This is a group paper. The group paper is on Change Theories in healthcare informatics. However my section is on Planned Chan

PAPER OUTLINE 3

Paper Outline: Planned Change in Healthcare Informatics

Vladimir Belyaev

7/26/2020

Paper Outline: Planned Change in Healthcare Informatics

Thesis statement:

As health care systems seek to improve service delivery through advanced health care information systems, changes should be accompanied by thorough research in support of effective implementations

1) Healthcare Informatics is the optimization of knowledge and large sets of data with the intention of improving service delivery in the Healthcare Field

2) The Health Care field has reached a tipping point as the revolutionising effects of innovation, modernity and digitalization continue to catch up to it.

A. There is limited application of informatics when it comes to strategic change that is generally planned for the Healthcare field and various fields of practice (Booth et al., 2013).

B. There is need for an adaptive Healthcare system that is able to optimize on available resources rather than a responsive system characterized by poor planning which in turn affects service delivery (Boustani et al, 2010).

3) Everyone stands to benefit from an effective healthcare system.

A. Planned changes will transform the current system to one that is able to adapt to new challenges (Boustani et al., 2010).

B. There will be better optimization of available resources which will in turn save on costs of services (Dark et al., 2017).

C. A dynamic healthcare system will improve patient satisfaction (Terglav et al., 2019)

D. An effective system will improve healthcare personnel satisfaction which has been proven to be necessary in order to foster dedication and motivation among healthcare workers (Johnson & May, 2017).

4) The current healthcare system does not live up to its “Discovery to Delivery” Anthem

A. Planned changes for the Healthcare Filed are supported by little research and knowledge. These changes are therefore more likely to have little positive impact (Booth et al.,2013).

B. Current reviews of the Healthcare Field fail to depict the reality of the field and the challenges that shareholders face in their struggle to offer quality healthcare services (Pawson et al., 2014).

C. There is limited involvement of critical healthcare service providers in the plans to effect systemic change which will in future affect the implementation of change (Corace et al., 2016).

5) Planned changes for Healthcare Informatics need to follow the innovative process decision making process

A. The process needs to be supported by adequate and relevant research (Booth et al., 2013)

B. There is need for better communication among the relevant shareholders to ensure that there is total team involvement (Johnson & May, 2015)

C. Fina decisions need to be systemically implemented across the board for optimal results (Dark et al., 2017).

D. Systemic changes need to be frequently reviewed to evaluate their effectiveness in order to create a dynamic Healthcare system (Pawson et al., 2014).

This section will be 5 pages.

Thesis Statement: Diffusion of Innovation in Healthcare.

I. What is the history of Diffusion of Innovation?

A. The Theory of Diffusion of Innovation by Everett Rogers.

1. Inventor of Diffusion of Innovation Theory. (Mohammadi et al. 2018).

2. Five attributes of innovation and how the perception of these attributes impacts the rate of adoption. (Mohammadi et al. 2018).

II. Stages in Diffusion of Innovation.

A. There are various stages of Diffusion mentioned by Everett Rogers that play a role in how innovation is adapted by users.

1. Early Adopter Stage: Early adopters have a shorter decision process time, deal with abstract concepts and are more willing to accept the uncertainty in adopting an innovation. Evaluation and analysis of program implementation and clinical use is an important driver to adoption for the early majority practices. (Pelletier et al. 2011).

2. Early Majority Stage: Identifying key factors that ease the transition from early adopter group to early majority group. Some of the key factors that helped ease the transition was setting up champions in different stages and having senior leadership involvement during the various stages. (Pelletier et al. 2011).

III. Factors that Influence Diffusion of Innovation: There are many factors that influence or impact innovation from the early stages on through the phase of implementation. Some of the factors listed during this research were as follows:

A. Organizational.

1. The organizational leaders as a whole need to have vision, strategic plan, funding, a good Health Information Technology (HIT) department, great communication, standards and protocols in place, proper channels for dissemination of information and transparency of data. (Parston et al. 2015.).

B. Health Care Providers includes anyone who interacts with patients.

1. Knowledge level, work experience and perception of attributes plays a vital role in the adoption of innovation because as one develops an awareness toward the innovation, the more receptive they become. (Mohammed et al. 2018).

C. Patients.

1. The patient-level factor includes their beliefs, their level of motivation, personality and degree of illness which can impact outcomes. (Chaudoir et al. 2013).

D. Stakeholders. Stakeholders play a very important role from the beginning of innovation to the implementation stage. Every stakeholder has interests from their own experience and background. (Lambooij & Hummel. 2013).

IV. Advantages of Innovation in Healthcare. There are many advantages associated with innovations in healthcare. Over the years we have seen how electronic health records has positively impacted healthcare.

1. Are aimed at improving health outcomes, administrative efficiency, cost effectiveness, or users' experience. (Barnett et al. 2011).

2. Improvement in efficiency in health care, health gains of the patient after implementation of the innovation, employee and patient satisfaction. (Lambooij & Hummel. 2013).

V. Barriers to implementation of Innovation in HealthCare.

A. Although there are many advantages to healthcare innovations, there are many barriers that have impacted the diffusion and collaboration among every system.

1. Capital investment costs, lack of reliable reimbursement mechanisms, design defects that have made some systems time-consuming and inefficient to use. (Pelletier et al. 2011).

2. Lack of specific support staff. (Pelletier et al. 2011).

3. The barriers to adaption and use includes technology issues, time famine and lack of familiarity and experience of their utility. (Reyneke et al. 2018).

4. Misguided public opinion, biased incentives, Information overload, uneven implementation. (Balas et al. 2018).

5. Various Stakeholders groups. (Lambooij & Hummel. 2013).

This section will be 4-5 pages.

A. The five stages of the innovation-decision process play a crucial role in whether a technological system will be adopted (Walitzer et al., 2015).

I. Knowledge involves learning about an innovation which an individual is not exposed to yet. This process allows an individual to learn and have that exposure to innovation (Walitzer et al., 2015).

II. In the second step, the persuasion step involved the individual becoming more interested in innovation and is persuasive to continue finding more information about it (Walitzer et al., 2015).

III. The decision stage enables an individual to find the advantages and disadvantages of the innovation with the concepts of change to allow them to decided were to adopt or reject the innovation (Walitzer et al., 2015).

1. It is important to research innovations and identify their advantages and disadvantages before putting them forward for the use of patients (Turner et al., 2017).

IV. The fourth stage is the implementation stage in which innovation is applied to a situation to find its usefulness and do further research (Walitzer et al., 2015).

1. Systems have to be tested and modified if they are not serving their purpose (Turner et al., 2017).

2. . The usefulness of innovation will be one of the determining factors of its implementation in the public eye (Turner et al., 2017).

V. The last stage is the confirmation stage, in which the individual decides on deciding whether the innovation will be used (Walitzer et al., 2015).

B. Health information systems such as e-appointment scheduling services and Personal Health Records (PHRs) allow health informatics to modernize and make the healthcare delivery system more accessible (Zhang et al., 2015).

I. A “simple but typical consumer e-health innovation – an e-appointment scheduling service – was developed and implemented in a primary health care clinic” (Zhang et al., 2015).

1. This health information system wanted to help patients manage their healthcare care and allow this management to be done more efficiently and effectively (Zhang et al., 2015).

II. There “are a number of different fundamental designs for PHRs. We use the term PHR to refer to the records themselves and the information systems used to support them. Electronic versions can include internet-based portals or computer-based applications” (Archer, 2011).

1. Different versions of electronic personal health records are tested to determine the best option for patients to adopt and enable them to apply these systems to their healthcare management easily.

2. As “the uptake and use of tethered PHRs grew, empirical research emerged on adoption and used rates of and satisfaction with PHRs. In terms of PHR use, the most commonly used functionalities of PHRs are the review of medical test results (laboratory and radiology results), requests for medication refills, and clinical messaging with the provider and practice” (Emani et al., 2012).

I. The different functions of PHR systems allow its usefulness in the implementation stage to be identified to enable the decision-making process of adopting the system easier.

II. The “goal of the PHR is to encourage patients and health consumers to take individual responsibility for their health by being more engaged in the health care process through the use of the PHR” (Househ et al., 2014).

III. The “goal of the PHR is to encourage patients and health consumers to take individual responsibility for their health by being more engaged in the health care process through the use of the PHR” (Househ et al., 2014).

This section will be 4-5 pages.

References

Booth, B.J., Zwar, N. & Harris, M.F. (2013). Healthcare improvement as planned system

change or complex responsive processes? A longitudinal case study in general

practice. BMC Fam Pract 14, 51. https://doi.org/10.1186/1471-2296-14-51

Boustani, M. A., Munger, S., Gulati, R., Vogel, M., Beck, R. A., & Callahan, C. M. (2010). Selecting a change and evaluating its impact on the performance of a complex3

adaptive health care delivery system. Clinical interventions in aging, 5, 141–148.

https://doi.org/10.2147/cia.s9922

Corace, K.M, Srigley, J.A., Hargadon, D.P., et al. (2016). Using behavior change

frameworks to improve healthcare worker influenza vaccination rates: A systematic

review. Vaccine. 2016;34(28):3235-3242. doi:10.1016/j.vaccine.2016.04.071

Pawson R, Greenhalgh J, Brennan C, Glidewell E. (2014). Do reviews of healthcare interventions teach us how to improve healthcare systems?. Soc Sci Med;114:129-137. doi:10.1016/j.socscimed.2014.05.032

Terglav, B., Selak, Š., Vrdelja, M., Kaučič, B., & Gabrovec, B. (2019). Patient satisfaction with the level of being informed about the changes in Slovenian healthcare system, Pielegniarstwo XXI wieku / Nursing in the 21st Century, 18(1), 37-41. doi: https://doi.org/10.2478/pielxxiw-2019-0003

Dark, F., Whiteford, H., Ashkanasy, N.M., et al. (2017). The impact of organisational change and fiscal restraint on organizational culture. Int J Ment Health Syst 11, 11. https://doi.org/10.1186/s13033-016-0116-0

Johnson, M. J., & May, C. R. (2015). Promoting professional behaviour change in healthcare: what interventions work, and why? A theory-led overview of systematic reviews. BMJ open, 5(9), e008592.

Balas, E. A., & Chapman, W. W. (2018). Road map for diffusion of innovation in health care. Health Affairs (Project Hope), 37(2), 198-204. doi:10.1377/hlthaff.2017.1155

Barnett, J., Vasileiou, K., Djemil, F., Brooks, L., & Young, T. (2011). Understanding innovators' experiences of barriers and facilitators in implementation and diffusion of healthcare service innovations: a qualitative study. BMC Health Services Research. 11. https://doi.org/10.1186/1472-6963-11-342

Chaudoir, S. R., Dugan, A. G., & Barr, C. H. (2013). Measuring factors affecting implementation of health innovations: A systematic review of structural, organizational, provider, patient, and innovation level measures. Implementation Science. 8(1). doi:10.1186/1748-5908-8-22

Mohammadi, M.M., Poursaberi, R. & Salahshoor, M.R. (2018). Evaluating the Adoption of Evidence-Based Practice using Rogers's Diffusion of Innovation Theory: a model testing study. Health Promotion Perspectives. 8(1). 25-32.

doi:10.15171/hpp.2018.03

Parston, G., McQueen, J., Patel, H., Keown, O. P., Fontana, G., Kuwari, H. A., & Darzi, A. (2015). ANALYSIS & COMMENTARY: The science and art of delivery: Accelerating the diffusion of health care innovation. Health Affairs, 34(12). 2160- 2166. doi:http://dx.doi.org.ezproxy.liberty.edu/10.1377/hlthaff.2015.0406

Pelletier, A. C., Jethwani, K., Bello, H., Kvedar, J., & Grant, R. W. (2011). Implementing a Web-Based Home Monitoring System within an Academic Health Care Network: Barriers and Facilitators to Innovation Diffusion. Journal of Diabetes Science and Technology, 5(1), 32–38. https://doi.org/10.1177/193229681100500105

Reyneke, A., Jaye, C. & Stokes, T. (2018). “Local Clinical Pathways: From ‘good Ideas’ to ‘practicality’ for General Practitioners.” Journal of primary health care. 10(3).

Archer, N., Fevrier-Thomas, U., Lokker, C., McKibbon, K., Straus, S. (2011). Personal health records: a scoping review, Journal of the American Medical Informatics Association, 18(4), https://doi.org/10.1136/amiajnl-2011-000105

Emani, S., Yamin, C. K., Peters, E., Karson, A. S., Lipsitz, S. R., Wald, J. S., Williams, D. H., & Bates, D. W. (2012). Patient perceptions of a personal health record: a test of the diffusion of innovation model. Journal of medical Internet research, 14(6), e150. https://doi.org/10.2196/jmir.2278

Househ, M. S., Borycki, E. M., Rohrer, W. M., & Kushniruk, A. W. (2014). Developing a framework for meaningful use of personal health records (PHRs). Elsevier. https://daneshyari.com/article/preview/3327278.pdf

Turner, S., D'Lima, D., Hudson, E., Morris, S., Sheringham, J., Swart, N., & Fulop, N. J. (2017). Evidence use in decision-making on introducing innovations: a systematic scoping review with stakeholder feedback. Implementation science: IS, 12(1), 145. https://doi.org/10.1186/s13012-017-0669-6

Walitzer, K. S., Dermen, K. H., Barrick, C., & Shyhalla, K. (2015). Modeling the Innovation-Decision Process: Dissemination and Adoption of a Motivational Interviewing Preparatory Procedure In Addiction Outpatient Clinics. Journal of substance abuse treatment, 57, 18–29. https://doi.org/10.1016/j.jsat.2015.04.003

Zhang, X., Yu, P., Yan, J., & Ton A M Spil, I. (2015). Using diffusion of innovation theory to understand the factors impacting patient acceptance and use of consumer e-health innovations: a case study in a primary care clinic. BMC health services research, 15, 71. https://doi.org/10.1186/s12913-015-0726-2

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Annotated Bibliography

Vladimir Belyaev

Liberty University

1

Statement of Topic

This paper will seek to provide a perspective on planned change, diffusion of innovation, change theories, and the five stages of the innovation decision-making process. The development and applications of innovations in healthcare information systems will undergo a series of research, modifications, and trials before adopting or rejecting them. Improving healthcare involves conducting research, including policymakers, and applying theories.

Planned Change

Booth, B.J., Zwar, N. & Harris, M.F. (2013). Healthcare improvement as planned system change or complex responsive processes? A longitudinal case study in general practice. BMC Fam Pract 14, 51. https://doi.org/10.1186/1471-2296-14-51

This article confirms that the current discourse of stepwise and planned change in strategically targeted areas of practice activity did not provide an accurate explanation of organization reality of healthcare improvement. The study used a qualitative approach using pattern-matching logic that compared an empirically based pattern with two alternative predictions (complex responsive processes or planned system change) defined before data collection. The complexity concepts expressed in human terms as complex responsive processes of relating matched more accurately with the pattern of change. They proved to inform how providers, policymakers, and researchers participate in improving healthcare.

Boustani, M. A., Munger, S., Gulati, R., Vogel, M., Beck, R. A., & Callahan, C. M. (2010). Selecting a change and evaluating its impact on the performance of a complex adaptive health care delivery system. Clinical interventions in aging, 5, 141–148. https://doi.org/10.2147/cia.s9922

The article suggests that the Complex Adaptive System (CAS) nature of healthcare delivery systems and the current research infrastructure are not well designed to sustain the translational "discovery to delivery" practice that is aimed at reducing the existing and future burden of chronic care epidemics that poses a threat to the American society. The study uses complex adaptive system (CAS) theory to provide a framework to select, implement, and evaluate the new models of care delivery with the potential of satisfying the Institute of Medicine's (IOM) recommendations (Boustani et al., 2010). The article helps one to understand that changing the healthcare delivery system into a complex adaptive system might transform the healthcare system into a new integrated adaptive system that is capable of improving the quality, cost-utility, and safety of the American healthcare system.

Corace, K.M, Srigley, J.A., Hargadon, D.P., et al. (2016). Using behavior change frameworks to improve healthcare worker influenza vaccination rates: A systematic review. Vaccine. 2016;34(28):3235-3242. doi:10.1016/j.vaccine.2016.04.071

This article explains how influenza vaccination of healthcare workers can be critical for protecting both patients and staff even though the vaccine coverage among HCW is yet to reach the recommended patient safety targets. During the study, a team of experienced librarians study searched electronic databases using a defined literature search strategy. According to Corace et al., (2016), patient safety’s improvement using behavior change theories are frameworks for designing interventions, while increasing the rate of HCW vaccination should be evaluated. (Corace et al., 2016). Even though the study suggests that vaccination is a complex behavior, it also explains how psychological theories of behavior change can get used as the best tools to increase the uptake of HCW influenza vaccination.

Pawson R, Greenhalgh J, Brennan C, Glidewell E. (2014). Do reviews of healthcare interventions teach us how to improve healthcare systems?. Soc Sci Med;114:129-137. doi:10.1016/j.socscimed.2014.05.032

This article aims to answer the question of whether reviews of healthcare interventions do teach people how to enhance healthcare systems. The study attempted to analyze the problems faced by managers, policymakers, and planners in new health services from the perspective of evidence-based policy. The study concludes that reviews of healthcare programs lack the vital lessons to explain the ways to improve healthcare systems (Pawson et al., 2014). The article is essential because it helps people to understand that lasting system transformation depends on changes in healthcare systems.

Terglav, B., Selak, Š., Vrdelja, M., Kaučič, B., & Gabrovec, B. (2019). Patient satisfaction with the level of being informed about the changes in Slovenian healthcare system, Pielegniarstwo XXI wieku / Nursing in the 21st Century, 18(1), 37-41. doi:  https://doi.org/10.2478/pielxxiw-2019-0003

The article suggests that the information about the residents' satisfaction with the healthcare system is important for healthcare policymakers. The study focused on determining whether the residents of the Republic of Slovenia were satisfied with the current healthcare system and whether they are informed or aware of the proposed draft law changes (Terglav et al., 2019). The study used a structured survey questionnaire that applied quantitative research, a method of non-experimental sampling. The residents were required to answer thirty-eight questions and statements divided into four segments. The study found that the residents of Slovenia support the public healthcare system to a higher extend, but they are less in favor of the private healthcare system. They are satisfied with the current healthcare system. This article is essential because it determines the satisfaction level of residents with the healthcare system.

Dark, F., Whiteford, H., Ashkanasy, N.M., et al. (2017). The impact of organisational change and fiscal restraint on organizational culture. Int J Ment Health Syst 11, 11. https://doi.org/10.1186/s13033-016-0116-0

The article attempts to explain the relationship between organizational change and organizational culture. The study involves an examination of changes given organizational culture in two community mental health services that applied cognitive therapies in their daily psychosis care for more than three years. The study administered a survey of organizational culture to the clinical staff of each service at an interval of one year for over three years. The study concluded that organizational culture is relatively resilient and robust (Dark et al., 2017). The results did not show any difference between the two services of the organizational culture. This article is essential because it helps individuals to understand the relationship between the planned organizational change and the organizational culture.

Johnson, M. J., & May, C. R. (2015). Promoting professional behaviour change in healthcare: what interventions work, and why? A theory-led overview of systematic reviews. BMJ open, 5(9), e008592.

This article aims at establishing the features of successful behavior change interventions in the healthcare system. The study used a theory led-analysis using the concepts of normalization process theory (NPT). The study used a logical overview of systematic reviews that helped to determine how effective behavior change interventions exist. The study used patients and healthcare professionals from both primary and secondary care (Johnson & May, 2015). Out of the 4724 articles searched, 67 of them met the inclusion criteria. The theory-led analysis suggested that some interventions can offer the best chances of success.

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BUSI 505

Research Project – Draft Instructions

Using your Annotated Bibliography and Outline, your group will work collaboratively on the draft of a 20–25-page paper. The topic of the paper will be selected by the group and approved by the instructor. You will contribute weekly to the group’s discussion in the Research Project Group Discussion Board Forum about this paper. The paper must comply with the formatting and content instructions below.

Format

· Minimum of 20–25 pages, double-spaced, not including title and reference pages

· Times New Roman, 12-point font

· Left-justified only with 1 1/2 inch margins on the left side

· One-inch margins on the top, right, and bottom

· Current APA format

· Numbered pages

· Minimum of 20 scholarly articles from peer-reviewed journals. Must be less than 10 years old.

· Use block quotations for more than 40 words:

· Single-spaced with a double space separating quotes

· Indented 5 spaces from left margin

· No quotation marks

· Reference page in current APA format including active URL links (not included in page total)

· Single-space between references and double-space within the reference

Content

· A title page that includes:

· Running head and page number (right aligned)

· Course number and name

· Case name

· Group # and all group member names

· Date submitted

· “Respectfully submitted to: (Instructor’s Name)”

· Abstract (block formatted)

· Content of your topic and/or paper (review the associated grading rubric)

· Concepts from the textbook that are related to your topic, including page numbers where the concepts may be found. Credit will only be earned for concepts supported by text page numbers (essentially, this is accomplished through integration of the relevant course content using properly formatted, current APA citations).

· Use current APA in-text citations to credit sources listed in the reference list as needed

· Conclusion

· References

Plagiarism

Plagiarism will not be tolerated. Plagiarism commonly occurs when the student utilizes an author’s words and does not properly attribute the source. All sources must be referenced. Do not cut and paste or copy unless you are directly quoting a reference. Purchasing papers of any form will result in automatic failure for the course and a recommendation for expulsion.

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