Fluent Essays

Health information systems face challenges with data input and information output. Concerns with health information systems may vastly impact the accessibility and/or integrity of patient-protected health information (PHI). Health care leaders are continuously concerned about PHI value, quality, security, and efficiency. Meanwhile, technology is advancing in health care at an unsurpassed rate. Some health care organizations are very slow to adapt. Other organizations spend the time and resources ensuring that they remain competitive, measuring the risk versus the benefit of new or improved health information systems. Evaluate three threats to health information systems and explain their impact on patient health information.Chapter 8 Organizing Information Technology Services Privacy is an individuals constitutional right to be left alone, to be free from unwarranted publicity, and to conduct his or her life without its being made public. In the health care environment, privacy is an individuals right to limit access to his or her health care information. In spite of this constitutional protection and other legislated protections discussed in this chapter, approximately 112 million Americans (a third of the United States population) were affected by breaches of protected health information (PHI) in 2015 (Koch, 2016). Three large insurance-related corporations accounted for nearly one hundred million records being exposed (Koch, 2016). In one well-publicized security breach at Banner Health, where hackers gained entrance through food and beverage computers, approximately 3.7 million individuals information was accessed, much of it health information (Goedert, 2016). Health information privacy and security are key topics for health care administrators. In todays ever-increasing electronic world, where the Internet of Things is on the horizon and nearly every health care organization employee and visitor has a smart mobile device that is connected to at least one network, new and more virulent threats are an everyday concern. In this chapter we will examine and define the concepts of privacy, confidentiality, and security as they apply to health information. Major legislative efforts, historic and current, to protect health care information are outlined, with a focus on the Health Insurance Portability and Accountability Act (HIPAA) Privacy, Security, and Breach Notification rules. Different types of threats, intentional and unintentional, to health information will be discussed. Basic requirements for a strong health care organization security program will be outlined, and the chapter will conclude with the Chapter 7 Assessing and Achieving Value in Health Care Information Systems Virtually all the discussion in this book focuses on the knowledge and management processes necessary to achieve one fundamental objective: organizational investments in IT resulting in a desired value. That value might be the furtherance of organizational strategies, improvement in the performance of core processes, or the enhancement of decision making. Achieving value requires the alignment of IT with overall strategies, thoughtful governance, solid information system selection and implementation approaches, and effective organizational change. Failure to achieve desired value can result in significant problems for the organization. Money is wasted. Execution of strategies is hamstrung. Organizational processes can be damaged. This chapter carries the IT value discussion further. Specifically, it covers the following topics: The definition of IT-enabled value The IT project proposal Ensuring the delivery of value Analyses of the IT value challenge Definition of IT-Enabled Value We can make several observations about IT-enabled value: IT value can be tangible and intangible. IT value can be significant. IT value can be variable across organizations. IT value can be diverse across IT proposals. A single IT investment can have a diverse value proposition. Different IT investments have different objectives and hence different value propositions and value assessment techniques. These observations will be discussed in more detail in the following sections. Tangible and Intangible Tangible value can be measured whereas intangible value is very difficult, perhaps practically impossible, to measure. Some tangible value can be measured in terms of dollars: Increases in revenue Reductions in labor costs: for example, through staff layoffs, overtime reductions, or shifting work to less expensive staff members Reductions in supply costs: for example, Editorial Evaluation research studies essential to ensuring health information systems meet the needs of users, including patients Joanne Callen, BA, DipEd, MPH(Research), PhD 1 Abstract Electronic health records and the Internet will continue to transform how information is accessed and shared. Users of health data such as health professionals, governments, policymakers, researchers and patients themselves need to be able to access the right information at the right time and be confident in the quality of that information, whether personal, aggregated or knowledge based. It is essential to evaluate information systems and applications that claim to improve infor- mation quality and access in order to provide evidence that they support healthcare delivery and improve patient outcomes. Keywords (MeSH) access to information; data quality; electronic medical records; evaluation research; health information management; health information systems; Internet; patient access to records; personal electronic health records Editorial I am pleased to advise that beginning with this Issue, the Health Information Management Journal (HIMJ) will have a new publisher, SAGE Publishing Ltd (SAGE). Previously our research journal was published ‘in house’ by the Health Information Management Association of Australia (HIMAA). This suited our needs as evidenced by the increasing quality of the journal content and our ability to obtain an impact factor in 2009. Recently, it became appar- ent that for HIMJ to maintain its position among peer- reviewed journals and to develop it further, it was essential to move to an external publisher. The scientific publishing environment is changing rapidly, becoming highly compet- itive and complex. After negotiations with a number of potential publishers, HIMAA signed a 5-year contract with SAGE. Ownership and copyright of HIMJ will be retained by HIMAA, and the Editorial Board of HIMJ will retain full editorial independence. The benefits for HIMJ will be evident in the production service, including online submis- sion and tracking of papers, an increase in reach, visibility and profile, and an upgraded web page. SAGE is an inde- pendent company that, by its own constitution, cannot be subject to merger or acquisition and this guarantees stabi- lity in our partnership. I believe this is an exciting time for HIMJ. I look forward to our collaboration with SAGE and am confident it will ensure that HIMJ will continue to advance in terms of the quality and reach of published papers related to the management of health information. Users of health data such as health professionals, patients, governments, policymakers and researchers need to be confident in the quality of the information being accessed. Are the data reliable? The Canadian Institute for Health Information (2009) proposed five key dimensions of data quality: accuracy (how well information in or derived from the data holding reflects the 24 D A T A B A S E T R E N D S A N D A P P L I C A T I O N S TRENDS OCTOBER/NOVEMBER 2016 DATA GOVERNANCE is sometimes viewed as a roadblock that keeps data scientists and analysts from turning data into business insights quickly and efficiently. Yet, it’s often a lack of sound data governance that prevents organizations from realiz- ing the full value of their data. Data governance deals with such ques- tions as the origins, or lineage, of data; who can access data and what they can do with it; how data is categorized; and the quality and completeness of data. Here are five ways that a modern approach to data governance can make your data scientists and analysts more productive, enabling your business leaders to gain insights more quickly. Good business metadata is good for the business. Effectively gov- erned metadata—that’s data that labels or categorizes other data—facilitates the dis- covery process for data scientists, helping them find the data they need, when they need it. Tagging and cataloging data at the time of ingestion will help your organiza- tion keep its data lake clean while giving your data scientists a better understanding of what’s available to them. Effective schema management saves time and money, especially in a big data environment. Schemas define how data should be read. It’s essential that data consumers know which schema to use when looking at particular files. Yet managing schemas can be difficult, par- ticularly in a big data environment. Pro- grammatic technical and business schema discovery eases the problem. When a new dataset is ingested into a data lake, an open source tool can help you determine the schema automatically, and, in a mature environment, match the newly discovered data to existing business meta- data, providing you with both the business and technical metadata immediately. Pub- lishing, curating, and governing all known schemas will save your data scientists and analysts considerable time, freeing them to focus on their primary roles. Good data quality and profiling can accelerate time to insight. Poor data quality is among the key reasons that 40\% of business initiatives fail to achieve targeted benefits, according to a report by Gartner Inc., which also notes that data quality affects overall labor productivity by as much as 20\%. Developing a sound architecture and effective data quality protocols will help you keep your data lake from becoming a data swamp. Establishing data-usage agreements between producers and con- sumers of data will also prove helpful, as these agreements give everyone a better idea of the level of data quality expected and how it will be documented. Profiling data and storing the profiles with meta- data is also a useful practice, giving your data scientists a better understanding of the types of data contained in the system and allowing them to formulate hypothe- ses more quickly. Data lineage can helpAchieving the Promise of DigitaAchieving the Promise of Digital Health Information Systems Gary L. Kreps Author information Article notes Copyright and License information Disclaimer This article has been cited by other articles in PMC. Go to: The failed promise of digital health information dissemination Many pundits, including me, proclaimed the advent of an era of digital health where health information systems would transform the delivery of health care and the promotion of public health. 1-3 Digital health prophets described how health information systems would provide consumers and providers with relevant, timely, and influential health information to address challenging health issues and enhance health outcomes. However, the enthusiastic predictions about the amazing contributions of digital health programs for promoting public health has not reached fruition and the great promise of health information systems has resulted in limited returns. 4 There is a long way to go for digital health information systems to reach their incredible potential. Go to: https://pubmed.ncbi.nlm.nih.gov/?term=Kreps\%20GL\%5BAuthor\%5D https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274501/# https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274501/# https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274501/# https://www.ncbi.nlm.nih.gov/pmc/about/disclaimer/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274501/citedby/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274501/# https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274501/#ref1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274501/#ref4 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274501/# Digital media and the dissemination of relevant health information Timely, accurate, and appropriate health information is the most influential resource for guiding important health decisions. 5 Consumers and providers depend on access to relevant health information to increase their understanding about complex health risks, problems, and interventions, to guide accurate diagnoses, to identify and respond to serious health risks, and to select the best health promotion interventions. Health care issuP E R S P E C T I V E 815 From AIDS to Opioids — How to Combat an Epidemic n engl j med 375;9 nejm.org September 1, 2016 grams or vouchers (covering MAT medications and the overdose- reversal agent naloxone), perhaps as a new mechanism under the Substance Abuse Prevention and Treatment Block Grant program or Medicaid demonstration waiv- ers, could provide access for many people with OUD, even in states that haven’t expanded Medicaid under the ACA. Although the mental health parity law of 2008 requires most managed-Medicaid and private insurance plans that cover substance-abuse treatment to do so at the same level as other medical care, violations abound.5 Despite the requirement that sub- stance-abuse treatment be consid- ered an essential health benefit, and despite the fact that the Na- tional Institute on Drug Abuse deems MAT the first-line treatment for OUD, the Centers for Medi- care and Medicaid Services has not yet made methadone or bupre- norphine maintenance treatment for OUD a mandated benefit. Finally, another innovation of the response to AIDS was the creation of the Office of AIDS Research within the National In- stitutes of Health (NIH) to coor- dinate HIV–AIDS research efforts across institutes and programs. Such an office overseeing a na- tional strategy for addressing the opioid epidemic could be devel- oped and housed within the NIH or an appropriate division of the Department of Health and Hu- man Services; it could emphasize that OUD is a chronic medical disorder, as Surgeon General Vivek Murthy has insisted, that should be managed according to stan- dards analogous to those for other chronic disorders. The scope of reform needed to respond appropriately to this epi- demic is daunting. The response to AIDS, however, established a precedent for expanding access to lifesaving medications and sup- porting clinicians in implement- ing evidence-based treatment in marginalized populations. Current federal and state efforts have largely fallen short in addressing the opioid epidemic, as witnessed by ever-increasing mortality. We believe that federal funding should be used to promote new and ef- fective models that provide patients with evidence-based treatment rather than supporting outdated treatment programs that are un- willing or unable to evolve. Disclosure forms provided by the authors are available at NEJM.org. From the Division on Substance Abuse, Columbia University Department of Psychia- try, New York State Psychiatric Institute, New York. 1. Nosyk B, Anglin MD, Brissette S, et al. A call for evidence-based medical treatment of opioid dependence in the United States and Canada. Health Aff (Millwood) 2013; 32: 1462-9. 2. Buck JA. The looming expansion and transformation of public substance abuse treatment under the Affordable Care Act. Health Aff (Millwood) 2011; 30: 1402-10. 3. Sigmon SC. The untapped potential of office-based buprenorphine treatment. JAEMPIRICAL RESEARCH Understanding champion behaviour in a health- care information system development project – how multiple champions and champion behaviours build a coherent whole Joeri van Laere1 and Lena Aggestam2 1School of informatics, University of Skövde, Skövde, Sweden; 2School of Business, University of Skövde, Skövde, Sweden Correspondence: Joeri van Laere, School of informatics, University of Skövde, P.O. Box 408, SE-54128 Skövde, Sweden. Tel: +46-70-5594895; Fax: +46-500-448849; E-mail: [email protected] Received: 18 April 2013 Revised: 14 May 2014 2nd Revision: 10 December 2014 Accepted: 09 February 2015 Abstract Champions are commonly suggested as a means of promoting the adoption of information systems. Since there are many different definitions of the concepts of champion and champion behaviour in the literature, practitioners and researchers may be confused about how to exactly use these concepts. A qualitative analysis of a single case study in a Swedish health-care organisation enabled us to explain how different champion behaviours relate to each other and how multiple champions interact. Combining our rich case observations with an analysis of champion literature reveals how champion behaviours form a coherent and meaningful whole in which networks of different types of champions at different levels in an organisation utilise their network of relations, their knowledge of the organisation and their insight into strategic decision- making politics to time and orchestrate the framing of innovations and the involvement of the right people. In conclusion, championing is a complex performance of contextually dependent collective social interaction, varying over time, rather than a heroic act of one individual promoting an idea. Future studies need to focus more on how the relations between different champions and their behaviours develop across innovations and over time, in order to develop a richer understanding of championing. European Journal of Information Systems (2016) 25(1), 47–63. doi:10.1057/ejis.2015.5; published online 28 April 2015 Keywords: champions; champion behaviours; information system development; organisa- tional change; health-care informatics Introduction Since 1963, studies of both product and process innovations have identified and confirmed the role of influential individuals associated with the success of a technological innovation, so-called champions of innovation (Schön, 1963; Chakrabarti, 1974; Maidique, 1980; Howell & Higgins, 1990). Several studies have specifically focused on the adoption of Information Systems (IS) as a type of innovation (Curley & Gremillion, 1983; Howell & Higgins, 1990; Beath, 1991; Heng et al, 1999), confirming that lessons learned from champion literature in general also hold for champions influencing IS adoption. Even in health-care, the context of our case study, it has been shown how champions contribute to a change of work practices (Soo et al, 2009) or IS adoptio