Doctor of Healthcare Administration (D.H.A.), Franklin University, 2025, Health Programs

This study examined the impact of electronic prescription generation and transmission, patient access, and secure electronic messaging on health information exchange (HIE) utilization during healthcare transitions. Leveraging longitudinal data from the 2018 CMS EHR Incentive Program, this research tested hypotheses concerning the influence of these variables on HIE utilization using a quantitative method. Findings from logistic regression analyses indicated that electronic prescription practices (B = 2.265, OR = 9.628, p < .001) and patient electronic access capabilities (B = 1.108, OR = 3.027, p < .001) significantly increased HIE usage, aligning with previous studies that underscored the importance of digital prescription systems and patient empowerment in HIE enhancement. Additionally, secure electronic messaging showed a significant association with HIE utilization (χ²(1) = 126.982, p < .001), further reinforcing the role of secure communication in effective healthcare information exchange. A combined predictive model revealed that electronic prescriptions and patient electronic access drastically improved the likelihood of HIE adoption (B = 4.546, OR = 94.284, p < .001), highlighting a synergistic effect. These findings underscored the need for integrated technological frameworks within healthcare systems to optimize communication and care coordination, ultimately improving patient outcomes. The study advocated continued investment in digital health tools to strengthen HIE systems and enhance healthcare delivery.

Committee: Crissie Jameson (Committee Chair); Sunddip Aguilar (Committee Member); Alexander Akulli (Committee Member) Subjects: Health Care Management

Doctor of Philosophy, The Ohio State University, 2024, History

The origins of modern coalition warfare trace back to the Mediterranean theater of World War II. It was there on the treacherous battlefields of North Africa and Sicily where Anglo-American forces learned to harmonize joint and combined forces under a modular and largely experimental integrated theater headquarters for the very first time. Overcoming significant setbacks between 1942 and 1943, the Allies laid the foundations of a resoundingly effective military organization—a multinational coalition built around the distinctly modern principles of unity of command, combined and joint operations, partner integration as well as robust liaison, logistics, and administrative support. These synergistic elements constituted nothing less than an embryonic Allied victory formula, a theater-level template they would export wholesale to great effect in northwestern Europe and whose legacy lives on in western alliances and battlefield coalitions to this day.

Committee: Peter Mansoor (Advisor); Geoffrey Parker (Committee Member); Bruno Cabanes (Committee Member); David Steigerwald (Committee Member) Subjects: History

Doctor of Healthcare Administration (D.H.A.), Franklin University, 2022, Health Programs

An Accountable Care Organization (ACO) was first created during the enactment of the Affordable Care Act (ACA) in 2010. An ACO is a group of physicians, hospitals, and other providers that voluntarily form together to coordinate a value-based care approach that handled the best quality of care for patients and delivers the right care at the right time. The appropriate means of communication between these various groups are through referral management and processing. This study used an exploratory qualitative approach to understand the perceived barriers around components impacting the timeliness of referrals between Primary Care providers and Specialists. In-depth interviews with 21 participants that represented departments of primary care, specialty care, and operations were conducted via Zoom or Microsoft Teams in gathering their understanding on the efficiencies, barriers, and root cause analysis as it pertains to the referral process. The interviews were transcribed verbatim, coded, and analyzed for major themes. ATLAS.ti Cloud software was used for coding analysis of the collected data. The three major components that were discussed during the interviews were regarding network management, operational excellence, and technology enablement. Six major themes and 16 sub- themes resulted from the interviews. Recommendations for the perceived barriers were included for future healthcare administrators operating ACOs.

Committee: David Meckstroth (Committee Chair); Jesse Florang (Committee Member); Scott McDoniel (Committee Member) Subjects: Finance; Health; Health Care; Health Care Management

PHD, Kent State University, 2021, College of Communication and Information

The coronavirus disease 2019 (COVID-19) pandemic has revealed challenges and opportunities for data analytics, semantic interoperability, and decision making. The sharing of COVID-19 data has become crucial for leveraging research, testing drug effectiveness and therapeutic strategies, and developing policies for control, intervention, and potential eradication of this disease. Translating healthcare data between various clinical coding schemes is critical to their functioning, and semantic mappings must be established to ensure interoperability. Using design science research methodology as a guide, this work explains 1) how an ETL (Extract Transform Load) workflow tool could support the task of clinical coding scheme mapping, 2) how the mapping output from such a tool could support or affect annotation of clinical trials, particularly those used in COVID-19 research and 3) whether aspects of the socio-technical model could be leveraged to explain and assess mapping to achieve semantic interoperability in clinical coding schemes. Research outcomes include a reproducible and shareable artifact, that can be utilized beyond the domain of biomedicine in addition to observations and recommendations from the knowledge gained during the design and evaluation process of the artifact development.

Committee: Marcia Zeng (Advisor); Athena Salaba (Committee Member); Mary Anthony (Committee Member); Yi Hong (Committee Member); Rebecca Meehan (Committee Member) Subjects: Bioinformatics; Information Science

Doctor of Nursing Practice, Mount St. Joseph University , 2020, Department of Nursing

Executive Summary Ninety percent of intravenous (IV) medication administrations are given through a smart infusion pump. Intravenous medication errors are one of the top two types of medication errors, which can result in severe harm to patients due to their immediate biological effect. Unfortunately, smart infusion pumps have not eliminated IV medication errors as expected. Despite the built-in safety features nurses can create workarounds and shortcuts that bypass these safety features that were created to assist the bedside nurse in preventing IV medication errors. To reduce the need to create workarounds and shortcuts, a new standard of care for infusion therapy known as interoperability was developed to allow bi-directional communication to occur between the smart infusion pump and the infusion order in the electronic health record (EHR). Workarounds and shortcuts are a common practice in the Emergency Center (EC) due to a fast-paced environment. EHR-smart infusion pump interoperability was implemented in a 12-bed EC to assist twenty-three nurses with IV medication administration. When the results of post-implementation data were compared with 3 months of pre-implementation data, the results of the project demonstrated a: 1) 46% decrease in ID band scanning workarounds; 2) 68% decrease in medication scanning workarounds; 3) 59% decrease in severe harm averted alarms; 4) 10% increase in guardrail library usage; and 5) and 6% increase in the overall hospital usage rate of interoperability. Recommendations for this project include the implementation of EHR-smart infusion pump interoperability at all of the other ECs and current out-of-scope patient care areas in this thirteen-hospital system to further improve safety measures when administering IV medications.

Committee: Susan Johnson Ph.D, RN (Advisor) Subjects: Information Technology; Nursing

Doctor of Management, Case Western Reserve University, 2010, Weatherhead School of Management

Over time enterprises have woven together a fabric of processes, information structures, and computer tools to conduct their day-to-day business. Many of the components of this patchwork of systems cannot work together effectively, as the underlying models are incompatible. There is however, a strong business case to be made for ensuring that end-to- end business processes are interoperable, both across the enterprise, and with other enterprises. Qualitative research demonstrates that distinct cultures and non-overlapping knowledge between IS development (ISD) team members impedes system development success. It also identifies Boundary Spanning mechanisms as a significant mitigator. We develop these ideas further by exploring the mechanisms of knowledge sharing in project teams covering overlapping competence, and the presence of knowledge integration mechanisms - acculturation, boundary spanning roles- in how they affect ISD success. We utilize survey data derived from 139 ISD projects in a global US automotive OEM, completed between 2006 and 2009. We show that boundary spanning roles, acculturative processes, and cross-domain knowledge affect in significant ways IS development success. In particular, we demonstrate that facilitative boundary spanning roles - ambassador, coordinator, and scout - moderate the relationship between accumulated IS business domain knowledge and ISD success, and that IS business competence is partially determined by acculturation among IS team members, and the technical competence of the IS team. Teams with low levels of business domain knowledge may be able to mitigate their business knowledge deficit by engaging in boundary spanning behaviors as to enhance the flow of information across the team's knowledge boundaries.

Committee: Kalle Lyytinen, Ph.D. (Advisor); Nick Berente, Ph.D. (Advisor) Subjects: Information Systems

PHD, Kent State University, 2015, College of Arts and Sciences / Department of Computer Science

Interoperability in healthcare is stated as the ability of health information systems to work together within and across organizational boundaries in order to advance the effective delivery of healthcare for individuals and communities. The current healthcare information technology environment breeds incredibly complex data ecosystems. In many cases pertinent patient records are collected in multiple systems, often supplied by competing manufacturers with diverse data formats. This causes inefficiencies in data interoperability, as different formats of data create barriers in exchanging health information. This dissertation presents a semantic framework for healthcare information interoperability. We propose a system for translation of healthcare instance data, based on structured mapping definitions and using RDF as a common information representation to achieve semantic interoperability between different data models. Moreover, we introduce an entity similarity metric that utilizes the Jaccard index with the common relations of the data entities and common string literal words referenced by the data entities and augmented with data entity neighbors similarity. The precision of the similarity metric is enhanced by incorporating the auto-generated importance weights of the entity descriptors in the RDF representation of the dataset. Furthermore, we provide an automatic classification method, which we call summary graph generation, based on the pairwise entity similarities, and we propose that the summary graph can further be utilized for interoperability purposes. Finally, we present a suggestion based semi-automatic instance matching system and we test it on the RDF representation of a healthcare dataset. The system utilizes the entity similarity metric, and it presents similar node pairs to the user for possible instance matching. Based on the user feedback, it merges the matched nodes and suggests more matching pairs depending on the common relations and neigh (open full item for complete abstract)

Committee: Austin Melton (Advisor); Angela Guercio (Committee Member); Ye Zhao (Committee Member); Alan Brandyberry (Committee Member); Helen Piontkivska (Committee Member); Javed I. Khan (Committee Chair); James L. Blank (Other) Subjects: Computer Science; Health Care; Health Sciences; Information Systems; Information Technology; Medicine

MARCH, University of Cincinnati, 2014, Design, Architecture, Art and Planning: Architecture

Regardless of its tremendous power, the computer has been greatly underutilized in design. As Mario Carpo points out: “It is a well-known pattern in the history of technosocial change that new and potentially disruptive technologies are often first tasked to emulate preexisting ones.” The industry standard today, AutoCAD, although technically superior, is still methodologically inferior to its half century old ancestor. Even considering the fact that over the past decade, Computational Design (CD) has finally started to claim a small corner of the architectural realm, it is fighting a lopsided battle. In order for CD to flourish, the architectural profession must implement a synchronized and parallel advancement of design technology, material technology and construction technology. I will address two distinct but relevant aspects of design: Technology and Culture.In the first section I will investigate the causal link between technology and design, trace CD's immolation in the name of industry expediency, and finally situate CD and fabrication within contemporary practice. In the second section, I will address the cultural barriers imposed by traditional methodologies, how current generations find themselves sandwiched between arrogance and rigor, and how technological change will inevitably cause the latter to prevail. More specifically, I will begin with an investigation in the design potential of Shape Memory Alloys and elastic skin systems. The findings from this initial phase will inform the subsequent study of this technology in larger architectural applications. The final phase will concentrate on a full scale exploration into kinetic structures.

Committee: Michael McInturf M.Arch. (Committee Chair); Ming Tang M.Arch. (Committee Member) Subjects: Architecture

PhD, University of Cincinnati, 2006, Engineering : Computer Science and Engineering

The main topic of this dissertation involves cluster-based computing, specifically relating to computations performed on Beowulf clusters. I have developed a light-weight library for dynamic interoperable message passing, called the InterCluster Interface (ICI). This library not only supports computations performed over multiple clusters that are running different Message Passing Interface (MPI) implementations, but also can be used independently of MPI. In addition I developed the Backtracking Framework (BkFr) that simplifies implementations of the parallel backtracking paradigm in the single cluster environment, and supports the extension of computations over multiple clusters. BkFr uses MPI for the intra-cluster communication and ICI for the inter-cluster communication. I have also developed a template-based library of programming modules that facilitate the introduction of the rapidly emerging message passing parallel computing paradigm in upper-division undergraduate courses. An important application of ICI and the backtracking framework discussed in this dissertation is the computation of Van der Waerden numbers, which involve the existence of arithmetic progressions in arbitrary partitions of {1, 2, …, n} for sufficiently large n. The computations of these numbers utilized a special SAT solver that I developed. For example, I almost doubled the previously known lower bound for the Van der Waerden number W(2, 6), and I am running a calculation whether the lower bound is actually the exact value. Among other reductions, I was able to drastically reduce the search for potential solutions with the aid of a tunneling technique based on an aggressive addition of uninferred constraints. The tunneling technique has the likely potential to be used in a number of other satisfiability settings. I also developed an FPGA version of my SAT solver for Van der Waerden numbers that improved the search speed up to 230 times or more compared to its sequential equivalent. Utili (open full item for complete abstract)

Committee: Dr. Jerome Paul (Advisor) Subjects: Computer Science