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Biomedical subjects

Charles Safran

Publications and source records attributed to Charles Safran.

13 recordsLinked to original sources
PubMed2006

Toward a national framework for the secondary use of health data: an American Medical Informatics Association White Paper.

Secondary use of health data applies personal health information (PHI) for uses outside of direct health care delivery. It includes such activities as analysis, research, quality and safety measurement, public health, payment, provider certification or accreditation, marketing, and other business applications, including strictly commercial activities. Secondary use of health data can enhance health care experiences for individuals, expand knowledge about disease and appropriate treatments, strengthen understanding about effectiveness and efficiency of health care systems, support public health and security goals, and aid businesses in meeting customers' needs. Yet, complex ethical, political, technical, and social issues surround the secondary use of health data. While not new, these issues play increasingly critical and complex roles given current public and private sector activities not only expanding health data volume, but also improving access to data. Lack of coherent policies and standard "good practices" for secondary use of health data impedes efforts to strengthen the U.S. health care system. The nation requires a framework for the secondary use of health data with a robust infrastructure of policies, standards, and best practices. Such a framework can guide and facilitate widespread collection, storage, aggregation, linkage, and transmission of health data. The framework will provide appropriate protections for legitimate secondary use.

Access to Information↗
PubMed2005

Collaborative Approaches to e-Health: Valuable for Users and Non-users.

OBJECTIVE: To describe parental use of an Internet-based educational and emotional support system, in a regional NICU program. METHODS: Baby CareLink was installed in NICUs in 4 Denver area hospitals in 2003. Parents were offered access from hospital terminals and from any other Internet access point. Data on use of the program was collected by the computer system. Discharge status was verified by Colorado's Department of Public Assistance. RESULTS: Of the 388 families admitted to Denver area NICUs with Baby CareLink during the study period, 135 (34.8%) were identified as Medicaid families (needing public assistance). After exclusions, data for 81 Medicaid and 154 non-Medicaid families were available for analysis. Medicaid families who accessed 3 or more Baby CareLink web pages per day took their infants home 17.5 days sooner than families who used Baby CareLink less often (p=0.03). Among the non-Medicaid families, more frequent users of Baby CareLink took their infants home 14.3 days sooner (p=0.04). CONCLUSIONS: Internet portals will be used by both Medicaid and non-Medicaid parents with children in NICUs to meet educational needs. More frequent use of Baby CareLink was associated with significantly shorter length of stay. Self-help tools for parents may free nursing resource for families with greater needs.

Colorado↗
PubMed2005

A Medicaid eHealth program: an analysis of benefits to users and nonusers.

OBJECTIVE: To describe parental use of an Internet-based educational and emotional support system, in a regional NICU program. METHODS: Baby CareLink was installed in NICUs in 4 Denver area hospitals in 2003. Parents were offered access from hospital terminals and from any other Internet access point. Data on use of the program was collected by the computer system. Discharge status was verified by Colorado's Department of Public Assistance. RESULTS: Of the 388 families admitted to Denver area NICUs with Baby CareLink during the study period, 135 (34.8%) were identified as Medicaid families (needing public assistance). After exclusions, data for 81 Medicaid and 154 non-Medicaid families were available for analysis. Medicaid families who accessed 3 or more Baby CareLink web pages per day took their infants home 17.5 days sooner than families who used Baby CareLink less often (p=0.03). Among the non-Medicaid families, more frequent users of Baby CareLink took their infants home 14.3 days sooner (p=0.04). CONCLUSIONS: Internet portals will be used by both Medicaid and non-Medicaid parents with children in NICUs to meet educational needs. More frequent use of Baby CareLink was associated with significantly shorter length of stay. Self-help tools for parents may free nursing resource for families with greater needs.

Health Care Costs↗
PubMed2004

Bridging the digital divide: reaching vulnerable populations.

The AMIA 2003 Spring Congress entitled "Bridging the Digital Divide: Informatics and Vulnerable Populations" convened 178 experts including medical informaticians, health care professionals, government leaders, policy makers, researchers, health care industry leaders, consumer advocates, and others specializing in health care provision to underserved populations. The primary objective of this working congress was to develop a framework for a national agenda in information and communication technology to enhance the health and health care of underserved populations. Discussions during four tracks addressed issues and trends in information and communication technologies for underserved populations, strategies learned from successful programs, evaluation methodologies for measuring the impact of informatics, and dissemination of information for replication of successful programs. Each track addressed current status, ideal state, barriers, strategies, and recommendations. Recommendations of the breakout sessions were summarized under the overarching themes of Policy, Funding, Research, and Education and Training. The general recommendations emphasized four key themes: revision in payment and reimbursement policies, integration of health care standards, partnerships as the key to success, and broad dissemination of findings including specific feedback to target populations and other key stakeholders.

Financing, Organized↗
PubMed2004

Patient safety. Remember who it's really for.

Patients appear in the patient safety agenda in three important places: first and foremost as the individual most likely to experience the positive benefits of good care or negative consequences of unsafe care; second, as surveyors of quality of care indicators; and finally, through their presence as patient representatives on institutional safety committees. However, patient safety programs largely address provider-interests, and many times overlook patient preferences and needs. Active engagement of the patient in all aspects of the patient safety agenda is necessary for its success. Patient safety, then, requires: a comprehensive agenda informed by patient preferences and experiences; an informed and motivated populace; mechanisms integrate safe practices and patient preferences, and investment in safety-enhancing devices and care strategies.

Health Behavior↗
PubMed2004

Improving cancer related symptom management with collaborative healthware.

We conducted a feasibility study of an innovative Internet-based system, designed to support collaboration between patients and providers around cancer related symptom management. Our objective was to demonstrate the system's potential to enhance communication and clinical decision making between patients and their providers. Considering the high prevalence of cancer related symptoms and their impact on patients' quality of life, enhanced collaboration regarding assessment and treatment could significantly reduce illness burden. Twenty-seven patients with known malignancy and twenty-nine oncology clinicians were interviewed to identify functional requirements for the system. Patients reported the ability, willingness and desire to use a computer to help them manage their cancer related symptoms. Physicians recognized the potential of this system to improve communication and collaboration around symptom management, but voiced concern regarding a potential increased workload. Nurse providers had greater interest in reviewing symptoms online than did their physician counterparts. Patients in this study believe that using an Internet based system to report their cancer related symptoms would improve the quality of the care they receive. Our findings suggest that both patients and clinicians are concerned about the management of cancer related symptoms and would use Internet-based tools if they were shown to improve care.

Attitude to Computers↗
PubMed2003

The collaborative edge: patient empowerment for vulnerable populations.

OBJECTIVE: The problems with access to care and the special needs for educational outreach for disadvantage or vulnerable populations of patients require innovation. This paper describes Baby CareLink use of information technology to support communication, consultation, and collaboration among colleagues as well as with patients, their families, and community resources. METHODS: In response to the educational, emotional and communication needs of parents of premature infants and the clinicians who care for the infants and support the families, we developed Baby CareLink, a secure collaborative environment. Baby CareLink provides a nurturing environment where parents, even though remote from the Neonatal Intensive Care Unit, can actively participate in decisions surrounding their baby's care. RESULTS: In a southeastern hospital serving a mostly Medicaid population in a rural setting, more than 300 parents have used Baby CareLink more than 11000 times during the past year. Despite the common wisdom that Medicaid families do not have access to the Internet, approximately 85% of the parents access Baby CareLink from home, at work, from the library or other public access point. The median use of Baby CareLinks from outside the hospital by parents is 17 separate sessions. In a city hospital in the midwestern US which exclusively serves a Medicaid population, experience has been equally encouraging. More than 70 parents have initiated more than 600 secure sessions with Baby CareLink. In contrast to the rural hospital, only 35% of sessions have been initiated outside the hospital. DISCUSSION: Experience with Baby CareLink suggests that families from all walks of life will use and benefit from collaborative tools that keep them informed and involved in the care of their children. The most significant barrier to wider deployment is bandwidth limitations into the homes of most families. The care of premature infants is a great example of an area where medical knowledge and ability has grown dramatically, and where information and communication technology holds enormous potential.

Aftercare↗
PubMed2003

Report of conference track 3: patient empowerment.

Patient empowerment is a philosophy of health care that proceeds from the perspective that optimal outcomes of health care interventions are achieved when patients become active participants in the health care process. Under a patient empowerment philosophy, patients and clinicians jointly set goals, select interventions, and assess outcomes according to mutually-defined parameters. Employing patient empowerment as an information systems design philosophy leads to creation of computerized information resources, management systems and telehealth innovations in a manner that insures patients' abilities to participate as full partners in health care. Discussions in the track 3 discussion group led to refinement of the concept from patient empowerment to patient engagement. This report reflects the discussions by the participants.

Congresses as Topic↗