IJSHIM - International Journal of Social Health Information Management

Volume: 4, Issue: 7

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• TOWARD A NEW MODEL OF LIGHT ELECTRONIC MEDICAL RECORD FOR HOMELESS PATIENTS
  Author(s): Edgar Ferrer and Rafael Nieves
  

TOWARD A NEW MODEL OF LIGHT ELECTRONIC MEDICAL RECORD FOR HOMELESS PATIENTS

Author(s): Edgar Ferrer and Rafael Nieves

Electronic Medical Records (EMRs) are promising to improve quality and efficiency in healthcare services. Several models for adopting EMRs in healthcare centers have been developed, these are complex models that follow a clinician driven workflow. However, to provide healthcare to homeless patients requires that some unique conditions be met. This ongoing work present a novel model for adopting EMR to meet the particular medical record needs of homeless patients. The model is intended to be applied by non-profit organizations that reach out homeless, however delivering proper health care in a systematic and professional way could become cumbersome considering the difficult environment in which medical street outreach has to be done. The proposed model follows a patient driven workflow in order to use light EMRs with homeless patients. Grounded Theory techniques are used to analyze data from interviews with physicians that provide healthcare to homeless patients in the metropolitan area of San Juan, Puerto Rico. The model will lead to the implementation of a light EMR system which can be used to collect medical data on the streets. The EMR system follows a patient driven workflow that can run on mobile devices and tablet computers and can be easily integrated to a more complex EMR system.

Keywords: Electronic Medical Records (EMR), E-Health, Medical Records Systems, Patient-Driven Workflow.



• COMPARISON OF ELECTRONIC HEALTH RECORD IMPLEMENTATION IN THE UNITED STATES TO SELECTED OTHER COUNTRIES AROUND THE GLOBE
  Author(s): James A. Ellzy II
  

COMPARISON OF ELECTRONIC HEALTH RECORD IMPLEMENTATION IN THE UNITED STATES TO SELECTED OTHER COUNTRIES AROUND THE GLOBE

Author(s): James A. Ellzy II

This research compares the implementation of electronic health records in the United States to the records of Canada, Australia, and the United Kingdom. The researcher's theory is that countries with socialized medicine are further ahead than the United States. Throughout the research process, other countries, such as Denmark, Finland, the Netherlands, and Sweden were included in the study. These are countries that have achieved greater than ninety-percent use of electronic health records (EHRs) among primary care physicians. The findings are that if EHR implementation is measured in the numbers of primary care physicians utilizing them; then Denmark, Finland, the Netherlands and Sweden have been successful in EHR implementation. Australia and the United Kingdom have also made considerable progress in EHR implementation, while Canada, Germany and Japan are lagging behind with the United States. If successful EHR implementation includes hospital use, then only Finland has been successful, although Sweden has made considerable progress.

Keywords: Electronic Health Records, Socialized Medicine, Socialized Health Insurance, Health Care System, Information Technology.



• EFFECTS OF TENNCARE ON TENNESSEE HOSPITALS
  Author(s): Chinyere Ogbonna-McGruder
  

EFFECTS OF TENNCARE ON TENNESSEE HOSPITALS

Author(s): Chinyere Ogbonna-McGruder

The cost of providing health care has been escalating within the United States. This is especially true of the governmental Medicaid health care program. As such, the rising health care costs experienced by many states, have led during the past two decades, to enactment or shift towards the enactment of legislation that would reform the way that health care is provided and paid for within individual states. The health care reform plan implemented on January 1st 1994, by the State of Tennessee is known as TennCare. The health care reform program's main objectives, were concurrent control of rapidly rising health care costs and extension of health care coverage to a large uninsured Tennessee population, that did not have access to employer sponsored or other government sponsored health insurance. Beneficiaries were enrolled in competing, state chartered managed care organizations that were paid on a capitation basis. Such organizations were responsible for providing broad health care services ranging from inpatient, outpatient and preventive services. This research is focused on analyzing the effects of TennCare health care reform program on all the hospitals in Tennessee. The research will indicate if the reform program had a general negative effect on the well being of Tennessee hospitals. This is important to know especially with the newly enacted March 23rd 2010, Federal Patient Protection and Affordable Care Act, which was also implemented with the main goals of ensuring universal health coverage while reining in rising health care costs.

Keywords: TennCare, Disproportionate Share Hospitals, Non Disproportionate Share Hospitals, Average Daily Census, Admissions and Discharges, Profit, Medicaid, Patient Protection and Affordable Care Act, Medicare, Managed Care, Social Security Act, Eligibility Standards, Universal Coverage.



• HEALTH SYSTEM REFORM ANALYSIS
  Author(s): Melanie M. Tidman
  

HEALTH SYSTEM REFORM ANALYSIS

Author(s): Melanie M. Tidman

The objectives of any healthcare system are multifaceted and complex in today's ever-changing world. This paper will focus on healthcare delivery as it relates to the concepts of funding, patient-centered care and physician shortages within the systems of Canada, the United Kingdom (UK) and France. Of great concern in the United States is the fact that healthcare is not universal. There are currently more than 43 million Americans who are uninsured. Poor funding affects patient access to care and the patient-centered focus of the U.S. healthcare delivery system. Collaborative patient-centered practice is a method that facilitates health care professionals working together and with their patients. Suggestions for reform in the United States will be discussed as they relate to the most successful aspects of each of the healthcare delivery systems in Canada, France, and the United Kingdom.

Keywords: Healthcare Reform, Access, Patient-Centered Care, Prevention, Patient Outcomes.



• FEASIBILITY OF APPLYING SPORT PSYCHOLOGY MENTAL SKILLS WITH CHINESE ATHLETES
  Author(s): Soek Hau
  

FEASIBILITY OF APPLYING SPORT PSYCHOLOGY MENTAL SKILLS WITH CHINESE ATHLETES

Author(s): Soek Hau

Since the official establishment of the Physical Education and Sport Psychology Commission in November, 1979 (Ma, 1990), the field of sport psychology has been growing in China. Historically, most of the commonly used mental skills were advanced upon the Western culture (especially North America) in which individualism was greatly valued. Thus, the effectiveness of implementing them to the Chinese athletes coming from a collective culture could be questionable. In this review, we will discuss several characteristics of Chinese athletes such as their perceptions on controllability, achievement motivation, coping styles and performance appraisal. Further, suggestions on altering the traditional mental skills to suit the Chinese culture will be given. These suggestions are made based on three principles: (a) relationship-oriented, (b) explicit rules and principles, and (c) inclusion of a coach. Other suggestions on sport psychology service delivery in China such as psycho-education with the coaches and the athletes and increase of athlete's autonomy will also be addressed. To conclude, directions on future research within the field will also be discussed.

Keywords: Sport Psychology, Cultural Difference, Mental Skills, Chinese.



• ASSESSMENT OF ENERGY EXPENDITURE, SUBJECTIVE UNIT OF DISTURBANCE, AND RATING OF PERCEIVED EXERTION OF OBESE AND NONOBESE FEMALES DURING PERFORMING REGULATED EXERCISE PROTOCOLS
  Author(s): Abdelhadi Halawa
  

ASSESSMENT OF ENERGY EXPENDITURE, SUBJECTIVE UNIT OF DISTURBANCE, AND RATING OF PERCEIVED EXERTION OF OBESE AND NONOBESE FEMALES DURING PERFORMING REGULATED EXERCISE PROTOCOLS

Author(s): Abdelhadi Halawa

Purpose: The intent of the research study was to investigate the effectiveness of performing low-intensity exercise in the treatment of obesity in women employing three prescribed of walking at low to moderate speeds. The data obtained from this physiological evaluation were utilized to identify the most optimal pattern(s), size(s), and speed(s) of walking to be employed in exercise testing and individualized exercise prescription for weight loss. Methods: Subjects for this study were 18 obese and 21 non-obese adult females. All subjects participated in 2 separate sessions of testing. The first session included administering hydrostatic weighing and residual lung volume tests to determine percent body fat and the level of obesity. A graded treadmill V_{O2 MAX} test was conducted and used as a criterion gold standard for determining the individualized speeds for the walking field test. A modified version of the Cunningham Protocol was employed. The second session was held at least 24 hours following the first session. In this session, the subjects walked at individually prescribed speeds (1 to 5 mph) on three different walking patterns (circle, oval, and shuttle) in random order to all subjects for a 3-minute period each. A 1-minute gas sample was collected in a meteorological balloon at the end of each period. A 30-second %HR_MAX was used to calculate the 12 energy expenditure components (Kcal). Results: No differences were found between the 2 groups in Kcal^.-1.m^-2. A significant difference was found between the 2 groups in Kcal^. L^-1.kg^-1. The obese group expended higher energy in Kcal^.L^-1 in walking on the circle-shaped course than did the non-obese group, and higher energy Kcal^.L^-1.m^-2 in walking the circle-shaped course than in walking the oval-shaped and shuttle-shaped courses. The non-obese group expended the highest energy in Kcal^.-1.kg^-1 on the shuttle-shaped course. No differences were found between the 2 groups for the other 9 independent variables. No interactions were found for these variables. Conclusion: The obese individuals are expected to consume higher energy walking at a low-to-moderate speed in a circular pattern than the nonobese individuals. The non-obese individuals are expected to consume higher energy walking in an oval-shaped or a shuttle-shaped pattern than the obese individuals.

Keywords: Energy Expenditure, Regulated Exercise Protocols, Female Obesity and Overweight, Exercise Testing and Prescription, Subjective Unit of Disturbance (SUDS), and Rating of Perceived Exertion (RPE).



• WILL THE USE OF SUPPLEMENTAL CREATINE DECREASE REHABILITATION TIME AMONG YOUNG ADULTS COPING WITH THE EFFECTS OF IMMOBILIZATION RELATED INJURIES?
  Author(s): Matthew Corn, Don Kallail, Darin Payne, Chad Bullock and Edilberto A. Raynes
  

WILL THE USE OF SUPPLEMENTAL CREATINE DECREASE REHABILITATION TIME AMONG YOUNG ADULTS COPING WITH THE EFFECTS OF IMMOBILIZATION RELATED INJURIES?

Author(s): Matthew Corn, Don Kallail, Darin Payne, Chad Bullock and Edilberto A. Raynes

There is a paucity of research on using oral supplements to shorten rehabilitation times. Creatine monohydrate is a dietary supplement ingested orally in powder or tablet form, which has been used heavily by athletes and recreational enthusiasts over the last ten years in an effort to improve strength gains and reduce recovery times. The researchers hypothesize using supplemental creatine as an adjunct to physical therapy interventions will decrease rehabilitation times by improving strength gains and decreasing adverse effects of immobilization. A systematic review of literature was conducted based on the scale provided by the Oxford Centre of Evidence-based Medicine. The literature reviewed focused on beneficial effects of creatine, physiological pathways within the muscle cell, pharmacokinetics, pharmacodynamics, and potential health risks of creatine use. Based on the evidence gathered, the researchers determined that creatine is effective during glycolysis for energy production, and also in the recovery period after high intensity exercise by reducing lactic acid production, sparing glycogen, promoting myogenic transcription and maintaining a stable environment for protein synthesis. The researchers concluded that creatine might be beneficial as an adjunct to traditional physical therapy interventions in decreasing rehabilitation time.

Keywords: Creatine, Atrophy, Muscle Strength, Endurance, Disuse Atrophy, Skeletal Muscle, Hypertrophy, Immobilization, and Rehabilitation.



• TELE-OCCUPATIONAL THERAPY IN RURAL NEW MEXICO: IMPROVING ACCESS
  Author(s): Melanie M. Tidman
  

TELE-OCCUPATIONAL THERAPY IN RURAL NEW MEXICO: IMPROVING ACCESS

Author(s): Melanie M. Tidman

During the past decade, information technologies have addressed the need for accessibility and cost-effectiveness to provide therapy services and improve the quality of rural health care. Occupational Therapists (OTs) work with individuals to achieve their self-care goals however access to these services is especially problematic in rural areas of the US. In the State of New Mexico, there are 30 counties out of a total of 33 deemed medically underserved with little or no access to OT services. Tele-Rehabilitation has been credited as providing greater cost effectiveness in treatment of the elderly population with management of chronic conditions. The use of videoconferencing in the provision of occupational therapy services is an appropriate method of providing individualized treatment for patients in their homes. Ongoing, high-quality research regarding Tele-OT in rural New Mexico will support the development and assessment of the quality of these services as they relate to improved patient outcomes.

Keywords: Tele-Health, Occupational Therapy, Stroke, Access, Rural Healthcare.