Background: Patient education delivered by a health care provider increases patients' understandi... more Background: Patient education delivered by a health care provider increases patients' understanding and adherence to medical instructions, which helps to improve patient health. Multiple challenges exist to delivering effective patient education to patients with multiple chronic conditions, including giving the necessary time, range, and types of learning materials, and assessing the level of understanding. To help overcome these challenges, it is important to study new electronic means to assist in patient education, such as the use of mobile devices, interactive media, 3-dimensional images, and multimedia educational content at the bedside. Objective: The goal of this study was to address the need for blended learning strategies combining technical and workflow integration of digital patient education systems for patients with chronic conditions within and across the regular process of care. Studies are needed to evaluate the utility and benefits of these technologies for providers and patients alike. Methods: A mixed-methods approach was employed including survey administration to 178 patients after they received digital patient education in person with a health care provider, and qualitative interviews with 16 nurse educators who used the mobile digital health education technology to deliver instruction to patients. Patient survey data were analyzed using chi-square statistical tests. Qualitative interviews were analyzed for user acceptance and perceived value themes. Results: Patients who were counseled using a blended digital health education approach reported improved understanding of educational content (P=.034) and chronic health conditions (P<.001), were more motivated to care for themselves at home (P<.001), were more likely to say that they felt capable of making health care decisions with their doctors (P<.001) and on their own (P=.001), and were more likely to report their intention to follow their doctor's instructions (P<.001) than were patients whose education was not computer-based. Nurse educators felt that the digital education system and content enhanced their education efforts and could be easily integrated into the outpatient clinical workflow. Conclusions: Patient education for individuals with chronic conditions may be more effective than traditional formats when provided in blended digital formats supervised by a health care provider.
IntroductionThe COVID-19 pandemic has affected communities of colour the hardest. Non-Hispanic bl... more IntroductionThe COVID-19 pandemic has affected communities of colour the hardest. Non-Hispanic black and Hispanic pregnant women appear to have disproportionate SARS-CoV-2 infection and death rates.Methods and analysisWe will use the socioecological framework and employ a concurrent triangulation, mixed-methods study design to achieve three specific aims: (1) examine the impacts of the COVID-19 pandemic on racial/ethnic disparities in severe maternal morbidity and mortality (SMMM); (2) explore how social contexts (eg, racial/ethnic residential segregation) have contributed to the widening of racial/ethnic disparities in SMMM during the pandemic and identify distinct mediating pathways through maternity care and mental health; and (3) determine the role of social contextual factors on racial/ethnic disparities in pregnancy-related morbidities using machine learning algorithms. We will leverage an existing South Carolina COVID-19 Cohort by creating a pregnancy cohort that links COVID-...
Over the past 30 years, researchers have demonstrated that health care information technology can... more Over the past 30 years, researchers have demonstrated that health care information technology can improve patient safety and quality of care. More recently, attention has turned increasingly to the role of information and communication technology as a means to improve clinical decision-making, and organizational efficiency and effectiveness. Despite these streams of research, there is a lack of investigations that look at why and how health care executives leverage HIT. In this paper, the researchers investigate the factors, such as working in a JCAHO certified organization, that impact health care executives ’ degree of HIT use in their workplace. The analysis of data collected suggests that there are varying degrees of HIT use among health care executives. Further analysis of the data indicates that, even though the executives in general believe in usefulness of HIT for better service delivery, those beliefs are not a factor in their intent to use HIT in their
This paper formulates, operationalizes, and empirically validates a dual-factor model of healthca... more This paper formulates, operationalizes, and empirically validates a dual-factor model of healthcare information technology (HIT) adoption, by taking into account both the enabling factors driving HIT adoption and the inhibiting factors constraining such adoption. Perceived usefulness and perceived ease of use were examined as enablers and perceived loss of control as an inhibitor. Using survey data on adoption of a new computerized patient order entry system among physicians at a community hospital, we demonstrate that inhibitors not only have a negative effect on one’s intention to adopt HIT systems, counteracting the positive effect of enablers, but also negatively bias some of the enabling perceptions. The overall negative impact posed by inhibitors may override and surpass any positive impact posed by a multitude of enablers. Implications of
This study examines the role of organizational support in motivating organizational members' ... more This study examines the role of organizational support in motivating organizational members' usage of information technology (IT). We postulate two organizational support factors, namely infrastructure support and technical support, theoretically link them to IT usage perceptions using the technology acceptance model (TAM), and empirically test these associations using field survey data from a nationwide sample of healthcare administrators. The results of this study confirm that organizational support plays a critical role in shaping user perceptions toward IT and their subsequent IT usage. Further, it extends personal-usage models such as TAM by incorporating organizational support, which can play a crucial role in motivating IT usage in workplace settings.
Children in foster care face disproportionate rates of biopsychosocial challenges but social and ... more Children in foster care face disproportionate rates of biopsychosocial challenges but social and extracurricular activities (SEAs) may support their healthy development. The Reasonable and Prudent Parenting Standard (RPPS), a 2014 federal policy, aims to increase access to these opportunities for children in foster care. Analyses of statutes from 50 US states and the District of Columbia (n = 51) revealed similarities and differences in state-level RPPS policy implementation. Building on these findings, researchers conducted semi-structured retrospective telephone interviews with foster parents across one southeastern state (n = 20) to identify local retrospective perspectives on RPPS implementation. Using thematic inductive coding two unique themes emerged about SEAs prior to RPPS: 1) negative social impacts and 2) complicated activity approval processes. Three unique themes emerged after RPPS: 1) empowerment, 2) implementation disparities and 3) resource recommendations. Policy im...
Background Patient education delivered by a health care provider increases patients’ understandin... more Background Patient education delivered by a health care provider increases patients’ understanding and adherence to medical instructions, which helps to improve patient health. Multiple challenges exist to delivering effective patient education to patients with multiple chronic conditions, including giving the necessary time, range, and types of learning materials, and assessing the level of understanding. To help overcome these challenges, it is important to study new electronic means to assist in patient education, such as the use of mobile devices, interactive media, 3-dimensional images, and multimedia educational content at the bedside. Objective The goal of this study was to address the need for blended learning strategies combining technical and workflow integration of digital patient education systems for patients with chronic conditions within and across the regular process of care. Studies are needed to evaluate the utility and benefits of these technologies for providers ...
This project intends to identify and develop context-specific measurements that would capture nur... more This project intends to identify and develop context-specific measurements that would capture nursing’s contribution to the quality of care provided to the patient during their visit to the hospital. In this time period nurses play a critical role in many facets of establishing of care quality. There are significant numbers of outcome measures capturing the quality of care provided for the patient. However, there is a deficiency in the area for assessing the factors that would have an important effect on the nurses who are the primary contact with the patient. Literature provides us with evidence that there is a
Aim of this study was to determine nurse managers’ views and attitudes towards health information... more Aim of this study was to determine nurse managers’ views and attitudes towards health information technology. The study was planned as a mixed methods study. Sample of the study consisted of 52 nurse managers. Participants were selected from the nurse managers working at training and research hospitals of a university in Turkey. Content analysis was used for data obtained from face-to-face interviews, and data obtained from other data collection tools were analyzed by frequency, percentage distributions, means, and standard deviations. According to the results obtained from the study; respondents noted strengths of health information technology, such as easing workflow and minimizing medication errors through better documentation. Perceived weaknesses included long waits to obtain patients’ medications when the system was busy, and time lost entering information into the system. Mean score for attitudes about health information technology was 4.90 (±0.90) out of 7. Nurse managers ex...
Musculoskeletal (MSK) conditions are the 3rd largest healthcare burden, affecting 54% of the U.S.... more Musculoskeletal (MSK) conditions are the 3rd largest healthcare burden, affecting 54% of the U.S. population, accounting for nearly 1 in 5 healthcare visits, and exceeding $870 billion in direct and indirect healthcare costs per year. MSK treatment costs increased more than 120% from 1996 to 2011. Yet, there is little evidence that these higher costs improved outcomes for MSK patients and hence the value of care. Measures of patient-reported outcomes (PROs), considered the ultimate validator of value in healthcare, are needed to create this evidence. Existing electronic medical record (EMR) systems are not equipped to incorporate PROs in MSK care making it impossible to assess value. New or re-designed methods, tools, and instruments are needed to consistently collect, analyze, and report on PROs across all patients with MSK conditions to measure value, enhance decision-making, and improve population health. The aims of this research are to 1) assess the opportunities and barriers for collecting PROs for all patients with MSK conditions, and 2) build a prototype agnostic PRO application for collecting and integrating PROs with EMR treatment data for MSK patients. We employ a design science research approach for the systematic analysis, design and development of a prototype integration platform and application for MSK PROs based on extensive prior work with a major health system in the Southeast. The broader impacts include enabling patient-centered decision making, value measurement for MSK populations, and an innovative technology powered environment that enables decision-making capabilities for providers, software vendors, and patients
BACKGROUND The Coronavirus Disease 2019 (COVID-19) caused by the severe acute respiratory syndrom... more BACKGROUND The Coronavirus Disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2) remains a serious global pandemic. Currently, all age groups are at risk for infection but the elderly and persons with underlying health conditions are at higher risk of severe complications. In the United States (US), the pandemic curve is rapidly changing with over 6,786,352 cases and 199,024 deaths reported. South Carolina (SC) as of 9/21/2020 reported 138,624 cases and 3,212 deaths across the state. OBJECTIVE The growing availability of COVID-19 data provides a basis for deploying Big Data science to leverage multitudinal and multimodal data sources for incremental learning. Doing this requires the acquisition and collation of multiple data sources at the individual and county level. METHODS The population for the comprehensive database comes from statewide COVID-19 testing surveillance data (March 2020- till present) for all SC COVID-19 patients (N≈140,00...
2016 International Conference on Computational Science and Computational Intelligence (CSCI), 2016
This study analyzed the effect of PACS technology automation and integration maturity on hospital... more This study analyzed the effect of PACS technology automation and integration maturity on hospital quality scores in U.S. hospitals (n = 2,256). We found cardiology PACS level of integration (CPLI) had a significant effect on hospital efficiency (p=0.000); while level of radiology PACS integration (RPLI) had a significant effect on patient experience and outcome scores (p
The purpose of this study was to determine the roles, expectations and problems of patient compan... more The purpose of this study was to determine the roles, expectations and problems of patient companions and to develop solutions to the difficulties encountered by the nurses, patients and their companions. A qualitative approach with semi-structured face-to-face interviews was used during May and June 2014 to collect data. A convenience sample of participants was selected from the nurses, patients and their companions. Content analysis was used for the data. The results of this study revealed that the need for companions is important to the current Turkish healthcare system, but it has many drawbacks. As companions are witness to a patient's declining health and family, social and financial problems, their role should be to support their patients emotionally or socially, but they should not perform medical tasks. Therefore, the agencies responsible for managing the use of patient companions should regularly review its function by communicating often with the patients and their ca...
Background: Patient education delivered by a health care provider increases patients' understandi... more Background: Patient education delivered by a health care provider increases patients' understanding and adherence to medical instructions, which helps to improve patient health. Multiple challenges exist to delivering effective patient education to patients with multiple chronic conditions, including giving the necessary time, range, and types of learning materials, and assessing the level of understanding. To help overcome these challenges, it is important to study new electronic means to assist in patient education, such as the use of mobile devices, interactive media, 3-dimensional images, and multimedia educational content at the bedside. Objective: The goal of this study was to address the need for blended learning strategies combining technical and workflow integration of digital patient education systems for patients with chronic conditions within and across the regular process of care. Studies are needed to evaluate the utility and benefits of these technologies for providers and patients alike. Methods: A mixed-methods approach was employed including survey administration to 178 patients after they received digital patient education in person with a health care provider, and qualitative interviews with 16 nurse educators who used the mobile digital health education technology to deliver instruction to patients. Patient survey data were analyzed using chi-square statistical tests. Qualitative interviews were analyzed for user acceptance and perceived value themes. Results: Patients who were counseled using a blended digital health education approach reported improved understanding of educational content (P=.034) and chronic health conditions (P<.001), were more motivated to care for themselves at home (P<.001), were more likely to say that they felt capable of making health care decisions with their doctors (P<.001) and on their own (P=.001), and were more likely to report their intention to follow their doctor's instructions (P<.001) than were patients whose education was not computer-based. Nurse educators felt that the digital education system and content enhanced their education efforts and could be easily integrated into the outpatient clinical workflow. Conclusions: Patient education for individuals with chronic conditions may be more effective than traditional formats when provided in blended digital formats supervised by a health care provider.
IntroductionThe COVID-19 pandemic has affected communities of colour the hardest. Non-Hispanic bl... more IntroductionThe COVID-19 pandemic has affected communities of colour the hardest. Non-Hispanic black and Hispanic pregnant women appear to have disproportionate SARS-CoV-2 infection and death rates.Methods and analysisWe will use the socioecological framework and employ a concurrent triangulation, mixed-methods study design to achieve three specific aims: (1) examine the impacts of the COVID-19 pandemic on racial/ethnic disparities in severe maternal morbidity and mortality (SMMM); (2) explore how social contexts (eg, racial/ethnic residential segregation) have contributed to the widening of racial/ethnic disparities in SMMM during the pandemic and identify distinct mediating pathways through maternity care and mental health; and (3) determine the role of social contextual factors on racial/ethnic disparities in pregnancy-related morbidities using machine learning algorithms. We will leverage an existing South Carolina COVID-19 Cohort by creating a pregnancy cohort that links COVID-...
Over the past 30 years, researchers have demonstrated that health care information technology can... more Over the past 30 years, researchers have demonstrated that health care information technology can improve patient safety and quality of care. More recently, attention has turned increasingly to the role of information and communication technology as a means to improve clinical decision-making, and organizational efficiency and effectiveness. Despite these streams of research, there is a lack of investigations that look at why and how health care executives leverage HIT. In this paper, the researchers investigate the factors, such as working in a JCAHO certified organization, that impact health care executives ’ degree of HIT use in their workplace. The analysis of data collected suggests that there are varying degrees of HIT use among health care executives. Further analysis of the data indicates that, even though the executives in general believe in usefulness of HIT for better service delivery, those beliefs are not a factor in their intent to use HIT in their
This paper formulates, operationalizes, and empirically validates a dual-factor model of healthca... more This paper formulates, operationalizes, and empirically validates a dual-factor model of healthcare information technology (HIT) adoption, by taking into account both the enabling factors driving HIT adoption and the inhibiting factors constraining such adoption. Perceived usefulness and perceived ease of use were examined as enablers and perceived loss of control as an inhibitor. Using survey data on adoption of a new computerized patient order entry system among physicians at a community hospital, we demonstrate that inhibitors not only have a negative effect on one’s intention to adopt HIT systems, counteracting the positive effect of enablers, but also negatively bias some of the enabling perceptions. The overall negative impact posed by inhibitors may override and surpass any positive impact posed by a multitude of enablers. Implications of
This study examines the role of organizational support in motivating organizational members' ... more This study examines the role of organizational support in motivating organizational members' usage of information technology (IT). We postulate two organizational support factors, namely infrastructure support and technical support, theoretically link them to IT usage perceptions using the technology acceptance model (TAM), and empirically test these associations using field survey data from a nationwide sample of healthcare administrators. The results of this study confirm that organizational support plays a critical role in shaping user perceptions toward IT and their subsequent IT usage. Further, it extends personal-usage models such as TAM by incorporating organizational support, which can play a crucial role in motivating IT usage in workplace settings.
Children in foster care face disproportionate rates of biopsychosocial challenges but social and ... more Children in foster care face disproportionate rates of biopsychosocial challenges but social and extracurricular activities (SEAs) may support their healthy development. The Reasonable and Prudent Parenting Standard (RPPS), a 2014 federal policy, aims to increase access to these opportunities for children in foster care. Analyses of statutes from 50 US states and the District of Columbia (n = 51) revealed similarities and differences in state-level RPPS policy implementation. Building on these findings, researchers conducted semi-structured retrospective telephone interviews with foster parents across one southeastern state (n = 20) to identify local retrospective perspectives on RPPS implementation. Using thematic inductive coding two unique themes emerged about SEAs prior to RPPS: 1) negative social impacts and 2) complicated activity approval processes. Three unique themes emerged after RPPS: 1) empowerment, 2) implementation disparities and 3) resource recommendations. Policy im...
Background Patient education delivered by a health care provider increases patients’ understandin... more Background Patient education delivered by a health care provider increases patients’ understanding and adherence to medical instructions, which helps to improve patient health. Multiple challenges exist to delivering effective patient education to patients with multiple chronic conditions, including giving the necessary time, range, and types of learning materials, and assessing the level of understanding. To help overcome these challenges, it is important to study new electronic means to assist in patient education, such as the use of mobile devices, interactive media, 3-dimensional images, and multimedia educational content at the bedside. Objective The goal of this study was to address the need for blended learning strategies combining technical and workflow integration of digital patient education systems for patients with chronic conditions within and across the regular process of care. Studies are needed to evaluate the utility and benefits of these technologies for providers ...
This project intends to identify and develop context-specific measurements that would capture nur... more This project intends to identify and develop context-specific measurements that would capture nursing’s contribution to the quality of care provided to the patient during their visit to the hospital. In this time period nurses play a critical role in many facets of establishing of care quality. There are significant numbers of outcome measures capturing the quality of care provided for the patient. However, there is a deficiency in the area for assessing the factors that would have an important effect on the nurses who are the primary contact with the patient. Literature provides us with evidence that there is a
Aim of this study was to determine nurse managers’ views and attitudes towards health information... more Aim of this study was to determine nurse managers’ views and attitudes towards health information technology. The study was planned as a mixed methods study. Sample of the study consisted of 52 nurse managers. Participants were selected from the nurse managers working at training and research hospitals of a university in Turkey. Content analysis was used for data obtained from face-to-face interviews, and data obtained from other data collection tools were analyzed by frequency, percentage distributions, means, and standard deviations. According to the results obtained from the study; respondents noted strengths of health information technology, such as easing workflow and minimizing medication errors through better documentation. Perceived weaknesses included long waits to obtain patients’ medications when the system was busy, and time lost entering information into the system. Mean score for attitudes about health information technology was 4.90 (±0.90) out of 7. Nurse managers ex...
Musculoskeletal (MSK) conditions are the 3rd largest healthcare burden, affecting 54% of the U.S.... more Musculoskeletal (MSK) conditions are the 3rd largest healthcare burden, affecting 54% of the U.S. population, accounting for nearly 1 in 5 healthcare visits, and exceeding $870 billion in direct and indirect healthcare costs per year. MSK treatment costs increased more than 120% from 1996 to 2011. Yet, there is little evidence that these higher costs improved outcomes for MSK patients and hence the value of care. Measures of patient-reported outcomes (PROs), considered the ultimate validator of value in healthcare, are needed to create this evidence. Existing electronic medical record (EMR) systems are not equipped to incorporate PROs in MSK care making it impossible to assess value. New or re-designed methods, tools, and instruments are needed to consistently collect, analyze, and report on PROs across all patients with MSK conditions to measure value, enhance decision-making, and improve population health. The aims of this research are to 1) assess the opportunities and barriers for collecting PROs for all patients with MSK conditions, and 2) build a prototype agnostic PRO application for collecting and integrating PROs with EMR treatment data for MSK patients. We employ a design science research approach for the systematic analysis, design and development of a prototype integration platform and application for MSK PROs based on extensive prior work with a major health system in the Southeast. The broader impacts include enabling patient-centered decision making, value measurement for MSK populations, and an innovative technology powered environment that enables decision-making capabilities for providers, software vendors, and patients
BACKGROUND The Coronavirus Disease 2019 (COVID-19) caused by the severe acute respiratory syndrom... more BACKGROUND The Coronavirus Disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2) remains a serious global pandemic. Currently, all age groups are at risk for infection but the elderly and persons with underlying health conditions are at higher risk of severe complications. In the United States (US), the pandemic curve is rapidly changing with over 6,786,352 cases and 199,024 deaths reported. South Carolina (SC) as of 9/21/2020 reported 138,624 cases and 3,212 deaths across the state. OBJECTIVE The growing availability of COVID-19 data provides a basis for deploying Big Data science to leverage multitudinal and multimodal data sources for incremental learning. Doing this requires the acquisition and collation of multiple data sources at the individual and county level. METHODS The population for the comprehensive database comes from statewide COVID-19 testing surveillance data (March 2020- till present) for all SC COVID-19 patients (N≈140,00...
2016 International Conference on Computational Science and Computational Intelligence (CSCI), 2016
This study analyzed the effect of PACS technology automation and integration maturity on hospital... more This study analyzed the effect of PACS technology automation and integration maturity on hospital quality scores in U.S. hospitals (n = 2,256). We found cardiology PACS level of integration (CPLI) had a significant effect on hospital efficiency (p=0.000); while level of radiology PACS integration (RPLI) had a significant effect on patient experience and outcome scores (p
The purpose of this study was to determine the roles, expectations and problems of patient compan... more The purpose of this study was to determine the roles, expectations and problems of patient companions and to develop solutions to the difficulties encountered by the nurses, patients and their companions. A qualitative approach with semi-structured face-to-face interviews was used during May and June 2014 to collect data. A convenience sample of participants was selected from the nurses, patients and their companions. Content analysis was used for the data. The results of this study revealed that the need for companions is important to the current Turkish healthcare system, but it has many drawbacks. As companions are witness to a patient's declining health and family, social and financial problems, their role should be to support their patients emotionally or socially, but they should not perform medical tasks. Therefore, the agencies responsible for managing the use of patient companions should regularly review its function by communicating often with the patients and their ca...
Uploads
Papers by Neset Hikmet