Clinicians often attribute much of their burnout experience to use of the electronic health record, the adoption of which was greatly accelerated by the Health Information Technology for Economic and Clinical Health Act of 2009. That same year, AMIA's Policy Meeting focused on possible unintended consequences associated with rapid implementation of electronic health records, generating 17 potential consequences and 15 recommendations to address them. At the 2020 annual meeting of the American College of Medical Informatics (ACMI), ACMI fellows participated in a modified Delphi process to assess the accuracy of the 2009 predictions and the response to the recommendations. Among the findings, the fellows concluded that the degree of clinician burnout and its contributing factors, such as increased documentation requirements, were significantly underestimated. Conversely, problems related to identify theft and fraud were overestimated. Only 3 of the 15 recommendations were adjudged more than half-addressed.
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http://dx.doi.org/10.1093/jamia/ocaa320 | DOI Listing |
Afr J Emerg Med
December 2024
Accident & Emergency Department, The Aga Khan University, Nairobi, Nairobi, Kenya.
Background And Objectives: The Kenya Emergency Medical Care (EMC) Policy 2020-2030 was created to guide the advancement of EMC throughout Kenya. This report describes and maps the ongoing EMC policy development process across Kenya's 47 counties, serving as a real-world example of EMC policy development within a decentralized healthcare system in a low-or middle-income country (LMIC).
Methods: This report evaluates the development of county-specific EMC policies using the Kenya Institute for Public Policy Research and Analysis (KIPPRA) six stages for policy development: 1) problem identification, 2) agenda setting, 3) policy design, 4) approval, 5) implementation, and 6) monitoring and evaluation.
Health Aff Sch
January 2025
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, United States.
Enrollment in Medicare Advantage (MA) plans rose to over 50% of eligible Medicare patients in 2023. Payments to MA plans incorporate risk scores that are largely based on patient diagnoses from the prior year, which incentivizes MA plans to code diagnoses more intensively. We estimated coding inflation rates for individual MA contracts using a method that allows for differential selection into contracts based on patient health.
View Article and Find Full Text PDFConserv Biol
January 2025
Department of Food and Resource Economics, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark.
Thousands of plants, fungi, and lichen species are traded every year. Although sustainable use is critical for livelihoods and biodiversity conservation, insufficient data prevent detailed sustainability assessments for most species. How can the sustainability of trade in such data-deficient species be enhanced? We considered a country-level example of 300 medicinal and aromatic plant, fungus, and lichen species traded in tens of thousands of tons worth tens of millions of US dollars in and from Nepal annually.
View Article and Find Full Text PDFJ Gen Intern Med
January 2025
Department of Medicine, Harvard Medical School, Boston, MA, USA.
Background: Accounting for approximately 1 in 4 community-dwelling adults in the United States (US), people with disabilities (PWD) experience significant disparities in health care quality, access, and outcomes. At the same time, US physicians have reported feeling unprepared to care for PWD and have revealed significant negative bias about this population.
Objective: To understand how physicians are trained to care for PWD in US medical schools.
J Health Serv Res Policy
January 2025
Assistant Professor, Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK.
Objectives: Urinary tract infections (UTIs) can negatively impact quality of life, especially when recurring. Patients often seek medical advice to relieve painful symptoms. UTIs are also the second most common reason antibiotics are prescribed in English primary care.
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