Exploring How Personal, Social, and Institutional Characteristics Contribute to Geriatric Medicine Subspecialty Decisions: A Qualitative Study of Trainees' Perceptions.

Purpose: To explore internal medicine residents' and geriatrics fellows' perceptions of how personal, social, and institutional characteristics contribute to their professional identity and subspecialty decisions related to geriatric medicine.

Method: The authors conducted 23 in-depth, semistructured interviews with internal medicine residents, with and without an interest in geriatrics, and geriatrics fellows across 3 academic medical centers in the United States from October 2018 through June 2019. They then used a qualitative narrative approach to analyze the interview data.

Trust and Privacy: How Patient Trust in Providers is Related to Privacy Behaviors and Attitudes.

Healthcare today requires extensive sharing and access to patient health information. The use of health information technology (health IT) exacerbates patients' privacy concerns because it expands the availability of patient data to numerous members of the healthcare team. Patient concerns about the privacy of their data may be associated with nondisclosure of their information to providers.

Who Isn't Using Patient Portals And Why? Evidence And Implications From A National Sample Of US Adults.

Patient portals that provide secure online access to medical record information and provider communication can improve health care. Yet new technologies can exacerbate existing disparities. We analyzed information about 2,325 insured respondents to the nationally representative 2017 Health Information National Trends Survey to examine characteristics of portal nonusers and reasons for nonuse.

The Catch to Confidentiality: The Use of Electronic Health Records in Adolescent Health Care.

Purpose: This study aims to understand pediatric health-care providers' expectations and the practices they employ to protect confidentiality in electronic health records (EHRs) and subsequently how EHRs affect the documentation and dissemination of information in the course of health-care delivery to adolescent minors.

Methods: Twenty-six pediatric health-care providers participated in in-depth interviews about their experiences using EHRs to understand a broad spectrum of expectations and practices guiding the documentation and dissemination of information in the EHR. A thematic analysis of interviews was conducted to draw findings and conclusions.

Health IT and inappropriate utilization of outpatient imaging: A cross-sectional study of U.S. hospitals.

Objective: To determine whether the use of information technology (IT), measured by Meaningful Use capability, is associated with lower rates of inappropriate utilization of imaging services in hospital outpatient settings.

Research Design: A retrospective cross-sectional analysis of 3332 nonfederal U.S.

Privacy in practice: professional discourse about information control in health care.

Purpose: The purpose of this paper is to explore different health care professionals' discourse about privacy - its definition and importance in health care, and its role in their day-to-day work. Professionals' discourse about privacy reveals how new technologies and laws challenge existing practices of information control within and between professional groups in health care, with implications not only for patient privacy, but also for the role of information control in professions more generally.

Design/methodology/approach: The authors conducted in-depth, semi-structured interviews with n=83 doctors, nurses, and health information professionals in two academic medical centers and one veteran's administration hospital/clinic in the Northeastern USA.

Information technology and hospital patient safety: a cross-sectional study of US acute care hospitals.

Objectives: To determine whether health information technology (IT) systems are associated with better patient safety in acute care settings.

Study Design: In a cross-sectional retrospective study, data on hospital patient safety performance for October 2008 to June 2010 were combined with 2007 information technology systems data. The sample included 3002 US non-federal acute care hospitals.

Seeking and receiving social support on Facebook for surgery.

Social networking sites such as Facebook provide a new way to seek and receive social support, a factor widely recognized as important for one's health. However, few studies have used actual conversations from social networking sites to study social support for health related matters. We studied 3,899 Facebook users, among a sample of 33,326 monitored adults, who initiated a conversation that referred to surgery on their Facebook Wall during a six-month period.

The double-edged sword of electronic health records: implications for patient disclosure.

Objective: Electronic health record (EHR) systems are linked to improvements in quality of care, yet also privacy and security risks. Results from research studies are mixed about whether patients withhold personal information from their providers to protect against the perceived EHR privacy and security risks. This study seeks to reconcile the mixed findings by focusing on whether accounting for patients' global ratings of care reveals a relationship between EHR provider-use and patient non-disclosure.

Institutionalizing HIPAA compliance: organizations and competing logics in U.S. health care.

Health care in the United States is highly regulated, yet compliance with regulations is variable. For example, compliance with two rules for securing electronic health information in the 1996 Health Insurance Portability and Accountability Act took longer than expected and was highly uneven across U.S.

Do health care users think electronic health records are important for themselves and their providers?: Exploring group differences in a national survey.

Patient access to electronic health records (EHR) is expected to have a variety of benefits, including enhanced patient involvement in care and access to health information, yet little is known about potential demand. We used the 2007 Health Information and National Trends Survey, a national probability-based survey, to determine which health care users with Internet access are likely to report that electronic access to their health records is important for themselves and their providers. Respondents who represent populations that generally experience health and healthcare disparities (Blacks, Latina/os, and patients with psychological distress) were among the most likely to report that the EHR was very important for them, even after controlling for respondents' socio-economic status, health status, health care context, and disposition toward health information.

Did you hear the one about the doctor? An examination of doctor jokes posted on Facebook.

Background: Social networking sites such as Facebook have become immensely popular in recent years and present a unique opportunity for researchers to eavesdrop on the collective conversation of current societal issues.

Objective: We sought to explore doctor-related humor by examining doctor jokes posted on Facebook.

Methods: We performed a cross-sectional study of 33,326 monitored Facebook users, 263 (0.

Continuity of care and the risk of preventable hospitalization in older adults.

Importance: Preventable hospitalizations are common among older adults for reasons that are not well understood.

Objective: To determine whether Medicare patients with ambulatory visit patterns indicating higher continuity of care have a lower risk of preventable hospitalization.

Design: Retrospective cohort study.

Meaningful use of electronic health record systems and process quality of care: evidence from a panel data analysis of U.S. acute-care hospitals.

Objective: To estimate the incremental effects of transitions in electronic health record (EHR) system capabilities on hospital process quality.

Data Source: Hospital Compare (process quality), Health Information and Management Systems Society Analytics (EHR use), and Inpatient Prospective Payment System (hospital characteristics) for 2006-2010.

Study Setting: Hospital EHR systems were categorized into five levels (Level_0 to Level_4) based on use of eight clinical applications.

Medication administration quality and health information technology: a national study of US hospitals.

Objective: To determine whether the use of computerized physician order entry (CPOE) and electronic medication administration records (eMAR) is associated with better quality of medication administration at medium-to-large acute-care hospitals. DATA/STUDY SETTING: A retrospective cross-sectional analysis of data from three sources: CPOE/eMAR usage from HIMSS Analytics (2010), medication quality scores from CMS Hospital Compare (2010), and hospital characteristics from CMS Acute Inpatient Prospective Payment System (2009). The analysis focused on 11 quality indicators (January-December 2009) at 2603 medium-to-large (≥ 100 beds), non-federal acute-care hospitals measuring proportion of eligible patients given (or prescribed) recommended medications for conditions, including acute myocardial infarction, heart failure, and pneumonia, and surgical care improvement.

Seniors' perceptions of health care not closely associated with physician supply.

We conducted a national random survey of Medicare beneficiaries to better understand the association between the supply of physicians and patients' perceptions of their health care. We found that patients living in areas with more physicians per capita had perceptions of their health care that were similar to those of patients in regions with fewer physicians. In addition, there were no significant differences between the groups of patients in terms of numbers of visits to their personal physician in the previous year; amount of time spent with a physician; or access to tests or specialists.

How much do patients' preferences contribute to resource use?

Regional variation in health care use may stem, in part, from the fact that patients in high-utilization regions demand and receive more-intensive care. We examine the association between patients' care-seeking preferences and use of services, using a national survey of Medicare patients. Patients' preferences, in addition to health and sociodemographic characteristics, are associated with differences in individuals' use of office visits.

Racial and ethnic differences in preferences for end-of-life treatment.

Background: Studies using local samples suggest that racial minorities anticipate a greater preference for life-sustaining treatment when faced with a terminal illness. These studies are limited by size, representation, and insufficient exploration of sociocultural covariables.

Objective: To explore racial and ethnic differences in concerns and preferences for medical treatment at the end of life in a national sample, adjusting for sociocultural covariables.

Relationship between regional per capita Medicare expenditures and patient perceptions of quality of care.

Context: Wide variations in Medicare expenditures exist across regions, but little is known about whether beneficiaries residing in low-expenditure regions perceive receiving lower-quality care than those in high-expenditure regions.

Objective: To evaluate how Medicare beneficiaries' perceptions of their health care are related to per capita expenditure in the areas where they live. DESIGN, SETTING, AND RESPONDENTS: A probability sample of Medicare beneficiaries living in households in the United States was surveyed by a combination of mail and telephone in 2005.

Are regional variations in end-of-life care intensity explained by patient preferences?: A Study of the US Medicare Population.

Objective: We sought to test whether variations across regions in end-of-life (EOL) treatment intensity are associated with regional differences in patient preferences for EOL care.

Research Design: Dual-language (English/Spanish) survey conducted March to October 2005, either by mail or computer-assisted telephone questionnaire, among a probability sample of 3480 Medicare part A and/or B eligible beneficiaries in the 20% denominator file, age 65 or older on July 1, 2003. Data collected included demographics, health status, and general preferences for medical care in the event the respondent had a serious illness and less than 1 year to live.