Browsing by Subject "information technology"
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Item Balancing risk with virtual private networking during a pandemic(Elsevier, 2021-07) Korty, Andrew; Calarco, Daniel; Spencer, Mark; IUPUI Vice President Information TechnologyWhen the pandemic struck and teaching went online worldwide, universities had to make pressing decisions that balanced cybersecurity against other factors, including health and safety, usability, and cost. One such challenge Indiana University (IU) faced was how to accommodate the secure telecommunications needs of 130,000 faculty, staff, and students who would now be teaching, learning, doing research, and working from home. Some universities reflexively promoted virtual private network (VPN) use for all activities. Such an approach would have been unsustainable at IU, however, owing both to the licenses and resources needed for the sheer number of users and to the high-throughput applications on which they rely. Perhaps even worse, it would have increased the chances that the VPN would be unavailable during a critical incident or other situation in which secure communications must be guaranteed. Instead, IU launched an awareness campaign demonstrating exactly when VPN use is and isn’t needed. In addition, network staff employed a VPN feature called split tunneling to reduce the load. This article discusses the advantages and disadvantages of this approach and how IU made the decision to balance both sides of the risk equation to ensure the continued advancement of its mission throughout the pandemic.Item Experiences Applying Technology to Overcome Common Challenges in Pharmacy Practice-Based Research in the United States(MDPI, 2020-05-30) Gernant, Stephanie A.; Adeoye-Olatunde, Omolola A.; Murawski, Matthew M.; Jaynes, Heather; Chewning, Betty; Knox, Lyndee M.; Martinez III, Moises; Schommer, Jon C.; Snyder, Margie E.; Pharmacology and Toxicology, School of MedicineDespite the importance of pharmacy practice-based research in generating knowledge that results in better outcomes for patients, health systems and society alike, common challenges to PPBR persist. Herein, we authors describe PPBR challenges our research teams have encountered, and our experiences using technology-driven solutions to overcome such challenges. Notably, limited financial resources reduce the time available for clinicians and researchers to participate in study activities; therefore, resource allocation must be optimized. We authors have also encountered primary data collection challenges due to unique data needs and data access/ownership issues. Moreover, we have experienced a wide geographic dispersion of study practices and collaborating researchers; a lack of trained, on-site research personnel; and the identification and enrollment of participants meeting study eligibility criteria. To address these PPBR challenges, we authors have begun to turn to technology-driven solutions, as described here.Item Information Technology’s Failure to Disrupt Healthcare(2012-07) Terry, Nicolas P.Information Technology (IT) surrounds us every day. IT products and services from smart phones and search engines to online banking and stock trading have been transformative. However, IT has made only modest and less than disruptive inroads into healthcare. This article explores the economic and technological relationships between healthcare and healthcare information technologies (HIT), asks (leveraging the work of Clayton Christensen) whether current conceptions of HIT are disruptive or merely sustaining, and canvasses various explanations for HIT’s failure to disrupt healthcare. The conclusion is that contemporary HIT is only a sustaining rather than disruptive technology. Notwithstanding that we live in a world of disruption, healthcare is more akin to the stubborn television domain, where similarly complex relationships and market concentrations have impeded the forces of disruption. There are three potential exceptions to this pessimistic conclusion. First, because advanced HIT is not a good fit for episodic healthcare delivery, we may be experiencing a holding pattern while healthcare rights itself with the introduction of process-centric care models. Second, the 2010 PCAST report was correct, the healthcare data model is broken. If Stage 3 of the MU subsidy program or some other initiative can fundamentally rethink interoperability (and we can fix the privacy issues) investment and innovation will migrate to data services built on top of shareable data. The final and potentially most interesting exception may be Mobile Medical Apps; products that are built on hugely disruptive platforms and championed by some of our most disruptive companies. Leveraging the growing computing power of smartphones and linkable biometric sensors, these apps hold the promise for “healthcare everywhere” and may be where the real disruption of healthcare will begin.Item Integrating Clinical Decision Support into Workflow(2011) Doebbeling, Bradley N.; Saleem, Jason; Haggstrom, David; Militello, Laura; Flanagan, Mindy; Arbuckle, Nicole; Kiess, Chris; Hoke, Shawn; Dexter, Paul; Linder, Jeff; Sarbah, Steedman; Burgo, LucillePurpose: The aims were to (1) identify barriers and facilitators related to integration of clinical decision support (CDS) into workflow and (2) develop and test CDS design alternatives. Scope: To better understand CDS integration, we studied its use in practice, focusing on CDS for colorectal cancer (CRC) screening and followup. Phase 1 involved outpatient clinics of four different systems—120 clinic staff and providers and 118 patients were observed. In Phase 2, prototyped design enhancements to the Veterans Administration’s CRC screening reminder were compared against its current reminder in a simulation experiment. Twelve providers participated. Methods: Phase 1 was a qualitative project, using key informant interviews, direct observation, opportunistic interviews, and focus groups. All data were analyzed using a coding template, based on the sociotechnical systems theory, which was modified as coding proceeded and themes emerged. Phase 2 consisted of rapid prototyping of CDS design alternatives based on Phase 1 findings and a simulation experiment to test these design changes in a within-subject comparison. Results: Very different CDS types existed across sites, yet there are common barriers: (1) lack of coordination of “outside” results and between primary and specialty care; (2) suboptimal data organization and presentation; (3) needed provider and patient education; (4) needed interface flexibility; (5) needed technological enhancements; (6) unclear role assignments; (7) organizational issues; and (8) disconnect with quality reporting. Design enhancements positively impacted usability and workflow integration but not workload. Conclusions: Effective CDS design and integration requires: (1) organizational and workflow integration; (2) integrating outside results; (3) improving data organization and presentation in a flexible interface; and (4) providing just-in time education, cognitive support, and quality reporting.Item Local Health Departments' Partners and Challenges in Electronic Exchange of Health Information(Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins, 2016-11) Shah, Gulzar H.; Vest, Joshua R.; Lovelace, Kay; McCullough, J. Mac; Department of Health Policy and Management, Richard M. Fairbanks School of Public HealthBACKGROUND: Unprecedented amounts of data are produced by the health care and other sectors, presenting opportunities for local health departments (LHDs) to access these data. LHDs will need to participate in health information exchange (HIE) with a number of partners in order to benefit from these data resources. LHDs' participation in HIEs with specific partners has not been studied. OBJECTIVES: To describe the level of and challenges in LHD participation in HIE with other partners, and variation by LHD population size and governance type. DATA AND METHODS: This research uses data from the 2015 Informatics Capacity and Needs Assessment Survey, with a target population of all LHDs in the United States. A representative sample of 650 LHDs was drawn using a stratified random sampling design. A total of 324 completed responses were received with a 50% response rate. Survey data were cleaned, and bivariate comparisons were conducted using χ and Somer's D. RESULTS: Substantial variation existed in LHDs' participation in HIE by type of exchange partner. Although 71% participated in HIE with the state departments of health, only 12% with jail/correctional health, 14% with health or county-based purchasing plans, and 15% with home health agencies. Compared with large LHDs (jurisdiction populations of ≥500 000), smaller LHDs were more likely to participate in HIE with state departments of health, but less likely with other exchange partners. The challenges to HIE participation were technological, and organizational/interorganizational in nature and variation existed by LHDs' population size and governance structure with respect to state authority. CONCLUSIONS: Local public health agencies more commonly participate in HIE with some partners, but may need to improve HIE with many others. National strategies targeting an increase in HIE of LHDs may use our findings to focus those initiatives.Item Mobile Health Assessing the Barriers(2015-05) Terry, Nicolas P.Mobile health (mHealth) combines the decentralization of health care with patient centeredness. Mature mHealth applications (apps) and services could provide actionable information, coaching, or alerts at a fraction of the cost of conventional health care. Different categories of apps attract diverse safety and privacy regulation. It is too early to tell whether these apps can overcome questions about their use cases, business models, and regulation.Item The Perceived Impact of Information Technology Experiential Learning on Career Success: A Pilot Study(American Society for Engineering Education, 2015-06) Bishop, Dalton; Justice, Connie; Fernandez, Eugenia; Department of Engineering Technology, Purdue School of Engineering and Technology, IUPUIEmployers in the Information Technology field place significant value on the amount of real-world experience prospective employees possess. Recent IT graduates face a competitive job market against seasoned professionals with years of experience. Students must build a solid experience base from which they can advance professionally. This cannot be done without first holding an IT position. The key to solving the experience paradox is experiential learning – the process of learning by doing. The Living Lab at is a non-traditional undergraduate course based on the concept of experiential learning in the field of Information Technology. The Living Lab is structured similarly to a corporate IT department, with students playing the role of IT personnel. Students learn to apply their previous course material and gain resume-worthy experience, while working in teams to complete IT projects for their university and local businesses. Projects are fully documented and reported on throughout the course with a final presentation at semester end. This study investigates what, if any, benefit graduates gain from the Living Lab experience. Graduates who were involved in the Living Lab were electronically surveyed about their professional careers after college. Questions focused on how the student felt their time in Living Lab helped them gain employment and enhance their ability to perform as an employee. Results will be used to gauge the validity of the Living Lab program and experiential learning as an effective tool in terms of IT education. Data from this study can be used to improve the program, and help prospective students to make an informed decision when considering the Living Lab. Ultimately, other institutions may be encouraged to consider implementing a Living Lab or similar IT experiential learning environment of their own.Item Pit Crews with Computers: Can Health Information Technology Fix Fragmented Care(2014) Terry, Nicolas P.Fragmentation and lack of coordination remain as some of the most intractable problems facing health care. Attention has often alighted on the promise of Health care Information Technology not least because IT has had such positive impact on many other personal, professional and industrial domains. For at least two decades the HIT-panacea narrative has been persistent even though the context has shifted. At various times we have been promised that patient safety technologies would solve our medical error problems, electronic transactions would simplify healthcare administration and insurance and clinical data would become interoperable courtesy of electronic medical records. Today the IoM is positioning HIT at the center of its new “continuously learning” health care model that is in large part aimed at solving our fragmentation and lack of coordination problems. While the consensus judgment that HIT can reduce fragmentation and increase coordination has intuitive force the specifics are more complicated. First, the relationship between health care and IT has been both culturally and financially complex. Second, HIT has been overhyped as a solution for all of health care’s woes; it has its own problems. Third, the HIT-fragmentation solution presents a chicken-and-egg problem — can HIT solve health care fragmentation and lack of coordination problems or must health care problems such as episodic care be solved prior to successful deployment of HIT? The article takes a critical look at both health care and HIT with those questions in mind before concluding with some admittedly difficult recommendations designed to break the chicken-and-egg deadlock.Item Systematic Study of Data Science and Analytics Programs(ASEE, 2017-06) Wu, Huanmei; BioHealth Informatics, School of Informatics and ComputingRapid advances in information technologies have led to the generation of massive data sets, especially in life science and biomedical informatics. These data sets are valuable assets and in great needs to be analyzed. However, there is a shortage of workforce for big data analysis. Education innovations are required to empower students with the skills and technologies for large dataset analysis. Over the last few years, there is a high demand for new programs in data science and analytics (DSA). We has performed a systematic study of the existing DSA programs in the US by checking the detailed information about the degree programs, the program competencies, the curriculum designs, the expected learning outcomes, program sizes, professional careers, and other related information. There are more than 70 DSA programs offered in the US. This study provides guidance on DSA related program development and curriculum design. It also provides the potential trainees in DSA with the current market needs and the required knowledge for their future career.Item Task, Usability, and Error Analyses of Ambulance-based Telemedicine for Stroke Care(Taylor & Francis, 2021) Rogers, Hunter; Madathil, Kapil Chalil; Joseph, Anjali; McNeese, Nathan; Holmstedt, Christine; Holden, Richard; McElligott, James T.; Medicine, School of MedicinePast research has established that telemedicine improves stroke care through decreased time to treatment and more accurate diagnoses. The goals of this study were to 1) study how clinicians complete stroke assessment using a telemedicine system integrated in ambulances, 2) determine potential errors and usability issues when using the system, and 3) develop recommendations to mitigate these issues. This study investigated use of a telemedicine platform to evaluate a stroke patient in an ambulance with a geographically distributed caregiving team comprised of a paramedic, nurse, and neurologist. It first determined the tasks involved based on 13 observations of a simulated stroke using 39 care providers. Based on these observational studies, a Hierarchical Task Analysis (HTA) was developed, and subsequently, a heuristic evaluation was conducted to determine the usability issues in the interface of the telemedicine system. This was followed by a Systematic Human Error Reduction and Prediction Approach (SHERPA) to determine the possibility of human error while providing care using the telemedicine work system. The results from the HTA included 6 primary subgoals categorizing the 97 tasks to complete the stroke evaluation. The heuristic evaluation found 123 unique violations to heuristics, with an average severity of 2.38. One hundred and thirty-one potential human errors were found with SHERPA, the two most common being miscommunication and selecting an incorrect option. Several recommendations are proposed, including improvement of labeling, consistent formatting, rigid or suggested formatting for data input, automation of task structure and camera movement, and audio/visual improvements to support communication.