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This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.
Health Information Exchange: Navigating and Managing a Network of Health Information Systems, Second Edition, now fully updated, is a practical guide on how to understand, manage and make use of a health information exchange infrastructure, which moves patient-centered information within the health care system. The book informs and guides the development of new infrastructures as well as the management of existing and expanding infrastructures across the globe. Sections explore the reasons for the health information exchange (HIE) infrastructures, how to manage them, examines the key drivers of HIE, and barriers to their widespread use. In addition, the book explains the underlying technologies and methods for conducting HIE across communities as well as nations. Finally, the book explains the principles of governing an organization that chiefly moves protected health information around. The text unravels the complexities of HIE and provides guidance for those who need to access HIE data and support operations. - Encompasses comprehensive knowledge on the technology and governance of health information exchanges (HIEs) - Presents business school style case studies that explore why a given HIE has or hasn't been successful - Discusses the kinds of data and practical examples of the infrastructure required to exchange clinical data to support modern medicine in a world of disparate EHR systems
Commissioned by the Department of Health and Human Services, Key Capabilities of an Electronic Health Record System provides guidance on the most significant care delivery-related capabilities of electronic health record (EHR) systems. There is a great deal of interest in both the public and private sectors in encouraging all health care providers to migrate from paper-based health records to a system that stores health information electronically and employs computer-aided decision support systems. In part, this interest is due to a growing recognition that a stronger information technology infrastructure is integral to addressing national concerns such as the need to improve the safety and the quality of health care, rising health care costs, and matters of homeland security related to the health sector. Key Capabilities of an Electronic Health Record System provides a set of basic functionalities that an EHR system must employ to promote patient safety, including detailed patient data (e.g., diagnoses, allergies, laboratory results), as well as decision-support capabilities (e.g., the ability to alert providers to potential drug-drug interactions). The book examines care delivery functions, such as database management and the use of health care data standards to better advance the safety, quality, and efficiency of health care in the United States.
Determinants of health - like physical activity levels and living conditions - have traditionally been the concern of public health and have not been linked closely to clinical practice. However, if standardized social and behavioral data can be incorporated into patient electronic health records (EHRs), those data can provide crucial information about factors that influence health and the effectiveness of treatment. Such information is useful for diagnosis, treatment choices, policy, health care system design, and innovations to improve health outcomes and reduce health care costs. Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2 identifies domains and measures that capture the social determinants of health to inform the development of recommendations for the meaningful use of EHRs. This report is the second part of a two-part study. The Phase 1 report identified 17 domains for inclusion in EHRs. This report pinpoints 12 measures related to 11 of the initial domains and considers the implications of incorporating them into all EHRs. This book includes three chapters from the Phase 1 report in addition to the new Phase 2 material. Standardized use of EHRs that include social and behavioral domains could provide better patient care, improve population health, and enable more informative research. The recommendations of Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2 will provide valuable information on which to base problem identification, clinical diagnoses, patient treatment, outcomes assessment, and population health measurement.
Global Health Informatics: How Information Technology Can Change Our Lives in a Globalized World discusses the critical role of information and communication technologies in health practice, health systems management and research in increasingly interconnected societies. In a global interconnected world the old standalone institutional information systems have proved to be inadequate for patient-centered care provided by multiple providers, for the early detection and response to emerging and re-emerging diseases, and to guide population-oriented public health interventions. The book reviews pertinent aspects and successful current experiences related to standards for health information systems; digital systems as a support for decision making, diagnosis and therapy; professional and client education and training; health systems operation; and intergovernmental collaboration. - Discusses how standalone systems can compromise health care in globalized world - Provides information on how information and communication technologies (ICT) can support diagnose, treatment, and prevention of emerging and re-emerging diseases - Presents case studies about integrated information and how and why to share data can facilitate governance and strategies to improve life conditions
The data warehousing bible updated for the new millennium Updated and expanded to reflect the many technological advances occurring since the previous edition, this latest edition of the data warehousing "bible" provides a comprehensive introduction to building data marts, operational data stores, the Corporate Information Factory, exploration warehouses, and Web-enabled warehouses. Written by the father of the data warehouse concept, the book also reviews the unique requirements for supporting e-business and explores various ways in which the traditional data warehouse can be integrated with new technologies to provide enhanced customer service, sales, and support-both online and offline-including near-line data storage techniques.
With at least 40% new or updated content since the last edition, Clinical Decision Support, 2nd Edition explores the crucial new motivating factors poised to accelerate Clinical Decision Support (CDS) adoption. This book is mostly focused on the US perspective because of initiatives driving EHR adoption, the articulation of 'meaningful use', and new policy attention in process including the Office of the National Coordinator for Health Information Technology (ONC) and the Center for Medicare and Medicaid Services (CMS). A few chapters focus on the broader international perspective. Clinical Decision Support, 2nd Edition explores the technology, sources of knowledge, evolution of successful forms of CDS, and organizational and policy perspectives surrounding CDS. Exploring a roadmap for CDS, with all its efficacy benefits including reduced errors, improved quality, and cost savings, as well as the still substantial roadblocks needed to be overcome by policy-makers, clinicians, and clinical informatics experts, the field is poised anew on the brink of broad adoption. Clinical Decision Support, 2nd Edition provides an updated and pragmatic view of the methodological processes and implementation considerations. This book also considers advanced technologies and architectures, standards, and cooperative activities needed on a societal basis for truly large-scale adoption. At least 40% updated, and seven new chapters since the previous edition, with the new and revised content focused on new opportunities and challenges for clinical decision support at point of care, given changes in science, technology, regulatory policy, and healthcare finance Informs healthcare leaders and planners, health IT system developers, healthcare IT organization leaders and staff, clinical informatics professionals and researchers, and clinicians with an interest in the role of technology in shaping healthcare of the future
This revised edition covers all aspects of public health informatics and discusses the creation and management of an information technology infrastructure that is essential in linking state and local organizations in their efforts to gather data for the surveillance and prevention. Public health officials will have to understand basic principles of information resource management in order to make the appropriate technology choices that will guide the future of their organizations. Public health continues to be at the forefront of modern medicine, given the importance of implementing a population-based health approach and to addressing chronic health conditions. This book provides informatics principles and examples of practice in a public health context. In doing so, it clarifies the ways in which newer information technologies will improve individual and community health status. This book's primary purpose is to consolidate key information and promote a strategic approach to information systems and development, making it a resource for use by faculty and students of public health, as well as the practicing public health professional. Chapter highlights include: The Governmental and Legislative Context of Informatics; Assessing the Value of Information Systems; Ethics, Information Technology, and Public Health; and Privacy, Confidentiality, and Security. Review questions are featured at the end of every chapter. Aside from its use for public health professionals, the book will be used by schools of public health, clinical and public health nurses and students, schools of social work, allied health, and environmental sciences.
In this book the authors explore the state of the art on efficiency measurement in health systems and international experts offer insights into the pitfalls and potential associated with various measurement techniques. The authors show that: - The core idea of efficiency is easy to understand in principle - maximizing valued outputs relative to inputs, but is often difficult to make operational in real-life situations - There have been numerous advances in data collection and availability, as well as innovative methodological approaches that give valuable insights into how efficiently health care is delivered - Our simple analytical framework can facilitate the development and interpretation of efficiency indicators.
This book is a comprehensive text about all aspects of public health informatics and information technology. This books emphasizes the essential role that public health informatics plays in implementing a population-based health approach and to addressing chronic health conditions. This book is intended for public health specialists, nurses, medical informaticians, information technology professionals, and family physicians.