Characteristics of Local Health Departments Associated with Implementation of Electronic Health Records and other Informatics Systems

Shah, Gulzar H.; Leider, Jonathon P.; Castrucci, Brian C.; Williams, Karmen S.; Luo, Huabin

doi:10.1177/003335491613100211

Cited by 42 publications

(42 citation statements)

References 27 publications

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“…18 Readiness assessment, as a comprehensive measure in order to provide a proper image of existing conditions and the preparedness of healthcare organization to change, is also a way to identify potential causes of failure in innovation. 19 This study therefore aims to assess the readiness and associated factors among health professionals towardEMR implementation in the selected hospitals.…”

Section: Introductionmentioning

confidence: 99%

<p>Health Professionals’ Readiness and Its Associated Factors to Implement Electronic Medical Record System in Four Selected Primary Hospitals in Ethiopia</p>

Awol¹,

Birhanu²,

Mekonnen³

et al. 2020

AMEP

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Background: Incorporating electronic medical record systems (EMRs) into the healthcare system is not only about modernizing the health system, but is about saving lives by facilitating communication and practicing evidence-based decision. Globally, more than 50% of EMR projects fail before they reach their target. Even though EMRs are an essential tool for health care, their adoption and utilization remains low in developing countries including Ethiopia. Objective: The aim of this study was to determine health professionals' readiness and associated factors toward the implementation of EMRs in four selected primary hospitals in Ethiopia. Methods: An institutionbased cross-sectional study supplemented with a qualitative approach was conducted on 414 health professionals from March 2 to May 5, 2018 in four selected primary hospitals in Ethiopia. A self-administered questionnaire was used to collect the quantitative data and in-depth interviews were employed for the qualitative data. The data were analyzed using SPSS version 20 software. Descriptive statistics, bivariable, and multivariable logistic regression analyses were done. An adjusted odds ratio (AOR) with 95% CI was used to determine the association between the determinants and the outcome variable. Results: More than half (258; 62.3%) of health professionals were ready to use the electronic medical recording system. EMR knowledge (AOR = 2.64; 95% CI: [1.62, 4.29]), attitude (AOR = 1.63; 95% CI: [1.01, 2.63]), computer literacy (AOR = 3.30; 95% CI: [2.05, 5.31]), and EMR training (AOR = 3.63, ;5% CI: [1.69, 5.80]) were significantly associated with EMR readiness. Conclusion and Recommendation: In general, the overall readiness of health professionals for EMR implementation was found to be low. Comprehensive packages of capacitybuilding are crucial to raise the level of knowledge, attitude, and computer skill among health workers.

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Section: Introductionmentioning

confidence: 99%

<p>Health Professionals’ Readiness and Its Associated Factors to Implement Electronic Medical Record System in Four Selected Primary Hospitals in Ethiopia</p>

Awol¹,

Birhanu²,

Mekonnen³

et al. 2020

AMEP

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“…HIEs have demonstrated savings in health care costs [22,23], improvements in patient safety [24], workflow efficiencies [25], and improved data sharing among information systems and HIE participants [26]. HIEs are also stimulating structural and business process changes for PHAs [27,28]. An HIE has the potential to link EHR and laboratory data, providing PHAs with integrated, timely, consistently organized information that alleviates many challenges PHAs face in managing case reports.…”

Section: Introductionmentioning

confidence: 99%

Leveraging public health's participation in a Health Information Exchange to improve communicable disease reporting

Painter

Revere

Gibson³

et al. 2017

OJPHI

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BackgroundInfectious diseases can appear and spread rapidly. Timely information about disease patterns and trends allows public health agencies to quickly investigate and efficiently contain those diseases. But disease case reporting to public health has traditionally been paper-based, resulting in somewhat slow, burdensome processes. Fortunately, the expanding use of electronic health records and health information exchanges has created opportunities for more rapid, complete, and easily managed case reporting and investigation. To assess how this new service might impact the efficiency and quality of a public health agency's case investigations, we compared the timeliness of usual case investigation to that of case investigations based on case report forms that were partially pre-populated with electronic data.InterventionBetween September 2013-March 2014, chlamydia disease report forms for certain clinics in Indianapolis were electronically pre-populated with clinical, lab and patient data available through the Indiana Health Information Exchange, then provided to the patientâ€™s doctor. Doctors could then sign the form and deliver it to public health for investigation and population-level disease tracking. Methods: We utilized a novel matched case analysis of timeliness changes in receipt and processing of communicable disease report forms. Each Chlamydia cases reported with the pre-populated form were matched to cases reported in usual ways. We assessed the time from receipt of the case at the public health agency: 1) inclusion of the case into the public health surveillance system and 2) to close to case. A hierarchical random effects model was used to compare mean difference in each outcome between the target cases and the matched cases, with random intercepts for case.ResultsTwenty-one Chlamydia cases were reported to the public health agency using the pre-populated form. Sixteen of these pre-populated form cases were matched to at least one other case, with a mean of 23 matches per case. The mean Reporting Lag for the pre-populated form cases was 2.5 days, which was 2.7 days shorter than the mean Reporting Lag for the matched controls (p = <0.001). The mean time to close a pre-populated form case was 4.7 days, which was 0.2 days shorter than time to close for the matched controls (p = 0.792).ConclusionsUse of pre-populated forms significantly decreased the time it took for the local public health agency to begin documenting and closing chlamydia case investigations. Thoughtful use of electronic health data for case reporting may decrease the per-case workload of public health agencies, and improve the timeliness of information about the pattern and spread of disease.

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“…Shah et al 30 indicated that both modifiable aspects, such as staffing and financial barriers, and non-modifiable aspects, such as geography, were highly associated with uptake of information systems. In addition, LHD characteristics, such as, length of tenure of top executive, having an information specialist on staff, and performing more clinical services were associated with the implementation of HIEs.…”

Section: Health Information Exchangementioning

confidence: 99%

“…In addition, LHD characteristics, such as, length of tenure of top executive, having an information specialist on staff, and performing more clinical services were associated with the implementation of HIEs. 30 Despite the challenges, EHRs and HIEs have the ability to improve care delivery and outcomes, and inform population health interventions and policy. 31 Although legislation has increased priority of health informatics in public health agencies, the literature suggests there are still barriers challenging the implementation of EHRs and HIEs.…”

Section: Health Information Exchangementioning

confidence: 99%

Overcoming Barriers to Experience Benefits: A Qualitative Analysis of Electronic Health Records and Health Information Exchange Implementation in Local Health Departments

Williams¹,

Shah²,

Leider³

et al. 2017

eGEMs

Self Cite

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Introduction: Electronic Health Records (EHRs) and Health Information Exchanges (HIEs) are changing surveillance and analytic operations within local health departments (LHDs) across the United States. The objective of this study was to analyze the status, benefits, barriers, and ways of overcoming challenges in the implementation of EHRs and HIEs in LHDs. Methods:This study employed a mixed methods approach, first using the 2013 National Profile of LHDs survey to ascertain the status of EHR and HIE implementation across the US, as well as to aid in selection of respondents for the second, interview-based part of project. Next, forty-nine key-informant interviews of local health department staff were conducted. Data were coded thematically and independently by two researchers. Coding was compared and re-coded using the consensus definitions.Results: Twenty-three percent of LHDs nationwide are using EHRs and 14 percent are using HIEs. The most frequently mentioned benefits for implementation were identified as care coordination, retrieval or managing information, and the ability to track outcomes of care. A few mentioned barriers included financial resources, resistance to change, and IT related issues during implementation.Discussion: Despite financial, technical capacity, and operational constraints, leaders interviewed as part of this project were optimistic about the future of EHRs in local health departments. Recent policy changes and accreditation have implications of improving processes to affect populations served. Conclusions:Overcoming the challenges in implementing EHRs can result in increased efficiencies in surveillance and higher quality patient care and tracking. However, significant opportunity cost does exist.

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Characteristics of Local Health Departments Associated with Implementation of Electronic Health Records and other Informatics Systems

Cited by 42 publications

References 27 publications

<p>Health Professionals’ Readiness and Its Associated Factors to Implement Electronic Medical Record System in Four Selected Primary Hospitals in Ethiopia</p>

<p>Health Professionals’ Readiness and Its Associated Factors to Implement Electronic Medical Record System in Four Selected Primary Hospitals in Ethiopia</p>

Leveraging public health's participation in a Health Information Exchange to improve communicable disease reporting

Overcoming Barriers to Experience Benefits: A Qualitative Analysis of Electronic Health Records and Health Information Exchange Implementation in Local Health Departments

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