With the growing use of mobile technology to access health information, patients are being empowered in their healthcare choices. While specific mobile applications are becoming available for patients to manage their own care, most treatment processes support healthcare professionals and offer little support for patient centered care. In order to address this problem, federal regulations require providers to become "meaningful users" of Health Information Technology (HIT) in an effort to encourage patient centered care through the assessment of health outcomes. This paper contends that addressing meaningful use practices for patient centered care involves the activation of knowledge, which means bringing knowledge into action. A survey of 73 health care providers sought to discover how their knowledge activation affects patient centered care. The results suggest that current HIT usage by providers has limited knowledge activation. The contribution of this research is in that it identifies areas that would to bring about improvements in patient centered care and a model that shows how mobile access to patient records could potentially streamline the patient care process.

A B S T R A C TIntroduction: Despite the known benefits of colorectal cancer (CRC) screening, rural areas have consistently reported lower screening rates than their urban counterparts. Alternative healthcare delivery models, such as accountable care organizations (ACOs), have the potential to increase CRC rates through collaboration among healthcare providers with the aim of improving quality and decreasing cost. However, researchers have not sufficiently explored how this innovative model could influence the promotion of cancer screening. The purpose of the study was to explore the mechanism of how CRC screening can be promoted in ACO-participating rural primary care clinics. Methods: The study collected qualitative data from in-depth interviews with 21 healthcare professionals employed in ACOparticipating primary care clinics in rural Nebraska. Participants were asked about their views on opportunities and challenges to promote CRC screening in an ACO context. Data were analyzed using a grounded theory approach. Results: The study found that the new healthcare delivery model can offer opportunities to promote cancer screening in rural areas through enhanced electronic health record use, information sharing and collaborative learning within ACO networks, use of standardized quality measures and performance feedback, a shift to preventive/comprehensive care, adoption of team-based care, © J Kim, L Young, S Bekmuratova, DJ Schober, H Wang, S Roy, SS Bhuyan, A Schumaker, L-W Chen, 2017. A Licence to publish this material has been given to James Cook University, http://www.jcu.edu.au 2 and empowered care coordinators. The perceived challenges were found in financial instability, increased staff workload, lack of provider training/education, and lack of resources in rural areas.Conclusions: This study found that the innovative care delivery model, ACO, could provide a well-designed platform for promoting CRC screening in rural areas, if sustainable resources (eg finance, health providers, and education) are provided. This study provides 'practical' information to identify effective and sustainable intervention programs to promote preventive screening. Further efforts are needed to facilitate delivery system reforms in rural primary care, such as improving performance evaluation measures and methods.Key words: accountable care organizations, colorectal cancer screening, delivery system innovation, primary care, rural health services, USA. IntroductionColorectal cancer (CRC) is the second-leading cause of death in the USA 1. The US Preventive Services Task Force recommends that adults aged between 50 and 75 years have a CRC screening, including fecal occult blood testing annually, sigmoidoscopy every 5 years, or colonoscopy every 10 years 2 . Despite the significant health benefits of routine CRC screening [2][3][4][5][6][7] , previous studies well documented the disparities between urban and rural communities in CRC screenings [8][9][10][11] . Primary care providers (PCPs) in rural clinics can play a critical role i...

Leadership programs in public health have been declining in numbers since 2012. The decline in training programs could be due to the lack of outcome‐based results and the lack of a manageable set of standardized skills needed for public health leadership. A comprehensive study was completed in two phases to determine if the current model of public health leadership institutes is effective at generating outcome‐based results. The following paper will focus on the first phase of the study. The first phase included a qualitative analysis to determine the domains, definitions, and skills needed to lead. An analysis of the skills, domains, definitions, and traits included in five established and commonly used leadership models/theories in public health leadership development (Transformational, Servant, Appreciative, Collaborative, and Emotional Intelligence leadership) plus the National Public Health Leadership Development Network (NLN) Leadership for Community Health, Safety & Resilience Competency Framework was completed. Of the 161 different skills, definitions, traits, and/or competencies from the five leadership models and the NLN competency framework, 123 were determined to be related to one of six domains needed for leadership and were defined into 21 skills. The findings could lead to more uniformity in public health leadership development and evaluation.

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