Browsing by Subject "Digital divide"
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Item A decade post-HITECH: Critical access hospitals have electronic health records but struggle to keep up with other advanced functions(Oxford University Press, 2021) Apathy, Nate C.; Holmgren, A. Jay; Adler-Milstein, Julia; Health Policy and Management, Richard M. Fairbanks School of Public HealthObjective: Despite broad electronic health record (EHR) adoption in U.S. hospitals, there is concern that an "advanced use" digital divide exists between critical access hospitals (CAHs) and non-CAHs. We measured EHR adoption and advanced use over time to analyzed changes in the divide. Materials and methods: We used 2008 to 2018 American Hospital Association Information Technology survey data to update national EHR adoption statistics. We stratified EHR adoption by CAH status and measured advanced use for both patient engagement (PE) and clinical data analytics (CDA) domains. We used a linear probability regression for each domain with year-CAH interactions to measure temporal changes in the relationship between CAH status and advanced use. Results: In 2018, 98.3% of hospitals had adopted EHRs; there were no differences by CAH status. A total of 58.7% and 55.6% of hospitals adopted advanced PE and CDA functions, respectively. In both domains, CAHs were less likely to be advanced users: 46.6% demonstrated advanced use for PE and 32.0% for CDA. Since 2015, the advanced use divide has persisted for PE and widened for CDA. Discussion: EHR adoption among hospitals is essentially ubiquitous; however, CAHs still lag behind in advanced use functions critical to improving care quality. This may be rooted in different advanced use needs among CAH patients and lack of access to technical expertise. Conclusions: The advanced use divide prevents CAH patients from benefitting from a fully digitized healthcare system. To close the widening gap in CDA, policymakers should consider partnering with vendors to develop implementation guides and standards for functions like dashboards and high-risk patient identification algorithms to better support CAH adoption.Item Big Data Analytics for developing countries – Using the Cloud for Operational BI in Health(Wiley, 2013) Braa, Jørn; Purkayastha, SaptarshiThe multi-layered view of digital divide suggests there is inequality of access to ICT, inequality of capability to exploit ICT and inequality of outcomes after exploiting ICT. This is evidently clear in the health systems of developing countries. In this paper, we look at cloud computing being able to provide computing as a utility service that might bridge this digital divide for Health Information Systems in developing countries. We highlight the role of Operational Business Intelligence (BI) tools to be able to make better decisions in health service provisioning. Through the case of DHIS2 software and its Analytics-as-a-Service (AaaS) model, we look at how tools can exploit Cloud computing capabilities to perform analytics on Big Data that is resulting from integration of health data from multiple sources. Beyond looking at purely warehousing techniques, we suggest understanding Big Data from Organizational Capabilities and expanding organizational capabilities by offloading computing as a utility to vendors through cloud computing.Item Digital Divide Challenges Access to E-Government(American Library Association, 2014-12) Macy, Katharine V.The article discusses the transition to e-government within the U.S. with federal, local, and state government agencies eliminating some paper processes altogether and how it affects populations that fall within the digital divide. Topics discussed include U.S. President Barack Obama's memorandum directing government agencies to reform records management practices and the role of public libraries in providing access through services and programming.Item Disparities in Pediatric Patient Portal Activation and Feature Us(Oxford University Press, 2021-09-29) LeLaurin, Jennifer H.; Nguyen, Oliver T.; Thompson, Lindsay A.; Hall, Jaclyn; Bian, Jiang; Cho, Hee Deok; Acharya, Ratna; Harle, Christopher A.; Salloum, Ramzi G.; Biostatistics and Health Data Science, Richard M. Fairbanks School of Public HealthObjective: Disparities in adult patient portal adoption are well-documented; however, less is known about disparities in portal adoption in pediatrics. This study examines the prevalence and factors associated with patient portal activation and the use of specific portal features in general pediatrics. Materials and methods: We analyzed electronic health record data from 2012 to 2020 in a large academic medical center that offers both parent and adolescent portals. We summarized portal activation and use of select portal features (messaging, records access and management, appointment management, visit/admissions summaries, and interactive feature use). We used logistic regression to model factors associated with patient portal activation among all patients along with feature use and frequent feature use among ever users (ie, ≥1 portal use). Results: Among 52 713 unique patients, 39% had activated the patient portal, including 36% of patients aged 0-11, 41% of patients aged 12-17, and 62% of patients aged 18-21 years. Among activated accounts, ever use of specific features ranged from 28% for visit/admission summaries to 92% for records access and management. Adjusted analyses showed patients with activated accounts were more likely to be adolescents or young adults, white, female, privately insured, and less socioeconomically vulnerable. Individual feature use among ever users generally followed the same pattern. Conclusions: Our findings demonstrate that important disparities persist in portal adoption in pediatric populations, highlighting the need for strategies to promote equitable access to patient portals.Item Human rights challenges of IT-led democratization(2013-08-13) Caparas, Perfecto "Boyet"