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Hospital readmission risk modeling is of great interest to both hospital administrators and health care policy makers, for reducing preventable readmission and advancing care service quality. To accommodate the needs of both stakeholders, a readmission risk model is preferable if it (i) exhibits superior prediction performance; (ii) identifies risk factors to help target the most at-risk individuals; and (iii) constructs composite metrics to evaluate multiple hospitals, hospital networks, and geographic regions. Existing work mainly addressed the first two features and it is challenging to address the third one because available medical data are fragmented across hospitals. To simultaneously address all three features, this paper proposes readmission risk models with incorporation of latent heterogeneity, and takes advantage of administrative claims data, which is less fragmented and involves larger patient cohorts. Different levels of latent heterogeneity are considered to quantify the effects of unobserved factors, provide composite measures for performance evaluation at various aggregate levels, and compensate less informative claims data. To demonstrate the prediction performances of the proposed models, a real case study is considered on a state-wide heart failure patient cohort. A systematic comparison study is then carried out to evaluate the performances of 49 risk models and their variants. [ABSTRACT FROM AUTHOR]

Businesses often benefit by forming alliances with other firms but risk becoming dependent on their partners. We discuss two situations in which dependence may create serious problems: first, if a partner shuts down and, second, if a partner forms a relationship with a new partner. We examine collaborative relationships formed by businesses operating in the U.S. hospital software systems industry during the 1961-91 period. We find that businesses faced increased risk of dissolution if they did not form new partnerships after partners shut down or formed collaborative relationships with new partners. The results have implications for developing an evolutionary theory of business strategy and performance. Our approach implies that the performance of a focal business often depends on how the strategies of its business partners evolve over time. An evolutionary theory of strategy must incorporate key characteristics of actions and relationships throughout a web of business partnerships. The dual nature of interfirm relationships, which both help a business survive at one time and inhibit its ability to adapt at another, helps explain why so many successful businesses fail when their environments change. [ABSTRACT FROM AUTHOR]

The nature of the task to be performed by the information systems (IS) unit as a contextual factor has received little attention in the IS research literature. In addition, prior empirical work examining IS structure lacks theoretical foundation. In this paper we first clarify the multidimensional nature of an organization's subunit structure. Then, we examine the impact of the structure variables on the perceived effectiveness of a subunit of lS--software development--using "task" as the contextual contingency influencing this relationship. Organizational information processing theory provides the theoretical foundation for this study. Analysis of data from thirty hospital reveals that a contingency relationship exists between task context and structural dimensions of software development subunits in determining their effectiveness. Task complexity and decision-making structure in interaction exhibit a nonmonotonic effect on the software development subunit's effectiveness. While the interaction of subunit work flow interdependence with both decision-making structure and control structure was significant, the direction of effect was unexpected. Implications of these findings for practicing managers, and IS planners and researchers are discussed. [ABSTRACT FROM AUTHOR]

Hospital administrative data are attractive for comparing performance of maternity units because of their often large sample sizes, lack of selection bias and the relatively low costs of accessing these data compared with conducting primary data collection. However, using administrative data to develop indicators can also present challenges including varying data quality, the limited detail on clinical risk factors and a lack of structural and user experience measures. This review illustrates how to develop performance indicators for maternity units using hospital administrative data, including methods to address the challenges that administrative data pose.Tweetable Abstract: How to develop maternity indicators from administrative data. [ABSTRACT FROM AUTHOR]

The topology of the patient flow network in a hospital is complex, comprising hundreds of overlapping patient journeys, and is a determinant of operational efficiency. To understand the network architecture of patient flow, we performed a data-driven network analysis of patient flow through two acute hospital sites of King’s College Hospital NHS Foundation Trust. Administration databases were queried for all intra-hospital patient transfers in an 18-month period and modelled as a dynamic weighted directed graph. A ‘core’ subnetwork containing only 13–17% of all edges channelled 83–90% of the patient flow, while an ‘ephemeral’ network constituted the remainder. Unsupervised cluster analysis and differential network analysis identified sub-networks where traffic is most associated with A&E performance. Increased flow to clinical decision units was associated with the best A&E performance in both sites. The component analysis also detected a weekend effect on patient transfers which was not associated with performance. We have performed the first data-driven hypothesis-free analysis of patient flow which can enhance understanding of whole healthcare systems. Such analysis can drive transformation in healthcare as it has in industries such as manufacturing. [ABSTRACT FROM AUTHOR]

Objectives To evaluate the accuracy of an algorithm identifying newly diagnosed immune thrombocytopenia ( ITP) patients in the French national health insurance database ( SNIIRAM). Methods The source of data was the SNIIRAM of Midi-Pyrenees region (southwest of France, three million inhabitants). Data of patients with at least one ITP code (D69.3 code of the International Classification of Disease, version 10) were extracted between January 1, 2012, and December 31, 2014. We used an algorithm that identifies newly diagnosed primary ITPs. Medical charts of incident ITPs were reviewed. Positive predictive values ( PPVs) of identification of true, incident, and primary ITP cases were estimated. Results Of the 168 patients selected, 161 were true ITP cases yielding a PPV of 95.8% (95% confidence interval-95% CI: 92.8-98.8). Among them, 128 were truly incident according to symptom onset date and 134 according to the diagnosis date yielding PPVs of 79.5% (95% CI: 73.2-85.7) and 83.2% (95% CI: 77.4-89.0), respectively. Median time between estimated diagnosis date by the algorithm and true diagnosis date was 0 days (interquartile range: 0 to 15). Conclusions This study showed a very good PPV of this algorithm identifying incident primary ITP patients in the SNIIRAM. [ABSTRACT FROM AUTHOR]

Objective: To explore and understand approaches to user engagement through investigating the range of ways in which health care workers and organizations accommodated the introduction of computerized physician order entry (CPOE) and computerized decision support (CDS) for hospital prescribing.Study Setting: Six hospitals in England, United Kingdom.Study Design: Qualitative case study.Data Collection: We undertook qualitative semi-structured interviews, non-participant observations of meetings and system use, and collected organizational documents over three time periods from six hospitals. Thematic analysis was initially undertaken within individual cases, followed by cross-case comparisons.Findings: We conducted 173 interviews, conducted 24 observations, and collected 17 documents between 2011 and 2015. We found that perceived individual and safety benefits among different user groups tended to facilitate engagement in some, while other less engaged groups developed resistance and unsanctioned workarounds if systems were perceived to be inadequate. We identified both the opportunity and need for sustained engagement across user groups around system enhancement (e.g., through customizing software) and the development of user competencies and effective use.Conclusions: There is an urgent need to move away from an episodic view of engagement focused on the preimplementation phase, to more continuous holistic attempts to engage with and respond to end-users. [ABSTRACT FROM AUTHOR]

Objectives To perform a national analysis of the perioperative outcome of major head and neck cancer surgery to develop a stratification strategy and outcomes assessment framework using hospital administrative data. Design A Hospital Episode Statistics N = near-all analysis. Settings The English National Health Service. Main outcome measures Local audit data were used to assess and triangulate the quality of the administrative dataset. Within the national dataset, cancer sites, morbidities, social deprivation, treatment, complications, and in-hospital mortality were recorded. Results Within local audit datasets, the accuracy of assigning newly-derived Cancer Site Strata and Resection Strata were 92.3% and 94.2%, respectively. Accuracy of morbidities assignment was 97%. Within the national dataset, we identified 17 623 major head and neck cancer resections between 2002 and 2012. There were 12 413 males and mean age at surgery was 63 ± 12 years. The commonest cancer site strata were oral cavity (42%) and larynx-hypopharynx (32%). The commonest resection site was the larynx ( n = 4217), and 13 211 and 11 841 patients had neck dissection and flap-based reconstruction, respectively. There were prognostically significant baseline differences between patients with oromandibular and pharyngolaryngeal malignancy. Patients with pharyngolaryngeal malignancies had a greater burden of morbidities, lower socio-economic status, fewer primary resections, and a sixfold increased risk of undergoing their major resection during an emergency hospital admission. Mean length of stay was 25 days and each complication linearly increased it by 9.6 days. There were 609 (3.5%) in-hospital deaths and a basket of seven medical and three surgical complications significantly increased the risk of in-hospital death. At least one potentially lethal complication occurred in 26% of patients. The risk of in-hospital death in a patient with no potentially lethal complication was 1.1% and this increased to 6% with one potentially lethal complication, and to 15.1% if two potentially lethal complications occurred in one patient. Complex oral-pharyngeal resections and pharyngolaryngectomies had the highest risks of complications and mortality. Conclusion Mortality following head and neck cancer surgery shows variation across different resection strata. We propose an Informatics-based Framework for Outcomes Surveillance ( IFOS) in Head and Neck Surgery for perpetual quality assurance, using the local hospital coding data or its collated destination, the national administrative dataset. [ABSTRACT FROM AUTHOR]

The nurse call system is the lifeline for a patient in a hospital room. Nurse call systems help patients initiate calls from their room in a hospital, and the response to these calls is a crucial factor in providing timely quality care and improving patient satisfaction. Two questions arise in relation to response time. Are there differences in the response to patient calls in different hospital units? Does an IT-enabled escalation of calls to ensure care quality improve the call response efficiency and effectiveness? In this study, we explore these two research questions. We argue that differences in call response time are influenced by two operational attributes of care units: velocity and uncertainty. These attributes will determine how nursing staff view both the need and urgency associated with calls and respond to them. Internet discussion forums at allnurses.com (secondary data analysis) are used to answer the first question. The analysis validates a 2 ? 2 framework, which maps four different hospital units on velocity and uncertainty dimensions. A quantitative approach is then used to address the second question by analyzing the response time differences to patient calls by different hospital units when an IT-based escalation protocol is used. Data from 1,131 patient rooms provides evidence of response time differences in different units, each with a varying degree of velocity and uncertainty. We then discuss the implications of this research for future studies on patient satisfaction using a single metric such as nurse call response time. [ABSTRACT FROM AUTHOR]

Background The routine collection of large amounts of clinical data, 'big data', is becoming more common, as are research studies that make use of these data source. The aim of this paper is to provide an overview of the uses of data from large multi-institution clinical databases for research. Methods This article considers the potential benefits, the types of data source, and the use to which the data is put. Additionally, the main challenges associated with using these data sources for research purposes are considered. Results Common uses of the data include: providing population characteristics; identifying risk factors and developing prediction (diagnostic or prognostic) models; observational studies comparing different interventions; exploring variation between healthcare providers; and as a supplementary source of data for another study. The main advantages of using such big data sources are their comprehensive nature, the relatively large number of patients they comprise, and the ability to compare healthcare providers. The main challenges are demonstrating data quality and confidently applying a causal interpretation to the study findings. Conclusion Large clinical database research studies are becoming ubiquitous and offer a number of potential benefits. However, the limitations of such data sources must not be overlooked; each research study needs to be considered carefully in its own right, together with the justification for using the data for that specific purpose. [ABSTRACT FROM AUTHOR]

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The article discusses a linked patient blood management (PBM) data system in a Western Australian hospital and presents blood usage data obtained by the system. It mentions the use of a patient identifier to connect the Patient Administration System with the Laboratory Information System. The number of blood transfusions between August 2008 and July 2009 is cited. The system's facilitation of the effective targeting of PBM strategies is also addressed.

Introduction: Users' role in the successful application of Hospital Information Systems (HIS) is of crucial importance. Diffusion of Innovation Theory (DIT) is a theoretical model for understanding the relationship between users and technological systems including HIS by assessing users' intentions to use these systems. This study aimed at determining the factors associated with users' intentions to use HIS on the basis of DIT. Methods: The participants of this descriptive and analytical study were randomly selected from 50 HIS users of Razi Hospital in Ahvaz. The instrument was a questionnaire the reliability of which was measured by test-retest (r = 0.84) and its internal consistency by Cronbach's alpha (α =0/90). Content validity, and face validity of the questionnaire were also determined. The data were analyzed by SPSS (version 17) using descriptive and inferential statistics. Results: There were negative correlations between age and relative advantage (r = -0.56, p< 0.05), kinds of job and relative advantage (r = -0.32, p< 0.05), age and compatibility (r = -0.28, p< 0.05), kinds of job and compatibility (r = - 0.29, p< 0.05) and kinds of job and observed ability (r = - 0.30, p< 0.05). However, there were positive correlations between educational level and complexity (r = 0.29, p< 0.05), computer training and trial ability (r= 0.28, p< 0.05), financial organizational support and relative advantage (r =0.31, p< 0.05), emotional organizational support and relative advantage (r = 0.36, p< 0.05), and emotional organizational support and compatibility (r = 0.27, p< 0.05). Discussion: The results revealed the effects of DIT on users' intentions to use HIS. Further studies are required to support the findings of the present study in order to enhance adaptation and compatibility of HIS. [ABSTRACT FROM AUTHOR]

The article presents a study on the Procedural Index for Mortality Risk (PIMR): an index calculated using administrative data to quantify the independent influence of procedures on risk of hospital death. An internally validated an index to quantify the independent association of a broad range of therapeutic procedures with risk of death in hospital was derived. The study shows that this scale will improve risk adjustment when administrative data are used for analyses.

The article focuses on the extracted index terms in recorded diseases in hospital discharge summaries and examines the capability of the vector space model to select a suitable diagnosis. The study used morphological analysis and constructed an original dictionary for the discharge summary analysis of several Japanese hospitals. It presents the Diagnosis Procedure Combination (DPC) codes and analyzes the group of summaries according to the classification of DPCs. It suggests that extraction of suitable terms for each disease and characteristics can be obtained from the calculated vectors. It also adds that characterization of the contents of electronic discharge summaries and deduction of the data can be obtained by text mining.

Inpatient diabetes programs have an opportunity to influence system-wide changes that can lead to improved quality and safety outcomes for patients. Data collection and analysis can lead to these improved outcomes through practice changes, development of protocols and order sets, and staff education. Tools and resources are available to assist diabetes professionals with their efforts toward continuous quality improvement. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives ‘Real world data’ are needed to assess the quality of pharmacological treatments in clinical practice. The aim of this study was to determine whether administrative databases can be used to assess the quality of prophylaxis with low-molecular-weight heparin after major orthopaedic surgery. Methods The study was performed in a Belgian university hospital. Patients undergoing total hip replacement (THR), total knee replacement (TKR) or hip fracture surgery (HFS) were selected retrospectively from the hospital's 2002 and 2003 administrative databases. Readmissions during the same year as the procedure were also analysed. Three quality indicators were assessed: incidence of venous thromboembolism (VTE), major bleeding and death; adherence to guidelines; and the costs of care. Results Although 70% of data were collected from administrative databases, patients' records also had to be examined. During the period studied, VTE and major bleeding events were rare. Patients undergoing HFS were at greater risk of having a pulmonary embolism [Exact odds ratio (OR) = 3.78; 95% confidence interval (CI) = 1.13–16.22; P = 0.03] or of death from any cause (Exact OR = 2.15; 95% CI = 1.52–infinity; P < 0.01) than patients undergoing THR or TKR. The hospital's prophylaxis protocol was not always followed. Half the patients received higher prophylaxis doses than recommended and 11% received lower doses but no impact on adverse events was demonstrated. Conclusion Results show that administrative databases contain enough information to measure the frequency of adverse events but complementary data on patient weight and on non-reimbursed drugs must be extracted from the patients' records to evaluate adherence to guidelines. Our findings stress the need for better integration of information systems. [ABSTRACT FROM AUTHOR]

This study is concerned with methods to measure population-based indicators of quality end-of-life care. Using a retrospective cohort approach, we assessed the feasibility, validity and reliability of using administrative databases to measure quality indicators of end-of-life care in two Canadian provinces. The study sample consisted of all females who died of breast cancer between 1 January 1998 and 31 December 2002, in Nova Scotia or Ontario, Canada. From an initial list of 19 quality indicators selected from the literature, seven were determined to be fully measurable in both provinces. An additional seven indicators in one province and three in the other province were partially measurable. Tests comparing administrative and chart data show a high level of agreement with inter-rater reliability, confirming consistency in the chart abstraction process. Using administrative data is an efficient, population-based method to monitor quality of care which can compliment other methods, such as qualitative and purposefully collected clinical data. [ABSTRACT FROM AUTHOR]

Objective: Relatively little is known about the ability of Canadian emergency departments (EDs) and the federal, provincial and territorial governments to quantify ED activity. The objectives of this study were to determine the use of electronic patient data in Canadian ED5, the accessibility of provincial data on ED visits, and to identify the data elements and current methods of ED information system (EDIS) data collection nationally. Methods: Surveys were conducted of the following 3 groups: 1) all ED directors of Canadian hospitals located in communities of >10 000 people, 2) all electronic EDIS vendors, and 3) representatives from the ministries of health from 13 provincial and territorial jurisdictions who had knowledge of ED data collection. Results: Of the 243 ED directors contacted, 158 completed the survey (65% response rate) and 39% of those reported using an electronic EDIS. All 11 EDIS vendor representatives responded. Most of the vendors provide a similar package of basic EDIS options, with add-on features. All 13 provincial or territorial government representatives completed the survey. Nine (69%) provinces and territories collect ED data, however the source of this information varies. Five provinces and territories collect triage data, and 3 have a comprehensive, jurisdiction-wide, population-based ED database. Thirty-nine percent of ED5 in larger Canadian communities track patients using electronic methods. A variety of EDIS vendor options are available and used in Canada. Conclusion: The wide variation in methods and in data collected presents serious barriers to meaningful comparison of ED services across the country. It is little wonder that the majority of information regarding ED overcrowding in Canada is anecdotal, when the collection of this critical health information is so variable. There is an urgent need to place the collection of ED information on the provincial and national agenda and to ensure that the collection of this information consistent, comprehensive and mandatory. [ABSTRACT FROM AUTHOR]

Background and Objectives We wanted to establish a permanent national database system, which can be utilized to study transfusion recipients and blood use in Finland. Materials and Methods A regularly updated register for permanent use was developed. To study the usability of the database, years 2002 and 2003 were further analysed. Database included all transfused patients in major blood-transfusing hospitals from four university and five central hospital districts managing altogether 63% of Finnish inpatient hospital episodes. Results Audit of gathered data reveal 96·8% match in adult blood components with Finnish Red Cross, Blood Service sales figures. Model data set includes 59 535 transfused patients (44·3% men and 55·7% women) having received 529 104 blood components. Half of all blood units were transfused in connection with surgical operations. Most of the blood recipients were elderly (51·6% are over 64 years of age). Blood-component use and transfusion-related costs varied widely between hospitals. Conclusion Hospital data managing systems can be useful for creating a population-based database system to monitor and compare transfusion practices. This record provides information about transfusion epidemiology for transfusion professionals, hospital management, and hospital administration. [ABSTRACT FROM AUTHOR]

Background: The success or failure of a computer information system (CIS) depends on whether physicians accept or resist its implementation. Using case studies, we analyzed the implementation of such systems in 3 hospitals to understand better the dynamics of physicians' resistance to CIS implementation. Methods: We selected cases to maximize variation while allowing comparison of CIS implementations. Data were collected from observations, documentation and interviews, the last being the main source of data. Interviewees comprised 15 physicians, 14 nurses and 14 system implementers. Transcripts were produced; 45 segments of the transcripts were coded by several judges, with an appropriate level of intercoder reliability. We conducted within-case and cross-case analyses of the data. Results: Initially, most staff were neutral or enthusiastic about the CIS implementations. During implementation, the level of resistance varied and in 2 instances became great enough to lead to major disruptions and system withdrawal. Implementers' responses to physicians' resistance behaviours played a critical role. In one case, the responses were supportive and addressed the issues related to the real object of resistance; the severity of resistance decreased, and the CIS implementation was ultimately successful. In the other 2 cases, the implementers' responses reinforced the resistance behaviours. Three types of responses had such an effect in these cases: implementers' lack of response to resistance behaviours, antagonistic responses, and supportive responses aimed at the wrong object of resistance. Interpretation: The 3 cases we analyzed showed the importance of the roles played by implementers and users in determining the outcomes of a CIS implementation. [ABSTRACT FROM AUTHOR]

Background: Administrative data can serve as an easily available source for epidemiological and evaluation studies. The aim of this study is to evaluate the use of hospital administrative data to determine breast cancer severity and the appropriateness of surgical treatment. Methods: the study population consisted of 398 patients randomly selected from a cohort of women hospitalized for first-time breast cancer surgery in the Lazio Region, Italy. Tumor severity was defined in three different ways: 1) tumor size; 2) clinical stage (TNM); 3) severity indicator based on HIS data (SI). Sensitivity, specificity, and positive predictive value (PPV) of the severity indicator in evaluating appropriateness of surgery were calculated. The accuracy of HIS data was measured using Kappa statistic. Results: Most of 387 cases were classified as T1 and T2 (tumor size), more than 70% were in stage I or II and the SI classified 60% of cases in medium-low category. Variation from guidelines indications identified under and over treatments. The accuracy of the SI to predict under-treatment was relatively good (58% of all procedures classified as under-treatment using pT where also classified as such using SI), and even greater predicting over-treatment (88.2% of all procedures classified as over treatment using pT where also classified as such using SI). Agreement between clinical chart and hospital discharge reports was K = 0.35. Conclusion: Our findings suggest that administrative data need to be used with caution when evaluating surgical appropriateness, mainly because of the limited ability of SI to predict tumor size and the questionable quality of HIS data as observed in other studies. [ABSTRACT FROM AUTHOR]

Explores the implications for the nursing profession of the trend among hospitals to adopt computerized record maintenance system and information technology. Amount of investments made by hospitals in the U.S. in 2003 to adopt computerized record maintenance system; Potential impact for healthcare delivery of computerized record maintenance system; Concerns of nurses about the trend.

This article describes the importance and the development of data concerning hospital read-missions as an outcomes Indicator. It emphasizes the need for consistent definition of read-missions according to time intervals and diagnostic categories. It describes the development of readmission information using computer abstract databases to ensure consistency of indicators. It also provides examples of data developed through this approach. [ABSTRACT FROM AUTHOR]

This article describes the importance of hospital admission rates as utilization indicators and provides guidance on the development of related data. It identifies categories for analysis of hospital admission rates, including Inpatient services, age groups, and geographic units, it describes how resident hospital admission rates can be developed from computer abstract data and contains examples of this information. [ABSTRACT FROM AUTHOR]

This article outlines the types of health care data currently available from internal and external sources. It describes utilization, outcomes, and financial data. It focuses on information available through computer abstract hospital databases. It provides information concerning the sources and content of these databases. [ABSTRACT FROM AUTHOR]

The authors briefly describe the Medical Illness Severity Groupings System (MedisGroups), a computerized hospital management information system focusing on health outcomes. The implications of health outcome information for hospital marketing activities are discussed. Important changes in the way hospitals currently approach these marketing functions are recommended. [ABSTRACT FROM AUTHOR]

The article focuses on innovative and creative solutions to common nursing management problems based on a study which centered on operating room (O. R.) automation at the Tampa General Hospital (TGH) in the Gulf Coast of Florida. The implemented computerized management system known as STANDACARE O.R. includes software that automates surgical suite management. The resulting benefits of the computerized management system represent a blend of quantitative and qualitative factors. Financial analysis of the surgical suite management information system is also presented. It is concluded that the TGH is enthusiastic about the benefits provided by the O.R. system.

Purpose: Administrative databases are increasingly used for epidemiological investigations. We performed a study to assess the validity of ICD-9 codes for upper urinary tract stone disease in an administrative database. Materials and Methods: We retrieved the records of all inpatients and outpatients at Johns Hopkins Hospital between November 2007 and October 2008 with an ICD-9 code of 592, 592.0, 592.1 or 592.9 as one of the first 3 diagnosis codes. A random number generator selected 100 encounters for further review. We considered a patient to have a true diagnosis of an upper tract stone if the medical records specifically referenced a kidney stone event, or included current or past treatment for a kidney stone. Descriptive and comparative analyses were performed. Results: A total of 8,245 encounters coded as upper tract calculus were identified and 100 were randomly selected for review. Two patients could not be identified within the electronic medical record and were excluded from the study. The positive predictive value of using all ICD-9 codes for an upper tract calculus (592, 592.0, 592.1) to identify subjects with renal or ureteral stones was 95.9%. For 592.0 only the positive predictive value was 85%. However, although the positive predictive value for 592.1 only was 100%, 26 subjects (76%) with a ureteral stone were not appropriately billed with this code. Conclusions: ICD-9 coding for urinary calculi is likely to be sufficiently valid to be useful in studies using administrative data to analyze stone disease. However, ICD-9 coding is not a reliable means to distinguish between subjects with renal and ureteral calculi. [Copyright &y& Elsevier]

The article focuses on the research regarding the use of health information technology (HIT) to reduce health care costs in Texas. It states that the impact of the HIT come from either the single-institution studies or economic models based on projections. It highlights the study by Amarasingham and colleagues which assessed the association between HIT and medical care costs and clinical outcomes of hospitals in the state. It notes that the study evaluated if hospital automation is related to mortality and costs by using Clinical Information Technology Assessment Tool (CITAT). It points out that the findings of the study are circumstantial because it has effectively shown the relationship between better quality, safety, and lower medical costs.

Provides information on a health survey data from the U.S. National Center for Health Statistics as of 2003. Application of electronic and computerized systems in the recording of medical data; Use of automated drug dispensing systems in hospital emergency departments; Life expectancy in 2003.

The article presents question and answers related to coding and documentation in health facilities of the U.S. including what services in medical facilities should be billed, another related to same-day office visits and observation care and one related to fluorescein eye testing.