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Informatics implementation in the Veterans Health Administration (VHA) healthcare system to improve quality of care.

Authors: Bradley N. Doebbeling; Thomas E. Vaughn; Kimberly D. McCoy; Peter A. Glassman;

Informatics implementation in the Veterans Health Administration (VHA) healthcare system to improve quality of care.

Abstract

We describe VHA's information technology (IT) implementation from the providers' perspective, and identify factors influencing its effective implementation to improve care. We surveyed a stratified random national sample of 4227 clinicians from three VHA primary care provider groups: 1) physicians; 2) nurse practitioners, physician assistants; and 3) nurses. Facility-level IT support availability was rated across six dimensions: 1) access to literature/evidence, 2) computerized decision support, 3) computerized clinical data, 4) error reduction, 5) provider communication, and 6) patient communication. Factor analysis identified a 5-item scale (IT clinical support, á = 0.76). Generalized estimating equation models identified factors influencing IT clinical support. Complete data from 123 hospitals (1777 providers) were included. IT clinical support was higher in urban hospitals (p<0.05) and those with cooperative cultures (p<0.01). Opportunities exist to enhance effective use of IT to support clinical decision making, electronic communication with patients and access to recommendations while delivering care.

Keywords

Medical Records Systems, Computerized, Quality Assurance, Health Care, Delivery of Health Care, Integrated, Hospitals, Veterans, Organizational Culture, Organizational Innovation, United States, Personnel, Hospital, United States Department of Veterans Affairs, Health Care Surveys, Humans, Regression Analysis, Factor Analysis, Statistical, Information Systems

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Powered by OpenAIRE graph
Found an issue? Give us feedback
selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
12
Average
Top 10%
Top 10%
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