The American journal of managed care
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First, to assess whether hospitals expand the network breadth of their health information exchange (HIE) partners after joining an accountable care organization (ACO). Second, to analyze whether this HIE network expansion effect varies across markets with differing levels of ACO penetration. ⋯ Hospitals that joined ACOs increased their HIE breadth, but this effect was heterogenous across markets and across time. Our findings illustrate a "network effect," with large, immediate effects in HIE breadth following ACO participation in high-ACO penetration markets and smaller, delayed effects in low-ACO penetration markets.
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Patient portals are health information technology tools that offer patients access to their personal health information and a means to communicate with health care providers, but little is known about their impact on patient satisfaction. Identifying factors that increase patient satisfaction may improve patient care and can protect health care providers from financial penalties. Our study sought to investigate how patient portals are associated with patient satisfaction in both inpatient and outpatient settings. ⋯ Our study suggests the potential for patient portals to enhance patient satisfaction, especially in areas such as care coordination and care transitions. In both inpatient and outpatient settings, portal use may improve the patient-centeredness of care. Our findings indicate important considerations for both health care organizations and their patients to promote patient portal use as a means of improving patient satisfaction, especially in the context of potential impacts on reimbursement and reputation.
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To develop a text analytics methodology to analyze in a refined manner the drivers of primary care physicians' (PCPs') electronic health record (EHR) inbox work. ⋯ This study demonstrated that advanced text analytics provide a reliable data-driven methodology to understand the individual physician's EHR inbox management work with a significantly greater level of detail than previous approaches. This methodology can inform decision makers on appropriate workflow redesign to eliminate unnecessary workload on PCPs and to improve cost and quality of care, as well as staff work satisfaction.
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As predictive analytics are increasingly used and developed by health care systems, recognition of the threat posed by bias has grown along with concerns about how providers can make informed decisions related to predictive models. To facilitate informed decision-making around the use of these models and limit the reification of bias, this study aimed to (1) identify user requirements for informed decision-making and utilization of predictive models and (2) anticipate and reflect equity concerns in the information provided about models. ⋯ Health systems should provide key information about predictive models to clinicians and other users to facilitate informed decision-making about the use of these models. Implementation efforts should also expand to routinely incorporate equity considerations from inception through the model development process.
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The tropomyosin receptor kinase (TRK) family of proteins is encoded by neurotrophic tyrosine receptor kinase (NTRK) genes and has a role in the development and normal functioning of the nervous system. NTRK gene fusions have been identified as oncogenic drivers in a wide range of tumors in both adult and pediatric patients. ⋯ The development of drugs that specifically target oncogenic drivers of cancer has led to the emergence of screening technologies to identify the patients most likely to benefit from targeted therapy. This review describes the role of NTRK gene fusions in cancer and outlines the epidemiology of NTRK gene fusions, the therapeutic benefits of targeting TRK fusions with small molecule inhibitors, and recommendations for NTRK gene fusion testing in adult and pediatric patients with cancer, in order to guide treatment decisions.