This investigation is in response to the requirement for Strategic Highway Safety Plans (SHSPs), ... more This investigation is in response to the requirement for Strategic Highway Safety Plans (SHSPs), legislated by SAFETEA-LU, to address the need for data systems to allow for evidence-based safety planning. This study evaluates the use of information systems and intelligent transportation systems across the emergency response continuum of care to vehicle crash emergencies. Organizations that participate in the emergency response process often have siloed IT systems and are not able to share data with other agencies and organizations. An integrated system to produce data for real-time decision making and holistic performance and clinical analysis currently does not exist, but has the potential to improve emergency response and patient care. Proposed in this study is an
This document is in the public domain and may be used and reprinted without permission except tho... more This document is in the public domain and may be used and reprinted without permission except those copyrighted materials that are clearly noted in the document. Further reproduction of those copyrighted materials is prohibited without the specific permission of copyright holders. Preface The Enabling Patient-Centered Care Through Health • Improving Quality Through Clinician Use of IT initiative is part of the Agency for Healthcare Health IT (FOA HS-07-006), which supported Research and Quality's (AHRQ's) Ambulatory Safety research related to the development, implemen-and Quality (ASQ) program. The purpose of the tation, and use of health IT to assist clinicians, AHRQ ASQ program is to improve the safety and practices, and systems in improving the quality and quality of ambulatory health care in the United safety of care delivery in ambulatory care settings. States. The program's components, with the excep-• Enabling Patient-Centered Care Through Health tion of the risk ...
The U.S. Department of Veterans Affairs (VA) Veteran Health Information Exchange (VHIE, formerly ... more The U.S. Department of Veterans Affairs (VA) Veteran Health Information Exchange (VHIE, formerly Virtual Lifetime Electronic Record, or VLER) Retail Immunization Coordination Project established a partnership between VA and Walgreens to empower Veterans to elect to receive their immunizations at a local Walgreens, which might be located closer to their home than their nearest VA facility. Analysis of Veterans immunized at Walgreens between September 2014 and January 2015 showed that 64% of study Veterans now traveled <5 miles to receive their immunization, 12% of study Veterans traveled between 5 to 10 miles, and 24% of study Veterans traveled more than 10 miles. In addition, we note that 93% of Veterans traveled less than 54 miles, the average distance rural Veterans traveled to the nearest VA facility. We conclude that the VHIE Retail Immunization Coordination Project improved Veteran access to healthcare and discuss future directions of this effort.
The U.S. Department of Veterans Affairs (VA) Veteran Health Information Exchange (VHIE, formerly ... more The U.S. Department of Veterans Affairs (VA) Veteran Health Information Exchange (VHIE, formerly Virtual Lifetime Electronic Record, or VLER) had been deployed at all VA sites and used to exchange clinical information with private sector healthcare partners nationally. This paper examined VHIE's effect on allergy documentation. Review of all inbound VHIE transactions in FY14 showed that VHIE use was associated with a nearly eight-fold increase in allergy documentation rate. Preliminary manual document review further showed that VA and partners had shared knowledge of only 38% ofpatient allergies, while VA had exclusive knowledge of another 58% ofpatient allergies, and partners had exclusive knowledge of the last 5% of patient allergies. To our knowledge, this is the first study that examined the effect of HIE on allergy documentation.
As part of ongoing data quality efforts authors monitored health information retrieved through th... more As part of ongoing data quality efforts authors monitored health information retrieved through the United States Department of Veterans Affairs' (VA) Virtual Lifetime Electronic Record (VLER) Health operation. Health data exchanged through the eHealth Exchange (managed by Healtheway, Inc.) between VA and external care providers was evaluated in order to test methods of data quality surveillance and to identify key quality concerns. Testing evaluated transition of care data from 20 VLER Health partners. Findings indicated operational monitoring discovers issues not addressed during onboarding testing, that many issues result from specification ambiguity, and that many issues require human review. We make recommendations to address these issues, specifically to embed automated testing tools within information exchange transactions and to continuously monitor and improve data quality, which will facilitate adoption and use.
Abstract Promotion of the development and use of learning objects assists the ongoing evolution o... more Abstract Promotion of the development and use of learning objects assists the ongoing evolution of modern instructional technologies and enrich the efforts and opportunities of distance education theory and research. In order to identify successful training strategies, faculty were recruited from southern California community colleges to receive training in the development and use of online learning materials called learning objects. A learning object is small, single concept, reusable, instructional content that is typically delivered using digital multimedia. Background and Problem Faculty members need training and support in order to teach effectively with technology (Fuller, 2000). They need to know more than merely the technical and administrative aspects of using technology. Faculty training and support must address how technology may be used to enhance student learning and performance; simply introducing software and other technological tools to faculty will not ensure that they are able to use them effectively to help their students learn (McKenzie, 2000). Inadequate faculty expertise in educational technology presents a challenge to building quality distance education programs at community colleges. Faculty need training that provides them with the skills to develop and use pedagogically sound learning materials appropriate for online instruction. Training in learning objects addresses the challenges many online faculty face when converting from face-to-face instruction to online instruction. Instructional materials should be developed as discrete learning objects to serve the needs of faculty members creating online courses. Learning objects are interactive instructional materials or small multimedia or digital modules that can be re-used to support a specific learning objective. Faculty teaching distance education courses need to be able to access instructional materials that teach the specific concepts they have set as objectives for their course (Bratina, Hayes, & Blumsack, 2002; Carnevale, 2001). Instructional resources available on the internet abound. However, many materials are designed at course or unit level, rather than the learning object level and hence lack reusability (Longmire, 2000). To address this need, the California Virtual Campus Region 3 (http://www.cvc3.org/) funded the Learning About Learning Objects Project to train faculty in the development and use of learning objects. During 2003, community college faculty in southern California received instruction on the development of learning objects through their participation in the project. The project was developed and implemented by the San Diego Community College District. The Board of Governors of the California Community Colleges and the Chancellor selected the project to receive the 2002-03 Technology Focus Award. Learning Object Definitions The project used the following definition for learning objects: A learning object is instructional content that is small, reusable, self-contained, durable in multiple contexts, and multimedia or digital modules. It usually involves interactivity and assessment, supports a single learning objective and can be grouped with other learning objects. A learning object is content that can be used to help teach a particular concept (Jacobson, 2002; Longmire, 2000). Interactive elements and/or graphical elements used for learning objects include graphics, navigation schemes, assessments, collaboration tools, games, simulations, problem-solving, case studies, webquests, electronic calculators, animations, tutorials, websites, bibliographies, audio and video clips, photographs, illustrations, diagrams, graphs, maps, and charts (also see Mayer, 2001). One example of learning objects (see AliveTek website http://www.alivetek.com) is a 60 second animated streaming video that explains the difference between social conformity and compliance by asking viewers to engage in specific timed tasks. …
Authors studied the United States (U.S.) Department of Veterans Affairs' (VA) Virtual Lifetim... more Authors studied the United States (U.S.) Department of Veterans Affairs' (VA) Virtual Lifetime Electronic Record (VLER) Health pilot phase relative to two attributes of data quality - the adoption of eHealth Exchange data standards, and clinical content exchanged. The VLER Health pilot was an early effort in testing implementation of eHealth Exchange standards and technology. Testing included evaluation of exchange data from the VLER Health pilot sites partners: VA, U.S. Department of Defense (DoD), and private sector health care organizations. Domains assessed data quality and interoperability as it relates to: 1) conformance with data standards related to the underlying structure of C32 Summary Documents (C32) produced by eHealth Exchange partners; and 2) the types of C32 clinical content exchanged. This analysis identified several standards non-conformance issues in sample C32 files and informed further discourse on the methods needed to effectively monitor Health Information...
The efforts of this research are to educate patients within vulnerable populations in the use of ... more The efforts of this research are to educate patients within vulnerable populations in the use of electronic personal health records so they may better monitor their health, attain desired health goals and manage their health services. Evaluation measures will include facets of self-management of health, patient-physician communication, and assessment of accessibility and usability factors of the personal health record.
International Journal of Medical Informatics, 2014
We describe the Department of Veterans Affairs&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;am... more We describe the Department of Veterans Affairs&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; (VA) Virtual Lifetime Health Electronic Record (VLER) pilot phase in 12 communities to exchange health information with private sector health care organizations and the Department of Defense (DoD), key findings, lessons, and implications for advancing Health Information Exchanges (HIE), nationally. A mixed methods approach was used to monitor and evaluate the status of VLER Health Exchange pilot phase implementation from December 2009 through October 2012. Selected accomplishments, contributions, challenges, and early lessons that are relevant to the growth of nationwide HIE are discussed. Veteran patient and provider acceptance, trust, and perceived value of VLER Health Exchange are found to be high, and usage by providers is steadily growing. Challenges and opportunities to improve provider use are identified, such as better data quality and integration with workflow. Key findings and lessons for advancing HIE are identified. VLER Health Exchange has made great strides in advancing HIE nationally by addressing important technical and policy issues that have impeded scalability, and by increasing trust and confidence in the value and accuracy of HIE among users. VLER Health Exchange has advanced HIE interoperability standards and patient consent policies nationally. Policy, programmatic, technology, and health Information Technology (IT) standards implications to advance HIE for improved delivery and coordination of health care are discussed. The pilot phase success led to VA-wide deployment of this data sharing capability in 2013.
Abstract: Traffic injuries are the number one non-disease related cause of death in the world. It... more Abstract: Traffic injuries are the number one non-disease related cause of death in the world. It has been estimated that throughout the world close to 1.2 million people die each year due to traffic accidents. Outside of the loss and harm to human life, there are also considerable ...
... Benjamin Schooley Nathan Botts Aisha Noamani School of Information Systems and Technology Cla... more ... Benjamin Schooley Nathan Botts Aisha Noamani School of Information Systems and Technology Claremont Graduate University January 2009 Published by ... In 2001, data collected by CODES helped pass Senate Bill 48, Passenger Limitations for Young Drivers. ...
As the field of e-government expands and grows, the number of academic courses, professional work... more As the field of e-government expands and grows, the number of academic courses, professional workshops, online courses, and continuing education opportunities in this field also increases. Due to the interdisciplinary nature of the field, learning and teaching content tends to be pulled from numerous paper and electronic sources. This pilot study explored the potential structure and benefits of an online repository of electronic learning objects for the field of e-government. Design research was used as a methodology to design, implement, and evaluate an online learning object repository within the context of a University e-government course. The pilot project is described, qualitative evaluation findings reported, and implications and future research directions are presented.
This investigation is in response to the requirement for Strategic Highway Safety Plans (SHSPs), ... more This investigation is in response to the requirement for Strategic Highway Safety Plans (SHSPs), legislated by SAFETEA-LU, to address the need for data systems to allow for evidence-based safety planning. This study evaluates the use of information systems and intelligent transportation systems across the emergency response continuum of care to vehicle crash emergencies. Organizations that participate in the emergency response process often have siloed IT systems and are not able to share data with other agencies and organizations. An integrated system to produce data for real-time decision making and holistic performance and clinical analysis currently does not exist, but has the potential to improve emergency response and patient care. Proposed in this study is an
This document is in the public domain and may be used and reprinted without permission except tho... more This document is in the public domain and may be used and reprinted without permission except those copyrighted materials that are clearly noted in the document. Further reproduction of those copyrighted materials is prohibited without the specific permission of copyright holders. Preface The Enabling Patient-Centered Care Through Health • Improving Quality Through Clinician Use of IT initiative is part of the Agency for Healthcare Health IT (FOA HS-07-006), which supported Research and Quality's (AHRQ's) Ambulatory Safety research related to the development, implemen-and Quality (ASQ) program. The purpose of the tation, and use of health IT to assist clinicians, AHRQ ASQ program is to improve the safety and practices, and systems in improving the quality and quality of ambulatory health care in the United safety of care delivery in ambulatory care settings. States. The program's components, with the excep-• Enabling Patient-Centered Care Through Health tion of the risk ...
The U.S. Department of Veterans Affairs (VA) Veteran Health Information Exchange (VHIE, formerly ... more The U.S. Department of Veterans Affairs (VA) Veteran Health Information Exchange (VHIE, formerly Virtual Lifetime Electronic Record, or VLER) Retail Immunization Coordination Project established a partnership between VA and Walgreens to empower Veterans to elect to receive their immunizations at a local Walgreens, which might be located closer to their home than their nearest VA facility. Analysis of Veterans immunized at Walgreens between September 2014 and January 2015 showed that 64% of study Veterans now traveled <5 miles to receive their immunization, 12% of study Veterans traveled between 5 to 10 miles, and 24% of study Veterans traveled more than 10 miles. In addition, we note that 93% of Veterans traveled less than 54 miles, the average distance rural Veterans traveled to the nearest VA facility. We conclude that the VHIE Retail Immunization Coordination Project improved Veteran access to healthcare and discuss future directions of this effort.
The U.S. Department of Veterans Affairs (VA) Veteran Health Information Exchange (VHIE, formerly ... more The U.S. Department of Veterans Affairs (VA) Veteran Health Information Exchange (VHIE, formerly Virtual Lifetime Electronic Record, or VLER) had been deployed at all VA sites and used to exchange clinical information with private sector healthcare partners nationally. This paper examined VHIE's effect on allergy documentation. Review of all inbound VHIE transactions in FY14 showed that VHIE use was associated with a nearly eight-fold increase in allergy documentation rate. Preliminary manual document review further showed that VA and partners had shared knowledge of only 38% ofpatient allergies, while VA had exclusive knowledge of another 58% ofpatient allergies, and partners had exclusive knowledge of the last 5% of patient allergies. To our knowledge, this is the first study that examined the effect of HIE on allergy documentation.
As part of ongoing data quality efforts authors monitored health information retrieved through th... more As part of ongoing data quality efforts authors monitored health information retrieved through the United States Department of Veterans Affairs' (VA) Virtual Lifetime Electronic Record (VLER) Health operation. Health data exchanged through the eHealth Exchange (managed by Healtheway, Inc.) between VA and external care providers was evaluated in order to test methods of data quality surveillance and to identify key quality concerns. Testing evaluated transition of care data from 20 VLER Health partners. Findings indicated operational monitoring discovers issues not addressed during onboarding testing, that many issues result from specification ambiguity, and that many issues require human review. We make recommendations to address these issues, specifically to embed automated testing tools within information exchange transactions and to continuously monitor and improve data quality, which will facilitate adoption and use.
Abstract Promotion of the development and use of learning objects assists the ongoing evolution o... more Abstract Promotion of the development and use of learning objects assists the ongoing evolution of modern instructional technologies and enrich the efforts and opportunities of distance education theory and research. In order to identify successful training strategies, faculty were recruited from southern California community colleges to receive training in the development and use of online learning materials called learning objects. A learning object is small, single concept, reusable, instructional content that is typically delivered using digital multimedia. Background and Problem Faculty members need training and support in order to teach effectively with technology (Fuller, 2000). They need to know more than merely the technical and administrative aspects of using technology. Faculty training and support must address how technology may be used to enhance student learning and performance; simply introducing software and other technological tools to faculty will not ensure that they are able to use them effectively to help their students learn (McKenzie, 2000). Inadequate faculty expertise in educational technology presents a challenge to building quality distance education programs at community colleges. Faculty need training that provides them with the skills to develop and use pedagogically sound learning materials appropriate for online instruction. Training in learning objects addresses the challenges many online faculty face when converting from face-to-face instruction to online instruction. Instructional materials should be developed as discrete learning objects to serve the needs of faculty members creating online courses. Learning objects are interactive instructional materials or small multimedia or digital modules that can be re-used to support a specific learning objective. Faculty teaching distance education courses need to be able to access instructional materials that teach the specific concepts they have set as objectives for their course (Bratina, Hayes, & Blumsack, 2002; Carnevale, 2001). Instructional resources available on the internet abound. However, many materials are designed at course or unit level, rather than the learning object level and hence lack reusability (Longmire, 2000). To address this need, the California Virtual Campus Region 3 (http://www.cvc3.org/) funded the Learning About Learning Objects Project to train faculty in the development and use of learning objects. During 2003, community college faculty in southern California received instruction on the development of learning objects through their participation in the project. The project was developed and implemented by the San Diego Community College District. The Board of Governors of the California Community Colleges and the Chancellor selected the project to receive the 2002-03 Technology Focus Award. Learning Object Definitions The project used the following definition for learning objects: A learning object is instructional content that is small, reusable, self-contained, durable in multiple contexts, and multimedia or digital modules. It usually involves interactivity and assessment, supports a single learning objective and can be grouped with other learning objects. A learning object is content that can be used to help teach a particular concept (Jacobson, 2002; Longmire, 2000). Interactive elements and/or graphical elements used for learning objects include graphics, navigation schemes, assessments, collaboration tools, games, simulations, problem-solving, case studies, webquests, electronic calculators, animations, tutorials, websites, bibliographies, audio and video clips, photographs, illustrations, diagrams, graphs, maps, and charts (also see Mayer, 2001). One example of learning objects (see AliveTek website http://www.alivetek.com) is a 60 second animated streaming video that explains the difference between social conformity and compliance by asking viewers to engage in specific timed tasks. …
Authors studied the United States (U.S.) Department of Veterans Affairs' (VA) Virtual Lifetim... more Authors studied the United States (U.S.) Department of Veterans Affairs' (VA) Virtual Lifetime Electronic Record (VLER) Health pilot phase relative to two attributes of data quality - the adoption of eHealth Exchange data standards, and clinical content exchanged. The VLER Health pilot was an early effort in testing implementation of eHealth Exchange standards and technology. Testing included evaluation of exchange data from the VLER Health pilot sites partners: VA, U.S. Department of Defense (DoD), and private sector health care organizations. Domains assessed data quality and interoperability as it relates to: 1) conformance with data standards related to the underlying structure of C32 Summary Documents (C32) produced by eHealth Exchange partners; and 2) the types of C32 clinical content exchanged. This analysis identified several standards non-conformance issues in sample C32 files and informed further discourse on the methods needed to effectively monitor Health Information...
The efforts of this research are to educate patients within vulnerable populations in the use of ... more The efforts of this research are to educate patients within vulnerable populations in the use of electronic personal health records so they may better monitor their health, attain desired health goals and manage their health services. Evaluation measures will include facets of self-management of health, patient-physician communication, and assessment of accessibility and usability factors of the personal health record.
International Journal of Medical Informatics, 2014
We describe the Department of Veterans Affairs&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;am... more We describe the Department of Veterans Affairs&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; (VA) Virtual Lifetime Health Electronic Record (VLER) pilot phase in 12 communities to exchange health information with private sector health care organizations and the Department of Defense (DoD), key findings, lessons, and implications for advancing Health Information Exchanges (HIE), nationally. A mixed methods approach was used to monitor and evaluate the status of VLER Health Exchange pilot phase implementation from December 2009 through October 2012. Selected accomplishments, contributions, challenges, and early lessons that are relevant to the growth of nationwide HIE are discussed. Veteran patient and provider acceptance, trust, and perceived value of VLER Health Exchange are found to be high, and usage by providers is steadily growing. Challenges and opportunities to improve provider use are identified, such as better data quality and integration with workflow. Key findings and lessons for advancing HIE are identified. VLER Health Exchange has made great strides in advancing HIE nationally by addressing important technical and policy issues that have impeded scalability, and by increasing trust and confidence in the value and accuracy of HIE among users. VLER Health Exchange has advanced HIE interoperability standards and patient consent policies nationally. Policy, programmatic, technology, and health Information Technology (IT) standards implications to advance HIE for improved delivery and coordination of health care are discussed. The pilot phase success led to VA-wide deployment of this data sharing capability in 2013.
Abstract: Traffic injuries are the number one non-disease related cause of death in the world. It... more Abstract: Traffic injuries are the number one non-disease related cause of death in the world. It has been estimated that throughout the world close to 1.2 million people die each year due to traffic accidents. Outside of the loss and harm to human life, there are also considerable ...
... Benjamin Schooley Nathan Botts Aisha Noamani School of Information Systems and Technology Cla... more ... Benjamin Schooley Nathan Botts Aisha Noamani School of Information Systems and Technology Claremont Graduate University January 2009 Published by ... In 2001, data collected by CODES helped pass Senate Bill 48, Passenger Limitations for Young Drivers. ...
As the field of e-government expands and grows, the number of academic courses, professional work... more As the field of e-government expands and grows, the number of academic courses, professional workshops, online courses, and continuing education opportunities in this field also increases. Due to the interdisciplinary nature of the field, learning and teaching content tends to be pulled from numerous paper and electronic sources. This pilot study explored the potential structure and benefits of an online repository of electronic learning objects for the field of e-government. Design research was used as a methodology to design, implement, and evaluate an online learning object repository within the context of a University e-government course. The pilot project is described, qualitative evaluation findings reported, and implications and future research directions are presented.
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