Department of Epidemiology Works

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    The Landscape of the AHRQ Health Information Technology Portfolio
    (2006) Dixon, Brian E.
    A major agenda item of the President and Congress is widespread adoption of health information technology (health IT) to improve the quality, safety, and efficiency of health care. This has allowed federal agencies to invest additional money into health IT research. The distribution and potential impact of research dollars spent by one agency supporting this agenda is examined here.
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    Development of a Taxonomy for Health Information Technology
    (2007) Dixon, Brian E.; Zafar, Atif; McGowan, Julie J
    Taxonomies provide schemas to help classify entities and define the relationships between them. Early computing enabled the development of ontologies and Medical Subject Headings (MeSH), the first modern classification of medical terminology as applied to medical literature. Later developments, such as MEDLINE, expanded MeSH to include a number of medical informatics terms. However, a lack of specificity in MeSH and other existing informatics taxonomies for terminology used to describe the growing field of health information technology (health IT) created the need for the development of a specialized taxonomy. Experts associated with the Agency for Healthcare Research and Qualitys (AHRQs) National Resource Center for Health Information Technology (NRC) created and evaluated a taxonomy for health IT, to enable users of a public health IT Web site to efficiently identify resources within an online, searchable repository.
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    Pulling Back the Covers: Technical Lessons of a Real-World Health Information Exchange
    (2007) Zafar, Atif; Dixon, Brian E.
    Several nations and local communities are striving to achieve widespread, secure exchange of clinical data between various health care providers and public health organizations. Most of the literature on health information exchange focuses on the financial, political, and privacy aspects of these initiatives. Perhaps just as important are the technical and organizational factors that have influenced development of data exchange methods and results. One mature network in the Midwestern United States has had success in establishing consistent, secure exchange of clinical data for more than ten years. Presented here are the technical lessons learned and design decisions made from this initiative with the hope that they can be used by others striving to connect disparate clinical information systems for the improvement of health care quality and safety.
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    Enhancing the Informatics Evaluation Toolkit with Remote Usability Testing
    (2009) Dixon, Brian E.
    Developing functional clinical informatics products that are also usable remains a challenge. Despite evidence that usability testing should be incorporated into the lifecycle of health information technologies, rarely does this occur. Challenges include poor standards, a lack of knowledge around usability practices, and the expense involved in rigorous testing with a large number of users. Remote usability testing may be a solution for many of these challenges. Remotely testing an application can greatly enhance the number of users who can iteratively interact with a product, and it can reduce the costs associated with usability testing. A case study presents the experiences with remote usability testing when evaluating a Web site designed for health informatics knowledge dissemination. The lessons can inform others seeking to enhance their evaluation toolkits for clinical informatics products.
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    The selection of high-impact health informatics literature: a comparison of results between the content expert and the expert searcher
    (http://www-ncbi-nlm-nih-gov.proxy.medlib.iupui.edu/pmc/articles/PMC2706443/, 2009-07) Whipple, Elizabeth C.; McGowan, Julie J.; Dixon, Brian E.; Zafar, Atif
    BACKGROUND: The Agency for Healthcare Research and Quality (AHRQ) National Resource Center for Health Information Technology (NRC) created the Health IT Bibliography that contains peer-reviewed articles in eleven different health informatics categories. To create the bibliography, informatics experts identified what they considered the seminal articles in each category. METHODS:Using the same eleven categories, an expert searcher (librarian) compiled a list of the "best" health informatics articles using information seeking and retrieval tools. The two sets of articles were then compared using high citation counts as a measure of value. RESULTS: The expert searcher set (8,230) contained more than 3 times the citations to chosen articles compared to the content expert set (2,382). Of 60 articles, 27% of those articles (n = 16) were included in both sets. The frequently cited journals were similar for both sets, and one-third of the same authors were cited in both sets. DISCUSSION: While citation counts and the timeliness of the articles differed in the two sets, the same authors and same journals were frequently present in both sets. CONCLUSION: A best practice for locating high-quality articles may be collaboration between expert searchers and content experts.
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    Building a Production-Ready Infrastructure to Enhance Medication Management: Early Lessons from the Nationwide Health Information Network
    (2009-11) Simonaitis, Linas; Dixon, Brian E.; Belsito, Anne; Miller, Theda; Overhage, J. Marc
    Poor medication management practices can lead to serious erosion of health care quality and safety. The DHHS Medication Management Use Case outlines methods for the exchange of electronic health information to improve medication management practices. In this case report, the authors describe initial development of Nationwide Health Information Network (NHIN) services to support the Medication Management Use Case. The technical approach and core elements of medication management transactions involved in the NHIN are presented. Early lessons suggest the pathway to improvements in quality and safety are achievable, yet there are challenges for the medical informatics community to address through future research and development activities.
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    Enhancing a Taxonomy for Health Information Technology: An Exploratory Study of User Input Towards Folksonomy
    (2010) Dixon, Brian E.; McGowan, Julie J
    The U.S. Agency for Healthcare Research and Quality has created a public website to disseminate critical information regarding its health information technology initiative. The website is maintained by AHRQ's Natiomal Resource Center (NRC) for Health Information Technology. In the latest continuous quality improvement project, the NRC used the site's search logs to extract user-generated search phrases. The phrases were then compared to the site's controlled vocabulary with respect to language, grammar, and search precision. Results of the comparison demonstrate that search log data can be a cost-effective way to improve controlled vocabularies as well as information retrieval. User-entered search phrases were found to also share many similarities with folksonomy tags.
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    Towards E-Government 2.0: An Assessment of Where E-Government 2.0 Is and Where It Is Headed
    (2010) Dixon, Brian E.
    The aim of electronic government (e-government) is to increase the convenience and accessibility of government services and information. E-government's past emphasized the automation of routine government operations. Modern e-government centers on Web-based delivery of information and services. As the Internet moves away from version 1.0, the author examines the literature for evidence and best practices on the adoption and use to date of Web 2.0 technologies in government. Despite evidence that Web 2.0 technologies have the potential to enhance knowledge management and citizen engagement, there remains a weak body of evidence on its adoption and usage. The essay explores the early evidence and suggests a path towards realization of the promise that e-government 2.0 holds. The path involves support and collaboration from a diverse set of stakeholders to study the impact of, as well as develop best practices for, using Web 2.0 technologies to improve government services and public administration.