Role of Data in Improving Care within a Health System: A Case Study of the Australian Health System / Lopamudra Das
- Bib ID:
- 7730179
- Format:
- Book and Microform
- Author:
- Das, Lopamudra, author
- Description:
-
- Ann Arbor : ProQuest Dissertations & Theses, 2017
- 240 p.
- ISBN:
- 9780355265545
- Summary:
-
Background - Health information technology (HIT) has been an emerging solution to reducing some gaps in care. Several nations have implemented expensive, large-scale, HIT projects; most have struggled with poor uptake, interoperability, and low sharing and reuse of data. Lack of understanding of complex "multilevel tensions" was a common reason for failure. Objective - This study aims to understand how organizational context and interfaces affect the collection, management, and use of data for care improvement (CI). Methods - The case study consisted of 33 hour-long semi-structured interviews with 38 informants from 27 organizations from 2 states. Primary data collected using snowball sampling in 2007-08 and elicited information on the use of data for improving quality of colorectal cancer care.
Data were supplemented using publicly available organizational information. Data analysis included coding to identify themes and converting data into thematic matrices to enable the detection of patterns and comparative analysis. Results - CI activities centered around the "patient-provider-hospital" relationship. Commonwealth and state entities exhibited higher levels of diversity in CI projects compared to local entities. Funding was a key driver of CI; bulk of CI activities occurred either in response to or in anticipation of funding. Some successful CI caused negative system feedbacks like further weakening of stressed systems and generated perverse incentives to shift costs. The NGO sector was a valuable government ally in CI due to their ability to: 1) influence the "patient-provider-hospital" relationships; 2) focus on diverse and niche areas of care; 3) contribute to CI knowledge base; 4) mitigate governmental conflicts of interest, and 5) act as a policy counterbalance.
There were four fundamental uses of data within the health system --- operations, CI, reporting, and knowledge generation. Data flow (sharing) occurred in response to funding and five distinct patterns of data-funding flows were identified within the health system. Existing data resources were largely underutilized due to various reasons like suboptimal data quality, failure to meet stakeholder needs, high administrative burden of linking and using data, privacy laws, and unwillingness to allow secondary uses of data. Data flow was hindered due to fragmentations including those arising from sovereignty, specificity, or philosophical issues.
- Notes:
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- Source: Dissertation Abstracts International, Volume: 78-12(E), Section: A.
- Advisors: Gery W. Ryan.
- English
- Subject:
- Other authors/contributors:
- The Pardee RAND Graduate School, degree granting institution
- Copyright:
-
In Copyright
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Copyright status was determined using the following information:
- Material type:
- Literary Dramatic Musical
- Published status:
- Published
- Publication date:
- 2017
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