Registries for Evaluating Patient Outcomes

Registries for Evaluating Patient Outcomes

Author: Agency for Healthcare Research and Quality/AHRQ

Publisher: Government Printing Office

Published: 2014-04-01

Total Pages: 385

ISBN-13: 1587634333

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This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.


Patient Safety

Patient Safety

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2003-12-20

Total Pages: 551

ISBN-13: 0309090776

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Americans should be able to count on receiving health care that is safe. To achieve this, a new health care delivery system is needed â€" a system that both prevents errors from occurring, and learns from them when they do occur. The development of such a system requires a commitment by all stakeholders to a culture of safety and to the development of improved information systems for the delivery of health care. This national health information infrastructure is needed to provide immediate access to complete patient information and decision-support tools for clinicians and their patients. In addition, this infrastructure must capture patient safety information as a by-product of care and use this information to design even safer delivery systems. Health data standards are both a critical and time-sensitive building block of the national health information infrastructure. Building on the Institute of Medicine reports To Err Is Human and Crossing the Quality Chasm, Patient Safety puts forward a road map for the development and adoption of key health care data standards to support both information exchange and the reporting and analysis of patient safety data.


Electronic Healthcare Information Security

Electronic Healthcare Information Security

Author: Charles A. Shoniregun

Publisher: Springer Science & Business Media

Published: 2010-11-03

Total Pages: 203

ISBN-13: 038784919X

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The adoption of Information and Communication Technologies (ICT) in healthcare is driven by the need to contain costs while maximizing quality and efficiency. However, ICT adoption for healthcare information management has brought far-reaching effects and implications on the spirit of the Hippocratic Oath, patient privacy and confidentiality. A wave of security breaches have led to pressing calls for opt-in and opt-out provisions where patients are free to choose to or not have their healthcare information collected and recorded within healthcare information systems. Such provisions have negative impact on cost, efficiency and quality of patient care. Thus determined efforts to gain patient trust is increasingly under consideration for enforcement through legislation, standards, national policy frameworks and implementation systems geared towards closing gaps in ICT security frameworks. The ever-increasing healthcare expenditure and pressing demand for improved quality and efficiency in patient care services are driving innovation in healthcare information management. Key among the main innovations is the introduction of new healthcare practice concepts such as shared care, evidence-based medicine, clinical practice guidelines and protocols, the cradle-to-grave health record and clinical workflow or careflow. Central to these organizational re-engineering innovations is the widespread adoption of Information and Communication Technologies (ICT) at national and regional levels, which has ushered in computer-based healthcare information management that is centred on the electronic healthcare record (EHR).


Principles of Health Interoperability

Principles of Health Interoperability

Author: Tim Benson

Publisher: Springer

Published: 2016-06-22

Total Pages: 461

ISBN-13: 3319303708

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This book provides an introduction to health interoperability and the main standards used. Health interoperability delivers health information where and when it is needed. Everybody stands to gain from safer more soundly based decisions and less duplication, delays, waste and errors. The third edition of Principles of Health Interoperability includes a new part on FHIR (Fast Health Interoperability Resources), the most important new health interoperability standard for a generation. FHIR combines the best features of HL7’s v2, v3 and CDA while leveraging the latest web standards and a tight focus on implementability. FHIR can be implemented at a fraction of the price of existing alternatives and is well suited for use in mobile phone apps, cloud communications and EHRs. The book is organised into four parts. The first part covers the principles of health interoperability, why it matters, why it is hard and why models are an important part of the solution. The second part covers clinical terminology and SNOMED CT. The third part covers the main HL7 standards: v2, v3, CDA and IHE XDS. The new fourth part covers FHIR and has been contributed by Grahame Grieve, the original FHIR chief.


Health Informatics - E-Book

Health Informatics - E-Book

Author: Ramona Nelson

Publisher: Elsevier Health Sciences

Published: 2016-12-08

Total Pages: 691

ISBN-13: 0323402259

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Awarded second place in the 2017 AJN Book of the Year Awards in the Information Technology category. See how information technology intersects with health care! Health Informatics: An Interprofessional Approach, 2nd Edition prepares you for success in today's technology-filled healthcare practice. Concise coverage includes information systems and applications such as electronic health records, clinical decision support, telehealth, ePatients, and social media tools, as well as system implementation. New to this edition are topics including data science and analytics, mHealth, principles of project management, and contract negotiations. Written by expert informatics educators Ramona Nelson and Nancy Staggers, this edition enhances the book that won a 2013 American Journal of Nursing Book of the Year award! - Experts from a wide range of health disciplines cover the latest on the interprofessional aspects of informatics — a key Quality and Safety Education for Nurses (QSEN) initiative and a growing specialty area in nursing. - Case studies encourage higher-level thinking about how concepts apply to real-world nursing practice. - Discussion questions challenge you to think critically and to visualize the future of health informatics. - Objectives, key terms and an abstract at the beginning of each chapter provide an overview of what you will learn. - Conclusion and Future Directions section at the end of each chapter describes how informatics will continue to evolve as healthcare moves to an interprofessional foundation. - NEW! Updated chapters reflect the current and evolving practice of health informatics, using real-life healthcare examples to show how informatics applies to a wide range of topics and issues. - NEW mHealth chapter discusses the use of mobile technology, a new method of health delivery — especially for urban or under-served populations — and describes the changing levels of responsibility for both patients and providers. - NEW Data Science and Analytics in Healthcare chapter shows how Big Data — as well as analytics using data mining and knowledge discovery techniques — applies to healthcare. - NEW Project Management Principles chapter discusses proven project management tools and techniques for coordinating all types of health informatics-related projects. - NEW Contract Negotiations chapter describes strategic methods and tips for negotiating a contract with a healthcare IT vendor. - NEW Legal Issues chapter explains how federal regulations and accreditation processes may impact the practice of health informatics. - NEW HITECH Act chapter explains the regulations relating to health informatics in the Health Information Technology for Education and Clinical Health Act as well as the Meaningful Use and Medicare Access & CHIP Reauthorization Act of 2015.


Taking Action Against Clinician Burnout

Taking Action Against Clinician Burnout

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2020-01-02

Total Pages: 335

ISBN-13: 0309495474

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Patient-centered, high-quality health care relies on the well-being, health, and safety of health care clinicians. However, alarmingly high rates of clinician burnout in the United States are detrimental to the quality of care being provided, harmful to individuals in the workforce, and costly. It is important to take a systemic approach to address burnout that focuses on the structure, organization, and culture of health care. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being builds upon two groundbreaking reports from the past twenty years, To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, which both called attention to the issues around patient safety and quality of care. This report explores the extent, consequences, and contributing factors of clinician burnout and provides a framework for a systems approach to clinician burnout and professional well-being, a research agenda to advance clinician well-being, and recommendations for the field.


Integrating Social Care into the Delivery of Health Care

Integrating Social Care into the Delivery of Health Care

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2020-01-30

Total Pages: 195

ISBN-13: 0309493439

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Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health was released in September 2019, before the World Health Organization declared COVID-19 a global pandemic in March 2020. Improving social conditions remains critical to improving health outcomes, and integrating social care into health care delivery is more relevant than ever in the context of the pandemic and increased strains placed on the U.S. health care system. The report and its related products ultimately aim to help improve health and health equity, during COVID-19 and beyond. The consistent and compelling evidence on how social determinants shape health has led to a growing recognition throughout the health care sector that improving health and health equity is likely to depend â€" at least in part â€" on mitigating adverse social determinants. This recognition has been bolstered by a shift in the health care sector towards value-based payment, which incentivizes improved health outcomes for persons and populations rather than service delivery alone. The combined result of these changes has been a growing emphasis on health care systems addressing patients' social risk factors and social needs with the aim of improving health outcomes. This may involve health care systems linking individual patients with government and community social services, but important questions need to be answered about when and how health care systems should integrate social care into their practices and what kinds of infrastructure are required to facilitate such activities. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health examines the potential for integrating services addressing social needs and the social determinants of health into the delivery of health care to achieve better health outcomes. This report assesses approaches to social care integration currently being taken by health care providers and systems, and new or emerging approaches and opportunities; current roles in such integration by different disciplines and organizations, and new or emerging roles and types of providers; and current and emerging efforts to design health care systems to improve the nation's health and reduce health inequities.


Procuring Interoperability

Procuring Interoperability

Author: National Academy of Medicine

Publisher:

Published: 2023-09-03

Total Pages: 0

ISBN-13: 9780309705271

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Realizing the promise of digital technology will depend on the ability to share information across time and space from multiple devices, sources, systems, and organizations. The major barrier to progress is not technical; rather, it is in the failure of organizational demand and purchasing requirements. In contrast to many other industries, the purchasers of health care technologies have not marshaled their purchasing power to drive interoperability as a key requirement. Better procurement practices, supported by compatible interoperability platforms and architecture, will allow for better, safer patient care; reduced administrative workload for clinicians; protection from cybersecurity attacks; and significant financial savings across multiple markets. With funding support from the Gordon and Betty Moore Foundation, this National Academy of Medicine Special Publication represents a multi-stakeholder exploration of the path toward achieving large-scale interoperability through strategic acquisition of health information technology solutions and devices. In this publication, data exchanges over three environments are identified as critical to achieving interoperability: facility-to-facility (macro-tier); intra-facility (meso-tier); and at point-of-care (micro-tier). The publication further identifies the key characteristics of information exchange involved in health and health care, the nature of the requirements for functional interoperability in care processes, the mapping of those requirements into prevailing contracting practices, the specification of the steps necessary to achieve system-wide interoperability, and the proposal of a roadmap for using procurement specifications to engage those steps. The publication concludes with a series of checklists to be used by health care organizations and other stakeholders to accelerate progress in achieving system-wide interoperability.


Capturing Social and Behavioral Domains and Measures in Electronic Health Records

Capturing Social and Behavioral Domains and Measures in Electronic Health Records

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2015-01-08

Total Pages: 287

ISBN-13: 0309312450

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Determinants of health - like physical activity levels and living conditions - have traditionally been the concern of public health and have not been linked closely to clinical practice. However, if standardized social and behavioral data can be incorporated into patient electronic health records (EHRs), those data can provide crucial information about factors that influence health and the effectiveness of treatment. Such information is useful for diagnosis, treatment choices, policy, health care system design, and innovations to improve health outcomes and reduce health care costs. Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2 identifies domains and measures that capture the social determinants of health to inform the development of recommendations for the meaningful use of EHRs. This report is the second part of a two-part study. The Phase 1 report identified 17 domains for inclusion in EHRs. This report pinpoints 12 measures related to 11 of the initial domains and considers the implications of incorporating them into all EHRs. This book includes three chapters from the Phase 1 report in addition to the new Phase 2 material. Standardized use of EHRs that include social and behavioral domains could provide better patient care, improve population health, and enable more informative research. The recommendations of Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2 will provide valuable information on which to base problem identification, clinical diagnoses, patient treatment, outcomes assessment, and population health measurement.