be able to mediate their information effectively. While privately, each discussant recognizes that there are many sides to this complex issue, each followed the debater’s tradition of taking an extreme position in order emphasize some of the polarizing aspects in the short time allotted them. In preparing this summary, we sought to convey the substance and spirit of the debate in printed form. Transcripts of the actual debate were edited for clarity, and appropriate supporting citations were added for the further edification of the reader. PMID:24561078

Consumer-mediated health information exchanges: the 2012 ACMI debate.

Science.gov (United States)

Cimino, James J; Frisse, Mark E; Halamka, John; Sweeney, Latanya; Yasnoff, William

2014-04-01

The American College of Medical Informatics (ACMI) sponsors periodic debates during the American Medical Informatics Fall Symposium to highlight important informatics issues of broad interest. In 2012, a panel debated the following topic: "Resolved: Health Information Exchange Organizations Should Shift Their Principal Focus to Consumer-Mediated Exchange in Order to Facilitate the Rapid Development of Effective, Scalable, and Sustainable Health Information Infrastructure." Those supporting the proposition emphasized the need for consumer-controlled community repositories of electronic health records (health record banks) to address privacy, stakeholder cooperation, scalability, and sustainability. Those opposing the proposition emphasized that the current healthcare environment is so complex that development of consumer control will take time and that even then, consumers may not be able to mediate their information effectively. While privately each discussant recognizes that there are many sides to this complex issue, each followed the debater's tradition of taking an extreme position in order emphasize some of the polarizing aspects in the short time allotted them. In preparing this summary, we sought to convey the substance and spirit of the debate in printed form. Transcripts of the actual debate were edited for clarity, and appropriate supporting citations were added for the further edification of the reader. Published by Elsevier Inc.

Barriers and facilitators to exchanging health information: a systematic review.

Science.gov (United States)

Eden, Karen B; Totten, Annette M; Kassakian, Steven Z; Gorman, Paul N; McDonagh, Marian S; Devine, Beth; Pappas, Miranda; Daeges, Monica; Woods, Susan; Hersh, William R

2016-04-01

We conducted a systematic review of studies assessing facilitators and barriers to use of health information exchange (HIE). We searched MEDLINE, PsycINFO, CINAHL, and the Cochrane Library databases between January 1990 and February 2015 using terms related to HIE. English-language studies that identified barriers and facilitators of actual HIE were included. Data on study design, risk of bias, setting, geographic location, characteristics of the HIE, perceived barriers and facilitators to use were extracted and confirmed. Ten cross-sectional, seven multiple-site case studies, and two before-after studies that included data from several sources (surveys, interviews, focus groups, and observations of users) evaluated perceived barriers and facilitators to HIE use. The most commonly cited barriers to HIE use were incomplete information, inefficient workflow, and reports that the exchanged information that did not meet the needs of users. The review identified several facilitators to use. Incomplete patient information was consistently mentioned in the studies conducted in the US but not mentioned in the few studies conducted outside of the US that take a collective approach toward healthcare. Individual patients and practices in the US may exercise the right to participate (or not) in HIE which effects the completeness of patient information available to be exchanged. Workflow structure and user roles are key but understudied. We identified several facilitators in the studies that showed promise in promoting electronic health data exchange: obtaining more complete patient information; thoughtful workflow that folds in HIE; and inclusion of users early in implementation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Household of care in electronic health information exchange systems

CSIR Research Space (South Africa)

Sibiya, Mhlupheki G

2017-09-01

Full Text Available by the organisation have presented the protocols and message profiles that can be used for communication among the systems within Electronic Health Information Exchange (HIE)[17, 6]. HIE “allows doctors, nurses, pharmacists, other healthcare providers and patients...

Information retrieval pathways for health information exchange in multiple care settings.

Science.gov (United States)

Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R

2014-11-01

To determine which health information exchange (HIE) technologies and information retrieval pathways healthcare professionals relied on to meet their information needs in the context of laboratory test results, radiological images and reports, and medication histories. Primary data was collected over a 2-month period across 3 emergency departments, 7 primary care practices, and 2 public health clinics in New York state. Qualitative research methods were used to collect and analyze data from semi-structured interviews and participant observation. The study reveals that healthcare professionals used a complex combination of information retrieval pathways for HIE to obtain clinical information from external organizations. The choice for each approach was setting- and information-specific, but was also highly dynamic across users and their information needs. Our findings about the complex nature of information sharing in healthcare provide insights for informatics professionals about the usage of information; indicate the need for managerial support within each organization; and suggest approaches to improve systems for organizations and agencies working to expand HIE adoption.

Information retrieval pathways for health information exchange in multiple care settings

DEFF Research Database (Denmark)

Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R.

2014-01-01

Objectives To determine which health information exchange (HIE) technologies and information retrieval pathways healthcare professionals relied on to meet their information needs in the context of laboratory test results, radiological images and reports, and medication histories. Study Design...... The study reveals that healthcare professionals used a complex combination of information retrieval pathways for HIE to obtain clinical information from external organizations. The choice for each approach was setting- and information-specific, but was also highly dynamic across users and their information...... needs. Conclusions Our findings about the complex nature of information sharing in healthcare provide insights for informatics professionals about the usage of information; indicate the need for managerial support within each organization; and suggest approaches to improve systems for organizations...

Electronic tools for health information exchange: an evidence-based analysis.

Science.gov (United States)

2013-01-01

As patients experience transitions in care, there is a need to share information between care providers in an accurate and timely manner. With the push towards electronic medical records and other electronic tools (eTools) (and away from paper-based health records) for health information exchange, there remains uncertainty around the impact of eTools as a form of communication. To examine the impact of eTools for health information exchange in the context of care coordination for individuals with chronic disease in the community. A literature search was performed on April 26, 2012, using OVID MEDLINE, OVID MEDLINE In-Process and Other Non-Indexed Citations, OVID EMBASE, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database, for studies published until April 26, 2012 (no start date limit was applied). A systematic literature search was conducted, and meta-analysis conducted where appropriate. Outcomes of interest fell into 4 categories: health services utilization, disease-specific clinical outcomes, process-of-care indicators, and measures of efficiency. The quality of the evidence was assessed individually for each outcome. Expert panels were assembled for stakeholder engagement and contextualization. Eleven articles were identified (4 randomized controlled trials and 7 observational studies). There was moderate quality evidence of a reduction in hospitalizations, hospital length of stay, and emergency department visits following the implementation of an electronically generated laboratory report with recommendations based on clinical guidelines. The evidence showed no difference in disease-specific outcomes; there was no evidence of a positive impact on process-of-care indicators or measures of efficiency. A limited body of research specifically examined eTools for health information exchange in the population and setting of interest. This evidence included a

Leader-Member Exchange Relationships in Health Information Management

OpenAIRE

Hunt, T.J.

2014-01-01

This article seeks to raise awareness of the leader-member exchange (LMX) theory of leadership and its potential benefit to the health information management (HIM) profession. A literature review that was conducted identified a leadership challenge for HIM practitioners. The review also provides examples of leadership definitions, and potential benefits of LMX to HIM professionals in leading people and influencing leaders in their organizations. The LMX concept may be an avenue to investigate...

Health information exchange implementation: lessons learned and critical success factors from a case study.

Science.gov (United States)

Feldman, Sue S; Schooley, Benjamin L; Bhavsar, Grishma P

2014-08-15

Much attention has been given to the proposition that the exchange of health information as an act, and health information exchange (HIE), as an entity, are critical components of a framework for health care change, yet little has been studied to understand the value proposition of implementing HIE with a statewide HIE. Such an organization facilitates the exchange of health information across disparate systems, thus following patients as they move across different care settings and encounters, whether or not they share an organizational affiliation. A sociotechnical systems approach and an interorganizational systems framework were used to examine implementation of a health system electronic medical record (EMR) system onto a statewide HIE, under a cooperative agreement with the Office of the National Coordinator for Health Information Technology, and its collaborating organizations. The objective of the study was to focus on the implementation of a health system onto a statewide HIE; provide insight into the technical, organizational, and governance aspects of a large private health system and the Virginia statewide HIE (organizations with the shared goal of exchanging health information); and to understand the organizational motivations and value propositions apparent during HIE implementation. We used a formative evaluation methodology to investigate the first implementation of a health system onto the statewide HIE. Qualitative methods (direct observation, 36 hours), informal information gathering, semistructured interviews (N=12), and document analysis were used to gather data between August 12, 2012 and June 24, 2013. Derived from sociotechnical concepts, a Blended Value Collaboration Enactment Framework guided the data gathering and analysis to understand organizational stakeholders' perspectives across technical, organizational, and governance dimensions. Several challenges, successes, and lessons learned during the implementation of a health system to the

Supporting multi-state collaboration on privacy and security to foster health IT and health information exchange.

Science.gov (United States)

Banger, Alison K; Alakoye, Amoke O; Rizk, Stephanie C

2008-11-06

As part of the HHS funded contract, Health Information Security and Privacy Collaboration, 41 states and territories have proposed collaborative projects to address cross-state privacy and security challenges related to health IT and health information exchange. Multi-state collaboration on privacy and security issues remains complicated, and resources to support collaboration around these topics are essential to the success of such collaboration. The resources outlined here offer an example of how to support multi-stakeholder, multi-state projects.

Investigation of the Impact of Extracting and Exchanging Health Information by Using Internet and Social Networks.

Science.gov (United States)

Pistolis, John; Zimeras, Stelios; Chardalias, Kostas; Roupa, Zoe; Fildisis, George; Diomidous, Marianna

2016-06-01

Social networks (1) have been embedded in our daily life for a long time. They constitute a powerful tool used nowadays for both searching and exchanging information on different issues by using Internet searching engines (Google, Bing, etc.) and Social Networks (Facebook, Twitter etc.). In this paper, are presented the results of a research based on the frequency and the type of the usage of the Internet and the Social Networks by the general public and the health professionals. The objectives of the research were focused on the investigation of the frequency of seeking and meticulously searching for health information in the social media by both individuals and health practitioners. The exchanging of information is a procedure that involves the issues of reliability and quality of information. In this research, by using advanced statistical techniques an effort is made to investigate the participant's profile in using social networks for searching and exchanging information on health issues. Based on the answers 93 % of the people, use the Internet to find information on health-subjects. Considering principal component analysis, the most important health subjects were nutrition (0.719 %), respiratory issues (0.79 %), cardiological issues (0.777%), psychological issues (0.667%) and total (73.8%). The research results, based on different statistical techniques revealed that the 61.2% of the males and 56.4% of the females intended to use the social networks for searching medical information. Based on the principal components analysis, the most important sources that the participants mentioned, were the use of the Internet and social networks for exchanging information on health issues. These sources proved to be of paramount importance to the participants of the study. The same holds for nursing, medical and administrative staff in hospitals.

The utilization rate of the regional health information exchange: how it impacts on health care delivery outcomes.

Science.gov (United States)

Mäenpää, Tiina; Asikainen, Paula; Gissler, Mika; Siponen, Kimmo; Maass, Marianne; Saranto, Kaija; Suominen, Tarja

2012-01-01

Interest in improving quality and effectiveness is the primary driver for health information exchange efforts across a health care system to improve the provision of public health care services. The aim here was to describe and identify the impact of a regional health information exchange (HIE) using quantitative statistics for 2004-2008 in one hospital district in Finland. We conducted a comparative, longitudinal 5-year follow-up study to evaluate the utilization rates of HIE, and the impact on health care delivery outcomes. The selected outcomes were total laboratory tests, radiology examinations, appointments, emergency visits, and referrals. The HIE utilization rates increased annually in all 10 federations of municipalities, and the viewing of reference information increased steadily in each professional group over the 5-year study period. In these federations, a significant connection was found to the number of laboratory tests and radiology examinations, with a statistically significant increase in the number of viewed references and use of HIE. The higher the numbers of emergency visits and appointments, the higher the numbers of emergency referrals to specialized care, viewed references, and HIE usage among the groups of different health care professionals. There is increasing interest in HIE usage through regional health information system among health professionals to improve health care delivery regionally and bring information on the patient directly to care delivery. It will be important to study which changes in working methods in the service system are explained by RHIS. Also, the experiences of the change that has taken place should be studied among the different stakeholders, administrative representatives, and patients.

Consumer Opinions of Health Information Exchange, e-Prescribing, and Personal Health Records.

Science.gov (United States)

Cochran, Gary L; Lander, Lina; Morien, Marsha; Lomelin, Daniel E; Brittin, Jeri; Reker, Celeste; Klepser, Donald G

2015-01-01

Consumer satisfaction is a crucial component of health information technology (HIT) utilization, as high satisfaction is expected to increase HIT utilization among providers and to allow consumers to become full participants in their own healthcare management. The primary objective of this pilot study was to identify consumer perspectives on health information technologies including health information exchange (HIE), e-prescribing (e-Rx), and personal health records (PHRs). Eight focus groups were conducted in seven towns and cities across Nebraska in 2013. Each group consisted of 10-12 participants. Discussions were organized topically in the following categories: HIE, e-Rx, and PHR. The qualitative analysis consisted of immersion and crystallization to develop a coding scheme that included both preconceived and emergent themes. Common themes across focus groups were identified and compiled for each discussion category. The study had 67 participants, of which 18 (27 percent) were male. Focus group findings revealed both perceived barriers and benefits to the adoption of HIT. Common HIT concerns expressed across focus groups included privacy and security of medical information, decreases in quality of care, inconsistent provider participation, and the potential cost of implementation. Positive expectations regarding HIT included better accuracy and completeness of information, and improved communication and coordination between healthcare providers. Improvements in patient care were expected as a result of easy physician access to consolidated information across providers as well as the speed of sharing and availability of information in an emergency. In addition, participants were optimistic about patient empowerment and convenient access to and control of personal health data. Consumer concerns focused on privacy and security of the health information, as well as the cost of implementing the technologies and the possibility of an unintended negative impact on the

Barriers to cross--institutional health information exchange: a literature review.

Science.gov (United States)

Edwards, Ashley; Hollin, Ilene; Barry, Jeffrey; Kachnowski, Stan

2010-01-01

While the development of health information technology, particularly electronic health records (EHR), is a triumph for the advancement of healthcare, non-interoperable clinical data systems lead to fragmented communication and incomplete records. If interoperable HIT systems could be achieved integrated HIT could be leveraged to lessen medical errors, improve patient care and optimize epidemiological research. To understand the barriers to interoperability or health information exchange (HIE), we reviewed the literature on HIT and barriers to HIE. Our search yielded 492 articles, 25 meeting our inclusion criteria. In general, we found that the predominant barriers to HIE are need for standards, security concerns, economic loss to competitors, and federated systems. Research on interoperability is limited because most HIE programs are still in formative stages. More research is needed to fully understand interoperability of HIT, how to overcome the barriers to interoperability, and how to design HIT to better facilitate HIE.

The strategic use of standardized information exchange technology in a university health system.

Science.gov (United States)

Cheng, Po-Hsun; Chen, Heng-Shuen; Lai, Feipei; Lai, Jin-Shin

2010-04-01

This article illustrates a Web-based health information system that is comprised of specific information exchange standards related to health information for healthcare services in National Taiwan University Health System. Through multidisciplinary teamwork, medical and informatics experts collaborated and studied on system scope definition, standard selection challenges, system implementation barriers, system management outcomes, and further expandability of other systems. After user requirement analysis and prototyping, from 2005 to 2008, an online clinical decision support system with multiple functions of reminding and information push was implemented. It was to replace its original legacy systems and serve among the main hospital and three branches of 180-200 clinics and 7,500-8,000 patient visits per day. To evaluate the effectiveness of this system, user surveys were performed, which revealed that the average score of user satisfaction increased from 2.80 to 3.18 on a 4-point scale. Among the items, especially e-learning for training service, courtesy communications for system requests, and courtesy communications for system operations showed statistically significant improvement. From this study, the authors concluded that standardized information exchange technologies can be used to create a brand new enterprise value and steadily obtain more competitive advantages for a prestige healthcare system.

Consumer perceptions of electronic health information exchange.

Science.gov (United States)

Ancker, Jessica S; Edwards, Alison M; Miller, Melissa C; Kaushal, Rainu

2012-07-01

Public support will be critical to the success and long-term sustainability of electronic health information exchange (HIE) initiatives currently promoted by federal policy. The goal of this study was to assess consumer perceptions of HIE in a state (New York) with a 6-year history of successful HIE organizations. The Empire State Poll is a random-digit-dial telephone survey of adult New York State residents conducted annually by the Survey Research Institute at Cornell University. In 2011, it contained 77 items. The survey was conducted and data were analyzed in 2011. Eight hundred respondents participated (71% response rate). Large majorities supported HIE among healthcare providers (69%); thought it would improve quality of care (68%); and supported "break the glass" access to HIE data without need for consent in emergencies (90%). Support was lower among people who rated large corporations as less trustworthy. Privacy and security concerns were expressed by 68%. Respondents were supportive whether the architecture involved a physician sending data to another physician, a physician sending data to a patient who could send it to other physicians, or a physician accessing data from other institutions. In New York, public support for HIE is strong. Policy and outreach pertaining to this type of exchange may be most effective if it clarifies the roles and responsibilities of large businesses involved in different aspects of the exchange, and privacy and security controls. Differing architectures received similar levels of support. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Learning from health information exchange technical architecture and implementation in seven beacon communities.

Science.gov (United States)

McCarthy, Douglas B; Propp, Karen; Cohen, Alexander; Sabharwal, Raj; Schachter, Abigail A; Rein, Alison L

2014-01-01

As health care providers adopt and make "meaningful use" of health information technology (health IT), communities and delivery systems must set up the infrastructure to facilitate health information exchange (HIE) between providers and numerous other stakeholders who have a role in supporting health and care. By facilitating better communication and coordination between providers, HIE has the potential to improve clinical decision-making and continuity of care, while reducing unnecessary use of services. When implemented as part of a broader strategy for health care delivery system and payment reform, HIE capability also can enable the use of analytic tools needed for population health management, patient engagement in care, and continuous learning and improvement. The diverse experiences of seven communities that participated in the three-year federal Beacon Community Program offer practical insight into factors influencing the technical architecture of exchange infrastructure and its role in supporting improved care, reduced cost, and a healthier population. The case studies also document challenges faced by the communities, such as significant time and resources required to harmonize variations in the interpretation of data standards. Findings indicate that their progress developing community-based HIE strategies, while driven by local needs and objectives, is also influenced by broader legal, policy, and market conditions.

Learning from Health Information Exchange Technical Architecture and Implementation in Seven Beacon Communities

Science.gov (United States)

McCarthy, Douglas B.; Propp, Karen; Cohen, Alexander; Sabharwal, Raj; Schachter, Abigail A.; Rein, Alison L.

2014-01-01

As health care providers adopt and make “meaningful use” of health information technology (health IT), communities and delivery systems must set up the infrastructure to facilitate health information exchange (HIE) between providers and numerous other stakeholders who have a role in supporting health and care. By facilitating better communication and coordination between providers, HIE has the potential to improve clinical decision-making and continuity of care, while reducing unnecessary use of services. When implemented as part of a broader strategy for health care delivery system and payment reform, HIE capability also can enable the use of analytic tools needed for population health management, patient engagement in care, and continuous learning and improvement. The diverse experiences of seven communities that participated in the three-year federal Beacon Community Program offer practical insight into factors influencing the technical architecture of exchange infrastructure and its role in supporting improved care, reduced cost, and a healthier population. The case studies also document challenges faced by the communities, such as significant time and resources required to harmonize variations in the interpretation of data standards. Findings indicate that their progress developing community-based HIE strategies, while driven by local needs and objectives, is also influenced by broader legal, policy, and market conditions. PMID:25848591

A security framework for nationwide health information exchange based on telehealth strategy.

Science.gov (United States)

Zaidan, B B; Haiqi, Ahmed; Zaidan, A A; Abdulnabi, Mohamed; Kiah, M L Mat; Muzamel, Hussaen

2015-05-01

This study focuses on the situation of health information exchange (HIE) in the context of a nationwide network. It aims to create a security framework that can be implemented to ensure the safe transmission of health information across the boundaries of care providers in Malaysia and other countries. First, a critique of the major elements of nationwide health information networks is presented from the perspective of security, along with such topics as the importance of HIE, issues, and main approaches. Second, a systematic evaluation is conducted on the security solutions that can be utilized in the proposed nationwide network. Finally, a secure framework for health information transmission is proposed within a central cloud-based model, which is compatible with the Malaysian telehealth strategy. The outcome of this analysis indicates that a complete security framework for a global structure of HIE is yet to be defined and implemented. Our proposed framework represents such an endeavor and suggests specific techniques to achieve this goal.

Exploring Business Strategy in Health Information Exchange Organizations.

Science.gov (United States)

Langabeer, James R; Champagne, Tiffany

2016-01-01

Unlike consumer goods industries, healthcare has been slow to implement technolo gies that support exchange of data in patients' health records. This results in avoid able medication errors, avoidable hospital readmissions, unnecessary duplicate testing, and other inefficient or wasteful practices. Community-based regional health information exchange (HIE) organizations have evolved in response to federal aims to encourage interoperability, yet little is known about their strategic approach. We use the lens of institutional and strategic management theories to empirically explore the differences in business strategies deployed in HIEs that are, to date, financially sustainable versus those that are not. We developed a 20-question survey targeted to CEOs to assess HIE business strategies. Our sample consisted of 60 community-based exchanges distributed throughout the United States, and we achieved a 58% response rate. Questions centered on competitive strategy and financial sustainability. We relied on logistic regression methods to explore relationships between variables. Our regression identified characteristics common to sustainable organizations. We defined sustainability as revenues exceeding operational costs. Seventeen of the 35 organizations (49%) defined themselves as currently sustainable. Focus and cost leadership strategies were significantly associated with sustainability. Growth strate gies, which were much more common than other strategies, were not associated with sustainability. We saw little evidence of a differentiation strategy (i.e., the basis of competition whereby the attributes of a product or service are unmatched by rivals). Most CEOs had a relatively optimistic outlook, with 60% stating they were confident of surviving over the next 5 years; however, nearly 9% of the organizations were in some phase of divestiture or exit from the market. HIEs are evolving differently based on local leadership decisions, yet their strategic approach is

Real time alert system: a disease management system leveraging health information exchange.

Science.gov (United States)

Anand, Vibha; Sheley, Meena E; Xu, Shawn; Downs, Stephen M

2012-01-01

Rates of preventive and disease management services can be improved by providing automated alerts and reminders to primary care providers (PCPs) using of health information technology (HIT) tools. Using Adaptive Turnaround Documents (ATAD), an existing Health Information Exchange (HIE) infrastructure and office fax machines, we developed a Real Time Alert (RTA) system. RTA is a computerized decision support system (CDSS) that is able to deliver alerts to PCPs statewide for recommended services around the time of the patient visit. RTA is also able to capture structured clinical data from providers using existing fax technology. In this study, we evaluate RTA's performance for alerting PCPs when their patients with asthma have an emergency room visit anywhere in the state. Our results show that RTA was successfully able to deliver "just in time" patient-relevant alerts to PCPs across the state. Furthermore, of those ATADs faxed back and automatically interpreted by the RTA system, 35% reported finding the provided information helpful. The PCPs who reported finding information helpful also reported making a phone call, sending a letter or seeing the patient for follow up care. We have successfully demonstrated the feasibility of electronically exchanging important patient related information with the PCPs statewide. This is despite a lack of a link with their electronic health records. We have shown that using our ATAD technology, a PCP can be notified quickly of an important event such as a patient's asthma related emergency room admission so further follow up can happen in near real time.

How can knowledge exchange portals assist in knowledge management for evidence-informed decision making in public health?

Science.gov (United States)

Quinn, Emma; Huckel-Schneider, Carmen; Campbell, Danielle; Seale, Holly; Milat, Andrew J

2014-05-12

Knowledge exchange portals are emerging as web tools that can help facilitate knowledge management in public health. We conducted a review to better understand the nature of these portals and their contribution to knowledge management in public health, with the aim of informing future development of portals in this field. A systematic literature search was conducted of the peer-reviewed and grey literature to identify articles that described the design, development or evaluation of Knowledge Exchange Portals KEPs in the public health field. The content of the articles was analysed, interpreted and synthesised in light of the objectives of the review. The systematic search yielded 2223 articles, of which fifteen were deemed eligible for review, including eight case studies, six evaluation studies and one commentary article. Knowledge exchange portals mainly included design features to support knowledge access and creation, but formative evaluation studies examining user needs suggested collaborative features supporting knowledge exchange would also be useful. Overall web usage statistics revealed increasing use of some of these portals over time; however difficulties remain in retaining users. There is some evidence to suggest that the use of a knowledge exchange portal in combination with tailored and targeted messaging can increase the use of evidence in policy and program decision making at the organisational level. Knowledge exchange portals can be a platform for providing integrated access to relevant content and resources in one location, for sharing and distributing information and for bringing people together for knowledge exchange. However more performance evaluation studies are needed to determine how they can best support evidence-informed decision making in public health.

Uncovering Hospitalists' Information Needs from Outside Healthcare Facilities in the Context of Health Information Exchange Using Association Rule Learning.

Science.gov (United States)

Martinez, D A; Mora, E; Gemmani, M; Zayas-Castro, J

2015-01-01

Important barriers to health information exchange (HIE) adoption are clinical workflow disruptions and troubles with the system interface. Prior research suggests that HIE interfaces providing faster access to useful information may stimulate use and reduce barriers for adoption; however, little is known about informational needs of hospitalists. To study the association between patient health problems and the type of information requested from outside healthcare providers by hospitalists of a tertiary care hospital. We searched operational data associated with fax-based exchange of patient information (previous HIE implementation) between hospitalists of an internal medicine department in a large urban tertiary care hospital in Florida, and any other affiliated and unaffiliated healthcare provider. All hospitalizations from October 2011 to March 2014 were included in the search. Strong association rules between health problems and types of information requested during each hospitalization were discovered using Apriori algorithm, which were then validated by a team of hospitalists of the same department. Only 13.7% (2 089 out of 15 230) of the hospitalizations generated at least one request of patient information to other providers. The transactional data showed 20 strong association rules between specific health problems and types of information exist. Among the 20 rules, for example, abdominal pain, chest pain, and anaemia patients are highly likely to have medical records and outside imaging results requested. Other health conditions, prone to have records requested, were lower urinary tract infection and back pain patients. The presented list of strong co-occurrence of health problems and types of information requested by hospitalists from outside healthcare providers not only informs the implementation and design of HIE, but also helps to target future research on the impact of having access to outside information for specific patient cohorts. Our data

A strategic gaming model for health information exchange markets.

Science.gov (United States)

Martinez, Diego A; Feijoo, Felipe; Zayas-Castro, Jose L; Levin, Scott; Das, Tapas K

2018-03-01

Current market conditions create incentives for some providers to exercise control over patient data in ways that unreasonably limit its availability and use. Here we develop a game theoretic model for estimating the willingness of healthcare organizations to join a health information exchange (HIE) network and demonstrate its use in HIE policy design. We formulated the model as a bi-level integer program. A quasi-Newton method is proposed to obtain a strategy Nash equilibrium. We applied our modeling and solution technique to 1,093,177 encounters for exchanging information over a 7.5-year period in 9 hospitals located within a three-county region in Florida. Under a set of assumptions, we found that a proposed federal penalty of up to $2,000,000 has a higher impact on increasing HIE adoption than current federal monetary incentives. Medium-sized hospitals were more reticent to adopt HIE than large-sized hospitals. In the presence of collusion among multiple hospitals to not adopt HIE, neither federal incentives nor proposed penalties increase hospitals' willingness to adopt. Hospitals' apathy toward HIE adoption may threaten the value of inter-connectivity even with federal incentives in place. Competition among hospitals, coupled with volume-based payment systems, creates no incentives for smaller hospitals to exchange data with competitors. Medium-sized hospitals need targeted actions (e.g., outside technological assistance, group purchasing arrangements) to mitigate market incentives to not adopt HIE. Strategic game theoretic models help to clarify HIE adoption decisions under market conditions at play in an extremely complex technology environment.

A system dynamics evaluation model: implementation of health information exchange for public health reporting.

Science.gov (United States)

Merrill, Jacqueline A; Deegan, Michael; Wilson, Rosalind V; Kaushal, Rainu; Fredericks, Kimberly

2013-06-01

To evaluate the complex dynamics involved in implementing electronic health information exchange (HIE) for public health reporting at a state health department, and to identify policy implications to inform similar implementations. Qualitative data were collected over 8 months from seven experts at New York State Department of Health who implemented web services and protocols for querying, receipt, and validation of electronic data supplied by regional health information organizations. Extensive project documentation was also collected. During group meetings experts described the implementation process and created reference modes and causal diagrams that the evaluation team used to build a preliminary model. System dynamics modeling techniques were applied iteratively to build causal loop diagrams representing the implementation. The diagrams were validated iteratively by individual experts followed by group review online, and through confirmatory review of documents and artifacts. Three casual loop diagrams captured well-recognized system dynamics: Sliding Goals, Project Rework, and Maturity of Resources. The findings were associated with specific policies that address funding, leadership, ensuring expertise, planning for rework, communication, and timeline management. This evaluation illustrates the value of a qualitative approach to system dynamics modeling. As a tool for strategic thinking on complicated and intense processes, qualitative models can be produced with fewer resources than a full simulation, yet still provide insights that are timely and relevant. System dynamics techniques clarified endogenous and exogenous factors at play in a highly complex technology implementation, which may inform other states engaged in implementing HIE supported by federal Health Information Technology for Economic and Clinical Health (HITECH) legislation.

Joint efforts and shared responsibilities - Health information exchange in primary care for people with intellectual disabilities

NARCIS (Netherlands)

Mastebroek, M.

2017-01-01

People with intellectual disabilities (ID) have a considerably worse health than people without ID, for a great part related to the quality of healthcare provision and health communication. This research studied health information exchange (HIE) between people with ID, their support network, and

Impact of Health Information Exchange on Emergency Medicine Clinical Decision Making.

Science.gov (United States)

Gordon, Bradley D; Bernard, Kyle; Salzman, Josh; Whitebird, Robin R

2015-12-01

The objective of the study was to understand the immediate utility of health information exchange (HIE) on emergency department (ED) providers by interviewing them shortly after the information was retrieved. Prior studies of physician perceptions regarding HIE have only been performed outside of the care environment. Trained research assistants interviewed resident physicians, physician assistants and attending physicians using a semi-structured questionnaire within two hours of making a HIE request. The responses were recorded, then transcribed for qualitative analysis. The transcribed interviews were analyzed for emerging qualitative themes. We analyzed 40 interviews obtained from 29 providers. Primary qualitative themes discovered included the following: drivers for requests for outside information; the importance of unexpected information; historical lab values as reference points; providing context when determining whether to admit or discharge a patient; the importance of information in refining disposition; improved confidence of provider; and changes in decisions for diagnostic imaging. ED providers are driven to use HIE when they're missing a known piece of information. This study finds two additional impacts not previously reported. First, providers sometimes find additional unanticipated useful information, supporting a workflow that lowers the threshold to request external information. Second, providers sometimes report utility when no changes to their existing plan are made as their confidence is increased based on external records. Our findings are concordant with previous studies in finding exchanged information is useful to provide context for interpreting lab results, making admission decisions, and prevents repeat diagnostic imaging.

A user needs assessment to inform health information exchange design and implementation.

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Strauss, Alexandra T; Martinez, Diego A; Garcia-Arce, Andres; Taylor, Stephanie; Mateja, Candice; Fabri, Peter J; Zayas-Castro, Jose L

2015-10-12

Important barriers for widespread use of health information exchange (HIE) are usability and interface issues. However, most HIEs are implemented without performing a needs assessment with the end users, healthcare providers. We performed a user needs assessment for the process of obtaining clinical information from other health care organizations about a hospitalized patient and identified the types of information most valued for medical decision-making. Quantitative and qualitative analysis were used to evaluate the process to obtain and use outside clinical information (OI) using semi-structured interviews (16 internists), direct observation (750 h), and operational data from the electronic medical records (30,461 hospitalizations) of an internal medicine department in a public, teaching hospital in Tampa, Florida. 13.7 % of hospitalizations generate at least one request for OI. On average, the process comprised 13 steps, 6 decisions points, and 4 different participants. Physicians estimate that the average time to receive OI is 18 h. Physicians perceived that OI received is not useful 33-66 % of the time because information received is irrelevant or not timely. Technical barriers to OI use included poor accessibility and ineffective information visualization. Common problems with the process were receiving extraneous notes and the need to re-request the information. Drivers for OI use were to trend lab or imaging abnormalities, understand medical history of critically ill or hospital-to-hospital transferred patients, and assess previous echocardiograms and bacterial cultures. About 85 % of the physicians believe HIE would have a positive effect on improving healthcare delivery. Although hospitalists are challenged by a complex process to obtain OI, they recognize the value of specific information for enhancing medical decision-making. HIE systems are likely to have increased utilization and effectiveness if specific patient-level clinical information is

Review of successful hospital readmission reduction strategies and the role of health information exchange.

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Kash, Bita A; Baek, Juha; Davis, Elise; Champagne-Langabeer, Tiffany; Langabeer, James R

2017-08-01

The United States has invested substantially in technologies that enable health information exchange (HIE), which in turn can be deployed to reduce avoidable hospital readmission rates in many communities. With avoidable hospital readmissions as the primary focus, this study profiles successful hospital readmission rate reduction initiatives that integrate HIE as a strategy. We hypothesized that the use of HIE is associated with decreased hospital readmissions beyond other observed population health benefits. Results of this systematic review are used to describe and profile successful readmission reduction programs that integrate HIE as a tool. A systematic review of literature provided an understanding of the use of HIE as a strategy to reduce hospital readmission rates. We conducted a review of 4,862 citations written in English about readmission reduction strategies from January 2006 to September 2016 in the MEDLINE-PubMed database. Of these, 106 studies reported 30-day readmission rates as an outcome and only 13 articles reported using HIE. Only a very small number (12%) of hospitals incorporated HIE as a primary tool for evidence-based readmission reduction initiatives. Information exchange between providers has been suggested to play a key role in reducing avoidable readmission rates, yet there is not currently evidence supporting current HIE-enabled readmission initiatives. Most successful readmission reduction programs demonstrate collaboration with primary care providers to augment transitions of care to existing care management functions without additional staff while using effective information exchange capabilities. This research confirms there is very little integration of HIE into health systems readmissions initiatives. There is a great opportunity to achieve population health targets using the HIE infrastructure. Hospitals should consider partnering with primary care clinics to implement multifaceted transitions of care programs to significantly

Implementing health information exchange for public health reporting: a comparison of decision and risk management of three regional health information organizations in New York state

Science.gov (United States)

Phillips, Andrew B; Wilson, Rosalind V; Kaushal, Rainu; Merrill, Jacqueline A

2014-01-01

Health information exchange (HIE) is a significant component of healthcare transformation strategies at both the state and national levels. HIE is expected to improve care coordination, and advance public health, but implementation is massively complex and involves significant risk. In New York, three regional health information organizations (RHIOs) implemented an HIE use case for public health reporting by demonstrating capability to deliver accurate responses to electronic queries via a set of services called the Universal Public Health Node. We investigated process and outcomes of the implementation with a comparative case study. Qualitative analysis was structured around a decision and risk matrix. Although each RHIO had a unique operational model, two common factors influenced risk management and implementation success: leadership capable of agile decision-making and commitment to a strong organizational vision. While all three RHIOs achieved certification for the public health reporting, only one has elected to deploy a production version. PMID:23975626

Data governance and data sharing agreements for community-wide health information exchange: lessons from the beacon communities.

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Allen, Claudia; Des Jardins, Terrisca R; Heider, Arvela; Lyman, Kristin A; McWilliams, Lee; Rein, Alison L; Schachter, Abigail A; Singh, Ranjit; Sorondo, Barbara; Topper, Joan; Turske, Scott A

2014-01-01

Unprecedented efforts are underway across the United States to electronically capture and exchange health information to improve health care and population health, and reduce costs. This increased collection and sharing of electronic patient data raises several governance issues, including privacy, security, liability, and market competition. Those engaged in such efforts have had to develop data sharing agreements (DSAs) among entities involved in information exchange, many of whom are "nontraditional" health care entities and/or new partners. This paper shares lessons learned based on the experiences of six federally funded communities participating in the Beacon Community Cooperative Agreement Program, and offers guidance for navigating data governance issues and developing DSAs to facilitate community-wide health information exchange. While all entities involved in electronic data sharing must address governance issues and create DSAs accordingly, until recently little formal guidance existed for doing so - particularly for community-based initiatives. Despite this lack of guidance, together the Beacon Communities' experiences highlight promising strategies for navigating complex governance issues, which may be useful to other entities or communities initiating information exchange efforts to support delivery system transformation. For the past three years, AcademyHealth has provided technical assistance to most of the 17 Beacon Communities, 6 of whom contributed to this collaborative writing effort. Though these communities varied widely in terms of their demographics, resources, and Beacon-driven priorities, common themes emerged as they described their approaches to data governance and DSA development. The 6 Beacon Communities confirmed that DSAs are necessary to satisfy legal and market-based concerns, and they identified several specific issues, many of which have been noted by others involved in network data sharing initiatives. More importantly, these

Effects of health information exchange adoption on ambulatory testing rates.

Science.gov (United States)

Ross, Stephen E; Radcliff, Tiffany A; Leblanc, William G; Dickinson, L Miriam; Libby, Anne M; Nease, Donald E

2013-01-01

To determine the effects of the adoption of ambulatory electronic health information exchange (HIE) on rates of laboratory and radiology testing and allowable charges. Claims data from the dominant health plan in Mesa County, Colorado, from 1 April 2005 to 31 December 2010 were matched to HIE adoption data on the provider level. Using mixed effects regression models with the quarter as the unit of analysis, the effect of HIE adoption on testing rates and associated charges was assessed. Claims submitted by 306 providers in 69 practices for 34 818 patients were analyzed. The rate of testing per provider was expressed as tests per 1000 patients per quarter. For primary care providers, the rate of laboratory testing increased over the time span (baseline 1041 tests/1000 patients/quarter, increasing by 13.9 each quarter) and shifted downward with HIE adoption (downward shift of 83, prates or imputed charges in either provider group. Ambulatory HIE adoption is unlikely to produce significant direct savings through reductions in rates of testing. The economic benefits of HIE may reside instead in other downstream outcomes of better informed, higher quality care.

The Effects of Public Concern for Information Privacy on the Adoption of Health Information Exchanges (HIEs) by Healthcare Entities.

Science.gov (United States)

Esmaeilzadeh, Pouyan

2018-05-08

The implementation of Health Information Exchanges (HIEs) by healthcare organizations may not achieve the desired outcomes as consumers may request that their health information remains unshared because of information privacy concerns. Drawing on the insights of concern for information privacy (CFIP) literature, this work extends the application of CFIP to the HIE domain. This study attempts to develop and test a model centered on the four dimensions of CFIP construct (collection, errors, unauthorized access, and secondary use) and their antecedents to predict consumers' opt-in behavioral intention toward HIE in the presence of the perceived health status' effects. We conducted an online survey in the United States using 826 samples. The results demonstrate that the perceived health information sensitivity and computer anxiety meaningfully contribute to information privacy concerns and CFIP construct significantly impedes consumers' opt-in decision to HIEs. Interestingly, contrary to our expectation, perceived poor health status considerably attenuates the negative effects exerted by CFIP on opt-in intention. The model proposed by this study can be used as a useful conceptual tool by both further studies and practitioners to examine the complex nature of patients' reactions to information privacy threats associated with the use of HIE technology in the healthcare industry.

Speeding decisions. Social security's information exchange program.

Science.gov (United States)

Winter, Kitt; Hastings, Bob

2011-05-01

The Social Security Administration has plenty of reasons to streamline its records request process-more than 15 million reasons each year, in fact. That's why it has been pioneering information exchange projects with the private sector, including use of the Nationwide Health Information Network.

Simulation Suggests That Medical Group Mergers Won’t Undermine The Potential Utility Of Health Information Exchanges

Science.gov (United States)

Schneider, Eric C.; Volk, Lynn A.; Szolovits, Peter; Salzberg, Claudia A.; Simon, Steven R.; Bates, David W.

2013-01-01

Substantial resources are being invested in health information exchanges (HIE), community-based consortia that enable independent health-care organizations to exchange clinical data. However, under pressure to form accountable care organizations, medical groups may merge and support private HIE, reducing the potential utility of community HIEs. Simulations of “care transitions” based on data from 10 Massachusetts communities suggest that mergers would have to be considerable to substantially reduce the potential utility of an HIE. Nonetheless, simulations also suggest that HIEs will need to recruit a large proportion of the medical groups in a community, as hospitals and the largest groups account for only 10 to 20% of care transitions in communities. PMID:22392665

Exchange of Information in Tax Matters

Directory of Open Access Journals (Sweden)

Paweł Szwajdler

2017-01-01

Full Text Available The main aim of this paper is to present issues related to exchange of tax information. The author focuses on models of exchange of information and boundaries of obligations in reference to above-mentioned problems. Automatic exchange of information, spontaneous exchange of information and exchange of information on request are analysed in this work on the base of OECD Convention on Mutual Administrative Assistance in Tax Matters, Council Directive 2011/16 and OECD Model Agreement on Exchange of Information in Tax Matters. In the summary, it was showed that the most efficient method of exchange of tax information is automatic exchange of information. Furthermore, it was stated that exchange on request can be related to negative phenomenon such as fishing expedition. Spontaneous exchange of information is thought to play only supportive role.  The author also considers that boundaries of exchange of information in tax matters were regulated so as to protect jeopardised raison d’ État.

Exchange of Information in Tax Matters

OpenAIRE

Paweł Szwajdler

2017-01-01

The main aim of this paper is to present issues related to exchange of tax information. The author focuses on models of exchange of information and boundaries of obligations in reference to above-mentioned problems. Automatic exchange of information, spontaneous exchange of information and exchange of information on request are analysed in this work on the base of OECD Convention on Mutual Administrative Assistance in Tax Matters, Council Directive 2011/16 and OECD Model Agreement on Exchange...

The Veteran-Initiated Electronic Care Coordination: A Multisite Initiative to Promote and Evaluate Consumer-Mediated Health Information Exchange.

Science.gov (United States)

Klein, Dawn M; Pham, Kassi; Samy, Leila; Bluth, Adam; Nazi, Kim M; Witry, Matthew; Klutts, J Stacey; Grant, Kathleen M; Gundlapalli, Adi V; Kochersberger, Gary; Pfeiffer, Laurie; Romero, Sergio; Vetter, Brian; Turvey, Carolyn L

2017-04-01

Information continuity is critical to person-centered care when patients receive care from multiple healthcare systems. Patients can access their electronic health record data through patient portals to facilitate information exchange. This pilot was developed to improve care continuity for rural Veterans by (1) promoting the use of the Department of Veterans Affairs (VA) patient portal to share health information with non-VA providers, and (2) evaluating the impact of health information sharing at a community appointment. Veterans from nine VA healthcare systems were trained to access and share their VA Continuity of Care Document (CCD) with their non-VA providers. Patients and non-VA providers completed surveys on their experiences. Participants (n = 620) were primarily older, white, and Vietnam era Veterans. After training, 78% reported the CCD would help them be more involved in their healthcare and 86% planned to share it regularly with non-VA providers. Veterans (n = 256) then attended 277 community appointments. Provider responses from these appointments (n = 133) indicated they were confident in the accuracy of the information (97%) and wanted to continue to receive the CCD (96%). Ninety percent of providers reported the CCD improved their ability to have an accurate medication list and helped them make medication treatment decisions. Fifty percent reported they did not order a laboratory test or another procedure because of information available in the CCD. This pilot demonstrates feasibility and value of patient access to a CCD to facilitate information sharing between VA and non-VA providers. Outreach and targeted education are needed to promote consumer-mediated health information exchange.

The development of a health information exchange to enhance care and improve patient outcomes among HIV+ individuals in rural North Carolina.

Science.gov (United States)

Messer, Lynne C; Parnell, Heather; Huffaker, Renee; Wooldredge, Rich; Wilkin, Aimee

2012-10-01

The Regional Health Information Integration Project (RHIIP) has developed the Carolina HIV Information Cooperative regional health information organization (CHIC RHIO). The CHIC RHIO was implemented to improve patient care and health outcomes by enhancing communication among geographically disconnected networks of HIV care providers in rural North Carolina. CHIC RHIO comprises one medical clinic and five AIDS Service Organizations (ASOs) serving clients in eight rural counties. Communication among the CHIC RHIO members is facilitated by CAREWare software. The RHIIP team assessed organizational readiness to change, facilitated relationship-building for CHIC RHIO, created the CHIC RHIO and used both qualitative and quantitative approaches to evaluate the process-related effects of implementing a data-sharing intervention. We found the CHIC RHIO member organizations were ready to engage in the IT intervention prior to its implementation, which most likely contributed to its successful adoption. The qualitative findings indicate that CHIC RHIO members personally benefited - and perceived their clients benefited - from participation in the information exchange. The quantitative results echoed the qualitative findings; following the CHIC RHIO intervention, quality improvements were noted in the ASO and medical clinic relationships, information exchange, and perceived level of patient care. Furthermore, hopes for what data sharing would accomplish were overly high at the beginning of the project, thus requiring a recalibration of expectations as the project came to a close. Innovative strategies for health information exchange can be implemented in rural communities to increase communication among providers. With this increased communication comes the potential for improved health outcomes and, in turn, healthier communities. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Exchange of Information in Tax Matters

OpenAIRE

Szwajdler, Paweł

2017-01-01

Szwajdler Paweł. Exchange of Information in Tax Matters. Journal of Education, Health and Sport. 2017;7(1):556-570. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.893161 http://ojs.ukw.edu.pl/index.php/johs/article/view/4828 https://pbn.nauka.gov.pl/sedno-webapp/works/831606 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 754 (09.12.2016). 754 Journal of Education, Health and Sport...

Organizational Uses of Health Information Exchange to Change Cost and Utilization Outcomes: A Typology from a Multi-Site Qualitative Analysis.

Science.gov (United States)

Vest, Joshua R; Abramson, Erika

2015-01-01

Health information exchange (HIE) systems facilitate access to patient information for a variety of health care organizations, end users, and clinical and organizational goals. While a complex intervention, organizations' usage of HIE is often conceptualized and measured narrowly. We sought to provide greater specificity to the concept of HIE as an intervention by formulating a typology of organizational HIE usage. We interviewed representatives of a regional health information organization and health care organizations actively using HIE information to change patient utilization and costs. The resultant typology includes three dimensions: user role, usage initiation, and patient set. This approach to categorizing how health care organizations are actually applying HIE information to clinical and business tasks provides greater clarity about HIE as an intervention and helps elucidate the conceptual linkage between HIE an organizational and patient outcomes.

Notifications of hospital events to outpatient clinicians using health information exchange: a post-implementation survey

Directory of Open Access Journals (Sweden)

Richard Altman

2013-09-01

Full Text Available Background The trend towards hospitalist medicine can lead to disjointed patient care. Outpatient clinicians may be unaware of patients’ encounters with a disparate healthcare system. Electronic notifications to outpatient clinicians of patients’ emergency department (ED visits and inpatient admissions and discharges using health information exchange can inform outpatient clinicians of patients’ hospital-based events.Objective Assess outpatient clinicians’ impressions of a new, secure messaging-based, patient event notification system.Methods Twenty outpatient clinicians receiving notifications of hospital-based events were recruited and 14 agreed to participate. Using a semi-structured interview, clinicians were asked about their use of notifications and the impact on their practices.Results Nine of 14 interviewed clinicians (64% thought that without notifications, they would have heard about fewer than 10% of ED visits before the patient’s next visit. Nine clinicians (64% thought that without notifications, they would have heard about fewer than 25% of inpatient admissions and discharges before the patient’s next visit. Six clinicians (43% reported that they call the inpatient team more often because of notifications. Eight users (57% thought that notifications improved patient safety by increasing their awareness of the patients’ clinical events and their medication changes. Key themes identified were the importance of workflow integration and a desire for more clinical information in notifications.Conclusions The notification system is perceived by clinicians to be of value. These findings should instigate further message-oriented use of health information exchange and point to refinements that can lead to even greater benefits.

Physician capability to electronically exchange clinical information, 2011.

Science.gov (United States)

Patel, Vaishali; Swain, Matthew J; King, Jennifer; Furukawa, Michael F

2013-10-01

To provide national estimates of physician capability to electronically share clinical information with other providers and to describe variation in exchange capability across states and electronic health record (EHR) vendors using the 2011 National Ambulatory Medical Care Survey Electronic Medical Record Supplement. Survey of a nationally representative sample of nonfederal office-based physicians who provide direct patient care. The survey was administered by mail with telephone follow-up and had a 61% weighted response rate. The overall sample consisted of 4326 respondents. We calculated estimates of electronic exchange capability at the national and state levels, and applied multivariate analyses to examine the association between the capability to exchange different types of clinical information and physician and practice characteristics. In 2011, 55% of physicians had computerized capability to send prescriptions electronically; 67% had the capability to view lab results electronically; 42% were able to incorporate lab results into their EHR; 35% were able to send lab orders electronically; and, 31% exchanged patient clinical summaries with other providers. The strongest predictor of exchange capability is adoption of an EHR. However, substantial variation exists across geography and EHR vendors in exchange capability, especially electronic exchange of clinical summaries. In 2011, a majority of office-based physicians could exchange lab and medication data, and approximately one-third could exchange clinical summaries with patients or other providers. EHRs serve as a key mechanism by which physicians can exchange clinical data, though physicians' capability to exchange varies by vendor and by state.

Short-Term Medical Costs of a VHA Health Information Exchange: A CHEERS-Compliant Article

Science.gov (United States)

French, Dustin D.; Dixon, Brian E.; Perkins, Susan M.; Myers, Laura J.; Weiner, Michael; Zillich, Allan J.; Haggstrom, David A.

2016-01-01

Abstract The Virtual Lifetime Electronic Record (VLER) Health program provides the Veterans Health Administration (VHA) a framework whereby VHA providers can access the veterans’ electronic health record information to coordinate healthcare across multiple sites of care. As an early adopter of VLER, the Indianapolis VHA and Regenstrief Institute implemented a regional demonstration program involving bi-directional health information exchange (HIE) between VHA and non-VHA providers. The aim of the study is to determine whether implementation of VLER HIE reduces 1 year VHA medical costs. A cohort evaluation with a concurrent control group compared VHA healthcare costs using propensity score adjustment. A CHEERs compliant checklist was used to conduct the cost evaluation. Patients were enrolled in the VLER program onsite at the Indianapolis VHA in outpatient clinics or through the release-of-information office. VHA cost data (in 2014 dollars) were obtained for both enrolled and nonenrolled (control) patients for 1 year prior to, and 1 year after, the index date of patient enrollment. There were 6104 patients enrolled in VLER and 45,700 patients in the control group. The annual adjusted total cost difference per patient was associated with a higher cost for VLER enrollees $1152 (95% CI: $807–1433) (P < 0.01) (in 2014 dollars) than VLER nonenrollees. Short-term evaluation of this demonstration project did not show immediate reductions in healthcare cost as might be expected if HIE decreased redundant medical tests and treatments. Cost reductions from shared health information may be realized with longer time horizons. PMID:26765453

The Influence of Organizational Systems on Information Exchange in Long-Term Care Facilities: An Institutional Ethnography.

Science.gov (United States)

Caspar, Sienna; Ratner, Pamela A; Phinney, Alison; MacKinnon, Karen

2016-06-01

Person-centered care is heavily dependent on effective information exchange among health care team members. We explored the organizational systems that influence resident care attendants' (RCAs) access to care information in long-term care (LTC) settings. We conducted an institutional ethnography in three LTC facilities. Investigative methods included naturalistic observations, in-depth interviews, and textual analysis. Practical access to texts containing individualized care-related information (e.g., care plans) was dependent on job classification. Regulated health care professionals accessed these texts daily. RCAs lacked practical access to these texts and primarily received and shared information orally. Microsystems of care, based on information exchange formats, emerged. Organizational systems mandated written exchange of information and did not formally support an oral exchange. Thus, oral information exchanges were largely dependent on the quality of workplace relationships. Formal systems are needed to support structured oral information exchange within and between the microsystems of care found in LTC. © The Author(s) 2016.

Leveraging health information exchange to improve population health reporting processes: lessons in using a collaborative-participatory design process.

Science.gov (United States)

Revere, Debra; Dixon, Brian E; Hills, Rebecca; Williams, Jennifer L; Grannis, Shaun J

2014-01-01

Surveillance, or the systematic monitoring of disease within a population, is a cornerstone function of public health. Despite significant investment in information technologies (IT) to improve the public's health, health care providers continue to rely on manual, spontaneous reporting processes that can result in incomplete and delayed surveillance activities. Participatory design principles advocate including real users and stakeholders when designing an information system to ensure high ecological validity of the product, incorporate relevance and context into the design, reduce misconceptions designers can make due to insufficient domain expertise, and ultimately reduce barriers to adoption of the system. This paper focuses on the collaborative and informal participatory design process used to develop enhanced, IT-enabled reporting processes that leverage available electronic health records in a health information exchange to prepopulate notifiable-conditions report forms used by public health authorities. Over nine months, public health stakeholders, technical staff, and informatics researchers were engaged in a multiphase participatory design process that included public health stakeholder focus groups, investigator-engineering team meetings, public health survey and census regarding high-priority data elements, and codesign of exploratory prototypes and final form mock-ups. A number of state-mandated report fields that are not highly used or desirable for disease investigation were eliminated, which allowed engineers to repurpose form space for desired and high-priority data elements and improve the usability of the forms. Our participatory design process ensured that IT development was driven by end user expertise and needs, resulting in significant improvements to the layout and functionality of the reporting forms. In addition to informing report form development, engaging with public health end users and stakeholders through the participatory design

Barriers and facilitators to health information exchange in low- and middleincome country settings: a systematic review protocol

Directory of Open Access Journals (Sweden)

Ather Akhlaq

2015-03-01

Full Text Available IntroductionThe ability to capture, exchange and use accurate information about patients and services is vital for building strong health systems, providing comprehensive and integrated patient care, managing public health risks and informing policies for public health and health financing. However, the organisational and technological systems necessary to achieve effective Health Information Exchange are lacking in many low- and middle-income countries (LMIC. Developing strategies for addressing this depends on understanding the barriers and facilitators to HIE at the individual, provider organisational, community, district, provincial and national levels. This systematic review aims to identify, critically appraise and synthesise the existing published evidence addressing these factors.ObjectiveTo assess what is known, from published / unpublished empirical studies, about barriers and facilitators to HIE in LMIC so as to identify issues that need to be addressed and approaches that can fruitfully be pursued in future improvement strategies.MethodsWe will conduct a systematic review to identify the empirical evidence base on the barriers and facilitators to HIE in LMIC.  Two reviewers will independently search 11 major international and national databases for published, unpublished and in-progress qualitative, quantitative and mixed methods studies published during 1990-July 2014 in any language. These searches of scientific databases will be supplemented by looking for eligible reports available online. The included studies will be independently critically appraised using the Mixed Method Appraisal Tool (MMAT, version 2011. Descriptive, narrative and interpretative synthesis of data will be undertaken.   Results These will be presented in a manuscript that will be published in the peer-reviewed literature. The protocol is registered with the International Prospective Register for Systematic Reviews (PROSPERO CRD 42014009826

Towards automatic exchange of information

OpenAIRE

Oberson, Xavier

2015-01-01

This article describes the various steps that led towards automatic exchange of information as the global standard and the issues that remain to be solved. First, the various competing models of exchange information, such as Double Tax Treaty (DTT), TIEA's, FATCA or UE Directives are described with a view to show how they interact between themselves. Second, the so-called Rubik Strategy is summarized and compared with an automatic exchange of information (AEOI). The third part then describes ...

Public attitudes toward health information exchange: perceived benefits and concerns.

Science.gov (United States)

Dimitropoulos, Linda; Patel, Vaishali; Scheffler, Scott A; Posnack, Steve

2011-12-01

To characterize consumers' attitudes regarding the perceived benefits of electronic health information exchange (HIE), potential HIE privacy and security concerns, and to analyze the intersection of these concerns with perceived benefits. A cross-sectional study. A random-digit-dial telephone survey of English-speaking adults was conducted in 2010. Multivariate logistic regression models examined the association between consumer characteristics and concerns related to the security of electronic health records (EHRs) and HIE. A majority of the 1847 respondents reported they were either "very" or "somewhat" concerned about privacy of HIE (70%), security of HIE (75%), or security of EHRs (82%). Concerns were significantly higher (P security, and 60% would permit HIE for treatment purposes even if the physician might not be able to protect their privacy all of the time. Over half (52%) wanted to choose which providers access and share their data. Greater participation by consumers in determining how HIE takes place could engender a higher degree of trust among all demographic groups, regardless of their varying levels of privacy and security concerns. Addressing the specific privacy and security concerns of minorities, individuals 40 to 64 years old, and employed individuals will be critical to ensuring widespread consumer participation in HIE.

Multiprocessor shared-memory information exchange

International Nuclear Information System (INIS)

Santoline, L.L.; Bowers, M.D.; Crew, A.W.; Roslund, C.J.; Ghrist, W.D. III

1989-01-01

In distributed microprocessor-based instrumentation and control systems, the inter-and intra-subsystem communication requirements ultimately form the basis for the overall system architecture. This paper describes a software protocol which addresses the intra-subsystem communications problem. Specifically the protocol allows for multiple processors to exchange information via a shared-memory interface. The authors primary goal is to provide a reliable means for information to be exchanged between central application processor boards (masters) and dedicated function processor boards (slaves) in a single computer chassis. The resultant Multiprocessor Shared-Memory Information Exchange (MSMIE) protocol, a standard master-slave shared-memory interface suitable for use in nuclear safety systems, is designed to pass unidirectional buffers of information between the processors while providing a minimum, deterministic cycle time for this data exchange

47 CFR 90.555 - Information exchange.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Information exchange. 90.555 Section 90.555...-805 MHz Bands § 90.555 Information exchange. (a) Prior notification. Public safety licensees... Safety Information Exchange. (1) Upon request by a 746-757, 758-763, 776-787, or 788-793 MHz band...

CALINX (California Information Exchange): a multi-stakeholder statewide initiative to improve healthcare information flows.

Science.gov (United States)

Hopkins, D S; Oswald, N; McCaffrey, K; Bressler, S; Davidson, N; Vela, L

2000-01-01

Given the diffusion of responsibilities for gathering and reporting healthcare information in a managed care environment, California stakeholders are taking concrete steps to break the deadlock on data and information flows that has characterized the industry for some time. The California Information Exchange (CALINX) was established to facilitate the implementation of the Health Insurance Portability and Accountability Act (HIPAA) standards in California and to create trust for data exchange between trading partners, without which data exchange still will not occur. Strategic directions are set by the chief executives of key associations and organizations representing purchasers, plans, providers, and consumers. Multi-stakeholder workgroups have produced detailed data guidelines for the HIPAA standards along with rules for exchange of key data sets between trading partners. These rules address frequency, timeliness, and accuracy of data submission. Both the data guidelines and the rules have been tested in live demonstration projects, and the results of these projects have been reported to substantiate the business case for implementation. Further incentives are being built into contracts between purchasers and plans, and between plans and providers. CALINX is currently promoting widespread adoption of the data guidelines and rules for exchange with all members of the industry.

A snapshot of health information exchange across five nations: an investigation of frontline clinician experiences in emergency care.

Science.gov (United States)

Klapman, Seth; Sher, Emily; Adler-Milstein, Julia

2018-06-01

Ensuring the ability to exchange patient information among disparate electronic health records systems is a top priority and a domain of substantial public investment across countries. However, we know little about the extent to which current capabilities meet the needs of frontline clinicians. We conducted in-person, semistructured interviews with emergency care physicians and nurses in select hospitals in Canada, Denmark, Finland, Germany, and the USA. We characterized the state of health information exchange (HIE) by country and used thematic analysis to identify the perceived benefits of access to complete past medical history (PMH), the conditions under which PMH is sought, and the challenges to accessing and using HIE capabilities. HIE approaches, and the information electronically accessible to clinicians, differed by country. Benefits of access to PMH included safer care, reduced patient length of stay, and fewer lab and imaging orders. Conditions under which PMH was sought included moderate-acuity patients, patients with chronic conditions, and instances where accessing PMH was convenient. Challenges to HIE access and use included difficulty knowing where information is located, delay in receiving information, and difficulty finding information within documents. Even with different HIE approaches across countries, all clinicians reported shortcomings in their country's approach. Notably, challenges were similar and shaped the conditions under which PMH was sought. As countries continue to pursue broad-based HIE, they appear to be facing similar challenges in realizing HIE value and therefore have an opportunity to learn from one another.

Health and Environment Linked for Information Exchange in Atlanta (HELIX-Atlanta): A Pilot Tracking System

Science.gov (United States)

Rickman, Doug; Shire, J.; Qualters, J.; Mitchell, K.; Pollard, S.; Rao, R.; Kajumba, N.; Quattrochi, D.; Estes, M., Jr.; Meyer, P.;

47 CFR 90.675 - Information exchange.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Information exchange. 90.675 Section 90.675... exchange. (a) Prior coordination. Public safety/CII licensees may notify an ESMR or part 22 Cellular... cell is activated. (c) Public safety information exchange. (1) Upon request by an ESMR or part 22...

Balancing Health Information Exchange and Privacy Governance from a Patient-Centred Connected Health and Telehealth Perspective.

Science.gov (United States)

Kuziemsky, Craig E; Gogia, Shashi B; Househ, Mowafa; Petersen, Carolyn; Basu, Arindam

2018-04-22

 Connected healthcare is an essential part of patient-centred care delivery. Technology such as telehealth is a critical part of connected healthcare. However, exchanging health information brings the risk of privacy issues. To better manage privacy risks we first need to understand the different patterns of patient-centred care in order to tailor solutions to address privacy risks.  Drawing upon published literature, we develop a business model to enable patient-centred care via telehealth. The model identifies three patient-centred connected health patterns. We then use the patterns to analyse potential privacy risks and possible solutions from different types of telehealth delivery.  Connected healthcare raises the risk of unwarranted access to health data and related invasion of privacy. However, the risk and extent of privacy issues differ according to the pattern of patient-centred care delivery and the type of particular challenge as they enable the highest degree of connectivity and thus the greatest potential for privacy breaches.  Privacy issues are a major concern in telehealth systems and patients, providers, and administrators need to be aware of these privacy issues and have guidance on how to manage them. This paper integrates patient-centred connected health care, telehealth, and privacy risks to provide an understanding of how risks vary across different patterns of patient-centred connected health and different types of telehealth delivery. Georg Thieme Verlag KG Stuttgart.

International information exchange in fusion research

International Nuclear Information System (INIS)

Strickler, C.S.

1979-01-01

Formal and informal agreements exist between the US and several other countries, assuring the unrestricted exchange of magnetic fusion information. The Fusion Energy Library at Oak Ridge National Laboratory uses the US Department of Energy standard distribution system and exchange agreements to ensure the receipt of current reports. Selective dissemination of information, computer networks, and exchange programs are additional means for information gathering. The importance of these means as they relate to the fusion program in the US and specifically at ORNL is discussed

Information exchange - DOE oversight programs

International Nuclear Information System (INIS)

Tubbs, D.C.; Field, H.C.

1988-01-01

Oversight programs are conducted by the U.S. Department of Energy to review activities carried out by field and contractor organizations. Two of these oversight programs focus on safeguards and security and on safety and health activities. These two programs are independent, but share many common objectives and review techniques. The mutual potential benefit was recognized from an exchange of information on review techniques. The first step in this exchange was the participation by an Office of Security Evaluations (OSE) staff member with the Office of Nuclear Safety (ONS) during their planning, conduct and reporting of a Technical Safety Appraisal (TSA). This paper briefly describes the OSE and ONS programs. It also identifies and analyzes the similarities and differences of the two programs. The purpose of this paper is to provide perspectives on the approach taken, the techniques used and the differences between two oversight programs conducted by the Department of Energy

Evaluation of a Pilot Surveillance System: Health and Environment Linked for Information Exchange in Atlanta (HELIX-Atlanta)

Science.gov (United States)

Meyer, P.; Shire, J.; Qualters, Judy; Daley, Randolph; Fiero, Leslie Todorov; Autry, Andy; Avchen, Rachel; Stock, Allison; Correa, Adolofo; Siffel, Csaba;

Exchanging information

International Nuclear Information System (INIS)

1971-01-01

The Agency has a statutory mandate to foster 'the exchange of scientific and technical information on the peaceful uses of atomic energy'. The prime responsibility for this work within the Agency lies with the Division of Scientific and Technical Information, a part of the Department of Technical Operations. The Division accomplishes its task by holding conferences and symposia (Scientific Conferences Section), through the Agency Library, by publishing scientific journals, and through the International Nuclear Information System (INIS). The Computer Section of the Division, which offers services to the Agency as a whole, provides resources for the automation of data storage and retrieval. (author)

User experiences with different regional health information exchange systems in Finland.

Science.gov (United States)

Hyppönen, Hannele; Reponen, Jarmo; Lääveri, Tinja; Kaipio, Johanna

2014-01-01

The interest in cross-organizational Health Information Exchange (HIE) is increasing at regional, national and cross-European levels. The purpose of our study was to compare user experiences (usability) of different regional health information exchange system (RHIE) types as well as the factors related to the experienced level of success of different RHIE system types. A web-based questionnaire was sent to 95% of Finnish physicians aged between 25 and 65 years of age. RHIE systems were mainly available in the public sector and only in certain regions. Those 1693 physicians were selected from the 3929 respondents of the original study, who met these criteria. The preferred means (paper/fax vs. electronic) of cross-organizational HIE, and replies to the 11 questions measuring RHIE success were used as the main dependent variables. Two thirds (73%) of the primary care physicians and one third (33%) of the specialized care physicians replied using an electronic RHIE system rather than paper or fax as a primary means of cross-organizational HIE. Respondents from regions where a regional virtual EHR (type 3) RHIE system was employed had used electronic means rather than paper HIE to a larger extend compared to their colleagues in regions where a master patient index-type (type 1) or web distribution model (type 2) RHIE system was used. Users of three local EHR systems preferred electronic HIE to paper to a larger extend than users of other EHR systems. Experiences with an integrated RHIE system (type 3) were more positive than those with other types or RHIE systems. The study revealed User preferences for the integrated virtual RHIE-system (type 3) over the master index model (type 1) or web distribution model (type 2). Success of individual HIE tasks of writing, sending and reading were impacted by the way these functionalities were realized in the EHR systems. To meet the expectations of increased efficiency, continuity, safety and quality of care, designers of HIE

Shifts in the architecture of the Nationwide Health Information Network.

Science.gov (United States)

Lenert, Leslie; Sundwall, David; Lenert, Michael Edward

2012-01-01

In the midst of a US $30 billion USD investment in the Nationwide Health Information Network (NwHIN) and electronic health records systems, a significant change in the architecture of the NwHIN is taking place. Prior to 2010, the focus of information exchange in the NwHIN was the Regional Health Information Organization (RHIO). Since 2010, the Office of the National Coordinator (ONC) has been sponsoring policies that promote an internet-like architecture that encourages point to-point information exchange and private health information exchange networks. The net effect of these activities is to undercut the limited business model for RHIOs, decreasing the likelihood of their success, while making the NwHIN dependent on nascent technologies for community level functions such as record locator services. These changes may impact the health of patients and communities. Independent, scientifically focused debate is needed on the wisdom of ONC's proposed changes in its strategy for the NwHIN.

How could health information exchange better meet the needs of care practitioners?

Science.gov (United States)

Kierkegaard, P; Kaushal, R; Vest, J R

2014-01-01

Health information exchange (HIE) has the potential to improve the quality of healthcare by enabling providers with better access to patient information from multiple sources at the point of care. However, HIE efforts have historically been difficult to establish in the US and the failure rates of organizations created to foster HIE have been high. We sought to better understand how RHIO-based HIE systems were used in practice and the challenges care practitioners face using them. The objective of our study were to so investigate how HIE can better meet the needs of care practitioners. We performed a multiple-case study using qualitative methods in three communities in New York State. We conducted interviews onsite and by telephone with HIE users and non-users and observed the workflows of healthcare professionals at multiple healthcare organizations participating in a local HIE effort in New York State. The empirical data analysis suggests that challenges still remain in increasing provider usage, optimizing HIE implementations and connecting HIE systems across geographic regions. Important determinants of system usage and perceived value includes users experienced level of available information and the fit of use for physician workflows. Challenges still remain in increasing provider adoption, optimizing HIE implementations, and demonstrating value. The inability to find information reduced usage of HIE. Healthcare organizations, HIE facilitating organizations, and states can help support HIE adoption by ensuring patient information is accessible to providers through increasing patient consents, fostering broader participation, and by ensuring systems are usable.

Assessments of the Veteran Medication Allergy Knowledge Gap and Potential Safety Improvements with the Veteran Health Information Exchange (VHIE).

Science.gov (United States)

Pan, Eric; Botts, Nathan; Jordan, Harmon; Olinger, Lois; Donahue, Margaret; Hsing, Nelson

2016-01-01

The U.S. Department of Veterans Affairs (VA) Veteran Health Information Exchange (VHIE, formerly Virtual Lifetime Electronic Record, or VLER) had been deployed at all VA sites and used to exchange clinical information with private sector healthcare partners nationally. This paper examined VHIE's effect on allergy documentation. Review of all inbound VHIE transactions in FY14 showed that VHIE use was associated with a nearly eight-fold increase in allergy documentation rate. Preliminary manual document review further showed that VA and partners had shared knowledge of only 38% ofpatient allergies, while VA had exclusive knowledge of another 58% ofpatient allergies, and partners had exclusive knowledge of the last 5% of patient allergies. To our knowledge, this is the first study that examined the effect of HIE on allergy documentation.

47 CFR 22.880 - Information exchange.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Information exchange. 22.880 Section 22.880 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Air-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.880 Information exchange. (a...

47 CFR 22.973 - Information exchange.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Information exchange. 22.973 Section 22.973 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Cellular Radiotelephone Service § 22.973 Information exchange. (a) Prior notification. Public safety/CII...

Factors Influencing Electronic Clinical Information Exchange in Small Medical Group Practices

Science.gov (United States)

Kralewski, John E.; Zink, Therese; Boyle, Raymond

2012-01-01

Purpose: The purpose of this study was to identify the organizational factors that influence electronic health information exchange (HIE) by medical group practices in rural areas. Methods: A purposive sample of 8 small medical group practices in 3 experimental HIE regions were interviewed to determine the extent of clinical information exchange…

77 FR 70786 - Request for Information Regarding Health Care Quality for Exchanges

Science.gov (United States)

2012-11-27

... satisfaction survey system, the results of which will be available to Exchange consumers shopping for insurance... quality measure sets and quality improvement initiatives in conjunction with other factors, such as... specific preventive services, health plan performance and customer service)? Should these be similar to or...

40 CFR 22.52 - Information exchange and discovery.

Science.gov (United States)

2010-07-01

... Procedure Act § 22.52 Information exchange and discovery. Respondent's information exchange pursuant to § 22.19(a) shall include information on any economic benefit resulting from any activity or failure to act... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Information exchange and discovery. 22...

INFORMATION EXCHANGE AND SUPPLY CHAIN PERFORMANCE

OpenAIRE

T. RAMAYAH; ROAIMAH OMAR

2010-01-01

The purpose of this study is to examine the effects of operational and strategic information exchange on supply chain performance and the moderating role of information quality in relation to both operational and strategic information exchange. The study was conducted using manufacturing companies located in the Northern region of Malaysia. Hierarchical multiple regressions were applied to test the hypotheses developed for the study. It was found that operational and strategic information exc...

How Supervisor Relationships and Protection Rules Affect Employees' Attempts to Manage Health Information at Work.

Science.gov (United States)

Westerman, Catherine Y K; Currie-Mueller, Jenna L; Motto, Justin S; Curti, Logan C

2017-12-01

This article explores the issue of health information sharing at work through the lens of Communication Privacy Management theory. As employees must often share some health information at work for various reasons (e.g., to obtain sick leave or accommodations), determining how much to share and how to manage health information is important. The leader-member exchange relationship, stigma, risk perceptions, and the degree of privacy of each individual's health information were investigated. The results show that leader-member exchange, stigma, and privacy contribute to an individual's willingness to disclose health information at work and that leader-member exchange impacts perceptions of risk associated with sharing health information.

75 FR 65485 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

Science.gov (United States)

2010-10-25

... Team, Enrollment, Governance, Adoption/ Certification, and Information Exchange workgroups. General... the electronic exchange and use of health information as is consistent with the Federal Health IT...; November 3rd Information Exchange Workgroup, 10 a.m. to 11:30 a.m./ET; November 5th Governance Workgroup, 1...

Construction Operations Building Information Exchange (COBIE)

Science.gov (United States)

2007-06-01

Swalley U.S. Department of State, Overseas Buildings Operations Toby Wilson U.S. Army, Corps of Engineers, Engineer R&D Center Jeff Wix AEC3 The...exchanged in COBIE. To map those information exchanges to the IFC model, the Information Delivery Manual (IDM) process [ Wix 2007] was also used. The...Folksonomy. Wikimedia Foundation. http://en.wikipedia.org/wiki/Folksonomy/, accessed 3 August 2007. Wix , Jeffrey. 2007. Information Delivery Manual

Harnessing Private-Sector Innovation to Improve Health Insurance Exchanges.

Science.gov (United States)

Gresenz, Carole Roan; Hoch, Emily; Eibner, Christine; Rudin, Robert S; Mattke, Soeren

2016-05-09

Overhauling the individual health insurance market-including through the creation of health insurance exchanges-was a key component of the Patient Protection and Affordable Care Act's multidimensional approach to addressing the long-standing problem of the uninsured in the United States. Despite succeeding in enrolling millions of Americans, the exchanges still face several challenges, including poor consumer experience, high operational and development costs, and incomplete market penetration. In light of these challenges, analysts considered a different model for the exchanges-privately facilitated exchanges-which could address these challenges and deepen the Affordable Care Act's impact. In this model, the government retains control over sovereign exchange functions but allows the private sector to assume responsibility for more-peripheral exchange functions, such as developing and sustaining exchange websites. Although private-sector entities have already undertaken exchange-related functions on a limited basis, privately facilitated exchanges could conceivably relieve the government of its responsibility for front-end website operations and consumer decision-support functions entirely. A shift to privately facilitated exchanges could improve the consumer experience, increase enrollment, and lower costs for state and federal governments. A move to such a model requires, nonetheless, managing its risks, such as reduced consumer protection, increased consumer confusion, and the possible lack of a viable revenue base for privately facilitated exchanges, especially in less populous states. On net, the benefits are large enough and the risks sufficiently manageable to seriously consider such a shift. This paper provides background information and more detail on the analysts' assessment.

Firm handling; the information exchange interaction by parents in paediatric care – An observational study

Directory of Open Access Journals (Sweden)

Carina Berterö

2011-01-01

Full Text Available Background: Information exchange is fundamental in the paediatric care encounter. Health care professionals need further background knowledge to encounter the parents/guardians from their perspective in their minors’ paediatric care. The parents’/guardians’ ability to manage the situation is dependent on their receiving optimal information, which is why it is important to study how information is exchanged.Aim: The aim of this study was to identify, describe and conceptualize how parents/guardians resolved their main concern ininformation exchange with health care professionals in paediatric care situations involving their minors.Methodology: Glaser’s grounded theory method was used and all data were analysed using constant comparative analysis. The observational study took place at three paediatric outpatient units at a university hospital and 24 parents/guardians participated. Data sources were field notes from 37 observations of paediatric care situations and five adherent excerpts from the minors’ medical records. Grounded theory is a method of conceptualising behaviour, which is why an observational study of parents’/guardians’ information exchange and social interaction in the context of nursing care is relevant as research design.Results: Firm handling was revealed as the way the parents/guardians resolved their main concerns when they were exchanging information about their minors’ paediatric care. Firm handling is built on five inter-related categories: representative advocating, collaborating, aim sharing, supportive resourcing and minor bypassing.Conclusions: This knowledge suggests possible ways for health care professionals to design paediatric care that supports, facilitates, strengthens and improves the parents’/guardians’ firm handling. The key issue is to find ways to support parents/guardians and minors so they can participate in health care encounters according to their preferences. Firm handling gives an

Technology, Incentives, or Both? Factors Related to Level of Hospital Health Information Exchange.

Science.gov (United States)

Lin, Sunny C; Everson, Jordan; Adler-Milstein, Julia

2018-02-28

To assess whether the level of health information exchange (HIE) in U.S. hospitals is related to technology capabilities, incentives to exchange, or both. A total of 1,812 hospitals attesting to stage 2 of Medicare's Meaningful Use Incentive Program through April 2016. Hospital-level, multivariate OLS regression with state fixed effects was used to analyze the relationship between technology capability and incentives measures, and percent of care transitions with summary of care records (SCRs) sent electronically to subsequent providers. Stage 2 hospitals reported sending SCRs electronically for an average of 41 percent (median = 33 percent) of transitions. HIE level is related to four capability measures, one incentive measure, and one measure that is related to both capability and incentive. Percent of transitions with SCRs sent electronically was 3 percentage points higher (95 percent CI: 0.1-5.1) for hospitals with a third-party HIE vendor, 3 percentage points higher (95 percent CI: 0.5-5.4) for hospitals with an EHR vendor as their HIE vendor, and 3 percentage points higher (95 percent CI: 0.4-5.4) for hospitals that automatically alert primary care providers. The direction and statistical significance of the relationships between specific EHR vendor and electronic SCR transmission level varied by vendor. Nonprofits and government hospitals performed 5 percentage points higher (95 percent CI: 1.5-9.1) and 8 percentage points higher (95 percent CI: 3.4-12.3) than for-profits. Hospitals in systems performed 3 percentage points higher (95 percent CI: 0.8-6.1). The overall level of HIE is low, with hospitals sending an SCR electronically for less than half of patient transitions. Specific hospital characteristics related to both technology capabilities and incentives were associated with higher levels of HIE. © Health Research and Educational Trust.

Health information exchanges--Unfulfilled promise as a data source for clinical research.

Science.gov (United States)

Parker, Carol; Weiner, Michael; Reeves, Mathew

2016-03-01

To determine the use of health information exchange organizations (HIEs) to support and conduct clinical research. This scoping review included US-based studies published between January 2003 and March 2014 that used data from an HIE to address at least one of three categories of research: clinical or epidemiological research, financial evaluation, or utilization of health services. Eligibility was not restricted to research on HIEs. Studies with research questions outside of the evaluation of HIEs themselves were sought. Eighteen articles met final study inclusion criteria from an initial list of 847 hits. Fifteen studies addressed a clinical or epidemiological research question, 6 addressed a financial consideration, and 8 addressed a utilization issue. Considerable overlap was found among the research categories: 13 articles addressed more than one category. Of the eighteen included studies, only two used HIE data to answer a research objective that was NOT specific to HIE use. Research designs were varied and ranged from observational studies, such as cohort and cross-sectional studies, to randomized trials. The 18 articles represent the involvement of a small number of HIEs; 7 of the studies were from a single HIE. This review demonstrates that HIE-provided information is available and used to answer clinical or epidemiological, financial, or utilization-based research questions; however, the majority of the studies using HIE data are done with the primary goal of evaluating the use and impact of HIEs on health care delivery and outcomes. As HIEs mature and become integrated parts of the health care industry, the authors anticipate that fewer studies will be published that describe or validate the role of HIEs, and more will use HIEs as multi-institutional data sources for conducting clinical research and improving health services and clinical outcomes. Articles identified in this review indicate the limited extent that HIE data are being used for clinical

Qualitative study of patient consent for health information exchange in an HIV clinic.

Science.gov (United States)

Ramos, S Raquel; Bakken, Suzanne

2014-01-01

Health information exchange (HIE) is the secure, electronic transfer and/or accessibility of clinical data among healthcare providers. In the United States (US), the consent process for participation varies state to state. New York State (NYS) mandates written patient consent. The purpose of this study was to examine workflow and perceptions related to obtaining HIE consent in an HIV clinic. We used contextual inquiry to observe the HIE consent-related workflow of four registration clerks for a total of 4 hours on two weekdays and subsequently created a flow chart and sequence model diagram. Clerks were also interviewed and the resulting narrative data were coded into themes. Observational and interview data suggested that patient privacy/confidentiality/trust, high volume workflow, and multiple competing demands affect the patient HIE consent process. Additional qualitative data needs to be gathered from the perspectives of patients and clinicians about the HIE consent process.

Integrating a health information exchange into a community pharmacy transitions of care service.

Science.gov (United States)

Fanizza, Frank A; Ruisinger, Janelle F; Prohaska, Emily S; Melton, Brittany L

2018-04-03

To describe the incorporation of a state health information exchange (HIE) into a community pharmacy transitions of care (TOC) service and to assess its impact on 30-day readmission rates. Three suburban community pharmacies in Olathe, Kansas. Balls Food Stores is a grocery store chain which operates 21 supermarket community pharmacies in the Kansas City metropolitan area. Balls Food Stores launched a pharmacist-led self-referral TOC study in which a state HIE was utilized to collect discharge information from patients' electronic medical records (EMRs) to facilitate TOC comprehensive medication reviews (CMRs). Descriptive statistics were used to assess types and outcomes of identified drug therapy problems and the ability to access Kansas Health Information Network EMRs. A chi-square test was used to assess 30-day readmissions between patients who accepted and declined the service. Forty patients were identified for inclusion and 18 elected to participate in the service. The majority of participants were white females with a median age of 64.5 years. Out of 40 study patients, 85% had an EMR available; 12.5% of patients had a medication list included in their EMR hospitalization documentation. Participants who underwent the service had a statistically significantly lower rate of overall 30-day hospital readmission than those who declined (11.1% vs 36.4%, P = 0.032). Among the 18 TOC CMRs performed, 90 drug therapy problems were identified and 77 were resolved in collaboration with a patient, caregiver, or physician. Incorporation of a state HIE into a community pharmacist-led TOC service is a novel strategy for collecting patient data. During the study, no TOC participants were readmitted within 30 days. However, pharmacists found HIE data alone was insufficient to perform TOC CMRs for the majority of participants. In order to expand state HIE utilization, more health systems will need to upload a minimum standard data set to help facilitate care. Copyright © 2018

Symmetry in social exchange and health

Science.gov (United States)

Siegrist, Johannes

2005-10-01

Symmetry is a relevant concept in sociological theories of exchange. It is rooted in the evolutionary old norm of social reciprocity and is particularly important in social contracts. Symmetry breaking through violation of the norm of reciprocity generates strain in micro-social systems and, above all, in victims of non-symmetric exchange. In this contribution, adverse healthconsequences of symmetry breaking in contractual social exchange are analysed, with a main focus on the employment contract. Scientific evidence is derived from prospective epidemiological studies testing the model of effort-reward imbalance at work. Overall, a twofold elevated risk of incident disease is observed in employed men and women who are exposed to non-symmetric exchange. Health risks include coronary heart disease, depression and alcohol dependence, among others. Preliminary results suggest similar effects on health produced by symmetry breaking in other types of social relationships (e.g. partnership, parental roles). These findings underline the importance of symmetry in contractual social exchange for health and well-being.

Facilitating health information exchange in low- and middle-income countries: conceptual considerations, stakeholders perspectives and deployment strategies illustrated through an in-depth case study of Pakistan

OpenAIRE

Akhlaq, Ather

2016-01-01

Background Health information exchange (HIE) may help healthcare professionals and policymakers make informed decisions to improve patient and population health outcomes. There is, however, limited uptake of HIE in many low- and middle-income countries (LMICs). While resource constraints are an obvious barrier to implementation of HIE, it is important to explore what other political, structural, technical, environmental, legal and cultural factors may be involved. In particu...

The next public health revolution: public health information fusion and social networks.

Science.gov (United States)

Khan, Ali S; Fleischauer, Aaron; Casani, Julie; Groseclose, Samuel L

2010-07-01

Social, political, and economic disruptions caused by natural and human-caused public health emergencies have catalyzed public health efforts to expand the scope of biosurveillance and increase the timeliness, quality, and comprehensiveness of disease detection, alerting, response, and prediction. Unfortunately, efforts to acquire, render, and visualize the diversity of health intelligence information are hindered by its wide distribution across disparate fields, multiple levels of government, and the complex interagency environment. Achieving this new level of situation awareness within public health will require a fundamental cultural shift in methods of acquiring, analyzing, and disseminating information. The notion of information "fusion" may provide opportunities to expand data access, analysis, and information exchange to better inform public health action.

Can knowledge exchange support the implementation of a health-promoting schools approach? Perceived outcomes of knowledge exchange in the COMPASS study.

Science.gov (United States)

Brown, Kristin M; Elliott, Susan J; Robertson-Wilson, Jennifer; Vine, Michelle M; Leatherdale, Scott T

2018-03-13

Despite the potential population-level impact of a health-promoting schools approach, schools face challenges in implementation, indicating a gap between school health research and practice. Knowledge exchange provides an opportunity to reduce this gap; however, there has been limited evaluation of these initiatives. This research explored researchers' and knowledge users' perceptions of outcomes associated with a knowledge exchange initiative within COMPASS, a longitudinal study of Canadian secondary students and schools. Schools received annual tailored summaries of their students' health behaviours and suggestions for action and were linked with knowledge brokers to support them in taking action to improve student health. Qualitative semi-structured interviews were conducted with COMPASS researchers (n = 13), school staff (n = 13), and public health stakeholders (n = 4) to explore their experiences with COMPASS knowledge exchange. Key issues included how knowledge users used school-specific findings, perceived outcomes of knowledge exchange, and suggestions for change. Outcomes for both knowledge users and researchers were identified; interestingly, knowledge users attributed more outcomes to using school-specific findings than knowledge brokering. School and public health participants indicated school-specific findings informed their programming and planning. Importantly, knowledge exchange provided a platform for partnerships between researchers, schools, and public health units. Knowledge brokering allowed researchers to gain feedback from knowledge users to enhance the study and a better understanding of the school environment. Interestingly, COMPASS knowledge exchange outcomes aligned with Samdal and Rowling's eight theory-driven implementation components for health-promoting schools. Hence, knowledge exchange may provide a mechanism to help schools implement a health-promoting schools approach. This research contributes to the limited

SatisFactory Common Information Data Exchange Model

OpenAIRE

CERTH

2016-01-01

This deliverable defines the Common Information Data Exchange Model (CIDEM). The aim of CIDEM is to provide a model of information elements (e.g. concepts, even, relations, interfaces) used for information exchange between components as well as for modelling work performed by other tasks (e.g. knowledge models to support human resources optimization). The CIDEM definition is considered as a shared vocabulary that enables to address the information needs for the SatisFactory framework components.

Health information exchange technology on the front lines of healthcare: workflow factors and patterns of use

Science.gov (United States)

Johnson, Kevin B; Lorenzi, Nancy M

2011-01-01

Objective The goal of this study was to develop an in-depth understanding of how a health information exchange (HIE) fits into clinical workflow at multiple clinical sites. Materials and Methods The ethnographic qualitative study was conducted over a 9-month period in six emergency departments (ED) and eight ambulatory clinics in Memphis, Tennessee, USA. Data were collected using direct observation, informal interviews during observation, and formal semi-structured interviews. The authors observed for over 180 h, during which providers used the exchange 130 times. Results HIE-related workflow was modeled for each ED site and ambulatory clinic group and substantial site-to-site workflow differences were identified. Common patterns in HIE-related workflow were also identified across all sites, leading to the development of two role-based workflow models: nurse based and physician based. The workflow elements framework was applied to the two role-based patterns. An in-depth description was developed of how providers integrated HIE into existing clinical workflow, including prompts for HIE use. Discussion Workflow differed substantially among sites, but two general role-based HIE usage models were identified. Although providers used HIE to improve continuity of patient care, patient–provider trust played a significant role. Types of information retrieved related to roles, with nurses seeking to retrieve recent hospitalization data and more open-ended usage by nurse practitioners and physicians. User and role-specific customization to accommodate differences in workflow and information needs may increase the adoption and use of HIE. Conclusion Understanding end users' perspectives towards HIE technology is crucial to the long-term success of HIE. By applying qualitative methods, an in-depth understanding of HIE usage was developed. PMID:22003156

VLER Health Exchange by Area

Data.gov (United States)

Department of Veterans Affairs — “Connect Your Docs” through the Virtual Lifetime Electronic Record (VLER) Health Exchange program. This program gives VA and community health care providers secure...

Use patterns of health information exchange through a multidimensional lens: conceptual framework and empirical validation.

Science.gov (United States)

Politi, Liran; Codish, Shlomi; Sagy, Iftach; Fink, Lior

2014-12-01

Insights about patterns of system use are often gained through the analysis of system log files, which record the actual behavior of users. In a clinical context, however, few attempts have been made to typify system use through log file analysis. The present study offers a framework for identifying, describing, and discerning among patterns of use of a clinical information retrieval system. We use the session attributes of volume, diversity, granularity, duration, and content to define a multidimensional space in which each specific session can be positioned. We also describe an analytical method for identifying the common archetypes of system use in this multidimensional space. We demonstrate the value of the proposed framework with a log file of the use of a health information exchange (HIE) system by physicians in an emergency department (ED) of a large Israeli hospital. The analysis reveals five distinct patterns of system use, which have yet to be described in the relevant literature. The results of this study have the potential to inform the design of HIE systems for efficient and effective use, thus increasing their contribution to the clinical decision-making process. Copyright © 2014 Elsevier Inc. All rights reserved.

Communication and Exchange of Specialized Health-Related Support Among People With Experiential Similarity on Facebook.

Science.gov (United States)

Gage-Bouchard, Elizabeth A; LaValley, Susan; Mollica, Michelle; Beaupin, Lynda Kwon

2017-10-01

Social support is an important factor that shapes how people cope with illness, and health-related communication among peers managing the same illness (network ties with experiential similarity) offers specialized information, resources, and emotional support. Facebook has become a ubiquitous part of many Americans' lives, and may offer a way for patients and caregivers experiencing a similar illness to exchange specialized health-related support. However, little is known about the content of communication among people who have coped with the same illness on personal Facebook pages. We conducted a content analysis of 12 months of data from 18 publicly available Facebook pages hosted by parents of children with acute lymphoblastic leukemia, focusing on communication between users who self-identified as parents of pediatric cancer patients. Support exchanges between users with experiential similarity contained highly specialized health-related information, including information about health services use, symptom recognition, compliance, medication use, treatment protocols, and medical procedures. Parents also exchanged tailored emotional support through comparison, empathy, encouragement, and hope. Building upon previous research documenting that social media use can widen and diversify support networks, our findings show that cancer caregivers access specialized health-related informational and emotional support through communication with others who have experienced the same illness on personal Facebook pages. These findings have implications for health communication practice and offer evidence to tailor M-Health interventions that leverage existing social media platforms to enhance peer support for patients and caregivers.

International exchange of safety and licensing information

International Nuclear Information System (INIS)

Lafleur, J.D. Jr.; Hauber, R.D.; Chenier, D.M.

1977-01-01

A network of formal and informal bilateral arrangements for the exchange of nuclear safety information is being established by the U.S. Nuclear Regulatory Commission. For developing countries, such arrangements can provide ready access to the extensive, fully documented safety analyses and safety research results that NRC has accumulated. NRC has been receiving foreign visitors at a rate of about 500 per year, largely for discussions of safety and licensing questions related to light water reactors. Exchanges also are taking place on the safety of advanced reactors. A special interest of the NRC is in providing for reciprocal communicaion, at the earliest possible time, of important problems, decisions and other actions on nuclear safety matters. For example, it is essential that a newly-discovered problem in a nuclear reactor be brought immediately to the attention of other governments which are responsible for the safety of similar reactors. Definite progress has been made in the U.S. Freedom of Information Act. Certain exchanges have taken place on this basis. Experience in the establishment and operation of NRC's bilateral exchange arrangements is summarized. A typical exchange with the regulatory authority of country building its first power reactor is described

International exchange of safety and licensing information

International Nuclear Information System (INIS)

Lafleur, J.D. Jr.; Hauber, R.D.; Chenier, D.M.

1977-01-01

A network of formal and informal bilateral arrangements for the exchange of nuclear safety information is being established by the US Nuclear Regulatory Commission. For developing countries such arrangements can provide ready access to the extensive, fully documented safety analyses and safety research results that USNRC has accumulated. USNRC has been receiving foreign visitors at a rate of about 500 per year, largely for discussions of safety and licensing questions related to light water reactors. Exchanges also are taking place on the safety of advanced reactors. A special interest of the USNRC is in providing for reciprocal communication, at the earliest possible time, of important problems, decisions and other actions on nuclear safety matters. For example, it is essential that a newly discovered problem in a nuclear reactor be brought immediately to the attention of other governments that are responsible for the safety of similar reactors. Definite progress has been made in the USA in defining categories of information that USNRC can receive in confidence from foreign countries, and can protect from disclosure under the US Freedom of Information Act. Certain exchanges have taken place on this basis. Experience in the establishment and operation of USNRC's bilateral exchange arrangements is summarized. A typical exchange with the regulatory authority of a country building its first power reactor is described. (author)

75 FR 51819 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

Science.gov (United States)

2010-08-23

... Team, Enrollment, Governance, Adoption/ Certification, and Information Exchange workgroups. General... the electronic exchange and use of health information as is consistent with the Federal Health IT... hold the following public meetings during September 2010: September 3rd Governance Workgroup, 1 p.m. to...

Promoting Information Literacy by Promoting Health Literacy in the Information Society

Directory of Open Access Journals (Sweden)

Meisam Dastani

2016-09-01

Full Text Available In the information society, the production, distribution and use of information are freely and widely available for all issues of life. Proper and appropriate use of reliable information is especially important in health care. The present study introduces the concepts and benefits of health literacy and information literacy and its role in improving health literacy. This study was a review based on the concepts of information society, information literacy and information education to present importance of promoting information literacy on health literacy in the information society. The information society is presented by providing a platform of information technology and computer systems to attempt to exchange and develop information among people in the community. Currently, electronic and web-based health information in the mass form is available. Information as a fundamental base of the information society is a phenomenon that our decisions are affected in relation to various issues such as safety and health issues. It is important to avoid the mass of invalid, incorrect and inappropriate information which is available on the internet. This requires information literacy skills such as identifying, accessing and evaluating information. In general, it can be said that the promotion of health literacy in communities requires learning different skills in the form of information literacy.Data obtained from this study can be used in developing the long term health programs to prevention of non-communicable diseases in our country

Environmental Public Health Tracking: Health and Environment Linked for Information Exchange-Atlanta (HEXIX-Atlanta: A cooperative Program Between CDC and NASA for Development of an Environmental Public Health Tracking Network in the Atlanta Metropolitan Area

Science.gov (United States)

Quattrochi, Dale A.; Niskar, Amanda Sue

2005-01-01

The Centers for Disease Control and Prevention (CDC) is coordinating HELIX- Atlanta to provide information regarding the five-county Metropolitan Atlanta Area (Clayton, Cobb, DeKalb, Fulton, and Gwinett) via a network of integrated environmental monitoring and public health data systems so that all sectors can take action to prevent and control environmentally related health effects. The HELIX-Atlanta Network is a tool to access interoperable information systems with optional information technology linkage functionality driven by scientific rationale. HELIX-Atlanta is a collaborative effort with local, state, federal, and academic partners, including the NASA Marshall Space Flight Center. The HELIX-Atlanta Partners identified the following HELIX-Atlanta initial focus areas: childhood lead poisoning, short-latency cancers, developmental disabilities, birth defects, vital records, respiratory health, age of housing, remote sensing data, and environmental monitoring, HELIX-Atlanta Partners identified and evaluated information systems containing information on the above focus areas. The information system evaluations resulted in recommendations for what resources would be needed to interoperate selected information systems in compliance with the CDC Public Health Information Network (PHIN). This presentation will discuss the collaborative process of building a network that links health and environment data for information exchange, including NASA remote sensing data, for use in HELIX-Atlanta.

An Assessment of Information Exchange Practices, Challenges, and Opportunities to Support US Disease Surveillance in 3 States.

Science.gov (United States)

Garcia, Macarena C; Garrett, Nedra Y; Singletary, Vivian; Brown, Sheereen; Hennessy-Burt, Tamara; Haney, Gillian; Link, Kimberly; Tripp, Jennifer; Mac Kenzie, William R; Yoon, Paula

2017-12-07

State and local public health agencies collect and use surveillance data to identify outbreaks, track cases, investigate causes, and implement measures to protect the public-s health through various surveillance systems and data exchange practices. The purpose of this assessment was to better understand current practices at state and local public health agencies for collecting, managing, processing, reporting, and exchanging notifiable disease surveillance information. Over an 18-month period (January 2014-June 2015), we evaluated the process of data exchange between surveillance systems, reporting burdens, and challenges within 3 states (California, Idaho, and Massachusetts) that were using 3 different reporting systems. All 3 states use a combination of paper-based and electronic information systems for managing and exchanging data on reportable conditions within the state. The flow of data from local jurisdictions to the state health departments varies considerably. When state and local information systems are not interoperable, manual duplicative data entry and other work-arounds are often required. The results of the assessment show the complexity of disease reporting at the state and local levels and the multiple systems, processes, and resources engaged in preparing, processing, and transmitting data that limit interoperability and decrease efficiency. Through this structured assessment, the Centers for Disease Control and Prevention (CDC) has a better understanding of the complexities for surveillance of using commercial off-the-shelf data systems (California and Massachusetts), and CDC-developed National Electronic Disease Surveillance System Base System. More efficient data exchange and use of data will help facilitate interoperability between National Notifiable Diseases Surveillance Systems.

75 FR 57026 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

Science.gov (United States)

2010-09-17

... Team, Enrollment, Governance, Adoption/ Certification, and Information Exchange workgroups. General... the electronic exchange and use of health information as is consistent with the Federal Health IT... hold the following public meetings during October 2010: October 4th Governance Workgroup, 9 a.m. to 4 p...

Information exchange in virtual communities: a typology

Directory of Open Access Journals (Sweden)

Gary Burnett

2000-01-01

Full Text Available While there is wide agreement that virtual communities - and other phenomena utilizing CMC technologies - have the capability to provide both interpersonal and informational interactions, the degree to which they can be seen as specifically information-oriented social spaces has been open to some question. Drawing upon theoretical and empirical work that emphasizes an environmental model of human information behaviour, a foundation is developed for a model of information exchange in virtual communities, and a typology of the varieties of information behaviour to be found in virtual communities is proposed. This typology will provide a mechanism for assessing the characteristics of virtual communities in terms of their support for information exchange, and has the potential to enhance our understanding of virtual communities as information environments.

Double Taxation, Tax Credits and the Information Exchange Puzzle

OpenAIRE

Wolfgang Eggert

2003-01-01

This paper analyzes the choice of taxes and international information exchange by governments in a capital tax competition model. We explain situations where countries can choose tax rates on tax savings income and exchange information about the domestic savings of foreigners, implying that the decentralized equilibrium is efficient. However, we also identify situations with adverse welfare properties in which information exchange is compatible with zero taxes on capital income. The model hel...

Report: Information Meeting / Awareness of Actors on the Chemical Information Exchange Network (CIEN)

International Nuclear Information System (INIS)

Senghor, Cheikh

2015-01-01

As part of the implementation of the Stockholm Convention, Senegal has established a Chemical Information Exchange Network. The overall objective of this meeting was to identify the various actors involved in the management of chemicals information and to study the modalities for the implementation of the chemical information exchange network in Senegal.

102: PROMOTING INFORMATION LITERACY BY PROMOTING HEALTH LITERACY IN THE INFORMATION SOCIETY

Science.gov (United States)

Dastani, Meisam; Sattari, Masoume

2017-01-01

Background and aims In the information society the production, distribution and use of information is freely and widely available for all issues of life. Correct and appropriate use of appropriate and reliable information is especially important in health care. The present study introduces the concepts and benefits of health literacy and information literacy and its role in improving health literacy. Methods This study is a review based on a review of the concepts of the information society, information literacy and information educated to present importance of promoting information literacy on health literacy in the information society. Results and Conclusion The information society by providing a platform of information technology and computer systems to attempts exchange and development information between people in the community. Currently, electronic and web-based health information in the form of mass is available for people. Information as a fundamental base of the information society is a phenomenon that our decisions are affect in relation to various issues such as safety and health issues. It is important point to avoid the mass of information invalid, incorrect and inappropriate available on the internet. This requires information literacy skills such as identifying, accessing and evaluating information. In general, it can be said that the promotion of health literacy in communities are required to learn different skills in the form of information literacy.

Information exchange using a prescribed form and involvement of occupational health nurses promotes occupational physicians to collaborate with attending physicians for supporting workers with illness in Japan.

Science.gov (United States)

Muto, Go; Nakamura, Rina Ishii; Yokoyama, Kazuhito; Kitamura, Fumihiko; Omori, Yuki; Saito, Masahiko; Endo, Motoki

2017-12-19

The maintenance of a balance between work and disease treatment is an important issue in Japan. This study explored factors that affect collaboration between occupational physicians (OPs) and attending physicians (APs). A questionnaire was mailed to 1,102 OPs. The questionnaire assessed the demographic characteristics of OPs; their opinions and behaviors related to collaboration, including the exchange of medical information with APs; and the occupational health service system at their establishments. In total, 275 OPs completed the questionnaire (25.0% response rate). Over 80% of respondents believed OPs should collaborate with APs. After adjusting for company size, collaboration >10 times/year (with regard to both returning to work following sick leave and annual health check-ups for employees) was significantly associated with environmental factors, such as the presence of occupational health nurses (odds ratio (OR): 5.56 and 5.01, respectively, p0.05). The majority of OPs believed that collaboration with APs is important for supporting workers with illnesses. Support systems including prescribed forms of information exchange and occupational health nurses, play pivotal roles in promoting this collaboration.

Long-term evaluation of a hospital-based violence intervention program using a regional health information exchange.

Science.gov (United States)

Bell, Teresa M; Gilyan, Dannielle; Moore, Brian A; Martin, Joel; Ogbemudia, Blessing; McLaughlin, Briana E; Moore, Reilin; Simons, Clark J; Zarzaur, Ben L

2018-01-01

Hospital-based violence intervention programs (HVIP) aim to reduce violent-injury recidivism by providing intensive case management services to high-risk patients who were violently injured. Although HVIP have been found effective at reducing recidivism, few studies have sought to identity how long their effects last. Additionally, prior studies have been limited by the fact that HVIP typically rely on self-report or data within their own healthcare system to identify new injuries. Our aim was to quantify the long-term recidivism rate of participants in an HVIP program using more objective and comprehensive data from a regional health information exchange. The study included 328 patients enrolled in Prescription for Hope (RxH), an HVIP, between January 2009 and August 2016. We obtained RxH participants' emergency department (ED) encounter data from a regional health information exchange database from the date of hospital discharge to February 2017. Our primary outcome was violent-injury recidivism rate of the RxH program. We also examined reasons for ED visits that were unrelated to violent injury. We calculated a 4.4% recidivism rate based on 8 years of statewide data, containing 1,575 unique encounters. More than 96% of participants were matched in the state database. Of the 15 patients who recidivated, only five were admitted for their injury. More than half of new violence-related injuries were treated outside of the HVIP-affiliated trauma center. The most common reasons for ED visits were pain (718 encounters), followed by suspected complications or needing additional postoperative care (181 encounters). Substance abuse, unintentional injuries, and suicidal ideation were also frequent reasons for ED visits. The low, long-term recidivism rate for RxH indicates that HVIPs have enduring positive effects on the majority of participants. Our results suggest that HVIP may further benefit patients by partnering with organizations that work to prevent suicide

The experiential health information processing model: supporting collaborative web-based patient education.

Science.gov (United States)

O'Grady, Laura A; Witteman, Holly; Wathen, C Nadine

2008-12-16

First generation Internet technologies such as mailing lists or newsgroups afforded unprecedented levels of information exchange within a variety of interest groups, including those who seek health information. With emergence of the World Wide Web many communication applications were ported to web browsers. One of the driving factors in this phenomenon has been the exchange of experiential or anecdotal knowledge that patients share online, and there is emerging evidence that participation in these forums may be having an impact on people's health decision making. Theoretical frameworks supporting this form of information seeking and learning have yet to be proposed. In this article, we propose an adaptation of Kolb's experiential learning theory to begin to formulate an experiential health information processing model that may contribute to our understanding of online health information seeking behaviour in this context. An experiential health information processing model is proposed that can be used as a research framework. Future research directions include investigating the utility of this model in the online health information seeking context, studying the impact of collaborating in these online environments on patient decision making and on health outcomes are provided.

The experiential health information processing model: supporting collaborative web-based patient education

Science.gov (United States)

O'Grady, Laura A; Witteman, Holly; Wathen, C Nadine

2008-01-01

Background First generation Internet technologies such as mailing lists or newsgroups afforded unprecedented levels of information exchange within a variety of interest groups, including those who seek health information. With emergence of the World Wide Web many communication applications were ported to web browsers. One of the driving factors in this phenomenon has been the exchange of experiential or anecdotal knowledge that patients share online, and there is emerging evidence that participation in these forums may be having an impact on people's health decision making. Theoretical frameworks supporting this form of information seeking and learning have yet to be proposed. Results In this article, we propose an adaptation of Kolb's experiential learning theory to begin to formulate an experiential health information processing model that may contribute to our understanding of online health information seeking behaviour in this context. Conclusion An experiential health information processing model is proposed that can be used as a research framework. Future research directions include investigating the utility of this model in the online health information seeking context, studying the impact of collaborating in these online environments on patient decision making and on health outcomes are provided. PMID:19087353

The experiential health information processing model: supporting collaborative web-based patient education

Directory of Open Access Journals (Sweden)

Wathen C Nadine

2008-12-01

Full Text Available Abstract Background First generation Internet technologies such as mailing lists or newsgroups afforded unprecedented levels of information exchange within a variety of interest groups, including those who seek health information. With emergence of the World Wide Web many communication applications were ported to web browsers. One of the driving factors in this phenomenon has been the exchange of experiential or anecdotal knowledge that patients share online, and there is emerging evidence that participation in these forums may be having an impact on people's health decision making. Theoretical frameworks supporting this form of information seeking and learning have yet to be proposed. Results In this article, we propose an adaptation of Kolb's experiential learning theory to begin to formulate an experiential health information processing model that may contribute to our understanding of online health information seeking behaviour in this context. Conclusion An experiential health information processing model is proposed that can be used as a research framework. Future research directions include investigating the utility of this model in the online health information seeking context, studying the impact of collaborating in these online environments on patient decision making and on health outcomes are provided.

Technology and Policy Challenges in the Adoption and Operation of Health Information Exchange Systems.

Science.gov (United States)

Ji, Hyerim; Yoo, Sooyoung; Heo, Eun-Young; Hwang, Hee; Kim, Jeong-Whun

2017-10-01

This study aimed to identify problems and issues that arise with the implementation of online health information exchange (HIE) systems in a medical environment and to identify solutions to facilitate the successful operation of future HIE systems in primary care clinics and hospitals. In this study, the issues that arose during the establishment and operation of an HIE system in a hospital were identified so that they could be addressed to enable the successful establishment and operation of a standard-based HIE system. After the issues were identified, they were reviewed and categorized by a group of experts that included medical information system experts, doctors, medical information standard experts, and HIE researchers. Then, solutions for the identified problems were derived based on the system development, operation, and improvement carried out during this work. Twenty-one issues were identified during the implementation and operation of an online HIE system. These issues were then divided into four categories: system architecture and standards, documents and data items, consent of HIE, and usability. We offer technical and policy recommendations for various stakeholders based on the experiences of operating and improving the online HIE system in the medical field. The issues and solutions identified in this study regarding the implementation and operate of an online HIE system can provide valuable insight for planners to enable them to successfully design and operate such systems at a national level in the future. In addition, policy support from governments is needed.

78 FR 6275 - Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in...

Science.gov (United States)

2013-01-30

... Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative...'s Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 430...

International exchange of radiological information in emergency conditions

International Nuclear Information System (INIS)

De Cort, M.; De Vries, G.; Breitenbach, L.; Fraser, G.; Vade, S.

1998-01-01

Description of the current system, experience gained, and expected future developments is given for the ECURIE system and, in particular, the EURDEP European-wide radiological information exchange system. It is concluded that the existing situation continues to be inhomogeneous. Although EURDEP foresees a common format for data exchange, which has been successfully implemented in 9 European countries, and regular exercises for data have been performed for a few years, important efforts will still have to be made to come to a more homogeneous and consistent European system for radiological information exchange. (P.A.)

Health Information Brokers in the General Population: An Analysis of the Health Information National Trends Survey 2013-2014.

Science.gov (United States)

Cutrona, Sarah L; Mazor, Kathleen M; Agunwamba, Amenah A; Valluri, Sruthi; Wilson, Patrick M; Sadasivam, Rajani S; Finney Rutten, Lila J

2016-06-03

Health information exchanged between friends or family members can influence decision making, both for routine health questions and for serious health issues. A health information broker is a person to whom friends and family turn for advice or information on health-related topics. Characteristics and online behaviors of health information brokers have not previously been studied in a national population. The objective of this study was to examine sociodemographic characteristics, health information seeking behaviors, and other online behaviors among health information brokers. Data from the Health Information National Trends Survey (2013-2014; n=3142) were used to compare brokers with nonbrokers. Modified Poisson regression was used to examine the relationship between broker status and sociodemographics and online information seeking. Over half (54.8%) of the respondents were consulted by family or friends for advice or information on health topics (ie, they acted as health information brokers). Brokers represented 54.1% of respondents earning brokers (PR 1.34, 95% CI 1.23-1.47) as were those with education past high school (PR 1.42, CI 1.22-1.65). People aged ≥75 were less likely to be brokers as compared to respondents aged 35-49 (PR 0.81, CI 0.67-0.99). Brokers used the Internet more frequently for a variety of online behaviors such as seeking health information, creating and sharing online content, and downloading health information onto a mobile device; and also reported greater confidence in obtaining health information online. More than 50% of adults who responded to this national survey, including those with low income and those born abroad, were providing health information or advice to friends and family. These individuals may prove to be effective targets for initiatives supporting patient engagement and disease management, and may also be well-positioned within their respective social networks to propagate health messages.

78 FR 4593 - Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in...

Science.gov (United States)

2013-01-22

...'s Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans...-2334-P] RIN 0938-AR04 Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health... 2010 (collectively referred to as the Affordable Care Act), and the Children's Health Insurance Program...

Envisioning a social-health information exchange as a platform to support a patient-centered medical neighborhood: a feasibility study.

Science.gov (United States)

Nguyen, Oanh Kieu; Chan, Connie V; Makam, Anil; Stieglitz, Heather; Amarasingham, Ruben

2015-01-01

Social determinants directly contribute to poorer health, and coordination between healthcare and community-based resources is pivotal to addressing these needs. However, our healthcare system remains poorly equipped to address social determinants of health. The potential of health information technology to bridge this gap across the delivery of healthcare and social services remains unrealized. We conducted in-depth, in-person interviews with 50 healthcare and social service providers to determine the feasibility of a social-health information exchange (S-HIE) in an urban safety-net setting in Dallas County, Texas. After completion of interviews, we conducted a town hall meeting to identify desired functionalities for a S-HIE. We conducted thematic analysis of interview responses using the constant comparative method to explore perceptions about current communication and coordination across sectors, and barriers and enablers to S-HIE implementation. We sought participant confirmation of findings and conducted a forced-rank vote during the town hall to prioritize potential S-HIE functionalities. We found that healthcare and social service providers perceived a need for improved information sharing, communication, and care coordination across sectors and were enthusiastic about the potential of a S-HIE, but shared many technical, legal, and ethical concerns around cross-sector information sharing. Desired technical S-HIE functionalities encompassed fairly simple transactional operations such as the ability to view basic demographic information, visit and referral data, and medical history from both healthcare and social service settings. A S-HIE is an innovative and feasible approach to enabling better linkages between healthcare and social service providers. However, to develop S-HIEs in communities across the country, policy interventions are needed to standardize regulatory requirements, to foster increased IT capability and uptake among social service agencies

78 FR 56711 - Health Insurance Exchanges; Application by the Accreditation Association for Ambulatory Health...

Science.gov (United States)

2013-09-13

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-9953-PN] Health Insurance Exchanges; Application by the Accreditation Association for Ambulatory Health Care To Be... Federal Register announcing the result of our determination. (Health Insurance Exchanges; Application by...

Injustice in Access to Health Information: The Difference between Health Professionals and Patients

Directory of Open Access Journals (Sweden)

Hasan Ashrafi-rizi

2016-10-01

Full Text Available The role of information is undeniable in promoting public health (1-3. “Access to health information for all” was the slogan of the World Health Organization in 2004 (4. The proving of this slogan requires access to health information by beneficiaries (health professionals and patients. Access to health information by specialists as partly been achieved, but access to health information for patients and their families is considered low (5-7, which could have adverse effects. Health professionals have quick and easy access to information through libraries and medical information centers, participation in seminars, exchange of scientific information with other professionals, as well as identifying ways to effectively access to health information, but patients and their families do not have access to such facilities and capabilities. Therefore, patients and their families are faced with a phenomenon known as “inequity in access to health information” and the continuation of the injustice leads to health information poverty. Thus, the main question now is what we should do? It seems that the government needs to develop a national policy in the field of health information and it is the most important step. In the next step, the government should expand the concept production via using potentials of different organizations like public media (TV and Radio, health ministry and press and increase the access of patients to health information in the easy language (level of health information between health professionals and patients is different.

Digital technology use among disadvantaged Australians: implications for equitable consumer participation in digitally-mediated communication and information exchange with health services.

Science.gov (United States)

Newman, Lareen; Biedrzycki, Kate; Baum, Fran

2012-05-01

To present research findings on access to, and use of, digital information and communication technologies (ICTs) by Australians from lower income and disadvantaged backgrounds to determine implications for equitable consumer access to digitally-mediated health services and information. Focus groups were held in 2008-09 with 80 residents from lower income and disadvantaged backgrounds in South Australia, predominantly of working- and family-formation age (25 to 55 years). Qualitative analysis was conducted on a-priori and emergent themes to describe dominant categories. Access to, and use of, computers, the Internet and mobile phones varied considerably in extent, frequency and quality within and across groups due to differences in abilities, resources and life experience. Barriers and facilitators included English literacy (including for native speakers), technological literacy, education, income, housing situation, social connection, health status, employment status, and trust. Many people gained ICT skills by trial and error or help from friends, and only a few from formal programs, resulting in varied skills. The considerable variation in ICT access and use within lower income and disadvantaged groups must be acknowledged and accommodated by health initiatives and services when delivering digitally-mediated consumer-provider interaction, online health information, or online self-management of health conditions. If services require consumers to participate in a digitally-mediated communication exchange, then we suggest they might support skills and technology acquisition, or provide non-ICT alternatives, in order to avoid exacerbating health inequities.

The on-line European Community urgent radiological information exchange (ECURIE) information system

International Nuclear Information System (INIS)

De Cort, M.; Breitenbach, L.; De Vries, G.

1998-01-01

Immediately after the accident at the Chernobyl NPP, both the International Atomic Energy Agency (IAEA) and the Commission of the European Communities (CEC) set up a system to meet the requirements for early warning and exchange of information. The Environment Institute of the CEC JRC-Ispra provides technical assistance for the European community Urgent Radiological Information Exchange system (ECURIE). By this system, Member State contact points can exchange information in a coded format. In order to facilitate the use and to assure the data quality, a Coding-Decoding Software (CDS) was developed in collaboration with the I.A.E.A. A new version, called CoDecS, is under development. An ECURIE data bank is under construction, which will automatically recognize and store incoming ECURIE messages. Further on, query and reporting software will be developed. The background objectives and the conceptual basis for the structure of the on-line information system is described. (author)

75 FR 17744 - Office of the National Coordinator for Health Information Technology HIT Policy Committee...

Science.gov (United States)

2010-04-07

... Coordinator for Health Information Technology, HHS. ACTION: Notice of change of location for meetings. This... Coordinator for Health Information Technology (ONC). The meeting will be open to the public. Name of Committee... health information technology infrastructure that permits the electronic exchange and use of health...

Data Exchange Management Information System (DEMIS)

Data.gov (United States)

Social Security Administration — DEMIS combines a database (Operational Data Store - ODS) of data exchange-related Management Information (MI) with the agency's querying and reporting utility, the...

Revenue Sharing and Information Exchange under Non-Discriminatory Taxation

NARCIS (Netherlands)

Keen, M.; Ligthart, J.E.

2005-01-01

The international exchange of tax information, and its merits compared to withholding taxes, is the central topic in current debates in international tax policy.The purpose of this paper is to characterize and compare the tax regimes that emerge with and without information exchange, under the

Indivo: a personally controlled health record for health information exchange and communication

Directory of Open Access Journals (Sweden)

Crawford William CR

2007-09-01

Full Text Available Abstract Background Personally controlled health records (PCHRs, a subset of personal health records (PHRs, enable a patient to assemble, maintain and manage a secure copy of his or her medical data. Indivo (formerly PING is an open source, open standards PCHR with an open application programming interface (API. Results We describe how the PCHR platform can provide standard building blocks for networked PHR applications. Indivo allows the ready integration of diverse sources of medical data under a patient's control through the use of standards-based communication protocols and APIs for connecting PCHRs to existing and future health information systems. Conclusion The strict and transparent personal control model is designed to encourage widespread participation by patients, healthcare providers and institutions, thus creating the ecosystem for development of innovative, consumer-focused healthcare applications.

Structural analysis of health-relevant policy-making information exchange networks in Canada.

Science.gov (United States)

Contandriopoulos, Damien; Benoît, François; Bryant-Lukosius, Denise; Carrier, Annie; Carter, Nancy; Deber, Raisa; Duhoux, Arnaud; Greenhalgh, Trisha; Larouche, Catherine; Leclerc, Bernard-Simon; Levy, Adrian; Martin-Misener, Ruth; Maximova, Katerina; McGrail, Kimberlyn; Nykiforuk, Candace; Roos, Noralou; Schwartz, Robert; Valente, Thomas W; Wong, Sabrina; Lindquist, Evert; Pullen, Carolyn; Lardeux, Anne; Perroux, Melanie

2017-09-20

Health systems worldwide struggle to identify, adopt, and implement in a timely and system-wide manner the best-evidence-informed-policy-level practices. Yet, there is still only limited evidence about individual and institutional best practices for fostering the use of scientific evidence in policy-making processes The present project is the first national-level attempt to (1) map and structurally analyze-quantitatively-health-relevant policy-making networks that connect evidence production, synthesis, interpretation, and use; (2) qualitatively investigate the interaction patterns of a subsample of actors with high centrality metrics within these networks to develop an in-depth understanding of evidence circulation processes; and (3) combine these findings in order to assess a policy network's "absorptive capacity" regarding scientific evidence and integrate them into a conceptually sound and empirically grounded framework. The project is divided into two research components. The first component is based on quantitative analysis of ties (relationships) that link nodes (participants) in a network. Network data will be collected through a multi-step snowball sampling strategy. Data will be analyzed structurally using social network mapping and analysis methods. The second component is based on qualitative interviews with a subsample of the Web survey participants having central, bridging, or atypical positions in the network. Interviews will focus on the process through which evidence circulates and enters practice. Results from both components will then be integrated through an assessment of the network's and subnetwork's effectiveness in identifying, capturing, interpreting, sharing, reframing, and recodifying scientific evidence in policy-making processes. Knowledge developed from this project has the potential both to strengthen the scientific understanding of how policy-level knowledge transfer and exchange functions and to provide significantly improved advice

Exchange Network

Science.gov (United States)

The Environmental Information Exchange Network (EN) is an Internet-based system used by state, tribal and territorial partners to securely share environmental and health information with one another and EPA.

Regulating a health insurance exchange: implications for individuals with mental illness.

Science.gov (United States)

McGuire, Thomas G; Sinaiko, Anna D

2010-11-01

Under the newly enacted health reform law, millions of lower- and middle-income Americans will purchase individual or family health insurance through state-based markets for private health insurance called insurance "exchanges," which consolidate and regulate the market for individual and small-group health insurance. The authors consider options for structuring choice and pricing of health insurance in an exchange from the perspective of efficiently and fairly serving persons with mental illness. Exchanges are intended to foster choice and competition. However, certain features-open enrollment, individual choice, and imperfect risk adjusters-create incentives for "adverse selection," especially in providing coverage for persons with mental illness, who have higher overall health care costs. The authors review the experience of persons with mental illness in insurance markets similar to the exchanges, such as the Massachusetts Connector and the Federal Employees Health Benefit Program, and note that competition among health plans for enrollees who are "good risks" can undermine coverage and efficiency. They review the possible approaches for contending with selection-related incentives, such as carving out all or part of mental health benefits, providing reinsurance for some mental health care costs, or their preferred option, running the exchange in the same way that an employer runs its employee benefits and addressing selection and cost control issues by choice of contractor. The authors also consider approaches an exchange could use to promote effective consumer choice, such as passive and active roles for the exchange authority. Regulation will be necessary to establish a foundation for success of the exchanges.

An interoperability architecture for the health information exchange in Rwanda

CSIR Research Space (South Africa)

Crichton, R

2012-08-01

Full Text Available Rwanda, one of the smallest and most densely populated countries in Africa, has made rapid and substantial progress towards designing and deploying a national health information system. One of the challenging aspects of the system is the design...

Information Technology: DOD and VA Have Increased Their Sharing of Health Information, but Further Actions Are Needed

National Research Council Canada - National Science Library

Melvin, Valerie C

2008-01-01

...) and the Department of Veterans Affairs (VA) to accelerate the exchange of health information between the departments and to develop systems or capabilities that allow for full interoperability...

Verifier-based three-party authentication schemes using extended chaotic maps for data exchange in telecare medicine information systems.

Science.gov (United States)

Lee, Tian-Fu

2014-12-01

Telecare medicine information systems provide a communicating platform for accessing remote medical resources through public networks, and help health care workers and medical personnel to rapidly making correct clinical decisions and treatments. An authentication scheme for data exchange in telecare medicine information systems enables legal users in hospitals and medical institutes to establish a secure channel and exchange electronic medical records or electronic health records securely and efficiently. This investigation develops an efficient and secure verified-based three-party authentication scheme by using extended chaotic maps for data exchange in telecare medicine information systems. The proposed scheme does not require server's public keys and avoids time-consuming modular exponential computations and scalar multiplications on elliptic curve used in previous related approaches. Additionally, the proposed scheme is proven secure in the random oracle model, and realizes the lower bounds of messages and rounds in communications. Compared to related verified-based approaches, the proposed scheme not only possesses higher security, but also has lower computational cost and fewer transmissions. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Standardized structure of electronic records for information exchange

International Nuclear Information System (INIS)

Galabova, Sevdalina; Trencheva, Tereza; Trenchev, Ivan

2009-01-01

In the paper is presented the structure of the electronic record whose form is standardized in ISO 2709:2008. This International Standard describes a generalized structure, a framework designed specially for communications between data processing systems and not for use as a processing format within systems.Basic terms are defined as follows: character, data field, directory, directory map, field, field separator etc. It’s presented the general structure of a record. The application analysis of this structure shows the effective information exchange in the widest range.The purpose of this research is to find out advantages and structure of the information exchange format standardized in ISO 2709:2008. Key words: Standardized structure, electronic records, exchange formats, data field, directory, directory map, indicators, identifiers

Business Information Exchange System with Security, Privacy, and Anonymity

Directory of Open Access Journals (Sweden)

Sead Muftic

2016-01-01

Full Text Available Business Information Exchange is an Internet Secure Portal for secure management, distribution, sharing, and use of business e-mails, documents, and messages. It has three applications supporting three major types of information exchange systems: secure e-mail, secure instant messaging, and secure sharing of business documents. In addition to standard security services for e-mail letters, which are also applied to instant messages and documents, the system provides innovative features of privacy and full anonymity of users and their locations, actions, transactions, and exchanged resources. In this paper we describe design, implementation, and use of the system.

Patient Privacy, Consent, and Identity Management in Health Information Exchange: Issues for the Military Health System

Science.gov (United States)

2013-01-01

JPC-1b Joint Program Committee-1b on Health Information Technology and Medical Informatics MAeHC Massachusetts eHealth Collaborative MHS Military...efficiency of care. The second study, by the eHealth Initiative (2011), surveyed communities across the United States with initiatives to share health...Simon et al. (2009) conducted focus groups involving 64 participants in several rural towns participating in the Massachusetts eHealth Collaborative

COG: information exchange. The new initiatives

International Nuclear Information System (INIS)

Guiry, C.

2000-01-01

The CANDU Owners Group (COG) is dedicated to providing programs for cooperation, mutual assistance and exchange of information for the successful support, development, operation, maintenance and economics of CANDU Technology. This paper summarises the COG Mission, COG Vision and COG Values

Method for selecting e-health standards to support interoperability of healthcare information systems

CSIR Research Space (South Africa)

Adebesin, F

2014-05-01

Full Text Available There is growing concern over the fragmentation and inability of healthcare information systems (e-health systems) to exchange pertinent healthcare information that can empower healthcare professionals to make informed decisions regarding the care...

Group Awareness and Self-Presentation in Computer-Supported Information Exchange

Science.gov (United States)

Kimmerle, Joachim; Cress, Ulrike

2008-01-01

A common challenge in many situations of computer-supported collaborative learning is increasing the willingness of those involved to share their knowledge with other group members. As a prototypical situation of computer-supported information exchange, a shared-database setting was chosen for the current study. This information-exchange situation…

Securing the smart grid information exchange

Energy Technology Data Exchange (ETDEWEB)

Fries, Steffen; Falk, Rainer [Siemens AG, Corporate Technology, Muenchen (Germany)

2012-07-01

The smart grid is based on information exchange between various stakeholders using open communication technologies, to control the physical electric grid through the information grid. Protection against cyber attacks is essential to ensure a reliable operation of the smart grid. This challenge is addressed by various regulatory, standardization, and research activities. After giving an overview of the security demand of a smart grid, existing and appearing standardization activities are described. (orig.)

Map Specifications and Exchange of Geographical Information

DEFF Research Database (Denmark)

Frederiksen, Poul

1999-01-01

Specifications for Technical Maps 1993 – 99 are described giving an overview of the specification structure including the object description of the latest version: TK99.The technical map specifications are related to the standards for topographical maps - especially the TOP10DK standard. Common...... object definitions are essential for the standards. Technical as well as topographical map information is exchangeable through the Danish developed “Standard for Exchange of Digital Map Information”, known as the DSFL-format....

Electronic Health Records: DOD and VA Have Increased Their Sharing of Health Information, but More Work Remains

National Research Council Canada - National Science Library

Melvin, Valerie C; Oliver, Barbara S; Collier, Barbara; Shaw, Kelly; Williams, Jr, Robert

2008-01-01

...) and the Department of Veterans Affairs (VA) are required to accelerate the exchange of health information between the departments and to develop systems or capabilities that allow for full interoperability...

Tax Information Exchange with Developing Countries and Tax Havens

OpenAIRE

Braun, Julia; Zagler, Martin

2015-01-01

The exchange of tax information has received ample attention recently, due to a number of recent headlines on aggressive tax planning and tax evasion. Whilst both participating tax authorities will gain when foreign investments (FDI) are bilateral, we demonstrate that FDI receiving nations will lose in asymmetric situations. We solve a bargaining model that proves that tax information exchange will only happen voluntarily with compensation for this loss. We then present empirical evidence in ...

Health Information Exchange as a Complex and Adaptive Construct: Scoping Review

Directory of Open Access Journals (Sweden)

Ather Akhlaq

2017-01-01

The concept of HIE is an evolving and adaptive one, reflecting the ongoing quest for integrated and interoperable information to improve the efficiency and effectiveness of health systems, in a changing technological and policy environment.

Sharing sensitive health information through social media in the Arab world.

Science.gov (United States)

Asiri, Eman; Khalifa, Mohamed; Shabir, Syed-Abdul; Hossain, Md Nassif; Iqbal, Usman; Househ, Mowafa

2017-02-01

Sharing daily activities on social media has become a part of our lifestyle, but little is known about sharing sensitive health information in the Arab world. The objective of this study is to explore how social media users in the Arab world share sensitive health information through Facebook. A retrospective qualitative analysis was used in the study. A total of 110 Facebook groups, related to HIV, sickle cell and depression were screened between 5 June and 1 December 2014. Forty four Facebook groups met the inclusion criteria. 28 471 posts were extracted, of which 649 met inclusion criteria. Forty two percent of health information exchanged were related to HIV, 34% to depression and 24% to sickle cell diseases. The majority of postings were from Egypt 21.1%, Saudi Arabia 20%, Algeria 10% and Libya 9.2%. Male posts were 54.2% while 45.8% were posted by females. Individuals utilized Facebook groups to share personal experiences of their disease 31%, in addition to being used for seeking queries 13.6%, offering explicit advice 8.3%, reporting signs and symptoms of the disease 7.3% and posting their communication with the health-care provider 6.6%. Users in the Arab world use social media to exchange sensitive health information, which could have serious implications regarding the privacy of the information shared with other members of the group. On the other hand, sharing health information could have positive effects for patients, such as sharing disease experiences and peer support. However, more work is needed to ensure that Facebook users in the Arab world are aware of the potential consequences of sharing sensitive health information through social media. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Improving community health through marketing exchanges: A participatory action research study on water, sanitation, and hygiene in three Melanesian countries.

Science.gov (United States)

Barrington, D J; Sridharan, S; Saunders, S G; Souter, R T; Bartram, J; Shields, K F; Meo, S; Kearton, A; Hughes, R K

2016-12-01

Diseases related to poor water, sanitation and hygiene (WaSH) are major causes of mortality and morbidity. While pursuing marketing approaches to WaSH to improve health outcomes is often narrowly associated with monetary exchange, marketing theory recognises four broad marketing exchange archetypes: market-based, non-market-based, command-based and culturally determined. This diversity reflects the need for parameters broader than monetary exchange when improving WaSH. This study applied a participatory action research process to investigate how impoverished communities in Melanesian urban and peri-urban informal settlements attempt to meet their WaSH needs through marketing exchange. Exchanges of all four archetypes were present, often in combination. Motivations for participating in the marketing exchanges were based on social relationships alongside WaSH needs, health aspirations and financial circumstances. By leveraging these motivations and pre-existing, self-determined marketing exchanges, WaSH practitioners may be able to foster WaSH marketing exchanges consistent with local context and capabilities, in turn improving community physical, mental and social health. Copyright © 2016 Elsevier Ltd. All rights reserved.

Software Prototyping: A Case Report of Refining User Requirements for a Health Information Exchange Dashboard.

Science.gov (United States)

Nelson, Scott D; Del Fiol, Guilherme; Hanseler, Haley; Crouch, Barbara Insley; Cummins, Mollie R

2016-01-01

Health information exchange (HIE) between Poison Control Centers (PCCs) and Emergency Departments (EDs) could improve care of poisoned patients. However, PCC information systems are not designed to facilitate HIE with EDs; therefore, we are developing specialized software to support HIE within the normal workflow of the PCC using user-centered design and rapid prototyping. To describe the design of an HIE dashboard and the refinement of user requirements through rapid prototyping. Using previously elicited user requirements, we designed low-fidelity sketches of designs on paper with iterative refinement. Next, we designed an interactive high-fidelity prototype and conducted scenario-based usability tests with end users. Users were asked to think aloud while accomplishing tasks related to a case vignette. After testing, the users provided feedback and evaluated the prototype using the System Usability Scale (SUS). Survey results from three users provided useful feedback that was then incorporated into the design. After achieving a stable design, we used the prototype itself as the specification for development of the actual software. Benefits of prototyping included having 1) subject-matter experts heavily involved with the design; 2) flexibility to make rapid changes, 3) the ability to minimize software development efforts early in the design stage; 4) rapid finalization of requirements; 5) early visualization of designs; 6) and a powerful vehicle for communication of the design to the programmers. Challenges included 1) time and effort to develop the prototypes and case scenarios; 2) no simulation of system performance; 3) not having all proposed functionality available in the final product; and 4) missing needed data elements in the PCC information system.

Quantum secret information equal exchange protocol based on dense coding

Science.gov (United States)

Jiang, Ying-Hua; Zhang, Shi-Bin; Dai, Jin-Qiao; Shi, Zhi-Ping

2018-04-01

In this paper, we design a novel quantum secret information equal exchange protocol, which implements the equal exchange of secret information between the two parties with the help of semi-trusted third party (TP). In the protocol, EPR pairs prepared by the TP are, respectively, distributed to both the communication parties. Then, the two parties perform Pauli operation on each particle and return the new particles to TP, respectively. TP measures each new pair with Bell basis and announces the measurement results. Both parties deduce the secret information of each other according to the result of announcement by TP. Finally, the security analysis shows that this protocol solves the problem about equal exchange of secret information between two parties and verifies the security of semi-trusted TPs. It proves that the protocol can effectively resist glitch attacks, intercept retransmission attacks and entanglement attack.

Facilitators on networks reveal optimal interplay between information exchange and reciprocity.

Science.gov (United States)

Szolnoki, Attila; Perc, Matjaž; Mobilia, Mauro

2014-04-01

Reciprocity is firmly established as an important mechanism that promotes cooperation. An efficient information exchange is likewise important, especially on structured populations, where interactions between players are limited. Motivated by these two facts, we explore the role of facilitators in social dilemmas on networks. Facilitators are here mirrors to their neighbors-they cooperate with cooperators and defect with defectors-but they do not participate in the exchange of strategies. As such, in addition to introducing direct reciprocity, they also obstruct information exchange. In well-mixed populations, facilitators favor the replacement and invasion of defection by cooperation as long as their number exceeds a critical value. In structured populations, on the other hand, there exists a delicate balance between the benefits of reciprocity and the deterioration of information exchange. Extensive Monte Carlo simulations of social dilemmas on various interaction networks reveal that there exists an optimal interplay between reciprocity and information exchange, which sets in only when a small number of facilitators occupy the main hubs of the scale-free network. The drawbacks of missing cooperative hubs are more than compensated for by reciprocity and, at the same time, the compromised information exchange is routed via the auxiliary hubs with only marginal losses in effectivity. These results indicate that it is not always optimal for the main hubs to become leaders of the masses, but rather to exploit their highly connected state to promote tit-for-tat-like behavior.

Social Media and Population Health Virtual Exchange for Senior Nursing Students: An International Collaboration.

Science.gov (United States)

Procter, Paula M; Brixey, Juliana J; Honey, Michelle L L; Todhunter, Fern

2016-01-01

The authors have all engaged in using social media with students as a means for collaboration across national and international boundaries for various educational purposes. Following the explosion of big data in health the authors are now moving this concept forward within undergraduate and postgraduate nursing curricula for the development of population health virtual exchanges. Nursing has a global presence and yet it appears as though students have little knowledge of the health and social care needs and provision outside their local environment. This development will allow for explorative exchange amongst students in three countries, enhancing their understanding of their own and the selected international population health needs and solutions through asking and responding to questions amongst the learning community involved. The connection of the students will be recorded for their use in reflection; of particular interest will be the use of information included by the students to answer questions about their locality.

Automatic exchange of information: towards a new global standard of tax transparency

Directory of Open Access Journals (Sweden)

Miguel Eduardo Pecho Trigueros

2014-07-01

Full Text Available Tax authorities are increasingly relying on mutual cooperation with their foreign peers to enforce more effectively their internal tax laws. After the banking scandals of 2008 and the subsequent global financial crisis, the Global Forum on Transparency and Exchange of Information for TaxPurposes has proposed the exchange of information upon request as the fiscal transparency standard. However, some measures adopted by the European Union, previous initiatives from the Organization for Economic Cooperation and Development (OECD and, above all, the introduction of the Foreign Account Tax Compliance Act (Fatca by the United States in 2010 have promoted the need to adopt the automatic exchange of information as the new fiscal transparency standard. Automatic exchange of information allows home countries to verify whether their taxpayers have correctly included foreign income, allowing tax authorities to have early warning of possible noncompliance cases. In February 2014, the OECD published its proposal for a new global model of automatic exchange of financial account information. The new global model contains the necessary legal instruments and due diligence and reporting procedures, mainly for financial institutions.

An architecture and reference implementation of an open health information mediator: enabling interoperability in the Rwandan health information exchange

CSIR Research Space (South Africa)

Crichton, R

2013-06-01

Full Text Available Rwanda, one of the smallest and most densely populated countries in Africa, has made rapid and substantial progress towards designing and deploying a national health information system. One of the more challenging aspects of the system is the design...

Accelerated Adoption of Advanced Health Information Technology in Beacon Community Health Centers.

Science.gov (United States)

Jones, Emily; Wittie, Michael

2015-01-01

To complement national and state-level HITECH Act programs, 17 Beacon communities were funded to fuel community-wide use of health information technology to improve quality. Health centers in Beacon communities received supplemental funding. This article explores the association between participation in the Beacon program and the adoption of electronic health records. Using the 2010-2012 Uniform Data System, trends in health information technology adoption among health centers located within and outside of Beacon communities were explored using differences in mean t tests and multivariate logistic regression. Electronic health record adoption was widespread and rapidly growing in all health centers, especially quality improvement functionalities: structured data capture, order and results management, and clinical decision support. Adoption lagged for functionalities supporting patient engagement, performance measurement, care coordination, and public health. The use of advanced functionalities such as care coordination grew faster in Beacon health centers, and Beacon health centers had 1.7 times higher odds of adopting health records with basic safety and quality functionalities in 2010-2012. Three factors likely underlie these findings: technical assistance, community-wide activation supporting health information exchange, and the layering of financial incentives. Additional technical assistance and community-wide activation is needed to support the use of functionalities that are currently lagging. © Copyright 2015 by the American Board of Family Medicine.

Information Exchange Automation in Maritime Transport

Directory of Open Access Journals (Sweden)

Zbigniew Pietrzykowski

2014-06-01

Full Text Available To ensure the safety of maritime transport the access to information must be provided through a commonly used services. However, an equally important task is to determine or agree on interpretation of incoming data and assessment of a current and predicted navigational situation and, in further step, intentions of the participants in the transport process. Thanks to the standardization of information format, automatic information exchange gets increasingly wider. Another step ahead is automatic interpretation of information and automation of negotiation processes - intelligent communication. Rapid development of IT and ICT technologies creates such opportunities. This article presents the results of research on a system of automatic communication and co-operation in maritime transport.

Exchange of information in the EU and counteraction of tax avoiding

Directory of Open Access Journals (Sweden)

Robert Draba

2014-12-01

Full Text Available This paper presents an assessment of selected European Union legislation of the exchange of information between EU countries in context of preventing tax avoiding. The primary tool to prevent tax avoidance within the EU is information exchanging between EU countries and between EU countires and other countries.

Military Health System Transformation Implications on Health Information Technology Modernization.

Science.gov (United States)

Khan, Saad

2018-03-01

With the recent passage of the National Defense Authorization Act for Fiscal Year 2017, Congress has triggered groundbreaking Military Health System organizational restructuring with the Defense Health Agency assuming responsibility for managing all hospitals and clinics owned by the Army, Navy, and Air Force. This is a major shift toward a modern value-based managed care system, which will require much greater military-civilian health care delivery integration to be in place by October 2018. Just before the National Defense Authorization Act for Fiscal Year 2017 passage, the Department of Defense had already begun a seismic shift and awarded a contract for the new Military Health System-wide electronic health record system. In this perspective, we discuss the implications of the intersection of two large-scope and large-scale initiatives, health system transformation, and information technology modernization, being rolled out in the largest and most complex federal agency and potential risk mitigating steps. The Military Health System will require an expanded unified clinical leadership to spearhead short-term transformation; furthermore, developing, organizing, and growing a cadre of informatics expertise to expand the use and diffusion of novel solutions such as health information exchanges, data analytics, and others to transcend organizational barriers are still needed to achieve the long-term aim of health system reform as envisioned by the National Defense Authorization Act for Fiscal Year 2017.

Towards a multi-agent system for regulated information exchange in crime investigations

NARCIS (Netherlands)

Dijkstra, Pieter; Prakken, H.; Vey Mestdagh, C.N.J. de

2005-01-01

This paper outlines a multi-agent architecture for regulated information exchange of crime investigation data between police forces. Interactions between police officers about information exchange are analysed as negotiation dialogues with embedded persuasion dialogues. An architecture is then

How Does Electronic Health Information Exchange Affect Hospital Performance Efficiency? The Effects of Breadth and Depth of Information Sharing.

Science.gov (United States)

Cho, Na-Eun; Ke, Weiling; Atems, Bebonchu; Chang, Jongwha

2018-01-01

This research was motivated by the large investment in health information technology (IT) by hospitals and the inconsistent findings related to the effects of health IT adoption on hospital performance. Building on resource orchestration theory and the information systems literature, the authors developed a research model to investigate how the configuration strategies for sharing information under health IT systems affect hospital efficiency. The hypotheses were tested using data from the 2010 annual and IT surveys of the American Hospital Association, Centers for Medicare & Medicaid Services case mix index, and U.S. Census Bureau's small-area income and poverty estimates. The study revealed that in health IT systems, the breadth (extent) and depth (level of detail) of digital information sharing among stakeholders each has a curvilinear relationship with hospital efficiency. In addition, breadth and depth reinforce each other's positive effects and attenuate each other's negative effects, and their balance has a positive effect on hospital efficiency. The results of this research have the potential to enrich the literature on the value of adopting health IT systems as well as in providing practitioner guidelines for meaningful use.

The Effectiveness of Health Care Information Technologies: Evaluation of Trust, Security Beliefs, and Privacy as Determinants of Health Care Outcomes

Science.gov (United States)

2018-01-01

Background The diffusion of health information technologies (HITs) within the health care sector continues to grow. However, there is no theory explaining how success of HITs influences patient care outcomes. With the increase in data breaches, HITs’ success now hinges on the effectiveness of data protection solutions. Still, empirical research has only addressed privacy concerns, with little regard for other factors of information assurance. Objective The objective of this study was to study the effectiveness of HITs using the DeLone and McLean Information Systems Success Model (DMISSM). We examined the role of information assurance constructs (ie, the role of information security beliefs, privacy concerns, and trust in health information) as measures of HIT effectiveness. We also investigated the relationships between information assurance and three aspects of system success: attitude toward health information exchange (HIE), patient access to health records, and perceived patient care quality. Methods Using structural equation modeling, we analyzed the data from a sample of 3677 cancer patients from a public dataset. We used R software (R Project for Statistical Computing) and the Lavaan package to test the hypothesized relationships. Results Our extension of the DMISSM to health care was supported. We found that increased privacy concerns reduce the frequency of patient access to health records use, positive attitudes toward HIE, and perceptions of patient care quality. Also, belief in the effectiveness of information security increases the frequency of patient access to health records and positive attitude toward HIE. Trust in health information had a positive association with attitudes toward HIE and perceived patient care quality. Trust in health information had no direct effect on patient access to health records; however, it had an indirect relationship through privacy concerns. Conclusions Trust in health information and belief in the effectiveness of

The Effectiveness of Health Care Information Technologies: Evaluation of Trust, Security Beliefs, and Privacy as Determinants of Health Care Outcomes.

Science.gov (United States)

Kisekka, Victoria; Giboney, Justin Scott

2018-04-11

The diffusion of health information technologies (HITs) within the health care sector continues to grow. However, there is no theory explaining how success of HITs influences patient care outcomes. With the increase in data breaches, HITs' success now hinges on the effectiveness of data protection solutions. Still, empirical research has only addressed privacy concerns, with little regard for other factors of information assurance. The objective of this study was to study the effectiveness of HITs using the DeLone and McLean Information Systems Success Model (DMISSM). We examined the role of information assurance constructs (ie, the role of information security beliefs, privacy concerns, and trust in health information) as measures of HIT effectiveness. We also investigated the relationships between information assurance and three aspects of system success: attitude toward health information exchange (HIE), patient access to health records, and perceived patient care quality. Using structural equation modeling, we analyzed the data from a sample of 3677 cancer patients from a public dataset. We used R software (R Project for Statistical Computing) and the Lavaan package to test the hypothesized relationships. Our extension of the DMISSM to health care was supported. We found that increased privacy concerns reduce the frequency of patient access to health records use, positive attitudes toward HIE, and perceptions of patient care quality. Also, belief in the effectiveness of information security increases the frequency of patient access to health records and positive attitude toward HIE. Trust in health information had a positive association with attitudes toward HIE and perceived patient care quality. Trust in health information had no direct effect on patient access to health records; however, it had an indirect relationship through privacy concerns. Trust in health information and belief in the effectiveness of information security safeguards increases

State Politics and the Creation of Health Insurance Exchanges

Science.gov (United States)

Greer, Scott L.

2013-01-01

Health insurance exchanges are a key component of the Affordable Care Act. Each exchange faces the challenge of minimizing friction with existing policies, coordinating churn between programs, and maximizing take-up. State-run exchanges would likely be better positioned to address these issues than a federally run exchange, yet only one third of states chose this path. Policymakers must ensure that their exchange—whether state or federally run—succeeds. Whether this happens will greatly depend on the political dynamics in each state. PMID:23763405

National Information Exchange Model (NIEM): DoD Adoption and Implications for C2 (Briefing Charts)

Science.gov (United States)

2014-06-18

Application Data Consumers Information Exchange Package ( IEP ) the data exchanged at runtime Data Producers IES defines Information Exchange...Specification (IES) build-time description of the data to be exchanged Developers System / Application System / Application IEP | 9 | Data...Exchange Package ( IEP ) the data exchanged at runtime Data Producers System / Application System / Application IEP Consumer’s Understanding

Falling short: how state laws can address health information exchange barriers and enablers.

Science.gov (United States)

Schmit, Cason D; Wetter, Sarah A; Kash, Bita A

2018-06-01

Research on the implementation of health information exchange (HIE) organizations has identified both positive and negative effects of laws relating to governance, incentives, mandates, sustainability, stakeholder participation, patient engagement, privacy, confidentiality, and security. We fill a substantial research gap by describing whether comprehensive state and territorial HIE legal frameworks address identified legal facilitators and barriers. We used the Westlaw database to identify state and territorial laws relating to HIEs in effect on June 7, 2016 (53 jurisdictions). We blind-coded all laws and addressed coding discrepancies in peer-review meetings. We recorded a consensus code for each law in a master database. We compared 20 HIE legal attributes with identified barriers to and enablers of HIE activity in the literature. Forty-two states, the District of Columbia, and 2 territories have laws relating to HIEs. On average, jurisdictions address 8.32 of the 20 criteria selected in statutes and regulations. Twenty jurisdictions unambiguously address ≤5 criteria in statutes and regulations. None of the significant legal criteria are unambiguously addressed in >60% of the 53 jurisdictions. Laws can be barriers to or enablers of HIEs. However, jurisdictions are not addressing many significant issues identified by researchers. Consequently, there is a substantial risk that existing legal frameworks are not adequately supporting HIEs. The current evidence base is insufficient for comparative assessments or impact rankings of the various factors. However, the detailed Centers for Disease Control and Prevention dataset of HIE laws could enable investigations into the types of laws that promote or impede HIEs.

Information Exchange, Market Transparency and Dynamic Oligopoly

DEFF Research Database (Denmark)

Overgaard, Per Baltzer; Møllgaard, Peter

2005-01-01

In the economics literature, various views on the likely (efficiency) effects of information exchange,communication between firms and market transparency present themselves. Often these views oninformation flows are highly conflicting. On the one hand, it is argued that increased...... informationdissemination improves firm planning to the benefit of society (including customers) and/or allowspotential customers to make the right decisions given their preferences. On the other hand, theliterature also suggests that increased information dissemination can have significant coordinating orcollusive......, where informational issues have played a significant role....

Taxpayers' confidentiality and privacy rights in the international exchange of tax information

Directory of Open Access Journals (Sweden)

Anđelković Mileva

2014-01-01

Full Text Available The exchange of tax information is a distinctive feature of international tax cooperation processes. The trend of intensive communication between the national tax administrations has been a political priority in economically developed countries. This area of international tax law has been subject to significant changes in the past few years. Countries are prompted to pursue the automatic exchange of tax information by entering into multilateral treaties on the exchange of tax information rather than engage in international exchange of tax information upon request by entering into bilateral agreements. These processes are promptly expedited owing to the incredible development of information and communication technologies. These developments are basically aimed at preventing different forms of international tax fraud which generate significant financial losses in the circumstances of current economic crisis. Such efforts may be justifiable regarding the interests of the countries of residence; but, what about the legal status of ordinary taxpayers who are now subject to a comprehensive and far-reaching control? The new concept may be appropriate for tracking tax fraud or embezzlement but what are its implications for law-abiding taxpayers? The national legislatures are obliged to provide for the protection of confidentiality of exchanged tax information but many states have not fully recognized the importance of providing adequate legal protection of sensitive personal and financial data. There are only a few countries whose legislations explicitly prescribe the taxpayers' right to be informed, the right to consult tax administration and the right to seek tax administration intervention as a form of legal protection in international exchange of tax information. The Serbian tax legislation does not envisage the obligation of tax authorities to notify the taxpayers about the request submitted by foreign tax authorities to provide some tax

The IAEA's role in international information exchange

International Nuclear Information System (INIS)

Brittinger, M.T.M.; Selling, H.A.

1993-01-01

The International Atomic Energy Agency strives to foster the exchange of scientific and technical information in the transport safety area through a dual work programme covering the development and maintenance of the Regulations for the Safe Transport of Radioactive Material, on the one hand, and their implementation, on the other. Under the implementation aspect of its transport safety programme the IAEA takes advantage of the increased availability of mass storage media and the equipment to access them to use databases for information exchange. Information is collected on the identification of national competent authorities, package approval certificates, events in radioactive material transport, research and development, shipments, and exposure data. Data on national competent authorities and the package approval certificates that they issue is updated and disseminated annually to all Member States. Research in progress is described in a document that is published every two years. Databases on events, shipments and radiation exposure are in the development phase. Member States experience difficulty in obtaining the appropriate information and thus, the reporting periods for these subject areas are extended. Information gathered through these activities serve as regulatory aids to the national competent authorities responsible in the Member States for the transport of radioactive material, both internationally and nationally. In addition, it is useful in support of the continuous review and revision process of the transport Regulations and their supporting documents. (J.P.N.)

Bargaining over Tax Information Exchange

OpenAIRE

May Elsayyad

2012-01-01

This paper empirically studies recent treaty signings between tax havens and OECD countries as the outcome of a bargaining process over treaty form. Havens can decide not to sign an agreement, to sign a tax information exchange agreement or to sign a double taxation convention. We use a highly stylized bargaining model to develop testable hypotheses with regards to the type of agreement signed. We show that the main determinants of treaty signing are a haven's bargaining power and good govern...

An approach for message exchange using archetypes.

Science.gov (United States)

Moraes, João L C; Souza, Wanderley L; Cavalini, Luciana T; Pires, Luís F; Prado, Antonio F

2013-01-01

The application of ICT on the whole range of health sector activities, known as e-health, can simplify the access to health care services and will only be acceptable for realistic scenarios if it supports efficient information exchange amongst the caregivers and their patients. The aim of this paper is present an approach for message exchange to realistic scenarios.

The Affordable Care Act and Health Insurance Exchanges: Advocacy Efforts for Children's Oral Health.

Science.gov (United States)

Orynich, C Ashley; Casamassimo, Paul S; Seale, N Sue; Litch, C Scott; Reggiardo, Paul

2015-01-01

To evaluate legislative differences in defining the Affordable Care Act's (ACA) pediatric dental benefit and the role of pediatric advocates across states with different health insurance Exchanges. Data were collected through public record investigation and confidential health policy expert interviews conducted at the state and federal level. Oral health policy change by the pediatric dental profession requires advocating for the mandatory purchase of coverage through the Exchange, tax subsidy contribution toward pediatric dental benefits, and consistent regulatory insurance standards for financial solvency, network adequacy and provider reimbursement. The pediatric dental profession is uniquely positioned to lead change in oral health policy amidst health care reform through strengthening state-level formalized networks with organized dentistry and commercial insurance carriers.

Online Cancer Information Seeking: Applying and Extending the Comprehensive Model of Information Seeking.

Science.gov (United States)

Van Stee, Stephanie K; Yang, Qinghua

2017-10-30

This study applied the comprehensive model of information seeking (CMIS) to online cancer information and extended the model by incorporating an exogenous variable: interest in online health information exchange with health providers. A nationally representative sample from the Health Information National Trends Survey 4 Cycle 4 was analyzed to examine the extended CMIS in predicting online cancer information seeking. Findings from a structural equation model supported most of the hypotheses derived from the CMIS, as well as the extension of the model related to interest in online health information exchange. In particular, socioeconomic status, beliefs, and interest in online health information exchange predicted utility. Utility, in turn, predicted online cancer information seeking, as did information-carrier characteristics. An unexpected but important finding from the study was the significant, direct relationship between cancer worry and online cancer information seeking. Theoretical and practical implications are discussed.

The israeli virtual national health record: a robust national health information infrastructure based on a firm foundation of trust.

Science.gov (United States)

Saiag, Esther

2005-01-01

In many developed countries, a coordinated effort is underway to build national and regional Health Information Infrastructures (HII) for the linking of disparate sites of care, so that an access to a comprehensive Health Record will be feasible when critical medical decisions are made [1]. However, widespread adoption of such national projects is hindered by a series of barriers- regulatory, technical, financial and cultural. Above all, a robust national HII requires a firm foundation of trust: patients must be assured that their confidential health information will not be misused and that there are adequate legal remedies in the event of inappropriate behavior on the part of either authorized or unauthorized parties[2].The Israeli evolving National HII is an innovative state of the art implementation of a wide-range clinical inter-organizational data exchange, based on a unique concept of virtually temporary sharing of information. A logically connection of multiple caregivers and medical organizations creates a patient-centric virtual repository, without centralization. All information remains in its original format, location, system and ownership. On demand, relevant information is instantly integrated and delivered to the point of care. This system, successfully covering more than half of Israel's population, is currently evolving from a voluntary private-public partnership (dbMOTION and CLALIT HMO) to a formal national reality. The governmental leadership, now taking over the process, is essential to achieve a full potential of the health information technology. All partners of the Israeli health system are coordinated in concert with each other, driven with a shared vision - realizing that a secured, private, confidential health information exchange is assured.

Information Exchange of the Atomic Energy Society of Japan with Nuclear Societies Worldwide

International Nuclear Information System (INIS)

Masao Hori; Yasushi Tomita

2000-01-01

This paper describes committees of the Atomic Energy Society of Japan (AESJ) related to information exchange, AESJ publications, AESJ Internet applications, and means for future information exchange between nuclear societies

Improving performance in the ED through laboratory information exchange systems.

Science.gov (United States)

Raymond, Louis; Paré, Guy; Maillet, Éric; Ortiz de Guinea, Ana; Trudel, Marie-Claude; Marsan, Josianne

2018-03-12

The accessibility of laboratory test results is crucial to the performance of emergency departments and to the safety of patients. This study aims to develop a better understanding of which laboratory information exchange (LIE) systems emergency care physicians (ECPs) are using to consult their patients' laboratory test results and which benefits they derive from such use. A survey of 163 (36%) ECPs in Quebec was conducted in collaboration with the Quebec's Department of Health and Social Services. Descriptive statistics, chi-square tests, cluster analyses, and ANOVAs were conducted. The great majority of respondents indicated that they use several LIE systems including interoperable electronic health record (iEHR) systems, laboratory results viewers (LRVs), and emergency department information systems (EDIS) to consult their patients' laboratory results. Three distinct profiles of LIE users were observed. The extent of LIE usage was found to be primarily determined by the functional design differences between LIE systems available in the EDs. Our findings also indicate that the more widespread LIE usage, the higher the perceived benefits. More specifically, physicians who make extensive use of iEHR systems and LRVs obtain the widest range of benefits in terms of efficiency, quality, and safety of emergency care. Extensive use of LIE systems allows ECPs to better determine and monitor the health status of their patients, verify their diagnostic assumptions, and apply evidence-based practices in laboratory medicine. But for such benefits to be possible, ECPs must be provided with LIE systems that produce accurate, up-to-date, complete, and easy-to-interpret information.

Incentives and Information Exchange in International Taxation

NARCIS (Netherlands)

Keen, M.; Ligthart, J.E.

2004-01-01

The exchange of taxpayer-specific information between national tax authorities has recently emerged as a key and controversial topic in international tax policy discussions, most notably with the OECD s harmful tax practices project and the EU s savings tax initiative.This paper analyses the effects

Process Control Security in the Cybercrime Information Exchange NICC

NARCIS (Netherlands)

Luiijf, H.A.M.

2009-01-01

Detecting, investigating and prosecuting cybercrime? Extremely important, but not really the solution for the problem. Prevention is better! The sectors that have joined the Cybercrime Information Exchange have accepted the challenge of ensuring the effectiveness of the (information) security of

[Problems encountered by hospital pharmacists with information systems: Analysis of exchanges within social networks].

Science.gov (United States)

Charpiat, B; Mille, F; Fombeur, P; Machon, J; Zawadzki, E; Bobay-Madic, A

2018-05-21

The development of information systems in French hospitals is mandatory. The aim of this work was to analyze the content of exchanges carried out within social networks, dealing with problems encountered with hospital pharmacies information systems. Messages exchanged via the mailing list of the Association pour le Digital et l'Information en Pharmacie and abstracts of communications presented at hospital pharmacists trade union congresses were analyzed. Those referring to information systems used in hospital pharmacies were selected. From March 2015 to June 2016, 122 e-mails sent by 80 pharmacists concerned information systems. From 2002 to 2016, 45 abstracts dealt with this topic. Problems most often addressed in these 167 documents were "parameterization and/or functionalities" (n=116), interfaces and complexity of the hospital information systems (n=52), relationship with health information technologies vendors and poor reactivity (n=32), additional workload (n=32), ergonomics (n=30), insufficient user training (n=22). These problems are interdependent, lead to errors and in order to mitigate their consequences, they compel pharmacy professionals to divert a significant amount of working hours to the detriment of pharmaceutical care and dispensing and preparing drugs. Hospital pharmacists are faced with many problems of insecurity and inefficiency generated by information systems. Researches are warranted to determine their cost, specify their deleterious effects on care and identify the safest information systems. Copyright © 2018 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Associations between perceived crisis mode work climate and poor information exchange within hospitals.

Science.gov (United States)

Patterson, Mark E; Bogart, Miller S; Starr, Kathleen R

2015-03-01

Because hospital units operating in crisis mode could create unsafe transitions of care due to miscommunication, our objective was to estimate associations between perceived crisis mode work climate and patient information exchange problems within hospitals. Self-reported data from 247,140 hospital staff members across 884 hospitals were obtained from the 2010 Hospital Survey on Patient Safety Culture. Presence of a crisis mode work climate was defined as respondents agreeing that the hospital unit in which they work tries to do too much too quickly. Presence of patient information exchange problems was defined as respondents agreeing that problems often occur in exchanging patient information across hospital units. Multivariable ordinal regressions estimated the likelihood of perceived problems in exchanging patient information across hospital units, controlling for perceived levels of crisis mode work climate, skill levels, work climate, and hospital infrastructure. Compared to those disagreeing, hospital staff members agreeing that the hospital unit in which they work tries to do too much too quickly were 1.6 times more likely to perceive problems in exchanging patient information across hospital units (odds ratio: 1.6, 95% confidence interval: 1.58-1.65). Hospital staff members perceiving crisis mode work climates within their hospital unit are more likely to perceive problems in exchanging patient information across units, underscoring the need to improve communication during transitions of care. © 2014 Society of Hospital Medicine.

Closed Loop Brain Model of Neocortical Information Based Exchange

Directory of Open Access Journals (Sweden)

James eKozloski

2016-01-01

Full Text Available Here we describe an information based exchange' model of brain function that ascribes to neocortex, basal ganglia, and thalamus distinct network functions. The model allows us to analyze whole brain system set point measures, such as the rate and heterogeneity of transitions in striatum and neocortex, in the context of neuromodulation and other perturbations. Our closed-loop model is grounded in neuroanatomical observations, proposing a novel Grand Loop through neocortex, and invokes different forms of plasticity at specific tissue interfaces and their principle cell synapses to achieve these transitions. By implementing a system for maximum information based exchange of action potentials between modeled neocortical areas, we observe changes to these measures in simulation. We hypothesize that similar dynamic set points and modulations exist in the brain's resting state activity, and that different modifications to information based exchange may shift the risk profile of different component tissues, resulting in different neurodegenerative diseases. This model is targeted for further development using IBM's Neural Tissue Simulator, which allows scalable elaboration of networks, tissues, and their neural and synaptic components towards ever greater complexity and biological realism.

The Secure Information Exchange (SIX) Project at the OPCW

International Nuclear Information System (INIS)

Gulay, M.; Milenkovic, G.

2015-01-01

The Chemical Weapons Convention (CWC) entered into force in 1997 and the member states of the Organisation for the Prohibition of Chemical Weapons (OPCW) have obligations for making declarations under various articles of the convention. These declarations could contain confidential information and until recently the only mechanism to submit confidential information to the OPCW Technical Secretariat was through physical delivery by the permanent representatives of the member states which introduced delays in the exchange of information in general. In 2012, the Technical Secretariat initiated a strategic project to establish a secure electronic transmission channel that could be used as an alternative option for the exchange of information between the Technical Secretariat and the member states. The Secure Information Exchange (SIX) Project has been given priority by the Director-General and it received support from the member states. A core project team comprising representatives of the main business unit, the office of legal affairs, IT security and implementation teams were established. Following a feasibility study and with continuous communication with the representatives of the member states, the pilot phase of the project was completed successfully in 2013. In the near future, the project will go live and the member states and the Technical Secretariat will benefit from this key initiative. This paper aims to provide an overview of the project: the solution approach, data gathered in order to assess the delays in communication through traditional means, IT security and implementation issues as well as the legal considerations. (author)

Information Exchange Architecture for Integrating Unmanned Vehicles into Maritime Missions

National Research Council Canada - National Science Library

Woolsey, Aaron

2004-01-01

.... The focus of this study is to analyze the structure of information flow for unmanned systems and suggest an exchange architecture to successfully inform and build decision maker understanding based...

77 FR 18309 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

Science.gov (United States)

2012-03-27

.... 8901, et seq.) HEDIS Healthcare Effectiveness Data and Information Set HHS U.S. Department of Health... small businesses the same purchasing clout as big businesses. This final rule: (1) Sets forth the...)--Related to timeliness standards for Exchange eligibility determinations; Sec. 155.315(g)--Related to...

Smart Questions : Context-dependent mobile information exchange for military operations

NARCIS (Netherlands)

Streefkerk, J.W.; Heuvelink, A.

2014-01-01

During military mISSIOns, mobile devices allow information exchange between distributed groups of soldiers. As the context of use changes frequently and more (unstructured) information becomes available during missions, the challenge is to ensure that the right information reaches the right

Exchanging Medical Information with Eastern Europe through the Internet.

Science.gov (United States)

Daniels, Julie K.; Cronje, Ruth J.; Sokolowski, Beth C.

1998-01-01

Interviews foreign Information Coordinators who facilitate exchange of medical information over the Internet between healthcare providers in America and eastern Europe to learn how Internet technologies are being introduced, disseminated, and adopted in their institutions. Applies diffusion of innovations theory for interpretation. Shows technical…

The Trends and Prospects of Health Information Standards : Standardization Analysis and Suggestions

International Nuclear Information System (INIS)

Kim, Chang Soo

2008-01-01

Ubiquitous health care system, which is one of the developing solution technologies of IT, BT and NT, could give us new medical environments in future. Implementing health information systems can be complex, expensive and frustrating. Healthcare professionals seeking to acquire or upgrade systems do not have a convenient, reliable way of specifying a level of adherence to communication standards sufficient to achieve truly efficient interoperability. Great progress has been made in establishing such standards-DICOM, IHE and HL7, notably, are now highly advanced. IHE has defined a common framework to deliver the basic interoperability needed for local and regional health information networks. It has developed a foundational set of standards-based integration profiles for information exchange with three interrelated efforts. HL7 is one of several ANSI-accredited Standards Developing Organizations operating in the healthcare arena. Most SDOs produce standards (protocols) for a particular healthcare domain such as pharmacy, medical devices, imaging or insurance transactions. HL7's domain is clinical and administrative data. HL7 is an international community of healthcare subject matter experts and information scientists collaborating to create standards for the exchange, management and integration of electronic healthcare information. The ASTM specification for Continuity of Care Record was developed by subcommittee E31.28 on electronic health records, which includes clinicians, provider institutions, administrators, patient advocates, vendors, and health industry. In this paper, there are suggestions that provide a test bed, demonstration and specification of how standards such a IHE, HL7, ASTM can be used to provide an integrated environment.

The Trends and Prospects of Health Information Standards : Standardization Analysis and Suggestions

Energy Technology Data Exchange (ETDEWEB)

Kim, Chang Soo [Dept. of Radiological Science, College of Health Science, Catholic University of Pusan, Pusan (Korea, Republic of)

2008-03-15

Ubiquitous health care system, which is one of the developing solution technologies of IT, BT and NT, could give us new medical environments in future. Implementing health information systems can be complex, expensive and frustrating. Healthcare professionals seeking to acquire or upgrade systems do not have a convenient, reliable way of specifying a level of adherence to communication standards sufficient to achieve truly efficient interoperability. Great progress has been made in establishing such standards-DICOM, IHE and HL7, notably, are now highly advanced. IHE has defined a common framework to deliver the basic interoperability needed for local and regional health information networks. It has developed a foundational set of standards-based integration profiles for information exchange with three interrelated efforts. HL7 is one of several ANSI-accredited Standards Developing Organizations operating in the healthcare arena. Most SDOs produce standards (protocols) for a particular healthcare domain such as pharmacy, medical devices, imaging or insurance transactions. HL7's domain is clinical and administrative data. HL7 is an international community of healthcare subject matter experts and information scientists collaborating to create standards for the exchange, management and integration of electronic healthcare information. The ASTM specification for Continuity of Care Record was developed by subcommittee E31.28 on electronic health records, which includes clinicians, provider institutions, administrators, patient advocates, vendors, and health industry. In this paper, there are suggestions that provide a test bed, demonstration and specification of how standards such a IHE, HL7, ASTM can be used to provide an integrated environment.

Construction Operations Building Information Exchange (COBIE): Requirements Definition and Pilot Implementation Standard

Science.gov (United States)

2007-06-01

Swalley U.S. Department of State, Overseas Buildings Operations Toby Wilson U.S. Army, Corps of Engineers, Engineer R&D Center Jeff Wix AEC3 The...exchanged in COBIE. To map those information exchanges to the IFC model, the Information Delivery Manual (IDM) process [ Wix 2007] was also used. The...Folksonomy. Wikimedia Foundation. http://en.wikipedia.org/wiki/Folksonomy/, accessed 3 August 2007. Wix , Jeffrey. 2007. Information Delivery Manual

International exchange of radiological information in the event of a nuclear accident - future perspectives

International Nuclear Information System (INIS)

De-Cort, M.; De-Vries, G.; Breitenbach, L.; Leeb, H.; Weiss, W.

1996-01-01

Immediately after the Chernobyl accident most European countries established or enhanced their national radioactivity monitoring and information systems. The large transboundary effect of the radioactive release also triggered the need for bilateral and international agreements on the exchange of radiological information in case of a nuclear accident. Based on the experiences gained from existing bi- and multilateral data exchange the Commission of the European Communities has made provision for and is developing technical systems to exchange information of common interest. Firstly the existing national systems and systems based on bilateral agreements are summarized. The objectives and technical realizations of the EC international information exchange systems ECURIE and EURDEP, are described. The experiences gained over the past few years and the concepts for the future, in which central and eastern European countries will be included, are discussed. The benefits that would result from improving the international exchange of radiological information in the event of a future nuclear accident are further being described

Financial Performance of Health Insurers: State-Run Versus Federal-Run Exchanges.

Science.gov (United States)

Hall, Mark A; McCue, Michael J; Palazzolo, Jennifer R

2018-06-01

Many insurers incurred financial losses in individual markets for health insurance during 2014, the first year of Affordable Care Act mandated changes. This analysis looks at key financial ratios of insurers to compare profitability in 2014 and 2013, identify factors driving financial performance, and contrast the financial performance of health insurers operating in state-run exchanges versus the federal exchange. Overall, the median loss of sampled insurers was -3.9%, no greater than their loss in 2013. Reduced administrative costs offset increases in medical losses. Insurers performed better in states with state-run exchanges than insurers in states using the federal exchange in 2014. Medical loss ratios are the underlying driver more than administrative costs in the difference in performance between states with federal versus state-run exchanges. Policy makers looking to improve the financial performance of the individual market should focus on features that differentiate the markets associated with state-run versus federal exchanges.

Electronic Health Records: DOD's and VA's Sharing of Information Could Benefit from Improved Management

National Research Council Canada - National Science Library

2009-01-01

...) and the Department of Veterans Affairs (VA) are required to accelerate the exchange of health information between the departments and to develop systems or capabilities that allow for interoperability...

A platform independent prototype for data and information exchange between decision support systems

International Nuclear Information System (INIS)

Carle, B.; Baig, S.

2003-01-01

Full text: A survey amongst participants in the Decision Support System network (DSSNET) community showed that the organization dealing with the Information exchange between participants and stakeholders in nuclear emergency is too disparate to be defined in one well defined procedure or analysis. Looking at the organization of the national emergency response organizations, and especially when modelling the information flow, diversity is the most striking finding: originators of the information are different, decision making organisation can be different, the approval and publishing of information to press and wider public is dealt with in different ways and the responsibilities for the information flow to other authorities differ as well. Moreover, the place of decision support systems (DSS) in the emergency response organization varies for the different countries. This variation can be found in the way one of the 'big three' (RODOS, ARGOS and RECASS) systems is implemented, and even more in the way other, often country-specific systems, are in use and function more integrated with the particular emergency response organization of the country. Hence we can conclude that there is a need to structure the information exchange system, but this has to be flexible enough to work with the above described variety of existing organizations and procedures. Though it may not be feasible to agree on all specifications of information to be exchanged, we can define at least a minimal set. A prototype for data and information exchange is being developed under the EC project MODEM (Monitoring data and Information exchange among decision support systems). It establishes links between the decision support systems RODOS, ARGOS and RECASS. For setting up this data exchange, the use of xml-based data specifications allows a flexible integration with existing applications. The power to include metadata in a structured way allows the use of automated transformation tools and limits the

The Role of Private Information in Short-term Fluctuations of Won/Dollar Exchange Rates

Directory of Open Access Journals (Sweden)

Haesik Park

1999-12-01

Full Text Available In this paper, we have examined the short-run movement of the won/dollar exchange rate using information obtained from the inter-bank market in Korea. First, we constructed the hourly measure of excess demand for dollar and used it as a proxy for the trading pattern of market participants. To construct this time series, we relied on the bid and ask won/dollar exchange rates collected on the two-minute interval. We then estimated the structural VAR model consisting of the actually observed won/dollar exchange rate and the proxied trading pattern of market participants to see if private information, as opposed to public information, is relevant for explaining the hourly movement of the won/dollar exchange rate. Private information is found to account for more 30% of hourly variations of the won/dollar exchange rate. Next, we constructed the trading pattern of market participants on a daily basis using the same data set employed to build the hourly measure. We then examined whether private information is useful for predicting the daily won/dollar exchange rate movement. We found that the forecast model using both private and public information reduces out-of-sample forecast errors of an alternative model relying only on public information by 20~25%. Also, the out-of-sample forecast of the model using both private and public information is found to be more accurate than the random walk model.

Exploring the Use of Internet by University Students for Seeking Health Related Information

Science.gov (United States)

Ahmad, Asad; Khan, Mohammed Naved; Rahman, Obaidur

2017-01-01

Purpose: Internet is both a medium and a platform for information exchange. This characteristic of internet is gradually metamorphosing it into an e-learning enabler. A significant percentage of internet users access health-related information through the medium of internet, but little is known about the factors that determine such behaviour. This…

Health Insurance Exchanges: Health Insurance Navigators and In-Person Assistance

Science.gov (United States)

2013-09-25

apply for coverage through the exchanges may be eligible for small business tax credits.5 Consumers may apply for coverage over the phone, online , via...more recent CMS announcements reference 20-30 hours of training. 47 The Medicare Learning Network online navigator training is estimated to take 20...about scam artists seeking to obtain personal information under the guise of verifying information regarding ACA coverage.114

Bilateral communication and information exchange, an attempt relating to mandate 8 of the Dutch-German commission (NDKK)

International Nuclear Information System (INIS)

Salfeld, H.Ch.; Hable, K.; Kok, Y.S.; Reinen, H.A.J.M.

2003-01-01

Full text: According to a memorandum of understanding between Germany and the Netherlands, the NDKK has to review the existing communication methods. Proceeding from this review proposals have to be developed to improve the bilateral communication and data exchange in case of events near the German-Dutch border and more generally for every event involving nuclear facilities. The NDKK has established a working group for reviewing and working out the proposals. Members of the working group are federal institutions resp. state institutions. Within their scope of duties are emergency management and communication, data collection and communication and expert advice to stakeholders. On the Dutch side the National Institute for Public Health and the Environment (RIVM) takes part, on the German side, the Federal Office for Radiation Protection (BfS) and the Lower Saxony State Agency for Ecology (NLOE) are involved. At international level, the ECURIE (European Community Urgent Radiological Information Exchange, system of the EU) and EMERCON (Emergency Convention, system of the IAEA) are used for early notification and subsequent messaging. The designated contact points and competent authorities are VROM (Ministry of Housing, Spatial Planning and the Environment) and BMU (German Federal Ministry for the Environment, Nature Conservation and Nuclear Safety). According to a bilateral agreement, there is an additional direct communication for emergency notification between BMU and VROM. For the exchange of radiological measurement data the EURDEP standard (European Radiological Data Exchange Platform) is applied. In addition to the multinational procedure, it has been decided to exchange data directly in order to make the exchange faster and redundant. Presently, data are exchanged on a weekly basis by ftp, using EURDEP 2.0 format. The only NPP located near the Dutch-German border is the German NPP Emsland (KKE) close to the town of Lingen. Other nuclear facilities in this area

Health Information Infrastructure for People with Intellectual and Developmental Disabilities (I/DD) Living in Supported Accommodation: Communication, Co-Ordination and Integration of Health Information.

Science.gov (United States)

Dahm, Maria R; Georgiou, Andrew; Balandin, Susan; Hill, Sophie; Hemsley, Bronwyn

2017-10-25

People with intellectual and/or developmental disability (I/DD) commonly have complex health care needs, but little is known about how their health information is managed in supported accommodation, and across health services providers. This study aimed to describe the current health information infrastructure (i.e., how data and information are collected, stored, communicated, and used) for people with I/DD living in supported accommodation in Australia. It involved a scoping review and synthesis of research, policies, and health documents relevant in this setting. Iterative database and hand searches were conducted across peer-reviewed articles internationally in English and grey literature in Australia (New South Wales) up to September 2015. Data were extracted from the selected relevant literature and analyzed for content themes. Expert stakeholders were consulted to verify the authors' interpretations of the information and content categories. The included 286 sources (peer-reviewed n = 27; grey literature n = 259) reflect that the health information for people with I/DD in supported accommodation is poorly communicated, coordinated and integrated across isolated systems. 'Work-as-imagined' as outlined in policies, does not align with 'work-as-done' in reality. This gap threatens the quality of care and safety of people with I/DD in these settings. The effectiveness of the health information infrastructure and services for people with I/DD can be improved by integrating the information sources and placing people with I/DD and their supporters at the centre of the information exchange process.

Information Exchange, Market Transparency and Dynamic Oligopoly

DEFF Research Database (Denmark)

Møllgaard, H. Peter; Overgaard, Per Baltzer

Economic literature often offers conflicting views on the likely efficiency effects of information exchanges, communication between firms, and market transparency. On the one hand, it is argued that increased information dissemination improves firm planning to the benefit of society (including...... buyers) and allows potential buyers to make correct decisions given their preferences. On the other hand, economic literature also shows that increased information dissemination can raise prices through tacit or explicit collusion to the benefit of firms but at the expense of society at large....... This chapter provides a general analytical framework to reconcile these views and presents some basic conclusions for antitrust practice. In addition, the chapter reviews cases from both sides of the Atlantic where informational issues have played a significant role....

Achievement goals and interpersonal behaviour: How mastery and performance goals shape information exchange

NARCIS (Netherlands)

Poortvliet, P.M.; Janssen, O.; Van Yperen, N.W.; Van de Vliert, E.

2007-01-01

The present research examines the impact of achievement goals on task-related information exchange. Studies 1 and 2 reveal that relative to those with mastery goals or no goal, individuals pursuing performance goals were less open in their information giving to exchange partners. Study 2 further

Negotiating multisectoral evidence: a qualitative study of knowledge exchange at the intersection of transport and public health

Directory of Open Access Journals (Sweden)

Cornelia Guell

2017-01-01

Full Text Available Abstract Background For the prevention and control of chronic diseases, two strategies are frequently highlighted: that public health should be evidence based, and that it should develop a multisectoral approach. At the end of a natural experimental study of the health impacts of new transport infrastructure, we took the opportunity of a knowledge exchange forum to explore how stakeholders assessed, negotiated and intended to apply multisectoral evidence in policy and practice at the intersection of transport and health. We aimed to better understand the challenges they faced in knowledge exchange, as well as their everyday experiences with working in multisectoral remits. Methods In 2015, we conducted participant observation during an interactive event with 41 stakeholders from national and local government, the third sector and academia in Cambridge, UK. Formal and informal interactions between stakeholders were recorded in observational field notes. We also conducted 18 semistructured interviews reflecting on the event and on knowledge exchange in general. Results We found that stakeholders negotiated a variety of challenges. First, stakeholders had to negotiate relatively new formal and informal multisectoral remits; and how to reconcile the differing expectations of transport specialists, who tended to emphasise the importance of precedence in guiding action, and health specialists’ concern for the rigour and synthesis of research evidence. Second, research in this field involved complex study designs, and often produced evidence with uncertain transferability to other settings. Third, health outcomes of transport schemes had political traction and were used strategically but not easily translated into cost-benefit ratios. Finally, knowledge exchange meant multiple directions of influence. Stakeholders were concerned that researchers did not always have skills to translate their findings into understandable evidence, and some stakeholders

Process Control Security in the Cybercrime Information Exchange NICC

OpenAIRE

Luiijf, H.A.M.

2009-01-01

Detecting, investigating and prosecuting cybercrime? Extremely important, but not really the solution for the problem. Prevention is better! The sectors that have joined the Cybercrime Information Exchange have accepted the challenge of ensuring the effectiveness of the (information) security of process control systems (PCS), including SCADA. This publication makes it clear why it is vital that organizations establish and maintain control over the security of the information and communication...

Influence of Peer-Based Needle Exchange Programs on Mental Health Status in People Who Inject Drugs: A Nationwide New Zealand Study.

Science.gov (United States)

Hay, Bianca; Henderson, Charles; Maltby, John; Canales, Juan J

2016-01-01

Alleviating the personal and social burden associated with substance use disorders requires the implementation of a comprehensive strategy, including outreach, education, community interventions, psychiatric treatment, and access to needle exchange programs (NEP), where peer support may be available. Given that substantial research underscores the potential benefits of peer support in psychiatric interventions, we aimed to conduct a national survey to examine key domains of mental health status in people who inject drugs (PWID) in New Zealand. PWID were recruited from 24 pharmacies and 16 dedicated peer-based needle exchanges (PBNEs) across the country. We focused on two mental health outcomes: (1) affective dysregulation, across the three emotional domains of the Depression Anxiety Stress Scale, due to its role in the maintenance of continued drug use, and (2) positive cognition and effective health- and drug-related information exchange with the provider, using the Satisfaction with Life Scale and an ad hoc questionnaire, respectively, in view of their association with improved mental health outcomes. We hypothesized that access to peer support would be associated with mental health benefits for PWIDs. Remarkably, the results of a multistep regression analysis revealed that irrespective of sex, age, ethnicity, main drug used, length of drug use, and frequency of visits to the NEP, the exclusive or preferential use of PBNEs predicted significantly lower depression and anxiety scores, greater satisfaction with life, and increased health-related information exchange with the service provider. These findings demonstrate for the first time an association between access to peer support at PBNEs and positive indices of mental health, lending strong support to the effective integration of such peer-delivered NEP services into the network of mental health services for PWID worldwide.

Emergency exercises and information exchange. Does practice make perfect? Final report

Energy Technology Data Exchange (ETDEWEB)

Naadland Holo, E

1999-09-01

This project has covered a series of exercises and exercise like activities, in addition to a survey of scenario development tools and development of a suggestion for a Nordic system for data and information exchange. The results from the activities are presented in this report in a methodical perspective. The results reveal three similar components in almost all exercise activities: tools and methods to be used in an emergency situation need further development, systems for communication and information exchange should be developed and implemented, and the format and content of the information to be exchanged in an emergency situation should be agreed upon. Recommendations for future tasks regarding Nordic exercises are given according to this methodical approach. A major aspect here is to develop strategies for the over-all emergency planning. Such strategies should include the use of systematically chosen exercise types to improve the emergency response in a systematic way. (au)

Models of information exchange between radio interfaces of Wi-Fi group of standards

Science.gov (United States)

Litvinskaya, O. S.

2018-05-01

This paper offers models of information exchange between radio interfaces of the Wi-Fi group of standards by the example of a real facility management system for the oil and gas industry. Interaction between the MU-MIMO and MIMO technologies is analyzed. An optimal variant of information exchange is proposed.

Secure Data Exchange in Environmental Health Monitoring System through Wireless Sensor Network

Directory of Open Access Journals (Sweden)

Amang Sudarsono

2016-04-01

Full Text Available Recently, disseminating latest sensory information regarding the status of environmental health in the surroundings of human life is one of very important circumstances which must be known by everyone. These circumstances should be accessible at anytime and anywhere by everyone through any type of end-user devices, both fixed and mobile devices, i.e., Desktop PCs, Laptop PCs, and Smartphones. Wireless Sensor Network (WSN is one of the networks which deals with data sensors distribution from sensor nodes to the gateway node toward a Data Center Server. However, there is a big possibility for many adversaries to intercept and even manipulate data sensors crossing the network. Hence, a secure data sensor exchange in the system would be strongly desirable. In this research, we propose an environmental health conditions monitoring system through WSN and its implementation with considering secure data sensor exchange within the network and secure data sensor access. This work may contribute to support a part of smart cities and take in part the Internet of Thing (IoT technology. In our proposed system, we collect some environmental health information such as temperature, humidity, luminosity, noise, carbon monoxide (CO and carbon dioxide (CO2 from sensor nodes. We keep the confidentiality and integrity of transmitted data sensors propagating through IEEE802.15.4-based communication toward a gateway node. Further, the collected data sensors in the gateway are synchronized to the Data Center Server through a secure TCP/IP connection for permanently storing. At anytime and anywhere, only legitimated users who successfully pass-through an attribute-based authentication system are able to access the data sensors.

Prolegomena to a theory of nuclear information exchange

International Nuclear Information System (INIS)

Van Nuffelen, Dominique

1997-01-01

From the researcher's point of view, the communications with the agricultural populations in case of radiological emergency can not be anything else but the application of a theory of nuclear information exchange among social groups. Consequently, it is essentially necessary to work out such a theory, the prolegomena of which are exposed in this paper. It describes an experiment conducted at 'Service de protection contre les radiations ionisantes' - Belgium (SPRI), and proposes an investigation within the scientific knowledge in this matter. The available empirical and theoretical data allow formulating pragmatic recommendations, among which the principal one is the necessity of creating in normal radiological situation of a number of scenarios of messages adapted to the agricultural populations. The author points out that in order to be perfectly adapted these scenarios must been negotiated between the emitter and receiver. If this condition is satisfied the information in case of nuclear emergency will really be an exchange of knowledge between experts and the agricultural population i.e. a 'communication'

78 FR 77470 - Health Insurance Exchanges; Approval of an Application by the Accreditation Association for...

Science.gov (United States)

2013-12-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-9953-FN] Health Insurance Exchanges; Approval of an Application by the Accreditation Association for Ambulatory...\\ Health Insurance Exchanges; Application by the Accreditation Association for Ambulatory Health Care To Be...

[Linking: relationships between health professionals in the informal health networks].

Science.gov (United States)

Sarradon-Eck, A; Vega, A; Faure, M; Humbert-Gaudart, A; Lustman, M

2008-07-01

During the last years, the french health system has been developing formal health networks. So, it was necessary to study informal health networks as networks. More precisely, we studied the nature of relationships between various stakeholders around general practionners wich are commonly considering as the stakeholder of the health system private sector. Fieldwork (ethnography based on direct observations and interviews) was conducted between October 2002 and april 2004, in the South-East of France. Ten monographs of general practioner's offices were achieved in a rural area; then, we achieved fieldwork of the informal health networks identified. There is a cultural frame wich is common to all private professionals. This frame includes a triple ideal (teamwork built up the hospital model, independance, and an relational approach with patients). This frame does not square with the real practices. In fact, regulation mechanisms preserve the balance of relashionships between professionnal groups, by restricting/promoting exchanges and complex alliance strategies. These mecanisms include: (1) a few professionnal's rule as disponibility (to the patients and to the professionnals), as communication about patient, as patient's reference, as obligation to communicate between professionals; (2) some constraints such as territory superposition and competition with other professional groups; (3) some needs for: rileiving (of emotions and worries connected to work), sharing (decisions, responsabilities), of delegation (medical treatment, practices), protection against social and legal risk through the creation of trust relationships. These trust relationships are based on several logics (affinity, solidarity, similarity). The study shows the major place of the patient who is often the main organizer of his network, and even though he makes an important structuring work between medical staff, and an information transfer (on his diagnosis, on his treatment, and professionals

Automatic exchange of information: towards a new global standard of tax transparency

OpenAIRE

Miguel Eduardo Pecho Trigueros

2014-01-01

Tax authorities are increasingly relying on mutual cooperation with their foreign peers to enforce more effectively their internal tax laws. After the banking scandals of 2008 and the subsequent global financial crisis, the Global Forum on Transparency and Exchange of Information for TaxPurposes has proposed the exchange of information upon request as the fiscal transparency standard. However, some measures adopted by the European Union, previous initiatives from the Organization for Economic...

Why common carrier and network neutrality principles apply to the Nationwide Health Information Network (NWHIN).

Science.gov (United States)

Gaynor, Mark; Lenert, Leslie; Wilson, Kristin D; Bradner, Scott

2014-01-01

The Office of the National Coordinator will be defining the architecture of the Nationwide Health Information Network (NWHIN) together with the proposed HealtheWay public/private partnership as a development and funding strategy. There are a number of open questions--for example, what is the best way to realize the benefits of health information exchange? How valuable are regional health information organizations in comparison with a more direct approach? What is the role of the carriers in delivering this service? The NWHIN is to exist for the public good, and thus shares many traits of the common law notion of 'common carriage' or 'public calling,' the modern term for which is network neutrality. Recent policy debates in Congress and resulting potential regulation have implications for key stakeholders within healthcare that use or provide services, and for those who exchange information. To date, there has been little policy debate or discussion about the implications of a neutral NWHIN. This paper frames the discussion for future policy debate in healthcare by providing a brief education and summary of the modern version of common carriage, of the key stakeholder positions in healthcare, and of the potential implications of the network neutrality debate within healthcare.

75 FR 13288 - Agency Information Collection Request; 30-Day Public Comment Request

Science.gov (United States)

2010-03-19

...' attitudes toward electronic health information exchange and the extent to which they are interested in... permit us to better understand individuals' attitudes toward electronic health information exchange and... Toward Electronic Health Information Exchange and Associated Privacy and Security Aspects--OMB No. 0990...

Integration of IEEE 1451 and HL7 exchanging information for patients' sensor data.

Science.gov (United States)

Kim, Wooshik; Lim, Suyoung; Ahn, Jinsoo; Nah, Jiyoung; Kim, Namhyun

2010-12-01

HL7 (Health Level 7) is a standard developed for exchanging incompatible healthcare information generated from programs or devices among heterogenous medical information systems. At present, HL7 is growing as a global standard. However, the HL7 standard does not support effective methods for treating data from various medical sensors, especially from mobile sensors. As ubiquitous systems are growing, HL7 must communicate with various medical transducers. In the area of sensor fields, IEEE 1451 is a group of standards for controlling transducers and for communicating data from/to various transducers. In this paper, we present the possibility of interoperability between the two standards, i.e., HL7 and IEEE 1451. After we present a method to integrate them and show the preliminary results of this approach.

Policy and system strategies in promoting child health information systems, including the role of Medicaid, the state children's health insurance program, and public financing.

Science.gov (United States)

MacTaggart, Patricia; Bagley, Bruce

2009-01-01

Government, through its unique roles as regulator, purchaser, provider, and facilitator, has an opportunity and an obligation to play a major role in accelerating the implementation of electronic health record systems and electronic health information exchange. Providers, who are expected to deliver appropriate care at designated locations at an appropriate cost, are dependent on health information technology for efficient effective health care. As state and federal governments move forward with health care purchasing reforms, they must take the opportunity to leverage policy and structure and to align incentives that enhance the potential for provider engagement in electronic health record adoption.

Determination of Minimum Data Set (MSD) in Echocardiography Reporting System to Exchange with Iran's Electronic Health Record (EHR) System.

Science.gov (United States)

Mahmoudvand, Zahra; Kamkar, Mehran; Shahmoradi, Leila; Nejad, Ahmadreza Farzaneh

2016-04-01

Determination of minimum data set (MDS) in echocardiography reports is necessary for documentation and putting information in a standard way, and leads to the enhancement of electrocardiographic studies through having access to precise and perfect reports and also to the development of a standard database for electrocardiographic reports. to determine the minimum data set of echocardiography reporting system to exchange with Iran's electronic health record (EHR) system. First, a list of minimum data set was prepared after reviewing texts and studying cardiac patients' records. Then, to determine the content validity of the prepared MDS, the expert views of 10 cardiologists and 10 health information management (HIM) specialists were obtained; to estimate the reliability of the set, test-retest method was employed. Finally, the data were analyzed using SPSS software. The highest degree of consensus was found for the following MDSs: patient's name and family name (5), accepting doctor's name and family name, familial death records due to cardiac disorders, the image identification code, mitral valve, aortic valve, tricuspid valve, pulmonary valve, left ventricle, hole, atrium valve, Doppler examination of ventricular and atrial movement models and diagnoses with an average of. To prepare a model of echocardiography reporting system to exchange with EHR system, creation a standard data set is the vital point. Therefore, based on the research findings, the minimum reporting system data to exchange with Iran's electronic health record system include information on entity, management, medical record, carried-out acts, and the main content of the echocardiography report, which the planners of reporting system should consider.

Proceedings of information and opinion exchange conference on geoscientific study, 2007

International Nuclear Information System (INIS)

Nishio, Kazuhisa; Iyatomi, Yosuke; Ogata, Nobuhisa

2008-05-01

The Tono Geoscience Center (TGC) of Japan Atomic Energy Agency (JAEA) has been conducting a geoscientific studies in order to establish a scientific and technological basis for the geological disposal of HLW. Information and Opinion Exchange Conference on Geoscientific Study has been held by TGC annually. The conference provides technical information and an opportunity for peer review and exchange of opinions on the geoscientific studies conducted at TGC. Research specialists and engineers from Japanese universities, research organizations and private companies usually participate the conference. This document compiles research presentations, posters of the conference on October 19th, 2007 at Mizunami. (author)

Proceedings of information and opinion exchange conference on geoscientific study, 2009

International Nuclear Information System (INIS)

Nishio, Kazuhisa; Iyatomi, Yosuke; Shimada, Akiomi

2010-02-01

The Tono Geoscience Center (TGC) of Japan Atomic Energy Agency (JAEA) has been conducting a geoscientific studies in order to establish a scientific and technological basis for the geological disposal of HLW. Information and Opinion Exchange Conference on Geoscientific Study has been held by TGC annually. The conference provides technical information and an opportunity for peer review and exchange of opinions on the geoscientific studies conducted at TGC. Research specialists and engineers from Japanese universities, research organizations and private companies usually participate the conference. This document compiles research presentations, posters of the conference on October 27th, 2009 at Mizunami. (author)

Facilitating the Information Exchange Using a Modular Electronic Discharge Summary.

Science.gov (United States)

Denecke, Kerstin; Dittli, Pascal A; Kanagarasa, Niveadha; Nüssli, Stephan

2018-01-01

Discharge summaries are a standard communication tool delivering important clinical information from inpatient to ambulatory care. To ensure a high quality, correctness and completeness, the generation process is time consuming. It requires also contributions of multiple persons. This is problematic since the primary care provider needs the information from the discharge summary for continuing the intended treatment. To address this challenge, we developed a concept for exchanging a modular electronic discharge summary. Through a literature review and interviews with multiple stakeholders, we analysed existing processes and derived requirements for an improved communication of the discharge summary. In this paper, we suggest a concept of a modular electronic discharge summary that is exchanged through the electronic patient dossier in CDA CH level 2 documents. Until 2020, all Swiss hospitals are obliged to connect to the electronic patient dossier. Our concept allows to access already completed modules of the discharge summary from the primary care side, before the entire report is entirely finalised. The data is automatically merged with the local patient record on the physician side and prepared for data integration into the practice information system. Our concept offers the opportunity not only to improve the information exchange between hospital and primary care, but it also provides a potential use case and demonstrates a benefit of the electronic patient dossier for primary care providers who are so far not obliged to connect to the patient dossier in Switzerland.

The Earth Information Exchange: A Portal for Earth Science From the ESIP Federation

Science.gov (United States)

Wertz, R.; Hutchinson, C.; Hardin, D.

2006-12-01

current working groups are focused toward the issues of Air Quality, Coastal Management, Disaster Management, Ecological Forecasting, Public Health, and Water Management. Initially, the Exchange will be linked to USGS's Geospatial One Stop portal, NASA's Earth Science Gateway, the Global Change Master Directory (GCMD) and the Eos ClearingHOuse (ECHO). The Earth Information Exchange will be an integrated system of distributed components that work together to expedite the process of Earth science and to increase the effective application of its results to benefit the public. Specifically the EIE is designed to provide a comprehensive inventory of Earth observation metadata by GEOSS and other commonly used issue area categories. To provide researchers, educators and policy makers with ready access to metadata over the web, via URLs. To provide researchers with access to data in common scientific data formats such as netCDF and HDF-EOS and common scientific data models such as swath, point and grid. To provide policy makers and others with an e-commerce marketplace where advanced data products (analysis tools, models, simulations, decision support products) can be found and acquired. And, to provide researchers, educators and policy makers with a broad inventory of the human resources associated with the Federation and its partners.

Health insurance exchanges bring potential opportunities.

Science.gov (United States)

Jacobs, M Orry; Eggbeer, Bill

2012-11-01

The introduction of the state health insurance exchanges, as provided for in the Affordable Care Act, has many strategic implications for healthcare providers: Unprecedented transparency; The "Walmart Effect", with patients playing a greater role as healthcare consumers; A rise in narrow networks spurred by low prices and narrow geographies; The potential end of the cross subsidy of Medicare and Medicaid by commercial plans; The possible end of not-for-profit status for hospitals

Information exchange examined : an interpersonal account of achievement goals

NARCIS (Netherlands)

Poortvliet, P.M.

2008-01-01

In this thesis it is argued and demonstrated, that the achievement goals that individuals pursue in achievement situations may crucially influence how they perceive and act in information exchange situations. Notably, whether people are striving to improve their own performance, as compared with

78 FR 39644 - Information Reporting for Affordable Insurance Exchanges

Science.gov (United States)

2013-07-02

... Federal Register. Drafting Information The principal authors of these proposed regulations are Shareen S. Pflanz and Stephen J. Toomey of the Office of Associate Chief Counsel (Income Tax and Accounting... required contribution for self-only coverage and the Exchange's determination of whether the employer...

Confidentiality, privacy, and security of genetic and genomic test information in electronic health records: points to consider.

Science.gov (United States)

McGuire, Amy L; Fisher, Rebecca; Cusenza, Paul; Hudson, Kathy; Rothstein, Mark A; McGraw, Deven; Matteson, Stephen; Glaser, John; Henley, Douglas E

2008-07-01

As clinical genetics evolves, and we embark down the path toward more personalized and effective health care, the amount, detail, and complexity of genetic/genomic test information within the electronic health record will increase. This information should be appropriately protected to secure the trust of patients and to support interoperable electronic health information exchange. This article discusses characteristics of genetic/genomic test information, including predictive capability, immutability, and uniqueness, which should be considered when developing policies about information protection. Issues related to "genetic exceptionalism"; i.e., whether genetic/genomic test information should be treated differently from other medical information for purposes of data access and permissible use, are also considered. These discussions can help guide policy that will facilitate the biological and clinical resource development to support the introduction of this information into health care.

45 CFR 170.205 - Content exchange standards and implementation specifications for exchanging electronic health...

Science.gov (United States)

2010-10-01

.... The Healthcare Information Technology Standards Panel (HITSP) Summary Documents Using HL7 CCD... HEALTH AND HUMAN SERVICES HEALTH INFORMATION TECHNOLOGY HEALTH INFORMATION TECHNOLOGY STANDARDS... TECHNOLOGY Standards and Implementation Specifications for Health Information Technology § 170.205 Content...

Improving exchange with consumers within mental health organizations: Recognizing mental ill health experience as a 'sneaky, special degree'.

Science.gov (United States)

Scholz, Brett; Bocking, Julia; Happell, Brenda

2018-02-01

Stigmatizing views towards consumers may be held even by those working within mental health organizations. Contemporary mental health policies require organizations to work collaboratively with consumers in producing and delivering services. Using social exchange theory, which emphasises mutual exchange to maximise benefits in partnership, the current study explores the perspectives of those working within organizations that have some level of consumer leadership. Interviews were conducted with 14 participants from a range of mental health organizations. Data were transcribed, and analyzed using thematic analytic and discursive psychological techniques. Findings suggest stigma is still prevalent even in organizations that have consumers in leadership positions, and consumers are often perceived as less able to work in mental health organizations than non-consumers. Several discourses challenged such a view - showing how consumers bring value to mental health organizations through their expertise in the mental health system, and their ability to provide safety and support to other consumers. Through a social exchange theory lens, the authors call for organizations to challenge stigma and promote the value that consumers can bring to maximize mutual benefits. © 2017 Australian College of Mental Health Nurses Inc.

Proceedings of information and opinion exchange conference on geoscientific study, 2006

International Nuclear Information System (INIS)

Nishio, Kazuhisa; Iyatomi, Yosuke; Ogata, Nobuhisa

2008-03-01

The Tono Geoscience Center (TGC) of Japan Atomic Energy Agency (JAEA) has been conducting a geoscientific studies in order to establish a scientific and technological basis for the geological disposal of HLW. Information and Opinion Exchange Conference on Geoscientific Study has been held by TGC annually. The conference provides technical information and an opportunity for peer review and exchange of opinions on the geoscientific studies conducted at TGC. Research specialists and engineers from Japanese universities, research organizations and private companies usually participate the conference. This document collects research presentations, posters of the conference on October 19th to 20th, 2006 at Mizunami. (author)

Exploring the concepts of privacy and the sharing of sensitive health information.

Science.gov (United States)

Asiri, Eman; Asiri, Hanan; Househ, Mowafa

2014-01-01

People are increasingly sharing their personal information on social networks such as Facebook. Patients, in particular, join online support groups for specific conditions to get support and share their experience with other members of a social media group. Throughout this process, sensitive health information could be shared by group members as a part of this information exchange and privacy concerns can arise as a result. The purpose of this study is to explore various aspects relating to privacy and the sharing of sensitive health information through social media platforms. Our review found that social media such as Facebook already plays a large role in patients' lives as it helps patients to understand their health conditions and gain support from other people who suffer from the same condition. However, there are major concerns for those patients as their privacy and confidentiality can be harmed by improper use of their posted sensitive health information by governments, hospitals or individuals. More importantly, there is an increased need for laws and legislations that protect and empower patients. We recommend that healthcare organizations collaborate with social media software companies and create educational and awareness campaigns on the impacts of sharing sensitive health information through social media.

Does exchange of information between tax authorities influence multinationals' use of tax havens?

OpenAIRE

Braun, Julia; Weichenrieder, Alfons

2015-01-01

Since the mid-1990s, countries offering tax systems that facilitate international tax avoidance and evasion have been facing growing political pressure to comply with the internationally agreed standards of exchange of tax information. Using data of German investments in tax havens, we find evidence that the conclusion of a bilateral tax information exchange agreement (TIEA) is associated with fewer operations in tax havens and the number of German affiliates has on average ...

Understanding information exchange during disaster response: Methodological insights from infocentric analysis

Science.gov (United States)

Toddi A. Steelman; Branda Nowell; Deena. Bayoumi; Sarah. McCaffrey

2014-01-01

We leverage economic theory, network theory, and social network analytical techniques to bring greater conceptual and methodological rigor to understand how information is exchanged during disasters. We ask, "How can information relationships be evaluated more systematically during a disaster response?" "Infocentric analysis"—a term and...

Information Asymmetry and Financing Decisions: Evidence from Iran Stock Exchange

OpenAIRE

Mehdi Elhaei Sahar; Seyed Ali Vaez

2013-01-01

This study aims to investigate the relations of information asymmetry and financing decisions in Tehran Stock Exchange (TSE) during 2009 to 2011. Our statistical simple consist 170 firms and stepwise regression method has been used. We found that the relationship between information asymmetry and stock issuing is negative. Other results refer to positive relation between financing deficit and stock issuing.

Privacy and Confidentiality in Exchange of Information Procedures : Some Uncertainties, Many Issues, but Few Solutions

NARCIS (Netherlands)

Debelva, F.; Mosquera, Valderrama I.J.

2017-01-01

The overall aim of this article is to analyse the taxpayers’ rights to confidentiality and privacy in exchange of information including the new global standard of automatic exchange of information. Section 2 will analyse the state of the art regarding the right to privacy and confidentiality in

An approach for message exchange using archetypes

NARCIS (Netherlands)

Cardoso de Moraes, J.L.; Lopes de Souza, Wanderley; Cavalini, Luciana T.; Ferreira Pires, Luis; do Prado, Antonio F.; Lehmann, C.U.; Ammenwerth, E.; Nøhr, C.

The application of ICT on the whole range of health sector activities, known as e-health, can simplify the access to health care services and will only be acceptable for realistic scenarios if it supports efficient information exchange amongst the caregivers and their patients. The aim of this paper

The Affordable Care Act and health insurance exchanges: effects on the pediatric dental benefit.

Science.gov (United States)

Orynich, C Ashley; Casamassimo, Paul S; Seale, N Sue; Reggiardo, Paul; Litch, C Scott

2015-01-01

To examine the relationship between state health insurance Exchange selection and pediatric dental benefit design, regulation and cost. Medical and dental plans were analyzed across three types of state health insurance Exchanges: State-based (SB), State-partnered (SP), and Federally-facilitated (FF). Cost-analysis was completed for 10,427 insurance plans, and health policy expert interviews were conducted. One-way ANOVA compared the cost-sharing structure of stand-alone dental plans (SADP). T-test statistics compared differences in average total monthly pediatric premium costs. No causal relationships were identified between Exchange selection and the pediatric dental benefit's design, regulation or cost. Pediatric medical and dental coverage offered through the embedded plan design exhibited comparable average total monthly premium costs to aggregate cost estimates for the separately purchased SADP and traditional medical plan (P=0.11). Plan designs and regulatory policies demonstrated greater correlation between the SP and FF Exchanges, as compared to the SB Exchange. Parameters defining the pediatric dental benefit are complex and vary across states. Each state Exchange was subject to barriers in improving the quality of the pediatric dental benefit due to a lack of defined, standardized policy parameters and further legislative maturation is required.

26 CFR 1.6045-1T - Returns of information of brokers and barter exchanges (temporary).

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 13 2010-04-01 2010-04-01 false Returns of information of brokers and barter exchanges (temporary). 1.6045-1T Section 1.6045-1T Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF... of information of brokers and barter exchanges (temporary). (a)-(k) [Reserved] For further guidance...

Hospital readiness for health information exchange: development of metrics associated with successful collaboration for quality improvement.

Science.gov (United States)

Korst, Lisa M; Aydin, Carolyn E; Signer, Jordana M K; Fink, Arlene

2011-08-01

The development of readiness metrics for organizational participation in health information exchange is critical for monitoring progress toward, and achievement of, successful inter-organizational collaboration. In preparation for the development of a tool to measure readiness for data-sharing, we tested whether organizational capacities known to be related to readiness were associated with successful participation in an American data-sharing collaborative for quality improvement. Cross-sectional design, using an on-line survey of hospitals in a large, mature data-sharing collaborative organized for benchmarking and improvement in nursing care quality. Factor analysis was used to identify salient constructs, and identified factors were analyzed with respect to "successful" participation. "Success" was defined as the incorporation of comparative performance data into the hospital dashboard. The most important factor in predicting success included survey items measuring the strength of organizational leadership in fostering a culture of quality improvement (QI Leadership): (1) presence of a supportive hospital executive; (2) the extent to which a hospital values data; (3) the presence of leaders' vision for how the collaborative advances the hospital's strategic goals; (4) hospital use of the collaborative data to track quality outcomes; and (5) staff recognition of a strong mandate for collaborative participation (α=0.84, correlation with Success 0.68 [P<0.0001]). The data emphasize the importance of hospital QI Leadership in collaboratives that aim to share data for QI or safety purposes. Such metrics should prove useful in the planning and development of this complex form of inter-organizational collaboration. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Health insurance exchanges of past and present offer examples of features that could attract small-business customers.

Science.gov (United States)

Gardiner, Terry

2012-02-01

The Affordable Care Act calls on states to create health insurance exchanges serving small businesses by 2014. These exchanges will allow small-business owners to pool their buying power, have more choices of health plans, and buy affordable health insurance. However, creating an exchange that appeals to small-business owners poses several challenges. Past and current exchanges provide valuable insights into the role exchanges can play, services they can offer, and design features that can make them successful. For example, states should allow insurance brokers to provide employers with advice and analysis regarding plans offered in the exchanges. Exchanges should also provide services to ease enrollment, such as a single application for all of the plans they offer, and make additional benefits, such as wellness programs, available on a stand-alone basis or within insurance plans.

How small business health exchanges can offer value to their future customers--and why they must.

Science.gov (United States)

Kingsdale, Jon

2012-02-01

The success of the Small Business Health Options Program (SHOP)-health insurance exchanges targeted at the small-group market and opening for business in January 2014-will depend in large part on persuading small employers and qualified health plans to participate. The most important objective will be offering employers lower-cost health plans than they have now. Other critical objectives will be offering small firms administrative efficiencies and access to choices among high-value plans that are not offered elsewhere. This article frames the challenges that exchanges will encounter in meeting these objectives. In particular, it discusses the advisability of small-business exchanges' offering an "employee choice" model (which the article describes in detail); of combining the small-business and individual exchanges to broaden product offerings and gain operational efficiencies; and of encouraging low-cost plans to enter the exchange market, perhaps by enabling Medicaid managed care plans to offer comparable commercial products, and in turn affording health plans access to a uniquely motivated market of small firms and their workers who want affordable coverage.

Investing in Post-Acute Care Transitions: Electronic Information Exchange Between Hospitals and Long-Term Care Facilities.

Science.gov (United States)

Cross, Dori A; Adler-Milstein, Julia

2017-01-01

Electronic health information exchange (HIE) is expected to help improve care transitions from hospitals to long-term care (LTC) facilities. We know little about the prevalence of hospital LTC HIE in the United States and what contextual factors may motivate or constrain this activity. Cross-sectional analysis of U.S. acute-care hospitals responding to the 2014 AHA IT Supplement survey and with available readmissions data (n = 1,991). We conducted multivariate logistic regression to explore the relationship between hospital LTC HIE and selected IT and policy characteristics. Over half of the hospitals in our study (57.2%) reported engaging in some form of HIE with LTC providers: 33.9% send-only, 0.5% receive-only, and 22.8% send and receive. Hospitals that engaged in some form of LTC HIE were more likely than those that did not engage to have attested to meaningful use (odds ratio [OR], 1.87; P = .01 for stage 1 and OR, 2.05; P investing in electronic information exchange with LTCs as part of a general strategy to adopt EHRs and engage in HIE, but also potentially to strengthen ties to LTC providers and to reduce readmissions. To achieve widespread connectivity, continued focus on adoption of related health IT infrastructure and greater emphasis on aligning incentives for hospital-LTC care transitions would be valuable. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

The Advantage of Hiding Both Hands : Foreign Exchange Intervention, Ambiguity and Private Information

NARCIS (Netherlands)

Eijffinger, S.C.W.; Verhagen, W.H.

1997-01-01

This paper analyzes a dynamic exchange rate policy game in which the central bank has private information about its short-term exchange rate target, on the one hand, and in which the market is faced with a certain degree of ambiguity concerning the actual intervention volume, on the other.

Determination of Minimum Data Set (MSD) in Echocardiography Reporting System to Exchange with Iran’s Electronic Health Record (EHR) System

Science.gov (United States)

Mahmoudvand, Zahra; Kamkar, Mehran; Shahmoradi, Leila; Nejad, Ahmadreza Farzaneh

2016-01-01

Background: Determination of minimum data set (MDS) in echocardiography reports is necessary for documentation and putting information in a standard way, and leads to the enhancement of electrocardiographic studies through having access to precise and perfect reports and also to the development of a standard database for electrocardiographic reports. Aim: to determine the minimum data set of echocardiography reporting system to exchange with Iran’s electronic health record (EHR) system. Methods: First, a list of minimum data set was prepared after reviewing texts and studying cardiac patients’ records. Then, to determine the content validity of the prepared MDS, the expert views of 10 cardiologists and 10 health information management (HIM) specialists were obtained; to estimate the reliability of the set, test-retest method was employed. Finally, the data were analyzed using SPSS software. Results: The highest degree of consensus was found for the following MDSs: patient’s name and family name (5), accepting doctor’s name and family name, familial death records due to cardiac disorders, the image identification code, mitral valve, aortic valve, tricuspid valve, pulmonary valve, left ventricle, hole, atrium valve, Doppler examination of ventricular and atrial movement models and diagnoses with an average of. Conclusions: To prepare a model of echocardiography reporting system to exchange with EHR system, creation a standard data set is the vital point. Therefore, based on the research findings, the minimum reporting system data to exchange with Iran’s electronic health record system include information on entity, management, medical record, carried-out acts, and the main content of the echocardiography report, which the planners of reporting system should consider. PMID:27147803

The Usage of Informational Gateways for Data Exchange between Personal Data Systems of Different Classes

Directory of Open Access Journals (Sweden)

E. I. Goncharov

2010-03-01

Full Text Available When personal data exchange between informational systems takes place, one must guarantee the systems are not integrating but just interacting. This task can not be accomplished by using traditional tools such as firewalls, cryptography and so on. To solve the problem we suggest deploying of informational gateway in personal data exchange process.

An integrative review of information systems and terminologies used in local health departments.

Science.gov (United States)

Olsen, Jeanette; Baisch, Mary Jo

2014-02-01

The purpose of this integrative review based on the published literature was to identify information systems currently being used by local health departments and to determine the extent to which standard terminology was used to communicate data, interventions, and outcomes to improve public health informatics at the local health department (LHD) level and better inform research, policy, and programs. Whittemore and Knafl's integrative review methodology was used. Data were obtained through key word searches of three publication databases and reference lists of retrieved articles and consulting with experts to identify landmark works. The final sample included 45 articles analyzed and synthesized using the matrix method. The results indicated a wide array of information systems were used by LHDs and supported diverse functions aligned with five categories: administration; surveillance; health records; registries; and consumer resources. Detail regarding specific programs being used, location or extent of use, or effectiveness was lacking. The synthesis indicated evidence of growing interest in health information exchange groups, yet few studies described use of data standards or standard terminology in LHDs. Research to address these gaps is needed to provide current, meaningful data that inform public health informatics research, policy, and initiatives at and across the LHD level. Coordination at a state or national level is recommended to collect information efficiently about LHD information systems that will inform improvements while minimizing duplication of efforts and financial burden. Until this happens, efforts to strengthen LHD information systems and policies may be significantly challenged.

Knowledge flow and exchange in interdisciplinary primary health care teams (PHCTs): an exploratory study

Science.gov (United States)

Sibbald, Shannon L.; Wathen, C. Nadine; Kothari, Anita; Day, Adam M. B.

2013-01-01

Objective: Improving the process of evidence-based practice in primary health care requires an understanding of information exchange among colleagues. This study explored how clinically oriented research knowledge flows through multidisciplinary primary health care teams (PHCTs) and influences clinical decisions. Methods: This was an exploratory mixed-methods study with members of six PHCTs in Ontario, Canada. Quantitative data were collected using a questionnaire and analyzed with social network analysis (SNA) using UCINet. Qualitative data were collected using semi-structured interviews and analyzed with content analysis procedures using NVivo8. Results: It was found that obtaining research knowledge was perceived to be a shared responsibility among team members, whereas its application in patient care was seen as the responsibility of the team leader, usually the senior physician. PHCT members acknowledged the need for resources for information access, synthesis, interpretation, or management. Conclusion: Information sharing in interdisciplinary teams is a complex and multifaceted process. Specific interventions need to be improved such as formalizing modes of communication, better organizing knowledge-sharing activities, and improving the active use of allied health professionals. Despite movement toward team-based models, senior physicians are often gatekeepers of uptake of new evidence and changes in practice. PMID:23646028

Error Made in Conversation by Indonesian Learners Learning English Based on Syntax and Exchanging Information

Directory of Open Access Journals (Sweden)

Melania Wiannastiti

2014-10-01

Full Text Available In learning a second language or foreign language (L2, learners should master the competences. Normally, L2 learners first should master the linguistic competence which includes the mastery of vocabularies, pronunciation, and grammar. The study is to find out the syntax error made by L2 learners in conversation as well as to find out the exchanging information. The data were the recording conversation of Visual Communication Design students first semester of Binus University joining English Entrant. Error analysis was used to analyze the data. There are two points of view to analyze the data: syntax from taxonomy and exchanging information. Taxonomy employs the error in omission, addition, misinformation, and mis-ordering. Exchanging information point of view employs the error in finite element and mood. The result shows that L2 learners made some errors in grammar and exchanging information because they are influenced by the L1. They tend to transfer from L1 to L2 rather than thinking to create the utterances in L2. 

Neighbourhood Book Exchanges: Localising Information Practices

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Webster, Tenny; Gollner, Kathleen; Nathan, Lisa

2015-01-01

Introduction: Through this paper we report on an exploratory study into the design and use of neighbourhood book exchanges in North America. We identify dominant media framings of these book exchanges in North America, along with claims made concerning the influence of the exchanges. We compare the media claims with insights from interviews with…

Digital privacy in the marketplace perspectives on the information exchange

CERN Document Server

Milne, George

2015-01-01

Digital Privacy in the Marketplace focuses on the data ex-changes between marketers and consumers, with special ttention to the privacy challenges that are brought about by new information technologies. The purpose of this book is to provide a background source to help the reader think more deeply about the impact of privacy issues on both consumers and marketers. It covers topics such as: why privacy is needed, the technological, historical and academic theories of privacy, how market exchange af-fects privacy, what are the privacy harms and protections available, and what is the likely future of privacy.

The visit-data warehouse: enabling novel secondary use of health information exchange data.

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Fleischman, William; Lowry, Tina; Shapiro, Jason

2014-01-01

Health Information Exchange (HIE) efforts face challenges with data quality and performance, and this becomes especially problematic when data is leveraged for uses beyond primary clinical use. We describe a secondary data infrastructure focusing on patient-encounter, nonclinical data that was built on top of a functioning HIE platform to support novel secondary data uses and prevent potentially negative impacts these uses might have otherwise had on HIE system performance. HIE efforts have generally formed for the primary clinical use of individual clinical providers searching for data on individual patients under their care, but many secondary uses have been proposed and are being piloted to support care management, quality improvement, and public health. This infrastructure review describes a module built into the Healthix HIE. Healthix, based in the New York metropolitan region, comprises 107 participating organizations with 29,946 acute-care beds in 383 facilities, and includes more than 9.2 million unique patients. The primary infrastructure is based on the InterSystems proprietary Caché data model distributed across servers in multiple locations, and uses a master patient index to link individual patients' records across multiple sites. We built a parallel platform, the "visit data warehouse," of patient encounter data (demographics, date, time, and type of visit) using a relational database model to allow accessibility using standard database tools and flexibility for developing secondary data use cases. These four secondary use cases include the following: (1) tracking encounter-based metrics in a newly established geriatric emergency department (ED), (2) creating a dashboard to provide a visual display as well as a tabular output of near-real-time de-identified encounter data from the data warehouse, (3) tracking frequent ED users as part of a regional-approach to case management intervention, and (4) improving an existing quality improvement program

Medication errors in residential aged care facilities: a distributed cognition analysis of the information exchange process.

Science.gov (United States)

Tariq, Amina; Georgiou, Andrew; Westbrook, Johanna

2013-05-01

Medication safety is a pressing concern for residential aged care facilities (RACFs). Retrospective studies in RACF settings identify inadequate communication between RACFs, doctors, hospitals and community pharmacies as the major cause of medication errors. Existing literature offers limited insight about the gaps in the existing information exchange process that may lead to medication errors. The aim of this research was to explicate the cognitive distribution that underlies RACF medication ordering and delivery to identify gaps in medication-related information exchange which lead to medication errors in RACFs. The study was undertaken in three RACFs in Sydney, Australia. Data were generated through ethnographic field work over a period of five months (May-September 2011). Triangulated analysis of data primarily focused on examining the transformation and exchange of information between different media across the process. The findings of this study highlight the extensive scope and intense nature of information exchange in RACF medication ordering and delivery. Rather than attributing error to individual care providers, the explication of distributed cognition processes enabled the identification of gaps in three information exchange dimensions which potentially contribute to the occurrence of medication errors namely: (1) design of medication charts which complicates order processing and record keeping (2) lack of coordination mechanisms between participants which results in misalignment of local practices (3) reliance on restricted communication bandwidth channels mainly telephone and fax which complicates the information processing requirements. The study demonstrates how the identification of these gaps enhances understanding of medication errors in RACFs. Application of the theoretical lens of distributed cognition can assist in enhancing our understanding of medication errors in RACFs through identification of gaps in information exchange. Understanding

Negotiation of Meaning in Required and Optional Information Exchange Tasks: Discourse Issues

Directory of Open Access Journals (Sweden)

Zohre Mohamadi

2015-01-01

Full Text Available It is widely argued that different types of tasks facilitate the acquisition of communicative language to different degrees through providing different contexts for the occurrence of negotiation of meaning which is believed to have facilitative role in language acquisition. Although task based instruction provides a medium for acquiring the communicative language, it suffers from a number of oversimplifications.  The potentials of each task type in creating such a medium were not investigated in exhaustive detail, and it is left as a potentially interesting topic for further research.  This paper reports the analysis of the negotiation of meaning produced by eight intermediate EFL students engaged in required and optional information exchange tasks in dyads.  The results show that pushed output has different quality in these different task types meaning whereas required information exchange task provided a medium for more incidence of negotiation work, optional information exchange tasks engaged participants more with discourse work and led to more incidence of the clarification request as an interactional move that has a facilitative role in pushed output. Test constructors and materials developers need to take principled decisions in what to be included in the tests and texts.

A self-scaling, distributed information architecture for public health, research, and clinical care.

Science.gov (United States)

McMurry, Andrew J; Gilbert, Clint A; Reis, Ben Y; Chueh, Henry C; Kohane, Isaac S; Mandl, Kenneth D

2007-01-01

This study sought to define a scalable architecture to support the National Health Information Network (NHIN). This architecture must concurrently support a wide range of public health, research, and clinical care activities. The architecture fulfils five desiderata: (1) adopt a distributed approach to data storage to protect privacy, (2) enable strong institutional autonomy to engender participation, (3) provide oversight and transparency to ensure patient trust, (4) allow variable levels of access according to investigator needs and institutional policies, (5) define a self-scaling architecture that encourages voluntary regional collaborations that coalesce to form a nationwide network. Our model has been validated by a large-scale, multi-institution study involving seven medical centers for cancer research. It is the basis of one of four open architectures developed under funding from the Office of the National Coordinator of Health Information Technology, fulfilling the biosurveillance use case defined by the American Health Information Community. The model supports broad applicability for regional and national clinical information exchanges. This model shows the feasibility of an architecture wherein the requirements of care providers, investigators, and public health authorities are served by a distributed model that grants autonomy, protects privacy, and promotes participation.

A qualitative analysis of information sharing for children with medical complexity within and across health care organizations.

Science.gov (United States)

Quigley, Laura; Lacombe-Duncan, Ashley; Adams, Sherri; Hepburn, Charlotte Moore; Cohen, Eyal

2014-06-30

Children with medical complexity (CMC) are characterized by substantial family-identified service needs, chronic and severe conditions, functional limitations, and high health care use. Information exchange is critically important in high quality care of complex patients at high risk for poor care coordination. Written care plans for CMC are an excellent test case for how well information sharing is currently occurring. The purpose of this study was to identify the barriers to and facilitators of information sharing for CMC across providers, care settings, and families. A qualitative study design with data analysis informed by a grounded theory approach was utilized. Two independent coders conducted secondary analysis of interviews with parents of CMC and health care professionals involved in the care of CMC, collected from two studies of healthcare service delivery for this population. Additional interviews were conducted with privacy officers of associated organizations to supplement these data. Emerging themes related to barriers and facilitators to information sharing were identified by the two coders and the research team, and a theory of facilitators and barriers to information exchange evolved. Barriers to information sharing were related to one of three major themes; 1) the lack of an integrated, accessible, secure platform on which summative health care information is stored, 2) fragmentation of the current health system, and 3) the lack of consistent policies, standards, and organizational priorities across organizations for information sharing. Facilitators of information sharing were related to improving accessibility to a common document, expanding the use of technology, and improving upon a structured communication plan. Findings informed a model of how various barriers to information sharing interact to prevent optimal information sharing both within and across organizations and how the use of technology to improve communication and access to

The Perceived and Real Value of Health Information Exchange in Public Health Surveillance

Science.gov (United States)

Dixon, Brian Edward

2011-01-01

Public health agencies protect the health and safety of populations. A key function of public health agencies is surveillance or the ongoing, systematic collection, analysis, interpretation, and dissemination of data about health-related events. Recent public health events, such as the H1N1 outbreak, have triggered increased funding for and…

Mind the Gap: Assessing the Disconnect Between Postpartum Health Information Desired and Health Information Received.

Science.gov (United States)

Guerra-Reyes, Lucia; Christie, Vanessa M; Prabhakar, Annu; Siek, Katie A

Seeking and receiving health information are critical aspects of prenatal and postpartum care; however, many informational sources lack postpartum content. This study explores the gaps between information desired and information received postpartum and identifies the sources women use for health information seeking, with an emphasis on emergent online and mobile phone-based resources. Participants were recruited from our community partners' client base for a cross-sectional study. Mothers (n = 77) of a child 48 months or younger completed a survey on health information seeking, health information needs, and technology use. Postpartum health information gaps were defined as topics about which a participant indicated that she wanted information, but did not receive information. Bivariate analyses assessed the association between demographic characteristics, sources of health information used during pregnancy, and postpartum information gaps. Health care providers, Internet-based resources, and mobile applications were common sources of health information during pregnancy. Mental and sexual health were the most common types of postpartum health information gaps. In bivariate analyses, higher income and education were associated with postpartum information gaps in mental health and sexual health, respectively (p higher levels of education and income and postpartum health information gaps were observed in bivariate analyses. Health educators have the opportunity to capitalize on high rates of Internet information seeking by providing health information online. Health care providers must incorporate mental and sexual health into routine postpartum care. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

An Anesthesia Preinduction Checklist to Improve Information Exchange, Knowledge of Critical Information, Perception of Safety, and Possibly Perception of Teamwork in Anesthesia Teams.

Science.gov (United States)

Tscholl, David W; Weiss, Mona; Kolbe, Michaela; Staender, Sven; Seifert, Burkhardt; Landert, Daniel; Grande, Bastian; Spahn, Donat R; Noethiger, Christoph B

2015-10-01

An anesthesia preinduction checklist (APIC) to be performed before anesthesia induction was introduced and evaluated with respect to 5 team-level outcomes, each being a surrogate end point for patient safety: information exchange (the percentage of checklist items exchanged by a team, out of 12 total items); knowledge of critical information (the percentage of critical information items out of 5 total items such as allergies, reported as known by the members of a team); team members' perceptions of safety (the median scores given by the members of a team on a continuous rating scale); their perception of teamwork (the median scores given by the members of a team on a continuous rating scale); and clinical performance (the percentage of completed items out of 14 required tasks, e.g., suction device checked). A prospective interventional study comparing anesthesia teams using the APIC with a control group not using the APIC was performed using a multimethod design. Trained observers rated information exchange and clinical performance during on-site observations of anesthesia inductions. After the observations, each team member indicated the critical information items they knew and their perceptions of safety and teamwork. One hundred five teams using the APIC were compared with 100 teams not doing so. The medians of the team-level outcome scores in the APIC group versus the control group were as follows: information exchange: 100% vs 33% (P safety: 91% vs 84% (P improves information exchange, knowledge of critical information, and perception of safety in anesthesia teams-all parameters contributing to patient safety. There was a trend indicating improved perception of teamwork.

Effective transfer entropy approach to information flow between exchange rates and stock markets

International Nuclear Information System (INIS)

Sensoy, Ahmet; Sobaci, Cihat; Sensoy, Sadri; Alali, Fatih

2014-01-01

We investigate the strength and direction of information flow between exchange rates and stock prices in several emerging countries by the novel concept of effective transfer entropy (an alternative non-linear causality measure) with symbolic encoding methodology. Analysis shows that before the 2008 crisis, only low level interaction exists between these two variables and exchange rates dominate stock prices in general. During crisis, strong bidirectional interaction arises. In the post-crisis period, the strong interaction continues to exist and in general stock prices dominate exchange rates

45 CFR 170.210 - Standards for health information technology to protect electronic health information created...

Science.gov (United States)

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Standards for health information technology to... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH INFORMATION TECHNOLOGY HEALTH INFORMATION... FOR HEALTH INFORMATION TECHNOLOGY Standards and Implementation Specifications for Health Information...

[Information exchange via internet--possibilities, limits, future].

Science.gov (United States)

Schmiedl, S; Geishauser, M; Klöppel, M; Biemer, E

1998-01-01

Today, the exchange of information in the Internet is dominated by the WWW and e-mail. Discussion groups like mailing lists and newsgroups also permit communication in groups. Information retrieval becomes a crucial challenge in using the Internet. In the field of medicine, three more aspects are of special importance: privacy, legal requirements, and the necessity of transferring large amounts of data. For these problems, today's Internet doesn't provide a sufficient solution yet. Future developments will not only improve the existing services, but also lead to fundamental changes in the transfer technologies: Safer data transfer is to be ensured by new encrypting software together with the planned transfer protocol IPv6. Introducing the new transfer mode ATM will lead to better and resource saving transmission. Computer, telephone and TV networks will grow together, resulting in convergence of media.

Prescription Tablets in the Digital Age: A Cross-Sectional Study Exploring Patient and Physician Attitudes Toward the Use of Tablets for Clinic-Based Personalized Health Care Information Exchange.

Science.gov (United States)

Patel, Vishal; Hale, Timothy M; Palakodeti, Sandeep; Kvedar, Joseph C; Jethwani, Kamal

2015-10-19

To reduce the cost of health care while increasing efficiency and quality, health systems are seeking innovative means to engage and empower patients. Improved use of information technology and electronic health record (EHR) infrastructure is essential, and required for "meaningful use" as mandated by the federal government. Providing personalized health information using tablets at the point of care could enhance the clinical experience and enable efficient collection of patient reported outcome measures to guide clinical decision making. The aim of this study is to explore patient and provider attitudes and interest in a proposed clinic-based tablet system for personal health information exchange. To provide a context to understand patients' use of tablets during their clinic visit, we also examine patients' current activities and time spent in the waiting room, and their use of health information resources. Surveys were administered to 84 patients in the waiting room of a community health center affiliated with Massachusetts General Hospital (MGH) in Boston, MA. This survey included a vignette and illustration describing a proposed tablet-based system in which the patient, upon sign in at the clinic, receives a tablet loaded with personalized information tailored to their specific medical conditions and preferences. Patients were queried about their interest in such a system in comparison to traditional forms of patient education as well as their current health information seeking behaviors and activities and time spent in the waiting room. Interviews with five MGH-affiliated health care providers were conducted to assess their opinions regarding the proposed tablet system. The majority (>60%) of patients were "very" or "extremely" interested in the proposed tablet system and thought it would improve their knowledge about their medical condition (60%), assist them in making healthy choices (57%), and help them to feel more comfortable talking with their provider

Interactions through the network - understanding the myths to create new ways of information exchange

International Nuclear Information System (INIS)

Zakharov, I.V.

1996-01-01

The introduction of open data networks in the former Soviet Union, even concerning nuclear matters, collided with Soviet myths of, for example, nuclear secrets, information prohibition and dangers of international communication. Moreover, it was considered very complicated. These myths share many of the features with perception of radiation risk, such as dread, fear and misunderstanding. The new opportunities for information exchange, created by modern telecommunications and computer networks, can dispel these myths and perceptions concerning radiation risk, provided proper consideration of the myths' origins is taken. New ways of information exchange, such as creating extensive, international information infrastructures, based on Internet, can create new conditions for presenting the social conditions related to radiation risk. (author)

Agents Based e-Commerce and Securing Exchanged Information

Science.gov (United States)

Al-Jaljouli, Raja; Abawajy, Jemal

Mobile agents have been implemented in e-Commerce to search and filter information of interest from electronic markets. When the information is very sensitive and critical, it is important to develop a novel security protocol that can efficiently protect the information from malicious tampering as well as unauthorized disclosure or at least detect any malicious act of intruders. In this chapter, we describe robust security techniques that ensure a sound security of information gathered throughout agent’s itinerary against various security attacks, as well as truncation attacks. A sound security protocol is described, which implements the various security techniques that would jointly prevent or at least detect any malicious act of intruders. We reason about the soundness of the protocol usingSymbolic Trace Analyzer (STA), a formal verification tool that is based on symbolic techniques. We analyze the protocol in key configurations and show that it is free of flaws. We also show that the protocol fulfils the various security requirements of exchanged information in MAS, including data-integrity, data-confidentiality, data-authenticity, origin confidentiality and data non-repudiability.

Measuring the effects of online health information: Scale validation for the e-Health Impact Questionnaire.

Science.gov (United States)

Kelly, Laura; Ziebland, Sue; Jenkinson, Crispin

2015-11-01

Health-related websites have developed to be much more than information sites: they are used to exchange experiences and find support as well as information and advice. This paper documents the development of a tool to compare the potential consequences and experiences a person may encounter when using health-related websites. Questionnaire items were developed following a review of relevant literature and qualitative secondary analysis of interviews relating to experiences of health. Item reduction steps were performed on pilot survey data (n=167). Tests of validity and reliability were subsequently performed (n=170) to determine the psychometric properties of the questionnaire. Two independent item pools entered psychometric testing: (1) Items relating to general views of using the internet in relation to health and, (2) Items relating to the consequences of using a specific health-related website. Identified sub-scales were found to have high construct validity, internal consistency and test-retest reliability. Analyses confirmed good psychometric properties in the eHIQ-Part 1 (11 items) and the eHIQ-Part 2 (26 items). This tool will facilitate the measurement of the potential consequences of using websites containing different types of material (scientific facts and figures, blogs, experiences, images) across a range of health conditions. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

A qualitative study of sign-out processes between primary and on-call residents: relationships in information exchange, responsibility and accountability.

Science.gov (United States)

Lee, Soo-Hoon; Fisher, Dale A; Mah, Heidi; Goh, Wei-Ping; Phan, Phillip H

2017-10-01

To review a quality improvement event on the process of sign-outs between the primary and on-call residents. A retrospective qualitative study using semi-structured interviews. A tertiary academic medical center in Singapore with 283 inpatient Medicine beds served by 28 consultants, 29 registrars, 45 residents and 30 interns during the day but 5 residents and 3 interns at night. Residents, registrars and consultants. Quality improvement event on sign-out. Effectiveness of sign-out comprises exchange of patient information, professional responsibility and task accountability. The following process of sign-outs was noted. Primary teams were accountable to the on-call resident by selecting at-risk patients and preparing contingency plans for sign-out. Structured information exchanged included patient history, active problems and plans of care. On-call residents took ownership of at-risk patients by actively asking questions during sign-out and reporting back the agreed care plan. On-call residents were accountable to the primary team by reporting back at-risk patients the next day. A structured information exchange at sign-out increased the on-call resident's ability to care for at-risk patients when it was supported by two-way transfers of responsibility and accountability. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

WaterML, an Information Standard for the Exchange of in-situ hydrological observations

Science.gov (United States)

Valentine, D.; Taylor, P.; Zaslavsky, I.

2012-04-01

The WaterML 2.0 Standards Working Group (SWG), working within the Open Geospatial Consortium (OGC) and in cooperation with the joint OGC-World Meteorological Organization (WMO) Hydrology Domain Working Group (HDWG), has developed an open standard for the exchange of water observation data; WaterML 2.0. The focus of the standard is time-series data, commonly generated from in-situ style monitoring. This is high value data for hydrological applications such as flood forecasting, environmental reporting and supporting hydrological infrastructure (e.g. dams, supply systems), which is commonly exchanged, but a lack of standards inhibits efficient reuse and automation. The process of developing WaterML required doing a harmonization analysis of existing standards to identify overlapping concepts and come to agreement on a harmonized definition. Generally the formats captured similar requirements, all with subtle differences, such as how time-series point metadata was handled. The in-progress standard WaterML 2.0 incorporates the semantics of the hydrologic information: location, procedure, and observations, and is implemented as an application schema of the Geography Markup Language version 3.2.1, making use of the OGC Observations & Measurements standards. WaterML2.0 is designed as an extensible schema to allow encoding of data to be used in a variety of exchange scenarios. Example areas of usage are: exchange of data for operational hydrological monitoring programs; supporting operation of infrastructure (e.g. dams, supply systems); cross-border exchange of observational data; release of data for public dissemination; enhancing disaster management through data exchange; and exchange in support of national reporting The first phase of WaterML2.0 focused on structural definitions allowing for the transfer of time-series, with less work on harmonization of vocabulary items such as quality codes. Vocabularies from various organizations tend to be specific and take time to

Gharibi_FaceCard for Contacts and Easy Personal - Information Exchange

OpenAIRE

Gharibi, Wajeb; Gharibi, Gharib

2014-01-01

In this paper, we discuss a new contact way for exchanging personal information using mobile phones. The idea of this invention depends on allocating a special code called Gharibi Code (GC) for each personal mobile and creating a personal information file called Gharibi Face Card (GFC), which has all specified personal data of the mobile phone user. When you request someone's GC code, the other party's phone will send you the GFC of that person. We think that this approach will facilitate the...

76 FR 8804 - 30-Day Notice of Proposed Information Collection: Form DS-3097, Exchange Visitor Program Annual...

Science.gov (United States)

2011-02-15

... DS-3097, Exchange Visitor Program Annual Report, OMB Control Number 1405-0151 ACTION: Notice of... Department of State has submitted the following information collection request to the Office of Management... Information Collection: Exchange Visitor Program Annual Report. OMB Control Number: 1405-0151. Type of Request...

77 FR 20687 - 30-Day Notice of Proposed Information Collection: Form DS-3097, Exchange Visitor Program Annual...

Science.gov (United States)

2012-04-05

...-3097, Exchange Visitor Program Annual Report, OMB Control Number 1405-0151 ACTION: Notice of request... Department of State has submitted the following information collection request to the Office of Management... Information Collection: Exchange Visitor Program Annual Report. OMB Control Number: 1405-0151. Type of Request...

Summary of JRC activities related to European-wide exchange of radiological information during nuclear emergencies

International Nuclear Information System (INIS)

De Court, M.; Vries de, G.; Galmarini, S.

2003-01-01

Full text: The large transboundary effects of the radioactive release during the Chernobyl accident evidenced the need for international provisions for data and Information exchange. The JRC, in its EC support activity to DG TREN H.4, called REM (Radioactivity Environmental Monitoring), has more than 10 years experience in developing systems to make early notification and reliable radiological information exchange available to the EU member states in case of nuclear accidents. The aim and status of these systems are described: 1.)ECURIE: The legal basis for the EC systems is the Council Decision 87/600 of 14 December 1987. It resulted in the ECURIE network which allows the EU Member States and Switzerland to notify an accident and to subsequently exchange the radiological information as required by this Council decision. The underlying information exchange code (C.1. structure) does not only provide radiological measurements, but also predicted values, site meteorological data and decisions taken. Software was developed to facilitate coding and decoding of the messages. Initially the messages were transmitted by telex. The latest software (CoDecS, in use since the beginning of 2001) uses ISDN and Internet for the Information exchange. lt runs an the Windows NT and 2000 platforms. Regular exercises test the communication system and the software. In view of improving the efficiency of data and Information transfer for their common Member States, the IAEA and the EC are harmonizing ECURIE and the ENATOM early notification system. A first result has been the definition of an enhanced CIS format. Modifications will be made to the CoDecs software and to the IAEA - ENAC website so that information can be exchanged between the two systems in an automated manner. The EC wishes to extend the ECURIE network to the EU candidate countries. The official agreements are in an advanced state and participation of many candidate countries is foreseen by the end of 2003. It is

Health literacy in the "oral exchange": an important element of patient-provider communication.

Science.gov (United States)

Nouri, Sarah S; Rudd, Rima E

2015-05-01

Oral communication between health care providers and patients--the "oral exchange"--greatly impacts patient health outcomes; however, only recently have health literacy inquiries been incorporated into this field. This review examines the intersection between oral and aural literacy and the oral exchange. A systematic literature search was carried out. Papers published in English since 2003 that specifically examine oral/aural literacy and oral patient-provider communication were included. The search yielded 999 articles, 12 of which were included in this review. Three tools have been developed to measure either patient or provider oral/aural literacy. There is a discrepancy between patient and provider oral/aural literacy levels, and high literacy demand is associated with reduced patient learning. Low patient oral/aural literacy is associated with poor health outcomes. Two interventions have been developed to reduce literacy demand. This review demonstrates the critical role of oral and aural literacy in the oral exchange, the importance of reducing literacy demand, and the need for future research in this field. Recommendations include the use of plain language and teach-back by providers, as well as incorporation of awareness of oral and aural literacy into community programs and health care provider education and training. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The Need for Systematic Naming Software Tools for Exchange of Chemical Information

Directory of Open Access Journals (Sweden)

Andrey Yerin

1999-09-01

Full Text Available The availability of systematic names can enable the simple textual exchange of chemical structure information. The exchange of molecular structures in graphical format or connection tables has become well established in the field of cheminformatics and many structure drawing tools exist to enable this exchange. However, even with the availability of systematic naming rules, software tools to allow the generation of names from structures, and hopefully the reversal of these systematic names back to the original chemical structure, have been sorely lacking in capability and quality. Here we review the need for systematic naming as well as some of the tools and approaches being taken today in this area.

U.S. Department of Energy national technology information exchange workshops

International Nuclear Information System (INIS)

Daub, G.J.; Earle, S.D.; Smibert, A.M.; Wight, E.H.

1994-01-01

The U.S. Department of Energy National Technology Information Exchange (TIE) Workshops bring together environmental restoration and technology development personnel to exchange and share problems, needs, technological solutions, ideas, and successes and failures from lessons learned at DOE sites. The success of this forum is measured by the knowledge gained, contacts made, and program dollars saved by the people who actually do the work in the field. TIE is a unique opportunity to unite the DOE community and allow individuals to listen and to learn about each others' problems and solutions. By using today's technologies better, the National TIE Workshops help identify and implement cost-effective and appropriate technologies to meet the needs of the DOE environmental restoration program

Facilitating out-of-home caregiving through health information technology: survey of informal caregivers' current practices, interests, and perceived barriers.

Science.gov (United States)

Zulman, Donna M; Piette, John D; Jenchura, Emily C; Asch, Steven M; Rosland, Ann-Marie

2013-07-10

Many patients with chronic conditions are supported by out-of-home informal caregivers-family members, friends, and other individuals who provide care and support without pay-who, if armed with effective consumer health information technology, could inexpensively facilitate their care. We sought to understand caregivers' use of, interest in, and perceived barriers to health information technology for out-of-home caregiving. We conducted 2 sequential Web-based surveys with a national sample of individuals who provide out-of-home caregiving to an adult family member or friend with a chronic illness. We queried respondents about their use of health information technology for out-of-home caregiving and used multivariable regression to investigate caregiver and care-recipient characteristics associated with caregivers' technology use for caregiving. Among 316 out-of-home caregiver respondents, 34.5% (109/316) reported using health information technology for caregiving activities. The likelihood of a caregiver using technology increased significantly with intensity of caregiving (as measured by number of out-of-home caregiving activities). Compared with very low intensity caregivers, the adjusted odds ratio (OR) of technology use was 1.88 (95% CI 1.01-3.50) for low intensity caregivers, 2.39 (95% CI 1.11-5.15) for moderate intensity caregivers, and 3.70 (95% CI 1.62-8.45) for high intensity caregivers. Over 70% (149/207) of technology nonusers reported interest in using technology in the future to support caregiving. The most commonly cited barriers to technology use for caregiving were health system privacy rules that restrict access to care-recipients' health information and lack of familiarity with programs or websites that facilitate out-of-home caregiving. Health information technology use for out-of-home caregiving is common, especially among individuals who provide more intense caregiving. Health care systems can address the mismatch between caregivers' interest

77 FR 70444 - Office of the National Coordinator for Health Information Technology; Health Information...

Science.gov (United States)

2012-11-26

... Technology; Health Information Technology; HIT Policy Committee: Request for Comment Regarding the Stage 3 Definition of Meaningful Use of Electronic Health Records (EHRs) AGENCY: Health Information Technology (HIT) Policy Committee, Office of the National Coordinator for Health Information Technology (ONC), Department...

E-health and healthcare enterprise information system leveraging service-oriented architecture.

Science.gov (United States)

Hsieh, Sung-Huai; Hsieh, Sheau-Ling; Cheng, Po-Hsun; Lai, Feipei

2012-04-01

To present the successful experiences of an integrated, collaborative, distributed, large-scale enterprise healthcare information system over a wired and wireless infrastructure in National Taiwan University Hospital (NTUH). In order to smoothly and sequentially transfer from the complex relations among the old (legacy) systems to the new-generation enterprise healthcare information system, we adopted the multitier framework based on service-oriented architecture to integrate the heterogeneous systems as well as to interoperate among many other components and multiple databases. We also present mechanisms of a logical layer reusability approach and data (message) exchange flow via Health Level 7 (HL7) middleware, DICOM standard, and the Integrating the Healthcare Enterprise workflow. The architecture and protocols of the NTUH enterprise healthcare information system, especially in the Inpatient Information System (IIS), are discussed in detail. The NTUH Inpatient Healthcare Information System is designed and deployed on service-oriented architecture middleware frameworks. The mechanisms of integration as well as interoperability among the components and the multiple databases apply the HL7 standards for data exchanges, which are embedded in XML formats, and Microsoft .NET Web services to integrate heterogeneous platforms. The preliminary performance of the current operation IIS is evaluated and analyzed to verify the efficiency and effectiveness of the designed architecture; it shows reliability and robustness in the highly demanding traffic environment of NTUH. The newly developed NTUH IIS provides an open and flexible environment not only to share medical information easily among other branch hospitals, but also to reduce the cost of maintenance. The HL7 message standard is widely adopted to cover all data exchanges in the system. All services are independent modules that enable the system to be deployed and configured to the highest degree of flexibility

Information technology in health promotion.

Science.gov (United States)

Lintonen, T P; Konu, A I; Seedhouse, D

2008-06-01

eHealth, the use of information technology to improve or enable health and health care, has recently been high on the health care development agenda. Given the vivid interest in eHealth, little reference has been made to the use of these technologies in the promotion of health. The aim of this present study was to conduct a review on recent uses of information technology in health promotion through looking at research articles published in peer-reviewed journals. Fifteen relevant journals with issues published between 2003 and June 2005 yielded altogether 1352 articles, 56 of which contained content related to the use of information technology in the context of health promotion. As reflected by this rather small proportion, research on the role of information technology is only starting to emerge. Four broad thematic application areas within health promotion were identified: use of information technology as an intervention medium, use of information technology as a research focus, use of information technology as a research instrument and use of information technology for professional development. In line with this rather instrumental focus, the concepts 'ePromotion of Health' or 'Health ePromotion' would come close to describing the role of information technology in health promotion.

75 FR 76986 - Office of the National Coordinator for Health Information Technology; Health Information...

Science.gov (United States)

2010-12-10

... Technology; Health Information Technology; Request for Information Regarding the President's Council of... Information Technology To Improve Healthcare for Americans: The Path Forward'' AGENCY: Office of the National Coordinator for Health Information Technology (ONC), Department of Health and Human Services (HHS). ACTION...

[People's interest in health information].

Science.gov (United States)

Horch, K; Wirz, J

2005-11-01

Well-informed citizens and patients regard health policy innovations as a key element when it comes to reforms in the health service--both in health economics and with regard to prevention issues. We evaluated the data provided by the 2003 Telephone Health Survey (GSTel03) to examine demographic and social distinctions in the use of different information sources. At the same time we examined whether there are any population-related differences in people's interest in health information depending on their levels of health awareness, attitudes to prevention and related modes of behaviour. The data generated by the survey show that there is considerable interest in health-related topics. Only 2% of the people questioned used no information sources for this purpose. In addition to more traditional media (books, newspapers, information from pharmacies), information provided by health insurance companies and via the Internet is becoming increasingly important. With the exception of the Internet, all other sources of information are used more frequently by women than by men, and demand for most of the information media increases with age. The frequency of information use and the number of different media used increase from the lower to the upper strata of society. As far as selected variables of health-related behaviour are concerned (smoking, sport, alcohol), the results show a link between a more positive attitude to health and a greater interest in information.

The local exchange network in the information age - The need for new policy

Energy Technology Data Exchange (ETDEWEB)

Fons, J.P. (Ausley, McMullen, McGehee, Carothers and Proctor, Tallahassee, FL (USA))

1990-01-18

This article is an analysis of a conventional belief that the local exchange telephone networks are bottleneck monopolies. It also examines the alleged bases for excluding the local exchange telephone companies from participating directly in existing and developing technologies and markets other than those of a telephone service, or dial-tone. The author concludes that adherence to the current policy in the face of a demand for information age technology and services, and the availability of competing systems, will condemn the local exchange networks to the technological junk heap - and at the same time deprive the public of some of its best opportunities for new and enhanced services.

Interactional Features of Repair Negotiation in NS-NNS Interaction on Two Task Types: Information Gap and Personal Information Exchange

Science.gov (United States)

Kitajima, Ryu

2013-01-01

The studies in task-based approaches in second language acquisition claim that controlled and goal convergent tasks such as information gap tasks surpass open-ended conversations such as personal information exchange tasks for the development of the learner's interlanguage, in that the formers promote more repair negotiation. And yet, few studies…

Health literacy, information seeking, and trust in information in Haitians.

Science.gov (United States)

Lubetkin, Erica I; Zabor, Emily C; Isaac, Kathleen; Brennessel, Debra; Kemeny, M Margaret; Hay, Jennifer L

2015-05-01

To assess heath literacy, health information seeking, and trust in health-related information among Haitian immigrants seen in primary care. Health literacy was measured by the Brief Health Literacy Screen (BHLS); items on health information use were from the 2007 Health Information National Trends Survey. BHLS scores differed according to age, education, and survey language. Participants with lower levels of health literacy tended to be more likely to place "a lot" or "some" trust in family and friends and religious organizations and leaders as sources of information about health or medical topics. Constructing a culturally-tailored and appropriate intervention regarding health promotion requires understanding how the population accesses and conveys health information.

Correlates of consumer trust in online health information: findings from the health information national trends survey.

Science.gov (United States)

Ye, Yinjiao

2011-01-01

The past few decades have witnessed a dramatic increase in consumers seeking health information online. However, the quality of such information remains questionable, and the trustworthiness of online health information has become a hot topic, whereas little attention has been paid to how consumers evaluate online health information credibility. This study builds on theoretical perspectives of trust such as personal-capital-based, social-capital-based, and transfer-based, and it examines various correlates of consumer trust in online health information. The author analyzed the 2007 Health Information National Trends Survey data (N = 7,674). Results showed that consumer trust in online health information did not correlate with personal capital such as income, education, and health status. Social capital indicated by visiting social networking Web sites was not associated with trust in online health information either. Nevertheless, trust in online health information transferred from traditional mass media and government health agencies to the Internet, and it varied by such information features as easiness to locate and to understand. Age appeared to be a key factor in understanding the correlates of trust in online health information. Theoretical and empirical implications of the results are discussed.

Scoliosis and the Social Media: Facebook as a Means of Information Exchange.

Science.gov (United States)

Ng, Jonathan P; Tarazi, Nadim; Byrne, Damien P; Baker, Joseph F; McCabe, John P

2017-03-01

Over the last decade, the emergence of social networking websites such as Facebook have revolutionized information dissemination and broadened opportunities to engage in discussions. In particular, having been widely adopted in the younger generation, the use of this medium has become more prevalent in health disorders such as scoliosis in the adolescent population. However, the quality of information on Facebook is unregulated and variable, which may mislead patients in their decision making. To document the various types of information available and assess the quality of information on Facebook discussion boards using recognized scoring systems. To evaluate the quality of information on the social network. A search for the keyword "scoliosis" on Facebook was performed and the first 100 pages generated were reviewed. SCSS and DISCERN score. Content analysis was performed on discussion boards and personal blogs. Two independent examiners evaluated each site according to scoliosis-specific content score (SCSS) and the DISCERN criteria, both previously used instruments to judge the quality of information on the Internet pertaining to scoliosis. The SCSS range from 0 to 32 (higher score better) and the DISCERN 16 to 80 (higher score better). Of the 100 sites reviewed, 33 were discussion boards and personal blogs. Of these, the overall average SCSS was 5.7 (SD 5.8, range 0-20) and the DISCERN was 22.5 (SD 7.6, range 16-45), indicating that using general scoring systems the quality of information provided was overall poor. Using recognized scoring systems to analyze Facebook pages used as discussion forums or blogs, we showed that the quality in general was poor. For modern practices to adapt to an era of information exchange via the social network, the orthopedic community should develop ways to incorporate the social media in future patient education. Copyright © 2016 Scoliosis Research Society. All rights reserved.

Wisconsin’s Environmental Public Health Tracking Network: Information Systems Design for Childhood Cancer Surveillance

Science.gov (United States)

Hanrahan, Lawrence P.; Anderson, Henry A.; Busby, Brian; Bekkedal, Marni; Sieger, Thomas; Stephenson, Laura; Knobeloch, Lynda; Werner, Mark; Imm, Pamela; Olson, Joseph

2004-01-01

In this article we describe the development of an information system for environmental childhood cancer surveillance. The Wisconsin Cancer Registry annually receives more than 25,000 incident case reports. Approximately 269 cases per year involve children. Over time, there has been considerable community interest in understanding the role the environment plays as a cause of these cancer cases. Wisconsin’s Public Health Information Network (WI-PHIN) is a robust web portal integrating both Health Alert Network and National Electronic Disease Surveillance System components. WI-PHIN is the information technology platform for all public health surveillance programs. Functions include the secure, automated exchange of cancer case data between public health–based and hospital-based cancer registrars; web-based supplemental data entry for environmental exposure confirmation and hypothesis testing; automated data analysis, visualization, and exposure–outcome record linkage; directories of public health and clinical personnel for role-based access control of sensitive surveillance information; public health information dissemination and alerting; and information technology security and critical infrastructure protection. For hypothesis generation, cancer case data are sent electronically to WI-PHIN and populate the integrated data repository. Environmental data are linked and the exposure–disease relationships are explored using statistical tools for ecologic exposure risk assessment. For hypothesis testing, case–control interviews collect exposure histories, including parental employment and residential histories. This information technology approach can thus serve as the basis for building a comprehensive system to assess environmental cancer etiology. PMID:15471739

Data Leakage Prevention for Secure Cross-Domain Information Exchange

OpenAIRE

Nordbotten, Nils Agne; Engelstad, Paal E.; Kongsgård, Kyrre Wahl; Haakseth, Raymond; Mancini, Federico

2017-01-01

Cross-domain information exchange is an increasingly important capability for conducting efficient and secure operations, both within coalitions and within single nations. A data guard is a common cross-domain sharing solution that inspects the security labels of exported data objects and validates that they are such that they can be released according to policy. While we see that guard solutions can be implemented with high assurance, we find that obtaining an equivalent level of assurance i...

Finite-Time Approach to Microeconomic and Information Exchange Processes

Directory of Open Access Journals (Sweden)

Serghey A. Amelkin

2009-07-01

Full Text Available Finite-time approach allows one to optimize regimes of processes in macrosystems when duration of the processes is restricted. Driving force of the processes is difference of intensive variables: temperatures in thermodynamics, values in economics, etc. In microeconomic systems two counterflow fluxes appear due to the only driving force. They are goods and money fluxes. Another possible case is two fluxes with the same direction. The processes of information exchange can be described by this formalism.

National health information infrastructure model: a milestone for health information management education realignment.

Science.gov (United States)

Meidani, Zahra; Sadoughi, Farhnaz; Ahmadi, Maryam; Maleki, Mohammad Reza; Zohoor, Alireza; Saddik, Basema

2012-01-01

Challenges and drawbacks of the health information management (HIM) curriculum at the Master's degree were examined, including lack of well-established computing sciences and inadequacy to give rise to specific competencies. Information management was condensed to the hospital setting to intensify the indispensability of a well-organized educational campaign. The healthcare information dimensions of a national health information infrastructure (NHII) model present novel requirements for HIM education. Articles related to challenges and barriers to adoption of the personal health record (PHR), the core component of personal health dimension of an NHII, were searched through sources including Science Direct, ProQuest, and PubMed. Through a literature review, concerns about the PHR that are associated with HIM functions and responsibilities were extracted. In the community/public health dimension of the NHII the main components have been specified, and the targeted information was gathered through literature review, e-mail, and navigation of international and national organizations. Again, topics related to HIM were evoked. Using an information system (decision support system, artificial neural network, etc.) to support PHR media and content, patient education, patient-HIM communication skills, consumer health information, conducting a surveillance system in other areas of healthcare such as a risk factor surveillance system, occupational health, using an information system to analyze aggregated data including a geographic information system, data mining, online analytical processing, public health vocabulary and classification system, and emerging automated coding systems pose major knowledge gaps in HIM education. Combining all required skills and expertise to handle personal and public dimensions of healthcare information in a single curriculum is simply impractical. Role expansion and role extension for HIM professionals should be defined based on the essence of

SANDS: an architecture for clinical decision support in a National Health Information Network.

Science.gov (United States)

Wright, Adam; Sittig, Dean F

2007-10-11

A new architecture for clinical decision support called SANDS (Service-oriented Architecture for NHIN Decision Support) is introduced and its performance evaluated. The architecture provides a method for performing clinical decision support across a network, as in a health information exchange. Using the prototype we demonstrated that, first, a number of useful types of decision support can be carried out using our architecture; and, second, that the architecture exhibits desirable reliability and performance characteristics.

Designing digital health information in a health literacy context

NARCIS (Netherlands)

Meppelink, C.S.

2016-01-01

Digital health information is widely available, but not everyone fully benefits due to limited health literacy. Until now, little was known about how health literacy influences information processing and how design features of digital health information can be used to create optimal health messages

Radiology Reporting System Data Exchange With the Electronic Health Record System: A Case Study in Iran.

Science.gov (United States)

Ahmadi, Maryam; Ghazisaeidi, Marjan; Bashiri, Azadeh

2015-03-18

In order to better designing of electronic health record system in Iran, integration of health information systems based on a common language must be done to interpret and exchange this information with this system is required. This study provides a conceptual model of radiology reporting system using unified modeling language. The proposed model can solve the problem of integration this information system with the electronic health record system. By using this model and design its service based, easily connect to electronic health record in Iran and facilitate transfer radiology report data. This is a cross-sectional study that was conducted in 2013. The study population was 22 experts that working at the Imaging Center in Imam Khomeini Hospital in Tehran and the sample was accorded with the community. Research tool was a questionnaire that prepared by the researcher to determine the information requirements. Content validity and test-retest method was used to measure validity and reliability of questioner respectively. Data analyzed with average index, using SPSS. Also Visual Paradigm software was used to design a conceptual model. Based on the requirements assessment of experts and related texts, administrative, demographic and clinical data and radiological examination results and if the anesthesia procedure performed, anesthesia data suggested as minimum data set for radiology report and based it class diagram designed. Also by identifying radiology reporting system process, use case was drawn. According to the application of radiology reports in electronic health record system for diagnosing and managing of clinical problem of the patient, with providing the conceptual Model for radiology reporting system; in order to systematically design it, the problem of data sharing between these systems and electronic health records system would eliminate.

Digital Natives Versus Digital Immigrants: Influence of Online Health Information Seeking on the Doctor-Patient Relationship.

Science.gov (United States)

Haluza, Daniela; Naszay, Marlene; Stockinger, Andreas; Jungwirth, David

2017-11-01

Ubiquitous Internet access currently revolutionizes the way people acquire information by creating a complex, worldwide information network. The impact of Internet use on the doctor-patient relationship is a moving target that varies across sociodemographic strata and nations. To increase scientific knowledge on the patient-Web-physician triangle in Austria, this study reports findings regarding prevailing online health information-seeking behavior and the respective impact on doctor-patient interactions among a nonprobability convenience sample of Internet users. To investigate digital age group-specific influences, we analyzed whether digital natives and digital immigrants differed in their perspectives. The questionnaire-based online survey collected sociodemographic data and online health information-seeking behavior from a sample of 562 respondents (59% females, mean age 37 ± 15 years, 54% digital natives). Most respondents (79%) referred to the Internet to seek health information, making it the most commonly used source for health information, even more prevalent then the doctor. We found similar predictors for using the Internet as a source for health-related information across digital age groups. Thus, the overall generational gap seems to be small among regular Internet users in Austria. However, study participants expressed a rather skeptical attitude toward electronic exchange of health data between health care professionals and patients, as well as toward reliability of online health information. To improve adoption of electronic doctor-patient communication and patient empowerment, public education and awareness programs are required to promote consumer-centered health care provision and patient empowerment.

Strengthening Rehabilitation in Health Systems Worldwide by Integrating Information on Functioning in National Health Information Systems.

Science.gov (United States)

Stucki, Gerold; Bickenbach, Jerome; Melvin, John

2017-09-01

A complete understanding of the experience of health requires information relevant not merely to the health indicators of mortality and morbidity but also to functioning-that is, information about what it means to live in a health state, "the lived experience of health." Not only is functioning information relevant to healthcare and the overall objectives of person-centered healthcare but to the successful operation of all components of health systems.In light of population aging and major epidemiological trends, the health strategy of rehabilitation, whose aim has always been to optimize functioning and minimize disability, will become a key health strategy. The increasing prominence of the rehabilitative strategy within the health system drives the argument for the integration of functioning information as an essential component in national health information systems.Rehabilitation professionals and researchers have long recognized in WHO's International Classification of Functioning, Disability and Health the best prospect for an internationally recognized, sufficiently complete and powerful information reference for the documentation of functioning information. This paper opens the discussion of the promise of integrating the ICF as an essential component in national health systems to secure access to functioning information for rehabilitation, across health systems and countries.

Mechanisms of Communicating Health Information Through Facebook: Implications for Consumer Health Information Technology Design.

Science.gov (United States)

Menefee, Hannah K; Thompson, Morgan J; Guterbock, Thomas M; Williams, Ishan C; Valdez, Rupa S

2016-08-11

Consumer health information technology (IT) solutions are designed to support patient health management and have the ability to facilitate patients' health information communication with their social networks. However, there is a need for consumer health IT solutions to align with patients' health management preferences for increased adoption of the technology. It may be possible to gain an understanding of patients' needs for consumer health IT supporting their health information communication with social networks by explicating how they have adopted and adapted social networking sites, such as Facebook, for this purpose. Our aim was to characterize patients' use of all communication mechanisms within Facebook for health information communication to provide insight into how consumer health IT solutions may be better designed to meet patients' communication needs and preferences. This study analyzed data about Facebook communication mechanisms use from a larger, three-phase, sequential, mixed-methods study. We report here on the results of the study's first phase: qualitative interviews (N=25). Participants were over 18, used Facebook, were residents or citizens of the United States, spoke English, and had a diagnosis consistent with type 2 diabetes. Participants were recruited through Facebook groups and pages. Participant interviews were conducted via Skype or telephone between July and September 2014. Data analysis was grounded in qualitative content analysis and the initial coding framework was informed by the findings of a previous study. Participants' rationales for the use or disuse of a particular Facebook mechanism to communicate health information reflected six broad themes: (1) characteristics and circumstances of the person, (2) characteristics and circumstances of the relationship, (3) structure and composition of the social network, (4) content of the information, (5) communication purpose, and (6) attributes of the technology. The results of this

Health information search to deal with the exploding amount of health information produced.

Science.gov (United States)

Müller, H; Hanbury, A; Al Shorbaji, N

2012-01-01

This focus theme deals with the various aspects of health information search that are necessary to cope with the challenges of an increasing amount and complexity of medical information currently produced. This editorial reviews the main challenges of health information search and summarizes the five papers of this focus theme. The five papers of the focus theme cover a large part of the current challenges in health information search such as coding standards, information extraction from complex data, user requirements analysis, multimedia data analysis and the access to big data. Several future challenges are identified such as the combination of visual and textual data for information search and the difficulty to scale when analyzing big data.

Investing in International Information Exchange Activities to Improve the Safety, Cost Effectiveness and Schedule of Cleanup - 13281

International Nuclear Information System (INIS)

Seed, Ian; James, Paula; Mathieson, John; Judd, Laurie; Elmetti-Ramirez, Rosa; Han, Ana

2013-01-01

With decreasing budgets and increasing pressure on completing cleanup missions as quickly, safely and cost-effectively as possible, there is significant benefit to be gained from collaboration and joint efforts between organizations facing similar issues. With this in mind, the US Department of Energy (DOE) and the UK Nuclear Decommissioning Authority (NDA) have formally agreed to share information on lessons learned on the development and application of new technologies and approaches to improve the safety, cost effectiveness and schedule of the cleanup legacy wastes. To facilitate information exchange a range of tools and methodologies were established. These included tacit knowledge exchange through facilitated meetings, conference calls and Site visits as well as explicit knowledge exchange through document sharing and newsletters. A DOE web-based portal has been established to capture these exchanges and add to them via discussion boards. The information exchange is operating at the Government-to-Government strategic level as well as at the Site Contractor level to address both technical and managerial topic areas. This effort has resulted in opening a dialogue and building working relationships. In some areas joint programs of work have been initiated thus saving resource and enabling the parties to leverage off one another activities. The potential benefits of high quality information exchange are significant, ranging from cost avoidance through identification of an approach to a problem that has been proven elsewhere to cost sharing and joint development of a new technology to address a common problem. The benefits in outcomes significantly outweigh the costs of the process. The applicability of the tools and methods along with the lessons learned regarding some key issues is of use to any organization that wants to improve value for money. In the waste management marketplace, there are a multitude of challenges being addressed by multiple organizations and

Investing in International Information Exchange Activities to Improve the Safety, Cost Effectiveness and Schedule of Cleanup - 13281

Energy Technology Data Exchange (ETDEWEB)

Seed, Ian; James, Paula [Cogentus Consulting (United States); Mathieson, John [NDA United Kingdom (United Kingdom); Judd, Laurie [NuVision Engineering, Inc. (United States); Elmetti-Ramirez, Rosa; Han, Ana [US DOE (United States)

2013-07-01

With decreasing budgets and increasing pressure on completing cleanup missions as quickly, safely and cost-effectively as possible, there is significant benefit to be gained from collaboration and joint efforts between organizations facing similar issues. With this in mind, the US Department of Energy (DOE) and the UK Nuclear Decommissioning Authority (NDA) have formally agreed to share information on lessons learned on the development and application of new technologies and approaches to improve the safety, cost effectiveness and schedule of the cleanup legacy wastes. To facilitate information exchange a range of tools and methodologies were established. These included tacit knowledge exchange through facilitated meetings, conference calls and Site visits as well as explicit knowledge exchange through document sharing and newsletters. A DOE web-based portal has been established to capture these exchanges and add to them via discussion boards. The information exchange is operating at the Government-to-Government strategic level as well as at the Site Contractor level to address both technical and managerial topic areas. This effort has resulted in opening a dialogue and building working relationships. In some areas joint programs of work have been initiated thus saving resource and enabling the parties to leverage off one another activities. The potential benefits of high quality information exchange are significant, ranging from cost avoidance through identification of an approach to a problem that has been proven elsewhere to cost sharing and joint development of a new technology to address a common problem. The benefits in outcomes significantly outweigh the costs of the process. The applicability of the tools and methods along with the lessons learned regarding some key issues is of use to any organization that wants to improve value for money. In the waste management marketplace, there are a multitude of challenges being addressed by multiple organizations and

Essential levels of health information in Europe: an action plan for a coherent and sustainable infrastructure.

Science.gov (United States)

Carinci, Fabrizio

2015-04-01

The European Union needs a common health information infrastructure to support policy and governance on a routine basis. A stream of initiatives conducted in Europe during the last decade resulted into several success stories, but did not specify a unified framework that could be broadly implemented on a continental level. The recent debate raised a potential controversy on the different roles and responsibilities of policy makers vs the public health community in the construction of such a pan-European health information system. While institutional bodies shall clarify the statutory conditions under which such an endeavour is to be carried out, researchers should define a common framework for optimal cross-border information exchange. This paper conceptualizes a general solution emerging from past experiences, introducing a governance structure and overarching framework that can be realized through four main action lines, underpinned by the key principle of "Essential Levels of Health Information" for Europe. The proposed information model is amenable to be applied in a consistent manner at both national and EU level. If realized, the four action lines outlined here will allow developing a EU health information infrastructure that would effectively integrate best practices emerging from EU public health initiatives, including projects and joint actions carried out during the last ten years. The proposed approach adds new content to the ongoing debate on the future activity of the European Commission in the area of health information. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Information dissemination and training: two key issues for consolidating and strengthening the results of health telematic projects.

Science.gov (United States)

Arcarese, T; Boi, S; Gagliardi, R

2000-01-01

The concepts expressed in this paper concerns the activities to be developed within HEALTHLINE, a European project under the Telematics Application programme. HEALTHLINE is an umbrella project which takes initiatives and provides links to other international projects on health telematics. The projects involved are NIVEMES and RISE; they represent the starting point from which a common approach will be developed. The experience gained from these projects has highlighted two emerging requirements: information dissemination and training. To fulfil the needs of information, an Internet corner will be set up; it will allow citizens and health professionals to find and exchange information as well as to discuss themes concerning health care. Due to the most advanced technologies recently introduced, the Health care sector has had to modify its traditional ways of working to aid professionals in exploiting new training techniques and Health Care provision methods. HEALTHLINE will focus on training and on the development of the use of new tools and services. Furthermore, the project will exploit the training methodologies based on multimedia technology for developing training-on-the-job modules. The entire system, in its final stage, will consist of a network for co-operating training and information dissemination; European sites in the project will share information, training material and provide education and information on tele-health, medical and health-care issues to health care providers, beneficiaries and the general public.

The business case for payer support of a community-based health information exchange: a humana pilot evaluating its effectiveness in cost control for plan members seeking emergency department care.

Science.gov (United States)

Tzeel, Albert; Lawnicki, Victor; Pemble, Kim R

2011-07-01

As emergency department utilization continues to increase, health plans must limit their cost exposure, which may be driven by duplicate testing and a lack of medical history at the point of care. Based on previous studies, health information exchanges (HIEs) can potentially provide health plans with the ability to address this need. To assess the effectiveness of a community-based HIE in controlling plan costs arising from emergency department care for a health plan's members. Albert Tzeel. The study design was observational, with an eligible population (N = 1482) of fully insured plan members who sought emergency department care on at least 2 occasions during the study period, from December 2008 through March 2010. Cost and utilization data, obtained from member claims, were matched to a list of persons utilizing the emergency department where HIE querying could have occurred. Eligible members underwent propensity score matching to create a test group (N = 326) in which the HIE database was queried in all emergency department visits, and a control group (N = 325) in which the HIE database was not queried in any emergency department visit. Post-propensity matching analysis showed that the test group achieved an average savings of $29 per emergency department visit compared with the control group. Decreased utilization of imaging procedures and diagnostic tests drove this cost-savings. When clinicians utilize HIE in the care of patients who present to the emergency department, the costs borne by a health plan providing coverage for these patients decrease. Although many factors can play a role in this finding, it is likely that HIEs obviate unnecessary service utilization through provision of historical medical information regarding specific patients at the point of care.

Arrangement for Cooperation and Exchange of Information between the Atomic Energy Control Board of Canada and the Health and Safety Executive of the United Kingdom

International Nuclear Information System (INIS)

1991-01-01

Under this Arrangement which covers the period 31 May 1991 to 1 June 1996, the Parties may exchange information on administrative, regulatory and technical questions as well as on press and public reactions to incidents. The information could concern the nuclear installation itself (siting, decommissioning), or safety (assessments, research and development work) or treatment of radioactive wastes. The Arrangement also covers information concerning any event that has a major radiological significance and the remedial actions undertaken in response. In addition, the Arrangement lists excepted information, for example for national security or commercial reasons. (NEA) [fr

Chairman's report. Report on the IEA round table on information exchange and co-operation in R and D

International Nuclear Information System (INIS)

Doucet, G.

1997-01-01

In contrast to the parallel Workshops, the Round Table was designed to stimulate simultaneous discussion among panelists and interaction with the audience. The task of the Round Table and Information Exchange and Co-operation in R and D was to answer six key questions: what are then more recent prospects or opportunities for natural gas utilisation which justify major commitments to information exchange and R and D? How have government social or economic goals affected funding for R and D in North America, Europe and Asia? Is the move to energy service and, in some key markets, deregulation forcing natural gas companies to reassess private commitments to R and D? How well do natural gas companies or centres of excellence around the world exchange information and promote technology transfer compared with coal and electricity interests? What is the future role of governments, universities, laboratories and international agencies like IEA to eliminate duplication and to foster funding partnerships? Are there useful models of information exchange using state-of-the-art electronic data which optimise linkages among key production and consumption markets? (R.P.)

Effects of Health Literacy and Social Capital on Health Information Behavior.

Science.gov (United States)

Kim, Yong-Chan; Lim, Ji Young; Park, Keeho

2015-01-01

This study aimed to examine whether social capital (bonding and bridging social capital) attenuate the effect of low functional health literacy on health information resources, efficacy, and behaviors. In-person interviews were conducted with 1,000 residents in Seoul, Korea, in 2011. The authors found that respondents' functional health literacy had positive effects on the scope of health information sources and health information self-efficacy but not health information-seeking intention. Respondents' social capital had positive effects on the scope of health information sources, health information efficacy, and health information-seeking intention. The authors found (a) a significant moderation effect of bridging social capital on the relation between health literacy and health information self-efficacy and (b) a moderation effect of bonding social capital on the relation between health literacy and health information-seeking intention.

Informed Consent and Routinisation

DEFF Research Database (Denmark)

Ploug, Thomas; Holm, Søren

2013-01-01

provide evidence of the routinisation of informed consent in various types of interaction on the internet; among these, the routinisation of consent to the exchange of health related information. We also provide evidence that the extent of the routinisation of informed consent is dependent...

Challenging the Chain : Governing the Automated Exchange and Processing of Business Information

NARCIS (Netherlands)

Bharosa, N.; Van Wijk, R.; De Winne, N.; Janssen, M.F.W.H.A.

2015-01-01

What is digital business reporting? Why do we need it? And how can we improve it? This book aims to address these questions by illustrating the rise of system-to-system information exchange and the opportunities for improving transparency and accountability. Governments around the world are looking

The Global Heat Health Information Network (GHHIN): Putting the Pieces Together

Science.gov (United States)

Jones, H.; Shumake, J.; Trtanj, J.

2017-12-01

Human exposure to extreme heat is one of the principal and most manageable impacts of climate on human health. Yet, every year worldwide, tens of thousands of people die as a result of avoidable heat-induced health consequences and countless others experience reduced labor productivity, physiological stress and ill health. The IPCC predicts with high confidence, that the observed trend of longer lasting, more frequent, more intense, and earlier onset heat waves will continue into the future. This situation requires the global health community to aggressively confront this recognized risk. Many countries and cities worldwide have developed heat action plans or heat health early warning systems, but these efforts are only connected in an ad-hoc fashion, use a broad range of non-standardized tools, methods, and approaches, and lack a clear mechanism to learn from each other in order to more rapidly advance health protection. To address this gap and accelerate heat health protection, the Global Heat Health Information Network (GHHIN) was launched in June 2016, by the WMO/WHO joint office for Climate and Health and the NOAA Climate Program Office. GHHIN is envisioned to be an independent, voluntary, member driven forum of scientists, professionals, and policymakers focused on enhancing and multiplying the global and local learning and resilience-building for heat health that is already occurring. GHHIN seeks to serve as a catalyst, knowledge broker, disseminator of good practices, and a forum for facilitating exchange and identifying needs. GHHIN will promote evidence-driven interventions, shared-learning, co-production of information, synthesis of priorities and capacity building to empower actors to take more effective and informed life-saving preparedness and planning measures. GHHIN is working toward several activities in 2018. The first Global Heat Health Synthesis report will be published to synthesize the state of science and practice to monitor, predict, and

The Health Information Literacy Research Project*

Science.gov (United States)

Kurtz-Rossi, Sabrina; Funk, Carla J.

2009-01-01

Objectives: This research studied hospital administrators' and hospital-based health care providers' (collectively, the target group) perceived value of consumer health information resources and of librarians' roles in promoting health information literacy in their institutions. Methods: A web-based needs survey was developed and administered to hospital administrators and health care providers. Multiple health information literacy curricula were developed. One was pilot-tested by nine hospital libraries in the United States and Canada. Quantitative and qualitative methods were used to evaluate the curriculum and its impact on the target group. Results: A majority of survey respondents believed that providing consumer health information resources was critically important to fulfilling their institutions' missions and that their hospitals could improve health information literacy by increasing awareness of its impact on patient care and by training staff to become more knowledgeable about health literacy barriers. The study showed that a librarian-taught health information literacy curriculum did raise awareness about the issue among the target group and increased both the use of National Library of Medicine consumer health resources and referrals to librarians for health information literacy support. Conclusions: It is hoped that many hospital administrators and health care providers will take the health information literacy curricula and recognize that librarians can educate about the topic and that providers will use related consumer health services and resources. PMID:19851494

Designing for scale: optimising the health information system architecture for mobile maternal health messaging in South Africa (MomConnect).

Science.gov (United States)

Seebregts, Christopher; Dane, Pierre; Parsons, Annie Neo; Fogwill, Thomas; Rogers, Debbie; Bekker, Marcha; Shaw, Vincent; Barron, Peter

2018-01-01

MomConnect is a national initiative coordinated by the South African National Department of Health that sends text-based mobile phone messages free of charge to pregnant women who voluntarily register at any public healthcare facility in South Africa. We describe the system design and architecture of the MomConnect technical platform, planned as a nationally scalable and extensible initiative. It uses a health information exchange that can connect any standards-compliant electronic front-end application to any standards-compliant electronic back-end database. The implementation of the MomConnect technical platform, in turn, is a national reference application for electronic interoperability in line with the South African National Health Normative Standards Framework. The use of open content and messaging standards enables the architecture to include any application adhering to the selected standards. Its national implementation at scale demonstrates both the use of this technology and a key objective of global health information systems, which is to achieve implementation scale. The system's limited clinical information, initially, allowed the architecture to focus on the base standards and profiles for interoperability in a resource-constrained environment with limited connectivity and infrastructural capacity. Maintenance of the system requires mobilisation of national resources. Future work aims to use the standard interfaces to include data from additional applications as well as to extend and interface the framework with other public health information systems in South Africa. The development of this platform has also shown the benefits of interoperability at both an organisational and technical level in South Africa.

76 FR 24956 - 30-Day Notice of Proposed Information Collection: Certificate of Eligibility for Exchange Visitor...

Science.gov (United States)

2011-05-03

...: Certificate of Eligibility for Exchange Visitor (J-1) Status; Form DS-2019, OMB No. 1405-0119. ACTION: Notice... Management and Budget (OMB) for approval in accordance with the Paperwork Reduction Act of 1995. Title of Information Collection: Certificate of Eligibility for Exchange Visitor (J-1) Status OMB Control Number: 1405...

Information technology acceptance in health information management.

Science.gov (United States)

Abdekhoda, M; Ahmadi, M; Dehnad, A; Hosseini, A F

2014-01-01

User acceptance of information technology has been a significant area of research for more than two decades in the field of information technology. This study assessed the acceptance of information technology in the context of Health Information Management (HIM) by utilizing Technology Acceptance Model (TAM) which was modified and applied to assess user acceptance of health information technology as well as viability of TAM as a research construct in the context of HIM. This was a descriptive- analytical study in which a sample of 187 personnel from a population of 363 personnel, working in medical records departments of hospitals affiliated to Tehran University of Medical Sciences, was selected. Users' perception of applying information technology was studied by a researcher-developed questionnaire. Collected data were analyzed by SPSS software (version16) using descriptive statistics and regression analysis. The results suggest that TAM is a useful construct to assess user acceptance of information technology in the context of HIM. The findings also evidenced the perceived ease of use (PEOU) and perceived usefulness (PE) were positively associated with favorable users' attitudes towards HIM. PU was relatively more associated (r= 0.22, p = 0.05) than PEOU (r = 0.014, p = 0.05) with favorable user attitudes towards HIM. Users' perception of usefulness and ease of use are important determinants providing the incentive for users to accept information technologies when the application of a successful HIM system is attempted. The findings of the present study suggest that user acceptance is a key element and should subsequently be the major concern of health organizations and health policy makers.

78 FR 14793 - Advancing Interoperability and Health Information Exchange

Science.gov (United States)

2013-03-07

...--including through shared-decision making--supported by the collection, use, and sharing of electronic health... Use functionalities--ranging from e- prescribing to clinical decision support--has grown by at least... regardless of where they receive care. With fee-for-service reimbursement and other business motivations...

Evaluating Health Information

Science.gov (United States)

Millions of consumers get health information from magazines, TV or the Internet. Some of the information is reliable and up to date; some is not. How can ... the site have an editorial board? Is the information reviewed before it is posted? Be skeptical. Things ...

Mobile health information system: a mobile app. to aid health ...

African Journals Online (AJOL)

Mobile health information system: a mobile app. to aid health workers relate health information. ... Global Journal of Mathematical Sciences ... phones in delivering vital health information and effective fieldwork reporting is of significance.

Implementation of a large-scale hospital information infrastructure for multi-unit health-care services.

Science.gov (United States)

Yoo, Sun K; Kim, Dong Keun; Kim, Jung C; Park, Youn Jung; Chang, Byung Chul

2008-01-01

With the increase in demand for high quality medical services, the need for an innovative hospital information system has become essential. An improved system has been implemented in all hospital units of the Yonsei University Health System. Interoperability between multi-units required appropriate hardware infrastructure and software architecture. This large-scale hospital information system encompassed PACS (Picture Archiving and Communications Systems), EMR (Electronic Medical Records) and ERP (Enterprise Resource Planning). It involved two tertiary hospitals and 50 community hospitals. The monthly data production rate by the integrated hospital information system is about 1.8 TByte and the total quantity of data produced so far is about 60 TByte. Large scale information exchange and sharing will be particularly useful for telemedicine applications.

Benefit requirements for substance use disorder treatment in state health insurance exchanges.

Science.gov (United States)

Tran Smith, Bikki; Seaton, Kathleen; Andrews, Christina; Grogan, Colleen M; Abraham, Amanda; Pollack, Harold; Friedmann, Peter; Humphreys, Keith

2018-01-01

Established in 2014, state health insurance exchanges have greatly expanded substance use disorder (SUD) treatment coverage in the United States as qualified health plans (QHPs) within the exchanges are required to conform to parity provisions laid out by the Affordable Care Act and the Mental Health Parity and Addiction Equity Act (MHPAEA). Coverage improvements, however, have not been even as states have wide discretion over how they meet these regulations. How states regulate SUD treatment benefits offered by QHPs has implications for the accessibility and quality of care. In this study, we assessed the extent to which state insurance departments regulate the types of SUD services and medications plans must provide, as well as their use of utilization controls. Data were collected as part of the National Drug Abuse Treatment System Survey, a nationally-representative, longitudinal study of substance use disorder treatment. Data were obtained from state Departments of Insurance via a 15-minute internet-based survey. States varied widely in regulations on QHPs' administration of SUD treatment benefits. Some states required plans to cover all 11 SUD treatment services and medications we assessed in the study, whereas others did not require plans to cover anything at all. Nearly all states allowed the plans to employ utilization controls, but reported little guidance regarding how they should be used. Although some states have taken full advantage of the health insurance exchanges to increase access to SUD treatment, others seem to have done the bare minimum required by the ACA. By not requiring coverage for the entire SUD continuum of care, states are hindering client access to appropriate types of care necessary for recovery.

Handling Internet-Based Health Information: Improving Health Information Web Site Literacy Among Undergraduate Nursing Students.

Science.gov (United States)

Wang, Weiwen; Sun, Ran; Mulvehill, Alice M; Gilson, Courtney C; Huang, Linda L

2017-02-01

Patient care problems arise when health care consumers and professionals find health information on the Internet because that information is often inaccurate. To mitigate this problem, nurses can develop Web literacy and share that skill with health care consumers. This study evaluated a Web-literacy intervention for undergraduate nursing students to find reliable Web-based health information. A pre- and postsurvey queried undergraduate nursing students in an informatics course; the intervention comprised lecture, in-class practice, and assignments about health Web site evaluation tools. Data were analyzed using Wilcoxon and ANOVA signed-rank tests. Pre-intervention, 75.9% of participants reported using Web sites to obtain health information. Postintervention, 87.9% displayed confidence in using an evaluation tool. Both the ability to critique health Web sites (p = .005) and confidence in finding reliable Internet-based health information (p = .058) increased. Web-literacy education guides nursing students to find, evaluate, and use reliable Web sites, which improves their ability to deliver safer patient care. [J Nurs Educ. 2017;56(2):110-114.]. Copyright 2017, SLACK Incorporated.

The Southeastern Minnesota Beacon Project for Community-driven Health Information Technology: Origins, Achievements, and Legacy.

Science.gov (United States)

Chute, Christopher G; Hart, Lacey A; Alexander, Alex K; Jensen, Daniel W

2014-01-01

The Southeastern (SE) Minnesota Beacon organized all the health care providers, county public health organizations, and school districts in the deployment and integration of health information exchange (HIE) and targeted health communication around childhood asthma and diabetes. The community cooperated to establish a clinical data repository for all residents in the 11-county region. Through this community of practice approach that involved traditional and nontraditional providers, the SE Minnesota Beacon was able to realize unique applications of this technology. This manuscript overviews the associated organization and infrastructure of this community collaboration. The Office of the National Coordinator for Health Information Technology (ONC), as part of the American Recovery and Reinvestment Act of 2009 (ARRA) stimulus, established 17 projects throughout the United States targeting the introduction and meaningful use of health information technology (HIT). These 17 communities were intended to serve as an example of what could be accomplished. The SE Minnesota Beacon is one of these communities. The community ultimately opted for peer-to-peer HIE, using Nationwide Health Information Network (NwHIN) Connect software. The clinical data repository was established using the infrastructure developed by the Regenstrief Institute, which operated as a trusted third party. As an extension to HIE, the consortium of county public health departments created a patient data portal for use by school nurses and parents. Childhood asthma was addressed by creating, exchanging, and maintaining an "asthma action plan" for each affected child, shared throughout the community, including through the patient portal. Diabetes management introduced patient treatment decision tools and patient quality of life measures, facilitating care. Influenza vaccination was enhanced by large-scale community reporting in partnership with the state vaccination registry. The methodology and

Breast Health Services: Accuracy of Benefit Coverage Information in the Individual Insurance Marketplace.

Science.gov (United States)

Hamid, Mariam S; Kolenic, Giselle E; Dozier, Jessica; Dalton, Vanessa K; Carlos, Ruth C

2017-04-01

The aim of this study was to determine if breast health coverage information provided by customer service representatives employed by insurers offering plans in the 2015 federal and state health insurance marketplaces is consistent with Patient Protection and Affordable Care Act (ACA) and state-specific legislation. One hundred fifty-eight unique customer service numbers were identified for insurers offering plans through the federal marketplace, augmented with four additional numbers representing the Connecticut state-run exchange. Using a standardized patient biography and the mystery-shopper technique, a single investigator posed as a purchaser and contacted each number, requesting information on breast health services coverage. Consistency of information provided by the representative with the ACA mandates (BRCA testing in high-risk women) or state-specific legislation (screening ultrasound in women with dense breasts) was determined. Insurer representatives gave BRCA test coverage information that was not consistent with the ACA mandate in 60.8% of cases, and 22.8% could not provide any information regarding coverage. Nearly half (48.1%) of insurer representatives gave coverage information about ultrasound screening for dense breasts that was not consistent with state-specific legislation, and 18.5% could not provide any information. Insurance customer service representatives in the federal and state marketplaces frequently provide inaccurate coverage information about breast health services that should be covered under the ACA and state-specific legislation. Misinformation can inadvertently lead to the purchase of a plan that does not meet the needs of the insured. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Internet Use for Health Information

Science.gov (United States)

... Health Services Utilization > Internet use for Health Information Internet use for Health Information Narrative Due in part ... adults in the United States who use the Internet has increased substantially, from 47 percent in 2000 ...

Filling the Gaps in a Fragmented Health Care System: Development of the Health and Welfare Information Portal (ZWIP).

Science.gov (United States)

Robben, Sarah Hm; Huisjes, Mirjam; van Achterberg, Theo; Zuidema, Sytse U; Olde Rikkert, Marcel Gm; Schers, Henk J; Heinen, Maud M; Melis, René Jf

2012-09-19

Current health care systems are not optimally designed to meet the needs of our aging populations. First, the fragmentation of care often results in discontinuity of care that can undermine the quality of care provided. Second, patient involvement in care decisions is not sufficiently facilitated. To describe the development and the content of a program aimed at: (1) facilitating self-management and shared decision making by frail older people and informal caregivers, and (2) reducing fragmentation of care by improving collaboration among professionals involved in the care of frail older people through a combined multidisciplinary electronic health record (EHR) and personal health record (PHR). We used intervention mapping to systematically develop our program in six consecutive steps. Throughout this development, the target populations (ie, professionals, frail older people, and informal caregivers) were involved extensively through their participation in semi-structured interviews and working groups. We developed the Health and Welfare Information Portal (ZWIP), a personal, Internet-based conference table for multidisciplinary communication and information exchange for frail older people, their informal caregivers, and professionals. Further, we selected and developed methods for implementation of the program, which included an interdisciplinary educational course for professionals involved in the care of frail older people, and planned the evaluation of the program. This paper describes the successful development and the content of the ZWIP as well as the strategies developed for its implementation. Throughout the development, representatives of future users were involved extensively. Future studies will establish the effects of the ZWIP on self-management and shared decision making by frail older people as well as on collaboration among the professionals involved.

E-health in Switzerland: The laborious adoption of the federal law on electronic health records (EHR) and health information exchange (HIE) networks.

Science.gov (United States)

De Pietro, Carlo; Francetic, Igor

2018-02-01

Within the framework of a broader e-health strategy launched a decade ago, in 2015 Switzerland passed a new federal law on patients' electronic health records (EHR). The reform requires hospitals to adopt interoperable EHRs to facilitate data sharing and cooperation among healthcare providers, ultimately contributing to improvements in quality of care and efficiency in the health system. Adoption is voluntary for ambulatories and private practices, that may however be pushed towards EHRs by patients. The latter have complete discretion in the choice of the health information to share. Moreover, careful attention is given to data security issues. Despite good intentions, the high institutional and organisational fragmentation of the Swiss healthcare system, as well as the lack of full agreement with stakeholders on some critical points of the reform, slowed the process of adoption of the law. In particular, pilot projects made clear that the participation of ambulatories is doomed to be low unless appropriate incentives are put in place. Moreover, most stakeholders point at the strategy proposed to finance technical implementation and management of EHRs as a major drawback. After two years of intense preparatory work, the law entered into force in April 2017. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Tensor exchange amplitudes in K +- N charge exchange reactions

International Nuclear Information System (INIS)

Svec, M.

1979-01-01

Tensor (A 2 ) exchange amplitudes in K +- N charge exchange (CEX) are constructed from the K +- N CEX data supplemented by information on the vector (rho) exchange amplitudes from πN sca tering. We observed new features in the t-structure of A 2 exchange amplitudes which contradict the t-de pendence anticipated by most of the Regge models. The results also provide evidence for violation of weak exchange degeneracy

Formalize clinical processes into electronic health information systems: Modelling a screening service for diabetic retinopathy.

Science.gov (United States)

Eguzkiza, Aitor; Trigo, Jesús Daniel; Martínez-Espronceda, Miguel; Serrano, Luis; Andonegui, José

2015-08-01

Most healthcare services use information and communication technologies to reduce and redistribute the workload associated with follow-up of chronic conditions. However, the lack of normalization of the information handled in and exchanged between such services hinders the scalability and extendibility. The use of medical standards for modelling and exchanging information, especially dual-model based approaches, can enhance the features of screening services. Hence, the approach of this paper is twofold. First, this article presents a generic methodology to model patient-centered clinical processes. Second, a proof of concept of the proposed methodology was conducted within the diabetic retinopathy (DR) screening service of the Health Service of Navarre (Spain) in compliance with a specific dual-model norm (openEHR). As a result, a set of elements required for deploying a model-driven DR screening service has been established, namely: clinical concepts, archetypes, termsets, templates, guideline definition rules, and user interface definitions. This model fosters reusability, because those elements are available to be downloaded and integrated in any healthcare service, and interoperability, since from then on such services can share information seamlessly. Copyright © 2015 Elsevier Inc. All rights reserved.

An interoperability architecture for the health information exchange in Rwanda

CSIR Research Space (South Africa)

Crichton, R

2012-08-01

Full Text Available Zulu-Natal and Council for Scientific and Industrial Research, Durban, South Africa 2 Jembi Health Systems, Cape Town and Durban, South Africa, 3 Medical Research Council, Cape Town, South Africa Abstract. Rwanda, one of the smallest and most densely populated... and the national rollout of an electronic medical record application[15]. The Rwanda Health Enterprise Architecture (RHEA) project, led by the Rwanda MoH and supported by a consortium of partners and donors has developed an architecture to contribute...

The Evolution of the Exchange of Information in Direct Tax Matters: The Taxpayer’s Rights under Pressure

OpenAIRE

DIEPVENS, Niels; Debelva, Filip

2015-01-01

EU Member States are confronted with a plethora of rules regarding the international exchange of information, mostly due to the adoption of automatic exchange of information as the new standard. The authors provide an overview of the recent developments and examine the recent instruments issued by the EU, OECD and the US. Afterwards, the application and interaction between these instruments is discussed. The authors conclude by stating that the above-mentioned developments have resulted in an...

Information exchange of the Atomic Energy Society of Japan with nuclear societies worldwide

International Nuclear Information System (INIS)

Hori, Masao; Tomita, Yasushi

2000-01-01

The Atomic Energy Society of Japan (AESJ) exchanges information with nuclear societies worldwide by intersocietal communication through international councils of nuclear societies and through bilateral agreements between foreign societies and by such media as international meetings, publications, and Internet applications

Sharing Service Resource Information for Application Integration in a Virtual Enterprise - Modeling the Communication Protocol for Exchanging Service Resource Information

Science.gov (United States)

Yamada, Hiroshi; Kawaguchi, Akira

Grid computing and web service technologies enable us to use networked resources in a coordinated manner. An integrated service is made of individual services running on coordinated resources. In order to achieve such coordinated services autonomously, the initiator of a coordinated service needs to know detailed service resource information. This information ranges from static attributes like the IP address of the application server to highly dynamic ones like the CPU load. The most famous wide-area service discovery mechanism based on names is DNS. Its hierarchical tree organization and caching methods take advantage of the static information managed. However, in order to integrate business applications in a virtual enterprise, we need a discovery mechanism to search for the optimal resources based on the given a set of criteria (search keys). In this paper, we propose a communication protocol for exchanging service resource information among wide-area systems. We introduce the concept of the service domain that consists of service providers managed under the same management policy. This concept of the service domain is similar to that for autonomous systems (ASs). In each service domain, the service information provider manages the service resource information of service providers that exist in this service domain. The service resource information provider exchanges this information with other service resource information providers that belong to the different service domains. We also verified the protocol's behavior and effectiveness using a simulation model developed for proposed protocol.

Perceived reciprocity in social exchange and health functioning in early old age: prospective findings from the GAZEL study.

Science.gov (United States)

Wahrendorf, Morten; Ribet, Celine; Zins, Marie; Goldberg, Marcel; Siegrist, Johannes

2010-05-01

To assess prospectively the effects of perceived non-reciprocity of exchange in three different types of social engagement on health functioning in early old age. In the frame of the prospective French GAZEL cohort study, data on reciprocity in three types of role-related social engagement (principal regular activity in everyday life, marital role relationship, trusting relationships in civic life) were collected from 8679 men and 2742 women (mean age: 60.4 years) in 2005. Two years later, health functioning was assessed using the SF-36 mental and physical component scores, as well as self-perceived health. Multivariate regressions were calculated, controlling for important confounders including baseline self-perceived health. Consistent effects of perceived non-reciprocity in all three types of social exchange on mental and physical health functioning were observed. After adjustment for relevant confounders including baseline self-perceived, health effects were attenuated, but largely remained significant. Findings underline the importance of the quality of social exchange (reciprocity vs. non-reciprocity) for health functioning in early old age.

Leveraging health information technology to achieve the "triple aim" of healthcare reform.

Science.gov (United States)

Sheikh, Aziz; Sood, Harpreet S; Bates, David W

2015-07-01

To investigate experiences with leveraging health information technology (HIT) to improve patient care and population health, and reduce healthcare expenditures. In-depth qualitative interviews with federal government employees, health policy, HIT and medico-legal experts, health providers, physicians, purchasers, payers, patient advocates, and vendors from across the United States. The authors undertook 47 interviews. There was a widely shared belief that Health Information Technology for Economic and Clinical Health (HITECH) had catalyzed the creation of a digital infrastructure, which was being used in innovative ways to improve quality of care and curtail costs. There were however major concerns about the poor usability of electronic health records (EHRs), their limited ability to support multi-disciplinary care, and major difficulties with health information exchange, which undermined efforts to deliver integrated patient-centered care. Proposed strategies for enhancing the benefits of HIT included federal stimulation of competition by mandating vendors to open-up their application program interfaces, incenting development of low-cost consumer informatics tools, and promoting Congressional review of the The Health Insurance Portability and Accountability Act (HIPPA) to optimize the balance between data privacy and reuse. Many underscored the need to "kick the legs from underneath the fee-for-service model" and replace it with a data-driven reimbursement system that rewards high quality care. The HITECH Act has stimulated unprecedented, multi-stakeholder interest in HIT. Early experiences indicate that the resulting digital infrastructure is being used to improve quality of care and curtail costs. Reform efforts are however severely limited by problems with usability, limited interoperability and the persistence of the fee-for-service paradigm-addressing these issues therefore needs to be the federal government's main policy target. © The Author 2015

Characteristics of Kentucky local health departments that influence public health communication during times of crisis: information dissemination associated with H1N1 novel influenza.

Science.gov (United States)

Howard, Alex F; Bush, Heather M; Shapiro, Robert M; Dearinger, Angela

2012-01-01

The purpose of this study was to investigate the association of selected characteristics of local health departments (LHDs) in Kentucky with the receipt of information by external stakeholders, specifically physicians and pharmacists, during the initial H1N1 outbreak of 2009. This study utilized a cross-sectional survey to gather characteristic information from local health departments. In addition, cross sectional surveys of physicians and pharmacists were used to determine information receipt. All 54 LHDs in Kentucky were surveyed; however, only those physicians belonging to the Kentucky Family Physician Association or the Kentucky Ambulatory Network were surveyed. Also, pharmacists included in this survey were members of the Kentucky Pharmacist Association. Descriptive data analyses, including chi-square test of independence, were conducted, and generalized estimating equations were used to calculate odds ratios to depict associations related to information exchange in this study. Response rates for the study were as follows: LHDs 65% (35/54), physicians 18.5% (96/518), and pharmacists 21.1% (211/1000). Of the 35 participating LHDs the most common characteristic identified was the presence of a public information officer (PIO) and a pandemic influenza plan, 76% and 64%, respectively. Despite these factors, 72% of external stakeholders did not receive any information regarding H1N1 from the LHD. Generalized estimating equations also indicated that stakeholders in jurisdictions lacking a PIO had 6 (95% confidence interval, 1.3-26.95) greater odds of not receiving information from the LHD. External stakeholders in jurisdictions without a pandemic influenza plan had 3.38 (95% confidence interval, 0.80-1.17) increased odds of not receiving information but this association was not statistically significant. Observations from this study indicate a need to improve information exchange between LHDs and their external stakeholders, specifically physicians and pharmacists

Comparison of Specialty Medication Use for Common Chronic Inflammatory Diseases Among Health Exchange and Other Commercially Insured Members.

Science.gov (United States)

Chen, Xiaoxue; Gautam, Santosh; Ruggieri, Alexander; Richards, Thomas; Devries, Andrea; Sylwestrzak, Gosia

2018-01-01

The Affordable Care Act of 2010 allows the purchase of health insurance through special marketplaces called "health exchanges." The majority of individuals enrolling in the exchanges were previously uninsured, older, and sicker than other commercially insured members. Early evidence also suggests that exchange plan members use more costly specialty drugs compared with other commercially insured members. To (a) examine patient characteristics and specialty drug use for common chronic inflammatory diseases (CIDs) among exchange plan members compared with other commercially insured members and (b) explore variations in specialty drug use within exchange plans by metal tiers (bronze, silver, gold, and platinum), as well as across local markets. This analysis included adults aged ≥ 18 years who were enrolled in exchange plans (exchange population) and other commercial health plans (nonexchange population). The primary outcome was the likelihood of using specialty drugs prescribed to treat common CIDs, such as rheumatoid arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis, psoriatic arthritis, and psoriasis. The adjusted likelihood of using CID specialty drugs was calculated from logistic regression controlling for prevalence of CIDs and other health risk factors. A total of 931,384 exchange plan members and 2,682,855 nonexchange plan members were included in the analysis. Compared with the nonexchange population, the exchange population was older, more likely to be female, had more comorbid conditions, but filled fewer prescriptions. The 2 groups were similar in terms of CID prevalence. The observed likelihood of CID specialty drug use was 20.0% lower in the exchange versus the nonexchange populations (341 users per 100,000 exchange members vs. 427 users per 100,000 nonexchange members; P exchange population, the observed likelihood of CID specialty drug use was 132 per 100,000 bronze plan members (69.1% lower than nonexchange); 326 per 100

Institutional and Actor-Oriented Factors Constraining Expert-Based Forest Information Exchange in Europe: A Policy Analysis from an Actor-Centred Institutionalist Approach

Directory of Open Access Journals (Sweden)

Tanya Baycheva-Merger

2018-03-01

Full Text Available Adequate and accessible expert-based forest information has become increasingly in demand for effective decisions and informed policies in the forest and forest-related sectors in Europe. Such accessibility requires a collaborative environment and constant information exchange between various actors at different levels and across sectors. However, information exchange in complex policy environments is challenging, and is often constrained by various institutional, actor-oriented, and technical factors. In forest policy research, no study has yet attempted to simultaneously account for these multiple factors influencing expert-based forest information exchange. By employing a policy analysis from an actor-centred institutionalist perspective, this paper aims to provide an overview of the most salient institutional and actor-oriented factors that are perceived as constraining forest information exchange at the national level across European countries. We employ an exploratory research approach, and utilise both qualitative and quantitative methods to analyse our data. The data was collected through a semi-structured survey targeted at forest and forest-related composite actors in 21 European countries. The results revealed that expert-based forest information exchange is constrained by a number of compound and closely interlinked institutional and actor-oriented factors, reflecting the complex interplay of institutions and actors at the national level. The most salient institutional factors that stand out include restrictive or ambiguous data protection policies, inter-organisational information arrangements, different organisational cultures, and a lack of incentives. Forest information exchange becomes even more complex when actors are confronted with actor-oriented factors such as issues of distrust, diverging preferences and perceptions, intellectual property rights, and technical capabilities. We conclude that expert-based forest information

Defining Information Quality Into Health Websites: A Conceptual Framework of Health Website Information Quality for Educated Young Adults.

Science.gov (United States)

Tao, Donghua; LeRouge, Cynthia; Smith, K Jody; De Leo, Gianluca

2017-10-06

Today's health care environment encourages health care consumers to take an active role in managing their health. As digital natives, young educated adults do much of their health information management through the Internet and consider it a valid source of health advice. However, the quality of information on health websites is highly variable and dynamic. Little is known about the understandings and perceptions that young educated adults have garnered on the quality of information on health websites used for health care-related purposes. To fill this gap, the aim of this study was to develop a conceptual framework of health website information quality with quality dimensions (ie, criteria) and associated quality drivers (ie, attributes) specified in the context of young educated adults' use of health websites for health care-related purposes. This aim was achieved by (1) identifying information quality dimensions of health websites from the perspective of young educated adults; (2) identifying the importance ratings of these quality dimensions; and (3) constructing a framework of health website information quality with quality dimensions and associated drivers specified in the context of young educated adults' use of health websites for health care-related purposes. The study employed both qualitative and quantitative methods. Methods included semistructured group interviews and an individual quality assessment exercise grounded in visiting various websites and responding to Likert scale questions regarding the importance ratings of information quality dimensions and open-ended questions with specifying website quality drivers. Study participants included junior and senior undergraduate and graduate students in business, allied health, and public health majors. Qualitative, open-coding procedures were used to develop the conceptual framework reflecting the participants' means of assessing information quality on health websites. Five dimensions of information

Social exchange as a framework for client-nurse interaction during public health nursing maternal-child home visits.

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Byrd, Mary E

2006-01-01

The purpose of this paper was to develop a nursing-focused use of social exchange theory within the context of maternal-child home visiting. The nature of social exchange theory, its application to client-nurse interaction, and its fit with an existing data set from a field research investigation were examined. Resources exchanged between the nurse and clients were categorized and compared across the patterns of home visiting, nursing strategies based on exchange notions were identified, and variations in exchange were linked with client outcomes. The nurse provided resources within the categories of information, status, service, and goods. Clients provided time, access to the home, space within the home to conduct the visit, opportunities to observe maternal-child interaction, access to the infant, and information. The ease and breadth of resource exchange varied across the patterns of home visiting. The social exchange perspective was useful in categorizing resources, specifying and uncovering new resource categories, understanding nursing strategies to initiate and maintain the client-nurse relationship, and linking client-nurse interactive phenomena with client outcomes. Social exchange theory is potentially useful for understanding client-nurse interaction in the context of maternal-child home visits.

Caregiver Burden, Care Recipient Depressive Symptomology, and Social Exchange: Does Race Matter?

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Ejem, Deborah; Bauldry, Shawn; Bakitas, Marie; Drentea, Patricia

2018-04-01

Informal caregivers play a vital role in supporting seriously ill patients. However, informal caregiving is burdensome and can lead to negative health outcomes for the caregiver and the care recipient. The study's aim was to evaluate relationships among caregiver burden, care recipient depressive symptomology, and race. Guided by the social exchange perspective, we examined cross-sectional dyadic data from the National Long-Term Care Survey (N = 1279). Using ordinal logistic regression, we found that higher caregiver-reported objective burden was associated with higher care recipient depressive symptoms ( P exchange of the social good "helpful company" with a caregiver. These findings illustrate the importance of supporting reciprocal exchange as a promising component of maintaining balanced caregiver-care recipient relationships among black older adults and their informal caregivers.

How Do Qataris Source Health Information?

Directory of Open Access Journals (Sweden)

Sopna M Choudhury

Full Text Available Qatar is experiencing rapid population expansion with increasing demands on healthcare services for both acute and chronic conditions. Sourcing accurate information about health conditions is crucial, yet the methods used for sourcing health information in Qatar are currently unknown. Gaining a better understanding of the sources the Qatari population use to recognize and manage health and/or disease will help to develop strategies to educate individuals about existing and emerging health problems.To investigate the methods used by the Qatari population to source health information. We hypothesized that the Internet would be a key service used to access health information by the Qatari population.A researcher-led questionnaire was used to collect information from Qatari adults, aged 18-85 years. Participants were approached in shopping centers and public places in Doha, the capital city of Qatar. The questionnaire was used to ascertain information concerning demographics, health status, and utilization of health care services during the past year as well as sources of health information used.Data from a total of 394 eligible participants were included. The Internet was widely used for seeking health information among the Qatari population (71.1%. A greater proportion of Qatari females (78.7% reported searching for health-related information using the Internet compared to Qatari males (60.8%. Other commonly used sources were family and friends (37.8% and Primary Health Care Centers (31.2%. Google was the most commonly used search engine (94.8%. Gender, age and education levels were all significant predictors of Internet use for heath information (P<0.001 for all predictors. Females were 2.9 times more likely than males (P<0.001 and people educated to university or college level were 3.03 times more likely (P<0.001 to use the Internet for heath information.The Internet is a widely used source to obtain health-related information by the Qatari

College Students' Health Information Activities on Facebook: Investigating the Impacts of Health Topic Sensitivity, Information Sources, and Demographics.

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Syn, Sue Yeon; Kim, Sung Un

2016-07-01

College students tend to lack access to health information. Because social networking sites (SNSs) are popularly adopted by college students, SNSs are considered to be good media channels for college students to obtain health-related information. This study examines the factors that influence college students' health information-seeking and -sharing activities on Facebook. An online survey was distributed to college students between the ages of 18 and 29 to determine intentions pertaining to health information activities according to the factors identified for the study. The factors included both contextual factors (such as health topic sensitivity and health information sources) as well as user factors (such as demographics). Our findings showed that college students are willing to read and post health-related information on Facebook when the health topic is not sensitive. In addition, there are clear differences in preferences between professional sources and personal sources as health information sources. It was found that most user factors, except gender, have no influence on health information activities. The impacts of SNS contexts, awareness of information sources, types of interlocutors, and privacy concerns are further discussed.

Improving Information Exchange in the Chicken Processing Sector Using Standardised Data Lists

Science.gov (United States)

Donnelly, Kathryn Anne-Marie; van der Roest, Joop; Höskuldsson, Stefán Torfi; Olsen, Petter; Karlsen, Kine Mari

Research has shown that to improve electronic communication between companies, universal standardised data lists are necessary. In food supply chains in particular there is an increased need to exchange data in the wake of food safety incidents. Food supply chain companies already record numerous measurements, properties and parameters. These records are necessary for legal reasons, labelling, traceability, profiling desirable characteristics, showing compliance and for meeting customer requirements. Universal standards for name and content of each of these data elements would improve information exchange between buyers, sellers, authorities, consumers and other interested parties. A case study, carried out for the chicken sector, attempted to identify the most relevant parameters including which of these were already communicated to external bodies.

[Infoxication in health. Health information overload on the Internet and the risk of important information becoming invisible].

Science.gov (United States)

D Agostino, Marcelo; Mejía, Felipe Medina; Martí, Myrna; Novillo-Ortiz, David; Hazrum, Flavio; de Cosío, Federico G

2018-02-19

The objectives of this study were to: 1) raise awareness of the volume of quality health information on the Internet; 2) explore perceptions of information professionals with regard to the use of qualified sources for health decision-making; and 3) make recommendations that facilitate strengthening health worker capacities and institutional competencies related to digital literacy. A non-experimental, descriptive cross-sectional study was conducted with a non-probability sample of 32 information professionals from nine countries. Internet information was compiled on the volume of content in Internet tools, social networks, and health information sources. Searches in English and Spanish were carried out using the keywords Ebola, Zika, dengue, chikungunya, safe food, health equity, safe sex, and obesity. Finally, information was obtained on opportunities for formal education on the subjects of digital literacy, information management, and other related topics. Selecting only four diseases with a high impact on public health in May 2016 and averaging minimum review time for each information product, it would take more than 50 years without sleeping to consult everything that is published online about dengue, Zika, Ebola, and chikungunya. We conclude that public health would benefit from: health institutions implementing formal knowledge management strategies; academic health sciences institutions incorporating formal digital literacy programs; and having health workers who are professionally responsible and functional in the information society.

Project to promote exchange of international information on environmental technologies; Kankyo gijutsu kokusai joho koryu sokushin jigyo

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-03-01

Mutual information exchange at international levels is important for practical application of global environment preservation technologies, whereas the APEC Virtual Center was established in fiscal 1997. Fiscal 1998 has discussed the future functions of the Virtual Center, and carried out the following matters to improve the functions and achieve its stable operation. Discussions were given on common use with the centers of other countries and regions of the specifications of classification systems for information areas and provided information that are provided by the Virtual Center. Visits were made to sub-managing countries and regions for smooth operation of the study groups, and opinions were exchanged. Visits were made to coordinators and contact points established in each country and region when the Center was founded in fiscal 1997. A visit was made to the U.S. Environmental Protection Agency to exchange opinions on coordination measures with the Cleaner Production Strategy of the U.S.A. being a project similar to the subject project. In order to strengthen the Japan's Center, attempts were made to expand the linking information to wider scope. Special pages publishing concentratedly the items of information that the users are interested were prepared as part of the information provision. (NEDO)

Which components of health information technology will drive financial value?

Science.gov (United States)

Kern, Lisa M; Wilcox, Adam; Shapiro, Jason; Dhopeshwarkar, Rina V; Kaushal, Rainu

2012-08-01

The financial effects of electronic health records (EHRs) and health information exchange (HIE) are largely unknown, despite unprecedented federal incentives for their use. We sought to understand which components of EHRs and HIE are most likely to drive financial savings in the ambulatory, inpatient, and emergency department settings. Framework development and a national expert panel. We searched the literature to identify functionalities enabled by EHRs and HIE across the 3 healthcare settings. We rated each of 233 functionality-setting combinations on their likelihood of having a positive financial effect. We validated the top-scoring functionalities with a panel of 28 national experts, and we compared the high-scoring functionalities with Stage 1 meaningful use criteria. We identified 54 high-scoring functionality- setting combinations, 27 for EHRs and 27 for HIE. Examples of high-scoring functionalities included providing alerts for expensive medications, providing alerts for redundant lab orders, sending and receiving imaging reports, and enabling structured medication reconciliation. Of the 54 high-scoring functionalities, 25 (46%) are represented in Stage 1 meaningful use. Many of the functionalities not yet represented in meaningful use correspond with functionalities that focus directly on healthcare utilization and costs rather than on healthcare quality per se. This work can inform the development and selection of future meaningful use measures; inform implementation efforts, as clinicians and hospitals choose from among a "menu" of measures for meaningful use; and inform evaluation efforts, as investigators seek to measure the actual financial impact of EHRs and HIE.

Patient-provider discussion of online health information: results from the 2007 Health Information National Trends Survey (HINTS).

Science.gov (United States)

Chung, Jae Eun

2013-01-01

Increasing numbers of people have turned to the Internet for health information. Little has been done beyond speculation to empirically investigate patients' discussion of online health information with health care professionals (HCPs) and patients' perception of HCPs' reactions to such discussion. The author analyzed data from the 2007 Health Information National Trends Survey (HINTS) to identify the characteristics of patients (a) who search for health information on the Internet, (b) who discuss the information found on the Internet with HCPs, and (c) who positively assess HCPs' reaction to the online information. Findings show that men were more likely than were women to have a conversation on online information with HCPs. It is unfortunate that patients who had trouble understanding or trusting online health information were no more likely to ask questions to or seek guidance from HCPs. Reactions of HCPs to online information were perceived as particularly negative by certain groups of patients, such as those who experienced poor health and those who had more concerns about the quality of their searched information. Results are discussed for their implications for patient empowerment and patient-HCP relationships.

Health Information Economy: Literature Review.

Science.gov (United States)

Ebrahimi, Kamal; Roudbari, Masoud; Sadoughi, Farahnaz

2015-04-19

Health Information Economy (HIE) is one of the broader, more complex, and challenging and yet important topics in the field of health science that requires the identification of its dimensions for planning and policy making. The aim of this study was to determine HIE concept dimensions. This paper presents a systematic methodology for analyzing the trends of HIE. For this purpose, the main keywords of this area were identified and searched in the databases and from among 4775 retrieved sources, 12 sources were studied in the field of HIE. Information Economy (IE) in the world has passed behind four paradigms that involve the information evaluation perspective, the information technology perspective, the asymmetric information perspective and information value perspective. In this research, the fourth perspective in the HIE was analyzed. The main findings of this research were categorized in three major groups, including the flow of information process in the field of health (production. collection, processing and dissemination), and information applications in the same field (education, research, health industry, policy, legislation, and decision-making) and the underlying fields. According to the findings, HIE has already developed a theoretical and conceptual gap that due to its importance in the next decade would be one of the research approaches to health science.

Health Information Economy: Literature Review

Science.gov (United States)

Ebrahimi, Kamal; Roudbari, Masoud; Sadoughi, Farahnaz

2015-01-01

Introduction: Health Information Economy (HIE) is one of the broader, more complex, and challenging and yet important topics in the field of health science that requires the identification of its dimensions for planning and policy making. The aim of this study was to determine HIE concept dimensions. Methods: This paper presents a systematic methodology for analyzing the trends of HIE. For this purpose, the main keywords of this area were identified and searched in the databases and from among 4775 retrieved sources, 12 sources were studied in the field of HIE. Results: Information Economy (IE) in the world has passed behind four paradigms that involve the information evaluation perspective, the information technology perspective, the asymmetric information perspective and information value perspective. In this research, the fourth perspective in the HIE was analyzed. The main findings of this research were categorized in three major groups, including the flow of information process in the field of health (production. collection, processing and dissemination), and information applications in the same field (education, research, health industry, policy, legislation, and decision-making) and the underlying fields. Conclusion: According to the findings, HIE has already developed a theoretical and conceptual gap that due to its importance in the next decade would be one of the research approaches to health science. PMID:26153182

Administrative arrangement between the United States Nuclear Regulatory Commission and the Atomic Energy Control Board of Canada for co-operation and the exchange of information in nuclear regulatory matters

International Nuclear Information System (INIS)

1989-06-01

This Administrative Arrangement covers co-operation and exchange of technical information relating to the regulation of the health, safety, security, safeguards and environmental protection aspects of nuclear facilities and materials as well as of radioactive substances and waste. The Arrangement was concluded for five years and is renewable [fr

Socially Shared Health Information

DEFF Research Database (Denmark)

Hansen, Kjeld S.

2018-01-01

In this PhD project, I'm investigating how health organizations are sharing health information on social media. My PhD project is divided into two parts, but in this paper, I will only focus on the first part: To understand current practices of how health organizations engage with health...... information and users on social media (empirical studies 1,2,3) and to develop a theoretical model for how it is done efficiently and effectively. I have currently conducted and published on two empirical studies (1,2). I am in the process of collecting data for a revised version of empirical study (2...

Identifying Health Consumers' eHealth Literacy to Decrease Disparities in Accessing eHealth Information.