Advances in health information science and practice最新文献

{"title":"SDOH Data as Health Care Data: The Multifaceted, Evolving, and Consequential Role of Law and Policy.","authors":"Rachel Landauer, Erika Hanson, Kathryn Garfield, Sara Raza, Carmel Shachar","doi":"10.63116/AH.000000006","DOIUrl":"10.63116/AH.000000006","url":null,"abstract":"<p><strong>Background: </strong>Social determinants of health (SDOH) are increasingly recognized as vital factors shaping health outcomes in the United States. With escalating integration of SDOH data into health information platforms, questions arise about appropriate regulation to both enable data-driven care and protect against potential harms. This article reviews the current regulatory landscape governing SDOH data within the US health care system, with an emphasis on identifying critical tensions, policy strategies, and gaps salient for policymakers, practitioners, and researchers.</p><p><strong>Methods: </strong>We conducted a scan to identify federal and state regulatory activity pertaining to SDOH data within the health care contexts. We synthesized these sources to map the current landscape and tease out emerging themes.</p><p><strong>Results/discussion: </strong>We identified 3 core areas of relevant regulation: (1) data standardization, interoperability, and exchange; (2) information privacy and security; and (3) oversight of advanced analytics, including artificial intelligence applications. Authorities actively wrestle with several key regulatory design questions, including: (1) whether to treat SDOH data created, collected, maintained, and used in or by health care settings in the same way as any other type of health information; (2) effective levers to promote desired policy outcomes; and (3) the rightsized jurisdictional balance between federal and state enforcement. Variations in decisions at these crossroads are entrenching the health care system in a scenario in which SDOH data exchange is more clearly part of the new standard of care in some states than others, and in which SDOH data is more protected in some states than others.</p><p><strong>Conclusion: </strong>Findings speak to the importance of cultivating a regulatory environment for SDOH data within the health care sector that is not only responsive to the current realities of the field but also responsive to rapid evolution and resilient to future challenges.</p>","PeriodicalId":521055,"journal":{"name":"Advances in health information science and practice","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing Preventive-to-E/M Code Conversion Using a Diagnosis-Triggered Documentation Template.","authors":"Joseph E Capito, Jonathon T Williamson, Kelsey Samek, Kimberley Lanham, Erika Bodkins","doi":"10.63116/AH.000000005","DOIUrl":"10.63116/AH.000000005","url":null,"abstract":"<p><strong>Background: </strong>Preventive visits may be converted to problem-oriented evaluation and management (E/M) services when documentation does not clearly support preventive service criteria, resulting in lost reimbursement despite appropriate care delivery. The objective of this study was to evaluate whether a diagnosis-triggered documentation template embedded within the electronic health record reduces conversion of preventive visit codes to problem-oriented E/M codes.</p><p><strong>Methods: </strong>We conducted a 4-month observational evaluation in an academic family medicine clinic. A SmartText-based documentation template was triggered by the diagnosis of \"annual physical examination\" and inserted a standardized health care maintenance attestation into the clinical note. Encounters were classified as templated or nontemplated based on the presence of a SmartData Element. Preventive visit billing data were obtained from institutional reporting systems, and conversion rates were compared using a chi-square test, with effect size calculated using Cramér's V.</p><p><strong>Results: </strong>Among 2310 preventive encounters, the template was used in 685 (29.7%). Overall, 37 visits (1.6%) were converted from preventive visit codes to problem-oriented E/M codes. Conversion occurred in 4 templated visits (0.6%) compared with 33 nontemplated visits (2.0%). Template use was associated with a statistically significant reduction in conversion (χ² = 6.40, <i>df</i> = 1, <i>P</i> = .011), with a small effect size (Cramér's V = 0.053).</p><p><strong>Conclusions: </strong>A diagnosis-triggered documentation template was associated with reduced conversion of preventive visit codes to problem-oriented E/M services. Relatively simple electronic health record (EHR) configuration changes may improve documentation consistency and influence downstream coding outcomes in primary care.</p>","PeriodicalId":521055,"journal":{"name":"Advances in health information science and practice","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Firewall: A Multistakeholder Simulation for Cybersecurity Response in Health Information and Informatics Practice.","authors":"Shannon H Houser, Cathy A Flite, Susan L Foster","doi":"10.63116/AH.000000004","DOIUrl":"10.63116/AH.000000004","url":null,"abstract":"<p><strong>Background: </strong>Cybersecurity incidents, particularly ransomware attacks, pose significant threats to health care systems by disrupting operations, compromising protected health information, and undermining patient trust. Health information management and informatics professionals play a central role in responding to these incidents; however, educational preparation often emphasizes theoretical knowledge with limited opportunities for applied, practice-based learning. This study aims to describe the design, implementation, and evaluation of a multistakeholder tabletop simulation to enhance competencies in cybersecurity incident response, regulatory compliance, and interdisciplinary collaboration.</p><p><strong>Methods: </strong>A simulation-based educational intervention was implemented in 2 settings, namely, a national professional conference workshop and an undergraduate health information management classroom at a large public research university. The simulation was designed as a multistakeholder tabletop exercise set in a 350-bed acute care hospital experiencing a ransomware attack affecting key systems, including the electronic health record and patient portal. Participants assumed interdisciplinary roles representing leadership, clinical, technical, compliance, and vendor perspectives. A postsimulation survey assessed perceptions of realism, clarity of objectives, debriefing effectiveness, and learning outcomes. Descriptive statistics were used to summarize the responses.</p><p><strong>Results: </strong>Participants in both groups strongly agreed that the simulation was realistic, well structured, and effective at reinforcing key learning objectives. The simulation enhanced participants' understanding of cybersecurity response processes, privacy and security principles, and interdisciplinary roles and responsibilities. Although responses were consistently positive, variation between professional and student participants reflected differences in experience and familiarity with health care operations.</p><p><strong>Conclusions: </strong>This study demonstrates that tabletop simulation is an effective, practice-oriented approach to preparing health information management and informatics learners to respond to complex cybersecurity incidents. By integrating technical, regulatory, and leadership perspectives within a realistic health care context, the simulation supports applied learning and workforce readiness. Simulation-based approaches offer a scalable strategy for strengthening cybersecurity preparedness in health information management and informatics education.</p>","PeriodicalId":521055,"journal":{"name":"Advances in health information science and practice","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13463233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Health Care Policies on Patient Portal Adoption and Engagement in US Hospitals: Trends From 2012 to 2024.","authors":"Shannon H Houser, Wei Lyu","doi":"10.63116/AH.000000003","DOIUrl":"10.63116/AH.000000003","url":null,"abstract":"<p><strong>Background: </strong>Patient portals are essential tools for patient engagement, transparency, and communication in US health care. Federal health information technology (IT) policies, such as Meaningful Use, Promoting Interoperability, and the 21st Century Cures Act, have played a pivotal role in driving the adoption of these tools. Despite prior work on portal availability and use, longitudinal, hospital-level analyses aligned with major policy milestones remain limited. This study examines national trends in hospital adoption of patient portal functionalities from 2012 to 2024 and assesses alignment with federal health IT policy initiatives.</p><p><strong>Methods: </strong>We analyzed 2012-2024 data from the American Hospital Association Annual Survey Information Technology Supplement. Three functional domains were evaluated: (1) patient access to information (view, download, and amend); (2) online administrative tools (bill payment, appointment scheduling, and prescription refill); and (3) patient-provider communication (secure messaging, patient-generated data submission, and external record import). Annual adoption rates were calculated, and monotonic trends were assessed using the Mann-Kendall test.</p><p><strong>Results: </strong>By 2024, 92% of hospitals had adopted both viewing and downloading functionalities (τ = 0.94 and τ = 0.97; <i>P</i> < .001). Bill payment increased from 45.9% (2012) to 87.0% (2020). By 2020, prescription refill (74.6%) exceeded appointment scheduling (66.5%). Secure messaging increased from 28.2% (2012) to 88.7% (2024), and patient-generated data submission from 8.4% to 67.7%. In contrast, amending information and importing external records showed greater volatility, with no significant monotonic trends over their measurement windows.</p><p><strong>Conclusions: </strong>US hospitals have made substantial progress in adopting patient portal functionalities over the past decade, broadly paralleling federal policy developments. Core access tools (view/download) are now nearly universal, whereas administrative and communication features continue to expand. Uneven uptake of advanced capabilities highlights variability in implementation and underscores the need for sustained policy support, technical assistance, and equity-focused strategies to ensure that all hospitals-and patients-realize the full benefits of digital engagement.</p>","PeriodicalId":521055,"journal":{"name":"Advances in health information science and practice","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Workforce Review of Health Information Technology Associate-Degree Graduates: 2017-2024.","authors":"Debra Hamada, Karima Lalani, Melanie Brodnik, Susan H Fenton, Angela Kennedy, David T Marc, Velma L Payne, Rebecca Reynolds","doi":"10.63116/AH.000000002","DOIUrl":"10.63116/AH.000000002","url":null,"abstract":"<p><strong>Background: </strong>The career path of associate-degree health information technology (HIT) graduates continues to change quickly as quality and payment regulations, technology requirements, and workforce expectations evolve to meet the demands of the changing health care environment. Although HIT professionals play an essential role in accuracy, regulatory compliance, and the overall function of health information systems, there is limited research describing HIT workforce trends.</p><p><strong>Methods: </strong>A mixed-methods approach was used with 587 survey responses. Quantitative data were standardized by job category, including a newly developed \"health information management (HIM) operations\" group, and career movement was visualized using a Sankey diagram. Qualitative comments were analyzed using inductive thematic coding, intercoder reliability checks, and a reconciled codebook. Both data sources were combined to provide a clearer picture of workforce patterns and graduate experiences.</p><p><strong>Results: </strong>Graduates reported a wide range of initial positions after graduation, most commonly in medical coding, HIM operations, billing, and patient registration. Many described strong upward mobility, moving into supervisory HIM roles, revenue cycle leadership, and growing opportunities in data analytics. Internships were frequently linked to job placement, and remote or hybrid work remained common. Three themes emerged from the qualitative analysis: (1) degree outcomes-graduates found the degree practical and career-building; (2) credential value-the Registered Health Information Technician (RHIT) continues to hold value but is not consistently recognized by all employers; and (3) employment issues-experience requirements and wages remain ongoing challenges.</p><p><strong>Conclusions: </strong>Overall, HIT graduates see clear value in their education and report meaningful career growth. At the same time, familiar challenges persist in work experience requirements that limit job availability for HIT graduates. Strengthening experiential learning, improving communication with employers about HIT competencies, and creating more intentional academic-employer partnerships may help close these gaps. These insights are intended to support educators, employers, and the broader HIM community in developing more effective workforce strategies.</p>","PeriodicalId":521055,"journal":{"name":"Advances in health information science and practice","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13318704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Traditional and Nontraditional Roles: Reframing Health Information Practice Through the Health Information Continuum.","authors":"Leah Grebner, Angela Campbell","doi":"10.63116/AH.000000001","DOIUrl":"10.63116/AH.000000001","url":null,"abstract":"<p><strong>Background: </strong>The health information (HI) profession has expanded beyond hospital-centered roles, yet it continues to rely on the labels \"traditional\" and \"nontraditional,\" which no longer reflect workforce realities.</p><p><strong>Methods: </strong>In this study, the authors used an evidence-informed, mixed-methods synthesis incorporating federal workforce data, professional literature, and original survey data from HI practitioners and educators.</p><p><strong>Results: </strong>The findings demonstrate that HI roles are increasingly cross-sector, technology-enabled, and functionally interconnected, with substantial workforce activity occurring outside hospital settings and beyond federally classified roles.</p><p><strong>Conclusions: </strong>In this article, the authors introduce the Health Information Continuum as a conceptual framework that reframes HI work around shared competencies and the health data life cycle, offering a more accurate and inclusive model for workforce description, education, and professional identity.</p>","PeriodicalId":521055,"journal":{"name":"Advances in health information science and practice","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13254278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148255517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revolutionizing Health Care Analytics Through Data Democratization at America's Largest Municipal Health Care Delivery System.","authors":"Bharti Sharma, Adnan Abdul, Hnin Phyu, Maninder Sarao, Maryam Nunez","doi":"10.63116/ahisp-26-003","DOIUrl":"10.63116/ahisp-26-003","url":null,"abstract":"<p><p>In the rapidly evolving landscape of health care data utilization, achieving data democracy is crucial for enhancing organizational agility and decision-making effectiveness. In this article, the authors document the journey toward data democracy at America's largest public hospital system, highlighting the strategic alignment among leadership and stakeholders to secure buy-in and commitment. Beginning with early adopters and an initial roadmap, the initiative progressed through iterative updates informed by evolving strategies and stakeholder input. A crucial element of this journey was the establishment of <i>data champions</i>. These champions were thoughtfully engaged and diligently trained by the data and analytics team through persistent efforts. In this article, the authors explore key areas of focus for data champions, including the establishment of a data academy, development of support mechanisms, formulation of governance policies and technical guardrails, curation of structured data assets, and facilitation of access to tools and technology. Challenges encountered in data integration, accessibility, and quality underscored the critical role of robust governance structures and policy frameworks in sustaining data-driven decision-making. The insights shared in this article aim to guide other organizations in fostering a data-informed culture, learning from both challenges and successes.</p>","PeriodicalId":521055,"journal":{"name":"Advances in health information science and practice","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on \"Protecting Against Unintended Risk From Student Quality Improvement Projects in Health Care\".","authors":"Valerie J M Watzlaf","doi":"10.63116/ahisp-26-008","DOIUrl":"10.63116/ahisp-26-008","url":null,"abstract":"<p><p>In this commentary, the author examines opportunities for extended research and discussion on the article entitled \"Protecting Against Unintended Risk From Student Quality Improvement Projects in Health Care,\" including protection of employee data and other types of sensitive information that may be included in quality improvement projects.</p>","PeriodicalId":521055,"journal":{"name":"Advances in health information science and practice","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13158512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148039271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Artificial Intelligence Into Health Informatics and Information Education: A Competency-Based Framework Using Miller's Pyramid.","authors":"Shannon H Houser, Cathy A Flite, Susan L Foster, Angela Morey","doi":"10.63116/ahisp-25-004","DOIUrl":"10.63116/ahisp-25-004","url":null,"abstract":"<p><p>The integration of artificial intelligence (AI) into health informatics and information management (HIIM) education presents both transformative opportunities and ethical complexities. As health care systems increasingly adopt AI-enabled tools and workflows, educational programs must prepare students to not only understand AI technologies but also apply them responsibly and effectively. In this article, the authors propose a competency-based framework for embedding AI into HIIM curricula, using Miller's Pyramid of Clinical Competence to scaffold progressive learning outcomes. With this developmental model, educators guide students from foundational knowledge to applied reasoning, simulation-based practice, and real-world performance using AI tools. The model can be used to foster problem-solving abilities and support workforce readiness by aligning AI-enhanced assignments with core HIIM domains. Ethical considerations are embedded throughout the learning process to promote the responsible and equitable use of AI. By offering flexible guidance for integrating AI into diverse educational settings, the competency-based framework enables instructors to design competency-aligned learning experiences that foster technical proficiency, ethical awareness, and professional confidence in today's AI-driven health care environment.</p>","PeriodicalId":521055,"journal":{"name":"Advances in health information science and practice","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Gap: A Synthetic X12 837i Claims Generator and Parser for Health Information and Informatics Education.","authors":"Hants Williams","doi":"10.63116/ahisp-25-003","DOIUrl":"10.63116/ahisp-25-003","url":null,"abstract":"<p><strong>Background: </strong>Health information management education faces challenges in teaching claims data. Regulations prohibit the use of real, non-deidentified patient claims data within classroom settings. This limits hands-on experience with real-world data formats such as X12 837 institutional (837i) transaction files. Most existing approaches rely on textbook examples or static datasets that have been heavily redacted, which may lack the complexity required to prepare students for roles involving the handling of claims-related data. In this report, the authors describe the design and deployment of an open-source synthetic claims generator and parser designed to democratize access to realistic health care claims data, bridging the gap between theoretical knowledge and practical skills.</p><p><strong>Methods: </strong>A Python-based system was developed that generates realistic X12 formatted 837i claims using real Centers for Medicare & Medicaid Services (CMS) provider and payer databases. The tool features a free browser-based interface, plus local deployment via a command-line interface (CLI) or application programming interface (API) for advanced educational contexts. Finally, a modular two-lecture curriculum framework for integration into existing health information management courses is provided.</p><p><strong>Results: </strong>The browser-based application enables instant access without installation, eliminating technical and privacy barriers. The tool supports generating 1-25 claims per session via the web interface, with the ability to perform batch generation of thousands of claims via CLI/API for analytics projects locally on a user's own machine. All generated files were validated against X12 5010 837i specifications using two independent electronic data interchange validation platforms, confirming zero structural errors and full conformance to industry standards. The framework aligns with American Health Information Management Association core competencies, offering a reproducible and scalable method to support workforce readiness for revenue cycle analyst, medical coding, and health care data analyst roles.</p><p><strong>Conclusions: </strong>By eliminating privacy concerns, financial barriers, and installation complexity, this method offers a scalable, reproducible model for teaching critical electronic data interchange and revenue cycle competencies related to the handling of claims data files. The open-source nature and multiple deployment options of this tool enable adoption across diverse institutional contexts, from community colleges to research universities, and from technical coding to nontechnical users.</p>","PeriodicalId":521055,"journal":{"name":"Advances in health information science and practice","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}