Person:
Middleton, Blackford

Profile Picture

Email Address

AA Acceptance Date

Birth Date

Research Projects

Organizational Units

Job Title

Last Name

Middleton

First Name

Blackford

Name

Middleton, Blackford

Filters

2006 - 200912010 - 20121

Settings

Author's Publications: search.filters.isAuthorOfPublication.9dc0f1be-7b5f-4914-88c9-d4720933ee7f

Search Results

Now showing 1 - 2 of 2
  • No Thumbnail Available
    Publication
    Assessing the level of healthcare information technology adoption in the United States: a snapshot
    (Springer Nature, 2006) Poon, Eric G; Jha, Ashish; Christino, Melissa; Honour, Melissa M; Fernandopulle, Rushika; Middleton, Blackford; Newhouse, Joseph; Leape, Lucian; Bates, David; Blumenthal, David; Kaushal, Rainu
    Background: Comprehensive knowledge about the level of healthcare information technology (HIT) adoption in the United States remains limited. We therefore performed a baseline assessment to address this knowledge gap. Methods: We segmented HIT into eight major stakeholder groups and identified major functionalities that should ideally exist for each, focusing on applications most likely to improve patient safety, quality of care and organizational efficiency. We then conducted a multi-site qualitative study in Boston and Denver by interviewing key informants from each stakeholder group. Interview transcripts were analyzed to assess the level of adoption and to document the major barriers to further adoption. Findings for Boston and Denver were then presented to an expert panel, which was then asked to estimate the national level of adoption using the modified Delphi approach. We measured adoption level in Boston and Denver was graded on Rogers' technology adoption curve by co-investigators. National estimates from our expert panel were expressed as percentages. Results: Adoption of functionalities with financial benefits far exceeds adoption of those with safety and quality benefits. Despite growing interest to adopt HIT to improve safety and quality, adoption remains limited, especially in the area of ambulatory electronic health records and physician-patient communication. Organizations, particularly physicians' practices, face enormous financial challenges in adopting HIT, and concerns remain about its impact on productivity. Conclusion: Adoption of HIT is limited and will likely remain slow unless significant financial resources are made available. Policy changes, such as financial incentivesto clinicians to use HIT or pay-for-performance reimbursement, may help health care providers defray upfront investment costs and initial productivity loss.
  • Thumbnail Image
    Publication
    Recommended Practices for Computerized Clinical Decision Support and Knowledge Management in Community Settings: A Qualitative Study
    (BioMed Central, 2012) Ash, Joan S; Sittig, Dean F; Guappone, Kenneth P; Dykstra, Richard H; Richardson, Joshua; Carpenter, James; McMullen, Carmit; Shapiro, Michael; Bunce, Arwen; Wright, Adam; Middleton, Blackford
    Background: The purpose of this study was to identify recommended practices for computerized clinical decision support (CDS) development and implementation and for knowledge management (KM) processes in ambulatory clinics and community hospitals using commercial or locally developed systems in the U.S. Methods: Guided by the Multiple Perspectives Framework, the authors conducted ethnographic field studies at two community hospitals and five ambulatory clinic organizations across the U.S. Using a Rapid Assessment Process, a multidisciplinary research team: gathered preliminary assessment data; conducted on-site interviews, observations, and field surveys; analyzed data using both template and grounded methods; and developed universal themes. A panel of experts produced recommended practices. Results: The team identified ten themes related to CDS and KM. These include: 1) workflow; 2) knowledge management; 3) data as a foundation for CDS; 4) user computer interaction; 5) measurement and metrics; 6) governance; 7) translation for collaboration; 8) the meaning of CDS; 9) roles of special, essential people; and 10) communication, training, and support. Experts developed recommendations about each theme. The original Multiple Perspectives framework was modified to make explicit a new theoretical construct, that of Translational Interaction. Conclusions: These ten themes represent areas that need attention if a clinic or community hospital plans to implement and successfully utilize CDS. In addition, they have implications for workforce education, research, and national-level policy development. The Translational Interaction construct could guide future applied informatics research endeavors.