Annotated Bibliography: Healthcare Information Technology Trends

Alexander, G. L., & Madsen, R. (2018). A National Report of Nursing Home Quality and
Information Technology: 2-Year Trends. Journal of nursing care quality, 33(3), 200.
The use of health information technology was spurred by federal legislation in the last
decade. The article explains the statutory legislation that incentivized the adoption of HIT in
acute care. For example, Federal approaches have promoted research, development of scientific
knowledge, and innovations on how HIT leads to improved health care delivery in the country.
There are also growing concerns about the disparity of adoption of HIT across healthcare
facilities. For example, the adoption of electronic patient records in nursing homes and other
facilities providing long-term care is varied. HIT leads to a reduction in medical errors, saves on
medical costs, and leads to improved patient outcomes. However, despite these benefits, some
facilities providing long-term care still lag in their decision to adopt. There is also limited
evidence on the adoption of HIT and quality measurement. Further deficiency in reporting
quality measurements by homecare nursing facilities has made it difficult to understand how
health I.T. can positively improve care delivery. This article explored the trends of technology
adoption in nursing homes in the United States for over two years. The relation of these trends to
the nationally reported quality measures by the facilities.
The study used a longitudinal survey done on nursing home supervisors once a year for
two years. The data sources used include an annual survey to identify trends in I.T. adoption and
nationally reported data on quality measures and organizational data from the nursing homes.
The home care nursing administrators recruited in the first year of study were also recruited for
year two. A total of 815 nursing home supervisors completed the I.T. sophistication survey in the

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first and second years. Further, the nursing homes were sampled from each State in the U.S. and
had the same characteristics, such as bed capacity and location. Data analysis was done using
descriptive statistics to understand nursing homes’ features in the second year of the survey
compared to those not sampled about ownership, bed capacity, and location. The authors also
used post-stratification weights to estimate the correlation between mean averages of quality
measures and differences in total I.T. sophistication.
Further regression analysis was performed on independent variables where the
differences in I.T. had higher correlations. The results showed that there was a 59 percent
response rate in the two years of study. Differences were also recorded among the homes that
responded and those that did not. The sampled households also reported having a smaller bed
capacity of between 60 and 120, and most of them were from rural areas. The total I.T.
sophistication was significant and increased by 28.1 from year one to year 2 of the study. The
results show that health I.T. impacts nursing homes’ quality measures since they contributed to
increased health outcomes and efficiency in care. The adoption of I.T. could be attributed,
therefore, to the location and capacity of the hospital to cover installation costs.
Beks, H., Healey, C., & Schlicht, K. G. (2018). “When you’re it”: a qualitative study exploring
the rural nurse experience of managing acute mental health presentations. Rural And
Remote Health, 18(3), 4616. https://doi-org.ezp.waldenulibrary.org/10.22605/RRH4616
The article explores the competency of rural nurses in managing acute mental health
cases in hospital settings. The rural environment does not have sufficient treatment facilities for
mental health patients. Most of the time, the patients rely on the emergency department to
provide care to patients with psychosis. The authors describe this as a problem because nurses in
emergency care are general care nurses and do not have the right expertise to treat these types of

HEALTHCARE INFORMATION TECHNOLOGY TRENDS 4
clients. The nurses also lack technological medical equipment to detect mental health disorders
as they stream into the facility. The study used a survey research design where nurses from rural
facilities without mental health training were sampled. A questionnaire was used to collect data
on the perception of the nurses in treating mental health patients, given a lack of experience and
training in the field. Descriptive and regression models were used to analyze the data collected.
The results revealed that 53 percent of the nurses did not have the proper training and equipment
to treat psychotic patients in general hospitals. Further, health facilities in rural communities are
further apart; hence it is difficult for them to receive proper urgent and specialized support. The
nurses also reported a lack of administrative support, since patients presenting with mental
illness cases should be given wearable detectors to examine their behavior and response to drugs
without endangering themselves, other patients, and medical staff. The nurses also reported using
telephone services to access instructions to treat such patients, which created miscommunication
and medical errors leading to fatalities (Beks, Healey, & Schlicht, 2018). The study shows that a
lack of supportive technologies in treating mentally ill patients lower the quality of care
delivered and prolong the recovery time of the patients.
Pawlowski, T., & Baranowski, P. (2018). Personality traits of nurses and organizational climate
in relation to the use of coercion in psychiatric wards. Perspectives In Psychiatric
Care, 54(2), 287–292.
The article explains the personality characteristics of the nurses who attend to psychiatric
patients. These nurses use coercion to influence patients to take the recommended medication.
This is a common scenario in hospital settings; hence, the supervisors should be wary of their
psychotic wards’ placement. The authors sought to understand the impact of coercive behavior
on the performance of patients in psychiatric wards. The research design used a survey in which

HEALTHCARE INFORMATION TECHNOLOGY TRENDS 5
83 nurses were sampled and observed for twelve months. The age of the sampled participants
was restricted to between 20 and 58 years. The selection criteria were involved in some coercion.
The authors’ used a previous record of restraint and seclusion to understand the specific
situations where the nurses used coercive behavior.
Further, a personality assessment test was administered to the nurses. Self-assessment
and evaluation were also used to study the nurses in terms of their behavior. The researchers
used ‘Gough’s Adjective Check List (ACL) and Kolb’s Organizing Climate’ questionnaire to
collect data. Analysis of data was done using summary statistics to identify the respondents’
mean age, and the personality tests were analyzed using the five-factor model. Regression
analysis was done to determine the relationship between personality traits and coercive behavior.
The results showed that the nurses initiated coercive events in 52 percent of all the cases. More
so more than 60 percent of them believed that restrictive behavior was necessary to enhance
patient therapy. The authors also found out that coercion was indirectly related to more extended
recovery periods. Further technologies linked to restrictive interventions, restraints, and
seclusion can monitor patients and understand their reactive tendencies. Safety is essential to the
nurses, and they can always have alarm devices with them to call for help in case of attacks by
psychotic clients. The authors document evidence of nurses forcing patients to take drugs.
However, I believe that in some cases, forced medication may be necessary if the patient can
harm himself and others; however, monitoring devices such as wearable detectors can be used to
identify such patients and recommend treatment that does not infringe on their rights.
Ronquillo, J. G., Erik Winterholler, J., Cwikla, K., Szymanski, R., & Levy, C. (2018). Health
I.T., hacking, and cybersecurity: national trends in data breaches of protected health
information. JAMIA Open, 1(1), 15-19.

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This article explains the rapid use of health I.T. in hospital facilities about the rising
reports of cyberattacks by ransomware, making cybersecurity an essential factor in healthcare.
The HITECH Act of 2009 favored the adoption of electronic health records across the united
states, which made the security of large databases a significant concern for all the health care
facilities in the region. The act also required organizations to publicly report security breaches of
confidential patient data that involves more than five hundred clients to the “the U.S.
Department of Health and Human Services (HHS)” and the “Office for Civil Rights (OCR)”
(Ronquillo, Erik Winterholler, Cwikla, Szymanski & Levy,2018). The authors did not find a
formal analysis of cybersecurity attacks on electronic medical records, and hacking incidences
have not been analyzed. The study seeks to leverage federal data to understand better
cybersecurity threats in health I.T. (Ronquillo et al., 2018). The authors used a “retrospective
observational study” of cross-sectional data on reported cases of security breaches in the U.S.
from 2013 to 2017. The data was downloaded from a federal database that is publicly available
to the researchers.
The study results revealed 1512 data breaches in health facilities, which affected
154 415 257 patient records. Similarly, the results also documented 128 electronic health record-
related security breaches affecting 4 867 920 patient records. Further, the authors also found out
that 363 hacking incidences were reported and affected 130 702 378 medical records. The results
reveal that hacking affected 85 percent of all the patient records despite being at a magnitude of
25 percent. The statistical analysis of the data used descriptive statistics to calculate the
frequencies and percentages of the number of data breaches affected patient records, entity,
media type, breach category, and State of occurrence. A chi-square test was used to evaluate the
differences in distribution data breaches in terms of category, and the State-level breaches were

HEALTHCARE INFORMATION TECHNOLOGY TRENDS 7
visualized using Plotly choropleth maps generated by the Python program. This implies that
innovations in medicine bring about the interconnectedness of devices used in healthcare
delivery. The facets to improve the quality of care are driven by informatics, and hence
improvements in cybersecurity are paramount to ensuring operative, safe, and secure health I.T.
systems.

Conclusion

Technological advancements have been on the rise in recent decades. Health I.T. has
been supported by federal legislation that improved the adoption of electronic medical records
and the use of medical devices such as smartphones and monitoring screens to deliver care. The
internet has enabled the sharing of patient data among health professionals and allows prompt
delivery of care. The future of health technology is bright since the field of genomics has not
been fully explored. However, cybersecurity issues need to be addressed to prevent data
breaches, hacking and system lockout, leading to fatalities.

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References

Alexander, G. L., & Madsen, R. (2018). A National Report of Nursing Home Quality and
Information Technology: 2-Year Trends. Journal of nursing care quality, 33(3), 200.
Beks, H., Healey, C., & Schlicht, K. G. (2018). “When you’re it”: a qualitative study exploring
the rural nurse experience of managing acute mental health presentations. Rural And
Remote Health, 18(3), 4616. https://doi-org.ezp.waldenulibrary.org/10.22605/RRH4616
Pawlowski, T., & Baranowski, P. (2018). Personality traits of nurses and organizational climate
in relation to the use of coercion in psychiatric wards. Perspectives In Psychiatric
Care, 54(2), 287–292.
Ronquillo, J. G., Erik Winterholler, J., Cwikla, K., Szymanski, R., & Levy, C. (2018). Health
I.T., hacking, and cybersecurity: national trends in data breaches of protected health
information. JAMIA Open, 1(1), 15-19.