HIT or Miss: the application of health care information technology to managing uncertainty in clinical decision making.
Summary of "HIT or Miss: the application of health care information technology to managing uncertainty in clinical decision making."
Abstract Objective To discuss the usefulness of health care information technology (HIT) in assisting care providers minimize uncertainty while simultaneously increasing efficiency of the care provided. Study design An ongoing study of HIT, performance measurement (clinical and production efficiency) and their implications to the payment for care represents the design of this study. Since 2006, all Maryland hospitals have embarked on a multi-faceted study of performance measures and HIT adoption surveys, which will shape the health care payment model in Maryland, the last of the all-payor states, in 2011. Methods This paper focuses on the HIT component of the Maryland care payment initiative. While the payment model is still under review and discussion, 'appropriateness' of care has been discussed as an important dimension of measurement. Within this dimension, the 'uncertainty' concept has been identified as associated with variation in care practices. Hence, the methods of this paper define how HIT can assist care providers in addressing the concept of uncertainty, and then provides findings from the first HIT survey in Maryland to infer the readiness of Maryland hospital in addressing uncertainty of care in part through the use of HIT. Results Maryland hospitals show noteworthy variation in their adoption and use of HIT. While computerized, electronic patient records are not commonly used among and across Maryland hospitals, many of the uses of HIT internally in each hospital could significantly assist in better communication about better practices to minimize uncertainty of care and enhance the efficiency of its production.
Affiliation
President, Center for Performance Sciences, Elkridge, MD, USA, Adjunct Professor, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA, Director, Information Systems and Analysis, The Maryland Patient Safety Center, Elkridge,
Journal Details
This article was published in the following journal.
Name: Journal of evaluation in clinical practice
ISSN: 1365-2753
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20630010
- DOI: http://dx.doi.org/10.1111/j.1365-2753.2010.01483.x
Medical and Biotech [MESH] Definitions
Patient Self-determination Act
The purpose of this 1990 federal act is to assure that individuals receiving health care services will be given an opportunity to participate in and direct health care decisions affecting themselves. Under this act, hospitals, health care agencies, and health maintenance organizations are responsible for developing patient information for distribution. The information must include patients' rights, advance directives, living wills, ethics committees' consultation and education functions, limited medical treatment (support/comfort care only), mental health treatment, resuscitation, restraints, surrogate decision making and transfer of care. (from JCAHO, Lexicon, 1994)
National Practitioner Data Bank
A databank established by the Health Care Quality Improvement Act of 1986 authorizing the Department of Health and Human Services to collect and release information on the professional competence and conduct of physicians, dentists, nurses, and other health care practitioners. The data include adverse actions on physicians' malpractice, licensure, hospital privileges, concealing of pertinent information, and the like.
Medical Informatics
The field of information science concerned with the analysis and dissemination of medical data through the application of computers to various aspects of health care and medicine.
Consumer Health Information
Information intended for potential users of medical and healthcare services. There is an emphasis on self-care and preventive approaches as well as information for community-wide dissemination and use.
Preconception Care
An organized and comprehensive program of health care that identifies and reduces a woman's reproductive risks before conception through risk assessment, health promotion, and interventions. Preconception care programs may be designed to include the male partner in providing counseling and educational information in preparation for fatherhood, such as genetic counseling and testing, financial and family planning, etc. This concept is different from PRENATAL CARE, which occurs during pregnancy.
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