Preconception Care in the Veterans Health Administration.

Preconception care (PCC), defined as a set of interventions to help women optimize their health and well-being prior to pregnancy, can improve pregnancy outcomes and is recommended by national organizations including the Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists. Women Veterans who use the Department of Veterans Affairs (VA) health care system may face elevated risks of adverse pregnancy and birth outcomes due to a high prevalence of chronic medical and mental health conditions as well as psychosocial stressors including sexual trauma history and intimate partner violence. Many women Veterans of childbearing age experience poverty and homelessness, which are key social determinants of poor reproductive health outcomes.

The future state of clinical data capture and documentation: a report from AMIA's 2011 Policy Meeting.

Much of what is currently documented in the electronic health record is in response toincreasingly complex and prescriptive medicolegal, reimbursement, and regulatory requirements. These requirements often result in redundant data capture and cumbersome documentation processes. AMIA's 2011 Health Policy Meeting examined key issues in this arena and envisioned changes to help move toward an ideal future state of clinical data capture and documentation.

The future of health IT innovation and informatics: a report from AMIA's 2010 policy meeting.

While much attention has been paid to the short-term impact that widespread adoption of health information technology (health IT) will have on the healthcare system, there is a corresponding need to look at the long-term effects that extant policies may have on health IT system resilience, innovation, and related ethical, social/legal issues. The American Medical Informatics Association's 2010 Health Policy Conference was convened to further the national discourse on the issues surrounding these longer-term considerations. Conference participants self-selected into three broad categories: resilience in healthcare and health IT; ethical, legal, and social challenges; and innovation, adoption, and sustainability.

Policy brief on the current status of certification of electronic Health Records in the US and Europe.

If Electronic Health Record systems are to provide an effective contribution to healthcare, a set of benchmarks need to be set to ensure quality control and interoperability of systems. This paper outlines the prevailing status of EHR certification in the US and the EU, compares and contrasts established schemes and poses opportunities for convergence of activity in the domain designed to advance certification endeavours generally. Several EU Member States have in the past proceeded with EHR systems quality labeling and/or certification, but these differ in scope, in legal framework under which they operate, in policies (legislation and financial incentives), in organization, and perhaps most importantly in the quality criteria used for benchmarking.

Evaluating healthcare information technology outside of academia: observations from the national resource center for healthcare information technology at the Agency for Healthcare Research and Quality.

The National Resource Center for Health Information Technology (NRC) was formed in the fall of 2004 as part of the Agency for Healthcare Research and Quality (AHRQ) health IT portfolio to support its grantees. One of the core functions of the NRC was to assist grantees in their evaluation efforts of Health IT. This manuscript highlights some common challenges experienced by health IT project teams at nonacademic institutions, including inappropriately scoped and resourced evaluation efforts, inappropriate choice of metrics, inadequate planning for data collection and analysis, and lack of consideration of qualitative methodologies.

Web-based tools from AHRQ's National Resource Center.

The Agency for Healthcare Research and Quality (AHRQ) has made an investment of over $216 million in research around health information technology (health IT). As part of their investment, AHRQ has developed the National Resource Center for Health IT (NRC) which includes a public domain Web site. New content for the web site, such as white papers, toolkits, lessons from the health IT portfolio and web-based tools, is developed as needs are identified.

A new taxonomy for telehealth technologies.

Today, the field of telehealth lacks a comprehensive taxonomy that reflects the variety of remote interactions, technologies used, and personnel involved. The Center for Information Technology Leadership (CITL) has created a taxonomy that categorizes telehealth around four factors: type of telehealth interaction, location of the controlling medical authority, urgency of care, and timing of communication. This comprehensive taxonomy may help to define the field of telehealth and may help with adoption, research, and reimbursement.

Cost of interconnecting health information exchanges to form a national network.

Despite the demonstrated need for a national health information network (NHIN), there has been little progress in turning this need into reality beyond limited local demonstrations. One barrier is the lack of information evaluating the potential costs of connecting these local networks to form a national network. The Center for Information Technology Leadership (CITL), in conjunction with national experts, developed assumptions around the components needed to develop the NHIN.

The value of provider-to-provider telehealth.

Telehealth has great potential to improve access to care, but its adoption in routine healthcare has been slow. The lack of clarity about the value of telehealth implementations has been one reason cited for this slow adoption. The Center for Information Technology Leadership has examined the value of telehealth encounters in which there is a provider both with the patient and at a distance from the patient.

The value proposition in the widespread use of telehealth.

Telehealth has great potential to improve access to care but its adoption in routine health care has been slow. The lack of clarity about the value of telehealth implementations has been one reason cited for this slow adoption. The Center for Information Technology Leadership has examined the value of telehealth encounters in which there is a provider both with the patient and at a distance from the patient.

Electronic health records and electronic prescribing: promise and pitfalls.

Health information technology (health IT), especially technology related to electronic health records (EHRs) and electronic prescription (e-prescribing) systems, is believed to be the cornerstone for improvements in quality of care, patient safety, and efficiencies, all leading to cost benefits. With increasing requirements for quality reporting and with new pay-for-performance programs being initiated by insurers, many physicians are asking if it is time to invest in health IT. However, as those who have already made this decision have found, adopting EHRs and e-prescribing systems is not an easy task: Our colleagues resist their use, they are costly, the case for a return on investment for an ambulatory practice has not been well established, incentives to use are misaligned, implementations may be difficult, and often such systems disrupt or inhibit workflow.

Formative evaluation: a critical component in EHR implementation.

This Viewpoint paper has grown out of a presentation at the American College of Medical Informatics 2007 Winter Symposium, the resulting discussion, and several activities that have coalesced around an issue that most informaticians accept as true but is not commonly considered during the implementation of Electronic Health Records (EHR) outside of academia or research institutions. Successful EHR implementation is facilitated and sometimes determined by formative evaluation, usually focusing on process rather than outcomes. With greater federal funding for the implementation of electronic health record systems in health care organizations unfamiliar with research protocols, the need for formative evaluation assistance is growing.

Benefits of information technology-enabled diabetes management.

Objective: To determine the financial and clinical benefits of implementing information technology (IT)-enabled disease management systems.

Research Design And Methods: A computer model was created to project the impact of IT-enabled disease management on care processes, clinical outcomes, and medical costs for patients with type 2 diabetes aged >25 years in the U.S.