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DISSERTATION ON HEALTH INFORMATION revision

Running head: HEALTH INFORMATION TECHNOLOGY
DISSERTATION ON HEALTH INFORMATION TECHNOLOGY
Student name
Institutional affiliation
HEALTH INFORMATION TECHNOLOGY 2
INTRODUCTION
1.0 Introduction
Health Information Technology (Health IT) pertain the integration of various innovative
designs, creations, developments, etc. in medical practices to enable the improvement and
maintenance of information systems in the health industry. The development and use of new
interoperable and automated health care information systems seek to ensure the eventual
realization of enhancement in medical care, increase efficiency, lowering of costs associated with
health services, reduction in errors incurred thus improving patient satisfaction. Alternatively, the
use of improved ICT technologies facilitates the optimization of reimbursements received by
health service providers on inpatient and ambulatory health services. In this modern era, the
health sector is looking forward to taking revolutionary steps and improve the living standard. As
far as the infrastructural developments are concerned, health service providers are getting more
advanced through the inclusion of information technology in health sector which is called as
Health Information Technology.
The primary and unifying goal of many health care providers and regulators is to
minimize the harm and improve patient safety through the use of Health Information Technology
(Rose and Young, 2008). This perspective leads to the increment of rates at which Information
Technology is being adopted in inpatient and outpatient care units. However, the adoption of
these innovative technologies is subject to high costs of implementation, hence acting as a
mitigating factor especially for small healthcare facilities that have minimal finances. In this
sense, there are various types of health information technology such as the Electronic Health
Recording system (EHR), Personal Health Record (PHR) and the HIE system. Health
Information Technology is crucial for both national and international health care organizations.
HEALTH INFORMATION TECHNOLOGY 3
Investments made around the globe concerning Health Information Technology (Health IT) over
the years have been central components of health care and improved service delivery.
Respectively, the health care systems are still facing challenging situations regarding Health
Information Technology (Rose and Young, 2008).
Health IT is essentially necessary for extensive patient awareness and patient safety
standards thus increasing the demand for various sources of health services within health
facilities. HIT has the perspective to bring improvements in the quality of health care, reduction
of costs incurred in the health sector and productivity enhancement. Apart from the health care
system, several kinds of literature have been written regarding the use of the IT in
macroeconomic business processes and its relative effectiveness and impacts (Sparks, 2014).
Many researchers have further looked into the effects of HIT through case studies on
particular organizations and health service providers. As far as the investment is concerned, it is
relatively low in health care technology and its consequent implementation (Onway and Terrell,
2010). As such, this dissertation study focuses on highlighting the various concerns associated
with the adoption and implementation of HIT in health organizations with succinct emphasis on
expenditure and training of health practitioners. Providing clarity on the various aspects
attributed to the benefits of HIT to health providers, the paper exemplifies further on the reasons
for ensuring the integration of Health IT to care services.
1.2 Research Questions
What emerging and current issues did health care providers experience before the
implementation of Health Information Technologies into their care services?
Consider how the integration of Health IT to care services in various health care
institutions has impacted the nature and quality of their services?
HEALTH INFORMATION TECHNOLOGY 4
1.3 Research Objectives
The research seeks to determine the various aspects of health care service provision
before the development and use of Health IT
Under the findings brought forth by the researcher, the dissertation brings forth an
analysis of the existing challenges attributed to the implementation of Health Information
Technology.
The researcher as well so it necessary to critique and thus examine the benefits of
implementing Health IT to health care providers, patients, and the cost of care.
The analysis of the various aspects and types of innovative technologies useful in the
health care industry was also essential to the research.
1.4 Rationale of Study
The inception of HITECH Act in the US in 2009 as indicated by the research brought
forth by Agarwal and GAO (2010) indicates a dramatic increase in the quality of services
provided thus the attainment of patient satisfaction and safety. Particularly, the integration of IT
technologies into health institutions requires succinct oversight by government agencies who
seek to ensure the certification of the systems operation-ability such that it does not deter patient
safety initiatives. As indicated by the research objectives, this study lays emphasis on the
assessment of the various elements of Health IT in the health sector such that the researcher
utilizes supportive scholarly reports and studies regarding the impacts of IT to health care service
provisions. Thereby, the existence of numerous studies regarding health care issues on the
standard or quality of care, patient safety, and ethics in health care exemplify on the necessity of
undertaking the vast research on Health Information Technology. It is as well clear that most of
the scholarly research studies avoid assessing the emerging ethical issues in health care that
HEALTH INFORMATION TECHNOLOGY 5
correlate with the integration of IT to health-care thus the researcher sought to expound the
research further to ensure the provision of recommendable strategies.
LITERATURE REVIEW
2.0 Introduction
The existence of various research studies such as the study by Lehoux (2010) demonstrates
the fact that researchers have yet to exhaustively address the benefits and emerging issues
associating with Health IT and the respective improvement of care in hospitals. Properly
addressing the beneficial features concerning various IT programs in health institutions require
researchers to conduct studies in various care organizations because of the existence of variance
in benefits and the incorporation of a program to the system of care in an institution. For this
reason, many of these organizations have been less inclined to embrace the concept of Health
Information Technology. Therefore, a comprehensive analysis of the existing health care
strategies and issues is a necessity to pave the way for the embrace of Health Information
Technology in Health
According to the research by Varkey, Horne, and Bennet (2010), the population of the
U.S was 318.9 million in 2009 with an annual growth rate of 1.00%. The minimal population
growth rate is a characteristic of increased death rate compared to birth rates due to the
prominence of diseases such as cancer, diabetes, etc. The study by Lehoux (2010) associates the
increasing death rate to the lack of well-equipped and trained professionals in the health sector,
whose expertise is crucial to solving the diverse medical issues. For this reason, the adoption of
information technology in health care organizations is an attempt to help ease the existing
workload and pressure on these professionals. To ensure and persuade organizations for
HEALTH INFORMATION TECHNOLOGY 6
integration of IT programs such as EHR to their routine medical service provision activities, it is
essential to develop a critical policy assessment program that critique the benefits and challenges
associated with Health technologies both in the organization and to their patients (Joshi and Buch
et al. 2016).
2.1 Types and Aspects of IT Used in Health Care
Most of the scientific studies like the research by Varkey, Horne, and Bennet (2010)
relate to the use of Health Information Technology with succinct consideration on the
development experienced over the past in the health sector. Most of these scholarly reports laid
emphasis on two themes; the adoption of Health Information Technology and the impacts on
efficiency, safety, and quality of health care provision. Hence, it is pivotal for the study to
provide exponential assessment of these aspects because the rate and extent of adoption and
implementation of Health Information Technology is related to how well health care
organizations make use of HIT to positively influence protection, excellence and the competence
of their healthcare amenities (Varkey, Horne and Bennet, 2010).
The adoption of IT programs into organizational health services is dependent on variables
such as the strategies and policies formulated by the health institution concerning the attainment
of better health services. The resource allocations by the management towards the institutional
Research and Development (R&D) as well as the objectives sought by the institution regarding
the quality of their services on patient safety also impacts the adoption of Health IT. For
instance, with quality research on R&D and Health IT, a health organization would determine
that integrating programs like EHR, PHR, and health information exchange (HIE) systems would
facilitate the synthesis, accessibility, and sharing of patient information thus improving their
services and patient safety standards.
HEALTH INFORMATION TECHNOLOGY 7
2.2 The Benefits of Implementing Health IT
2.2.1 Health Organizations.
The realization of organizational efficiency is a recipe for economic success and
competitive advantage for both profit and non-profit establishments. The enhancement of
operational capacities and retention of sustainable growth require organizations to execute
strategic approaches such that their activities are harmonized with objectives thus the employees
would optimize their productivity levels for better service outcome (Chaudhry et al. 2006). The
organizational leadership and management in this sense play a pivotal role in driving towards
effective integration of new technological programs that would bring forth positive impacts to
the workforce. For example, with any health care organization, it is crucial for the management
to develop a training program that would educate employees on the use of a new program and
equipment before purchase (Wu, 2006). To understand the concept of productivity and
effectiveness, the research by Hemphill and Knesek (2015)exemplify on the development of the
proper relationships in the health institution so as to facilitate cohesion and teamwork amongst
nursing and other medical practitioners.
Particularly the level of organizational performance in health organizations is dependent
on the functionality of their systems and the awareness levels retained by their medical
practitioners. Health Information Technology is supportive of organizational aspects such as
nursing roles, ethical culture, the structure of leadership, and finally the easy interaction of
employees through electronic platforms. The easy access to client information that is no longer
subject to tedious recording process improves the health services provided by a doctor in the ICU
unit can access client data through the nearest computer. This aspect concerning accessibility of
HEALTH INFORMATION TECHNOLOGY 8
data as well mitigates the occurrence of mistakes especially as other systems like the HIE
facilitates an analysis of prior diseases and allergies suffered by the patient (Hemphill and
Knesek, 2015). The foremost objective of leaders in healthcare organizations is to make a profit.
To achieve this goal, they must make their services stand out. Therefore, the attainment of
success regarding improving revenue collection or profitability requires health fraternities to
ensure the usage of Health IT programs as they improve service delivery as well as the quality
and safety standards of their patients (Wu, 2006).
2.2.1 Medical Practitioners
Regardless of existing critics about EHR and other IT programs on the reduction of
physician productivity levels in major health care organizations, it is clear that the cumbersome
federal regulations are a mere representation of the vast benefits brought forth by IT. For
example, Hemphill and Knesek (2015) claims that IT programs like EHR systems ensure doctors
integrate data analytics elements due to the existence of big data in health care regarding diseases
and patient health conditions. Additionally, with IT, doctors can conduct cognitive analysis and
computing process that ensure the performance of precise medical tailoring on individuals thus
improving their rates of recovery. The sharing of patient data on diseases such as cancer and
diabetes enable medical researchers to develop reports that would be essential in developing
treatment or drugs to mitigate the spread of the disease. According to the report by Rozenblum
(2011), the utilization of IT programs in health care services as well eliminates ethical issues of
malpractice and the development of surgical mistakes that could make the institution or doctors
liable to a lawsuit.
2.3 Challenges of Health IT
HEALTH INFORMATION TECHNOLOGY 9
There are major challenging issues that persist in the development of information technology in
health care. The report by Chaudhry et al. (2006) indicates that some of the obstacles like
interoperability associated with the absence of a clear and widely agreed strategy of data
interchange irrespective of the recent framework brought forth by HL7 International. The
organization is supportive of the use of the Fast Health Interoperability Resources (FHIR) policy
that promulgates the use of popular standards to ease the sharing of patient data in the sector.
Another emerging issue concerns the pervasive blocking of various IT vendors and providers to
stymie the rising need and practice of data sharing through their systems. Other emerging
obstacles correlate to the usability standards of the HER systems as many clinicians and doctors
often raise attributed to the poor design of user interfaces that complicates the easy access to
patient data. Vulnerabilities on cyber security are also emerging problems that affect the privacy
and security standard of patient information.
METHODOLOGY
3.1 Research Approach
The systematical evaluation of the impact of health information systems is a challenging
task. The implementation of Health IT in this sense is subject to dynamism thus is coupled with
diverse issues at various stages of the system integration. Therefore, it is quite difficult to weigh
the contribution of all the various elements involved the system development as well as
separating the crucial nature of each element in realizing the proper functioning of the system.
For the comprehensive and accurate data collection the research approach utilized by the
researcher entails a practical approach that entailed the following specifications:
Developing a conceptual framework for the overall evaluation of input
HEALTH INFORMATION TECHNOLOGY
10
Use of a mixed method approach that incorporates both qualitative and quantitative data
findings that relate to the separate information systems used by various health
institutions.
Focusing on the assessment of the impacts and quality of various IT models, the approach
integrated a specific search strategy that the researcher used in determining the essential
nature of various sources developed from Google bar and other relevant databases like
government agencies and health institutions.
The approach should provide the accurate information to the users for successful
outcomes.
3.2 Key Output
The key output of this study directs towards a conceptual framework of a health
information system. The design will include health facility processes and information, along with
other contributory factors that oversee the successful implementation of a health information
system.
3.3 Research Design
The development of a clear research design by the researcher was critical to the
development of the various procedures and methods necessary for data collection. The element
as understood by the researcher ensured logical and effective analysis of the research problem
formulated thus collected data findings that critical emphasize of the research objectives. As
such, the study integrates an exploratory research design that was crucial in the verification of
insights concerning the Healthcare information technology with corresponding impacts on health
service delivery and organizational growth. In this sense, the mixed method approach of data
HEALTH INFORMATION TECHNOLOGY
11
collection used in the collection of data concerning the study correlated with the selected
exploratory approach thus enabling the researcher to eliminate various insights that did not
exemplify clarity on the research topic. The exquisite quantitative survey undertaken on health
care databases had a direct impact on the study findings. The databases with the integration of
other government regulatory reports extracted from agency websites like the Fast Health
Interoperability Resources website provided insightful and informative data regarding the
implementation of Health IT elements especially the EHR systems.
3.4 Data Collection
3.4.1 Data Collection Techniques
The rationale and pragmatism associated with the use of the approach on mixed methods
in data analysis and collection are under the basic assumption that using paradigms with multiple
and extensive research elements contributes to the reliability and validity of data collected by the
researcher (Rozenblum, 2011). By integrating both quantitative and qualitative data findings in
the exploration of the topic, the researcher was able to capture distinct information and findings
from scholarly studies thus enabling succinct coverage of the topic objectives. In this sense, the
data collection techniques utilized involved using contextual report generated from scholarly
studies, internet articles, peer reviewed articles, health company databases, press releases on
Health IT, US government databases, etc. The focus of the case study report by Garavand et al.
(2016) was of great significance to the development of this report as the author using the health
organization NCBI developed a detailed report and findings that detailed the contemporary
issues associating to Health IT integration to the organization as well as the benefits gained by
the health institution. This report was useful as a secondary source with the aspects associating to
the Health IT in the institution laying a foundation for this study.
HEALTH INFORMATION TECHNOLOGY
12
3.4.2 Data Sampling
Data sampling techniques were critical in writing this research as the researcher gained
the eventual ability to critique and infer to the sources that were considerably crucial to
developing the report. Focusing on a purposive technique of data sampling the researcher utilized
a sample selection process that detailed the choice of sources of concern to the respective nature
of information or data contained. The pre-determined criteria chosen during this research laid
succinct emphasis on the previous objectives and research questions formulated. With the
purposive technique, the researcher was able to assess the relevance of individual source thus
avoiding sources that could have provided wrong interpretation of the topic.
3.5 Ethical Considerations
Maintaining the integrity of the research approach might prove to be a problem. To avoid
this problem, all sources used will be properly cited and referenced. Confidentiality of any data
collected from anonymous authors will be maintained if required. The population sample that has
been selected strongly indicates a high sense of impartiality and is free from any biasness.
HEALTH INFORMATION TECHNOLOGY
13
DISCUSSION AND FINDINGS
4.1 The Impact of Health IT to Health Institutions
Health information technology gives doctors and other medical practitioners a more
comprehensive picture of the patient health conditions. The effectiveness of these systems is
manifested through the fact that they provide centralized records that make it easier for doctors
to manage a patient’s health, especially when there is an emergency. The arrival of centralized
medical record has made the procedure of prescribing medications and tests quicker than ever.
Organizations with high-profit margins tend to develop faster in comparison to others. In the
health care sector, more investment into tech-savvy facilities and systems is an indication of
development, which improves the quality and provision of health facilities.
The processes involved in patient’s treatment do not necessarily lead to the success of a
health sector. Instead, the diagnostic procedures and the follow-up of patients also play a key
role (Vilamovska, 2010). Before the integration of the various Health IT programs to health
institutions, most Americans lacked the technology to enhance their relations with their doctors,
pharmacies, hospitals, and other individuals who make up their circle of care. As indicated by the
research undertaken by Garavand et al. (2016), transformations in health care IT bring forth
improved relationships between care providers such that their patients become the central focus
of their services. As indicated by the research the improvements in relationships aids change care
provision by integrating the ideology of “I” into health IT. The majority of care studies
exemplify on various measurable benefits that relate to the adoption of health IT while a few
findings and articles indicates suggestive evidence concerning negative influence of the
programs on health provision.
HEALTH INFORMATION TECHNOLOGY
14
From health IT leader
All others
P value (two-tail)
Number of Studies
28
126
Reached positive
overall conclusion
19 (68%)
83 (61%)
0.25
Used statistical
methods when testing
hypothesis
13 (46%)
52 (41%)
0.31
Mean number of
outcomes
1.64
1.52
0.20
Meaningful criteria
used
1.89
1.63
0.18
The outcomes provided through the table above is an indication of the study methods
used by the researcher. The criterion was essential in the comparison of health IT leadership
amongst various health institutions. Particularly, more than 64% of the 154 health institutions
involved in the study addressed the issues associated with Health IT in a foundation of an
integrated framework. Most of the organizations attained the eventual growth in revenue
generation and improved quality of services upon implementation of IT programs.
4.2 Health Information Technology and the Quality of Care
In a traditional sense, primary care physicians have always acted as the central hub for
their facilities including lab tests, records, and development of detailed reports concerning
patient health conditions and the type of care needed. In certain situations when a doctor is
changed, or the doctor is equipped with outdated information, this may lead to the decline of the
healthcare system. Therefore, health information systems must come up with a better way of
HEALTH INFORMATION TECHNOLOGY
15
establishing a central hub for all the progressions and procedures that take place in a healthcare
facility (Varkey, Horne and Bennet, 2010). It also brings up the aspect of the human element. As
humans are the end-users of this advanced technology, therefore they play a central role to make
sure the technology is delivering the required quality. Not everyone in a health care facility is
computer literate, providing basic education to all staff members on how to use the system, can
be vital to achieving excellence in health care services. The research highlighting the challenges
that come along with an implementation of Health Information System is still limited (Varkey,
Horne and Bennet, 2010). The conclusions provide a framework on how to improve the
technology’s implementation to facilitate a smooth transition to the latest technology.
The image above provides a succinct representation of the predominant positive results that were
developed by the researcher regarding the beneficial nature of health Information Technology to
health services and organizational growth. The data provides evaluated outcomes of Health IT
variables in various systems and institutions on Rating and Type.
HEALTH INFORMATION TECHNOLOGY
16
Safety and efficiency are the major factors in the provision of high-quality health care
services among the organization. Health information is based on Information Technology that
has potential to improve the quality, safety, and effectiveness of health services. Health
Information Technology helps with treatments, smoking cessations, loss of weight, physical
activity and diet to reduce health hazards and raise the health standards (Varkey, Horne, and
Bennet, 2010). Experts in clinical medicine field have pointed out that these aspects capture the
potential value of HIT and hence quality is best understood when the safety level and efficiency
that patients have both before and after they have been treated and even the follow-up processes.
Health Information Technology offers new ways to both health care providers and
patients to access the health information. Health Information Technology, therefore, improves
the quality through safety and system efficiency (Lehoux, 2010). For quality health services to be
delivered, the patients, as well as the health service providers, must integrate complex
information from diverse sources. Quality in health care is an accumulative effort of Health
Information Technology that tries to bring together efficiency in access to information and
appropriate use of health care information. The ability of patients to access information helps the
service providers to communicate with the health care system effectively.
HEALTH INFORMATION TECHNOLOGY
17
The graphical representation of data brought forth above provides a succinct overview of the
quarterly volume of patients amongst various faculty health providers that have integrated an
academic ophthalmology department with Electronic health record (EHR). The data represented
above is by highest volumes (top), the intermediate volume is in the middle, while the bottom
presents the lowest volume of patients received.
Two kinds of literature reviewed the use of Health Information Technology based on the
quality of services delivered and processes in health care organizations. One of the researchers
was funded by the AHRQ in the year 2006, and the other one was a follow-up research later
published in 2009. Both studies found some evidence of quality and cost benefits of
comprehensive implementation of Health Information Technology (Chaudhry et al. 2006). As
per the findings of these studies, the advanced HER systems comes with computerized order
entries and clinical support decision systems that greatly reduce errors and enhance the overall
quality through provision of decision support tools and raise the adherence to clinical guideline
practices.
HEALTH INFORMATION TECHNOLOGY
18
It is evident that Health Information Technology has a tremendous impact on the standard
health care by getting rid of poorly written and unorganized medical records. The technology
incorporates clinical pathways ad tools that help healthcare providers to manage the health of
patients easily. Despite the fact that the evidence cannot be disputed, it can be agreed that the
impact of these health information systems differs across health care facilities, and is primarily
determined by their size, capacity, availability of resources, and finance (Wu S, 2006). The
impact of the presence of a health information system is dominating in those facilities that have
all the necessary resources and finances. Such facilities offer higher quality healthcare facilities
as compare to those who have limited resources.
4.3 Outcomes of Health Information Technology in Health Care
The outcome of health information technology entails some components which not only
include the patient-centered outcomes but organizational structural and procedural concerns as
well. The use of Health Information Technology to deliver services in the health sector ensures
that appropriate information is availed to various stakeholders within the system and can access
information at all stages of service provision (Cutler and Everett, 2010). In this manner,
improved outcomes between the health care providers and the patients can be achieved. Every
stakeholder including the patients, their family members along with the health care providers
should have access to key information to make sure that transitions of health care are safe and
effective.
The use of Health Information Technology enhances the outcomes of health services in
some ways. Health Information Technology improves communication during the transitions
between health care providers, community support groups, caregivers, and patients. It also
HEALTH INFORMATION TECHNOLOGY
19
facilitates the development of standardized processes used to reconcile medication needs and
coordinate patients’ care (Lansisalmi et al., 2010). These achievements are a result of HIT that
enables the practitioners to account for the receipt, send and action upon receipt of health care
information and to ensure that there are safety and effective transition of information (Baker,
Gustafson & Shah, 2014). A successful outcome from HIT can be associated with development
performance through the use of electronic health records, communication system and even the
payroll system (Kumar, 2011).
VARIABLE
Paper
EHR
Paper
The no. of new patients’ n
(%)
6 (5%)
14 (12%)
5 (15%)
No. of follow-up patients n
(%)
121 (95%)
99(88%)
29 (85%)
Total no. of patients, n
127
113
34
Clinic time (hours/minutes)
26:50
28:30
10:24
Total non-clinic time
6:05
13:30
0:00
Total time (hours/minutes)
32:55
42:00
10:24
Mean clinic time per patient
12.7
15.1
18.4
Mean non-clinic period as
per patient
2.9
7.2
0.0
Mean total time per patient
(minutes)
15.6
22.3
18.4
The table provides a representation of time used to complete a paper on patient details
with a comparison to the time used with the Electronic Health Record (EHR) between two health
HEALTH INFORMATION TECHNOLOGY
20
providers; Provider A (retina) and Provider B (Pediatric). The assessment of the data exemplifies
the efficiency of EHR technologies whereby both providers recorded a significantly longer
service provision with EHR compared to the paper based recording technique.
Health Information Technology is essential for responses to an emergency. Technology
provides health providers, community, and patients with the standardized and more integrated
approaches to respond to health emergencies (Vilamovska, 2010). Health organizations make
use of integrated communication technology to enhance health care amenities with internet-
based applications through the use of mobile handsets and systems. Communication has made it
much easier to share information regarding health details and the provision of services
accordingly. Health information further plays a significant role in advising how to align members
of the workforce with their professional roles, resources, and systems (Mitchell et al. 2012).
Compared to other information technology aspects in which their applications are
complex, the use of Information Technology in healthcare organizations gives an edge to
decentralization of roles to facilitate job design hence making it possible to improve health
consequences (Vespignani, 2012). Cost is an essential and limiting factor in the implementation
of Health Information Technology. Though the procedure is expensive but once implemented, it
can reduce the cost of healthcare for both patients and health care organizations. (Agarwal and
Gao, 2010) To include this, implementation of information technology is a costly undertaking
which should be carried out considerably and with precautions.
HEALTH INFORMATION TECHNOLOGY
21
REFERENCES
Garavand, A., Mohseni, M., Asadi, H., Etemadi, M., Moradi-Joo, M., & Moosavi, A. (2016).
Factors influencing the adoption of health information technologies: a systematic review.
Electronic Physician., 8(8), 2713-2718.
Hemphill, T. A., & Knesek, G. (2015). The Non-Physician Remedy to the Physician Shortage.
Regulation., 38(2), 2-3.
J., C. (2009). Research Design: Qualitative, Quantitative, and Mixed Methods Approaches.
Thousand Oaks, CA: Sage.
Joshi, a., Buch, j., Kothari, n., & Shah, N. (2016). Evaluation of handwritten and computerized
out-patient prescription in urban parts of central Gujarat. Journal of Clinical &
Diagnostic Research., 10(6), 1-5.
Rozenblum R, J. Y. (2011). A qualitative study of Canada’s experience with the implementation
of electronic health information technology.
Wu S, C. B. (2006). Systematic review: impact of health information technology on quality,
efficiency, and costs of medical care. Ann Intern Med.

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