scholarly journals Wearable Health Technology and Electronic Health Record Integration: Scoping Review and Future Directions (Preprint)

2018 ◽  
Author(s):  
Catherine Dinh-Le ◽  
Rachel Chuang ◽  
Sara Chokshi ◽  
Devin Mann
Keyword(s):  
Health Systems ◽  
Meaningful Use ◽  
Health Technology ◽  
Patient Data ◽  
Insurance Companies ◽  
Publication Date ◽  
Patient Privacy ◽  
Patient Portals ◽  
Start Up ◽  
Electronic Health

BACKGROUND Due to the adoption of electronic health records (EHRs) and legislation on meaningful use in recent decades, health systems are increasingly interdependent on EHR capabilities, offerings, and innovations to better capture patient data. A novel capability offered by health systems encompasses the integration between EHRs and wearable health technology. Although wearables have the potential to transform patient care, issues such as concerns with patient privacy, system interoperability, and patient data overload pose a challenge to the adoption of wearables by providers. OBJECTIVE This study aimed to review the landscape of wearable health technology and data integration to provider EHRs, specifically Epic, because of its prevalence among health systems. The objectives of the study were to (1) identify the current innovations and new directions in the field across start-ups, health systems, and insurance companies and (2) understand the associated challenges to inform future wearable health technology projects at other health organizations. METHODS We used a scoping process to survey existing efforts through Epic’s Web-based hub and discussion forum, UserWeb, and on the general Web, PubMed, and Google Scholar. We contacted Epic, because of their position as the largest commercial EHR system, for information on published client work in the integration of patient-collected data. Results from our searches had to meet criteria such as publication date and matching relevant search terms. RESULTS Numerous health institutions have started to integrate device data into patient portals. We identified the following 10 start-up organizations that have developed, or are in the process of developing, technology to enhance wearable health technology and enable EHR integration for health systems: Overlap, Royal Philips, Vivify Health, Validic, Doximity Dialer, Xealth, Redox, Conversa, Human API, and Glooko. We reported sample start-up partnerships with a total of 16 health systems in addressing challenges of the meaningful use of device data and streamlining provider workflows. We also found 4 insurance companies that encourage the growth and uptake of wearables through health tracking and incentive programs: Oscar Health, United Healthcare, Humana, and John Hancock. CONCLUSIONS The future design and development of digital technology in this space will rely on continued analysis of best practices, pain points, and potential solutions to mitigate existing challenges. Although this study does not provide a full comprehensive catalog of all wearable health technology initiatives, it is representative of trends and implications for the integration of patient data into the EHR. Our work serves as an initial foundation to provide resources on implementation and workflows around wearable health technology for organizations across the health care industry.

scholarly journals Wearable Health Technology and Electronic Health Record Integration: Scoping Review and Future Directions

10.2196/12861 ◽  
2019 ◽  
Vol 7 (9) ◽  
pp. e12861 ◽  
Author(s):  
Catherine Dinh-Le ◽  
Rachel Chuang ◽  
Sara Chokshi ◽  
Devin Mann
Keyword(s):  
Health Systems ◽  
Meaningful Use ◽  
Health Technology ◽  
Patient Data ◽  
Insurance Companies ◽  
Publication Date ◽  
Patient Privacy ◽  
Patient Portals ◽  
Start Up ◽  
Electronic Health

Background Due to the adoption of electronic health records (EHRs) and legislation on meaningful use in recent decades, health systems are increasingly interdependent on EHR capabilities, offerings, and innovations to better capture patient data. A novel capability offered by health systems encompasses the integration between EHRs and wearable health technology. Although wearables have the potential to transform patient care, issues such as concerns with patient privacy, system interoperability, and patient data overload pose a challenge to the adoption of wearables by providers. Objective This study aimed to review the landscape of wearable health technology and data integration to provider EHRs, specifically Epic, because of its prevalence among health systems. The objectives of the study were to (1) identify the current innovations and new directions in the field across start-ups, health systems, and insurance companies and (2) understand the associated challenges to inform future wearable health technology projects at other health organizations. Methods We used a scoping process to survey existing efforts through Epic’s Web-based hub and discussion forum, UserWeb, and on the general Web, PubMed, and Google Scholar. We contacted Epic, because of their position as the largest commercial EHR system, for information on published client work in the integration of patient-collected data. Results from our searches had to meet criteria such as publication date and matching relevant search terms. Results Numerous health institutions have started to integrate device data into patient portals. We identified the following 10 start-up organizations that have developed, or are in the process of developing, technology to enhance wearable health technology and enable EHR integration for health systems: Overlap, Royal Philips, Vivify Health, Validic, Doximity Dialer, Xealth, Redox, Conversa, Human API, and Glooko. We reported sample start-up partnerships with a total of 16 health systems in addressing challenges of the meaningful use of device data and streamlining provider workflows. We also found 4 insurance companies that encourage the growth and uptake of wearables through health tracking and incentive programs: Oscar Health, United Healthcare, Humana, and John Hancock. Conclusions The future design and development of digital technology in this space will rely on continued analysis of best practices, pain points, and potential solutions to mitigate existing challenges. Although this study does not provide a full comprehensive catalog of all wearable health technology initiatives, it is representative of trends and implications for the integration of patient data into the EHR. Our work serves as an initial foundation to provide resources on implementation and workflows around wearable health technology for organizations across the health care industry.

scholarly journals Patient portal utilization: before and after stage 2 electronic health record meaningful use

2019 ◽  
Vol 26 (10) ◽  
pp. 960-967 ◽  
Author(s):  
Kea Turner ◽  
Young-Rock Hong ◽  
Sandhya Yadav ◽  
Jinhai Huo ◽  
Arch G Mainous
Keyword(s):  
Meaningful Use ◽  
Patient Portal ◽  
Patient Portals ◽  
Cross Sectional ◽  
Before And After ◽  
Health Care Policies ◽  
Race Ethnicity ◽  
Electronic Health ◽  
Independent Effects ◽  
Sectional Analysis

Abstract Objective Patient portal functionalities, such as patient–physician e-communication, can benefit patients by improving clinical outcomes. Utilization has historically been low but may have increased in recent years due to the implementation of Stage 2 Meaningful Use for electronic health records. This study has 2 objectives: 1) to compare patient portal utilization rates before Stage 2 (2011–2013) and after Stage 2 (2014–2017), and 2) to examine whether disparities in patient portal utilization attenuate after Stage 2. Materials and Methods We conducted an observational study using a pooled cross-sectional analysis of 2011–2017 National Health Interview Survey data (n = 254 183). Results The mean percent use of patient portals significantly increased from the pre-Stage 2 to the post-Stage 2 period (6.9%, 95% CI, 6.2–7.5; P < .001). Non-Hispanic Black individuals (OR 0.81, 95% CI, 0.76–0.86; P < .0001) and Hispanic individuals (OR 0.79, 95% CI, 0.74–0.84; P < .0001) have lower odds of using patient portals compared to non-Hispanic White individuals. Although we found independent effects of race/ethnicity, we did not find a statistically significant interaction between race/ethnicity and time. We found a similar level of increase in patient portal utilization from the pre- to postperiod across racial and ethnic groups. Discussion Health care policies such as Stage 2 Meaningful Use are likely contributing to increased patient portal utilization across all patients and helping to attenuate disparities in utilization between subgroups of patients. Conclusion Further research is needed to explore which patient portal functionalities are perceived as most beneficial to patients and whether patients have access to those functionalities.

scholarly journals Using social knowledge networking technology to enable meaningful use of electronic health record technology in hospitals and health systems

2014 ◽  
Vol 3 (6) ◽  
pp. 66
Author(s):  
Pavani Rangachari
Keyword(s):  
Information And Communication Technologies ◽  
Health Systems ◽  
Technology Use ◽  
Meaningful Use ◽  
Social Structures ◽  
Social Knowledge ◽  
Successful Implementation ◽  
Electronic Health ◽  
Practice Framework ◽  
Knowledge In Practice

Despite the federal policy momentum towards “meaningful use” of Electronic Health Records (EHRs), the healthcare organizational literature remains replete with reports of unintended adverse consequences of implementing EHRs, including: increased work for clinicians, unfavorable workflow changes, and unexpected changes in communication patterns & practices. In addition to being costly and unsafe, these unintended adverse consequences may pose a formidable barrier to “meaningful use” of EHRs. Correspondingly, it is essential for hospital administrators to understand and detect the causes of unintended adverse consequences, to ensure successful implementation of EHRs. The longstanding Technology-in-Practice framework emphasizes the role of human agency in enacting structures of technology use or “technologies-in-practice”. Given a set of unintended adverse consequences from health information technology implementation, this framework could help trace them back to specific actions (types of technology-in-practice) and institutional conditions (social structures). On the other hand, the more recent Knowledge-in-Practice framework helps understand how information and communication technologies (e.g., social knowledge networking systems) could be implemented alongside existing technology systems, to create new social structures, generate new knowledge-in-practice, and transform technology-in-practice. Therefore, integrating the two literature streams could serve the dual purpose of understanding and overcoming unintended adverse consequences of EHR implementation. This paper seeks to: (1) review the theoretical literatures on technology use & implementation, and identify a framework for understanding & overcoming unintended adverse consequences of implementing EHRs; (2) outline a broad project proposal to test the applicability of the framework in enabling “meaningful use” of EHRs in a healthcare context; and (3) identify strategies for successful implementation of EHRs in hospitals & health systems, based on the literature review and application.

scholarly journals Meaningful use in the safety net: a rapid ethnography of patient portal implementation at five community health centers in California

2017 ◽  
Vol 24 (5) ◽  
pp. 903-912 ◽  
Author(s):  
Sara L Ackerman ◽  
Urmimala Sarkar ◽  
Lina Tieu ◽  
Margaret A Handley ◽  
Dean Schillinger ◽  
...  
Keyword(s):  
Health Care ◽  
Health Systems ◽  
Low Income ◽  
Community Health Centers ◽  
Health Care Systems ◽  
Meaningful Use ◽  
Safety Net ◽  
Patient Portal ◽  
Patient Portals ◽  
Staff Support

Abstract Objective:US health care institutions are implementing secure websites (patient portals) to achieve federal Meaningful Use (MU) certification. We sought to understand efforts to implement portals in “safety net” health care systems that provide services for low-income populations. Materials and Methods:Our rapid ethnography involved visits at 4 California safety net health systems and in-depth interviews at a fifth. Visits included interviews with clinicians and executives (n = 12), informal focus groups with front-line staff (n = 35), observations of patient portal sign-up procedures and clinic work, review of marketing materials and portal use data, and a brief survey (n = 45). Results:Our findings demonstrate that the health systems devoted considerable effort to enlisting staff support for portal adoption and integrating portal-related work into clinic routines. Although all health systems had achieved, or were close to achieving, MU benchmarks, patients faced numerous barriers to portal use and our participants were uncertain how to achieve and sustain “meaningful use” as defined by and for their patients. Discussion:Health systems’ efforts to achieve MU certification united clinic staff under a shared ethos of improved quality of care. However, MU’s assumptions about patients’ demand for electronic access to health information and ability to make use of it directed clinics’ attention to enrollment and message routing rather than to the relevance and usability of a tool that is minimally adaptable to the safety net context. Conclusion:We found a mismatch between MU-based metrics of patient engagement and the priorities and needs of safety net patient populations.

A National Study of Challenges to Electronic Health Record Adoption and Meaningful Use

Medical Care ◽  
2014 ◽  
Vol 52 (2) ◽  
pp. 144-148 ◽  
Author(s):  
Dawn Heisey-Grove ◽  
Lisa-Nicole Danehy ◽  
Michelle Consolazio ◽  
Kimberly Lynch ◽  
Farzad Mostashari
Keyword(s):  
Electronic Health Record ◽  
Meaningful Use ◽  
National Study ◽  
Health Record ◽  
Electronic Health
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