TY - JOUR
T1 - Informatics Systems to Promote Improved Care for Chronic Illness
T2 - A Literature Review
AU - Dorr, David
AU - Bonner, Laura M.
AU - Cohen, Amy N.
AU - Shoai, Rebecca S.
AU - Perrin, Ruth
AU - Chaney, Edmund
AU - Young, Alexander S.
N1 - Funding Information:
This work was supported by the Department of Veterans Affairs through the Health Services Research & Development Service Quality Enhancement Research Initiative (MHS-03-218), and the Desert Pacific Mental Illness Research, Education and Clinical Centers (MIRECC); and by the John A. Hartford Foundation and National Library of Medicine (K22 LM 8427-01).
PY - 2007/3
Y1 - 2007/3
N2 - Objective: To understand information systems components important in supporting team-based care of chronic illness through a literature search. Design: Systematic search of literature from 1996-2005 for evaluations of information systems used in the care of chronic illness. Measurements: The relationship of design, quality, information systems components, setting, and other factors with process, quality outcomes, and health care costs was evaluated. Results: In all, 109 articles were reviewed involving 112 information system descriptions. Chronic diseases targeted included diabetes (42.9% of reviewed articles), heart disease (36.6%), and mental illness (23.2%), among others. System users were primarily physicians, nurses, and patients. Sixty-seven percent of reviewed experiments had positive outcomes; 94% of uncontrolled, observational studies claimed positive results. Components closely correlated with positive experimental results were connection to an electronic medical record, computerized prompts, population management (including reports and feedback), specialized decision support, electronic scheduling, and personal health records. Barriers identified included costs, data privacy and security concerns, and failure to consider workflow. Conclusion: The majority of published studies revealed a positive impact of specific health information technology components on chronic illness care. Implications for future research and system designs are discussed.
AB - Objective: To understand information systems components important in supporting team-based care of chronic illness through a literature search. Design: Systematic search of literature from 1996-2005 for evaluations of information systems used in the care of chronic illness. Measurements: The relationship of design, quality, information systems components, setting, and other factors with process, quality outcomes, and health care costs was evaluated. Results: In all, 109 articles were reviewed involving 112 information system descriptions. Chronic diseases targeted included diabetes (42.9% of reviewed articles), heart disease (36.6%), and mental illness (23.2%), among others. System users were primarily physicians, nurses, and patients. Sixty-seven percent of reviewed experiments had positive outcomes; 94% of uncontrolled, observational studies claimed positive results. Components closely correlated with positive experimental results were connection to an electronic medical record, computerized prompts, population management (including reports and feedback), specialized decision support, electronic scheduling, and personal health records. Barriers identified included costs, data privacy and security concerns, and failure to consider workflow. Conclusion: The majority of published studies revealed a positive impact of specific health information technology components on chronic illness care. Implications for future research and system designs are discussed.
UR - http://www.scopus.com/inward/record.url?scp=33847074557&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33847074557&partnerID=8YFLogxK
U2 - 10.1197/jamia.M2255
DO - 10.1197/jamia.M2255
M3 - Article
C2 - 17213491
AN - SCOPUS:33847074557
VL - 14
SP - 156
EP - 163
JO - Journal of the American Medical Informatics Association
JF - Journal of the American Medical Informatics Association
SN - 1067-5027
IS - 2
ER -