Transactions of the International Conference on Health Information Technology Advancement 2011 (ICHITA2011)

Western Michigan University, Kalamazoo, Michigan



Presentation Abstracts and PowerPoint Slides

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Friday, October 28, 2011

Fetzer Center

Western Michigan University

Kalamazoo, MI, USA




Paper Abstract


PowerPoint Link


11:10 AM


Paper Session #1 – Chair: Mr. Tremblay




Towards the National Health Information Network

in the United States of America

A. Targowski, Western Michigan University


The Health Infrastructure in the U.S. is called the National Health Information Network (NHIN) which is composed of regional Health Information Exchange (HIE) hubs. This approach has been exercised since 2008. However, there is a lack of one top-down comprehensive architecture of this system, which is being developing by each state individually. This paper provides the top-down model of such architecture, perhaps the first one which is made. The paper defines basic components of that system. Also some issues of security and privacy of stored and exchanged data are disputed. By the end, the paper provides conclusions regarding the issues of its implementation.





Examining Structural Constraints and Electronic Health Record Use In Acute Care Hospitals

D. Dobrzykowski, Eastern Michigan University


Electronic Health Record (EHR) use is expected to increase rapidly across the USA. It is the hope of the federal government and many hospitals that EHR use will not only increase, but also mature from basic applications such as EHR for results viewing (ERV) to more advanced applications such as Computerized Provider Order Entry (CPOE). At present, substantial heterogeneity is extant among hospitals in terms of EHR use and the progression toward advanced EHR applications. Understanding this heterogeneity is important as hospitals move toward advanced EHR. This study employs contingency theory to suggest that a hospital’s structural constraints may explain the heterogeneity among hospitals in terms of their use of ERV and CPOE. Survey data collected from 297 acute care hospitals in 47 states reveals that critical access hospitals may be slow to use EHR, even in the early stages of ERV. Conversely, major teaching hospitals appear to be early adopters, achieving advanced ERH use. These findings are important for hospital executives, Health Information Technology managers, and policymakers concerned with directing resources with an aim toward EHR adoption.  




Electronic Health Records: Implementation and post-implementation challenges

M. Razi, C. Emmert, D. Austin, J. M. Tarn, and K.N. Islam, Western Michigan University


The American healthcare industry lags behind other industries in its use of technology for the improvement of processes and quality of services for its patients. Globally, the US is significantly behind many European and Australian countries in the implementation of electronic health records (EHR). While the federal government is now mandating this change and also offering incentive programs, healthcare providers remain slow to comply because of challenges they face regarding EHR implementation.  This paper discusses EHR architecture, presents implementation challenges, provides a case study, and offers future research ideas. The information provided in this research could be beneficial for successful EHR implementation.








11:10 AM


Paper Session #2 -  Chair: Dr. Choi




It’s My iPad! Protecting Critical Data on Personal Mobile Devices in the Medical Setting

M. R. Lehrfeld, East Tennessee State University

R. M. Barrios, University of Detroit Mercy

C. Phillippe, East Tennessee State University


The pervasiveness of mobile devices has forced many organizations to support connectivity of corporate and private devices.  Corporate devices are highly configurable regarding authentication, encryption, and remote wiping.  BlackBerry devices can be fully deployed and managed using a centralized Blackberry Enterprise Server, however when a user owned device connects to enterprise servers, data security becomes a concern





Active Bundle Scheme for Protecting Electronic Medical Records

R. M. Salih  and L. Lilien, Western Michigan University


Adoption of the electronic medical records (EMRs) or electronic health records (EHRs) by healthcare providers and institutes will improve the quality of US healthcare and reduce its annual bill. However, it will also increase privacy threats due to easier of dissemination of EMRs/EHRs than “paper” health records. Current privacy protection solutions for patient EMRs/EHRs have two main limitations: (1) they require an extensive exchange of messages between computer systems of healthcare providers; and (2) they depend only on using data decryption keys that must be provided to specific caregivers.  In this position paper, we propose a solution that provides protection for the patients' EMRs/EHRs disseminated among different authorized healthcare provider systems. This is achieved through the use of the construct named active bundles (ABs).  ABs keep EMRs/EHRs as sensitive data, include metadata containing privacy policies, and encompass a virtual machine that enforces privacy policies.                





Security and Privacy Issues in Health Care Information Systems

K. L. Chen, University of Southern Mississippi

H. Lee, Eastern Michigan University

C. C. Shing, Radford University, and

M. L. Shing, Taipei Municipal University of Education, Taiwan


The purpose of this paper is to discuss the security and privacy issues for health care information systems.  New issues include medical server security issues, mobile device security, and security in medical ERP systems, and web applications security.








11:10 AM


Paper Session #3 – Chair: Dr. Manning-Walsh





M. Dohan, Ted Xenodemetropolous, MD, FRCPC

J. Tan, McMaster University


The central argument of this paper is that relationships between clinicians are a necessary resource for the support of practice audit functions for quality improvement. Practice audit entails the measurement and analysis of clinical work, and subsequent comparison against a defined standard or benchmark, for the overall purpose of continuous quality control and improvement. Clinician-clinician relationships are a necessary resource in overcoming the challenges associated with adopting and adhering to tasks and processes associated with practice audit, and technology subsequently plays an important role in supporting and developing these relationships. Keywords: practice audit, clinician-clinician relationship, continuous quality improvement.





Effect of Practitioner Self Care and Anxiety on Relationships within the Context of Organizational Change

J. Manning-Walsh, Western Michigan University


The purpose of this research paper is to review the literature and suggest the relationships between organizational change through implementation of new health information technology (HIT) and/or reconfiguration of existing HIT, practitioner anxiety, and effective caring practitioner/patient and practitioner/practitioner relationships using a conceptual framework of Relationship Centered Care (RCC). Engaging in frequent and regular self-care interventions has been shown to be related to practitioner/patient caring ability and caring efficacy. According to a published model of RCC, it may be anticipated that selfcare may decrease practitioner anxiety in the context of organizational change and increase ability of the practitioner to engage in effective caring relationships with patients and other practitioners. Through the lens of RCC and within the context of organizational changes such as implementing HIT, a conceptual model for research is proposed, research questions and hypotheses are stated, and methodology for a future stream of research is briefly discussed.




The Social Networking Adoption Matrix (SAM):Helping Healthcare Organizations Effectively Choose Social Networking Technologies

A. Rea,  R. Landeros,   and T. Stempien, Western Michigan University


Healthcare organizations looking to increase communication avenues to their community, providers, and healthcare consumers, as well create potential interest in their particular mission or promote education need to look to social networking technologies to harness to power of the Internet. However, simply creating a Facebook page or a blog account is not always the most effective means to accomplish the task. Without a thorough needs analysis, a healthcare organization may waste valuable limited resources with very little return on investment by haphazardly implementing social networking technologies. In this paper, the authors discuss preliminary research targeted to help organizations adopt relevant technologies using a Social Networking Adoption Matrix (SAM). SAM helps organizations decide which social networking technology categories are necessary to meet their strategic goals via the Social Network Adoption Matrix Expert System (SAMES). As a result, organizations can increase communication opportunities that match their needs while being aware of the necessary resource investment to be successful in the endeavor.








2:20 PM


Paper Session #4 – Chair: Dr. Ravotas




Factors Impacting Use of Information Technology by Physicians in Private Practice

J. DeMello & S. Deshpande, Western Michigan University


This research examines the impact of various factors on the use of IT in clinical practice, prescriptions, and patient information. This was done using a national sample of 3425 physicians who worked in a solo or group practice in the United States. Besides the extent of use of electronic medical records by physicians and number of physicians in practice, none of the other factors consistently impacted the use of IT in clinical practice, prescriptions, and patient information, respectively. The results of this study highlight the need to develop specific strategies to increase the use of information technology in healthcare.





Guiding Health Care Policy Through Applied Public Health Modeling and Simulation

J, P. Leidig, C. L. Barrett, and M. Marathe, Virginia Tech


The risk of a widespread epidemic is a primary public health concern with implications for healthcare providers and organizations. Modeling and simulation techniques have been successfully applied at the national level to set governmental polices and mitigation strategies through simulation-based predictions. Existing research in this field has been non-uniform in its coverage of local systems and region-specific findings. New collaborations between on the ground providers and modeling groups are required for successful simulation-based experimentation of region-specific health systems. These proposed collaborations are expected to contribute high-quality sub-population datasets to be used in experiments at the national level and allow for the reuse of existing disease models and simulation infrastructure in support of regional predictive experimentation.





Electronic Payments in Health Care 

C.R. Krishnaswamy, Western Michigan University


In this paper the author has developed a theoretical framework for addressing the healthcare costs and based on it he has analyzed the payment system that is an integral part of healthcare payments. The author concurs with the recommendations made in earlier studies that switching from a paper-based system to an electronic system would not only reduce costs but also improve the efficiency of the system. By using an electronic payment system for payment of healthcare claims, huge savings can be achieved on an annual basis, as the numbers of claims processed each year are in the billions.




Examining the Use of Institutionally Designed Documentation Templates as a Vehicle for Changing Values and Practices in Health Care

D. Ravotas, Western Michigan University


Changing values and requirements are common occurrences in today’s health care settings.  Institutionally designed documentation templates are often developed to demonstrate that these changes have been incorporated into clinical work.  Little research has been completed to examine whether the use of these institutional templates leads to the intended change or whether the changes clash with other influences on clinical work.  This paper illustrates how two qualitative methods: think aloud interviews and frame analysis can be combined to examine the use of the templates, the changing values themselves, and the influences on changes in clinical practice.  An analysis of local change from expert planning to person centered planning is used to illustrate the value of the approach. The analysis reveals influences that affect the adoption of this particular change, the usability of the template, and points of change that need to be negotiated with the users of those documents.







2:20 PM


Paper Session #5 – Chair: Dr. Rea




Curriculum Development on Healthcare Information Systems, Healthcare Supply Chain Management and Healthcare Operations Management

D. Dobrzykowski,  N. L'abbe Wu, and H. Lee, Eastern Michigan University


This paper presents the foundation for curriculum amendment in the College of Business at Eastern Michigan University to prepare our students for the tremendous job opportunities that are presently available in the healthcare arena. Specifically, this curriculum change incorporates three major areas in healthcare management: Healthcare Information Systems, Healthcare Supply Chain and Healthcare Operations Management. In order to properly chart the changes in the curriculum, research is presented that defines and discusses these components for suitable curriculum building that will enable graduates to effectively perform in the healthcare industry. Additionally, presented in this paper are the detailed objectives and teaching pedagogy of a special topics graduate course in Healthcare Operations Management that recently has been developed at Eastern Michigan University.





Say Good-Bye to the Silos and Hello to Collaboration: A New Curriculum Approach

S. Falan and B. Han, Western Michigan University


In sharp contrast with the customary traditions of educational silos in the delivery of knowledge and understanding, this paper presents a true interdisciplinary curriculum that is designed to supply the community with graduates who are prepared to take on diverse roles in health care and information management. The complexity of our modern communities and their anticipated futuristic needs suggest that graduates in health care must be able to apply more than a traditional singular knowledge domain to articulate problems and provide solutions to those problems in meaningful ways. The curriculum approach presented will facilitate interdisciplinary knowledge learning from existing classes, foster faculty collaboration, and enhance the resource sharing and integration. In essence, this new curriculum collapses the boundaries of education silos.





Changing Health Care Business Models and Costs

T. Rienzo, Western Michigan University


Changing the health care system has universal support in principal, but has proven contentious in practice.  This paper draws upon the theories and publications of three leading business thinkers, and the frameworks they developed for applying business practices to the health care industry: Drs. Clayton Christensen, Robert Kaplan, and Michael Porter of Harvard University.  It reviews the disruption theories of Christensen as he has applied them to the health care industry, and connects them with medical costing recommendations of Kaplan and Porter.  Two possible disruption possibilities for clinical care and venue are presented.




Health and Information Technology

D. Tremblay


The healthcare industry continues to grow to meet demands of a changing environment and a growing number of people. Moreover, the Information Technology space continues to expand to meet customer’s needs and the continuing desire of people and companies to be the most technologically advanced. In order to allow the healthcare industry [or any industry] to continue to grow, it has to allow itself to expand with technology to help serve its customers more effectively. Through this partnership, it is possible for healthcare to become something more to its customers through more efficient and effective healthcare management.