Going digital: a narrative overview of the clinical and organisational impacts of eHealth technologies in hospital practice

Keasberry, Justin; Scott, Ian A; Sullivan, Clair; Staib, Andrew; Ashby, Richard

doi:10.1071/ah16233

Cited by 104 publications

(87 citation statements)

References 18 publications

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“…Integration of the procedure into hospital EHR systems could also help routinize use of this program, and consistent use of the program could increase comfort and ease of use. Systematic reviews of the utilization of health information technology such as EHRs found that their use can increase adherence to protocolbased care, and may improve efficiency and level of patient care (Chaudhry et al, 2006;Keasberry, Scott, Sullivan, Staib, & Ashby, 2017). Computerized decision support systems, which integrate patient information and provide support for provider decision making, could be programmed to provide alerts or prompts when a call to the MROT would be recommended, though empirical evidence supporting the impact of these systems on quality of care is somewhat weak (Black et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

“Another tool for the tool box? I'll take it!”: Feasibility and acceptability of mobile recovery outreach teams (MROT) for opioid overdose patients in the emergency room

Wagner

Oman

Smith

et al. 2020

Journal of Substance Abuse Treatment

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A B S T R A C TDrug poisoning deaths involving opioids have increased exponentially in the United States. Post-overdose outreach to patients in the emergency room (ER) is a promising strategy for increasing uptake of medication assisted treatment and reducing subsequent overdose. We conducted a mixed methods study to investigate the feasibility and acceptability of a mobile recovery outreach team (MROT) program for opioid overdose patients presenting in Nevada's ERs, which was funded by the SAMHSA Opioid State Targeted Response (STR) grant. We interviewed 25 ER staff using quantitative questions informed by Diffusion of Innovation (DOI) theory and qualitative questions regarding their experiences caring for overdose patients, perceived benefits, and concerns about the MROT program. Respondents expressed strong support and enthusiasm for the program, identified advantages of the program relative to standard of care, highlighted logistical issues that must be addressed prior to implementation, and illustrated how the MROT program is compatible with their personal and professional values. Our results suggest that the STR-funded MROT program could reduce burden and stress among ER staff and improve patient outcomes, but must be informed by formative research that addresses issues of logistical complexity and cultural compatibility.

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Section: Discussionmentioning

confidence: 99%

“Another tool for the tool box? I'll take it!”: Feasibility and acceptability of mobile recovery outreach teams (MROT) for opioid overdose patients in the emergency room

Wagner

Oman

Smith

et al. 2020

Journal of Substance Abuse Treatment

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“…Keasberry et al 6 provided a narrative review of systematic reviews of the effects of EMR, CPOE, CDSS and ePrescribing published between 1 January 2010 and 31 October 2015. We update this review by replicating their search methods to review studies published from 1 November 2015 to 1 August 2017.…”

Section: Methodsmentioning

confidence: 99%

“…The aim of this paper is to provide an assessment of the current literature on the effects to be expected from hospital implementations of eHealth technologies. 6 This paper provides the detailed background evidence for our recently published Deeble Institute Evidence Brief. 7…”

Section: Introductionmentioning

confidence: 99%

Effects of eHealth on hospital practice: synthesis of the current literature

Eden¹,

Burton‐Jones²,

Scott³

et al. 2018

Aust. Health Review

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The transition to digital hospitals is fast-moving. Although US hospitals are further ahead than some others in implementing eHealth technologies, their early experiences are not necessarily generalisable to contemporary healthcare because both the systems and technologies have been rapidly evolving. It is important to provide up-to-date assessments of the evidence available. The aim of this paper is to provide an assessment of the current literature on the effects to be expected from hospital implementations of eHealth technologies. A narrative review was conducted of systematic reviews investigating the effects of eHealth technologies (clinical decision support systems (CDSS), computerised provider order entry (CPOE), ePrescribing, electronic medical records (EMRs)) published between November 2015 and August 2017 and compared the findings with those of a previous narrative review that examined studies published between January 2010 and October 2015. The same search strategy and selection criteria were used in both studies. Of the seven relevant articles, three (42.9%) examined the effects of more than one eHealth system: only two (28.6%) studies were high quality, three (42.9%) were of intermediate quality and two (28.6%) were of low quality. We identified that EMRs are largely associated with conflicting findings. Previous reviews suggested that CPOE are associated with significant positive results of cost savings, organisational efficiency gains, less resource utilisation and improved individual performance. However, these effects were not investigated in the more recent reviews, and only mixed findings for communication between clinicians were reported. Similarly, for ePrescribing, later reviews reported limited evidence of benefits, although when coupled with CDSS, more consistent positive findings were reported. This overview can help inform other hospitals in Australia and elsewhere of the likely effects resulting from eHealth technologies. The findings suggest that the effects of these systems are largely mixed, but there are positive findings, which encourage ongoing digital transformation of hospital practice. Governments are increasingly devoting substantial resources towards implementing eHealth technologies in hospital practice with the goals of improving clinical and financial outcomes. Yet, these outcomes are yet to be fully realised in practice and conflicting findings are often reported in the literature. This paper extends a previous narrative review of systematic reviews and categorises the effects of eHealth technologies into a typology of outcomes to enable overall findings to be reported and comparisons to be made. In doings so, we synthesise 7 years of eHealth effects. Mixed results are largely reported for EMRs, with many benefits being compromised by practices stemming from resistance to EMRs. Limited evidence of effectiveness exists for CPOE and ePrescribing. CDSS are associated with the most consistent positive findings for clinician- and hospital-level effects. We observed renewed int...

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“…A recent review on previous research on Digital Hospitals [15] indicates that eHealth technologies improve the efficiency and appropriateness of care and safety, while the effects on mortality, readmissions, total costs as well as patient and provider experience still remain uncertain.…”

Section: Discussionmentioning

confidence: 99%

Identifying opportunities for AI applications in healthcare — Renewing the national healthcare and social services

Tyrväinen

Silvennoinen

Talvitie-Lamberg

et al. 2018

2018 IEEE 6th International Conference on Serious Games and Applications for Health (SeGAH)

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Abstract-A vast variety of artificial intelligence techniques have been deployed to specific healthcare problems during the last thirty years with varying levels of success while there is a shortage of systematic matching of AI capabilities with the breadth of application opportunities. In this paper, we describe the process of identifying opportunities for deploying artificial intelligence to healthcare and social services on regional and national levels in Finland. The project involved a large number of stakeholders from a variety of backgrounds ranging from governmental agencies to entrepreneurs. The process described includes idea generation of an application or solution and its elaboration in workshops using a design thinking method. The resulting idea pool was filtered down to 34 best use case descriptions, which went through an architectural design process identifying AI capabilities needed in the components of these designs reported in this paper. The potential ones of the use cases were selected for prototype development. The subsequent steps in the process include feasibility prototypes and evaluation of the economic and business value of the solutions and applications.

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Going digital: a narrative overview of the clinical and organisational impacts of eHealth technologies in hospital practice

Cited by 104 publications

References 18 publications

“Another tool for the tool box? I'll take it!”: Feasibility and acceptability of mobile recovery outreach teams (MROT) for opioid overdose patients in the emergency room

“Another tool for the tool box? I'll take it!”: Feasibility and acceptability of mobile recovery outreach teams (MROT) for opioid overdose patients in the emergency room

Effects of eHealth on hospital practice: synthesis of the current literature

Identifying opportunities for AI applications in healthcare — Renewing the national healthcare and social services

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