Is Provider Secure Messaging Associated With Patient Messaging Behavior? Evidence From the US Army.

Background: Secure messaging with health care providers offers the promise of improved patient-provider relationships, potentially facilitating outcome improvements. But, will patients use messaging technology in the manner envisioned by policy-makers if their providers do not actively use it?

Objective: We hypothesized that the level and type of secure messaging usage by providers might be associated with messaging initiation by their patients.

Methods: The study employed a dataset of health care and secure messaging records of more than 81,000 US Army soldiers and nearly 3000 clinicians with access to a patient portal system.

Sickle Cell Trait, Rhabdomyolysis, and Mortality among U.S. Army Soldiers.

Background: Studies have suggested that sickle cell trait elevates the risks of exertional rhabdomyolysis and death. We conducted a study of sickle cell trait in relation to these outcomes, controlling for known risk factors for exertional rhabdomyolysis, in a large population of active persons who had undergone laboratory tests for hemoglobin AS (HbAS) and who were subject to exertional-injury precautions.

Methods: We used Cox proportional-hazards models to test whether the risks of exertional rhabdomyolysis and death varied according to sickle cell trait status among 47,944 black soldiers who had undergone testing for HbAS and who were on active duty in the U.

Prediction of all-cause occupational disability among US Army soldiers.

Introduction: Long-term occupational disability rates associated with eventual discharges from military service have risen sharply among active-duty US Army soldiers during the last three decades, with important implications for soldier health and national security alike. To address this problem, we built predictive models for long-term, all-cause occupational disability and identified disability risk factors using a very large, multisource database on the total active-duty US Army.

Methods: We conducted a cross-temporal retrospective cohort study and used mixed-effects logistic regression models to derive and validate disability risk assignments.

Leveraging Health Information Technology to Improve Quality in Federal Healthcare.

Purpose: Healthcare delivery in America is extremely complex because it is comprised of a fragmented and nonsystematic mix of stakeholders, components, and processes. Within the US healthcare structure, the federal healthcare system is poised to lead American medicine in leveraging health information technology to improve the quality of healthcare. We posit that through developing, adopting, and refining health information technology, the federal healthcare system has the potential to transform federal healthcare quality by managing the complexities associated with healthcare delivery.

An active learning approach to Bloom's Taxonomy.

As educators strive toward improving student learning outcomes, many find it difficult to instill their students with a deep understanding of the material the instructors share. One challenge lies in how to provide the material with a meaningful and engaging method that maximizes student understanding and synthesis. By following a simple strategy involving Active Learning across the 3 primary domains of Bloom's Taxonomy (cognitive, affective, and psychomotor), instructors can dramatically improve the quality of the lesson and help students retain and understand the information.

Evaluating the impact of investments in information technology on structural inertia in health organizations.

Structural inertia is the overall capacity of an organization to adapt within a market environment. This paper reviews the impact of healthcare investments in information management/information technology (IM/IT) on the strategic management concept of structural inertia. Research indicates that healthcare executives should consider the relative state of structural inertia for their firms and match them with potential IM/IT solutions.

Executive competencies in healthcare administration: preceptors of the Army-Baylor University Graduate Program.

The purpose of this research was to identify the mentoring and executive competencies required among preceptors of the Army-Baylor University Graduate Program in Health and Business Administration, and to specify the requisite skills, knowledge, and abilities (SKAs) needed to achieve those competencies. In the first wave of inquiry, a list of 123 competencies and associated SKAs was elicited from a network of 80 current and past preceptor executives employing a Delphi methodology using e-mail. An expert panel, which consisted of seven past program directors, examined and sorted the list into four preceptor content domains, viz.