42 CFR 495.302 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... technology per the ONC EHR certification criteria. Children's hospital means a separately certified children... AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements... thereof by the State agency. Acquisition means to acquire health information technology (HIT) equipment or...

The electronic medical record in dermatology.

PubMed

Grosshandler, Joshua A; Tulbert, Brittain; Kaufmann, Mark D; Bhatia, Ashish; Brodell, Robert T

2010-09-01

Governmental incentives to stimulate the "meaningful use" of electronic medical records and future disincentives for Medicaid and Medicare provide an impetus for dermatologists to consider adding this technology to their clinical practice. Dermatologists should carefully weigh the pros and cons of establishing an electronic medical record system before incorporating this expensive technology. This article reviews available scientific and economic data required for dermatologists to help make an informed choice.

42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning document...

42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning document...

42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning document...

42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning document...

42 CFR 495.338 - Health information technology implementation advance planning document requirements (HIT IAPD).

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Health information technology implementation... CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.338 Health information technology implementation advance planning document...

42 CFR 495.332 - State Medicaid health information technology (HIT) plan requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false State Medicaid health information technology (HIT... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.332 State Medicaid health information technology (HIT) plan requirements. Each State Medicaid HIT plan must include...

42 CFR 495.332 - State Medicaid health information technology (HIT) plan requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false State Medicaid health information technology (HIT... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.332 State Medicaid health information technology (HIT) plan requirements. Each State Medicaid HIT plan must include...

42 CFR 495.332 - State Medicaid health information technology (HIT) plan requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false State Medicaid health information technology (HIT... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.332 State Medicaid health information technology (HIT) plan requirements. Each State Medicaid HIT plan must include...

42 CFR 495.332 - State Medicaid health information technology (HIT) plan requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false State Medicaid health information technology (HIT... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.332 State Medicaid health information technology (HIT) plan requirements. Each State Medicaid HIT plan must include...

42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Health information technology planning advance... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document requirements...

42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false Health information technology planning advance... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document requirements...

42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Health information technology planning advance... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document requirements...

42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Health information technology planning advance... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document requirements...

42 CFR 495.332 - State Medicaid health information technology (HIT) plan requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false State Medicaid health information technology (HIT... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.332 State Medicaid health information technology (HIT) plan requirements. Each State Medicaid HIT plan must include...

42 CFR 495.336 - Health information technology planning advance planning document requirements (HIT PAPD).

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Health information technology planning advance... STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.336 Health information technology planning advance planning document requirements...

42 CFR 495.346 - Access to systems and records.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Access to systems and records. 495.346 Section 495.346 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE...

42 CFR 495.362 - Retroactive approval of FFP with an effective date of February 18, 2009.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.362... payments to providers, a State may request consideration of FFP by recorded request in a HIT advance...

42 CFR 495.352 - Reporting requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE... activities performed during the quarter, including progress in implementing the State's approved Medicaid HIT...

Medicare incentive payments for meaningful use of electronic health records: accounting and reporting developments.

PubMed

2012-02-01

The Healthcare Financial Management Association through its Principles and Practices (P&P) Board publishes issue analyses to provide short-term practical assistance on emerging issues in healthcare financial management. In a new issue analysis excerpted in this article, HFMA's P&P Board provides some clarity to the healthcare industry on certain accounting and reporting issues resulting from incentive payments under the Medicare program for the meaningful use of electronic health record (EHR) technology. Consultation on these matters with independent auditors is highly recommended.

The current state of electronic health record (EHR) use in Oklahoma.

PubMed

Khaliq, Amir A; Mwachofi, Ari K; Hughes, Danny R; Broyles, Robert W; Wheeler, Denna; Roswell, Robert H

2013-02-01

There is ample evidence of the positive impact of electronic health records (EHR) on operational efficiencies and quality of care. Yet, growth in the adoption of EHR and sharing of information among providers has been slow. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 provides financial incentives for eligible providers to adopt and implement EHR. Until now, little information was available regarding the use of EHR in Oklahoma. Sponsored by the Oklahoma Health Information Exchange Trust (OHIET), this study reveals that the frequency of use of EHR among Oklahoma providers is near the national average. Although a large number of Oklahoma physicians have received Medicaid incentive payments for planned adoption, implementation, or upgrade of EHR systems, relatively few eligible providers in Oklahoma have been certified to receive Medicare incentive payments through the Centers for Medicare and Medicaid Services (CMS) and even fewer have actually received these incentive payments.

42 CFR 495.302 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... of “Certified EHR Technology” for FY and CY 2015 and subsequent years). Children's hospital means a... AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements... thereof by the State agency. Acquisition means to acquire health information technology (HIT) equipment or...

Hospital Characteristics Related to the Intention to Apply for Meaningful Use Incentive Payments

PubMed Central

Diana, Mark L; Kazley, Abby Swanson; Ford, Eric W; Menachemi, Nir

2012-01-01

The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 provides incentives for hospitals to fully adopt and use electronic health records (EHRs). We used data from the 2009 American Hospital Association (AHA) Annual Survey Information Technology Supplement and the Centers for Medicare and Medicaid Services (CMS) 2008 Hospital Cost Reports to examine how various hospital characteristics are associated with the intention to pursue meaningful use incentives. Overall, 86 percent of hospitals indicated an intent to pursue HITECH incentives. However, hospitals that already have an EHR system, are larger, and are located in urban areas are more likely to indicate an intention to pursue incentives. Despite a high interest in HITECH incentives, certain hospital characteristics, including current EHR use, increase the proclivity for some hospitals to pursue meaningful use. Given these differences, there is the potential for the HITECH Act to inadvertently increase the digital divide between hospitals with certain characteristics and their counterparts without those characteristics. Policy makers should consider ways to alleviate barriers, especially for nonusers of EHRs, to realize the maximum benefits of the HITECH Act. PMID:22737100

2015 Edition Health Information Technology (Health IT) Certification Criteria, 2015 Edition Base Electronic Health Record (EHR) Definition, and ONC Health IT Certification Program Modifications. Final rule.

PubMed

2015-10-16

This final rule finalizes a new edition of certification criteria (the 2015 Edition health IT certification criteria or "2015 Edition'') and a new 2015 Edition Base Electronic Health Record (EHR) definition, while also modifying the ONC Health IT Certification Program to make it open and accessible to more types of health IT and health IT that supports various care and practice settings. The 2015 Edition establishes the capabilities and specifies the related standards and implementation specifications that Certified Electronic Health Record Technology (CEHRT) would need to include to, at a minimum, support the achievement of meaningful use by eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) under the Medicare and Medicaid EHR Incentive Programs (EHR Incentive Programs) when such edition is required for use under these programs.

42 CFR 495.368 - Combating fraud and abuse.

Code of Federal Regulations, 2014 CFR

2014-10-01

... (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE... laws and regulations designed to prevent fraud, waste, and abuse, including, but not limited to...

42 CFR 495.368 - Combating fraud and abuse.

Code of Federal Regulations, 2012 CFR

2012-10-01

... (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE... laws and regulations designed to prevent fraud, waste, and abuse, including, but not limited to...

42 CFR 495.368 - Combating fraud and abuse.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE... laws and regulations designed to prevent fraud, waste, and abuse, including, but not limited to...

42 CFR 495.368 - Combating fraud and abuse.

Code of Federal Regulations, 2013 CFR

2013-10-01

... (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE... laws and regulations designed to prevent fraud, waste, and abuse, including, but not limited to...

42 CFR 495.358 - Cost allocation plans.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE... acquire HIT equipment and services under this subpart are subject to cost allocation plan requirements in...

42 CFR 495.6 - Meaningful use objectives and measures for EPs, eligible hospitals, and CAHs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM General Provisions § 495.6 Meaningful use objectives and... their first payment year. For Medicaid EPs who adopt, implement, or upgrade certified EHR technology in... certified EHR technology in their first payment year, the meaningful use objectives and associated measures...

42 CFR 495.6 - Meaningful use objectives and measures for EPs, eligible hospitals, and CAHs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM General Provisions § 495.6 Meaningful use objectives and... their first payment year. For Medicaid EPs who adopt, implement, or upgrade certified EHR technology in... first payment year. (4) Flexible options for using certified EHR technology in 2014. For an EHR...

42 CFR 495.6 - Meaningful use objectives and measures for EPs, eligible hospitals, and CAHs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM General Provisions § 495.6 Meaningful use objectives and... year. For Medicaid EPs who adopt, implement, or upgrade certified EHR technology in their first payment... technology in their first payment year, the meaningful use objectives and associated measures of the Stage 1...

42 CFR 495.6 - Meaningful use objectives and measures for EPs, eligible hospitals, and CAHs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM General Provisions § 495.6 Meaningful use objectives and... year. For Medicaid EPs who adopt, implement, or upgrade certified EHR technology in their first payment... technology in their first payment year, the meaningful use objectives and associated measures of the Stage 1...

42 CFR 495.6 - Meaningful use objectives and measures for EPs, eligible hospitals, and CAHs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM General Provisions § 495.6 Meaningful use objectives and... year. For Medicaid EPs who adopt, implement, or upgrade certified EHR technology in their first payment... technology in their first payment year, the meaningful use objectives and associated measures of the Stage 1...

75 FR 36157 - Establishment of the Temporary Certification Program for Health Information Technology

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-24

...This final rule establishes a temporary certification program for the purposes of testing and certifying health information technology. This final rule is established under the authority granted to the National Coordinator for Health Information Technology (the National Coordinator) by section 3001(c)(5) of the Public Health Service Act (PHSA), as added by the Health Information Technology for Economic and Clinical Health (HITECH) Act. The National Coordinator will utilize the temporary certification program to authorize organizations to test and certify Complete Electronic Health Records (EHRs) and/or EHR Modules, thereby making Certified EHR Technology available prior to the date on which health care providers seeking incentive payments available under the Medicare and Medicaid EHR Incentive Programs may begin demonstrating meaningful use of Certified EHR Technology.

Hospital budget increase for information technology during phase 1 meaningful use.

PubMed

Neumeier, Harold; Berner, Eta S; Burke, Darrell E; Azuero, Andres

2015-01-01

Federal policies have a significant effect on how businesses spend money. The 2009 HITECH (Health Information Technology for Economic and Clinical Health Act) authorized incentive payments through Medicare and Medicaid to clinicians and hospitals when they use certified electronic health records privately and securely to achieve specified improvements in care delivery. Federal incentive payments were offered in 2011 for hospitals that had satisfied "meaningful use" criteria. A longitudinal study of nonfederal hospital information technology (IT) budgets (N = 493) during the years 2009 to 2011 found increases in the percentage of hospital annual operating budgets allocated to IT in the years leading up to these federal incentives. This increase was most pronounced among hospitals receiving high proportions of their reimbursements from Medicaid, followed by hospitals receiving high proportions of their reimbursements from Medicare, possibly indicating a budget shift during this period to more IT spending to achieve meaningful-use policy guidelines.

42 CFR 495.368 - Combating fraud and abuse.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE... identified as an overpayment regardless of recoupment from such providers, within 60 days of discovery of the...

42 CFR 495.4 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... technology has the same definition as this term is defined at 45 CFR 170.102. Critical access hospital (CAH) means a facility that has been certified as a critical access hospital under section 1820(e) of the Act... AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM General...

42 CFR 495.4 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... technology has the same definition as this term is defined at 45 CFR 170.102. Critical access hospital (CAH) means a facility that has been certified as a critical access hospital under section 1820(e) of the Act... AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM General...

42 CFR 495.342 - Annual HIT IAPD requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE... delays in meeting target dates in the approved HIT technology PAPD/IAPD and approved changes to it. (c) A... products. (d) A project activity schedule for the remainder of the project. (e) A project expenditure...

42 CFR 495.342 - Annual HIT IAPD requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE... delays in meeting target dates in the approved HIT technology PAPD/IAPD and approved changes to it. (c) A... products. (d) A project activity schedule for the remainder of the project. (e) A project expenditure...

75 FR 1843 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-13

... Information Technology for Economic and Clinical Health Act HMO Health Maintenance Organization HOS Health... Sponsored Organization RHC Rural Health Clinic RPPO Regional Preferred Provider Organization SMHP State... proposed rulemaking on the process for organizations to conduct the certification of EHR technology. DATES...

"Meaningful use" of EHR in dental school clinics: how to benefit from the U.S. HITECH Act's financial and quality improvement incentives.

PubMed

Kalenderian, Elsbeth; Walji, Muhammad; Ramoni, Rachel B

2013-04-01

Through the 2009 HITECH (Health Information Technology for Economic and Clinical Health) Act, the U.S. government committed $27 billion to incentivize the adoption and "meaningful use" of certified electronic health records (EHRs) by providers, including dentists. Given their patient profiles, dental school clinics are in a position to benefit from this time-delimited commitment to support the adoption and use of certified EHR technology under the Medicaid-based incentive. The benefits are not merely financial: rather, the meaningful use objectives and clinical quality measures can drive quality improvement initiatives within dental practices and help develop a community of medical and dental professionals focused on quality. This article describes how dentists can qualify as eligible providers and the set of activities that must be undertaken and attested to in order to obtain this incentive. Two case studies describe the approaches that can be used to meet the Medicaid threshold necessary to be eligible for the incentive. Dentists can and have successfully applied for meaningful use incentive payments. Given the diverse set of patients who are treated at dental schools, these dental practices are among those most likely to benefit from the incentive programs.

42 CFR 495.328 - Request for reconsideration of adverse determination.

Code of Federal Regulations, 2010 CFR

2010-10-01

... RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.328 Request for... planning document or State Medicaid HIT Plan under this subpart, or determines that requirements are met...

Implementing EHRs: An Exploratory Study to Examine Current Practices in Migrating Physician Practice

PubMed Central

Dolezel, Diane; Moczygemba, Jackie

2015-01-01

Implementation of electronic health record (EHR) systems in physician practices is challenging and complex. In the past, physicians had little incentive to move from paper-based records. With the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, Medicare and Medicaid incentive payments are now available for physicians who implement EHRs for meaningful use. The Office of the National Coordinator for Health Information Technology (ONC) has ample detail on clinical data needed for meaningful use in order to assess the quality of patient care. Details are lacking, however, on how much clinical data, if any, should be transferred from the old paper records during an EHR implementation project. The purpose of this exploratory study was to investigate and document the elements of longitudinal clinical data that are essential for inclusion in the EHR of physicians in a clinical practice setting, as reported by the office managers of the physicians in the study group. PMID:26807077

Bridging the knowledge-action gap in diabetes: information technologies, physician incentives and consumer incentives converge.

PubMed

Nobel, Jeremy

2006-03-01

The gap between current medical knowledge and its application in chronic disease management is especially apparent in diabetes care. Although research over the last decade has shown that adherence to standards of care can prevent or delay the onset of devastating diabetic complications, little more than one-third of patients achieve adequate glycaemic control. Obstacles to better care include 'system' factors such as inadequate record-keeping and reimbursement policies that reimburse amply for illness but poorly for diabetes education and interventions via telephone and computer. Disparities in healthcare compound the difficulty among vulnerable populations in urban and rural areas. Emerging healthcare delivery systems that encourage payers, providers and consumers to improve diabetes care with the use of information technology and financial incentives are described in different health management settings.

77 FR 53967 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program-Stage 2

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-04

...This final rule specifies the Stage 2 criteria that eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) must meet in order to qualify for Medicare and/or Medicaid electronic health record (EHR) incentive payments. In addition, it specifies payment adjustments under Medicare for covered professional services and hospital services provided by EPs, eligible hospitals, and CAHs failing to demonstrate meaningful use of certified EHR technology (CEHRT) and other program participation requirements. This final rule revises certain Stage 1 criteria, as finalized in the July 28, 2010 final rule, as well as criteria that apply regardless of Stage.

42 CFR 495.330 - Termination of FFP for failure to provide access to information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.330 Termination... HIT planning and implementation efforts, and the systems used to interoperate with electronic HIT...

Impact of Electronic Health Records on Nurses' Information Seeking and Discriminating Skills for Critical Thinking

ERIC Educational Resources Information Center

Jackson, Adria S.

2013-01-01

In February 2009, the United States government passed into law the Health Information Technology for Economic and Clinical Health Act (HITECH) and the American Recovery and Reinvestment Act (ARRA) providing incentive money for hospitals and care providers to implement a certified electronic health record (EHR) in order to promote the adoption and…

Medicare and Medicaid programs; modifications to the Medicare and Medicaid Electronic Health Record (EHR) Incentive Program for 2014 and other changes to EHR Incentive Program; and health information technology: revision to the certified EHR technology definition and EHR certification changes related to standards. Final rule.

PubMed

2014-09-04

This final rule changes the meaningful use stage timeline and the definition of certified electronic health record technology (CEHRT) to allow options in the use of CEHRT for the EHR reporting period in 2014. It also sets the requirements for reporting on meaningful use objectives and measures as well as clinical quality measure (CQM) reporting in 2014 for providers who use one of the CEHRT options finalized in this rule for their EHR reporting period in 2014. In addition, it finalizes revisions to the Medicare and Medicaid EHR Incentive Programs to adopt an alternate measure for the Stage 2 meaningful use objective for hospitals to provide structured electronic laboratory results to ambulatory providers; to correct the regulation text for the measures associated with the objective for hospitals to provide patients the ability to view online, download, and transmit information about a hospital admission; and to set a case number threshold exemption for CQM reporting applicable for eligible hospitals and critical access hospitals (CAHs) beginning with FY 2013. Finally, this rule finalizes the provisionally adopted replacement of the Data Element Catalog (DEC) and the Quality Reporting Document Architecture (QRDA) Category III standards with updated versions of these standards.

Technology, Incentives, or Both? Factors Related to Level of Hospital Health Information Exchange.

PubMed

Lin, Sunny C; Everson, Jordan; Adler-Milstein, Julia

2018-02-28

To assess whether the level of health information exchange (HIE) in U.S. hospitals is related to technology capabilities, incentives to exchange, or both. A total of 1,812 hospitals attesting to stage 2 of Medicare's Meaningful Use Incentive Program through April 2016. Hospital-level, multivariate OLS regression with state fixed effects was used to analyze the relationship between technology capability and incentives measures, and percent of care transitions with summary of care records (SCRs) sent electronically to subsequent providers. Stage 2 hospitals reported sending SCRs electronically for an average of 41 percent (median = 33 percent) of transitions. HIE level is related to four capability measures, one incentive measure, and one measure that is related to both capability and incentive. Percent of transitions with SCRs sent electronically was 3 percentage points higher (95 percent CI: 0.1-5.1) for hospitals with a third-party HIE vendor, 3 percentage points higher (95 percent CI: 0.5-5.4) for hospitals with an EHR vendor as their HIE vendor, and 3 percentage points higher (95 percent CI: 0.4-5.4) for hospitals that automatically alert primary care providers. The direction and statistical significance of the relationships between specific EHR vendor and electronic SCR transmission level varied by vendor. Nonprofits and government hospitals performed 5 percentage points higher (95 percent CI: 1.5-9.1) and 8 percentage points higher (95 percent CI: 3.4-12.3) than for-profits. Hospitals in systems performed 3 percentage points higher (95 percent CI: 0.8-6.1). The overall level of HIE is low, with hospitals sending an SCR electronically for less than half of patient transitions. Specific hospital characteristics related to both technology capabilities and incentives were associated with higher levels of HIE. © Health Research and Educational Trust.

An Analysis of the External Environmental and Internal Organizational Factors Associated with Adoption of the Electronic Health Record

ERIC Educational Resources Information Center

Kruse, Clemens Scott

2013-01-01

Despite a Presidential Order in 2004 that launched national incentives for the use of health information technology, specifically the Electronic Health Record (EHR), adoption of the EHR has been slow. This study attempts to quantify factors associated with adoption of the EHR and Computerized Provider Order Entry (CPOE) by combining multiple…

42 CFR 495.334 - [Reserved

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false [Reserved] 495.334 Section 495.334 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements...

76 FR 28791 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-18

... participation for expenditures under their Medicaid Electronic Health Record Incentive Program related to health... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [Document... currently approved collection; Title of Information Collection: State Medicaid Health Information Technology...

42 CFR 495.356 - Nondiscrimination requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Nondiscrimination requirements. 495.356 Section 495.356 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE...

“Meaningful use” of electronic health records and its relevance to laboratories and pathologists

PubMed Central

Henricks, Walter H.

2011-01-01

Electronic health records (EHRs) have emerged as a major topic in health care and are central to the federal government’s strategy for transforming healthcare delivery in the United States. Recent federal actions that aim to promote the use of EHRs promise to have significant implications for laboratories and for pathology practices. Under the HITECH (Health Information Technology Economic and Clinical Health) Act, an EHR incentive program has been established through which individual physicians and hospitals can qualify to receive incentive payments if they achieve “meaningful use” of “certified” EHR technology. The rule also establishes payment penalties in future years for eligible providers who have not met the requirements for meaningful use of EHRs. Meaningful use must be achieved using EHR technology that has been certified in accordance with functional and technical criteria that are set forth a regulation that parallels the meaningful use criteria in the incentive program. These actions and regulations are important to laboratories and pathologists for a number of reasons. Several of the criteria and requirements in the meaningful use rules and EHR certification criteria relate directly or indirectly to laboratory testing and laboratory information management, and future stage requirements are expected to impact the laboratory as well. Furthermore, as EHR uptake expands, there will be greater expectations for electronic interchange of laboratory information and laboratory information system (LIS)-EHR interfaces. Laboratories will need to be aware of the technical, operational, and business challenges that they may face as expectations for LIS-EHR increase. This paper reviews the important recent federal efforts aimed at accelerating EHR use, including the incentive program for EHR meaningful use, provider eligibility, and EHR certification criteria, from a perspective of their relevance for laboratories and pathology practices. PMID:21383931

42 CFR 495.100 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements... professionals: (1) A doctor of medicine or osteopathy. (2) A doctor of dental surgery or medicine. (3) A doctor of podiatric medicine. (4) A doctor of optometry. (5) A chiropractor. Geographic health professional...

42 CFR 495.100 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements... professionals: (1) A doctor of medicine or osteopathy. (2) A doctor of dental surgery or medicine. (3) A doctor of podiatric medicine. (4) A doctor of optometry. (5) A chiropractor. Geographic health professional...

42 CFR 495.100 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements... professionals: (1) A doctor of medicine or osteopathy. (2) A doctor of dental surgery or medicine. (3) A doctor of podiatric medicine. (4) A doctor of optometry. (5) A chiropractor. Geographic health professional...

42 CFR 495.100 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements... professionals: (1) A doctor of medicine or osteopathy. (2) A doctor of dental surgery or medicine. (3) A doctor of podiatric medicine. (4) A doctor of optometry. (5) A chiropractor. Geographic health professional...

42 CFR 495.100 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements... professionals: (1) A doctor of medicine or osteopathy. (2) A doctor of dental surgery or medicine. (3) A doctor of podiatric medicine. (4) A doctor of optometry. (5) A chiropractor. Geographic health professional...

42 CFR 495.348 - Procurement standards.

Code of Federal Regulations, 2013 CFR

2013-10-01

... (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE... solicit nor accept gratuities, favors, or anything of monetary value from contractors, or parties to sub... or the gift is an unsolicited item of nominal value. (5) The standards of conduct provide for...

42 CFR 495.348 - Procurement standards.

Code of Federal Regulations, 2012 CFR

2012-10-01

... (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE... solicit nor accept gratuities, favors, or anything of monetary value from contractors, or parties to sub... or the gift is an unsolicited item of nominal value. (5) The standards of conduct provide for...

42 CFR 495.348 - Procurement standards.

Code of Federal Regulations, 2014 CFR

2014-10-01

... (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE... solicit nor accept gratuities, favors, or anything of monetary value from contractors, or parties to sub... or the gift is an unsolicited item of nominal value. (5) The standards of conduct provide for...

42 CFR 495.312 - Process for payments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Process for payments. 495.312 Section 495.312 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE...

75 FR 44313 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-28

... care issues. Frank Szeflinski, (303) 844-7119, Medicare Advantage issues. SUPPLEMENTARY INFORMATION... MCO Managed Care Organization MITA Medicaid Information Technology Architecture MMIS Medicaid... Payment Calculation for Eligible Hospitals c. Medicare Share d. Charity Care e. Transition Factor f...

Understanding Productivity and Technostress for Oncology Nurses Using an Electronic Health Record (EHR) to Increase Safety, Quality, and Effectiveness of Care for Patients with Cancer

ERIC Educational Resources Information Center

Evans, Elizabeth M. Wertz

2013-01-01

Health information technology has become more prevalent in hospitals, physician offices, clinics, and other areas of medical treatment, especially since the federal government passed legislation to offer incentive payments for the meaningful use of electronic health records (EHRs). Previous research demonstrated a decrease in medical errors as…

Investment subsidies and the adoption of electronic medical records in hospitals.

PubMed

Dranove, David; Garthwaite, Craig; Li, Bingyang; Ody, Christopher

2015-12-01

In February 2009 the U.S. Congress unexpectedly passed the Health Information Technology for Economic and Clinical Health Act (HITECH). HITECH provides up to $27 billion to promote adoption and appropriate use of Electronic Medical Records (EMR) by hospitals. We measure the extent to which HITECH incentive payments spurred EMR adoption by independent hospitals. Adoption rates for all independent hospitals grew from 48 percent in 2008 to 77 percent by 2011. Absent HITECH incentives, we estimate that the adoption rate would have instead been 67 percent in 2011. When we consider that HITECH funds were available for all hospitals and not just marginal adopters, we estimate that the cost of generating an additional adoption was $48 million. We also estimate that in the absence of HITECH incentives, the 77 percent adoption rate would have been realized by 2013, just 2 years after the date achieved due to HITECH. Copyright © 2015 Elsevier B.V. All rights reserved.

Health information technology: standards, implementation specifications, and certification criteria for electronic health record technology, 2014 edition; revisions to the permanent certification program for health information technology. Final rule.

PubMed

2012-09-04

With this final rule, the Secretary of Health and Human Services adopts certification criteria that establish the technical capabilities and specify the related standards and implementation specifications that Certified Electronic Health Record (EHR) Technology will need to include to, at a minimum, support the achievement of meaningful use by eligible professionals, eligible hospitals, and critical access hospitals under the Medicare and Medicaid EHR Incentive Programs beginning with the EHR reporting periods in fiscal year and calendar year 2014. This final rule also makes changes to the permanent certification program for health information technology, including changing the program's name to the ONC HIT Certification Program.

Health information technology impact on productivity.

PubMed

Eastaugh, Steven R

2012-01-01

Managers work to achieve the greatest output for the least input effort, better balancing all factors of delivery to achieve the most with the smallest resource effort. Documentation of actual health information technology (HIT) cost savings has been elusive. Information technology and linear programming help to control hospital costs without harming service quality or staff morale. This study presents production function results from a study of hospital output during the period 2008-2011. The results suggest that productivity varies widely among the 58 hospitals as a function of staffing patterns, methods of organization, and the degree of reliance on information support systems. Financial incentives help to enhance productivity. Incentive pay for staff based on actual productivity gains is associated with improved productivity. HIT can enhance the marginal value product of nurses and staff, so that they concentrate their workday around patient care activities. The implementation of electronic health records (EHR) was associated with a 1.6 percent improvement in productivity.

42 CFR 495.206 - Timeframe for payment to qualifying MA organizations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false Timeframe for payment to qualifying MA... RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.206 Timeframe for payment to qualifying MA organizations. (a) CMS makes payment to qualifying MA...

42 CFR 495.206 - Timeframe for payment to qualifying MA organizations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Timeframe for payment to qualifying MA... RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.206 Timeframe for payment to qualifying MA organizations. (a) CMS makes payment to qualifying MA...

42 CFR 495.206 - Timeframe for payment to qualifying MA organizations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Timeframe for payment to qualifying MA... RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.206 Timeframe for payment to qualifying MA organizations. (a) CMS makes payment to qualifying MA...

42 CFR 495.206 - Timeframe for payment to qualifying MA organizations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Timeframe for payment to qualifying MA... RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.206 Timeframe for payment to qualifying MA organizations. (a) CMS makes payment to qualifying MA...

42 CFR 495.206 - Timeframe for payment to qualifying MA organizations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Timeframe for payment to qualifying MA... RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.206 Timeframe for payment to qualifying MA organizations. (a) CMS makes payment to qualifying MA...

Comparison of Project Management Software Tool Use in Healthcare and Other Industries

ERIC Educational Resources Information Center

Tait, Isabelle E.

2013-01-01

Hospitals, clinics, and physicians' offices are being mandated to implement health information technology to support electronic health records or receive reduced government reimbursements for the treatment of Medicare and Medicaid patients. The EHR Medicare and Medicaid Incentive Program, managed by the Centers for Medicare and Medicaid Services,…

42 CFR 495.340 - As-needed HIT PAPD update and as-needed HIT IAPD update requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.340 As... document or the HIT implementation advance planning document. (d) A change in implementation concept or a change to the scope of the project. (e) A change to the approved cost allocation methodology. ...

42 CFR 495.340 - As-needed HIT PAPD update and as-needed HIT IAPD update requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements Specific to the Medicaid Program § 495.340 As... document or the HIT implementation advance planning document. (d) A change in implementation concept or a change to the scope of the project. (e) A change to the approved cost allocation methodology. ...

Incentive program to strengthen motivation for increasing physical activity via conjoint analysis.

PubMed

Matsushita, Munehiro; Harada, Kazuhiro; Arao, Takashi

2017-01-01

Objectives　Promoting physical activity is a key public health issue. Incentive programs have attracted attention as a technique for promoting physical activity. For the use of effective incentives, there is a need to clarify the most effective incentive program conditions for the promotion of physical activity. Therefore, the present study used the conjoint analysis to examine the effective incentive program conditions for strengthening the motivation to increase physical activity.Methods　Data on 1,998 subjects (aged 40-74) were analyzed. The main variables in this study were physical activity (IPAQ-Short Form) and the strengthening of motivation to increase physical activity. The incentive programs that were implemented, comprised four factors: 1) cash equivalents (1,000 yen, 2,000 yen, and 3,000 yen); 2) duration between increase in physical activity and receipt of the incentive (1, 2, or 3 months); 3) method to record the physical activity (recording sheet, recording website, and automatic pedometer recording); and 4) lottery (yes or no). Eleven incentive programs were created, which was the minimum number required for comparison of these factors and levels. The average importance of each of the four factors was calculated to compare their contributions to the strengthening of the motivation to increase physical activity. The utility of each level was also calculated to compare their contributions to the strengthening of motivation. All statistics were stratified by age (≤65 years and 65+ years) and physical activity (<150 min/week, 150+ min/week) for additional analysis.Results　Cash incentives and the lottery ranked equally on average importance, followed by duration and recording methods. Utility was higher for each factor, as follows: 1) more valuable cash incentives, 2) shorter duration, 3) automatic pedometer recording, and 4) no lottery. There was no notable difference in the average importance and utility of age and physical activity.Conclusions　The results of this study suggest that no lottery and more valuable incentives were important for improving the effectiveness of incentive programs in increasing physical activity. Moreover, these two factors would be important regardless of age and physical activity levels. Further intervention studies on incentive programs for increasing physical activity considering the present results are needed.

Arkansas | Solar Research | NREL

Science.gov Websites

programs. State Incentive Programs There are currently no statewide solar financial incentive programs in Wyoming. Program Administrator Incentive Arkansas Energy Technology Loans for Green Technology Arkansas for the most up-to-date and accurate information on state and utility policies and incentive programs

Alternative Fuels Data Center: Idle Reduction

Science.gov Websites

Cities Annual Petroleum Savings Clean Cities Annual Petroleum Savings Incentive and Law Additions by Fuel /Technology Type Incentive and Law Additions by Fuel/Technology Type Incentive Additions by Policy Type Incentive Additions by Policy Type More Idle Reduction Data | All Maps & Data Case Studies Massachusetts

Creating value: unifying silos into public health business intelligence.

PubMed

Davidson, Arthur J

2014-01-01

Through September 2014, federal investments in health information technology have been unprecedented, with more than 25 billion dollars in incentive funds distributed to eligible hospitals and providers. Over 85 percent of eligible United States hospitals and 60 percent of eligible providers have used certified electronic health record (EHR) technology and received Meaningful Use incentive funds (HITECH Act1). Certified EHR technology could create new public health (PH) value through novel and rapidly evolving data-use opportunities, never before experienced by PH. The long-standing "silo" approach to funding has fragmented PH programs and departments,2 but the components for integrated business intelligence (i.e., tools and applications to help users make informed decisions) and maximally reuse data are available now. Challenges faced by PH agencies on the road to integration are plentiful, but an emphasis on PH systems and services research (PHSSR) may identify gaps and solutions for the PH community to address. Technology and system approaches to leverage this information explosion to support a transformed health care system and population health are proposed. By optimizing this information opportunity, PH can play a greater role in the learning health system.

Some hospitals are falling behind in meeting 'meaningful use' criteria and could be vulnerable to penalties in 2015.

PubMed

DesRoches, Catherine M; Worzala, Chantal; Bates, Scott

2013-08-01

With nearly $30 billion in incentives available, it is critical to know to what extent US hospitals have been able to respond to those incentives by adopting electronic health record (EHR) systems that meet Medicare's criteria for their "meaningful use." Medicare has provided aggregate incentive payment data, but still missing is an understanding of how these payments are distributed across hospital types and years. Our analysis of Medicare data found a substantial increase in the percentage of hospitals receiving EHR incentive payments between 2011 (17.4 percent) and 2012 (36.8 percent). However, this increase was not uniform across all hospitals, and the overall proportion of hospitals receiving a payment for meaningful use was low. Critical-access, smaller, and publicly owned or nonprofit hospitals appeared to be at particular risk for failing to meet Medicare's meaningful-use criteria, and the overall proportion of hospitals receiving a payment for meaningful use was low. Starting in 2015, hospitals that fail to meet the criteria will be subject to financial penalties. To address the needs of institutions in danger of incurring these penalties, policy makers could implement targeted grant programs and provide additional information technology workforce support. In addition, the capacity of EHR system vendors should be carefully monitored to ensure that these institutions have access to the technology they need.

Health information technology adoption in U.S. acute care hospitals.

PubMed

Zhang, Ning Jackie; Seblega, Binyam; Wan, Thomas; Unruh, Lynn; Agiro, Abiy; Miao, Li

2013-04-01

Previous studies show that the healthcare industry lags behind many other economic sectors in the adoption of information technology. The purpose of this study is to understand differences in structural characteristics between providers that do and that do not adopt Health Information Technology (HIT) applications. Publicly available secondary data were used from three sources: American Hospital Association (AHA) annual survey, Healthcare Information and Management Systems Society (HIMSS) analytics annual survey, and Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) databases. Fifty-two information technologies were grouped into three clusters: clinical, administrative, and strategic decision making ITs. Negative binomial regression was applied with adoption of technology as the dependent variables and eight organizational and contextual factors as the independent variables. Hospitals adopt a relatively larger proportion of administrative information technology as compared to clinical and strategic IT. Large size, urban location and HMO penetration were found to be the most influential hospital characteristics that positively affect information technology adoption. There are still considerable variations in the adoption of information technology across hospitals and in the type of technology adopted. Organizational factors appear to be more influential than market factors when it comes to information technology adoption. The future research may examine whether the Electronic Health Record (EHR) Incentive Program in 2011 would increase the information technology uses in hospitals as it provides financial incentives for HER adoptions and uses among providers.

Hospitals ineligible for federal meaningful-use incentives have dismally low rates of adoption of electronic health records.

PubMed

Wolf, Larry; Harvell, Jennie; Jha, Ashish K

2012-03-01

The US government has dedicated substantial resources to help certain providers, such as short-term acute care hospitals and physicians, adopt and meaningfully use electronic health record (EHR) systems. We used national data to determine adoption rates of EHR systems among all types of inpatient providers that were ineligible for these same federal meaningful-use incentives: long-term acute care hospitals, rehabilitation hospitals, and psychiatric hospitals. Adoption rates for these institutions were dismally low: less than half of the rate among short-term acute care hospitals. Specifically, 12 percent of short-term acute care hospitals have at least a basic EHR system, compared with 6 percent of long-term acute care hospitals, 4 percent of rehabilitation hospitals, and 2 percent of psychiatric hospitals. To advance the creation of a nationwide health information technology infrastructure, federal and state policy makers should consider additional measures, such as adopting health information technology standards and EHR system certification criteria appropriate for these ineligible hospitals; including such hospitals in state health information exchange programs; and establishing low-interest loan programs for the acquisition and use of certified EHR systems by ineligible providers.

Creating Value: Unifying Silos into Public Health Business Intelligence

PubMed Central

Davidson, Arthur J.

2014-01-01

Introduction: Through September 2014, federal investments in health information technology have been unprecedented, with more than 25 billion dollars in incentive funds distributed to eligible hospitals and providers. Over 85 percent of eligible United States hospitals and 60 percent of eligible providers have used certified electronic health record (EHR) technology and received Meaningful Use incentive funds (HITECH Act1). Technology: Certified EHR technology could create new public health (PH) value through novel and rapidly evolving data-use opportunities, never before experienced by PH. The long-standing “silo” approach to funding has fragmented PH programs and departments,2 but the components for integrated business intelligence (i.e., tools and applications to help users make informed decisions) and maximally reuse data are available now. Systems: Challenges faced by PH agencies on the road to integration are plentiful, but an emphasis on PH systems and services research (PHSSR) may identify gaps and solutions for the PH community to address. Conclusion: Technology and system approaches to leverage this information explosion to support a transformed health care system and population health are proposed. By optimizing this information opportunity, PH can play a greater role in the learning health system. PMID:25995989

A Review of the Literature on Remote Monitoring Technology in Incentive-Based Interventions for Health-Related Behavior Change.

PubMed

Kurti, Allison N; Davis, Danielle R; Redner, Ryan; Jarvis, Brantley P; Zvorsky, Ivori; Keith, Diana R; Bolivar, Hypatia A; White, Thomas J; Rippberger, Peter; Markesich, Catherine; Atwood, Gary; Higgins, Stephen T

2016-06-01

Use of technology (e.g., Internet, cell phones) to allow remote implementation of incentives interventions for health-related behavior change is growing. To our knowledge, there has yet to be a systematic review of this literature reported. The present report provides a systematic review of the controlled studies where technology was used to remotely implement financial incentive interventions targeting substance use and other health behaviors published between 2004 and 2015. For inclusion in the review, studies had to use technology to remotely accomplish one of the following two aims alone or in combination: (a) monitor the target behavior, or (b) deliver incentives for achieving the target goal. Studies also had to examine financial incentives (e.g., cash, vouchers) for health-related behavior change, be published in peer-reviewed journals, and include a research design that allowed evaluation of the efficacy of the incentive intervention relative to another condition (e.g., non-contingent incentives, treatment as usual). Of the 39 reports that met inclusion criteria, 18 targeted substance use, 10 targeted medication adherence or home-based health monitoring, and 11 targeted diet, exercise, or weight loss. All 39 (100%) studies used technology to facilitate remote monitoring of the target behavior, and 26 (66.7%) studies also incorporated technology in the remote delivery of incentives. Statistically significant intervention effects were reported in 71% of studies reviewed. Overall, the results offer substantial support for the efficacy of remotely implemented incentive interventions for health-related behavior change, which have the potential to increase the cost-effectiveness and reach of this treatment approach.

Health information technology: initial set of standards, implementation specifications, and certification criteria for electronic health record technology. Interim final rule.

PubMed

2010-01-13

The Department of Health and Human Services (HHS) is issuing this interim final rule with a request for comments to adopt an initial set of standards, implementation specifications, and certification criteria, as required by section 3004(b)(1) of the Public Health Service Act. This interim final rule represents the first step in an incremental approach to adopting standards, implementation specifications, and certification criteria to enhance the interoperability, functionality, utility, and security of health information technology and to support its meaningful use. The certification criteria adopted in this initial set establish the capabilities and related standards that certified electronic health record (EHR) technology will need to include in order to, at a minimum, support the achievement of the proposed meaningful use Stage 1 (beginning in 2011) by eligible professionals and eligible hospitals under the Medicare and Medicaid EHR Incentive Programs.

Understanding Electronic Medical Record Adoption in the United States: Communication and Sociocultural Perspectives

PubMed Central

Kreps, Gary L; Polit, Stan

2013-01-01

Background This paper adopts a communication and sociocultural perspective to analyze the factors behind the lag in electronic medical record (EMR) adoption in the United States. Much of the extant research on this topic has emphasized economic factors, particularly, lack of economic incentives, as the primary cause of the delay in EMR adoption. This prompted the Health Information Technology on Economic and Clinical Health Act that allow financial incentives through the Centers of Medicare and Medicaid Services for many health care organizations planning to adopt EMR. However, financial incentives alone have not solved the problem; many new innovations do not diffuse even when offered for free. Thus, this paper underlines the need to consider communication and sociocultural factors to develop a better understanding of the impediments of EMR adoption. Objective The objective of this paper was to develop a holistic understanding of EMR adoption by identifying and analyzing the impact of communication and sociocultural factors that operate at 3 levels: macro (environmental), meso (organizational), and micro (individual). Methods We use the systems approach to focus on the 3 levels (macro, meso, and micro) and developed propositions at each level drawing on the communication and sociocultural perspectives. Results Our analysis resulted in 10 propositions that connect communication and sociocultural aspects with EMR adoption. Conclusions This paper brings perspectives from the social sciences that have largely been missing in the extant literature of health information technology (HIT) adoption. In doing so, it implies how communication and sociocultural factors may complement (and in some instances, reinforce) the impact of economic factors on HIT adoption. PMID:23612390

Multiple behavior changes in diet and activity: a randomized controlled trial using mobile technology.

PubMed

Spring, Bonnie; Schneider, Kristin; McFadden, H Gene; Vaughn, Jocelyn; Kozak, Andrea T; Smith, Malaina; Moller, Arlen C; Epstein, Leonard H; Demott, Andrew; Hedeker, Donald; Siddique, Juned; Lloyd-Jones, Donald M

2012-05-28

Many patients exhibit multiple chronic disease risk behaviors. Research provides little information about advice that can maximize simultaneous health behavior changes. To test which combination of diet and activity advice maximizes healthy change, we randomized 204 adults with elevated saturated fat and low fruit and vegetable intake, high sedentary leisure time, and low physical activity to 1 of 4 treatments: increase fruit/vegetable intake and physical activity, decrease fat and sedentary leisure, decrease fat and increase physical activity, and increase fruit/vegetable intake and decrease sedentary leisure. Treatments provided 3 weeks of remote coaching supported by mobile decision support technology and financial incentives. During treatment, incentives were contingent on using the mobile device to self-monitor and attain behavioral targets; during follow-up, incentives were contingent only on recording. The outcome was standardized, composite improvement on the 4 diet and activity behaviors at the end of treatment and at 5-month follow-up. Of the 204 individuals randomized, 200 (98.0%) completed follow-up. The increase fruits/vegetables and decrease sedentary leisure treatments improved more than the other 3 treatments (P < .001). Specifically, daily fruit/vegetable intake increased from 1.2 servings to 5.5 servings, sedentary leisure decreased from 219.2 minutes to 89.3 minutes, and saturated fat decreased from 12.0% to 9.5% of calories consumed. Differences between treatment groups were maintained through follow-up. Traditional dieting (decrease fat and increase physical activity) improved less than the other 3 treatments (P < .001). Remote coaching supported by mobile technology and financial incentives holds promise to improve diet and activity. Targeting fruits/vegetables and sedentary leisure together maximizes overall adoption and maintenance of multiple healthy behavior changes.

The Relationship Between Magnet Designation, Electronic Health Record Adoption, and Medicare Meaningful Use Payments.

PubMed

Lippincott, Christine; Foronda, Cynthia; Zdanowicz, Martin; McCabe, Brian E; Ambrosia, Todd

2017-08-01

The objective of this study was to examine the relationship between nursing excellence and electronic health record adoption. Of 6582 US hospitals, 4939 were eligible for the Medicare Electronic Health Record Incentive Program, and 6419 were eligible for evaluation on the HIMSS Analytics Electronic Medical Record Adoption Model. Of 399 Magnet hospitals, 330 were eligible for the Medicare Electronic Health Record Incentive Program, and 393 were eligible for evaluation in the HIMSS Analytics Electronic Medical Record Adoption Model. Meaningful use attestation was defined as receipt of a Medicare Electronic Health Record Incentive Program payment. The adoption electronic health record was defined as Level 6 and/or 7 on the HIMSS Analytics Electronic Medical Record Adoption Model. Logistic regression showed that Magnet-designated hospitals were more likely attest to Meaningful Use than non-Magnet hospitals (odds ratio = 3.58, P < .001) and were more likely to adopt electronic health records than non-Magnet hospitals (Level 6 only: odds ratio = 3.68, P < .001; Level 6 or 7: odds ratio = 4.02, P < .001). This study suggested a positive relationship between Magnet status and electronic health record use, which involves earning financial incentives for successful adoption. Continued investigation is needed to examine the relationships between the quality of nursing care, electronic health record usage, financial implications, and patient outcomes.

77 FR 54163 - Health Information Technology: Standards, Implementation Specifications, and Certification...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-04

...With this final rule, the Secretary of Health and Human Services adopts certification criteria that establish the technical capabilities and specify the related standards and implementation specifications that Certified Electronic Health Record (EHR) Technology will need to include to, at a minimum, support the achievement of meaningful use by eligible professionals, eligible hospitals, and critical access hospitals under the Medicare and Medicaid EHR Incentive Programs beginning with the EHR reporting periods in fiscal year and calendar year 2014. This final rule also makes changes to the permanent certification program for health information technology, including changing the program's name to the ONC HIT Certification Program.

Meaningful use: a roadmap for the advancement of health information exchange

PubMed Central

2013-01-01

Frankel and colleagues have compared Israel and the U.S.’s experiences with health information exchange (HIE). They highlight the importance of institutional factors in fostering HIE development, notably the influence of local structures, experience and incentives. Historically, information infrastructure in the U.S. has been limited due to lack of standards, fragmented institutions and competition. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 authorized billions of dollars for the adoption and “Meaningful Use” of electronic health records. HITECH programs and Meaningful Use incentives target the advancement of HIE through 1) building blocks, 2) local support and 3) payment incentives. Meaningful Use requirements create a roadmap to broader electronic exchange of health information among providers and with patients. Ultimately, successful HIE in the U.S. will depend on whether Meaningful Use can address institutional needs within local markets. This is a commentary on http://www.ijhpr.org/content/2/1/722 PMID:23880399

Cardiopulmonary Laboratory Career Ladder, AFSCs 90251 and 90271.

DTIC Science & Technology

1983-12-01

RAND-HELD OR UPDRAFT NEBULIZERS 74 J283 INSTRUCT PATIENT IN USE OF INCENTIVE SPIROMETRY 74 E106 MAKE ENTRIES ON LOCAL FORMS FOR ARTERIAL BLOOD GAS...INSTRUCT PATIENT IN USE OF INCENTIVE SPIROMETRY 94 E109 MAKE ENTRIES ON LOCAL PULMONARY REQUEST FORMS 92 Ell MAK ENTRIES ON LOCAL TREADMILL REPORT FORMS...SCANNERS 31 44 . IMAGE INTENSIFIERS 7 14 INCENTIVE SPIROMETER DEVICES 71 62 MULTICHANNEL RECORDERS WITH TAPE RECORDERS 21 30 OSCILLOSCOPES 35 36

48 CFR 215.404-71-2 - Performance risk.

Code of Federal Regulations, 2011 CFR

2011-10-01

... incentive range when contract performance includes the introduction of new, significant technological innovation. Use the technology incentive range only for the most innovative contract efforts. Innovation may... reliability, or reduced costs; or (B) New products or systems that contain significant technological advances...

Electronic Health Records: Applying Diffusion of Innovation Theory to the Relationship between Multifactor Authentication and EHR Adoption

ERIC Educational Resources Information Center

Lockett, Daeron C.

2014-01-01

Electronic Health Record (EHR) systems are increasingly becoming accepted as future direction of medical record management systems. Programs such as the American Recovery and Reinvestment Act have provided incentives to hospitals that adopt EHR systems. In spite of these incentives, the perception of EHR adoption is that is has not achieved the…

State Clean Energy Policies Analysis (SCEPA): State Tax Incentives

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lantz, E.; Doris, E.

As a policy tool, state tax incentives can be structured to help states meet clean energy goals. Policymakers often use state tax incentives in concert with state and federal policies to support renewable energy deployment or reduce market barriers. This analysis used case studies of four states to assess the contributions of state tax incentives to the development of renewable energy markets. State tax incentives that are appropriately paired with complementary state and federal policies generally provide viable mechanisms to support renewable energy deployment. However, challenges to successful implementation of state tax incentives include serving project owners with limited statemore » tax liability, assessing appropriate incentive levels, and differentiating levels of incentives for technologies with different costs. Additionally, state tax incentives may result in moderately higher federal tax burdens. These challenges notwithstanding, state tax incentives that consider certain policy design characteristics can support renewable energy markets and state clean energy goals.The scale of their impact though is directly related to the degree to which they support the renewable energy markets for targeted sectors and technologies. This report highlights important policy design considerations for policymakers using state tax incentives to meet clean energy goals.« less

Predictive factors of telemedicine service acceptance and behavioral intention of physicians.

PubMed

Rho, Mi Jung; Choi, In Young; Lee, Jaebeom

2014-08-01

Despite the proliferation of telemedicine technology, telemedicine service acceptance has been slow in actual healthcare settings. The purpose of this research is to develop a theoretical model for explaining the predictive factors influencing physicians' willingness to use telemedicine technology to provide healthcare services. We developed the Telemedicine Service Acceptance model based on the technology acceptance model (TAM) with the inclusion of three predictive constructs from the previously published telemedicine literature: (1) accessibility of medical records and of patients as clinical factors, (2) self-efficacy as an individual factor and (3) perceived incentives as regulatory factors. A survey was conducted, and structural equation modeling was applied to evaluate the empirical validity of the model and causal relationships within the model using the data collected from 183 physicians. Our results confirmed the validity of the original TAM constructs: the perceived usefulness of telemedicine directly impacted the behavioral intention to use it, and the perceived ease of use directly impacted both the perceived usefulness and the behavioral intention to use it. In addition, new predictive constructs were found to have ramifications on TAM variables: the accessibility of medical records and of patients directly impacted the perceived usefulness of telemedicine, self-efficacy had a significant positive effect on both the perceived ease of use and the perceived usefulness of telemedicine, and perceived incentives were found to be important with respect to the intention to use telemedicine technology. This study demonstrated that the Telemedicine Service Acceptance model was feasible and could explain the acceptance of telemedicine services by physicians. These results identified important factors for increasing the involvement of physicians in telemedicine practice. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Adoption factors associated with electronic health record among long-term care facilities: a systematic review

PubMed Central

Kruse, Clemens Scott; Mileski, Michael; Alaytsev, Vyachelslav; Carol, Elizabeth; Williams, Ariana

2015-01-01

Objectives The Health Information Technology for Economic and Clinical Health (HITECH) Act created incentives for adopting electronic health records (EHRs) for some healthcare organisations, but long-term care (LTC) facilities are excluded from those incentives. There are realisable benefits of EHR adoption in LTC facilities; however, there is limited research about this topic. The purpose of this systematic literature review is to identify EHR adoption factors for LTC facilities that are ineligible for the HITECH Act incentives. Setting We conducted systematic searches of Cumulative Index of Nursing and Allied Health Literature (CINAHL) Complete via Ebson B. Stephens Company (EBSCO Host), Google Scholar and the university library search engine to collect data about EHR adoption factors in LTC facilities since 2009. Participants Search results were filtered by date range, full text, English language and academic journals (n=22). Interventions Multiple members of the research team read each article to confirm applicability and study conclusions. Primary and secondary outcome measures Researchers identified common themes across the literature: specifically facilitators and barriers to adoption of the EHR in LTC. Results Results identify facilitators and barriers associated with EHR adoption in LTC facilities. The most common facilitators include access to information and error reduction. The most prevalent barriers include initial costs, user perceptions and implementation problems. Conclusions Similarities span the system selection phases and implementation process; of those, cost was the most common mentioned. These commonalities should help leaders in LTC facilities align strategic decisions to EHR adoption. This review may be useful for decision-makers attempting successful EHR adoption, policymakers trying to increase adoption rates without expanding incentives and vendors that produce EHRs. PMID:25631311

Adopting electronic medical records: what do the new federal incentives mean to your individual physician practice?

PubMed

Neclerio, John M; Cheney, Kathleen; Goldman, C Mitchell; Clark, Lisa W

2009-01-01

Under President Obama's American Recovery and Reinvestment Act of 2009, the federal government is offering incentives to physicians to adopt electronic health records. The goal is to improve quality of care and constrain costs. Higher incentive payments are available for those physicians who act quickly to meet the government's standards. Physicians who practice in "health professional shortage areas" and who serve mainly Medicaid recipients may qualify for additional incentives. Although compliance is "voluntary, "physicians who have not met the standards by 2015 will face reductions in their Medicare reimbursements unless they can show a significant hardship. Physicians can get started by contacting hospitals with which they are affiliated and professional associations to find out what vendors are being used in their service area. Agreements for electronic health records should be reviewed carefully to ensure that physicians' interests are protected.

The Incentive Grant Approach in Higher Education: A 15 Year Record. Institute for Educational Leadership Reports: Nine.

ERIC Educational Resources Information Center

Finkelstein, Martin

The incentive grant approach in higher Education is a resource allocation strategy that may have significant positive impact on educational performance. This document covers: (1) the incentive grant approach to resource allocation; (2) the evolution during the past 15 years of types of incentive grant programs and the contrasting roles played by…

25 CFR 171.610 - Can I arrange an Incentive Agreement if I want to farm idle lands?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Can I arrange an Incentive Agreement if I want to farm... AND WATER IRRIGATION OPERATION AND MAINTENANCE Records, Agreements, and Other Matters § 171.610 Can I arrange an Incentive Agreement if I want to farm idle lands? We may approve an Incentive Agreement if: (a...

25 CFR 171.610 - Can I arrange an Incentive Agreement if I want to farm idle lands?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Can I arrange an Incentive Agreement if I want to farm... AND WATER IRRIGATION OPERATION AND MAINTENANCE Records, Agreements, and Other Matters § 171.610 Can I arrange an Incentive Agreement if I want to farm idle lands? We may approve an Incentive Agreement if: (a...

The effect of information technology on hospital performance.

PubMed

Williams, Cynthia; Asi, Yara; Raffenaud, Amanda; Bagwell, Matt; Zeini, Ibrahim

2016-12-01

While healthcare entities have integrated various forms of health information technology (HIT) into their systems due to claims of increased quality and decreased costs, as well as various incentives, there is little available information about which applications of HIT are actually the most beneficial and efficient. In this study, we aim to assist administrators in understanding the characteristics of top performing hospitals. We utilized data from the Health Information and Management Systems Society and the Center for Medicare and Medicaid to assess 1039 hospitals. Inputs considered were full time equivalents, hospital size, and technology inputs. Technology inputs included personal health records (PHR), electronic medical records (EMRs), computerized physician order entry systems (CPOEs), and electronic access to diagnostic results. Output variables were measures of quality, hospital readmission and mortality rate. The analysis was conducted in a two-stage methodology: Data Envelopment Analysis (DEA) and Automatic Interaction Detector Analysis (AID), decision tree regression (DTreg). Overall, we found that electronic access to diagnostic results systems was the most influential technological characteristics; however organizational characteristics were more important than technological inputs. Hospitals that had the highest levels of quality indicated no excess in the use of technology input, averaging one use of a technology component. This study indicates that prudent consideration of organizational characteristics and technology is needed before investing in innovative programs.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Spencer, D.F.

This analysis evaluates the incentives necessary to introduce commercial scale Advanced Clean Coal Technologies, specifically Integrated Coal Gasification Combined Cycle (ICGCC) and Pressurized Fluidized Bed Combustion (PFBC) powerplants. The incentives required to support the initial introduction of these systems are based on competitive busbar electricity costs with natural gas fired combined cycle powerplants, in baseload service. A federal government price guarantee program for up to 10 Advanced Clean Coal Technology powerplants, 5 each ICGCC and PFBC systems is recommended in order to establish the commercial viability of these systems by 2010. By utilizing a decreasing incentives approach as the technologiesmore » mature (plants 1--5 of each type), and considering the additional federal government benefits of these plants versus natural gas fired combined cycle powerplants, federal government net financial exposure is minimized. Annual net incentive outlays of approximately 150 million annually over a 20 year period could be necessary. Based on increased demand for Advanced Clean Coal Technologies beyond 2010, the federal government would be revenue neutral within 10 years of the incentives program completion.« less

Developing and testing a positive theory of instrument choice: Renewable energy policy in the fifty American states

NASA Astrophysics Data System (ADS)

Ciocirlan, Cristina E.

The environmental economics literature consistently suggests that properly designed and implemented economic incentives are superior to command-and-control regulation in reducing pollution. Economic incentives, such as green taxes, cap-and-trade programs, tax incentives, are able to reduce pollution in a cost-effective manner, provide flexibility to industry and stimulate innovation in cleaner technologies. In the past few decades, both federal and state governments have shown increased use of economic incentives in environmental policy. Some states have embraced them in an active manner, while others have failed to do so. This research uses a three-step analysis. First, it asks why some states employ more economic incentives than others to stimulate consumption of renewable energy by the residential, commercial and industrial sectors. Second, it asks why some states employ stronger incentives than others. And third, it asks why certain states employ certain instruments, such as electricity surcharges, cap-and-trade programs, tax incentives or grants, while others do not. The first two analyses were conducted using factor analysis and multiple regression analysis, while the third analysis employed logistic regression models to analyze the data. Data for all three analyses were obtained from a combination of primary and secondary sources. To address these questions, a theory of instrument choice at the state level, which includes both internal and external determinants of policy-making, was developed and tested. The state level of analysis was chosen. States have proven to be pioneers in designing policies to address greenhouse gases (see, for instance, the recent cap-and-trade legislation passed in California). The theory was operationalized with the help of four models: needs/responsiveness, interest group influence, professionalism/capacity and innovation-and-diffusion. The needs/responsiveness model suggests that states tend to choose more and stronger economic incentives when they are more dependent on conventional sources of energy, such as coal, oil and gas or when they have the potential to produce renewable energy. The interest group influence model suggests that instrument choice is ultimately a political decision, most likely to benefit some groups more than others. The professionalism/capacity model posits that states with more professional legislatures, with legislators who make more use of policy analysis, with more capacity to generate nonpartisan policy research and with larger agencies tend to employ more and stronger instruments to stimulate renewable energy consumption and production. And last, the innovation-and-diffusion model suggests that states with a proven innovation record in climate change tend to employ more and stronger economic incentives than states without such record. Also, this model explains states' instrument choice decisions as a function of the choices made by their neighbors.

Medicare Program; Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive Under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models. Final rule with comment period.

PubMed

2016-11-04

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repeals the Medicare sustainable growth rate (SGR) methodology for updates to the physician fee schedule (PFS) and replaces it with a new approach to payment called the Quality Payment Program that rewards the delivery of high-quality patient care through two avenues: Advanced Alternative Payment Models (Advanced APMs) and the Merit-based Incentive Payment System (MIPS) for eligible clinicians or groups under the PFS. This final rule with comment period establishes incentives for participation in certain alternative payment models (APMs) and includes the criteria for use by the Physician-Focused Payment Model Technical Advisory Committee (PTAC) in making comments and recommendations on physician-focused payment models (PFPMs). Alternative Payment Models are payment approaches, developed in partnership with the clinician community, that provide added incentives to deliver high-quality and cost-efficient care. APMs can apply to a specific clinical condition, a care episode, or a population. This final rule with comment period also establishes the MIPS, a new program for certain Medicare-enrolled practitioners. MIPS will consolidate components of three existing programs, the Physician Quality Reporting System (PQRS), the Physician Value-based Payment Modifier (VM), and the Medicare Electronic Health Record (EHR) Incentive Program for Eligible Professionals (EPs), and will continue the focus on quality, cost, and use of certified EHR technology (CEHRT) in a cohesive program that avoids redundancies. In this final rule with comment period we have rebranded key terminology based on feedback from stakeholders, with the goal of selecting terms that will be more easily identified and understood by our stakeholders.

Multiple Behavior Change in Diet and Activity: A Randomized Controlled Trial Using Mobile Technology

PubMed Central

Spring, Bonnie; Schneider, Kristin; McFadden, H.G.; Vaughn, Jocelyn; Kozak, Andrea T.; Smith, Malaina; Moller, Arlen C.; Epstein, Leonard H.; DeMott, Andrew; Hedeker, Donald; Siddique, Juned; Lloyd-Jones, Donald M.

2012-01-01

Background Many patients exhibit multiple chronic disease risk behaviors. Research provides little information about advice that can maximize simultaneous health behavior changes. Methods To test which combination of diet and activity advice maximizes healthy change, we randomized 204 adults with elevated saturated fat and low fruit/vegetable intakes, high sedentary leisure time and low physical activity to one of four treatments: increase fruit/vegetable and physical activity; decrease fat and sedentary leisure; decrease fat and increase physical activity; increase fruit/vegetable and decrease sedentary leisure. Treatments provided three weeks of remote coaching supported by mobile decision support technology and financial incentives. During treatment, incentives were contingent on using the mobile device to self-monitor and attain behavioral targets; during follow-up they were contingent only on recording. The outcome was standardized, composite improvement on the four diet and activity behaviors at end of treatment and five month follow-up. Results Of those randomized, 200 (98%) completed follow-up. The increase fruit/vegetable and decrease sedentary leisure treatment improved more than the other 3 treatments (p<.001). Specifically, fruit/vegetables increased from 1.2 servings/day to 5.5; sedentary leisure decreased from 219.2 minutes/day to 89.3; saturated fat decreased from 12.0% of calories consumed to 9.5%. Differences between treatment groups were maintained through follow-up. Traditional dieting (decrease fat and increase physical activity) improved less than the other 3 treatments (p<.001). Conclusions Remote coaching supported by mobile technology and financial incentives holds promise to improve diet and activity. Targeting fruits/vegetables and sedentary leisure together maximizes overall adoption and maintenance of multiple healthy behavior changes. PMID:22636824

Policy and system strategies in promoting child health information systems, including the role of Medicaid, the state children's health insurance program, and public financing.

PubMed

MacTaggart, Patricia; Bagley, Bruce

2009-01-01

Government, through its unique roles as regulator, purchaser, provider, and facilitator, has an opportunity and an obligation to play a major role in accelerating the implementation of electronic health record systems and electronic health information exchange. Providers, who are expected to deliver appropriate care at designated locations at an appropriate cost, are dependent on health information technology for efficient effective health care. As state and federal governments move forward with health care purchasing reforms, they must take the opportunity to leverage policy and structure and to align incentives that enhance the potential for provider engagement in electronic health record adoption.

42 CFR § 512.715 - Access to records and retention for FFS-CR participants.

Code of Federal Regulations, 2010 CFR

2017-10-01

... PAYMENT MODEL CR Incentive Payment Model for EPM and Medicare Fee-for-Service Participants Provisions for... investigation of the following: (1) The individual's or entity's compliance with CR incentive payment model... participant's participation in the CR incentive payment model or from the date of completion of any audit...

The LUGPA Alternative Payment Model for Initial Therapy of Newly Diagnosed Patients With Organ-confined Prostate Cancer: Rationale and Development.

PubMed

Kapoor, Deepak A; Shore, Neal D; Kirsh, Gary M; Henderson, Jonathan; Cohen, Todd D; Latino, Kathleen

2017-01-01

Over the past several decades, rapid expansion in healthcare expenditures has exposed the utilization incentives inherent in fee-for-service payment models. The passage of Medicare Access and CHIP Reauthorization Act of 2015 heralded a transition toward value-based care, creating incentives for practitioners to accept bidirectional risk linked to outcome and utilization metrics. At present, the limited availability of these vehicles excludes all but a handful of providers from participation in alternative payment models (APMs). The LUGPA APM supports the goals of the triple aim in improving the patient experience, enhancing population health and reducing expenditures. By requiring utilization of certified electronic health record technologies, tying payment to quality metrics, and requiring practices to bear more than nominal risk, the LUGPA APM qualifies as an advanced APM, thereby easing the reporting burden and creating opportunities for participating practices.

The LUGPA Alternative Payment Model for Initial Therapy of Newly Diagnosed Patients With Organ-confined Prostate Cancer: Rationale and Development

PubMed Central

Kapoor, Deepak A.; Shore, Neal D.; Kirsh, Gary M.; Henderson, Jonathan; Cohen, Todd D.; Latino, Kathleen

2017-01-01

Over the past several decades, rapid expansion in healthcare expenditures has exposed the utilization incentives inherent in fee-for-service payment models. The passage of Medicare Access and CHIP Reauthorization Act of 2015 heralded a transition toward value-based care, creating incentives for practitioners to accept bidirectional risk linked to outcome and utilization metrics. At present, the limited availability of these vehicles excludes all but a handful of providers from participation in alternative payment models (APMs). The LUGPA APM supports the goals of the triple aim in improving the patient experience, enhancing population health and reducing expenditures. By requiring utilization of certified electronic health record technologies, tying payment to quality metrics, and requiring practices to bear more than nominal risk, the LUGPA APM qualifies as an advanced APM, thereby easing the reporting burden and creating opportunities for participating practices. PMID:29726849

Achieving meaningful use: a health system perspective.

PubMed

Bero, Cynthia L; Lee, Thomas H

2010-12-01

In 2002, Partners HealthCare (Partners) launched a strategy to accelerate the use of ambulatory electronic medical records across its network of 6000 physicians. Through focus on quality software products, creation of a system of financial incentives, and active engagement of health system leadership, Partners reached high levels of physician adoption by late 2006. Partners eventually introduced a mandate that made ambulatory electronic medical record use a requirement for all of its physicians. During this multi-year initiative, Partners also focused on the effective use of electronic medical records and introduced a series of tactics designed to optimize the use of these systems. With introduction of the meaningful-use concepts in the Health Information Technology for Economic and Clinical Health (HITECH) Act, Partners will transition its efforts toward this important national priority. Partners' experience offers some unique insights into the process of electronic medical record adoption across a large, diverse health system.

Incentives for knowledge sharing: impact of organisational culture and information technology

NASA Astrophysics Data System (ADS)

Lyu, Hongbo; Zhang, Zuopeng Justin

2017-10-01

This research presents and examines an analytical model of knowledge management in which organisational culture dynamically improves with knowledge-sharing and learning activities within organisations. We investigate the effects of organisational incentives and the level of information technology on the motivation of knowledge sharing. We derive a linear incentive reward structure for knowledge sharing under both homogeneous and heterogeneous conditions. In addition, we show how the organisational culture and the optimum linear sharing reward change with several crucial factors, and summarise three sets of methods (strong IT support, congruent organisational culture, and effective employee assessment) to complement the best linear incentive. Our research provides valuable insights for practitioners in terms of implementing knowledge-management initiatives.

Alternative Fuels Data Center: Federal Laws and Incentives

Science.gov Websites

and Incentives on AddThis.com... More in this section... Search Federal State Local Examples Summary Payments Advanced Energy Research Project Grants Advanced Technology Vehicle (ATV) and Alternative Fuel Alternative Fuel Tax Exemption Alternative Fuel and Advanced Vehicle Technology Research and Demonstration

Motivation and Incentives for Distance Faculty

ERIC Educational Resources Information Center

Parker, Angie

2003-01-01

Colleges continue to offer growing numbers of courses and programs of study through distance education technologies. Yet despite this growth, relatively little is known about what inspires faculty to teach with a technology-mediated approach. The current study was designed as an exploration into the incentives that faculty perceive as motivating.…

Achieving the Meaningful Use Standard: A Model for Implementing Change Within Medical Practices.

PubMed

Fryefield, David C; Staggs, Stuart; Herman, William; Stickler, Alan; Ahmad, Asif; Patt, Debra A; Beveridge, Roy A

2014-03-01

Change management in medical practices is often an uphill battle. Lack of agreement on standards, ineffective leadership, inertia, inconsistent access to data, and inability to clearly define and communicate the benefits of change represent significant barriers to success. In 2009, the Health Information Technology for Economic and Clinical Health (HITECH) Act created the meaningful use (MU) incentive program administered through the Centers for Medicare and Medicaid Services (CMS). To earn financial incentive payments, eligible physicians adopt certified electronic health record (EHR) technology and use it to meet specified objectives. In response, leadership of the US Oncology Network launched an MU initiative designed to create a comprehensive system of tools, education, performance feedback, and support that would facilitate successful achievement of the MU standards. The EHR used by the majority of network physicians was modified according to the MU specifications, and EHR certification was obtained. Baseline compliance data were measured for each of the MU standards and for each of the eligible physicians. Physician and staff workflow processes necessary for consistent data input and compliance were outlined for each standard. Each practice identified one or more staff members who would act as MU leads. Training modules were developed for the MU leads as well as for physicians, mid-level providers, nurses, medical assistants, and office staff. An MU measurement tool was created, designed to target areas for MU process improvement and automate reporting. Data were updated and verified weekly to provide timely feedback to practices, including individual physician detail and links to individual patient records. A total of 943 practitioners within the US Oncology Network met eligibility criteria for the MU program. At baseline, compliance with each MU standard ranged from 0% (clinical summaries) to 100% (computerized order entry). In many cases, data were simply not being entered into the EHR. Time from program launch to first submission of MU attestation was 18 months. As of March 2013, 781 practitioners (83%) had achieved the MU standards. In comparison, CMS reported that 44% of all eligible physicians and 26% of hematologists and oncologists had successfully achieved Medicare MU standards and received payment. Successful change management in medical practices can be accomplished through a comprehensive system of leadership, education, support, timely feedback of data, and clearly defined incentives. Incentives alone may be far less effective.

Augmenting the impact of technology adoption with financial incentive to improve radiology report signature times.

PubMed

Andriole, Katherine P; Prevedello, Luciano M; Dufault, Allen; Pezeshk, Parham; Bransfield, Robert; Hanson, Richard; Doubilet, Peter M; Seltzer, Steven E; Khorasani, Ramin

2010-03-01

Radiology report signature time (ST) can be a substantial component of total report turnaround time. Poor turnaround time resulting from lengthy ST can adversely affect patient care. The combination of technology adoption with financial incentive was evaluated to determine if ST improvement can be augmented and sustained. This prospective study was performed at a 751-bed, urban, tertiary care adult teaching hospital. Test-site imaging volume approximated 48,000 examinations per month. The radiology department has 100 trainees and 124 attending radiologists serving multiple institutions. Over a study period of 4 years and 4 months, three interventions focused on radiologist signature performance were implemented: 1) a notification paging application that alerted radiologists when reports were ready for signature, 2) a picture archiving and communications systems (PACS)-integrated speech recognition report generation system, and 3) a departmental financial incentive to reward radiologists semiannually for ST performance. Signature time was compared before and after the interventions. Wilcoxon and linear regression statistical analyses were used to assess the significance of trends. Technology adoption (paging plus speech recognition) reduced median ST from >5 to <1 hour (P < .001) and 80th-percentile ST from >24 to 15 to 18 hours (P < .001). Subsequent addition of a financial incentive further improved 80th-percentile ST to 4 to 8 hours (P < .001). The gains in median and 80th-percentile ST were sustained over the final 31 months of the study period. Technology interventions coupled with financial incentive can result in synergistic and sustainable improvement in radiologist report-signing behavior. The addition of a financial incentive leads to better performance than that achievable through technology alone.

Update on Electronic Dental Record and Clinical Computing Adoption Among Dental Practices in the United States

PubMed Central

Schroeder, Dixie; Schwei, Kelsey; Chyou, Po-Huang

2017-01-01

This study sought to re-characterize trends and factors affecting electronic dental record (EDR) and technologies adoption by dental practices and the impact of the Health Information Technology for Economic and Clinical Health (HITECH) act on adoption rates through 2012. A 39-question survey was disseminated nationally over 3 months using a novel, statistically-modeled approach informed by early response rates to achieve a predetermined sample. EDR adoption rate for clinical support was 52%. Adoption rates were higher among: (1) younger dentists; (2) dentists ≤ 15 years in practice; (3) females; and (4) group practices. Top barriers to adoption were EDR cost/expense, cost-benefit ratio, electronic format conversion, and poor EDR usability. Awareness of the Federal HITECH incentive program was low. The rate of chairside computer implementation was 72%. Adoption of EDR in dental offices in the United States was higher in 2012 than electronic health record adoption rates in medical offices and was not driven by the HITECH program. Patient portal adoption among dental practices in the United States remained low. PMID:29229631

Adoption Factors of the Electronic Health Record: A Systematic Review

PubMed Central

2016-01-01

Background The Health Information Technology for Economic and Clinical Health (HITECH) was a significant piece of legislation in America that served as a catalyst for the adoption of health information technology. Following implementation of the HITECH Act, Health Information Technology (HIT) experienced broad adoption of Electronic Health Records (EHR), despite skepticism exhibited by many providers for the transition to an electronic system. A thorough review of EHR adoption facilitator and barriers provides ongoing support for the continuation of EHR implementation across various health care structures, possibly leading to a reduction in associated economic expenditures. Objective The purpose of this review is to compile a current and comprehensive list of facilitators and barriers to the adoption of the EHR in the United States. Methods Authors searched Cumulative Index of Nursing and Allied Health Literature (CINAHL) and MEDLINE, 01/01/2012–09/01/2015, core clinical/academic journals, MEDLINE full text, and evaluated only articles germane to our research objective. Team members selected a final list of articles through consensus meetings (n=31). Multiple research team members thoroughly read each article to confirm applicability and study conclusions, thereby increasing validity. Results Group members identified common facilitators and barriers associated with the EHR adoption process. In total, 25 adoption facilitators were identified in the literature occurring 109 times; the majority of which were efficiency, hospital size, quality, access to data, perceived value, and ability to transfer information. A total of 23 barriers to adoption were identified in the literature, appearing 95 times; the majority of which were cost, time consuming, perception of uselessness, transition of data, facility location, and implementation issues. Conclusions The 25 facilitators and 23 barriers to the adoption of the EHR continue to reveal a preoccupation on cost, despite incentives in the HITECH Act. Limited financial backing and outdated technology were also common barriers frequently mentioned during data review. Future public policy should include incentives commensurate with those in the HITECH Act to maintain strong adoption rates. PMID:27251559

Policy Studies Series: Japanese Technology Policy: What’s the Secret?

DTIC Science & Technology

1991-02-01

producers, while subsidies , tax incentives and loan programs provide incentives for Japanese industry to invest in and develop technology. These practices...Education [J Science and Technology Agency 0 MITI 234 12 Defense Agency o Ministry of Agric ., For. & Fish - Ministry of HeallhuWelfare 0 Min. of Posts and...34 The primary task of consortia is information exchange and coordination of a research agenda, not actual joint research. They are most effective in

Alternative Fuels Data Center: Technology Bulletins

Science.gov Websites

Alternative Fuel Vehicles and High Occupancy Vehicle Lanes Updated 9/15 Georgia Sets the Pace for Plug-In advanced vehicles. Laws and Incentives State Alternative Fuel and Advanced Vehicle Laws and Incentives Updated 1/18 State Alternative Fuel and Advanced Vehicle Laws and Incentives: 2016 Year in Review Updated

Financial Incentives to Enable Clean Energy Deployment: Policy Overview and Good Practices

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cox, Sadie

Financial incentives have been widely implemented by governments around the world to support scaled up deployment of renewable energy and energy efficiency technologies and practices. As of 2015, at least 48 countries have adopted financial incentives to support renewable energy and energy efficiency deployment. Broader clean energy strategies and plans provide a crucial foundation for financial incentives that often complement regulatory policies such as renewable energy targets, standards, and other mandates. This policy brief provides a primer on key financial incentive design elements, lessons from different country experiences, and curated support resources for more detailed and country-specific financial incentive designmore » information.« less

Public Health Surveillance and Meaningful Use Regulations: A Crisis of Opportunity

PubMed Central

Sundwall, David N.

2012-01-01

The Health Information Technology for Economic and Clinical Health Act is intended to enhance reimbursement of health care providers for meaningful use of electronic health records systems. This presents both opportunities and challenges for public health departments. To earn incentive payments, clinical providers must exchange specified types of data with the public health system, such as immunization and syndromic surveillance data and notifiable disease reporting. However, a crisis looms because public health’s information technology systems largely lack the capabilities to accept the types of data proposed for exchange. Cloud computing may be a solution for public health information systems. Through shared computing resources, public health departments could reap the benefits of electronic reporting within federal funding constraints. PMID:22390523

Public health surveillance and meaningful use regulations: a crisis of opportunity.

PubMed

Lenert, Leslie; Sundwall, David N

2012-03-01

The Health Information Technology for Economic and Clinical Health Act is intended to enhance reimbursement of health care providers for meaningful use of electronic health records systems. This presents both opportunities and challenges for public health departments. To earn incentive payments, clinical providers must exchange specified types of data with the public health system, such as immunization and syndromic surveillance data and notifiable disease reporting. However, a crisis looms because public health's information technology systems largely lack the capabilities to accept the types of data proposed for exchange. Cloud computing may be a solution for public health information systems. Through shared computing resources, public health departments could reap the benefits of electronic reporting within federal funding constraints.

Accelerated Adoption of Advanced Health Information Technology in Beacon Community Health Centers.

PubMed

Jones, Emily; Wittie, Michael

2015-01-01

To complement national and state-level HITECH Act programs, 17 Beacon communities were funded to fuel community-wide use of health information technology to improve quality. Health centers in Beacon communities received supplemental funding. This article explores the association between participation in the Beacon program and the adoption of electronic health records. Using the 2010-2012 Uniform Data System, trends in health information technology adoption among health centers located within and outside of Beacon communities were explored using differences in mean t tests and multivariate logistic regression. Electronic health record adoption was widespread and rapidly growing in all health centers, especially quality improvement functionalities: structured data capture, order and results management, and clinical decision support. Adoption lagged for functionalities supporting patient engagement, performance measurement, care coordination, and public health. The use of advanced functionalities such as care coordination grew faster in Beacon health centers, and Beacon health centers had 1.7 times higher odds of adopting health records with basic safety and quality functionalities in 2010-2012. Three factors likely underlie these findings: technical assistance, community-wide activation supporting health information exchange, and the layering of financial incentives. Additional technical assistance and community-wide activation is needed to support the use of functionalities that are currently lagging. © Copyright 2015 by the American Board of Family Medicine.

Malpractice liability, technology choice and negative defensive medicine.

PubMed

Feess, Eberhard

2012-04-01

We extend the theoretical literature on the impact of malpractice liability by allowing for two treatment technologies, a safe and a risky one. The safe technology bears no failure risk, but leads to patient-specific disutility since it cannot completely solve the health problems. By contrast, the risky technology (for instance a surgery) may entirely cure patients, but fail with some probability depending on the hospital's care level. Tight malpractice liability increases care levels if the risky technology is chosen at all, but also leads to excessively high incentives for avoiding the liability exposure by adopting the safe technology. We refer to this distortion toward the safe technology as negative defensive medicine. Taking the problem of negative defensive medicine seriously, the second best optimal liability needs to balance between the over-incentive for the safe technology in case of tough liability and the incentive to adopt little care for the risky technology in case of weak liability. In a model with errors in court, we find that gross negligence where hospitals are held liable only for very low care levels outperforms standard negligence, even though standard negligence would implement the first best efficient care level.

Influence of pay-for-performance programs on information technology use among child health providers: the devil is in the details.

PubMed

Menachemi, Nir; Struchen-Shellhorn, Wendy; Brooks, Robert G; Simpson, Lisa

2009-01-01

Pay-for-performance programs are used to promote improved health care quality, often through increased use of health information technology. However, little is known about whether pay-for-performance programs influence the adoption of health information technology, especially among child health providers. This study explored how various pay-for-performance compensation methods are related to health information technology use. Survey data from 1014 child health providers practicing in Florida were analyzed by using univariate and multivariate techniques. Questions asked about the adoption of electronic health records and personal digital assistants, as well as types of activities that affected child health provider compensation or income. The most common reported method to affect respondents' compensation was traditional productivity or billing (78%). Of the pay-for-performance-related methods of compensation, child health providers indicated that measures of clinical care (41%), patient surveys and experience (34%), the use of health information technology (29%), and quality bonuses or incentives (27%) were a major or minor factor in their compensation. In multivariate logistic regression analyses, only pay-for-performance programs that compensated directly for health information technology use were associated with an increased likelihood of electronic health record system adoption. Pay-for-performance programs linking measures of clinical quality to compensation were positively associated with personal digital assistant use among child health providers. Pay-for-performance programs that do not directly emphasize health information technology use do not influence the adoption of electronic health records among Florida physicians treating children. Understanding how different pay-for-performance compensation methods incentivize health information technology adoption is important for improving quality.

Country Review of Energy-Efficiency Financial Incentives in the Residential Sector

DOE Office of Scientific and Technical Information (OSTI.GOV)

Can, Stephane de la Rue du; Shah, Nihar; Phadke, Amol

A large variety of energy-efficiency policy measures exist. Some are mandatory, some are informative, and some use financial incentives to promote diffusion of efficient equipment. From country to country, financial incentives vary considerably in scope and form, the type of framework used to implement them, and the actors that administer them. They range from rebate programs administered by utilities under an Energy-Efficiency Resource Standards (EERS) regulatory framework (California, USA) to the distribution of Eco-points rewarding customers for buying highly efficient appliances (Japan). All have the primary objective of transforming the current market to accelerate the diffusion of efficient technologies bymore » addressing up-front cost barriers faced by consumers; in most instances, efficient technologies require a greater initial investment than conventional technologies. In this paper, we review the different market transformation measures involving the use of financial incentives in the countries belonging to the Major Economies Forum. We characterize the main types of measures, discuss their mechanisms, and provide information on program impacts to the extent that ex-ante or ex-post evaluations have been conducted. Finally, we identify best practices in financial incentive programs and opportunities for coordination between Major Economies Forum countries as envisioned under the Super Efficient Appliance Deployment (SEAD) initiative.« less

Physical activity loyalty cards for behavior change: a quasi-experimental study.

PubMed

Hunter, Ruth F; Tully, Mark A; Davis, Michael; Stevenson, Michael; Kee, Frank

2013-07-01

Financial incentives have been advocated by the UK and U.S. governments to encourage adoption of healthy lifestyles. However, evidence to support the use of incentives for changing physical activity (PA) behavior is sparse. To investigate the effectiveness of financial incentives to increase PA in adults in the workplace. Two-arm quasi-experimental design. Employees (n=406) in a workplace setting in Belfast, Northern Ireland, UK. Using a loyalty card to collect points and earn rewards, participants (n=199) in the Incentive Group monitored their PA levels and received financial incentives (retail vouchers) for minutes of PA completed over the course of a 12-week intervention period. Participants (n=207) in the comparison group used their loyalty card to self-monitor their PA levels but were not able to earn points or obtain incentives (No Incentive Group). The primary outcome was minutes of PA objectively measured using a novel PA tracking system at baseline (April 2011); Week 6 (June 2011); and Week 12 (July 2011). Other outcomes, including a self-report measure of PA, were collected at baseline, Week 12, and 6 months (October 2011). Data were analyzed in June 2012. No significant differences between groups were found for primary or secondary outcomes at the 12-week and 6-month assessments. Participants in the Incentive Group recorded 17.52 minutes of PA/week (95% CI=12.49, 22.56) compared to 16.63 minutes/week (95% CI=11.76, 21.51) in the No Incentive Group at Week 12 (p=0.59). At 6 months, participants in the Incentive Group recorded 26.18 minutes of PA/week (95% CI=20.06, 32.29) compared to 24.00 minutes/week (95% CI=17.45, 30.54) in the No Incentive Group (p=0.45). Financial incentives did not encourage participants to undertake more PA than self-monitoring PA. This study contributes to the evidence base and has important implications for increasing participation in physical activity and fostering links with the business sector. Copyright © 2013 American Journal of Preventive Medicine.

75 FR 2013 - Health Information Technology: Initial Set of Standards, Implementation Specifications, and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-13

...The Department of Health and Human Services (HHS) is issuing this interim final rule with a request for comments to adopt an initial set of standards, implementation specifications, and certification criteria, as required by section 3004(b)(1) of the Public Health Service Act. This interim final rule represents the first step in an incremental approach to adopting standards, implementation specifications, and certification criteria to enhance the interoperability, functionality, utility, and security of health information technology and to support its meaningful use. The certification criteria adopted in this initial set establish the capabilities and related standards that certified electronic health record (EHR) technology will need to include in order to, at a minimum, support the achievement of the proposed meaningful use Stage 1 (beginning in 2011) by eligible professionals and eligible hospitals under the Medicare and Medicaid EHR Incentive Programs.

Promoting healthcare innovation on the demand side.

PubMed

Eisenberg, Rebecca S; Price, W Nicholson

2017-04-01

Innovation policy often focuses on fortifying the incentives of firms that develop and sell new products by offering them lucrative rights to exclude competitors from the market. Regulators also rely on these same firms-and on similar incentives-to develop information about the effects of their products in patients, despite their obvious conflict of interest. The result may be a distorted understanding that leads to overuse of expensive new medical technologies. Recent technological advances have put healthcare payers in an excellent position to play a larger role in future innovation to improve healthcare and reduce its costs. Insurance companies and integrated healthcare providers have custody of treasure troves of data about healthcare provision and outcomes that can yield valuable insights about the effects of medical treatment without the need to conduct costly clinical trials. Some integrated healthcare systems have seized upon this advantage to make notable discoveries about the effects of particular products that have changed the standard of care. Moreover, to the extent that healthcare payers can profit from reducing costs, they will seek to avoid inappropriate use of costly technologies. Greater involvement of payers in healthcare innovation thus offers a potential counterweight to the incentives of product sellers to promote excessive use of costly new products. In recent years, the federal government has sought to promote innovation through analysis of healthcare records in a series of initiatives; some picture insurers as passive data repositories, while others provide opportunities for insurers to take a more active role in innovation. In this paper, we examine the role of health insurers in developing new knowledge about the provision and effects of healthcare-what we call 'demand-side innovation'. We address the contours of this underexplored area of innovation and describe the behavior of participating firms. We examine the effects of current legal rules on demand-side innovation, including insurance regulation, intellectual property rules, privacy protections, and FDA regulation of new healthcare technologies. Throughout, we highlight many policy tools that government can use and is using to facilitate payer innovation outside the traditional toolkit of patents and exclusive rights.

Increased Health Information Technology Adoption and Use Among Small Primary Care Physician Practices Over Time: A National Cohort Study.

PubMed

Rittenhouse, Diane R; Ramsay, Patricia P; Casalino, Lawrence P; McClellan, Sean; Kandel, Zosha K; Shortell, Stephen M

2017-01-01

Implementation and meaningful use of health information technology (HIT) has been shown to facilitate delivery system transformation, yet implementation is far from universal. This study examined correlates of greater HIT implementation over time among a national cohort of small primary care practices in the United States. We used data from a 40-minute telephone panel survey of 566 small primary care practices having 8 or fewer physicians to investigate adoption and use of HIT in 2007-2010 and 2012-2013. We used generalized estimating equations (GEE) to estimate the association of practice characteristics and external incentives with the adoption and use of HIT. We studied 18 measures of HIT functionalities, including record keeping, clinical decision support, patient communication, and health information exchange with hospitals and pharmacies. Overall, use of 16 HIT functionalities increased significantly over time, whereas use of 2 decreased significantly. On average, compared with physician-owned practices, hospital-owned practices used 1.48 (95% CI, 1.07-1.88; P <.001) more HIT processes. And relative to smaller practices, practices with 3 to 8 physicians used 2.49 (95% CI, 2.26-2.72; P <.001) more HIT processes. Participation in pay-for-performance programs, participation in public reporting of clinical quality data, and a larger proportion of revenue from Medicare were also associated with greater adoption and use of HIT. The new Medicare Access and CHIP Reauthorization Act (MACRA) will provide payment incentives and technical support to speed HIT adoption and use by small practices. We found that external incentives were, indeed, positively associated with greater adoption and use of HIT. Our findings also support a strategy of targeting assistance to smaller physician practices and those that are physician owned. © 2017 Annals of Family Medicine, Inc.

The Cornell Staff Retirement Incentive Program

ERIC Educational Resources Information Center

Whelan, Kenneth T.; Ehrenberg, Ronald G.; Hallock, Kevin F.; Seeber, Ronald L.

2011-01-01

We evaluate potential determinants of enrollment in an early retirement incentive program for non-tenure-track employees at a large university. Using administrative records on the eligible, population of employees not covered by collective bargaining agreements, historical employee count and layoff data by budget units, and public information on…

E-health blood pressure control program.

PubMed

Ahern, David K; Stinson, Lynda J; Uebelacker, Lisa A; Wroblewski, Joseph P; McMurray, Jerome H; Eaton, Charles B

2012-01-01

Both technological and human factors design requirements for integration of home blood pressure monitoring (HBPM) into a patient centered medical home (PCMH) model primary care practice are described. Patients with uncontrolled hypertension were given home blood pressure (BP) monitors, and after a three-month run-in period introduced to either a high-tech only (HBPM connectivity to personal health record and tailored Web portal access) or a high-tech/"high-touch" (high-tech solution plus patient navigator [PN]) solution. Features of the Web portal included: BP graphing function, traffic-light feedback system of BP goal attainment, economic incentives for self-monitoring, and dual patient-facing and care-team-facing dashboard functions. The e-health BP control system with PN support was well received by patients, providers, and the healthcare team. Current e-health technology and limited technological literacy of many patients suggest that a PN or some other personnel resource may be required for the adoption of patient-facing technology in primary care.

Does electronic health record use improve hospital financial performance? Evidence from panel data.

PubMed

Collum, Taleah H; Menachemi, Nir; Sen, Bisakha

2016-01-01

The aim of this study was to examine the impact of electronic health record (EHR) adoption on hospital financial performance. We constructed a longitudinal panel using data from the three secondary sources: (a) the 2007-2010 American Hospital Association (AHA) Annual Survey, (b) the 2007-2010 AHA Annual Survey Information Technology Supplement, and (c) the 2007-2011 Medicare Cost Reports from Centers for Medicare and Medicaid Services. Because potential financial benefits attributable to EHR adoption may take some time to accrue, we ran regressions with lags of 1 and 2 years that included hospital and year fixed effects to examine the relationship between the level of EHR adoption and three hospital financial performance measures. A change in the level of EHR adoption was not associated with changes in operating margin or return on assets within hospitals. However, total margin was significantly improved, after 2 years, in hospitals that moved from no EHR to having a comprehensive EHR in all areas of their hospital (β = 0.030, p < .034). On the other hand, hospitals that increased their level of EHR adoption but did not achieve hospital-wide comprehensive adoption did not experience changes in any financial performance measures examined. The improvements in total margin, as opposed to operating margin, are likely due to hospital incentive payments under the Health Information Technology for Economic and Clinical Health Act that are reflected in nonpatient revenues and therefore show up in total margin calculations. Thus, after 2 years of EHR adoption, hospital financial performance is observed to improve based only on meaningful use incentive payments. More research will be needed to determine whether EHR adoption impacts financial performance on a longer time horizon.

42 CFR 495.314 - Activities required to receive an incentive payment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Activities required to receive an incentive payment. 495.314 Section 495.314 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD...

75 FR 3778 - Agency Information Collection Activities: Proposed Request and Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-22

..., or to evaluate a family bible or other family record when determining eligibility for benefits. The... per Response: 10 minutes. Estimated Annual Burden: 3,333 hours. 5. Work Incentives Planning and Assistance Program--0960-0629. The Work Incentives Planning and Assistance (WIPA) program collects...

Converging blockchain and next-generation artificial intelligence technologies to decentralize and accelerate biomedical research and healthcare

PubMed Central

Mamoshina, Polina; Ojomoko, Lucy; Yanovich, Yury; Ostrovski, Alex; Botezatu, Alex; Prikhodko, Pavel; Izumchenko, Eugene; Aliper, Alexander; Romantsov, Konstantin; Zhebrak, Alexander; Ogu, Iraneus Obioma; Zhavoronkov, Alex

2018-01-01

The increased availability of data and recent advancements in artificial intelligence present the unprecedented opportunities in healthcare and major challenges for the patients, developers, providers and regulators. The novel deep learning and transfer learning techniques are turning any data about the person into medical data transforming simple facial pictures and videos into powerful sources of data for predictive analytics. Presently, the patients do not have control over the access privileges to their medical records and remain unaware of the true value of the data they have. In this paper, we provide an overview of the next-generation artificial intelligence and blockchain technologies and present innovative solutions that may be used to accelerate the biomedical research and enable patients with new tools to control and profit from their personal data as well with the incentives to undergo constant health monitoring. We introduce new concepts to appraise and evaluate personal records, including the combination-, time- and relationship-value of the data. We also present a roadmap for a blockchain-enabled decentralized personal health data ecosystem to enable novel approaches for drug discovery, biomarker development, and preventative healthcare. A secure and transparent distributed personal data marketplace utilizing blockchain and deep learning technologies may be able to resolve the challenges faced by the regulators and return the control over personal data including medical records back to the individuals. PMID:29464026

Converging blockchain and next-generation artificial intelligence technologies to decentralize and accelerate biomedical research and healthcare.

PubMed

Mamoshina, Polina; Ojomoko, Lucy; Yanovich, Yury; Ostrovski, Alex; Botezatu, Alex; Prikhodko, Pavel; Izumchenko, Eugene; Aliper, Alexander; Romantsov, Konstantin; Zhebrak, Alexander; Ogu, Iraneus Obioma; Zhavoronkov, Alex

2018-01-19

The increased availability of data and recent advancements in artificial intelligence present the unprecedented opportunities in healthcare and major challenges for the patients, developers, providers and regulators. The novel deep learning and transfer learning techniques are turning any data about the person into medical data transforming simple facial pictures and videos into powerful sources of data for predictive analytics. Presently, the patients do not have control over the access privileges to their medical records and remain unaware of the true value of the data they have. In this paper, we provide an overview of the next-generation artificial intelligence and blockchain technologies and present innovative solutions that may be used to accelerate the biomedical research and enable patients with new tools to control and profit from their personal data as well with the incentives to undergo constant health monitoring. We introduce new concepts to appraise and evaluate personal records, including the combination-, time- and relationship-value of the data. We also present a roadmap for a blockchain-enabled decentralized personal health data ecosystem to enable novel approaches for drug discovery, biomarker development, and preventative healthcare. A secure and transparent distributed personal data marketplace utilizing blockchain and deep learning technologies may be able to resolve the challenges faced by the regulators and return the control over personal data including medical records back to the individuals.

Incentives to create and sustain healthy behaviors: technology solutions and research needs.

PubMed

Teyhen, Deydre S; Aldag, Matt; Centola, Damon; Edinborough, Elton; Ghannadian, Jason D; Haught, Andrea; Jackson, Theresa; Kinn, Julie; Kunkler, Kevin J; Levine, Betty; Martindale, Valerie E; Neal, David; Snyder, Leslie B; Styn, Mindi A; Thorndike, Frances; Trabosh, Valerie; Parramore, David J

2014-12-01

Health-related technology, its relevance, and its availability are rapidly evolving. Technology offers great potential to minimize and/or mitigate barriers associated with achieving optimal health, performance, and readiness. In support of the U.S. Army Surgeon General's vision for a "System for Health" and its Performance Triad initiative, the U.S. Army Telemedicine and Advanced Technology Research Center hosted a workshop in April 2013 titled "Incentives to Create and Sustain Change for Health." Members of government and academia participated to identify and define the opportunities, gain clarity in leading practices and research gaps, and articulate the characteristics of future technology solutions to create and sustain real change in the health of individuals, the Army, and the nation. The key factors discussed included (1) public health messaging, (2) changing health habits and the environmental influence on health, (3) goal setting and tracking, (4) the role of incentives in behavior change intervention, and (5) the role of peer and social networks in change. This report summarizes the recommendations on how technology solutions could be employed to leverage evidence-based best practices and identifies gaps in research where further investigation is needed. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Study on government's optimal incentive intensity of intellectual property rights

NASA Astrophysics Data System (ADS)

Yang, Chengbin; Sun, Shengxiang; Wei, Hua

2018-05-01

The integration of military and civilian technology in the development stage of weapon equipment is an inherent requirement for the development of the deep integration of the military and the civilian. In order to avoid repeated development of existing technology and improve the efficiency of weaponry development, the government should take effective measures to encourage development institutions to actively adopt existing intellectual property technology in the process of equipment development. According to the theory of utility function and the characteristics of practical problems, the utility function of government and weapon equipment development units is constructed, and the optimization model of incentive strength for national defense intellectual property is established. According to the numerical simulation, the conclusion is, to improve the development efficiency, and at the same time, to encourage innovation, thre government need to make a trade-off in incentive policy making, to achieve a high level in intellectual property rights' innovation and application.

Policy support, economic incentives and the adoption of irrigation technology in China

NASA Astrophysics Data System (ADS)

Cremades, R.; Wang, J.; Morris, J.

2014-11-01

The challenges China faces in terms of water availability in the agricultural sector are exacerbated by the sector's low irrigation efficiency. To increase irrigation efficiency, promoting irrigation technology has been emphasized by policy makers in China. The overall goal of this paper is to understand the effect of policy support and economic incentives on the adoption of irrigation technology in China. Based on a unique dataset collected at household and village levels from seven provinces in China, results indicated that household-based irrigation technology has become noticeable in almost every Chinese village. In contrast, only about half of Chinese villages have adopted community-based irrigation technology. Despite the relatively high adoption level of household-based irrigation technology at the village level, its actual adoption on crop-sown areas was not high, and it was even lower for community-based irrigation technology. The econometric analyses results revealed that policy supports via subsidies and extension services have played an important role in promoting the adoption of irrigation technology. Strikingly, the present irrigation pricing policy has played significant but contradictory roles in promoting the adoption of different types of irrigation technology. Irrigation pricing showed a positive impact on household-based irrigation technology, and a negative impact on community-based irrigation technology, possibly related to their substitution relationship, because having higher adoption of household-based irrigation technology reduce the incentives to invest in community-based irrigation technology. The paper finally concludes and discusses some policy implications.

The impact of incentives on intrinsic and extrinsic motives for fitness-center attendance in college first-year students.

PubMed

Pope, Lizzy; Harvey, Jean

2015-01-01

A criticism of incentives for health behaviors is that incentives undermine intrinsic motivation. The objective of this study was to determine the impact of monetary incentive provision on participation motives for exercise in first-year college students at a northeastern public university. Randomized-controlled trial. Public university in the Northeastern United States. One hundred seventeen first-year college students. Participants were randomized to one of three conditions: a control condition receiving no incentives for meeting fitness-center attendance goals; a discontinued-incentive condition receiving weekly incentives during fall semester 2011, and no incentives during spring semester 2012; or a continued-incentive condition receiving weekly incentives during fall semester, and incentives on a variable-interval schedule during spring semester. The Exercise Motivation Inventory 2 measured exercise participation motives at baseline, end of fall semester, and end of spring semester. Fitness-center attendance was monitored by using ID-card check-in/check-out records. Repeated-measures analyses using linear mixed models with first-order autoregressive covariance structures were run to compare motive changes in the three conditions. Participation motives of Enjoyment and Revitalization associated with intrinsic motivation did not decrease significantly over time in any of the conditions, F(4, 218) = 2.25, p = .065 and F(4, 220) = 1.67, p = .16, respectively. Intrinsically associated participation motives for exercise did not decrease with incentive provision. Therefore, incentives may encourage fitness-center attendance without negatively impacting participation motives for exercise.

Incentive Mechanisms for Mobile Music Distribution

NASA Astrophysics Data System (ADS)

Furini, Marco; Montangero, Manuela

The mobile digital world is seen as an important business opportunity for two main reasons: the widespread usage of cellphones (more than two billions [30], most of them with sound features) and the pervasiveness of mobile technologies. As a result, music industry and telecoms are bringing the successful Internet-based music market strategy into the mobile scenario: record labels are setting up agreements with cellphone network providers (Sprint, Verizon, Vodafone, Orange just to name a few) to offer a download music service also in the mobile scenario. The strategy is to use wireless channels to distribute music contents in the attempt of replicating the success of the Internet-based download scenario.

Policies, economic incentives and the adoption of modern irrigation technology in China

NASA Astrophysics Data System (ADS)

Cremades, R.; Wang, J.; Morris, J.

2015-07-01

The challenges China faces in terms of water availability in the agricultural sector are exacerbated by the sector's low irrigation efficiency. To increase irrigation efficiency, promoting modern irrigation technology has been emphasized by policy makers in the country. The overall goal of this paper is to understand the effect of governmental support and economic incentives on the adoption of modern irrigation technology in China, with a focus on household-based irrigation technology and community-based irrigation technology. Based on a unique data set collected at household and village levels from seven provinces, the results indicated that household-based irrigation technology has become noticeable in almost every Chinese village. In contrast, only about half of Chinese villages have adopted community-based irrigation technology. Despite the relatively high adoption level of household-based irrigation technology at the village level, its actual adoption in crop sown areas was not high, even lower for community-based irrigation technology. The econometric analysis results revealed that governmental support instruments like subsidies and extension services policies have played an important role in promoting the adoption of modern irrigation technology. Strikingly, the present irrigation pricing policy has played a significant but contradictory role in promoting the adoption of different types of modern irrigation technology. Irrigation pricing showed a positive impact on household-based irrigation technology, and a negative impact on community-based irrigation technology, possibly related to the substitution effect that is, the higher rate of adoption of household-based irrigation technology leads to lower incentives for investment in community-based irrigation technology. The paper finally concludes and discusses some policy implications.

Impact of financial incentives on alcohol intervention delivery in primary care: a mixed-methods study.

PubMed

O'Donnell, Amy; Haighton, Catherine; Chappel, David; Shevills, Colin; Kaner, Eileen

2016-11-25

Local and national financial incentives were introduced in England between 2008 and 2015 to encourage screening and brief alcohol intervention delivery in primary care. We used routine Read Code data and interviews with General Practitioners (GPs) to assess their impact. A sequential explanatory mixed-methods study was conducted in 16 general practices representing 106,700 patients and 99 GPs across two areas in Northern England. Data were extracted on screening and brief alcohol intervention delivery for 2010-11 and rates were calculated by practice incentive status. Semi-structured interviews with 14 GPs explored which factors influence intervention delivery and recording in routine consultations. Screening and brief alcohol intervention rates were higher in financially incentivised compared to non-incentivised practices. However absolute rates were low across all practices. Rates of short screening test administration ranged from 0.05% (95% CI: 0.03-0.08) in non-incentivised practices to 3.92% (95% CI: 3.70-4.14) in nationally incentivised practices. For the full AUDIT, rates were also highest in nationally incentivised practices (3.68%, 95% CI: 3.47-3.90) and lowest in non-incentivised practices (0.17%, 95% CI: 0.13-0.22). Delivery of alcohol interventions was highest in practices signed up to the national incentive scheme (9.23%, 95% CI: 8.91-9.57) and lowest in non-incentivised practices (4.73%, 95% CI: 4.50-4.96). GP Interviews highlighted a range of influences on alcohol intervention delivery and subsequent recording including: the hierarchy of different financial incentive schemes; mixed belief in the efficacy of alcohol interventions; the difficulty of codifying complex conditions; and GPs' beliefs about patient-centred practice. Financial incentives have had some success in encouraging screening and brief alcohol interventions in England, but levels of recorded activity remain low. To improve performance, future policies must prioritise alcohol prevention work within the quality and outcomes framework, and address the values, attitudes and beliefs that shape how GPs' provide care.

Technology transfer needs and experiences: The NASA Research Center perspective

NASA Technical Reports Server (NTRS)

Gross, Anthony R.

1992-01-01

Viewgraphs on technology transfer needs and experiences - the NASA Research Center perspective are provided. Topics covered include: functions of NASA, incentives and benefits, technology transfer mechanisms, economics of technology commercialization, examples, and conclusions.

A business case for HIT adoption: effects of "meaningful use" EHR financial incentives on clinic revenue.

PubMed

Behkami, Nima A; Dorr, David A; Morrice, Stuart

2010-01-01

The goal of this study is to describe a framework that allows decision makers to efficiently evaluate factors that affect Electronic Health Record (EHR) adoption and test suitable interventions; specifically financial incentives. The United States healthcare delivery system is experiencing a transformation to improve population health. There is strong agreement that "meaningful use" of Health Information Technology (HIT) is a major enabler in this effort. However it's also understood that the high cost of implementing an EHR is an obstacle for adoption. To help understand these complexities we developed a simulation model designed to capture the dynamic nature of policy interventions that affect the adoption of EHR. We found that "Effective" use of HIT approaches break-even-point and larger clinic revenue many times faster that "average" or "poor" use of HIT. This study uses a systems perspective to the evaluate EHR adoption process through the "meaningful use" redesign as proposed in the American Reinvestment and Recovery Act 2009 in the United States healthcare industry by utilizing the System Dynamics methodology and Scenario Analysis.

Financial team incentives improved recording of diagnoses in primary care: a quasi-experimental longitudinal follow-up study with controls.

PubMed

Lehtovuori, Tuomo; Kauppila, Timo; Kallio, Jouko; Raina, Marko; Suominen, Lasse; Heikkinen, Anna Maria

2015-11-11

In primary care, financial incentives have usually been directed to physicians because they are thought to make the key decisions in order to change the functions of a medical organization. There are no studies regarding the impact that directing these incentives to all disciplines of the care team (e.g. group bonuses for both nurses and doctors) may have, despite the low frequency with which diagnoses were being recorded for primary care visits to doctors. This study tested the effect of offering group bonuses to the care teams. This was a retrospective quasi-experimental study with before-and-after settings and two control groups. In the intervention group, the mean percentage of visits to a doctor for which a diagnosis was recorded by each individual care team (mean team-based percentage of monthly visits to a doctor with recorded diagnoses) and simultaneously the same data was gathered from two different primary care settings where no team bonuses were applied. To study the sustainability of changes obtained with the group bonuses the respective data were derived from the electronic health record system for 2 years after the cessation of the intervention. The differences in the rate of marking diagnoses was analyzed with ANOVA and RM-ANOVA with appropriate post hoc tests, and the differences in the rate of change in marking diagnoses was analyzed with linear regression followed by t-test. The proportion of doctor visits having recorded diagnoses in the teams was about 55 % before starting to use group bonuses and 90 % after this intervention. There was no such increase in control units. The effect of the intervention weakened slightly after cessation of the group bonuses. Group bonuses may provide a method to alter clinical practices in primary care. However, sustainability of these interventions may diminish after ceasing this type of financial incentive.

Carbon prices and incentives for technological development.

PubMed

Lundgren, Tommy; Marklund, Per-Olov; Samakovlis, Eva; Zhou, Wenchao

2015-03-01

There is concern that the carbon prices generated through climate policies are too low to create the incentives necessary to stimulate technological development. This paper empirically analyzes how the Swedish carbon dioxide (CO2) tax and the European Union emission trading system (EU ETS) have affected productivity development in the Swedish pulp and paper industry 1998-2008. A Luenberger total factor productivity (TFP) indicator is computed using data envelopment analysis. The results show that climate policy had a modest impact on technological development in the pulp and paper industry, and if significant it was negative. The price of fossil fuels, on the contrary, seems to have created important incentives for technological development. Hence, the results suggest that the carbon prices faced by the industry through EU ETS and the CO2 tax have been too low. Even though the data for this study is specific for Sweden, the models and results are applicable internationally. When designing policy to mitigate CO2 emissions, it is vital that the policy creates a carbon price that is high enough - otherwise the pressure on technological development will not be sufficiently strong. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Health-related scientific and technological capabilities and university-industry research collaboration].

PubMed

Britto, Jorge; Vargas, Marco Antônio; Gadelha, Carlos Augusto Grabois; Costa, Laís Silveira

2012-12-01

To examine recent developments in health-related scientific capabilities, the impact of lines of incentives on reducing regional scientific imbalances, and university-industry research collaboration in Brazil. Data were obtained from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (Brazilian National Council for Scientific and Technological Development) databases for the years 2000 to 2010. There were assessed indicators of resource mobilization, research network structuring, and knowledge transfer between science and industry initiatives. Based on the regional distribution map of health-related scientific and technological capabilities there were identified patterns of scientific capabilities and science-industry collaboration. There was relative spatial deconcentration of health research groups and more than 6% of them worked in six areas of knowledge areas: medicine, collective health, dentistry, veterinary medicine, ecology and physical education. Lines of incentives that were adopted from 2000 to 2009 contributed to reducing regional scientific imbalances and improving preexisting capabilities or, alternatively, encouraging spatial decentralization of these capabilities. Health-related scientific and technological capabilities remain highly spatially concentrated in Brazil and incentive policies have contributed to reduce to some extent these imbalances.

School Desegregation and Federal Inducement: Lessons from the Emergency School Aid Act of 1972

ERIC Educational Resources Information Center

Hodge, Emily M.

2018-01-01

This study uses the example of the Emergency School Aid Act of 1972, a federal desegregation incentive program, to discuss the benefits and challenges of equity-oriented incentives. This study applies theories of policy instruments and the social construction of target populations to congressional records, archival program materials, and other…

42 CFR 495.106 - Incentive payments to CAHs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... PROGRAM Requirements Specific to the Medicare Program § 495.106 Incentive payments to CAHs. (a... computers and associated hardware and software, necessary to administer certified EHR technology as defined... determining if a CAH is a qualifying CAH under this section; (3) Specification of EHR reporting periods, cost...

42 CFR 495.106 - Incentive payments to CAHs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... PROGRAM Requirements Specific to the Medicare Program § 495.106 Incentive payments to CAHs. (a... computers and associated hardware and software, necessary to administer certified EHR technology as defined... determining if a CAH is a qualifying CAH under this section; (3) Specification of EHR reporting periods, cost...

Aligning incentives in supply chains.

PubMed

Narayanan, V G; Raman, Ananth

2004-11-01

Most companies don't worry about the behavior of their supply chain partners. Instead, they expect the supply chain to work efficiently without interference, as if guided by Adam Smith's famed invisible hand. In their study of more than 50 supply networks, V.G. Narayanan and Ananth Raman found that companies often looked out for their own interests and ignored those of their network partners. Consequently, supply chains performed poorly. Those results aren't shocking when you consider that supply chains extend across several functions and many companies, each with its own priorities and goals. Yet all those functions and firms must pull in the same direction for a chain to deliver goods and services to consumers quickly and cost-effectively. According to the authors, a supply chain works well only if the risks, costs, and rewards of doing business are distributed fairly across the network. In fact, misaligned incentives are often the cause of excess inventory, stock-outs, incorrect forecasts, inadequate sales efforts, and even poor customer service. The fates of all supply chain partners are interlinked: If the firms work together to serve consumers, they will all win. However, they can do that only if incentives are aligned. Companies must acknowledge that the problem of incentive misalignment exists and then determine its root cause and align or redesign incentives. They can improve alignment by, for instance, adopting revenue-sharing contracts, using technology to track previously hidden information, or working with intermediaries to build trust among network partners. It's also important to periodically reassess incentives, because even top-performing networks find that changes in technology or business conditions alter the alignment of incentives.

Health Information Technology (HIT) Adaptation: Refocusing on the Journey to Successful HIT Implementation

PubMed Central

McAlearney, Ann Scheck; Sieck, Cynthia J; Hefner, Jennifer L; Huerta, Timothy R

2017-01-01

In past years, policies and regulations required hospitals to implement advanced capabilities of certified electronic health records (EHRs) in order to receive financial incentives. This has led to accelerated implementation of health information technologies (HIT) in health care settings. However, measures commonly used to evaluate the success of HIT implementation, such as HIT adoption, technology acceptance, and clinical quality, fail to account for complex sociotechnical variability across contexts and the different trajectories within organizations because of different implementation plans and timelines. We propose a new focus, HIT adaptation, to illuminate factors that facilitate or hinder the connection between use of the EHR and improved quality of care as well as to explore the trajectory of changes in the HIT implementation journey as it is impacted by frequent system upgrades and optimizations. Future research should develop instruments to evaluate the progress of HIT adaptation in both its longitudinal design and its focus on adaptation progress rather than on one cross-sectional outcome, allowing for more generalizability and knowledge transfer. PMID:28882812

77 FR 13831 - Health Information Technology: Standards, Implementation Specifications, and Certification...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-07

...Under section 3004 of the Public Health Service Act, the Secretary of Health and Human Services is proposing to revise the initial set of standards, implementation specifications, and certification criteria adopted in an interim final rule published on January 13, 2010, and a subsequent final rule that was published on July 28, 2010, as well as to adopt new standards, implementation specifications, and certification criteria. The proposed new and revised certification criteria would establish the technical capabilities and specify the related standards and implementation specifications that Certified Electronic Health Record (EHR) Technology would need to include to, at a minimum, support the achievement of meaningful use by eligible professionals, eligible hospitals, and critical access hospitals under the Medicare and Medicaid EHR Incentive Programs beginning with the EHR reporting periods in fiscal year and calendar year 2014. This notice of proposed rulemaking also proposes revisions to the permanent certification program for health information technology, which includes changing the program's name.

Incentive spirometry for the tracheostomy patient.

PubMed

Goldstein, Gregg H; Iloreta, Alfred Marc; Ojo, Bukola; Malkin, Benjamin D

2012-12-01

To determine the feasibility of developing and using a customized incentive spirometer device for patients who have undergone a tracheostomy procedure. The authors performed a prospective case series approved by the institutional review board. Academic medical center. Patients were eligible for participation if they were older than 18 years and had a new tracheostomy. Spirometry exercises were performed using a protocol adapted from the American Academy of Respiratory Care guidelines. Patient data were recorded, including age, sex, tobacco use, surgical procedure, time under general anesthesia, length of hospital stay, and time until ambulation. The details of the spirometry exercises were also recorded along with any complications that occurred. An incentive spirometer was adapted for use with tracheostomy patients and received an investigational device exemption from the Food and Drug Administration. A total of 10 patients were enrolled (mean age 60 years). Sixty percent were current or former tobacco users, the mean anesthesia time was 9 hours, and 70% underwent a microvascular free flap reconstruction. Patients used the incentive spirometer for a mean of 1.6 days during the postoperative period, averaging 3.3 sessions per day and 6.8 breaths per session. The device was well tolerated by patients, and there were no complications associated with its use. This study supports the feasibility of using a customized incentive spirometer for tracheostomy patients and establishes a safety profile for the device to be used in future studies.

Growth Of New York Physician Participation In Meaningful Use Of Electronic Health Records Was Variable, 2011-12.

PubMed

Jung, Hye-Young; Unruh, Mark A; Kaushal, Rainu; Vest, Joshua R

2015-06-01

The federal government has invested $30 billion to promote the adoption and use of electronic health records (EHRs) through the Medicare and Medicaid EHR Incentive Programs. However, the associations between the characteristics of physicians, practices, and markets and the patterns of provider participation in ongoing federal meaningful-use incentive programs over time have been largely unexplored. In this article we describe the participation of New York physicians during the first two years of the meaningful-use initiative. We examined longitudinal patterns to identify characteristics associated with nonparticipation, late adoption of EHRs, noncontinuous participation, and switching programs. We found that 8.1 percent of 26,368 New York physicians participated in the Medicare incentive program in 2011, and 6.1 percent participated in the Medicaid program. Physician participation in the programs grew to 23.9 percent and 8.5 percent, respectively, in 2012. Many physicians in the Medicaid incentive program in 2011 did not participate in either program in 2012. Prior EHR use, access to financial resources, and organizational capacity were physician characteristics associated with early and consistent participation in the meaningful-use initiative. Annual participation requirements, coupled with different options to meet meaningful-use criteria under the incentive programs, create disparate groups of physicians, which illustrates the need to monitor participants for continued participation. Project HOPE—The People-to-People Health Foundation, Inc.

Effects of government incentives on wind innovation in the United States

NASA Astrophysics Data System (ADS)

Horner, Nathaniel; Azevedo, Inês; Hounshell, David

2013-12-01

In the United States, as elsewhere, state and federal governments have considered or implemented a range of policies to create more sustainable energy generation systems in response to concerns over climate change, security of fuel supply, and environmental impacts. These policies include both regulatory instruments such as renewable portfolio standards (RPSs) and market incentives such as tax credits. While these policies are primarily geared towards increasing renewable generation capacity, they can indirectly affect innovation in associated technologies through a ‘demand-pull’ dynamic. Other policies, such as public research and development (R&D) funding, directly incentivize innovation through ‘technology-push’ means. In this letter, we examine these effects on innovation in the United States wind energy industry. We estimate a set of econometric models relating a set of US federal and state policies to patenting activity in wind technologies over the period 1974-2009. We find that RPS policies have had significant positive effects on wind innovation, whereas tax-based incentives have not been particularly effective. We also find evidence that the effects of RPS incentives differ between states. Finally, we find that public R&D funding can be a significant driver of wind innovation, though its effect in the US has been modest.

Drug versus vaccine investment: a modelled comparison of economic incentives

PubMed Central

2013-01-01

Background Investment by manufacturers in research and development of vaccines is relatively low compared with that of pharmaceuticals. If current evaluation technologies favour drugs over vaccines, then the vaccines market becomes relatively less attractive to manufacturers. Methods We developed a mathematical model simulating the decision-making process of regulators and payers, in order to understand manufacturers’ economic incentives to invest in vaccines rather than curative treatments. We analysed the objectives and strategies of manufacturers and payers when considering investment in technologies to combat a disease that affects children, and the interactions between them. Results The model confirmed that, for rare diseases, the economically justifiable prices of vaccines could be substantially lower than drug prices, and that, for diseases spread across multiple cohorts, the revenues derived from vaccinating one cohort per year (routine vaccination) could be substantially lower than those generated by treating sick individuals. Conclusions Manufacturers may see higher incentives to invest in curative treatments rather than in routine vaccines. To encourage investment in vaccines, health authorities could potentially revise their incentive schemes by: (1) committing to vaccinate all susceptible cohorts in the first year (catch-up campaign); (2) choosing a long-term horizon for health technology evaluation; (3) committing higher budgets for vaccines than for treatments; and (4) taking into account all intangible values derived from vaccines. PMID:24011090

University-Affiliated Alcohol Marketing Enhances the Incentive Salience of Alcohol Cues.

PubMed

Bartholow, Bruce D; Loersch, Chris; Ito, Tiffany A; Levsen, Meredith P; Volpert-Esmond, Hannah I; Fleming, Kimberly A; Bolls, Paul; Carter, Brooke K

2018-01-01

We tested whether affiliating beer brands with universities enhances the incentive salience of those brands for underage drinkers. In Study 1, 128 undergraduates viewed beer cues while event-related potentials (ERPs) were recorded. Results showed that beer cues paired with in-group backgrounds (logos for students' universities) evoked an enhanced P3 ERP component, a neural index of incentive salience. This effect varied according to students' levels of identification with their university, and the amplitude of the P3 response prospectively predicted alcohol use over 1 month. In Study 2 ( N = 104), we used a naturalistic advertisement exposure to experimentally create in-group brand associations and found that this manipulation caused an increase in the incentive salience of the beer brand. These data provide the first evidence that marketing beer via affiliating it with students' universities enhances the incentive salience of the brand for underage students and that this effect has implications for their alcohol involvement.

Funding alternatives in EHR adoption: beyond HITECH incentives and traditional approaches.

PubMed

Wang, Tiankai; Wang, Yangmei; Biedermann, Sue

2013-05-01

The meaningful use incentives under HITECH may be inadequate to address the financial challenges many hospitals face in implementing electronic health records (EHRs). Hospitals can fill the capital gap between EHR costs and available funds by exploring other potential funding sources. These sources include additional grants, funding permissible under EHR regulations, vendor financing, and tax benefits under IRS Section 179.

The response of physician groups to P4P incentives.

PubMed

Mehrotra, Ateev; Pearson, Steven D; Coltin, Kathryn L; Kleinman, Ken P; Singer, Janice A; Rabson, Barbra; Schneider, Eric C

2007-05-01

Despite substantial enthusiasm among insurers and federal policy makers for pay-for-performance incentives, little is known about the current scope of these incentives or their influence on the delivery of care. To assess the scope and magnitude of pay-for-performance (P4P) incentives among physician groups and to examine whether such incentives are associated with quality improvement initiatives. Structured telephone survey of leaders of physician groups delivering primary care in Massachusetts. ASSESSED METHODS: Prevalence of P4P incentives among physician groups tied to specific measures of quality or utilization and prevalence of physician group quality improvement initiatives. Most group leaders (89%) reported P4P incentives in at least 1 commercial health plan contract. Incentives were tied to performance on Health Employer Data and Information Set (HEDIS) quality measures (89% of all groups), utilization measures (66%), use of information technology (52%), and patient satisfaction (37%). Among the groups with P4P and knowledge of all revenue streams, the incentives accounted for 2.2% (range, 0.3%-8.8%) of revenue. P4P incentives tied to HEDIS quality measures were positively associated with groups' quality improvement initiatives (odds ratio, 1.6; P = .02). Thirty-six percent of group leaders with P4P incentives reported that they were very important or moderately important to the group's financial success. P4P incentives are now common among physician groups in Massachusetts, and these incentives most commonly reward higher clinical quality or lower utilization of care. Although the scope and magnitude of incentives are still modest for many groups, we found an association between P4P incentives and the use of quality improvement initiatives.

A qualitative study of Canada's experience with the implementation of electronic health information technology.

PubMed

Rozenblum, Ronen; Jang, Yeona; Zimlichman, Eyal; Salzberg, Claudia; Tamblyn, Melissa; Buckeridge, David; Forster, Alan; Bates, David W; Tamblyn, Robyn

2011-03-22

In 2001, Canada Health Infoway unveiled a plan to implement a national system of interoperable electronic health records. This government-funded corporation introduced a novel model for interprovincial/territorial collaboration to establish core aspects of a national framework. Despite this $1.6 billion initiative, Canada continues to lag behind other Western countries in adopting electronic health records. We conducted a study to identify the success of different aspects of the Canadian plan and ways to improve the adoption of electronic health records. We used a case study approach to assess the 10-year history of Canada's e-health plan. National reports and documents were reviewed, and structured interviews were conducted with 29 key stakeholders representing national and provincial organizations responsible for establishing policy and strategic direction for health information technology. Using grounded theory, we analyzed transcripts of the interviews to identify themes and their relationships. Key stakeholders identified funding, national standards, patient registries and digital imaging as important achievements of the e-health plan. Lack of an e-health policy, inadequate involvement of clinicians, failure to establish a business case for using electronic health records, a focus on national rather than regional interoperability, and inflexibility in approach were seen as barriers to adoption of the plan. To accelerate adoption of electronic health records and timely return on investment, an e-health policy needs to be tightly aligned with the major strategic directions of health care reform. Adoption needs to be actively fostered through a bottom-up, clinical-needs-first approach, a national policy for investment in electronic health records, and financial incentives based on patient outcomes that can be achieved with electronic health records.

A qualitative study of Canada’s experience with the implementation of electronic health information technology

PubMed Central

Rozenblum, Ronen; Jang, Yeona; Zimlichman, Eyal; Salzberg, Claudia; Tamblyn, Melissa; Buckeridge, David; Forster, Alan; Bates, David W.; Tamblyn, Robyn

2011-01-01

Background In 2001, Canada Health Infoway unveiled a plan to implement a national system of interoperable electronic health records. This government-funded corporation introduced a novel model for interprovincial/territorial collaboration to establish core aspects of a national framework. Despite this $1.6 billion initiative, Canada continues to lag behind other Western countries in adopting electronic health records. We conducted a study to identify the success of different aspects of the Canadian plan and ways to improve the adoption of electronic health records. Methods We used a case study approach to assess the 10-year history of Canada’s e-health plan. National reports and documents were reviewed, and structured interviews were conducted with 29 key stakeholders representing national and provincial organizations responsible for establishing policy and strategic direction for health information technology. Using grounded theory, we analyzed transcripts of the interviews to identify themes and their relationships. Results Key stakeholders identified funding, national standards, patient registries and digital imaging as important achievements of the e-health plan. Lack of an e-health policy, inadequate involvement of clinicians, failure to establish a business case for using electronic health records, a focus on national rather than regional interoperability, and inflexibility in approach were seen as barriers to adoption of the plan. Interpretation To accelerate adoption of electronic health records and timely return on investment, an e-health policy needs to be tightly aligned with the major strategic directions of health care reform. Adoption needs to be actively fostered through a bottom-up, clinical-needs-first approach, a national policy for investment in electronic health records, and financial incentives based on patient outcomes that can be achieved with electronic health records. PMID:21343262

Factors associated with good compliance and long-term sustainability in a practitioner-based livestock disease surveillance system.

PubMed

Zurbrigg, Katherine J; Van den Borre, Nicole M

2013-03-01

The Ontario Farm call Surveillance Project (OFSP) was a practitioner-based, syndromic surveillance system for livestock disease. Three data-recording methods (paper, web-based, and handheld electronic) used by participating veterinarians were compared for timeliness (when the report arrived at the OFSP office), completeness of the report, and the usage and costs of incentives offered to veterinarians as compensation for their time to record data. There were no statistically significant differences in these parameters among the 3 data-recording methods. This indicates that different data-recording methods can be used within a single veterinary surveillance program while maintaining data integrity and timely reporting. Factors such as ease of data collection and providing incentives valued by veterinarians ensured high compliance and long-term participation in the project. It also increased the diversity of the participant group, reducing the likelihood of biased data submissions.

Factors associated with good compliance and long-term sustainability in a practitioner-based livestock disease surveillance system

PubMed Central

Zurbrigg, Katherine J.; Van den Borre, Nicole M.

2013-01-01

The Ontario Farm call Surveillance Project (OFSP) was a practitioner-based, syndromic surveillance system for livestock disease. Three data-recording methods (paper, web-based, and handheld electronic) used by participating veterinarians were compared for timeliness (when the report arrived at the OFSP office), completeness of the report, and the usage and costs of incentives offered to veterinarians as compensation for their time to record data. There were no statistically significant differences in these parameters among the 3 data-recording methods. This indicates that different data-recording methods can be used within a single veterinary surveillance program while maintaining data integrity and timely reporting. Factors such as ease of data collection and providing incentives valued by veterinarians ensured high compliance and long-term participation in the project. It also increased the diversity of the participant group, reducing the likelihood of biased data submissions. PMID:23997260

Intrinsic motivation and extrinsic incentives jointly predict performance: a 40-year meta-analysis.

PubMed

Cerasoli, Christopher P; Nicklin, Jessica M; Ford, Michael T

2014-07-01

More than 4 decades of research and 9 meta-analyses have focused on the undermining effect: namely, the debate over whether the provision of extrinsic incentives erodes intrinsic motivation. This review and meta-analysis builds on such previous reviews by focusing on the interrelationship among intrinsic motivation, extrinsic incentives, and performance, with reference to 2 moderators: performance type (quality vs. quantity) and incentive contingency (directly performance-salient vs. indirectly performance-salient), which have not been systematically reviewed to date. Based on random-effects meta-analytic methods, findings from school, work, and physical domains (k = 183, N = 212,468) indicate that intrinsic motivation is a medium to strong predictor of performance (ρ = .21-45). The importance of intrinsic motivation to performance remained in place whether incentives were presented. In addition, incentive salience influenced the predictive validity of intrinsic motivation for performance: In a "crowding out" fashion, intrinsic motivation was less important to performance when incentives were directly tied to performance and was more important when incentives were indirectly tied to performance. Considered simultaneously through meta-analytic regression, intrinsic motivation predicted more unique variance in quality of performance, whereas incentives were a better predictor of quantity of performance. With respect to performance, incentives and intrinsic motivation are not necessarily antagonistic and are best considered simultaneously. Future research should consider using nonperformance criteria (e.g., well-being, job satisfaction) as well as applying the percent-of-maximum-possible (POMP) method in meta-analyses. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Spared and impaired aspects of motivated cognitive control in schizophrenia.

PubMed

Mann, Claire L; Footer, Owen; Chung, Yu Sun; Driscoll, Lori L; Barch, Deanna M

2013-08-01

The ability to upregulate cognitive control in motivationally salient situations was examined in individuals with schizophrenia (patients) and healthy controls. Fifty-four patients and 39 healthy controls were recruited. A computerized monetary response conflict task required participants to identity a picture, over which was printed a matching (congruent), neutral, or incongruent word. This baseline condition was followed by an incentive condition, in which participants were given the opportunity to win money on reward-cued trials. These reward-cued trials were interleaved with nonreward cued trials. Reaction times (RT) were examined for both incentive context effects (difference in RT between baseline and nonreward cue trials in the incentive condition) and incentive cue effects (difference in RT between nonreward and reward cue trials in the incentive condition). Compared with baseline, controls showed a speeding of responses during both the nonreward (incentive context effect) and reward cued (incentive cue effect) trials during the incentive condition, but with a larger incentive context than incentive cue effect, suggesting a reliance on proactive control strategies. Although patients also showed a speeding of responses to both nonreward and reward cued trials, they showed a significantly smaller incentive context effect than controls, suggesting a reduction in the use of proactive control and a greater reliance on the use of "just-in-time," reactive control strategies. These results are discussed in light of the relationship between motivation and cognitive impairments in schizophrenia, and the potential role of impairments in prefrontally mediated active maintenance mechanisms. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Financial incentives to discontinue long-term benzodiazepine use: a discrete choice experiment investigating patient preferences and willingness to participate

PubMed Central

Marti, Joachim; Bachhuber, Marcus; Feingold, Jordyn; Meads, David; Richards, Michael; Hennessy, Sean

2017-01-01

Objectives Investigate the acceptability of financial incentives for initiating a medically supervised benzodiazepine discontinuation programme among people with long-term benzodiazepine use and to identify programme features that influence willingness to participate. Methods We conducted a discrete choice experiment in which we presented a variety of incentive-based programs to a sample of older adults with long-term benzodiazepine use identified using the outpatient electronic health record of a university-owned health system. We studied four programme variables: incentive amount for initiating the programme, incentive amount for successful benzodiazepine discontinuation, lottery versus certain payment and whether partial payment was given for dose reduction. Respondents reported their willingness to participate in the programmes and additional information was collected on demographics, history of use and anxiety symptoms. Results The overall response rate was 28.4%. Among the 126 respondents, all four programme variables influenced stated preferences. Respondents strongly preferred guaranteed cash-based incentives as opposed to a lottery, and the dollar amount of both the starting and conditional incentives had a substantial impact on choice. Willingness to participate increased with the amount of conditional incentive. Programme participation also varied by gender, duration of use and income. Conclusions Participation in an incentive-based benzodiazepine discontinuation programme might be relatively low, but is modifiable by programme variables including incentive amounts. These results will be helpful to inform the design of future trials of benzodiazepine discontinuation programmes. Further research is needed to assess the financial viability and potential cost-effectiveness of such economic incentives. PMID:28988167

Barriers to Electronic Health Record Adoption: a Systematic Literature Review.

PubMed

Kruse, Clemens Scott; Kristof, Caitlin; Jones, Beau; Mitchell, Erica; Martinez, Angelica

2016-12-01

Federal efforts and local initiatives to increase adoption and use of electronic health records (EHRs) continue, particularly since the enactment of the Health Information Technology for Economic and Clinical Health (HITECH) Act. Roughly one in four hospitals not adopted even a basic EHR system. A review of the barriers may help in understanding the factors deterring certain healthcare organizations from implementation. We wanted to assemble an updated and comprehensive list of adoption barriers of EHR systems in the United States. Authors searched CINAHL, MEDLINE, and Google Scholar, and accepted only articles relevant to our primary objective. Reviewers independently assessed the works highlighted by our search and selected several for review. Through multiple consensus meetings, authors tapered articles to a final selection most germane to the topic (n = 27). Each article was thoroughly examined by multiple authors in order to achieve greater validity. Authors identified 39 barriers to EHR adoption within the literature selected for the review. These barriers appeared 125 times in the literature; the most frequently mentioned barriers were regarding cost, technical concerns, technical support, and resistance to change. Despite federal and local incentives, the initial cost of adopting an EHR is a common existing barrier. The other most commonly mentioned barriers include technical support, technical concerns, and maintenance/ongoing costs. Policy makers should consider incentives that continue to reduce implementation cost, possibly aimed more directly at organizations that are known to have lower adoption rates, such as small hospitals in rural areas.

Why primary care practices should become digital health information hubs for their patients.

PubMed

Baird, Aaron; Nowak, Samantha

2014-11-25

Two interesting health care trends are currently occurring: 1) patient-facing technologies, such as personal health records, patient portals, and mobile health apps, are being adopted at rapid rates, and 2) primary care, which includes family practice, is being promoted as essential to reducing health care costs and improving health care outcomes. While these trends are notable and commendable, both remain subject to significant fragmentation and incentive misalignments, which has resulted in significant data coordination and value generation challenges. In particular, patient-facing technologies designed to increase care coordination, often fall prey to the very digital fragmentation issues they are supposed to overcome. Additionally, primary care providers are treating patients that may have considerable health information histories, but generating a single view of such multi-source data is nearly impossible. We contribute to this debate by proposing that primary care practices become digital health information hubs for their patients. Such hubs would offer health data coordination in a medically professional setting with the benefits of expert, trustworthy advice coupled with active patient engagement. We acknowledge challenges including: costs, information quality and provenance, willingness-to-share information and records, willingness-to-use (by both providers and patients), primary care scope creep, and determinations of technical and process effectiveness. Even with such potential challenges, we strongly believe that more debate is needed on this topic prior to full implementation of various health information technology incentives and reform programs currently being designed and enacted throughout the world. Ultimately, if we do not provide a meaningful way for the full spectrum of health information to be used by both providers and patients, especially early in the health care continuum, effectively improving health outcomes may remain elusive. We view the primary care practice as a central component of digital information coordination, especially when considering the current challenges of digital health information fragmentation. Given these fragmentation issues and the emphasis on primary care as central to improving health and lower overall health care costs, we suggest that primary care practices should embrace their evolving role and should seek to become digital health information hubs for their patients.

Extraversion and reward-related processing: probing incentive motivation in affective priming tasks.

PubMed

Robinson, Michael D; Moeller, Sara K; Ode, Scott

2010-10-01

Based on an incentive motivation theory of extraversion (Depue & Collins, 1999), it was hypothesized that extraverts (relative to introverts) would exhibit stronger positive priming effects in affective priming tasks, whether involving words or pictures. This hypothesis was systematically supported in four studies involving 229 undergraduates. In each of the four studies, and in a subsequent combined analysis, extraversion was positively predictive of positive affective priming effects, but was not predictive of negative affective priming effects. The results bridge an important gap in the literature between biological and trait models of incentive motivation and do so in a way that should be informative to subsequent efforts to understand the processing basis of extraversion as well as incentive motivation. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Effect of preoperative and postoperative incentive spirometry on lung functions after laparoscopic cholecystectomy.

PubMed

Kundra, Pankaj; Vitheeswaran, Madhurima; Nagappa, Mahesh; Sistla, Sarath

2010-06-01

This study was designed to compare the effects of preoperative and postoperative incentive spirometry on lung functions after laparoscopic cholecystectomy in 50 otherwise normal healthy adults. Patients were randomized into a control group (group PO, n=25) and a study group (group PR, n=25). Patients in group PR were instructed to carry out incentive spirometry before the surgery 15 times, every fourth hourly, for 1 week whereas in group PO, incentive spirometry was carried out during the postoperative period. Lung functions were recorded at the time of preanesthetic evaluation, on the day before the surgery, postoperatively at 6, 24, and 48 hours, and at discharge. Significant improvement in the lung functions was seen after preoperative incentive spirometry (group PR), P<0.05. The lung functions were significantly reduced till the time of discharge in both the groups. However, lung functions were better preserved in group PR at all times when compared with group PO; P<0.05. To conclude, lung functions are better preserved with preoperative than postoperative incentive spirometry.

Alternative approaches to pollution control and waste management: Regulatory and economic instruments. Planteamientos alternos para el control de la contaminacion y el manejo de desechos: instrumentos regulatorios y economicos

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bernstein, J.D.

1993-01-01

The paper examines ways in which developed and developing countries control pollution and manage urban wastes. It addresses pollution issues of concern to local, provincial, and national governments, as well as nongovernmental organizations. Two approaches to pollution management are discussed: direct regulation and economic incentives. Direct regulation sets standards and enforces them through permits, licenses, and controls on land or water use. Economic incentives encourage polluters to adopt control measures and are more flexible and cost effective. Such incentives include charging fees to enterprises for pollution discharges or providing government subsidies for pollution control technology. The author tells how economicmore » incentives can supplement direct regulation and why such incentives, when properly used, offer advantages over direct regulation. The author discusses how governments have used economic incentives to deal with specific environmental issues and what factors policymakers must address when they plan pollution controls.« less

Social, ethical and legal barriers to e-health.

PubMed

Anderson, James G

2007-01-01

Information technology such as electronic medical records (EMRs), electronic prescribing and decision support systems are recognized as essential tools in Europe, the U.S., Canada, Australia, and New Zealand. But significant barriers impede wide-scale adoption of these tools, especially EMR systems. The objectives of this study were to investigate the present status of information technology in health care, the perceived benefits and barriers by primary care physicians. Literature analysis and survey data from primary care physicians on adoption of information technology are reviewed. The U.S. trails European countries as well as Canada, Australia and New Zealand in the use of information technology in primary care. The results of the study indicate that physicians in general perceive benefits to information technology, but also cite major barriers to its implementation in their practices. These barriers include lack of access to capital by health care providers, complex systems and lack of data standards that permit exchange of clinical data, privacy concerns and legal barriers. Overcoming these barriers will require subsidies and performance incentives by payers and government; certification and standardization of vendor applications that permit clinical data exchange; removal of legal barriers; and greater security of medical data to convince practitioners and patients of the value of EMRs.

Commentary on the reimbursement paradox.

PubMed

Reaven, Nancy L; Rosenbloom, Judy

2009-07-01

Reimbursement policies are a critical step in the incorporation of new technologies and therapies into the clinical armamentarium. Reimbursement is an umbrella concept describing the process to manage and pay for healthcare services, including benefit coverage, coding, and payment processes. The technologies and services used in therapeutic temperature management are not directly reimbursed, leading to challenges by hospitals and physicians that the services are too expensive to use. The reimbursement models used in the United States make it increasingly difficult for new technologies and therapies to gain direct reimbursement, part of a strategy by insurers, including Medicare and private insurance companies, to manage access to health care services. Insurers, physicians, hospitals, and other providers face conflicting financial incentives in current reimbursement systems. Aligning the financial incentives underlying reimbursement systems is necessary to adequately support new technologies of merit.

Effect of preoperative incentive spirometry on fentanyl-induced cough: a prospective, randomized, controlled study.

PubMed

Goyal, Vipin Kumar; Bhargava, Suresh Kumar; Baj, Birbal

2017-10-01

Fentanyl-induced cough (FIC) has a reported incidence of 13-65% on induction of anesthesia. Incentive spirometry (IS) creates forceful inspiration, while stretching pulmonary receptors. We postulated that spirometry just before the fentanyl (F) bolus would decrease the incidence and severity of FIC. This study enrolled 200 patients aged 18-60 years and with American Society of Anesthesiologists status I or II. The patients were allocated to two groups of 100 patients each depending on whether they received preoperative incentive spirometry before fentanyl administration. Patients in the F+IS group performed incentive spirometry 10 times just before an intravenous bolus of 3 µg/kg fentanyl in the operating room. The onset time and number of coughs after fentanyl injection were recorded as primary outcomes. Any significant changes in blood pressure, heart rate, or adverse effects of the drug were recorded as secondary outcomes. Patients in the F+IS group had a significantly lower incidence of FIC than in the F group (6% vs. 26%) (P < 0.05). The severity of cough in the F+IS group was also significantly lower than that in group F (mild, 5 vs. 17; moderate 1 vs. 7; severe, 0 vs. 2) (P < 0.05). The median onset time was comparable in both groups (9 s [range: 6-12 s] in both groups). Preoperative incentive spirometry significantly reduces the incidence and severity of FIC when performed just before fentanyl administration.

Effect of preoperative incentive spirometry on fentanyl-induced cough: a prospective, randomized, controlled study

PubMed Central

Bhargava, Suresh Kumar; Baj, Birbal

2017-01-01

Background Fentanyl-induced cough (FIC) has a reported incidence of 13–65% on induction of anesthesia. Incentive spirometry (IS) creates forceful inspiration, while stretching pulmonary receptors. We postulated that spirometry just before the fentanyl (F) bolus would decrease the incidence and severity of FIC. Methods This study enrolled 200 patients aged 18–60 years and with American Society of Anesthesiologists status I or II. The patients were allocated to two groups of 100 patients each depending on whether they received preoperative incentive spirometry before fentanyl administration. Patients in the F+IS group performed incentive spirometry 10 times just before an intravenous bolus of 3 µg/kg fentanyl in the operating room. The onset time and number of coughs after fentanyl injection were recorded as primary outcomes. Any significant changes in blood pressure, heart rate, or adverse effects of the drug were recorded as secondary outcomes. Results Patients in the F+IS group had a significantly lower incidence of FIC than in the F group (6% vs. 26%) (P < 0.05). The severity of cough in the F+IS group was also significantly lower than that in group F (mild, 5 vs. 17; moderate 1 vs. 7; severe, 0 vs. 2) (P < 0.05). The median onset time was comparable in both groups (9 s [range: 6–12 s] in both groups). Conclusions Preoperative incentive spirometry significantly reduces the incidence and severity of FIC when performed just before fentanyl administration. PMID:29046775

Meaningful use of health information technology by rural hospitals.

PubMed

McCullough, Jeffrey; Casey, Michelle; Moscovice, Ira; Burlew, Michele

2011-01-01

This study examines the current status of meaningful use of health information technology (IT) in Critical Access Hospitals (CAHs), other rural, and urban US hospitals, and it discusses the potential role of Medicare payment incentives and disincentives in encouraging CAHs and other rural hospitals to achieve meaningful use. Data from the American Hospital Association (AHA) Annual Survey IT Supplement were analyzed, using t tests and probit regressions to assess whether implementation rates in CAHs and other rural hospitals are significantly different from rates in urban hospitals. Of the many measures we examined, only 4 have been met by a majority of rural hospitals: electronic recording of patient demographics and electronic access to lab reports, radiology reports, and radiology images. Meaningful use is even less prevalent among CAHs. We also find that rural hospitals lag behind urban institutions in nearly every measure of meaningful use. These differences are particularly large and significant for CAHs. The meaningful use incentive system creates many challenges for CAHs. First, investments are evaluated and subsidies determined after adoption. Thus, CAHs must accept financial risk when adopting health IT; this may be particularly important for large expenditures. Second, the subsidies may be low for relatively small expenditures. Third, since the subsidies are based on observable costs, CAHs will receive no support for their intangible costs (eg, workflow disruption). A variety of policies may be used to address these problems of financial risk, uncertain returns in a rural setting, and limited resources. © 2011 National Rural Health Association.

Where are we on the diffusion curve? Trends and drivers of primary care physicians' use of health information technology.

PubMed

Audet, Anne-Marie; Squires, David; Doty, Michelle M

2014-02-01

To describe trends in primary care physicians' use of health information technology (HIT) between 2009 and 2012, examine practice characteristics associated with greater HIT capacity in 2012, and explore factors such as delivery system and payment reforms that may affect adoption and functionality. We used data from the 2012 and 2009 Commonwealth Fund International Health Policy Surveys of Primary Care Physicians. The data were collected in both years by postal mail between March and July among a nationally representative sample of primary care physicians in the United States. We compared primary care physicians' HIT capacity in 2009 and 2012. We employed multivariable logistic regression to analyze whether participating in an integrated delivery system, sharing resources and support with other practices, and being eligible for financial incentives were associated with greater HIT capacity in 2012. Primary care physicians' HIT capacity has significantly expanded since 2009, although solo practices continue to lag. Practices that are part of an integrated delivery system or share resources with other practices have higher rates of electronic medical record (EMR) adoption, multifunctional HIT, electronic information exchange, and electronic access for patients. Receiving or being eligible for financial incentives is associated with greater adoption of EMRs and information exchange. Federal efforts to increase adoption have coincided with a rapid increase in HIT capacity. Delivery system and payment reforms and federally funded extension programs could offer promising pathways for further diffusion. © Health Research and Educational Trust.

SMART Money: Do Financial Incentives Encourage College Students to Study Science?

ERIC Educational Resources Information Center

Evans, Brent

2017-01-01

Increasing the number of science, technology, engineering, and mathematics (STEM) degrees is a major federal education priority. I investigate whether providing a $4,000 financial incentive to low-income students in their junior and senior years of college induces them to major in a STEM field. Using administrative data from Ohio public colleges,…

TECHNOLOGY ASSESSMENT OF AQUACULTURE SYSTEMS FOR MUNICIPAL WASTEWATER TREATMENT

EPA Science Inventory

The innovative and alternative technology provisions of the Clean Water Act of 1977 (PL 95-217) provide financial incentives to communities that use wastewater treatment alternatives to reduce costs or energy consumption over conventional systems. Some of these technologies have ...

Economic Incentives for Cybersecurity: Using Economics to Design Technologies Ready for Deployment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vishik, Claire; Sheldon, Frederick T; Ott, David

Cybersecurity practice lags behind cyber technology achievements. Solutions designed to address many problems may and do exist but frequently cannot be broadly deployed due to economic constraints. Whereas security economics focuses on the cost/benefit analysis and supply/demand, we believe that more sophisticated theoretical approaches, such as economic modeling, rarely utilized, would derive greater societal benefits. Unfortunately, today technologists pursuing interesting and elegant solutions have little knowledge of the feasibility for broad deployment of their results and cannot anticipate the influences of other technologies, existing infrastructure, and technology evolution, nor bring the solutions lifecycle into the equation. Additionally, potentially viable solutionsmore » are not adopted because the risk perceptions by potential providers and users far outweighs the economic incentives to support introduction/adoption of new best practices and technologies that are not well enough defined. In some cases, there is no alignment with redominant and future business models as well as regulatory and policy requirements. This paper provides an overview of the economics of security, reviewing work that helped to define economic models for the Internet economy from the 1990s. We bring forward examples of potential use of theoretical economics in defining metrics for emerging technology areas, positioning infrastructure investment, and building real-time response capability as part of software development. These diverse examples help us understand the gaps in current research. Filling these gaps will be instrumental for defining viable economic incentives, economic policies, regulations as well as early-stage technology development approaches, that can speed up commercialization and deployment of new technologies in cybersecurity.« less

Financial incentives to discontinue long-term benzodiazepine use: a discrete choice experiment investigating patient preferences and willingness to participate.

PubMed

Marti, Joachim; Bachhuber, Marcus; Feingold, Jordyn; Meads, David; Richards, Michael; Hennessy, Sean

2017-10-06

Investigate the acceptability of financial incentives for initiating a medically supervised benzodiazepine discontinuation programme among people with long-term benzodiazepine use and to identify programme features that influence willingness to participate. We conducted a discrete choice experiment in which we presented a variety of incentive-based programs to a sample of older adults with long-term benzodiazepine use identified using the outpatient electronic health record of a university-owned health system. We studied four programme variables: incentive amount for initiating the programme, incentive amount for successful benzodiazepine discontinuation, lottery versus certain payment and whether partial payment was given for dose reduction. Respondents reported their willingness to participate in the programmes and additional information was collected on demographics, history of use and anxiety symptoms. The overall response rate was 28.4%. Among the 126 respondents, all four programme variables influenced stated preferences. Respondents strongly preferred guaranteed cash-based incentives as opposed to a lottery, and the dollar amount of both the starting and conditional incentives had a substantial impact on choice. Willingness to participate increased with the amount of conditional incentive. Programme participation also varied by gender, duration of use and income. Participation in an incentive-based benzodiazepine discontinuation programme might be relatively low, but is modifiable by programme variables including incentive amounts. These results will be helpful to inform the design of future trials of benzodiazepine discontinuation programmes. Further research is needed to assess the financial viability and potential cost-effectiveness of such economic incentives. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A strategic gaming model for health information exchange markets.

PubMed

Martinez, Diego A; Feijoo, Felipe; Zayas-Castro, Jose L; Levin, Scott; Das, Tapas K

2018-03-01

Current market conditions create incentives for some providers to exercise control over patient data in ways that unreasonably limit its availability and use. Here we develop a game theoretic model for estimating the willingness of healthcare organizations to join a health information exchange (HIE) network and demonstrate its use in HIE policy design. We formulated the model as a bi-level integer program. A quasi-Newton method is proposed to obtain a strategy Nash equilibrium. We applied our modeling and solution technique to 1,093,177 encounters for exchanging information over a 7.5-year period in 9 hospitals located within a three-county region in Florida. Under a set of assumptions, we found that a proposed federal penalty of up to $2,000,000 has a higher impact on increasing HIE adoption than current federal monetary incentives. Medium-sized hospitals were more reticent to adopt HIE than large-sized hospitals. In the presence of collusion among multiple hospitals to not adopt HIE, neither federal incentives nor proposed penalties increase hospitals' willingness to adopt. Hospitals' apathy toward HIE adoption may threaten the value of inter-connectivity even with federal incentives in place. Competition among hospitals, coupled with volume-based payment systems, creates no incentives for smaller hospitals to exchange data with competitors. Medium-sized hospitals need targeted actions (e.g., outside technological assistance, group purchasing arrangements) to mitigate market incentives to not adopt HIE. Strategic game theoretic models help to clarify HIE adoption decisions under market conditions at play in an extremely complex technology environment.

The dynamic effect of incentives on postreward task engagement.

PubMed

Goswami, Indranil; Urminsky, Oleg

2017-01-01

Although incentives can be a powerful motivator of behavior when they are available, an influential body of research has suggested that rewards can persistently reduce engagement after they end. This research has resulted in widespread skepticism among practitioners and academics alike about using incentives to motivate behavior change. However, recent field studies looking at the longer term effects of temporary incentives have not found such detrimental behavior. We design an experimental framework to study dynamic behavior under temporary rewards, and find that although there is a robust decrease in engagement immediately after the incentive ends, engagement returns to a postreward baseline that is equal to or exceeds the initial baseline. As a result, the net effect of temporary incentives on behavior is strongly positive. The decrease in postreward engagement is not on account of a reduction in intrinsic motivation, but is instead driven by a desire to take a "break," consistent with maintaining a balance between goals with primarily immediate and primarily delayed benefits. Further supporting this interpretation, the initial decrease in postreward engagement is reduced by contextual factors (such as less task difficulty and higher magnitude incentives) that reduce the imbalance between effort and leisure. These findings are contrary to the predictions of major established accounts and have important implications for designing effective incentive policies to motivate behavior change. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Impact of a pay-for-performance incentive on support for smoking cessation and on smoking prevalence among people with diabetes.

PubMed

Millett, Christopher; Gray, Jeremy; Saxena, Sonia; Netuveli, Gopalakrishnan; Majeed, Azeem

2007-06-05

Many people with diabetes continue to smoke despite being at high risk of cardiovascular disease. We examined the impact of a pay-for-performance incentive in the United Kingdom introduced in 2004 as part of the new general practitioner contract to improve support for smoking cessation and to reduce the prevalence of smoking among people with chronic diseases such as diabetes. We performed a population-based longitudinal study of the recorded delivery of cessation advice and the prevalence of smoking using electronic records of patients with diabetes obtained from participating general practices. The survey was carried out in an ethnically diverse part of southwest London before (June-October 2003) and after (November 2005-January 2006) the introduction of a pay-for-performance incentive. Significantly more patients with diabetes had their smoking status ever recorded in 2005 than in 2003 (98.8% v. 90.0%, p <0.001). The proportion of patients with documented smoking cessation advice also increased significantly over this period, from 48.0% to 83.5% (p < 0.001). The prevalence of smoking decreased significantly from 20.0% to 16.2% (p < 0.001). The reduction over the study period was lower among women (adjusted odds ratio 0.71, 95% confidence interval 0.53-0.95) but was not significantly different in the most and least affluent groups. In 2005, smoking rates continued to differ significantly with age (10.6%-25.1%), sex (women, 11.5%; men, 20.6%) and ethnic background (4.9%-24.9%). The introduction of a pay-for-performance incentive in the United Kingdom increased the provision of support for smoking cessation and was associated with a reduction in smoking prevalence among patients with diabetes in primary health care settings. Health care planners in other countries may wish to consider introducing similar incentive schemes for primary care physicians.

Queued History based Mediator Identification for an Incentive Attached peer to peer Electronic Coupon System

NASA Astrophysics Data System (ADS)

Shojima, Taiki; Ikkai, Yoshitomo; Komoda, Norihisa

An incentive attached peer to peer (P2P) electronic coupon system is proposed in which users forward e-coupons to potential users by providing incentives to those mediators. A service provider needs to acquire distribution history for incentive payment by recording UserIDs (UIDs) in the e-coupons, since this system is intended for pure P2P environment. This causes problems of dishonestly altering distribution history. In order to solve such problems, distribution history is realized in a couple of queues structure. They are the UID queue, and the public key queue. Each element of the UID queue at the initial state consists of index, a secret key, and a digital signature. In recording one's UID, the encrypted UID is enqueued to the UID queue with a new digital signature created by a secret key of the dequeued element, so that each UID cannot be altered. The public key queue provides the functionality of validating digital signatures on mobile devices. This method makes it possible both each UID and sequence of them to be certificated. The availability of the method is evaluated by quantifying risk reduction using Fault Tree Analysis (FTA). And it's recognized that the method is better than common encryption methods.

Negativity bias and task motivation: testing the effectiveness of positively versus negatively framed incentives.

PubMed

Goldsmith, Kelly; Dhar, Ravi

2013-12-01

People are frequently challenged by goals that demand effort and persistence. As a consequence, philosophers, psychologists, economists, and others have studied the factors that enhance task motivation. Using a sample of undergraduate students and a sample of working adults, we demonstrate that the manner in which an incentive is framed has implications for individuals' task motivation. In both samples we find that individuals are less motivated when an incentive is framed as a means to accrue a gain (positive framing) as compared with when the same incentive is framed as a means to avoid a loss (negative framing). Further, we provide evidence for the role of the negativity bias in this effect, and highlight specific populations for whom positive framing may be least motivating. Interestingly, we find that people's intuitions about when they will be more motivated show the opposite pattern, with people predicting that positively framed incentives will be more motivating than negatively framed incentives. We identify a lay belief in the positive correlation between enjoyment and task motivation as one possible factor contributing to the disparity between predicted and actual motivation as a result of the framing of the incentive. We conclude with a discussion of the managerial implications for these findings. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Characteristics of patient portals developed in the context of health information exchanges: early policy effects of incentives in the meaningful use program in the United States.

PubMed

Otte-Trojel, Terese; de Bont, Antoinette; van de Klundert, Joris; Rundall, Thomas G

2014-11-21

In 2014, the Centers for Medicare & Medicaid Services in the United States launched the second stage of its Electronic Health Record (EHR) Incentive Program, providing financial incentives to providers to meaningfully use their electronic health records to engage patients online. Patient portals are electronic means to engage patients by enabling secure access to personal medical records, communication with providers, various self-management tools, and administrative functionalities. Outcomes of patient portals have mainly been reported in large integrated health systems. This may now change as the EHR Incentive Program enables and supports the use of patient portals in other types of health systems. In this paper, we focus on Health Information Exchanges (HIE): entities that facilitate data exchange within networks of independent providers. In response to the EHR Incentive Program, some Health Information Exchanges in the United States are developing patient portals and offering them to their network of providers. Such patient portals hold high value for patients, especially in fragmented health system contexts, due to the portals' ability to integrate health information from an array of providers and give patients one access point to this information. Our aim was to report on the early effects of the EHR incentives on patient portal development by HIEs. Specifically, we describe the characteristics of these portals, identify factors affecting adoption by providers during the 2013-2014 time frame, and consider what may be the primary drivers of providers' adoption of patient portals in the future. We identified four HIEs that were developing patient portals as of spring 2014. We collected relevant documents and conducted interviews with six HIE leaders as well as two providers that were implementing the portals in their practices. We performed content analysis on these data to extract information pertinent to our study objectives. Our findings suggest that there are two primary types of patient portals available to providers in HIEs: (1) portals linked to EHRs of individual providers or health systems and (2) HIE-sponsored portals that link information from multiple providers' EHRs. The decision of providers in the HIEs to adopt either one of these portals appears to be a trade-off between functionality, connectivity, and cost. Our findings also suggest that while the EHR Incentive Program is influencing these decisions, it may not be enough to drive adoption. Rather, patient demand for access to patient portals will be necessary to achieve widespread portal adoption and realization of potential benefits. Optimizing patient value should be the main principle underlying policies intending to increase online patient engagement in the third stage of the EHR Incentive Program. We propose a number of features for the EHR Incentive Program that will enhance patient value and thereby support the growth and sustainability of patient portals provided by Health Information Exchanges.

Privacy and the New Technology

ERIC Educational Resources Information Center

Godwin, William F.; Bode, Katharine Anne

1971-01-01

Technology has been charged with destroying personal privacy. Protection by control of human incentives holds most promise. This article suggests several steps we can take to avoid any individual gain from acquiring information about others. (Author)

Alternative Fuels Data Center: State Alternative Fuel and Advanced Vehicle

Science.gov Websites

reduction (2 laws and regulations, 1 state incentive), and other (1 law/regulation) Figure 1. * Because an incentive, law, or regulation may apply to more than one technology type, adding the totals results in ), acquisition/fuel use (9), air quality/emissions (1), and other (13) Figure 3.* Because a law or regulation may

A Mixed-Methods Randomized Controlled Trial of Financial Incentives and Peer Networks to Promote Walking among Older Adults

ERIC Educational Resources Information Center

Kullgren, Jeffrey T.; Harkins, Kristin A.; Bellamy, Scarlett L.; Gonzales, Amy; Tao, Yuanyuan; Zhu, Jingsan; Volpp, Kevin G.; Asch, David A.; Heisler, Michele; Karlawish, Jason

2014-01-01

Background: Financial incentives and peer networks could be delivered through eHealth technologies to encourage older adults to walk more. Methods: We conducted a 24-week randomized trial in which 92 older adults with a computer and Internet access received a pedometer, daily walking goals, and weekly feedback on goal achievement. Participants…

Heap pumps marketing problems and the role played by the financial incentives provided by the law 308/82

NASA Astrophysics Data System (ADS)

Dallavalle, E.; Piantoni, E.

The principle techno-economic factors which influence the utilization of heat pumps are examined. Through the analysis of current technology and the economic incentives expected from articles 6-7, 8-9, and 12 of law 308/82, some results are derived which give some indication of the future of the market.

Nuclear Symbiosis - A Means to Achieve Sustainable Nuclear Growth while Limiting the Spread of Sensititive Nuclear Technology

DOE Office of Scientific and Technical Information (OSTI.GOV)

David Shropshire

Global growth of nuclear energy in the 21st century is creating new challenges to limit the spread of nuclear technology without hindering adoption in countries now considering nuclear power. Independent nuclear states desire autonomy over energy choices and seek energy independence. However, this independence comes with high costs for development of new indigenous fuel cycle capabilities. Nuclear supplier states and expert groups have proposed fuel supply assurance mechanisms such as fuel take-back services, international enrichment services and fuel banks in exchange for recipient state concessions on the development of sensitive technologies. Nuclear states are slow to accept any concessions tomore » their rights under the Non-Proliferation Treaty. To date, decisions not to develop indigenous fuel cycle capabilities have been driven primarily by economics. However, additional incentives may be required to offset a nuclear state’s perceived loss of energy independence. This paper proposes alternative economic development incentives that could help countries decide to forgo development of sensitive nuclear technologies. The incentives are created through a nuclear-centered industrial complex with “symbiotic” links to indigenous economic opportunities. This paper also describes a practical tool called the “Nuclear Materials Exchange” for identifying these opportunities.« less

The Impact of Law on Syndromic Disease Surveillance Implementation.

PubMed

Purtle, Jonathan; Field, Robert I; Hipper, Thomas; Nash-Arott, Jillian; Chernak, Esther; Buehler, James W

Legal environments influence how health information technologies are implemented in public health practice settings. Syndromic disease surveillance (SyS) is a relatively new approach to surveillance that depends heavily on health information technologies to achieve rapid awareness of disease trends. Evidence suggests that legal concerns have impeded the optimization of SyS. To (1) understand the legal environments in which SyS is implemented, (2) determine the perceived legal basis for SyS, and (3) identify perceived legal barriers and facilitators to SyS implementation. Multisite case study in which 35 key informant interviews and 5 focus groups were conducted with 75 SyS stakeholders. Interviews and focus groups were audio recorded, transcribed, and analyzed by 3 coders using thematic content analysis. Legal documents were reviewed. Seven jurisdictions (5 states, 1 county, and 1 city) that were purposively selected on the basis of SyS capacity and legal environment. Health department directors, SyS system administrators, legal counsel, and hospital personnel. Federal (eg, HIPAA) and state (eg, notifiable disease reporting) laws that authorize traditional public health surveillance were perceived as providing a legal basis for SyS. Financial incentives for hospitals to satisfy Meaningful Use regulations have eased concerns about the legality of SyS and increased the number of hospitals reporting SyS data. Legal issues were perceived as barriers to BioSense 2.0 (the federal SyS program) participation but were surmountable. Major legal reforms are not needed to promote more widespread use of SyS. The current legal environment is perceived by health department and hospital officials as providing a firm basis for SyS practice. This is a shift from how law was perceived when SyS adoption began and has policy implications because it indicates that major legal reforms are not needed to promote more widespread use of the technology. Beyond SyS, our study suggests that federal monetary incentives can ameliorate legal concerns regarding novel health information technologies.

42 CFR § 512.110 - Access to records and retention.

Code of Federal Regulations, 2010 CFR

2017-10-01

... SERVICES (CONTINUED) HEALTH CARE INFRASTRUCTURE AND MODEL PROGRAMS EPISODE PAYMENT MODEL Episode Payment Model Participants § 512.110 Access to records and retention. EPM participants, EPM collaborators... requirements and, if applicable, the individual's or entity's compliance with CR incentive payment model...

76 FR 55057 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-06

... Records. System location: U.S. Army Human Resources Command, Education Incentives Branch, 1600 Spearhead... Social Security Number (SSN); Military Occupational Specialty (MOS). Student Loan: Qualifying student loan name, amount of loan, date of loan transaction, student education loan number assigned by the...

Carrots and Sticks: New Brunswick and Maine Forest Landowner Perceptions Toward Incentives and Regulations

NASA Astrophysics Data System (ADS)

Quartuch, Michael R.; Beckley, Thomas M.

2014-01-01

The governments of countries that allow private land ownership have two main tools to motivate landowner behavior: regulations and incentives. This research examines landowner preferences toward these policy tools and asks specifically: Do private forest landowners in New Brunswick and Maine believe that regulations and/or incentives are effective means to motivate responsible stewardship? Can landowners identify explicit regulations and policies that restrict property rights? Also, we were interested to see if any discernible differences existed between these adjacent jurisdictions from different countries, but that share similar forests and a similar settlement history. We identified and interviewed diverse landowners, recorded and transcribed our discussions, and analyzed the results using a grounded theory approach. Findings suggest that both New Brunswick and Maine participants are fairly comfortable with most regulations and many agreed that a combination of incentives and regulations are in fact useful. Furthermore, landowners in New Brunswick discussed non-monetary incentives as a mechanism to reward "good" stewardship; while Maine respondents articulated a degree of responsible stewardship that transcends a need to incentivize landowners. This study demonstrates that diverse landowners may be more comfortable with environmental regulations than previously understood and may be interested in non-monetary incentives.

"It's all about incentive": Social technology as a potential facilitator for self-determined physical activity participation for young people with physical disabilities.

PubMed

Knibbe, Tara Joy; McPherson, Amy C; Gladstone, Brenda; Biddiss, Elaine

2017-09-29

To investigate the perceived role of social technologies in promoting physical activity participation for young people with physical disabilities and to identify design considerations that should be addressed when creating social technologies to promote physical activity. Interactive design workshops for young people with physical disabilities aged 12-18 (n = 8) were held. Data were analyzed using interpretive thematic analysis. Young people perceived significant benefit for social technologies to promote physical activity as they have the potential to overcome many barriers to physical activity participation. Design features recommended by the participants included (1) options for diverse interests and preferences, (2) provision of informational support, (3) support through equitable technology design, (4) incentive through competition and play, and (5) opportunities to develop community. Social technology has potential to provide tailored, equitable opportunities for social engagement and physical activity participation for young people with physical disabilities through needs- and preference-specific design.

Calculations of financial incentives for providers in a pay-for-performance program: Manual review versus data from structured fields in electronic health records

PubMed Central

Urech, Tracy H.; Woodard, LeChauncy D.; Virani, Salim S.; Dudley, R. Adams; Lutschg, Meghan Z.; Petersen, Laura A.

2015-01-01

Background Hospital report cards and financial incentives linked to performance require clinical data that are reliable, appropriate, timely, and cost-effective to process. Pay-for-performance plans are transitioning to automated electronic health record (EHR) data as an efficient method to generate data needed for these programs. Objective To determine how well data from automated processing of structured EHR fields (AP-EHR) reflect data from manual chart review and the impact of these data on performance rewards. Research Design Cross-sectional analysis of performance measures used in a cluster randomized trial assessing the impact of financial incentives on guideline-recommended care for hypertension. Subjects A total of 2,840 patients with hypertension assigned to participating physicians at 12 Veterans Affairs hospital-based outpatient clinics. Fifty-two physicians and 33 primary care personnel received incentive payments. Measures Overall, positive and negative agreement indices and Cohen's kappa were calculated for assessments of guideline-recommended antihypertensive medication use, blood pressure (BP) control, and appropriate response to uncontrolled BP. Pearson's correlation coefficient was used to assess how similar participants’ calculated earnings were between the data sources. Results By manual chart review data, 72.3% of patients were considered to have received guideline-recommended antihypertensive medications compared to 65.0% by AP-EHR review (k=0.51). Manual review indicated 69.5% of patients had controlled BP compared to 66.8% by AP-EHR review (k=0.87). Compared to 52.2% of patients per the manual review, 39.8% received an appropriate response by AP-EHR review (k=0.28). Participants’ incentive payments calculated using the two methods were highly correlated (r≥0.98). Using the AP-EHR data to calculate earnings, participants’ payment changes ranged from a decrease of $91.00 (−30.3%) to an increase of $18.20 (+7.4%) for medication use (IQR, −14.4% to 0%) and a decrease of $100.10 (−31.4%) to an increase of $36.40 (+15.4%) for BP control or appropriate response to uncontrolled BP (IQR, −11.9% to −6.1%). Conclusions Pay-for-performance plans that use only EHR data should carefully consider the measures and the structure of the EHR before data collection and financial incentive disbursement. For this study, we feel that a 10% difference in the total amount of incentive earnings disbursed based on AP-EHR data compared to manual review is acceptable given the time and resources required to abstract data from medical records. PMID:26340661

Pediatric aspects of inpatient health information technology systems.

PubMed

Lehmann, Christoph U

2015-03-01

In the past 3 years, the Health Information Technology for Economic and Clinical Health Act accelerated the adoption of electronic health records (EHRs) with providers and hospitals, who can claim incentive monies related to meaningful use. Despite the increase in adoption of commercial EHRs in pediatric settings, there has been little support for EHR tools and functionalities that promote pediatric quality improvement and patient safety, and children remain at higher risk than adults for medical errors in inpatient environments. Health information technology (HIT) tailored to the needs of pediatric health care providers can improve care by reducing the likelihood of errors through information assurance and minimizing the harm that results from errors. This technical report outlines pediatric-specific concepts, child health needs and their data elements, and required functionalities in inpatient clinical information systems that may be missing in adult-oriented HIT systems with negative consequences for pediatric inpatient care. It is imperative that inpatient (and outpatient) HIT systems be adapted to improve their ability to properly support safe health care delivery for children. Copyright © 2015 by the American Academy of Pediatrics.

77 FR 52105 - Announcement of the Innovation in Arms Control Challenge Under the America Competes...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-28

...,'' with the goal of spurring innovation, and developing scientific and technological options that will... transparency efforts. Processes, incentives, and technologies must, in theory, be practical and implementable...

Summary of: dental practitioners and a digital future: an initial exploration of barriers and incentives to adopting digital technologies.

PubMed

Addy, Liam

2013-12-01

Digital technologies are proliferating into dental practices. While their technical attributes have often been studied, it remains unclear why some dentists adopt and use these technologies more than others. AIM To explore the incentives for and barriers against accepting and using digital dental technologies. Eleven semi-structured qualitative interviews were conducted with experts in dentistry, dental technology and dental education in the Netherlands. Dentists' acceptance and use of digital technologies are to varying degrees driven by the perceived advantages over analogue methods, perceived influence on treatment quality, dentists' personal and professional orientation, and social influence from peers and external groups. These effects are complemented by personal and dental-practice characteristics. The findings suggest that there are large differences in motivation to adopt and use digital technologies between early adopters, late adopters and non-adopters, which should be examined in greater detail. We recommend that educators, dentists, and representatives of the dental industry who deal with the diffusion of these technologies take account of dentists' widely different attitudes to digitalisation.

Is optimism real?

PubMed

Simmons, Joseph P; Massey, Cade

2012-11-01

Is optimism real, or are optimistic forecasts just cheap talk? To help answer this question, we investigated whether optimistic predictions persist in the face of large incentives to be accurate. We asked National Football League football fans to predict the winner of a single game. Roughly half (the partisans) predicted a game involving their favorite team, and the other half (the neutrals) predicted a game involving 2 teams they were neutral about. Participants were promised either a small incentive ($5) or a large incentive ($50) for correctly predicting the game's winner. Optimism emerged even when incentives were large, as partisans were much more likely than neutrals to predict partisans' favorite teams to win. Strong optimism also emerged among participants whose responses to follow-up questions strongly suggested that they believed the predictions they made. This research supports the claim that optimism is real. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

A Global Review of Incentive Programs to Accelerate Energy-Efficient Appliances and Equipment

DOE Office of Scientific and Technical Information (OSTI.GOV)

de la Rue du Can, Stephane; Phadke, Amol; Leventis, Greg

Incentive programs are an essential policy tool to move the market toward energy-efficient products. They offer a favorable complement to mandatory standards and labeling policies by accelerating the market penetration of energy-efficient products above equipment standard requirements and by preparing the market for increased future mandatory requirements. They sway purchase decisions and in some cases production decisions and retail stocking decisions toward energy-efficient products. Incentive programs are structured according to their regulatory environment, the way they are financed, by how the incentive is targeted, and by who administers them. This report categorizes the main elements of incentive programs, using casemore » studies from the Major Economies Forum to illustrate their characteristics. To inform future policy and program design, it seeks to recognize design advantages and disadvantages through a qualitative overview of the variety of programs in use around the globe. Examples range from rebate programs administered by utilities under an Energy-Efficiency Resource Standards (EERS) regulatory framework (California, USA) to the distribution of Eco-Points that reward customers for buying efficient appliances under a government recovery program (Japan). We found that evaluations have demonstrated that financial incentives programs have greater impact when they target highly efficient technologies that have a small market share. We also found that the benefits and drawbacks of different program design aspects depend on the market barriers addressed, the target equipment, and the local market context and that no program design surpasses the others. The key to successful program design and implementation is a thorough understanding of the market and effective identification of the most important local factors hindering the penetration of energy-efficient technologies.« less

Incentives and Barriers That Influence Clinical Computerization in Hong Kong: A Population-based Physician Survey

PubMed Central

Leung, Gabriel M.; Yu, Philip L. H.; Wong, Irene O. L.; Johnston, Janice M.; Tin, Keith Y. K.

2003-01-01

Objective: Given the slow adoption of medical informatics in Hong Kong and Asia, we sought to understand the contributory barriers and potential incentives associated with information technology implementation. Design and Measurements: A representative sample of 949 doctors (response rate = 77.0%) was asked through a postal survey to rank a list of nine barriers associated with clinical computerization according to self-perceived importance. They ranked seven incentives or catalysts that may influence computerization. We generated mean rank scores and used multidimensional preference analysis to explore key explanatory dimensions of these variables. A hierarchical cluster analysis was performed to identify homogenous subgroups of respondents. We further determined the relationships between the sets of barriers and incentives/catalysts collectively using canonical correlation. Results: Time costs, lack of technical support and large capital investments were the biggest barriers to computerization, whereas improved office efficiency and better-quality care were ranked highest as potential incentives to computerize. Cost vs. noncost, physician-related vs. patient-related, and monetary vs. nonmonetary factors were the key dimensions explaining the barrier variables. Similarly, within-practice vs external and “push” vs “pull” factors accounted for the incentive variables. Four clusters were identified for barriers and three for incentives/catalysts. Canonical correlation revealed that respondents who were concerned with the costs of computerization also perceived financial incentives and government regulation to be important incentives/catalysts toward computerization. Those who found the potential interference with communication important also believed that the promise of improved care from computerization to be a significant incentive. Conclusion: This study provided evidence regarding common barriers associated with clinical computerization. Our findings also identified possible incentive strategies that may be employed to accelerate uptake of computer systems. PMID:12595409

Enhancing Incentive Programs with Proximal Goals and Immediate Feedback: Engineered Labor Standards and Technology Enhancements in Stocker Replenishment

ERIC Educational Resources Information Center

Goomas, David T.; Ludwig, Timothy D.

2007-01-01

Under baseline conditions warehouse stockers (n = 23) could earn incentives if their team performed above the team quota of 18 cases stocked per hour. They were also subject to disciplinary action if they failed to regularly meet individual stocking quotas. In spite of these contingencies the stockers failed to receive bonus payments most of the…

A systematic review on incentive-driven mobile health technology: As used in diabetes management.

PubMed

de Ridder, Michael; Kim, Jinman; Jing, Yan; Khadra, Mohamed; Nanan, Ralph

2017-01-01

Introduction Mobile health (mHealth) technologies have been shown to improve self-management of chronic diseases, such as diabetes. However, mHealth tools, e.g. apps, often have low rates of retention, eroding their potential benefits. Using incentives is a common mechanism for engaging, empowering and retaining patients that is applied by mHealth tools. We conducted a systematic review aiming to categorize the different types of incentive mechanisms employed in mHealth tools for diabetes management, which we defined as incentive-driven technologies (IDTs). As an auxiliary aim, we also analyzed barriers to adoption of IDTs. Methods Literature published in English between January 2008-August 2014 was identified through searching leading publishers and indexing databases: IEEE, Springer, Science Direct, NCBI, ACM, Wiley and Google Scholar. Results A total of 42 articles were selected. Of these, 34 presented mHealth tools with IDT mechanisms; Education was the most common mechanism ( n = 21), followed by Reminder ( n = 11), Feedback ( n = 10), Social ( n = 8), Alert ( n = 5), Gamification ( n = 3), and Financial ( n = 2). Many of these contained more than one IDT ( n = 19). The remaining eight articles, from which we defined barriers for adoption, were review papers and a qualitative study of focus groups and interviews. Discussion While mHealth technologies have advanced over the last five years, the core IDT mechanisms have remained consistent. Instead, IDT mechanisms have evolved with the advances in technology, such as moving from manual to automatic content delivery and personalization of content. Conclusion We defined the concept of IDT to be core features designed to act as motivating mechanisms for retaining and empowering users. We then identified seven core IDT mechanisms that are used by mHealth tools for diabetes management and classified 34 articles into these categories.

State - Level Regulation's Effectiveness in Addressing Global Climate Change and Promoting Solar Energy Deployment

NASA Astrophysics Data System (ADS)

Peterman, Carla Joy

Paper 1, Local Solutions to Global Problems: Climate Change Policies and Regulatory Jurisdiction, considers the efficacy of various types of environmental regulations when they are applied locally to pollutants whose damages extend beyond the jurisdiction of the local regulators. Local regulations of a global pollutant may be ineffective if producers and consumers can avoid them by transacting outside the reach of the local regulator. In many cases, this may involve the physical relocation of the economic activity, a problem often referred to as "leakage." This paper highlights another way in which local policies can be circumvented: through the shuffling of who buys from whom. The paper maintains that the problems of reshuffling are exacerbated when the options for compliance with the regulations are more flexible. Numerical analyses is presented demonstrating that several proposed policies to limit greenhouse gas emissions from the California electricity sector may have very little effect on carbon emissions if they are applied only within that state. Paper 1 concludes that although local subsidies for energy efficiency, renewable electricity, and transportation biofuels constitute attempts to pick technology winners, they may be the only mechanisms that local jurisdictions, acting alone, have at their disposal to address climate change. Paper 2, Pass-Through of Solar PV Incentives to Consumers: The Early Years of California's Solar PV Incentives, examines the pass through of incentives to California solar PV system owners. The full post-subsidy price consumers pay for solar power is a key metric of the success of solar PV incentive programs and of overall PV market performance. This study examines the early years of California's most recent wave of distributed solar PV incentives (2000-2008) to determine the pass-through of incentives. Examination of this period is both intellectually and pragmatically important due to the high level of incentives provided and subsequent high cost to ratepayers; policymakers' expectations that price declines accrue to consumers; and market structure characteristics that might contribute to incomplete pass-through. This analysis shows that incentive passthrough in the California residential solar PV programs was incomplete. Consumer prices declined 54 cents for every additional dollar of incentive received. A large share of the incentive is captured by the solar PV contractor or other actors in the solar PV supply chain. The finding of incomplete pass-through is persistent across specifications. The analysis also identifies a lower degree of incentive pass-through for consumers in the highest income zip codes. Whether expectations of incentives' pass-through align with reality is critically important in the beginning years of emerging clean energy technology programs since this can affect the likelihood of future government investments and public support. Given the often-held policy assumption that consumer prices are declining in response to incentives, it is useful for policymakers to understand the circumstances under which such an assumption may not hold. Paper 3, Testing the Boundaries of the Solar Photovoltaic Learning System, tests how the choice of experience curves' geographic and technology assumptions affect solar PV experience curve results. Historically, solar PV experience curves have assumed one experience curve represents both module and non-module learning and that this learning happens at a global scale. These assumptions may be inaccurate for solar PV since the learning system, and technology and geographic boundaries, are likely different between PV modules and non-module components. Using 2004 to 2008 PV system price data from 13 states, and a longer time series of PV price data for California, some evidence is found that cumulative capacity at the state level is a better predictor of non-module costs than U.S. or global capacity. This paper explores, but is unable to significantly determine, how knowledge spillovers from neighboring states can influence a state's non-module costs. Given data limitations, and limitations to the two-factor experience model methodology itself, it is not possible to conclusively determine the correct geographic boundary for the non-module learning system. Throughout the paper ways in which the experience curve model and data can be augmented to achieve a better estimation are discussed. 2.

Do Physicians' Financial Incentives Affect Medical Treatment and Patient Health?†

PubMed Central

Clemens, Jeffrey; Gottlieb, Joshua D.

2014-01-01

We investigate whether physicians' financial incentives influence health care supply, technology diffusion, and resulting patient outcomes. In 1997, Medicare consolidated the geographic regions across which it adjusts physician payments, generating area-specific price shocks. Areas with higher payment shocks experience significant increases in health care supply. On average, a 2 percent increase in payment rates leads to a 3 percent increase in care provision. Elective procedures such as cataract surgery respond much more strongly than less discretionary services. Non-radiologists expand their provision of MRIs, suggesting effects on technology adoption. We estimate economically small health impacts, albeit with limited precision. PMID:25170174

Provider perceptions of the electronic health record incentive programs: a survey of eligible professionals who have and have not attested to meaningful use.

PubMed

Weeks, Douglas L; Keeney, Benjamin J; Evans, Peggy C; Moore, Quincy D; Conrad, Douglas A

2015-01-01

The HITECH Act of 2009 enabled the Centers for Medicare & Medicaid Services (CMS) to provide financial incentives to health care providers who demonstrate "meaningful use" (MU) of their electronic health records (EHRs). Despite stakeholder involvement in the rule-making phase, formal input about the MU program from a cross section of providers has not been reported since incentive payments began. To examine the perspectives and experiences of a random sample of health care professionals eligible for financial incentives (eligible professionals or EPs) for demonstrating meaningful use of their EHRs. It was hypothesized that EPs actively participating in the MU program would generally view the purported benefits of MU more positively than EPs not yet participating in the incentive program. Survey data were collected by mail from a random sample of EPs in Washington State and Idaho. Two follow-up mailings were made to non-respondents. The sample included EPs who had registered for incentive payments or attested to MU (MU-Active) and EPs not yet participating in the incentive program (MU-Inactive). The survey assessed perceptions of general realities and influences of MU on health care; views on the influence of MU on clinics; and personal views about MU. EP opinions were assessed with close- and open-ended items. Close-ended responses indicated that MU-Active providers were generally more positive about the program than MU-Inactive providers. However, the majority of respondents in both groups felt that MU would not reduce care disparities or improve the accuracy of patient information. The additional workload on EPs and their staff was viewed as too great a burden on productivity relative to the level of reimbursement for achieving MU goals. The majority of open-ended responses in each group reinforced the general perception that the MU program diverted attention from treating patients by imposing greater reporting requirements. Survey results indicate the need by CMS to step up engagement with EPs in future planning for the MU program, while also providing support for achieving MU standards.

R&D in the maritime industry : a supplement to an assessment of maritime trade and technology

DOT National Transportation Integrated Search

1985-05-01

Since the publication of "An Assessment of Maritime Trade and Technology" by Office of Technology Assessment (OTA) in October 1983, various proposals have been made to provide incentives for research and development (R&D) in an effort to enhance the ...

76 FR 54953 - Medicare Program; Changes to the Electronic Prescribing (eRx) Incentive Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-06

... That Encourage the Use of Health Information Technology,'' available at http://www.gao.gov/products/GAO... Coordinator for Health Information Technology (at the present time, these bodies are the Office of the National Coordinator for Health Information Technology (ONC)-Authorized Testing and Certification Bodies...

38 CFR 53.11 - General requirements for payments.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) PAYMENTS TO STATES FOR PROGRAMS TO PROMOTE THE HIRING AND RETENTION OF NURSES AT STATE VETERANS... an employee incentive program to reduce the shortage of nurses at the SVH, when the following... limited to SVH records showing nursing vacancies, SVH records showing nurse overtime use, and reports...

Impact of Thailand universal coverage scheme on the country's health information systems and health information technology.

PubMed

Kijsanayotin, Boonchai

2013-01-01

Thailand achieved universal healthcare coverage with the implementation of the Universal Coverage Scheme (UCS) in 2001. This study employed qualitative method to explore the impact of the UCS on the country's health information systems (HIS) and health information technology (HIT) development. The results show that health insurance beneficiary registration system helps improve providers' service workflow and country vital statistics. Implementation of casemix financing tool, Thai Diagnosis-Related Groups, has stimulated health providers' HIS and HIT capacity building, data and medical record quality and the adoption of national administrative data standards. The system called "Disease Management Information Systems" aiming at reimbursement for select diseases increased the fragmentation of HIS and increase burden on data management to providers. The financial incentive of outpatient data quality improvement project enhance providers' HIS and HIT investment and also induce data fraudulence tendency. Implementation of UCS has largely brought favorable impact on the country HIS and HIT development. However, the unfavorable effects are also evident.

Financial Incentives and Diabetes Disease Control in Employees: A Retrospective Cohort Analysis.

PubMed

Misra-Hebert, Anita D; Hu, Bo; Taksler, Glen; Zimmerman, Robert; Rothberg, Michael B

2016-08-01

Many employers offer worksite wellness programs, including financial incentives to achieve goals. Evidence supporting such programs is sparse. To assess whether diabetes and cardiovascular risk factor control in employees improved with financial incentives for participation in disease management and for attaining goals. Retrospective cohort study using insurance claims linked with electronic medical record data from January 2008-December 2012. Employee patients with diabetes covered by the organization's self-funded insurance and propensity-matched non-employee patient comparison group with diabetes and commercial insurance. Financial incentives for employer-sponsored disease management program participation and achieving goals. Change in glycosylated hemoglobin (HbA1c), low-density lipoprotein (LDL), systolic blood pressure (SBP), and weight. A total of 1092 employees with diabetes were matched to non-employee patients. With increasing incentives, employee program participation increased (7 % in 2009 to 50 % in 2012, p < 0.001). Longitudinal mixed modeling demonstrated improved diabetes and cardiovascular risk factor control in employees vs. non-employees [HbA1c yearly change -0.05 employees vs. 0.00 non-employees, difference in change (DIC) p <0.001]. In their first participation year, employees had larger declines in HbA1c and weight vs. non-employees (0.33 vs. 0.14, DIC p = 0.04) and (2.3 kg vs. 0.1 kg, DIC p < 0.001), respectively. Analysis of employee cohorts corresponding with incentive offerings showed that fixed incentives (years 1 and 2) or incentives tied to goals (years 3 and 4) were not significantly associated with HbA1c reductions compared to non-employees. For each employee cohort offered incentives, SBP and LDL also did not significantly differ in employees compared with non-employees (DIC p > 0.05). Financial incentives were associated with employee participation in disease management and improved cardiovascular risk factors over 5 years. Improvements occurred primarily in the first year of participation. The relative impact of specific incentives could not be discerned.

Public acceptability of financial incentives for smoking cessation in pregnancy and breast feeding: a survey of the British public

PubMed Central

Hoddinott, Pat; Morgan, Heather; MacLennan, Graeme; Sewel, Kate; Thomson, Gill; Bauld, Linda; Yi, Deokhee; Ludbrook, Anne; Campbell, Marion K

2014-01-01

Objective To survey public attitudes about incentives for smoking cessation in pregnancy and for breast feeding to inform trial design. Design Cross-sectional survey. Setting and participants British general public. Methods Seven promising incentive strategies had been identified from evidence syntheses and qualitative interview data from service users and providers. These were shopping vouchers for: (1) validated smoking cessation in pregnancy and (2) after birth; (3) for a smoke-free home; (4) for proven breast feeding; (5) a free breast pump; (6) payments to health services for reaching smoking cessation in pregnancy targets and (7) breastfeeding targets. Ipsos MORI used area quota sampling and home-administered computer-assisted questionnaires, with randomised question order to assess agreement with different incentives (measured on a five-point scale). Demographic data and target behaviour experience were recorded. Analysis used multivariable ordered logit models. Results Agreement with incentives was mixed (ranging from 34% to 46%) among a representative sample of 1144 British adults. Mean agreement score was highest for a free breast pump, and lowest for incentives for smoking abstinence after birth. More women disagreed with shopping vouchers than men. Those with lower levels of education disagreed more with smoking cessation incentives and a breast pump. Those aged 44 or under agreed more with all incentive strategies compared with those aged 65 and over, particularly provider targets for smoking cessation. Non-white ethnic groups agreed particularly with breastfeeding incentives. Current smokers with previous stop attempts and respondents who had breast fed children agreed with providing vouchers for the respective behaviours. Up to £40/month vouchers for behaviour change were acceptable (>85%). Conclusions Women and the less educated were more likely to disagree, but men and women of childbearing age to agree, with incentives designed for their benefit. Trials evaluating reach, impact on health inequalities and ethnic groups are required prior to implementing incentive interventions. Trial registration number CRD42012001980. PMID:25037645

The efficacy of postoperative incentive spirometry is influenced by the device-specific imposed work of breathing.

PubMed

Weindler, J; Kiefer, R T

2001-06-01

The study evaluated the impact of the additional imposed work of breathing (WBimp) generated by two different spirometers on postoperative incentive spirometry performance in patients at high risk and moderate risk for postoperative pulmonary complications (PPCs). Additionally, we investigated whether maximal inspiratory pressure (PImax) is an easy estimate of the WBimp imposed by incentive spirometers. Prospective, randomized, single-blind clinical trial. ICU of a university hospital. Thirty male patients were assigned to a group at high risk for PPCs (group A; inspiratory capacity [IC], < 1.6 L) or to a group at moderate risk for PPCs (group B; IC, 1.6 to 2.5 L) after upper-abdominal, thoracic, or two-cavity surgery. On the first or second postoperative day WBimp, IC, and PImax were recorded without spirometers (baseline) and during incentive spirometry with the Mediflo spirometer (Medimex; Hamburg, Germany) (high WBimp) and the Coach spirometer (Kendall; Neustadt, Germany) (low WBimp) using a pneumotachograph. In group A, the baseline and the ICs for both spirometers only differed slightly. In group B, the IC was significantly reduced for the Mediflo (p < 0.05), which imposed a WBimp twice as high as the Coach (p < 0.01). PImax was significantly increased for both the Mediflo and the Coach (p < 0.01). PImax was positively correlated with WBimp (r = 0.8). Incentive spirometers differ considerably in their additional Wbimp with a potential impact on the efficacy of postoperative incentive spirometry performance. PImax might be an easy clinical estimate for the WBimp during incentive spirometry. Incentive spirometers with low WBimp permit increased maximal sustained inspiration and, thus, enhanced incentive spirometry performance, and, therefore, it might be more suitable for use in postoperative respiratory care.

Alternative Fuels Data Center

Science.gov Websites

Advanced Technology Vehicle (ATV) and Alternative Fuel Infrastructure Manufacturing Incentives Through the Advanced Technology Vehicles Manufacturing Loan Program, manufacturers may be eligible for direct loans for up to 30% of the cost of re-equipping, expanding, or establishing manufacturing

The role of business incentives in the development of renewable energy technologies

NASA Astrophysics Data System (ADS)

A 15% business energy tax credit for renewable energy systems is examined. Witnesses from photovoltaics, solar thermal, wind, and OTEC industries testified about the importance of the credits to their ability to develop and demonstrate new technologies.

Exploring Faculty Incentives and Barriers to Participation in Web-Based Instruction

ERIC Educational Resources Information Center

Kinuthia, Wanjira

2006-01-01

The area of integration of technology in education is a continuous effort that revolves around looking for factors and practices that can be applied to encourage faculty to integrate technology into their areas of teaching. Web-based instruction (WBI) is one of the technologies affecting higher education, and historically Black colleges and…

Are Green Vehicles Worth the Extra Cost? The Case of Diesel-Electric Hybrid Technology for Urban Delivery Vehicles

ERIC Educational Resources Information Center

Krutilla, Kerry; Graham, John D.

2012-01-01

A central question for environmental policy is whether the long-term benefits of energy-saving technologies are sufficient to justify their short-term costs, and if so, whether financial incentives are needed to stimulate adoption. The fiscal effects of incentivizing new technologies, and the revenue effects of using the technology, are also…

The Integration of Technology into School Curriculum in Saudi Arabia: Factors Affecting Technology Implementation in the Classroom

ERIC Educational Resources Information Center

Barri, Moatasim A.

2013-01-01

There are a number of factors that influence technology implementation in the classroom including teachers' concerns; barriers; and intrinsic incentives. These factors give classroom teachers a chance to make a shift in their thinking and practice to help them properly integrate technology across the curriculum. This study was designed to assess:…

77 FR 23193 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program-Stage 2; Corrections

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-18

... for electronic medication administration record (eMAR). In addition, in Sec. 495.6(m)(1)(iii) we... description contact information TBD Title: Closing the referral loop: Centers for Medicare Care Coordination... corrected to read ``(ii) Measure. More than 10 percent of medication orders created by authorized providers...

Public policy for solar heating and cooling

NASA Technical Reports Server (NTRS)

Hirshberg, A. S.

1976-01-01

Recent analyses indicated that solar heating and cooling systems for residential buildings are nearly economically competitive with conventional fossil fuel or electric systems, the former having higher initial cost but a lower operating cost than the latter. The paper examines obstacles to the widespread acceptance and use of solar space conditioning systems and explores some general policies which could help to overcome them. The discussion covers such institutional barriers limiting the adoption of solar technologies as existing building codes, financing constraints, and organizational structure of the building industry. The potential impact of financial incentives is analyzed. It is noted that a tax incentive of 25% could speed the use of solar energy by 7 to 8 years and produce an 8% reduction in fossil fuel use by 1990. A preliminary incentive package which could be helpful in promoting solar energy both at federal and state levels is proposed, and the necessary incentive level is analysed.

Study protocol for Log2Lose: A feasibility randomized controlled trial to evaluate financial incentives for dietary self-monitoring and interim weight loss in adults with obesity.

PubMed

Voils, Corrine I; Levine, Erica; Gierisch, Jennifer M; Pendergast, Jane; Hale, Sarah L; McVay, Megan A; Reed, Shelby D; Yancy, William S; Bennett, Gary; Strawbridge, Elizabeth M; White, Allison C; Shaw, Ryan J

2018-02-01

The obesity epidemic has negative physical, psychological, and financial consequences. Despite the existence of effective behavioral weight loss interventions, many individuals do not achieve adequate weight loss, and most regain lost weight in the year following intervention. We report the rationale and design for a 2×2 factorial study that involves financial incentives for dietary self-monitoring (yes vs. no) and/or interim weight loss (yes vs. no). Outpatients with obesity participate in a 24-week, group-based weight loss intervention. All participants are asked to record their daily dietary and liquid intake on a smartphone application (app) and to weigh themselves daily at home on a study-provided cellular scale. An innovative information technology (IT) solution collates dietary data from the app and weight from the scale. Using these data, an algorithm classifies participants weekly according to whether they met their group's criteria to receive a cash reward ranging from $0 to $30 for dietary self-monitoring and/or interim weight loss. Notice of the reward is provided via text message, and credit is uploaded to a gift card. This pilot study will provide information on the feasibility of using this novel IT solution to provide variable-ratio financial incentives in real time via its effects on recruitment, intervention adherence, retention, and cost. This study will provide the foundation for a comprehensive, adequately-powered, randomized controlled trial to promote short-term weight loss and long-term weight maintenance. If efficacious, this approach could reduce the prevalence, adverse outcomes, and costs of obesity for millions of Americans. Clinicaltrials.gov registration: NCT02691260. Published by Elsevier Inc.

Instructional and Performance Technology in Brazil.

ERIC Educational Resources Information Center

Stone, John H.; Romiszowski, Alexander J.

1982-01-01

Describes the status and trends, achievements, and problems in the development of educational technology (ET) in Brazil. Areas examined include tax incentives for training programs, graduate programs in ET, teleducation and correspondence teaching, and government support of ET programs. Five references are listed. (MER)

Paying for performance: Performance incentives increase desire for the reward object.

PubMed

Hur, Julia D; Nordgren, Loran F

2016-09-01

The current research examines how exposure to performance incentives affects one's desire for the reward object. We hypothesized that the flexible nature of performance incentives creates an attentional fixation on the reward object (e.g., money), which leads people to become more desirous of the rewards. Results from 5 laboratory experiments and 1 large-scale field study provide support for this prediction. When performance was incentivized with monetary rewards, participants reported being more desirous of money (Study 1), put in more effort to earn additional money in an ensuing task (Study 2), and were less willing to donate money to charity (Study 4). We replicated the result with nonmonetary rewards (Study 5). We also found that performance incentives increased attention to the reward object during the task, which in part explains the observed effects (Study 6). A large-scale field study replicated these findings in a real-world setting (Study 7). One laboratory experiment failed to replicate (Study 3). (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Liking, wanting, and the incentive-sensitization theory of addiction.

PubMed

Berridge, Kent C; Robinson, Terry E

2016-11-01

Rewards are both "liked" and "wanted," and those 2 words seem almost interchangeable. However, the brain circuitry that mediates the psychological process of "wanting" a particular reward is dissociable from circuitry that mediates the degree to which it is "liked." Incentive salience or "wanting," a form of motivation, is generated by large and robust neural systems that include mesolimbic dopamine. By comparison, "liking," or the actual pleasurable impact of reward consumption, is mediated by smaller and fragile neural systems, and is not dependent on dopamine. The incentive-sensitization theory posits the essence of drug addiction to be excessive amplification specifically of psychological "wanting," especially triggered by cues, without necessarily an amplification of "liking." This is because of long-lasting changes in dopamine-related motivation systems of susceptible individuals, called "neural sensitization." A quarter-century after its proposal, evidence has continued to grow in support the incentive-sensitization theory. Further, its scope is now expanding to include diverse behavioral addictions and other psychopathologies. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Simulating the Effects of Widespread Adoption of Efficient Irrigation Technologies on Irrigation Water Use

NASA Astrophysics Data System (ADS)

Kendall, A. D.; Deines, J. M.; Hyndman, D. W.

2017-12-01

Irrigation technologies are changing: becoming more efficient, better managed, and capable of more precise targeting. Widespread adoption of these technologies is shifting water balances and significantly altering the hydrologic cycle in some of the largest irrigated regions in the world, such as the High Plains Aquifer of the USA. There, declining groundwater resources, increased competition from alternate uses, changing surface water supplies, and increased subsidies and incentives are pushing farmers to adopt these new technologies. Their decisions about adoption, irrigation extent, and total water use are largely unrecorded, limiting critical data for what is the single largest consumptive water use globally. Here, we present a novel data fusion of an annual water use and technology database in Kansas with our recent remotely-sensed Annual Irrigation Maps (AIM) dataset to produce a spatially and temporally complete record of these decisions. We then use this fusion to drive the Landscape Hydrologic Model (LHM), which simulates the full terrestrial water cycle at hourly timesteps for large regions. The irrigation module within LHM explicitly simulates each major irrigation technology, allowing for a comprehensive evaluation of changes in irrigation water use over time and space. Here we simulate 2000 - 2016, a period which includes a major increase in the use of modern efficient irrigation technology (such as Low Energy Precision Application, LEPA) as well as both drought and relative wet periods. Impacts on water use are presented through time and space, along with implications for adopting these technologies across the USA and globally.

Decision Analysis and Policy Formulation for Technology-Specific Renewable Energy Targets

NASA Astrophysics Data System (ADS)

Okioga, Irene Teshamulwa

This study establishes a decision making procedure using Analytic Hierarchy Process (AHP) for a U.S. national renewable portfolio standard, and proposes technology-specific targets for renewable electricity generation for the country. The study prioritizes renewable energy alternatives based on a multi-perspective view: from the public, policy makers, and investors' points-of-view, and uses multiple criteria for ranking the alternatives to generate a unified prioritization scheme. During this process, it considers a 'quadruple bottom-line' approach (4P), i.e. reflecting technical "progress", social "people", economic 'profits", and environmental "planet" factors. The AHP results indicated that electricity generation from solar PV ranked highest, and biomass energy ranked lowest. A "Benefits/Cost Incentives/Mandates" (BCIM) model was developed to identify where mandates are needed, and where incentives would instead be required to bring down costs for technologies that have potential for profitable deployment. The BCIM model balances the development of less mature renewable energy technologies, without the potential for rising near-term electricity rates for consumers. It also ensures that recommended policies do not lead to growth of just one type of technology--the "highest-benefit, least-cost" technology. The model indicated that mandates would be suited for solar PV, and incentives generally for geothermal and concentrated solar power. Development for biomass energy, as a "low-cost, low-benefits" alternative was recommended at a local rather than national level, mainly due to its low resource potential values. Further, biomass energy generated from wastewater treatment plants (WWTPs) had the least resource potential compared to other biomass sources. The research developed methodologies and recommendations for biogas electricity targets at WWTPs, to take advantage of the waste-to-energy opportunities.

Financial incentives, quality improvement programs, and the adoption of clinical information technology.

PubMed

Robinson, James C; Casalino, Lawrence P; Gillies, Robin R; Rittenhouse, Diane R; Shortell, Stephen S; Fernandes-Taylor, Sara

2009-04-01

Physician use of clinical information technology (CIT) is important for the management of chronic illness, but has lagged behind expectations. We studied the role of health insurers' financial incentives (including pay-for-performance) and quality improvement initiatives in accelerating adoption of CIT in large physician practices. National survey of all medical groups and independent practice association (IPA) physician organizations with 20 or more physicians in the United States in 2006 to 2007. The response rate was 60.3%. Use of 19 CIT capabilities was measured. Multivariate statistical analysis of financial and organizational factors associated with adoption and use of CIT. Use of information technology varied across physician organizations, including electronic access to laboratory test results (medical groups, 49.3%; IPAs, 19.6%), alerts for potential drug interactions (medical groups, 33.9%; IPAs, 9.5%), electronic drug prescribing (medical groups, 41.9%; IPAs, 25.1%), and physician use of e-mail with patients (medical groups, 34.2%; IPAs, 29.1%). Adoption of CIT was stronger for physician organizations evaluated by external entities for pay-for-performance and public reporting purposes (P = 0.042) and for those participating in quality improvement initiatives (P < 0.001). External incentives and participation in quality improvement initiatives are associated with greater use of CIT by large physician practices.

The High-Technology Connection: Academic/Industrial Cooperation for Economic Growth. ASHE-ERIC Higher Education Research Report No. 6.

ERIC Educational Resources Information Center

Johnson, Lynn G.

Cooperative arrangements between academic institutions and industry are examined, with attention to linkages in high technology research and development (R&D), the commercial application of R&D (technology transfer), and the preparation and continuing development of scientific and engineering personnel. Incentives and barriers to campus/corporate…

Effects of financial incentives for the purchase of healthy groceries on dietary intake and weight outcomes among older adults: A randomized pilot study

PubMed Central

Kral, Tanja V.E.; Bannon, Annika L.; Moore, Reneé H.

2016-01-01

Providing financial incentives can be a useful behavioral economics strategy for increasing fruit and vegetable intake among consumers. It remains to be determined whether financial incentives can promote intake of other low energy-dense foods and if consumers who are already using promotional tools for their grocery purchases may be especially responsive to receiving incentives. This randomized controlled trial tested the effects of offering financial incentives for the purchase of healthy groceries on 3-month changes in dietary intake, weight outcomes, and the home food environment among older adults. A secondary aim was to compare frequent coupon users (FCU) and non-coupon users (NCU) on weight status, home food environment, and grocery shopping behavior. FCU (n = 28) and NCU (n = 26) were randomly assigned to either an incentive or a control group. Participants in the incentive group received $1 for every healthy food or beverage they purchased. All participants completed 3-day food records and a home food inventory and had their height, weight, and waist circumference measured at baseline and after 3 months. Participants who were responsive to the intervention and received financial incentives significantly increased their daily vegetable intake (P = 0.04). Participants in both groups showed significant improvements in their home food environment (P = 0.0003). No significant changes were observed in daily energy intake or weight-related outcomes across groups (P < 0.12). FCU and NCU did not differ significantly in any anthropometric variables or the level at which their home food environment may be considered ‘obesogenic’ (P > 0.73). Increased consumption of vegetables did not replace intake of more energy-dense foods. Incentivizing consumers to make healthy food choices while simultaneously reducing less healthy food choices may be important. PMID:26879224

An economic analysis of private incentives to adopt DNA barcoding technology for fish species authentication in Canada.

PubMed

Ugochukwu, Albert I; Hobbs, Jill E; Phillips, Peter W B; Gray, Richard

2015-12-01

The increasing spate of species substitution and mislabelling in fish markets has become a concern to the public and a challenge to both the food industry and regulators. Species substitution and mislabelling within fish supply chains occurs because of price incentives to misrepresent products for economic gain. Emerging authenticity technologies, such as the DNA barcoding technology that has been used to identify plants and animal (particularly fish) species through DNA sequencing, offer a potential technological solution to this information problem. However, the adoption of these authenticity technologies depends also on economic factors. The present study uses economic welfare analysis to examine the effects of species substitution and mislabelling in fish markets, and examines the feasibility of the technology for a typical retail store in Canada. It is assumed that increased accuracy of the technology in detecting fraud and enforcement of legal penalties and other associated costs would be likely to discourage cheating. Empirical results suggest that DNA barcoding technology would be feasible presently for a typical retail store only if authentication is done in a third party laboratory, as it may not be feasible on an individual retail store level once fixed and other associated costs of the technology are considered.

Health Information Technology (HIT) Adaptation: Refocusing on the Journey to Successful HIT Implementation.

PubMed

Yen, Po-Yin; McAlearney, Ann Scheck; Sieck, Cynthia J; Hefner, Jennifer L; Huerta, Timothy R

2017-09-07

In past years, policies and regulations required hospitals to implement advanced capabilities of certified electronic health records (EHRs) in order to receive financial incentives. This has led to accelerated implementation of health information technologies (HIT) in health care settings. However, measures commonly used to evaluate the success of HIT implementation, such as HIT adoption, technology acceptance, and clinical quality, fail to account for complex sociotechnical variability across contexts and the different trajectories within organizations because of different implementation plans and timelines. We propose a new focus, HIT adaptation, to illuminate factors that facilitate or hinder the connection between use of the EHR and improved quality of care as well as to explore the trajectory of changes in the HIT implementation journey as it is impacted by frequent system upgrades and optimizations. Future research should develop instruments to evaluate the progress of HIT adaptation in both its longitudinal design and its focus on adaptation progress rather than on one cross-sectional outcome, allowing for more generalizability and knowledge transfer. ©Po-Yin Yen, Ann Scheck McAlearney, Cynthia J Sieck, Jennifer L Hefner, Timothy R Huerta. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 07.09.2017.

Public acceptability of financial incentives for smoking cessation in pregnancy and breast feeding: a survey of the British public.

PubMed

Hoddinott, Pat; Morgan, Heather; MacLennan, Graeme; Sewel, Kate; Thomson, Gill; Bauld, Linda; Yi, Deokhee; Ludbrook, Anne; Campbell, Marion K

2014-07-18

To survey public attitudes about incentives for smoking cessation in pregnancy and for breast feeding to inform trial design. Cross-sectional survey. British general public. Seven promising incentive strategies had been identified from evidence syntheses and qualitative interview data from service users and providers. These were shopping vouchers for: (1) validated smoking cessation in pregnancy and (2) after birth; (3) for a smoke-free home; (4) for proven breast feeding; (5) a free breast pump; (6) payments to health services for reaching smoking cessation in pregnancy targets and (7) breastfeeding targets. Ipsos MORI used area quota sampling and home-administered computer-assisted questionnaires, with randomised question order to assess agreement with different incentives (measured on a five-point scale). Demographic data and target behaviour experience were recorded. Analysis used multivariable ordered logit models. Agreement with incentives was mixed (ranging from 34% to 46%) among a representative sample of 1144 British adults. Mean agreement score was highest for a free breast pump, and lowest for incentives for smoking abstinence after birth. More women disagreed with shopping vouchers than men. Those with lower levels of education disagreed more with smoking cessation incentives and a breast pump. Those aged 44 or under agreed more with all incentive strategies compared with those aged 65 and over, particularly provider targets for smoking cessation. Non-white ethnic groups agreed particularly with breastfeeding incentives. Current smokers with previous stop attempts and respondents who had breast fed children agreed with providing vouchers for the respective behaviours. Up to £40/month vouchers for behaviour change were acceptable (>85%). Women and the less educated were more likely to disagree, but men and women of childbearing age to agree, with incentives designed for their benefit. Trials evaluating reach, impact on health inequalities and ethnic groups are required prior to implementing incentive interventions. CRD42012001980. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Incentive-Based Conservation Programs in Developing Countries: A Review of Some Key Issues and Suggestions for Improvements

NASA Astrophysics Data System (ADS)

Spiteri, Arian; Nepalz, Sanjay K.

2006-01-01

Biodiversity conservation in developing countries has been a challenge because of the combination of rising human populations, rapid technological advances, severe social hardships, and extreme poverty. To address the social, economic, and ecological limitations of people-free parks and reserves, incentives have been incorporated into conservation programs in the hopes of making conservation meaningful to local people. However, such incentive-based programs have been implemented with little consideration for their ability to fulfill promises of greater protection of biodiversity. Evaluations of incentive-based conservation programs indicate that the approach continually falls short of the rhetoric. This article provides an overview of the problems associated with incentive-based conservation approaches in developing countries. It argues that existing incentive-based programs (IBPs) have yet to realize that benefits vary greatly at different “community” scales and that a holistic conceptualization of a community is essential to incorporate the complexities of a heterogeneous community when designing and implementing the IBPs. The spatial complexities involved in correctly identifying the beneficiaries in a community and the short-term focus of IBPs are two major challenges for sustaining conservation efforts. The article suggests improvements in three key areas: accurate identification of “target” beneficiaries, greater inclusion of marginal communities, and efforts to enhance community aptitudes.

Financial Incentives and Physician Practice Participation in Medicare's Value-Based Reforms.

PubMed

Markovitz, Adam A; Ramsay, Patricia P; Shortell, Stephen M; Ryan, Andrew M

2017-07-26

To evaluate whether greater experience and success with performance incentives among physician practices are related to increased participation in Medicare's voluntary value-based payment reforms. Publicly available data from Medicare's Physician Compare (n = 1,278; January 2012 to November 2013) and nationally representative physician practice data from the National Survey of Physician Organizations 3 (NSPO3; n = 907,538; 2013). We used regression analysis to examine practice-level relationships between prior exposure to performance incentives and participation in key Medicare value-based payment reforms: accountable care organization (ACO) programs, the Physician Quality Reporting System ("Physician Compare"), and the Meaningful Use of Health Information Technology program ("Meaningful Use"). Prior experience and success with financial incentives were measured as (1) the percentage of practices' revenue from financial incentives for quality or efficiency; and (2) practices' exposure to public reporting of quality measures. We linked physician participation data from Medicare's Physician Compare to the NSPO3 survey. There was wide variation in practices' exposure to performance incentives, with 64 percent exposed to financial incentives, 45 percent exposed to public reporting, and 2.2 percent of practice revenue coming from financial incentives. For each percentage-point increase in financial incentives, there was a 0.9 percentage-point increase in the probability of participating in ACOs (standard error [SE], 0.1, p < .001) and a 0.8 percentage-point increase in the probability of participating in Meaningful Use (SE, 0.1, p < .001), controlling for practice characteristics. Financial incentives were not associated with participation in Physician Compare. Among ACO participants, a 1 percentage-point increase in incentives was associated with a 0.7 percentage-point increase in the probability of being "very well" prepared to utilize cost and quality data (SE, 0.1, p < .001). Physicians organizations' prior experience and success with performance incentives were related to participation in Medicare ACO arrangements and participation in the meaningful use criteria but not to participation in Physician Compare. We conclude that Medicare must complement financial incentives with additional efforts to address the needs of practices with less experience with such incentives to promote value-based payment on a broader scale. © Health Research and Educational Trust.

A Survey: The Principal Elements of Safety Programs of Nine Major American Shipyards

DTIC Science & Technology

1991-01-01

Urine Breath Q 39. Subst. abuse Hearing Chest X-Ray Spirometry Q 40. Yes Q 41. Yes Q 42. Yes Q 43. Yes Q 44. Yes < Pipe Wire rope Chain Wood 8 YARD 1...Maintenance Safety Other 1. . 2. 3. 4. Q 71. Yes Q 72. Company Yard 14 Which of the following do you use as incentives to worker safety? (“1” is the...accident recording form? * * * * * * * * 8 This form is unique to your. . . * * * * * * 6 * * * * 4 Incentive programs and awareness programs

The Long and Winding Path (from Instructional Design to Performance Technology).

ERIC Educational Resources Information Center

Carr, Clay; Totzke, Larry

1995-01-01

Presents a case study based on experiences at Amway Corporation that explains how the Human Resources Development Department progressed from providing training to providing a broader range of human performance technology interventions. Strategic planning is described, including identifying incentives and required competencies, providing for…

Columbia University's Axel Patents: Technology Transfer and Implications for the Bayh-Dole Act

PubMed Central

Colaianni, Alessandra; Cook-Deegan, Robert

2009-01-01

Context: The Bayh-Dole Act of 1980, which gave federal grantees and contractors the right to patent and license inventions stemming from federally funded research, was intended to encourage commercial dissemination of research that would otherwise languish for want of a patent incentive. The case of Columbia University's Axel patents, which claimed a scientific method to introduce foreign proteins into nucleated cells, illustrates a secondary outcome of the Bayh-Dole Act: the incentive for federal grantees and contractors to pursue royalty revenues from patented research, even for inventions for which commercial use did not require patents. Methods: This article describes oral interviews with two of the three inventors and a former high-ranking administrator at Columbia; correspondence with several faculty members at Columbia to obtain key royalty figures and information about Columbia's licensing strategy; patent searches; examinations of legal records of court proceedings; and analysis of citation trends for the seminal papers disclosing the invention of cotransformation. Findings: Columbia University and the inventors profited handsomely from the Axel patents, earning $790 million in revenues through licensing arrangements that tapped profits from end products made by biotechnology and pharmaceutical companies. Columbia's aggressive effort to extend the patent duration also led to considerable legal expenditures and fierce controversy. In particular, obtaining and enforcing a 2002 patent proved costly, politically difficult, and financially fruitless and attracted intense criticism for behavior unbecoming a nonprofit academic institution. Conclusions: This case study raises several important questions about the logic and future revisions of the Bayh-Dole Act: Are revenue generation and financial rewards for inventing valuable technologies legitimate goals for this act? If so, does the federal government need credible mechanisms for oversight of, or checks and balances on, the rights conferred? PMID:19751286

Columbia University's Axel patents: technology transfer and implications for the Bayh-Dole Act.

PubMed

Colaianni, Alessandra; Cook-Deegan, Robert

2009-09-01

The Bayh-Dole Act of 1980, which gave federal grantees and contractors the right to patent and license inventions stemming from federally funded research, was intended to encourage commercial dissemination of research that would otherwise languish for want of a patent incentive. The case of Columbia University's Axel patents, which claimed a scientific method to introduce foreign proteins into nucleated cells, illustrates a secondary outcome of the Bayh-Dole Act: the incentive for federal grantees and contractors to pursue royalty revenues from patented research, even for inventions for which commercial use did not require patents. This article describes oral interviews with two of the three inventors and a former high-ranking administrator at Columbia; correspondence with several faculty members at Columbia to obtain key royalty figures and information about Columbia's licensing strategy; patent searches; examinations of legal records of court proceedings; and analysis of citation trends for the seminal papers disclosing the invention of cotransformation. Columbia University and the inventors profited handsomely from the Axel patents, earning $790 million in revenues through licensing arrangements that tapped profits from end products made by biotechnology and pharmaceutical companies. Columbia's aggressive effort to extend the patent duration also led to considerable legal expenditures and fierce controversy. In particular, obtaining and enforcing a 2002 patent proved costly, politically difficult, and financially fruitless and attracted intense criticism for behavior unbecoming a nonprofit academic institution. This case study raises several important questions about the logic and future revisions of the Bayh-Dole Act: Are revenue generation and financial rewards for inventing valuable technologies legitimate goals for this act? If so, does the federal government need credible mechanisms for oversight of, or checks and balances on, the rights conferred?

Impact of monetary incentives on cognitive performance and error monitoring following sleep deprivation.

PubMed

Hsieh, Shulan; Li, Tzu-Hsien; Tsai, Ling-Ling

2010-04-01

To examine whether monetary incentives attenuate the negative effects of sleep deprivation on cognitive performance in a flanker task that requires higher-level cognitive-control processes, including error monitoring. Twenty-four healthy adults aged 18 to 23 years were randomly divided into 2 subject groups: one received and the other did not receive monetary incentives for performance accuracy. Both subject groups performed a flanker task and underwent electroencephalographic recordings for event-related brain potentials after normal sleep and after 1 night of total sleep deprivation in a within-subject, counterbalanced, repeated-measures study design. Monetary incentives significantly enhanced the response accuracy and reaction time variability under both normal sleep and sleep-deprived conditions, and they reduced the effects of sleep deprivation on the subjective effort level, the amplitude of the error-related negativity (an error-related event-related potential component), and the latency of the P300 (an event-related potential variable related to attention processes). However, monetary incentives could not attenuate the effects of sleep deprivation on any measures of behavior performance, such as the response accuracy, reaction time variability, or posterror accuracy adjustments; nor could they reduce the effects of sleep deprivation on the amplitude of the Pe, another error-related event-related potential component. This study shows that motivation incentives selectively reduce the effects of total sleep deprivation on some brain activities, but they cannot attenuate the effects of sleep deprivation on performance decrements in tasks that require high-level cognitive-control processes. Thus, monetary incentives and sleep deprivation may act through both common and different mechanisms to affect cognitive performance.

Federal incentives for industrial modernization: Historical review and future opportunities

NASA Technical Reports Server (NTRS)

Coleman, Sandra C.; Batson, Robert G.

1987-01-01

Concerns over the aging of the U.S. aerospace industrial base led DOD to introduce first its Technology Modernization (Tech Mod) Program, and more recently the Industrial Modernization Incentive Program (IMIP). These incentives include productivity shared savings rewards, contractor investment protection to allow for amortization of plant and equipment, and subcontractor/vendor participation. The purpose here is to review DOD IMIP and to evaluate whether a similar program is feasible for NASA and other non-DOD agencies. The IMIP methodology is of interest to industrial engineers because it provides a structured, disciplined approach to identifying productivity improvement opportunities and documenting their expected benefit. However, it is shown that more research on predicting and validating cost avoidance is needed.

Incorporating DSA in multipatterning semiconductor manufacturing technologies

NASA Astrophysics Data System (ADS)

Badr, Yasmine; Torres, J. A.; Ma, Yuansheng; Mitra, Joydeep; Gupta, Puneet

2015-03-01

Multi-patterning (MP) is the process of record for many sub-10nm process technologies. The drive to higher densities has required the use of double and triple patterning for several layers; but this increases the cost of the new processes especially for low volume products in which the mask set is a large percentage of the total cost. For that reason there has been a strong incentive to develop technologies like Directed Self Assembly (DSA), EUV or E-beam direct write to reduce the total number of masks needed in a new technology node. Because of the nature of the technology, DSA cylinder graphoepitaxy only allows single-size holes in a single patterning approach. However, by integrating DSA and MP into a hybrid DSA-MP process, it is possible to come up with decomposition approaches that increase the design flexibility, allowing different size holes or bar structures by independently changing the process for every patterning step. A simple approach to integrate multi-patterning with DSA is to perform DSA grouping and MP decomposition in sequence whether it is: grouping-then-decomposition or decomposition-then-grouping; and each of the two sequences has its pros and cons. However, this paper describes why these intuitive approaches do not produce results of acceptable quality from the point of view of design compliance and we highlight the need for custom DSA-aware MP algorithms.

Leveraging technology: creating and sustaining changes for health.

PubMed

Teyhen, Deydre S; Aldag, Matt; Edinborough, Elton; Ghannadian, Jason D; Haught, Andrea; Kinn, Julie; Kunkler, Kevin J; Levine, Betty; McClain, James; Neal, David; Stewart, Tiffany; Thorndike, Frances P; Trabosh, Valerie; Wesensten, Nancy; Parramore, David J

2014-09-01

The rapid growth and evolution of health-related technology capabilities are driving an established presence in the marketplace and are opening up tremendous potential to minimize and/or mitigate barriers associated with achieving optimal health, performance, and readiness. This article summarizes technology-based strategies that promote healthy habits related to physical activity, nutrition, and sleep. The Telemedicine and Advanced Technology Research Center convened a workshop titled "Leveraging Technology: Creating & Sustaining Changes for Health" (May 29-30, 2013, Fort Detrick, MD). Participants included experts from academia (n=3), government (n=33), and industry (n=16). A modified Delphi method was used to establish expert consensus in six topic areas: (1) physical activity, (2) nutrition, (3) sleep, (4) incentives for behavior change, (5) usability/interoperability, and (6) mobile health/open platform. Overall, 162 technology features, constructs, and best practices were reviewed and prioritized for physical activity monitors (n=29), nutrition monitors (n=35), sleep monitors (n=24), incentives for change (n=36), usability and interoperability (n=25), and open data (n=13). Leading practices, gaps, and research needs for technology-based strategies were identified and prioritized. This information can be used to provide a research and development road map for (1) leveraging technology to minimize barriers to enhancing health and (2) facilitating evidence-based techniques to create and sustain healthy behaviors.

Promoting healthcare innovation on the demand side

PubMed Central

Eisenberg, Rebecca S.

2017-01-01

Abstract Innovation policy often focuses on fortifying the incentives of firms that develop and sell new products by offering them lucrative rights to exclude competitors from the market. Regulators also rely on these same firms—and on similar incentives—to develop information about the effects of their products in patients, despite their obvious conflict of interest. The result may be a distorted understanding that leads to overuse of expensive new medical technologies. Recent technological advances have put healthcare payers in an excellent position to play a larger role in future innovation to improve healthcare and reduce its costs. Insurance companies and integrated healthcare providers have custody of treasure troves of data about healthcare provision and outcomes that can yield valuable insights about the effects of medical treatment without the need to conduct costly clinical trials. Some integrated healthcare systems have seized upon this advantage to make notable discoveries about the effects of particular products that have changed the standard of care. Moreover, to the extent that healthcare payers can profit from reducing costs, they will seek to avoid inappropriate use of costly technologies. Greater involvement of payers in healthcare innovation thus offers a potential counterweight to the incentives of product sellers to promote excessive use of costly new products. In recent years, the federal government has sought to promote innovation through analysis of healthcare records in a series of initiatives; some picture insurers as passive data repositories, while others provide opportunities for insurers to take a more active role in innovation. In this paper, we examine the role of health insurers in developing new knowledge about the provision and effects of healthcare—what we call ‘demand-side innovation’. We address the contours of this underexplored area of innovation and describe the behavior of participating firms. We examine the effects of current legal rules on demand-side innovation, including insurance regulation, intellectual property rules, privacy protections, and FDA regulation of new healthcare technologies. Throughout, we highlight many policy tools that government can use and is using to facilitate payer innovation outside the traditional toolkit of patents and exclusive rights. PMID:28852556

Information technology acceptance in health information management.

PubMed

Abdekhoda, M; Ahmadi, M; Dehnad, A; Hosseini, A F

2014-01-01

User acceptance of information technology has been a significant area of research for more than two decades in the field of information technology. This study assessed the acceptance of information technology in the context of Health Information Management (HIM) by utilizing Technology Acceptance Model (TAM) which was modified and applied to assess user acceptance of health information technology as well as viability of TAM as a research construct in the context of HIM. This was a descriptive- analytical study in which a sample of 187 personnel from a population of 363 personnel, working in medical records departments of hospitals affiliated to Tehran University of Medical Sciences, was selected. Users' perception of applying information technology was studied by a researcher-developed questionnaire. Collected data were analyzed by SPSS software (version16) using descriptive statistics and regression analysis. The results suggest that TAM is a useful construct to assess user acceptance of information technology in the context of HIM. The findings also evidenced the perceived ease of use (PEOU) and perceived usefulness (PE) were positively associated with favorable users' attitudes towards HIM. PU was relatively more associated (r= 0.22, p = 0.05) than PEOU (r = 0.014, p = 0.05) with favorable user attitudes towards HIM. Users' perception of usefulness and ease of use are important determinants providing the incentive for users to accept information technologies when the application of a successful HIM system is attempted. The findings of the present study suggest that user acceptance is a key element and should subsequently be the major concern of health organizations and health policy makers.

The Paradigm of Viral Communication.

ERIC Educational Resources Information Center

Welker, Carl B.

2002-01-01

Introduces the concepts of idea viruses and viral communication, a technology-based communication that spreads ideas quickly. Explains its applicability in the area of direct marketing and discusses a technology platform that provides the opportunity of sending a message to a large number of people and emotional or pecuniary incentives to…

Societal Incentives for Work: Lessons from Tanzania.

ERIC Educational Resources Information Center

Bjorkquist, David C.

1993-01-01

A study of work and economics, technology, and culture in Tanzania reveals that (1) material returns to rural workers were barely life sustaining; (2) people live dignified lives without consuming much; (3) simpler technological solutions were better; (4) tension exists between competitiveness and humaneness; and (5) tribal traditions contribute…

77 FR 64755 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program-Stage 2; Corrections

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-23

... EHR PQRS, ACO, Group Clinical Process/ Blood Pressure. Contact Information: Reporting PQRS, UDS... of hypertension and whose blood pressure was adequately controlled ( www.asco.org ;. cancer who are...

Electronic health records and cardiac implantable electronic devices: new paradigms and efficiencies.

PubMed

Slotwiner, David J

2016-10-01

The anticipated advantages of electronic health records (EHRs)-improved efficiency and the ability to share information across the healthcare enterprise-have so far failed to materialize. There is growing recognition that interoperability holds the key to unlocking the greatest value of EHRs. Health information technology (HIT) systems including EHRs must be able to share data and be able to interpret the shared data. This requires a controlled vocabulary with explicit definitions (data elements) as well as protocols to communicate the context in which each data element is being used (syntactic structure). Cardiac implantable electronic devices (CIEDs) provide a clear example of the challenges faced by clinicians when data is not interoperable. The proprietary data formats created by each CIED manufacturer, as well as the multiple sources of data generated by CIEDs (hospital, office, remote monitoring, acute care setting), make it challenging to aggregate even a single patient's data into an EHR. The Heart Rhythm Society and CIED manufacturers have collaborated to develop and implement international standard-based specifications for interoperability that provide an end-to-end solution, enabling structured data to be communicated from CIED to a report generation system, EHR, research database, referring physician, registry, patient portal, and beyond. EHR and other health information technology vendors have been slow to implement these tools, in large part, because there have been no financial incentives for them to do so. It is incumbent upon us, as clinicians, to insist that the tools of interoperability be a prerequisite for the purchase of any and all health information technology systems.

Chapter 15: Using System Dynamics to Model Industry's Developmental Response to Energy Policy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bush, Brian; Inman, Daniel; Newes, Emily

In this chapter we explore the potential development of the biofuels industry using the Biomass Scenario Model (BSM), a system dynamics model developed at the National Renewable Energy Laboratory through the support of the U.S. Department of Energy. The BSM is designed to analyze the implications of policy on the development of the supply chain for biofuels in the United States. It explicitly represents the behavior of decision makers such as farmers, investors, fueling station owners, and consumers. We analyze several illustrative case studies that explore a range of policies and discuss how incentives interact with individual parts of themore » supply chain as well as the industry as a whole. The BSM represents specific incentives that are intended to approximate policy in the form of selected laws and regulations. Through characterizing the decision making behaviors of economic actors within the supply chain that critically influence the adoption rate of new biofuels production technologies and demonstrating synergies among policies, we find that incentives with coordinated impacts on each major element of the supply chain catalyze net effects of decision maker behavior such that the combined incentives are greater than the summed effects of individual incentives in isolation.« less

Portfolio-Scale Optimization of Customer Energy Efficiency Incentive and Marketing: Cooperative Research and Development Final Report, CRADA Number CRD-13-535

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brackney, Larry J.

North East utility National Grid (NGrid) is developing a portfolio-scale application of OpenStudio designed to optimize incentive and marketing expenditures for their energy efficiency (EE) programs. NGrid wishes to leverage a combination of geographic information systems (GIS), public records, customer data, and content from the Building Component Library (BCL) to form a JavaScript Object Notation (JSON) input file that is consumed by an OpenStudio-based expert system for automated model generation. A baseline model for each customer building will be automatically tuned using electricity and gas consumption data, and a set of energy conservation measures (ECMs) associated with each NGrid incentivemore » program will be applied to the model. The simulated energy performance and return on investment (ROI) will be compared with customer hurdle rates and available incentives to A) optimize the incentive required to overcome the customer hurdle rate and B) determine if marketing activity associated with the specific ECM is warranted for that particular customer. Repeated across their portfolio, this process will enable NGrid to substantially optimize their marketing and incentive expenditures, targeting those customers that will likely adopt and benefit from specific EE programs.« less

Can economic incentives enhance adoption and use of a household energy technology? Evidence from a pilot study in Cambodia

NASA Astrophysics Data System (ADS)

Usmani, Faraz; Steele, Jason; Jeuland, Marc

2017-03-01

While much work has examined approaches to increase uptake of a variety of household environmental, health and energy technologies, researchers and policymakers alike have struggled to ensure long-term use. Drawing on a pilot-scale experiment conducted in rural Cambodia, this study evaluates whether economic incentives enhance continued use of—and fuel savings from—improved cookstoves (ICS). Capital-cost subsidies that have been traditionally employed to enhance ICS adoption were augmented with rebates linked to stated and objectively measured use in order to investigate impacts on both initial and sustained adoption in the treatment group. Results show that households do respond to these rebates by adopting the intervention ICS at significantly higher rates, and by using it more frequently and for longer periods. Consistent with these stove-use patterns, solid-fuel use and time spent collecting or preparing fuels also decline. However, this effect appears to diminish over time. Thus, while economic inducements may significantly increase adoption and use of new environmental health technologies, corresponding reductions in environmental or livelihood burdens are not guaranteed. Additional research on the design and implementation of incentive-based interventions targeting households directly—such as carbon financing or other forms of results-based financing (RBF) for improved cookstoves—therefore seems warranted prior to wider implementation of such solutions.

Future considerations for clinical dermatology in the setting of 21st century American policy reform: The Medicare Access and Children's Health Insurance Program Reauthorization Act and the Merit-based Incentive Payment System.

PubMed

Barbieri, John S; Miller, Jeffrey J; Nguyen, Harrison P; Forman, Howard P; Bolognia, Jean L; VanBeek, Marta J

2017-06-01

As the implementation of the Medicare Access and Children's Health Insurance Program Reauthorization Act begins, many dermatologists who provide Medicare Part B services will be subject to the reporting requirements of the Merit-based Incentive Payment System (MIPS). Clinicians subject to MIPS will receive a composite score based on performance across 4 categories: quality, advancing care information, improvement activities, and cost. Depending on their overall MIPS score, clinicians will be eligible for a positive or negative payment adjustment. Quality will replace the Physician Quality Reporting System and clinicians will report on 6 measures from a list of over 250 options. Advancing care information will replace meaningful use and will assess clinicians on activities related to integration of electronic health record technology into their practice. Improvement activities will require clinicians to attest to completion of activities focused on improvements in care coordination, beneficiary engagement, and patient safety. Finally, cost will be determined automatically from Medicare claims data. In this article, we will provide a detailed review of the Medicare Access and Children's Health Insurance Program Reauthorization Act with a focus on MIPS and briefly discuss the potential implications for dermatologists. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

77 FR 13697 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program-Stage 2

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-07

... for Economic and Clinical Health Act HMO--Health Maintenance Organization HOS--Health Outcomes Survey... rule by early 2014. The stages represent an initial graduated approach to arriving at the ultimate goal...

Regulatory Incentives and Disincentives for Utility Investments in Grid Modernization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kihm, Steve; Beecher, Janice; Lehr, Ronald L.

Electric power is America's most capital-intensive industry, with more than $100 billion invested each year in energy infrastructure. Investment needs are likely to grow as electric utilities make power systems more reliable and resilient, deploy advanced digital technologies, and facilitate new services to meet some consumers' expectations for greater choice and control. But do current regulatory approaches provide the appropriate incentives for grid modernization investments? This report presents three perspectives: -Financial analyst Steve Kihm begins by explaining that any major investor-owned electric utility that wants to raise capital today can do so at a reasonable cost. The question is whethermore » utility managers want to raise capital for grid modernization. Specifically, they look for investments that create the most value for their existing shareholders. In cases where grid modernization investments are not the best choice in terms of shareholder value, Kihm describes shareholder incentive mechanisms that regulators could consider to encourage such investments when they are in the public interest. -From an institutional perspective, Dr. Janice Beecher finds that the traditional rate-base/rate of return regulatory model provides powerful incentives for utilities to pursue investments, cost control, efficiency and even innovation, and it is well suited to the policy objectives of grid modernization. Prudence of grid modernization investments (fair returns) depends on careful evaluation of the specific asset, and any special incentives (bonus returns) should be used only if they promote economic efficiency consistent with the core goals of economic regulation. According to Beecher, realizing the promises of grid modernization depends on effective implementation of the traditional regulatory model and ratemaking tools to serve the public interest. -Conversely, former commissioner and clean energy consultant Ron Lehr says that rapid electric industry changes require a better alignment of utility investment incentives with changes challenging the electricity sector, emerging grid modernization options and benefits, and public policies. For example, investor-owned utilities typically have an incentive to make capital investments, but rarely to employ expense-based solutions, since utilities do not earn profits on expenses. Further, Lehr cites a variety of factors that stand in the way of creating well targeted and well aligned utility incentives, including litigated regulatory processes. These may be a poor choice for finding the right balance among competing interests, establishing rules of prospective application, justifying demonstrations of new technologies and approaches to meeting emerging consumer demands, and keeping pace with rapid change.« less

Effectiveness of a financial incentive to physicians for timely follow-up after hospital discharge: a population-based time series analysis.

PubMed

Lapointe-Shaw, Lauren; Mamdani, Muhammad; Luo, Jin; Austin, Peter C; Ivers, Noah M; Redelmeier, Donald A; Bell, Chaim M

2017-10-02

Timely follow-up after hospital discharge may decrease readmission to hospital. Financial incentives to improve follow-up have been introduced in the United States and Canada, but it is unknown whether they are effective. Our objective was to evaluate the impact of an incentive program on timely physician follow-up after hospital discharge. We conducted an interventional time series analysis of all medical and surgical patients who were discharged home from hospital between Apr. 1, 2002, and Jan. 30, 2015, in Ontario, Canada. The intervention was a supplemental billing code for physician follow-up within 14 days of discharge from hospital, introduced in 2006. The primary outcome was an outpatient visit within 14 days of discharge. Secondary outcomes were 7-day follow-up and a composite of emergency department visits, nonelective hospital readmission and death within 14 days. We included 8 008 934 patient discharge records. The incentive code was claimed in 31% of eligible visits by 51% of eligible physicians, and cost $17.5 million over the study period. There was no change in the average monthly rate of outcomes in the year before the incentive was introduced compared with the year following introduction: 14-day follow-up (66.5% v. 67.0%, overall p = 0.5), 7-day follow-up (44.9% v. 44.9%, overall p = 0.5) and composite outcome (16.7% v. 16.9%, overall p = 0.2). Despite uptake by physicians, a financial incentive did not alter follow-up after hospital discharge. This lack of effect may be explained by features of the incentive or by extra-physician barriers to follow-up. These barriers should be considered by policymakers before introducing similar initiatives. © 2017 Canadian Medical Association or its licensors.

76 FR 6496 - Special Flight Rules Area in the Vicinity of Grand Canyon National Park, Draft Environmental...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-04

... being considered include: Alternative A Current Condition: Key elements are corridors open year round, annual allocation cap of 93,971, and no quiet technology incentive. Current tours for helicopters and... to quiet technology aircraft. Alternative F Modified Current Condition: Key elements are similar to...

The Long Term Educational Needs of a High-Technology Society.

ERIC Educational Resources Information Center

Button, Kenneth; Cox, Kenneth; Stough, Roger; Taylor, Samantha

2002-01-01

Discusses information technology (IT) labor issues in the U.S. and elsewhere, including demand for IT workers, skills and education needed to pursue IT jobs, and methods to increase supply of IT workers. Examines legislative attempts to increase supply, including use of tax incentives. Discusses IT needs and training programs in six other…

Supporting Technology Integration within a Teacher Education System

ERIC Educational Resources Information Center

Schaffer, Scott P.; Richardson, Jennifer C.

2004-01-01

The purpose of this case study was to examine a teacher education system relative to the degree of performance support for the use of technology to support learning. Performance support was measured by the presence of factors such as clear expectations, feedback, tools, rewards, incentives, motivation, capacity, skills, and knowledge within the…

76 FR 31547 - Medicare Program; Proposed Changes to the Electronic Prescribing (eRx) Incentive Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-01

... unless we specify otherwise. For more information on which professionals are eligible to participate in... Information Technology,'' available at http://www.gao.gov/products/GAO-11-159 ). As a result of the above... certification body authorized by the National Coordinator for Health Information Technology (at the present time...

Meaningful Use of Health Information Technology by Rural Hospitals

ERIC Educational Resources Information Center

McCullough, Jeffrey; Casey, Michelle; Moscovice, Ira; Burlew, Michele

2011-01-01

Purpose: This study examines the current status of meaningful use of health information technology (IT) in Critical Access Hospitals (CAHs), other rural, and urban US hospitals, and it discusses the potential role of Medicare payment incentives and disincentives in encouraging CAHs and other rural hospitals to achieve meaningful use. Methods: Data…

The impact of alternative incentive schemes on completion of health risk assessments.

PubMed

Haisley, Emily; Volpp, Kevin G; Pellathy, Thomas; Loewenstein, George

2012-01-01

The biggest challenge for corporate wellness initiatives is low rates of employee participation. We test whether a behavioral economic approach to incentive design (i.e., a lottery) is more effective than a direct economic payment of equivalent monetary value (i.e., a grocery gift certificate) in encouraging employees to complete health risk assessments (HRAs). Employees were assigned to one of three arms. Assignment to a treatment arm versus the nontreatment arm was determined by management. Assignment to an arm among those eligible for treatment was randomized by office. A large health care management and information technology consulting company. A total of 1299 employees across 14 offices participated. All employees were eligible to receive $25 for completing the HRA. Those in the lottery condition were assigned to teams of four to eight people and, conditional on HRA completion, were entered into a lottery with a prize of $100 (expected value, $25) and a bonus value of an additional $25 if 80% of team members participated. Those in the grocery gift certificate condition who completed an HRA received a $25 grocery gift certificate. Those in the comparison condition received no additional incentive. HRA completion rates. Logistic regression analysis. HRA completion rates were significantly higher among participations in the lottery incentive condition (64%) than in both the grocery gift certificate condition (44%) and the comparison condition (40%). Effects were larger for lower-income employees, as indicated by a significant interaction between income and the lottery incentive. Lottery incentives that incorporate regret aversion and social pressure can provide higher impact for the same amount of money as simple economic incentives.

Current Incentives for Scientists Lead to Underpowered Studies with Erroneous Conclusions.

PubMed

Higginson, Andrew D; Munafò, Marcus R

2016-11-01

We can regard the wider incentive structures that operate across science, such as the priority given to novel findings, as an ecosystem within which scientists strive to maximise their fitness (i.e., publication record and career success). Here, we develop an optimality model that predicts the most rational research strategy, in terms of the proportion of research effort spent on seeking novel results rather than on confirmatory studies, and the amount of research effort per exploratory study. We show that, for parameter values derived from the scientific literature, researchers acting to maximise their fitness should spend most of their effort seeking novel results and conduct small studies that have only 10%-40% statistical power. As a result, half of the studies they publish will report erroneous conclusions. Current incentive structures are in conflict with maximising the scientific value of research; we suggest ways that the scientific ecosystem could be improved.

Current Incentives for Scientists Lead to Underpowered Studies with Erroneous Conclusions

PubMed Central

Higginson, Andrew D.; Munafò, Marcus R.

2016-01-01

We can regard the wider incentive structures that operate across science, such as the priority given to novel findings, as an ecosystem within which scientists strive to maximise their fitness (i.e., publication record and career success). Here, we develop an optimality model that predicts the most rational research strategy, in terms of the proportion of research effort spent on seeking novel results rather than on confirmatory studies, and the amount of research effort per exploratory study. We show that, for parameter values derived from the scientific literature, researchers acting to maximise their fitness should spend most of their effort seeking novel results and conduct small studies that have only 10%–40% statistical power. As a result, half of the studies they publish will report erroneous conclusions. Current incentive structures are in conflict with maximising the scientific value of research; we suggest ways that the scientific ecosystem could be improved. PMID:27832072

A computational substrate for incentive salience.

PubMed

McClure, Samuel M; Daw, Nathaniel D; Montague, P Read

2003-08-01

Theories of dopamine function are at a crossroads. Computational models derived from single-unit recordings capture changes in dopaminergic neuron firing rate as a prediction error signal. These models employ the prediction error signal in two roles: learning to predict future rewarding events and biasing action choice. Conversely, pharmacological inhibition or lesion of dopaminergic neuron function diminishes the ability of an animal to motivate behaviors directed at acquiring rewards. These lesion experiments have raised the possibility that dopamine release encodes a measure of the incentive value of a contemplated behavioral act. The most complete psychological idea that captures this notion frames the dopamine signal as carrying 'incentive salience'. On the surface, these two competing accounts of dopamine function seem incommensurate. To the contrary, we demonstrate that both of these functions can be captured in a single computational model of the involvement of dopamine in reward prediction for the purpose of reward seeking.

Effects of financial incentives for the purchase of healthy groceries on dietary intake and weight outcomes among older adults: A randomized pilot study.

PubMed

Kral, Tanja V E; Bannon, Annika L; Moore, Reneé H

2016-05-01

Providing financial incentives can be a useful behavioral economics strategy for increasing fruit and vegetable intake among consumers. It remains to be determined whether financial incentives can promote intake of other low energy-dense foods and if consumers who are already using promotional tools for their grocery purchases may be especially responsive to receiving incentives. This randomized controlled trial tested the effects of offering financial incentives for the purchase of healthy groceries on 3-month changes in dietary intake, weight outcomes, and the home food environment among older adults. A secondary aim was to compare frequent coupon users (FCU) and non-coupon users (NCU) on weight status, home food environment, and grocery shopping behavior. FCU (n = 28) and NCU (n = 26) were randomly assigned to either an incentive or a control group. Participants in the incentive group received $1 for every healthy food or beverage they purchased. All participants completed 3-day food records and a home food inventory and had their height, weight, and waist circumference measured at baseline and after 3 months. Participants who were responsive to the intervention and received financial incentives significantly increased their daily vegetable intake (P = 0.04). Participants in both groups showed significant improvements in their home food environment (P = 0.0003). No significant changes were observed in daily energy intake or weight-related outcomes across groups (P < 0.12). FCU and NCU did not differ significantly in any anthropometric variables or the level at which their home food environment may be considered 'obesogenic' (P > 0.73). Increased consumption of vegetables did not replace intake of more energy-dense foods. Incentivizing consumers to make healthy food choices while simultaneously reducing less healthy food choices may be important. Copyright © 2016 Elsevier Ltd. All rights reserved.

Development of sanitation technologies in African context : how could we make it more sustainable?

NASA Astrophysics Data System (ADS)

Dakouré, M. S.; Traoré, M. B.; Sossou, S. K.; Maïga, A. H.

2017-03-01

Access to sanitation technologies remains one of the biggest challenges in sub-Saharan Africa. To overcome this gap, a sanitation project called “Ameli-EAUR” translated from French as improvement of water and sanitation in urban and rural areas, was implemented in Burkina Faso for 5 years (2010-2016). The technologies from the project were designed on the basis of agro-sanitation concept, leading to package containing a composting toilet, a grey water treatment facility and a set of urine collection and treatment. The study aimed to evaluate of Ameli-EAUR project, one year after the end, and identify some key factors of sustainability of technologies. As methodology, a survey and a technical diagnostic of implemented technologies were done. The results showed that, the pilot families stopped using all the technologies one year after the end of the project. However, two main lessons can be learnt: (1) in term of efficiency and effectiveness of the project the technology of composting toilet was not robust enough, leading to a rapid abandonment after the project (2) in term of impact and sustainability, the economic incentive of the resource oriented sanitation concept was very weak compared to the needed workload. The technologies development in this kind of project should be carried on and associated with a more inclusive system driven by economic incentive.

Electronic Health Record Systems and Intent to Apply for Meaningful Use Incentives among Office-based Physician ...

MedlinePlus

... on Vital and Health Statistics Annual Reports Health Survey Research Methods Conference Reports from the National Medical Care Utilization and Expenditure Survey Clearinghouse on Health Indexes Statistical Notes for Health ...

American Power Act (Discussion of Draft)

EPA Pesticide Factsheets

To secure the energy future of the United States, to provide incentives for the domestic production of clean energy technology, to achieve meaningful pollution reductions, to create jobs, and for other purposes.

Advancing the Growth of the U.S. Wind Industry: Federal Incentives, Funding, and Partnership Opportunities

DOE Office of Scientific and Technical Information (OSTI.GOV)

The U.S. Department of Energy's (DOE's) Wind Energy Technologies Office (WETO) works to accelerate the development and deployment of wind power. The office provides information for researchers, developers, businesses, manufacturers, communities, and others seeking various types of federal assistance available for advancing wind projects. This fact sheet outlines the primary federal incentives for developing and investing in wind power, resources for funding wind power, and opportunities to partner with DOE and other federal agencies on efforts to move the U.S. wind industry forward.

Improving the Collection of Race, Ethnicity, and Language Data to Reduce Healthcare Disparities: A Case Study from an Academic Medical Center

PubMed Central

Lee, Wei-Chen; Veeranki, Sreenivas P.; Serag, Hani; Eschbach, Karl; Smith, Kenneth D.

2016-01-01

Well-designed electronic health records (EHRs) must integrate a variety of accurate information to support efforts to improve quality of care, particularly equity-in-care initiatives. This case study provides insight into the challenges those initiatives may face in collecting accurate race, ethnicity, and language (REAL) information in the EHR. We present the experience of an academic medical center strengthening its EHR for better collection of REAL data with funding from the EHR Incentive Programs for meaningful use of health information technology and the Texas Medicaid 1115 Waiver program. We also present a plan to address some of the challenges that arose during the course of the project. Our experience at an academic medical center can provide guidance about the likely challenges similar institutions may expect when they implement new initiatives to collect REAL data, particularly challenges regarding scope, personnel, and other resource needs. PMID:27843424

Reflections on social activism in otolaryngology.

PubMed

Kopelovich, Jonathan C

2014-03-01

What is "social activism" to you? For older otolaryngologists, the term is likely to signify the tumult of the 1960s. For incoming generations, this connotation is outdated. Rather, it more broadly reflects concerted efforts to improve the public good. Some ally with existing institutions to work toward incremental progress. Some start new organizations, using technological tools to build networks, marshal resources, and leapfrog hurdles. Countering these efforts are the ever-changing challenges of practicing otolaryngology today: electronic health records, shifting incentives, and changes in the practice model. Employment by large conglomerates is more common, decreasing our visibility as community leaders. Burnout is a recognized "hazard," and budding otolaryngologists are particularly susceptible. Adding one more thing, like social activism, to a full plate seems counterintuitive. But it shouldn't be. You don't need a "bigger" plate to get involved in social causes. Start simple. Find a partner. Scale up. You'll find it rewarding.

Making the case for a clinical information system: the chief information officer view.

PubMed

Cotter, Carole M

2007-03-01

Adequate decision support for clinicians and other caregivers requires accessible and reliable patient information. Powerful societal and economic forces are moving us toward an integrated, patient-centered health care information system that will allow caregivers to exchange up-to-date patient health information quickly and easily. These forces include patient safety, potential health care cost savings, empowerment of consumers (and their subsequent demands for quality), new federal policies, and growing regional health care initiatives. Underspending on health care information technologies has gone on for many years; and the creation and implementation of a comprehensive clinical information system will entail many difficulties, particularly in regard to patients' privacy and control of their information, standardization of electronic health records, cost of adopting information technology, unbalanced financial incentives, and the varying levels of preparation across caregivers. There will also be potential effects on the physician-patient relationship. Ultimately, an integrated system will require a concerted transformation of the health care industry that is akin to what the banking industry has accomplished with electronic automation. Critical care units provide a good starting point for how information system technologies can be used and electronic patient information collected, although the robust systems designed for intensive care units are not always used to their potential.

Individual differences in anticipatory activity to food rewards predict cue-induced appetitive 50-kHz calls in rats.

PubMed

Brenes, Juan C; Schwarting, Rainer K W

2015-10-01

Reward-related stimuli come to acquire incentive salience through Pavlovian learning and become capable of controlling reward-oriented behaviors. Here, we examined individual differences in anticipatory activity elicited by reward-related cues as indicative of how animals attribute incentive salience to otherwise neutral stimuli. Since adult rats can signal incentive motivation states through ultrasonic vocalizations (USVs) at around 50-kHz, such calls were recorded in food-deprived rats trained to associate cues with food rewards, which were subsequently devalued by satiation.We found that the extent to which animals developed conditioned anticipatory activity to food cues while food deprived determined the level of cue-induced appetitive USVs while sated. Re-exposure to reward cues after a free-testing period reinstated USVs, invigorated reward seeking and consumption, and again, increases in calling occurred only in animals with high levels of cue-induced anticipatory activity. Reward-experienced rats systemically challenged with the catecholamine agonist amphetamine or with the dopamine receptor antagonist flupenthixol showed attenuated responses to these drugs, especially for USVs and in subjects with high levels of cue-induced anticipatory activity. Our results suggest that individuals prone to attribute incentive salience to reward cues showed heightened reward-induced USVs which were reliably expressed over time and persisted despite physiological needs being fulfilled. Also, prone subjects seemed to undergo particular adaptations in their dopaminergic system related with incentive learning. Our findings may have translational relevance in preclinical research modeling compulsive disorders, which may be due to excessive attribution of incentive salience to reward cues, such as overeating, pathological gambling, and drug addiction.

Do rewards reinforce the growth mindset?: Joint effects of the growth mindset and incentive schemes in a field intervention.

PubMed

Chao, Melody Manchi; Visaria, Sujata; Mukhopadhyay, Anirban; Dehejia, Rajeev

2017-10-01

The current study draws on the motivational model of achievement which has been guiding research on the growth mindset intervention (Dweck & Leggett, 1988) and examines how this intervention interacts with incentive systems to differentially influence performance for high- and low-achieving students in Indian schools that serve low-SES communities. Although, as expected, the growth mindset intervention did interact with incentive systems and prior achievement to influence subsequent academic performance, the existing growth mindset framework cannot fully account for the observed effects. Specifically, we found that the growth mindset intervention did facilitate performance through persistence, but only when the incentive system imparted individuals with a sense of autonomy. Such a facilitation effect was only found among those students who had high prior achievement, but not among those who had underperformed. When the incentive did not impart a sense of autonomy, the growth mindset intervention undermined the performance of those who had high initial achievement. To reconcile these discrepancies and to advance understanding of the impacts of psychological interventions on achievement outcomes, we discuss how the existing theory can be extended and integrated with an identity-based motivation framework (Oyserman & Destin, 2010). We also discuss the implications of our work for future research and practice. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The Information Revolution and International Stability: A Multi-Article Exploration of Computing, Cyber, and Incentives for Conflict

ERIC Educational Resources Information Center

Schneider, Jacquelyn

2017-01-01

Over the last twenty years, the digital technologies of the information revolution have fundamentally impacted the nature of modern warfare and introduced significant uncertainty about capabilities, intentions, and the limits of conflict. How do these digital advances and the explosion of cyber technologies on and off the battlefield impact…

The Impact of Hybrid Electric Vehicles Incentives on Demand and the Determinants of Hybrid-Vehicle Adoption

NASA Astrophysics Data System (ADS)

Riggieri, Alison

According to the Energy Information Administration, transportation currently accounts for over 60% of U.S. oil demand (E.I.A. 2010). Improving automobile energy efficiency could therefore reduce oil consumption and the negative environmental effects of automobile use. Subsidies for energy-efficient technologies such as hybrid-electric vehicles have gained political popularity since their introduction into the market and therefore have been implemented with increasing frequency. After the introduction of hybrid-electric vehicles into the U.S. market, the federal government initially implemented a 2000 federal tax deduction for these vehicles (later increased to a 3500 credit). Many states followed, offering various exemptions, such as high-occupancy vehicle (HOV) lane use, and excise-tax, sales-tax, and income-tax exemptions. Because not all states have implemented these subsidies, this policy topic is an ideal candidate for an outcome evaluation using an observational study postulation. States adopt incentives for different reasons based on factors that make adoption more attractive, however, so it is first necessary to identify these differences that predict policy adoption. This allows for the evaluative work to control for self selection bias. Three classes of internal determinants of policy adoption, political context, problem severity, and institutional support, and one type of external diffusion factor, are tested using logistic regression. Results suggest that the number of neighboring states that have already adopted incentives are consistently a determinant of diffusion for all three types of incentives test, HOV lane exemptions, sales-tax exemptions, and income-tax exemptions. In terms of internal factors, constituent support, a type of political context, predicts, sale-tax, income-tax, and HOV lane exemptions, but that the other two classes of determinants, problem severity and institutional support, were not universally significant across types of incentives. Overall, these results suggest automobile manufacturing did not impact whether these policies were implemented, nor were they implemented to address air quality issues or gas price increases. Rather these policies were responses to popular support for hybrid vehicles. In addition, this dissertation identifies the average treatment effect of these incentives on state-level demand for hybrid vehicles. These effects are estimated using traditional parametric techniques, difference-in-difference regression, and fixed effects on two comparison groups: (1) the natural control group, states that did not adopt subsidies, and (2) a constructed control group, states that proposed subsidies during this same time period but did not adopt them. In addition to these parametric models, propensity score matching was used to construct a third comparison group using the models that identified determinants of the policy adoption. These findings were supplemented by exploratory analyses using the individual-level National Household Travel Survey. This multitude of evaluative analyses shows that overall, monetary hybrid incentives are not overwhelming effective in promoting the diffusion of this technology, but that HOV lane exemptions, however, if implemented in places with high traffic congestion, were found to impact aggregate demand and an individual's propensity to adopt a hybrid. The other two types of incentives, sales tax exemptions and income tax credits, were not found to be effective at the aggregate or the individual level. In addition, travel behavior was found to strongly predict adoption, more so than socioeconomic variables, stated attitudes, or characteristics of the built environment. The number of walking trips per month and the number of times a person used public transportation were found to be significant predictors of hybrid adoption, implying the decision to adopt a hybrid includes factors other than purely economic ones, such as environmental attitudes. These analyses provide insight into why states adopt certain policies and the circumstances in which these incentives are effective. Since people may be motivated by factors other than economic factors, creating effective incentives for energy efficiency technologies may be more challenging than just offsetting the price differential. Instead, customization to the local community's characteristics could help increase the efficacy of such policies.

78 FR 40084 - Proposed Requirement-Migrant Education Program Consortium Incentive Grant Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-03

... techniques may include ``identifying changing future compliance costs that might result from technological innovation or anticipated behavioral changes.'' We are issuing this proposed requirement only on a reasoned...

Application of advanced technology to space automation

NASA Technical Reports Server (NTRS)

Schappell, R. T.; Polhemus, J. T.; Lowrie, J. W.; Hughes, C. A.; Stephens, J. R.; Chang, C. Y.

1979-01-01

Automated operations in space provide the key to optimized mission design and data acquisition at minimum cost for the future. The results of this study strongly accentuate this statement and should provide further incentive for immediate development of specific automtion technology as defined herein. Essential automation technology requirements were identified for future programs. The study was undertaken to address the future role of automation in the space program, the potential benefits to be derived, and the technology efforts that should be directed toward obtaining these benefits.

Personal Health Record Use in the United States: Forecasting Future Adoption Levels

PubMed Central

Huerta, Timothy R

2016-01-01

Background Personal health records (PHRs) offer a tremendous opportunity to generate consumer support in pursing the triple aim of reducing costs, increasing access, and improving care quality. Moreover, surveys in the United States indicate that consumers want Web-based access to their medical records. However, concerns that consumers’ low health information literacy levels and physicians’ resistance to sharing notes will limit PHRs’ utility to a relatively small portion of the population have reduced both the product innovation and policy imperatives. Objective The purpose of our study was 3-fold: first, to report on US consumers’ current level of PHR activity; second, to describe the roles of imitation and innovation influence factors in determining PHR adoption rates; and third, to forecast future PHR diffusion uptake among US consumers under 3 scenarios. Methods We used secondary data from the Health Information National Trends Survey (HINTS) of US citizens for the survey years 2008, 2011, and 2013. Applying technology diffusion theory and Bass modeling, we evaluated 3 future PHR adoption scenarios by varying the introduction dates. Results All models displayed the characteristic diffusion S-curve indicating that the PHR technology is likely to achieve significant market penetration ahead of meaningful use goals. The best-performing model indicates that PHR adoption will exceed 75% by 2020. Therefore, the meaningful use program targets for PHR adoption are below the rates likely to occur without an intervention. Conclusions The promise of improved care quality and cost savings through better consumer engagement prompted the US Institute of Medicine to call for universal PHR adoption in 1999. The PHR products available as of 2014 are likely to meet and exceed meaningful use stage 3 targets before 2020 without any incentive. Therefore, more ambitious uptake and functionality availability should be incorporated into future goals. PMID:27030105

Effects of Deployment Investment on the Growth of the Biofuels Industry. 2016 Update

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vimmerstedt, Laura J.; Warner, Ethan S.; Stright, Dana

This report updates the 2013 report of the same title. Some text originally published in that report is retained and indicated in gray. In support of the national goals for biofuel use in the United States, numerous technologies have been developed that convert biomass to biofuels. Some of these biomass to biofuel conversion technology pathways are operating at commercial scales, while others are in earlier stages of development. The advancement of a new pathway toward commercialization involves various types of progress, including yield improvements, process engineering, and financial performance. Actions of private investors and public programs can accelerate the demonstrationmore » and deployment of new conversion technology pathways. These investors (both private and public) will pursue a range of pilot, demonstration, and pioneer scale biorefinery investments; the most cost-effective set of investments for advancing the maturity of any given biomass to biofuel conversion technology pathway is unknown. In some cases, whether or not the pathway itself will ultimately be technically and financially successful is also unknown. This report presents results from the Biomass Scenario Model--a system dynamics model of the biomass to biofuels system--that estimate effects of investments in biorefineries at different maturity levels and operational scales. The report discusses challenges in estimating effects of such investments and explores the interaction between this deployment investment and a volumetric production incentive. Model results show that investments in demonstration and deployment have a substantial growth impact on the development of the biofuels industry. Results also show that other conditions, such as accompanying incentives, have major impacts on the effectiveness of such investments. Results from the 2013 report are compared to new results. This report does not advocate for or against investments, incentives, or policies, but analyzes simulations of their hypothetical effects.« less

Design and baseline characteristics of participants in the Enhancing Physical Activity and Reducing Obesity through Smartcare and Financial Incentives (EPAROSFI): A pilot randomized controlled trial.

PubMed

Shin, Dong Wook; Joh, Hee-Kyung; Yun, Jae Moon; Kwon, Hyuk Tae; Lee, Hyejin; Min, Hyeyeon; Shin, Jung-Hyun; Chung, Won Joo; Park, Jin Ho; Cho, BeLong

2016-03-01

An activity tracker combined with a smartphone application (smartcare) may help people track and receive feedback on their own activities. However, activity trackers themselves generally fail to drive long-term sustained engagement for a majority of users. One potential strategy for increasing the effectiveness of smartcare is through the use of incentives. The purpose of this pilot randomized trial is to test the feasibility of our intervention and to assess the extent to which smartcare with or without financial incentives can increase physical activity levels and reduce weight over a 12-week period. This study employs a three-arm, open-label randomized controlled trial design: control (standard basic education), smartcare, and smartcare plus financial incentives. Male university students with body mass index ≥ 27 are enrolled. Our primary and secondary endpoints are the amount of weight loss and the level of physical activity respectively. The weight loss goal is 3% of baseline at week 4, 5% at week 8, and 7% at week 12. The daily physical activity goal was individualized according to the participants' weight. Process incentives are accumulated when participants met daily physical activity goals, and outcome incentives are provided when they met weight reduction goals. Given the global increase in physical inactivity and obesity, there is a growing need for effective, scalable, and affordable health promotion strategies. Our proof-of-concept study will provide the evidence for the combination of rising health promotion technology of activity trackers and smartphone applications with the modern concept of behavioral economics using financial incentives. Copyright © 2015. Published by Elsevier Inc.

The Use of Enhanced Appointment Access Strategies by Medical Practices.

PubMed

Rodriguez, Hector P; Knox, Margae; Hurley, Vanessa; Rittenhouse, Diane R; Shortell, Stephen M

2016-06-01

Strategies to enhance appointment access are being adopted by medical practices as part of patient-centered medical home (PCMH) implementation, but little is known about the use of these strategies nationally. We examine practice use of open access scheduling and after-hours care. Data were analyzed from the Third National Study of Physician Organizations (NSPO3) to examine which enhanced appointment access strategies are more likely to be used by practices with more robust PCMH capabilities and with greater external incentives. Logistic regression estimated the effect of PCMH capabilities and external incentives on practice use of open access scheduling and after-hours care. Physician organizations with >20% primary care physicians (n=1106). PCMH capabilities included team-based care, health information technology capabilities, quality improvement orientation, and patient experience orientation. External incentives included public reporting, pay-for-performance (P4P), and accountable care organization participation. A low percentage of practices (19.8%) used same-day open access scheduling, while after-hours care (56.1%) was more common. In adjusted analyses, system-owned practices and practices with greater use of team-based care, health information technology capabilities, and public reporting were more likely to use open access scheduling. Accountable care organization-affiliated practices and practices with greater use of public reporting and P4P were more likely to provide after-hours care. Open access scheduling may be most effectively implemented by practices with robust PCMH capabilities. External incentives appear to influence practice adoption of after-hours care. Expanding open access scheduling and after-hours care will require distinct policies and supports.

When do financial incentives reduce intrinsic motivation? comparing behaviors studied in psychological and economic literatures.

PubMed

Promberger, Marianne; Marteau, Theresa M

2013-09-01

To review existing evidence on the potential of incentives to undermine or "crowd out" intrinsic motivation, in order to establish whether and when it predicts financial incentives to crowd out motivation for health-related behaviors. We conducted a conceptual analysis to compare definitions and operationalizations of the effect, and reviewed existing evidence to identify potential moderators of the effect. In the psychological literature, we find strong evidence for an undermining effect of tangible rewards on intrinsic motivation for simple tasks when motivation manifest in behavior is initially high. In the economic literature, evidence for undermining effects exists for a broader variety of behaviors, in settings that involve a conflict of interest between parties. By contrast, for health related behaviors, baseline levels of incentivized behaviors are usually low, and only a subset involve an interpersonal conflict of interest. Correspondingly, we find no evidence for crowding out of incentivized health behaviors. The existing evidence does not warrant a priori predictions that an undermining effect would be found for health-related behaviors. Health-related behaviors and incentives schemes differ greatly in moderating characteristics, which should be the focus of future research. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Organ donation as an 'altruistic gift': incentives and reciprocity in deceased organ donation from a UK Polish migrant perspective.

PubMed

Sharp, Chloe; Randhawa, Gurch

2014-01-17

Incentives and reciprocity have been widely debated within the literature as an alternative to altruism to motivate the public to register and consent to organ donation. This pilot study was the first to examine the views of the UK Polish migrant community toward these issues. One-to-one and small group interviews were conducted in English and Polish to collect data. The interviews were recorded and transcribed and interviews in Polish were translated into English. All transcripts were coded, codes were grouped by theme and emergent themes were constantly compared to the new data until saturation. Participants were motivated to donate altruistically but would accept reciprocity for organs once consent was given. Payment for organs was viewed as unfavourable but participants would accept contribution toward funeral expenses. Deceased organ donation was viewed as an 'altruistic gift'. 'Altruism' and 'gift' are problematic in deceased organ donation and could explain the challenges that arise in the incentives and reciprocity debate. Mauss's gift exchange theory could frame incentives as forming the 'obligation to give' and could encourage registration but could lead to coercion. Reciprocity could benefit families and be viewed as 'fair' and a token of gratitude.

Life Cycle Assessment of Residential Heating and Cooling Systems in Minnesota A comprehensive analysis on life cycle greenhouse gas (GHG) emissions and cost-effectiveness of ground source heat pump (GSHP) systems compared to the conventional gas furnace and air conditioner system

NASA Astrophysics Data System (ADS)

Li, Mo

Ground Source Heat Pump (GSHP) technologies for residential heating and cooling are often suggested as an effective means to curb energy consumption, reduce greenhouse gas (GHG) emissions and lower homeowners' heating and cooling costs. As such, numerous federal, state and utility-based incentives, most often in the forms of financial incentives, installation rebates, and loan programs, have been made available for these technologies. While GSHP technology for space heating and cooling is well understood, with widespread implementation across the U.S., research specific to the environmental and economic performance of these systems in cold climates, such as Minnesota, is limited. In this study, a comparative environmental life cycle assessment (LCA) is conducted of typical residential HVAC (Heating, Ventilation, and Air Conditioning) systems in Minnesota to investigate greenhouse gas (GHG) emissions for delivering 20 years of residential heating and cooling—maintaining indoor temperatures of 68°F (20°C) and 75°F (24°C) in Minnesota-specific heating and cooling seasons, respectively. Eight residential GSHP design scenarios (i.e. horizontal loop field, vertical loop field, high coefficient of performance, low coefficient of performance, hybrid natural gas heat back-up) and one conventional natural gas furnace and air conditioner system are assessed for GHG and life cycle economic costs. Life cycle GHG emissions were found to range between 1.09 × 105 kg CO2 eq. and 1.86 × 10 5 kg CO2 eq. Six of the eight GSHP technology scenarios had fewer carbon impacts than the conventional system. Only in cases of horizontal low-efficiency GSHP and hybrid, do results suggest increased GHGs. Life cycle costs and present value analyses suggest GSHP technologies can be cost competitive over their 20-year life, but that policy incentives may be required to reduce the high up-front capital costs of GSHPs and relatively long payback periods of more than 20 years. In addition, results suggest that the regional electricity fuel mix and volatile energy prices significantly influence the benefits of employing GSHP technologies in Minnesota from both environmental and economic perspectives. It is worthy noting that with the historically low natural gas price in 2012, the conventional system's energy bill reduction would be large enough to bring its life-cycle cost below those of the GSHPs. As a result, the environmentally favorable GSHP technologies would become economically unfavorable, unless they are additionally subsidized. Improved understanding these effects, along with design and performance characteristics of GSGP technologies specific to Minnesota's cold climate, allows better decision making among homeowners considering these technologies and policy makers providing incentives for alternative energy solutions.

The Federal Workforce Restructuring Act of 1993. Hearing on S. 1535 To Amend Title 5, United States Code, To Eliminate Narrow Restrictions on Employee Training, To Provide a Temporary Voluntary Separation Incentive, and For Other Purposes before the Committee on Governmental Affairs. United States Senate, One Hundred Third Congress, First Session (October 19, 1993).

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Governmental Affairs.

This document records the oral and written testimony of witnesses who testified at a hearing on a proposed amendment to the Federal Workforce Restructuring Act of 1993. The amendment would spell out how the federal work force is to be reduced in size and would provide cash incentives for early retirement as well as make retraining of existing…

Impact of the HITECH Act on physicians' adoption of electronic health records.

PubMed

Mennemeyer, Stephen T; Menachemi, Nir; Rahurkar, Saurabh; Ford, Eric W

2016-03-01

The Health Information Technology for Economic and Clinical Health (HITECH) Act has distributed billions of dollars to physicians as incentives for adopting certified electronic health records (EHRs) through the meaningful use (MU) program ultimately aimed at improving healthcare outcomes. The authors examine the extent to which the MU program impacted the EHR adoption curve that existed prior to the Act. Bass and Gamma Shifted Gompertz (G/SG) diffusion models of the adoption of "Any" and "Basic" EHR systems in physicians' offices using consistent data series covering 2001-2013 and 2006-2013, respectively, are estimated to determine if adoption was stimulated during either a PrePay (2009-2010) period of subsidy anticipation or a PostPay (2011-2013) period when payments were actually made. Adoption of Any EHR system may have increased by as much as 7 percentage points above the level predicted in the absence of the MU subsidies. This estimate, however, lacks statistical significance and becomes smaller or negative under alternative model specifications. No substantial effects are found for Basic systems. The models suggest that adoption was largely driven by "imitation" effects (q-coefficient) as physicians mimic their peers' technology use or respond to mandates. Small and often insignificant "innovation" effects (p-coefficient) are found suggesting little enthusiasm by physicians who are leaders in technology adoption. The authors find weak evidence of the impact of the MU program on EHR uptake. This is consistent with reports that many current EHR systems reduce physician productivity, lack data sharing capabilities, and need to incorporate other key interoperability features (e.g., application program interfaces). © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Economic and technological aspects of the market introduction of renewable power technologies

NASA Astrophysics Data System (ADS)

Worlen, Christine M.

Renewable energy, if developed and delivered with appropriate technologies, is cleaner, more evenly distributed, and safer than conventional energy systems. Many countries and several states in the United States promote the development and introduction of technologies for "green" electricity production. This dissertation investigates economic and technological aspects of this process for wind energy. In liberalized electricity markets, policy makers use economic incentives to encourage the adoption of renewables. Choosing from a large range of possible policies and instruments is a multi-criteria decision process. This dissertation evaluates the criteria used and the trade-offs among the criteria, and develops a hierarchical flow scheme that policy makers can use to choose the most appropriate policy for a given situation. Economic incentives and market transformation programs seek to reduce costs through mass deployment in order to make renewable technologies competitive. Cost reduction is measured in "experience curves" that posit negative exponential relationships between cumulative deployment and production cost. This analysis reveals the weaknesses in conventional experience curve analyses for wind turbines, and concludes that the concept is limited by data availability, a weak conceptual foundation, and inappropriate statistical estimation. A revised model specifies a more complete set of economic and technological forces that determine the cost of wind power. Econometric results indicate that experience and upscaling of turbine sizes accounted for the observed cost reduction in wind turbines in the United States, Denmark and Germany between 1983 and 2001. These trends are likely to continue. In addition, future cost reductions will result from economies of scale in production. Observed differences in the performance of theoretically equivalent policy instruments could arise from economic uncertainty. To test this hypothesis, a methodology for the quantitative comparison of economic incentive schemes and their effect on uncertainty and investor behavior in renewable power markets is developed using option value theory of investment. Critical investment thresholds compared with actual benefit-cost ratios for several case studies in Germany indicate that uncertainty in prices for wind power and green certificates would delay investment. In Germany, the fixed-tariff system effectively removes this barrier.

Combined heat and power systems: economic and policy barriers to growth.

PubMed

Kalam, Adil; King, Abigail; Moret, Ellen; Weerasinghe, Upekha

2012-04-23

Combined Heat and Power (CHP) systems can provide a range of benefits to users with regards to efficiency, reliability, costs and environmental impact. Furthermore, increasing the amount of electricity generated by CHP systems in the United States has been identified as having significant potential for impressive economic and environmental outcomes on a national scale. Given the benefits from increasing the adoption of CHP technologies, there is value in improving our understanding of how desired increases in CHP adoption can be best achieved. These obstacles are currently understood to stem from regulatory as well as economic and technological barriers. In our research, we answer the following questions: Given the current policy and economic environment facing the CHP industry, what changes need to take place in this space in order for CHP systems to be competitive in the energy market? We focus our analysis primarily on Combined Heat and Power Systems that use natural gas turbines. Our analysis takes a two-pronged approach. We first conduct a statistical analysis of the impact of state policies on increases in electricity generated from CHP system. Second, we conduct a Cost-Benefit analysis to determine in which circumstances funding incentives are necessary to make CHP technologies cost-competitive. Our policy analysis shows that regulatory improvements do not explain the growth in adoption of CHP technologies but hold the potential to encourage increases in electricity generated from CHP system in small-scale applications. Our Cost-Benefit analysis shows that CHP systems are only cost competitive in large-scale applications and that funding incentives would be necessary to make CHP technology cost-competitive in small-scale applications. From the synthesis of these analyses we conclude that because large-scale applications of natural gas turbines are already cost-competitive, policy initiatives aimed at a CHP market dominated primarily by large-scale (and therefore already cost-competitive) systems have not been effectively directed. Our recommendation is that for CHP technologies using natural gas turbines, policy focuses should be on increasing CHP growth in small-scale systems. This result can be best achieved through redirection of state and federal incentives, research and development, adoption of smart grid technology, and outreach and education.

42 CFR 413.70 - Payment for services of a CAH.

Code of Federal Regulations, 2010 CFR

2010-10-01

... receives an incentive payment for the reasonable costs of purchasing certified EHR technology in a cost..., nurse practitioner, or clinical nurse specialist who is on call” means a doctor of medicine or...

42 CFR 413.70 - Payment for services of a CAH.

Code of Federal Regulations, 2014 CFR

2014-10-01

... receives an incentive payment for the reasonable costs of purchasing certified EHR technology in a cost..., nurse practitioner, or clinical nurse specialist who is on call” means a doctor of medicine or...

42 CFR 413.70 - Payment for services of a CAH.

Code of Federal Regulations, 2011 CFR

2011-10-01

... receives an incentive payment for the reasonable costs of purchasing certified EHR technology in a cost... call” means a doctor of medicine or osteopathy, a physician assistant, a nurse practitioner, or a...

42 CFR 413.70 - Payment for services of a CAH.

Code of Federal Regulations, 2013 CFR

2013-10-01

... receives an incentive payment for the reasonable costs of purchasing certified EHR technology in a cost... call” means a doctor of medicine or osteopathy, a physician assistant, a nurse practitioner, or a...

Use of incentives to encourage ITS deployment.

DOT National Transportation Integrated Search

2014-07-01

Moving Ahead for Progress in the 21st Century Act (MAP-21) identifies Intelligent Transportation Systems (ITS) as part of the solution to the Nations transportation needs and provides mechanisms for accelerating deployment of innovative technology...

Electricity distribution networks: Changing regulatory approaches

NASA Astrophysics Data System (ADS)

Cambini, Carlo

2016-09-01

Increasing the penetration of distributed generation and smart grid technologies requires substantial investments. A study proposes an innovative approach that combines four regulatory tools to provide economic incentives for distribution system operators to facilitate these innovative practices.

Veggie Rx: an outcome evaluation of a healthy food incentive programme.

PubMed

Cavanagh, Michelle; Jurkowski, Janine; Bozlak, Christine; Hastings, Julia; Klein, Amy

2017-10-01

One challenge to healthy nutrition, especially among low-income individuals, is access to and consumption of fresh fruits and vegetables. To address this problem, Veggie Rx, a healthy food incentive programme, was established within a community clinic to increase access to fresh produce for low-income patients diagnosed with obesity, hypertension and/or type 2 diabetes. The current research aimed to evaluate Veggie Rx programme effectiveness. A retrospective pre/post design using medical records and programme data was used to evaluate the programme. The study was approved by the University of Albany Institutional Review Board and the Patient Interest Committee of a community clinic. The study was conducted in a low-income, urban neighbourhood in upstate New York. Medical record data and Veggie Rx programme data were analysed for fifty-four eligible participants. An equal-sized control group of patients who were not programme participants were matched on age, ethnicity and co-morbidity status. A statistically significant difference in mean BMI change (P=0·02) between the intervention and the control group was calculated. The intervention group had a mean decrease in BMI of 0·74 kg/m2. Greater improvement in BMI was found among Veggie Rx programme participants. This information will guide programme changes and inform the field on the effectiveness of healthy food incentive programmes for improving health outcomes for low-income populations.

Veggie Rx: an outcome evaluation of a healthy food incentive programme

PubMed Central

Cavanagh, Michelle; Jurkowski, Janine; Bozlak, Christine; Hastings, Julia; Klein, Amy

2017-01-01

Objective One challenge to healthy nutrition, especially among low-income individuals, is access to and consumption of fresh fruits and vegetables. To address this problem, Veggie Rx, a healthy food incentive programme, was established within a community clinic to increase access to fresh produce for low-income patients diagnosed with obesity, hypertension and/or type 2 diabetes. The current research aimed to evaluate Veggie Rx programme effectiveness. Design A retrospective pre/post design using medical records and programme data was used to evaluate the programme. The study was approved by the University of Albany Institutional Review Board and the Patient Interest Committee of a community clinic. Setting The study was conducted in a low-income, urban neighbourhood in upstate New York. Subjects Medical record data and Veggie Rx programme data were analysed for fifty-four eligible participants. An equal-sized control group of patients who were not programme participants were matched on age, ethnicity and co-morbidity status. Results: A statistically significant difference in mean BMI change (P = 0.02) between the intervention and the control group was calculated. The intervention group had a mean decrease in BMI of 0.74 kg/m2. Conclusions Greater improvement in BMI was found among Veggie Rx programme participants. This information will guide programme changes and inform the field on the effectiveness of healthy food incentive programmes for improving health outcomes for low-income populations. PMID:27539192

Education Offered Via Telecommunications: Trends, Issues, and State-Level Problems in Instructional Technology for Colleges and Universities. Report 87-49.

ERIC Educational Resources Information Center

California State Postsecondary Education Commission, Sacramento.

Issues concerning telecommunications courses offered by California universities and colleges are reviewed with a focus on the progress made over the past 6 years regarding the lack of incentives for faculty to use instructional technology in their teaching, lack of coordination among interested institutions and agencies, and high initial costs for…

Nineteen Patents Issued in 2012 for Inventions by Frederick Researchers | Poster

Cancer.gov

By Karen Surabian, Contributing Writer Patents provide a period of exclusivity and are a way to exclude others from making, using, or selling an inventor’s novel technology. For the National Institutes of Health (NIH), patents are an incentive for an outside party to license, develop, and commercialize NIH technologies that will benefit public health, especially those that

Fuel Cell Electric Vehicles: Drivers and Impacts of Adoption.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Levinson, Rebecca Sobel; West, Todd H.; Manley, Dawn K.

We present scenario and parametric analyses of the US light duty vehicle (LDV) stock, sim- ulating the evolution of the stock in order to assess the potential role and impacts of fuel cell electric vehicles (FCEVs). The analysis probes the competition of FCEVs with other LDVs and the effects of FCEV adoption on LDV fuel use and emissions. We parameterize commodity and technology prices in order to explore the sensitivities of FCEV sales and emissions to oil, natural gas, battery technology, fuel cell technology, and hydrogen produc- tion prices. We additionally explore the effects of vehicle purchasing incentives for FCEVs,more » identifying potential impacts and tipping points. Our analyses lead to the following conclu- sions: (1) In the business as usual scenario, FCEVs comprise 7% of all new LDV sales by 2050. (2) FCEV adoption will not substantially impact green house gas emissions without either policy intervention, significant increases in natural gas prices, or technology improve- ments that motivate low carbon hydrogen production. (3) FCEV technology cost reductions have a much greater potential for impact on FCEV sales than hydrogen fuel cost reductions. (4) FCEV purchasing incentives must be both substantial and sustained in order to motivate lasting changes to FCEV adoption.« less

[Medical doctors driving technological innovation: questions about and innovation management approaches to incentive structures for lead users].

PubMed

Bohnet-Joschko, Sabine; Kientzler, Fionn

2010-01-01

Management science defines user-generated innovations as open innovation and lead user innovation. The medical technology industry finds user-generated innovations profitable and even indispensable. Innovative medical doctors as lead users need medical technology innovations in order to improve patient care. Their motivation to innovate is mostly intrinsic. But innovations may also involve extrinsic motivators such as gain in reputation or monetary incentives. Medical doctors' innovative activities often take place in hospitals and are thus embedded into the hospital's organisational setting. Hospitals find it difficult to gain short-term profits from in-house generated innovations and sometimes hesitate to support them. Strategic investment in medical doctors' innovative activities may be profitable for hospitals in the long run if innovations provide first-mover competitive advantages. Industry co-operations with innovative medical doctors offer chances but also bear potential risks. Innovative ideas generated by expert users may result in even higher complexity of medical devices; this could cause mistakes when applied by less specialised users and thus affect patient safety. Innovations that yield benefits for patients, medical doctors, hospitals and the medical technology industry can be advanced by offering adequate support for knowledge transfer and co-operation models.

Lean systems approaches to health technology assessment: a patient-focused alternative to cost-effectiveness analysis.

PubMed

Bridges, John F P

2006-12-01

Many countries now use health technology assessment (HTA) to review new and emerging technologies, especially with regard to reimbursement, pricing and/or clinical guidelines. One of the common, but not universal, features of these systems is the use of economic evaluation, normally cost-effectiveness analysis (CEA), to confirm that new technologies offer value for money. Many have criticised these systems as primarily being concerned with cost containment, rather than advancing the interests of patients or innovators. This paper calls into question the underlying principles of CEA by arguing that value in the healthcare system may in fact be unconstrained. It is suggested that 'lean management principles' can be used not only to trim waste from the health system, but as a method of creating real incentives for innovation and value creation. Following the lean paradigm, this value must be defined purely from the patients' perspective, and the entire health system needs to work towards the creation of such value. This paper offers as a practical example a lean approach to HTA, arguing that such an approach would lead to better incentives for innovation in health, as well as more patient-friendly outcomes in the long run.

Stabilizing the boundary between US politics and science: the role of the Office of Technology Transfer as a boundary organization.

PubMed

Guston, D H

1999-02-01

The sociological study of boundary-work and the political-ecomomic approach of principal-agent theory can be complementary ways of examining the relationship between society and science: boundary-work provides the empirical nuance to the principal-agent scheme, and principal-agent theory provides structure to the thick boundary description. This paper motivates this complementarity to examine domestic technology transfer in the USA from the intramural laboratories of the US National Institutes of Health (NIH). It casts US policy for technology transfer in the principal-agent framework, in which politicians attempt to manage the moral hazard of the productivity of research by providing specific incentives to the agents for engaging in measurable research-based innovation. Such incentives alter the previously negotiated boundary between politics and science. The paper identifies the crucial role of the NIH Office of Technology Transfer (OTT) as a boundary organization, which medicates the new boundary negotiations in its routine work, and stabilizes the boundary by performing successfully as an agent for both politicians and scientists. The paper hypothesizes that boundary organizations like OTT are general phenomena at the boundary between politics and science.

Thinking outside the medicine cabinet: a comparative content analysis of direct-to-consumer advertisements for prescription drug treatments.

PubMed

McKeever, Robert

2014-01-01

This study content analyzed online direct-to-consumer advertisements (DTCA) for prescription drug treatments to explore whether ads for prescription treatments for psychiatric conditions, which are commonly untreated, differ from other drug advertisements. Coded variables included the presence of interactive technological components, use of promotional incentives, and the social contexts portrayed in images shown on each site. Statistical analysis revealed ads for psychiatric medications contained fewer interactive website features, financial incentives, and calls to action than other types of prescription drug advertisements. Implications for health communication researchers are discussed.

Green Development Status in Zhejiang Province and the City of Ningbo, China: Examination of Policies, Strategies and Incentives at Multiple Levels

NASA Astrophysics Data System (ADS)

Cheshmehzangi, Ali; Deng, Wu; Zhang, Yun; Xie, Linjun

2017-05-01

China is undergoing the largest scale of urbanization in history and at an unprecedented pace. The construction and operation of buildings have inevitably brought severe pressures on resource conservation and environmental protection. China has initiated policies, strategies and financial incentive schemes at national level to address these issues. It is also seen that there is a growing interest in recent years at local government level in promoting green buildings. This paper will examine the current national policies, targets and standards and then discuss how these national initiatives are reflected at provincial and city level by taking Zhejiang Province and Ningbo City as case studies. A comparison between different levels of initiatives is conducted by reviewing incentive mechanisms, technological development and compliance requirements. It is concluded that the national initiatives may be not effective without local enhancement.

California Publicly-Owned Utilities (POUs) – LBNL ‘Beyond Widgets’ Project. Task: ambient lighting and occupancy-based plug load control. System Program Manual

DOE Office of Scientific and Technical Information (OSTI.GOV)

Robinson, Alastair; Mathew, Paul A.; Regnier, Cynthia

This program manual contains detailed technical information for implementing an incentive program for task-ambient lighting and occupancy-based plug load control. This manual was developed by Lawrence Berkeley National Laboratory, in collaboration with the California Publicly-Owned Utilities (CA POUs) as a partner in the ‘Beyond Widgets’ program funded by the U.S. Department of Energy Building Technologies Office. The primary audience for this manual is the program staff of the various CA POUs. It may also be used by other utility incentive programs to help develop similar programs. It is anticipated that the content of this manual be utilized by the CAmore » POU staff for developing related documents such as the Technical Resource Manual and other filings pertaining to the rollout of an energy systems-based rebate incentive program.« less

Identifying organizational capacities and incentives for clinical data-sharing: the case of a regional perinatal information system.

PubMed

Korst, Lisa M; Signer, Jordana M K; Aydin, Carolyn E; Fink, Arlene

2008-01-01

The development of regional data-sharing among healthcare organizations is viewed as an important step in the development of health information technology (HIT), but little is known about this complex task. This is a case study of a regional perinatal data system that involved four hospitals, together responsible for over 10,000 births annually. Using standard qualitative methods, we chronicled project milestones, and identified 31 "critical incidents" that delayed or prevented their achievement. We then used these critical incidents to articulate six organizational capacity domains associated with the achievement of project milestones, and a seventh domain consisting of organizational incentives. Finally, we analyzed the relationship of milestone achievement to the presence of these capacities and incentives. This data center case suggests four requirements for sharing data across organizations: 1) a readiness assessment; 2) a perceived mandate; 3) a formal governance structure; and 4) a third party IT component.

Rising Pulpwood Prices Stimulate Largest Lake States Pulpwood Harvest, 1966

Treesearch

James E. Blyth

1967-01-01

The 1966 Lake States pulpwood harvest climbed to 4 1/2 million cords, an 18 percent increase from 1965. Woods labor continued to be scarce, but a better logging season coupled with the higher prices provided the incentive for reaching the record harvest.

76 FR 47592 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-05

... Federal financial participation for expenditures under their Medicaid Electronic Health Record Incentive... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [Document...), Department of Health and Human Services, is publishing the following summary of proposed collections for...

Ridesharing options analysis and practitioners' toolkit

DOT National Transportation Integrated Search

2010-12-01

The purpose of this toolkit is to elaborate upon the recent changes in ridesharing, introduce the wide variety that exists in ridesharing programs today, and the developments in technology and funding availability that create greater incentives for p...

Energy and Environment Guide to Action - Chapter 4.2: Energy Efficiency Programs

EPA Pesticide Factsheets

Provides guidance and recommendations for designing, funding, and implementing effective energy efficiency programs, which provide a range of financial and other incentives to encourage investments in energy-efficient technologies and behavior change.

7 CFR 1466.23 - Payment rates.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) Residue management; (B) Nutrient management; (C) Air quality management; (D) Invasive species management; (E) Pollinator habitat development or improvement; (F) Animal carcass management technology; or (G... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS ENVIRONMENTAL QUALITY INCENTIVES PROGRAM Contracts and...

Hybrid Storage Market Assessment: A JISEA White Paper

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ericson, Sean J.; Rose, Eric; Jayaswal, Harshit

This white paper evaluates which markets are best suited for battery storage and storage hybrids and reviews regulations and incentives that support or impede the implementation of standalone storage and battery hybrids. The costs of battery storage technologies have dropped in recent years, resulting in a seven-fold increase in installed capacity over the last decade (1). These technologies offer an attractive rate of return in some locations; however, cost and regulatory barriers still limit the market for storage. Hybridizing a battery (combining the battery with a generator) can in some instances reduce total system costs and increase value compared tomore » separate installations. The fast ramping and dispatchability of a battery can complement the generator to provide services that neither battery nor generator could provide alone. Battery hybrids also benefit from some policy incentives and may be better able to meet market and regulatory requirements.« less

Wind power for the electric-utility industry: Policy incentives for fuel conservation

NASA Astrophysics Data System (ADS)

March, F.; Dlott, E. H.; Korn, D. H.; Madio, F. R.; McArthur, R. C.; Vachon, W. A.

1982-06-01

A systematic method for evaluating the economics of solar-electric/conservation technologies as fuel-savings investments for electric utilities in the presence of changing federal incentive policies is presented. The focus is on wind energy conversion systems (WECS) as the solar technology closest to near-term large scale implementation. Commercially available large WECS are described, along with computer models to calculate the economic impact of the inclusion of WECS as 10% of the base-load generating capacity on a grid. A guide to legal structures and relationships which impinge on large-scale WECS utilization is developed, together with a quantitative examination of the installation of 1000 MWe of WECS capacity by a utility in the northeast states. Engineering and financial analyses were performed, with results indicating government policy changes necessary to encourage the entrance of utilities into the field of windpower utilization.

Mobile Phone Incentives for Childhood Immunizations in Rural India.

PubMed

Seth, Rajeev; Akinboyo, Ibukunoluwa; Chhabra, Ankur; Qaiyum, Yawar; Shet, Anita; Gupte, Nikhil; Jain, Ajay K; Jain, Sanjay K

2018-04-01

Young children in resource-poor settings remain inadequately immunized. We evaluated the role of compliance-linked incentives versus mobile phone messaging to improve childhood immunizations. Children aged ≤24 months from a rural community in India were randomly assigned to either a control group or 1 of 2 study groups. A cloud-based, biometric-linked software platform was used for positive identification, record keeping for all groups, and delivery of automated mobile phone reminders with or without compliance-linked incentives (Indian rupee Rs30 or US dollar $0.50 of phone talk time) for the study groups. Immunization coverage was analyzed by using multivariable Poisson regression. Between July 11, 2016, and July 20, 2017, 608 children were randomly assigned to the study groups. Five hundred and forty-nine (90.3%) children fulfilled eligibility criteria, with a median age of 5 months; 51.4% were girls, 83.6% of their mothers had no schooling, and they were in the study for a median duration of 292 days. Median immunization coverage at enrollment was 33% in all groups and increased to 41.7% (interquartile range [IQR]: 23.1%-69.2%), 40.1% (IQR: 30.8%-69.2%), and 50.0% (IQR: 30.8%-76.9%) by the end of the study in the control group, the group with mobile phone reminders, and the compliance-linked incentives group, respectively. The administration of compliance-linked incentives was independently associated with improvement in immunization coverage and a modest increase in timeliness of immunizations. Compliance-linked incentives are an important intervention for improving the coverage and timeliness of immunizations in young children in resource-poor settings. Copyright © 2018 by the American Academy of Pediatrics.

Impact of e-alert systems on the care of patients with acute kidney injury.

PubMed

Breighner, Crystal M; Kashani, Kianoush B

2017-09-01

With the recent advancement in electronic health record systems and meaningful use of information technology incentive programs (i.e., the American Recovery and Reinvestment Act, the Health Information Technology for Economic and Clinical Health Act, and the Centers for Medicare & Medicaid Services), interest in clinical decision support systems has risen. These systems have been used to examine a variety of different syndromes with variable reported effects. In recent years, electronic alerts (e-alerts) have been implemented at various institutions to decrease the morbidity associated with acute kidney injury (AKI). AKI is common, accounting for 1 in 7 hospital admissions, and is associated with increased length of hospital stay and mortality. AKI is often underrecognized, causing delayed intervention. The use of e-alerts may result in earlier recognition and intervention, as well as decreased morbidity and mortality. This must be balanced with the possibility of increased resource utilization that e-alerts may cause. Before widespread implementation, the ethical and legal consequences of not following e-alert recommendations must be established, and the optimal algorithm for AKI e-alert detection must be determined. Copyright © 2017 Elsevier Ltd. All rights reserved.

The public role in promoting child health information technology.

PubMed

Conway, Patrick H; White, P Jonathan; Clancy, Carolyn

2009-01-01

The public sector plays an important role in promoting child health information technology. Public sector support is essential in 5 main aspects of child health information technology, namely, data standards, pediatric functions in health information systems, privacy policies, research and implementation funding, and incentives for technology adoption. Some innovations in health information technology for adult populations can be transferred to or adapted for children, but there also are unique needs in the pediatric population. Development of health information technology that addresses children's needs and effective adoption of that technology are critical for US children to receive care of the highest possible quality in the future.

Measuring the incentive value of escalating doses of heroin in heroin-dependent Fischer rats during acute spontaneous withdrawal

PubMed Central

Reed, Brian; Ho, Ann; Kreek, Mary Jeanne

2011-01-01

Rationale/objectives Although continued heroin use and relapse are thought to be motivated, in part, by the positive incentive-motivational value attributed to heroin, little is understood about heroin’s incentive value during the relapse-prone state of withdrawal. This study uses place preference to measure the incentive value attributed to escalating-dose heroin in the context of heroin dependence. Methods Male Fischer rats were exposed chronically to escalating doses of heroin in the homecage and during place preference conditioning sessions. Conditioned preference for the context paired with escalating-dose heroin was tested after homecage exposure was discontinued and rats entered acute spontaneous withdrawal. Individuals’ behavioral and locomotor responses to heroin and somatic withdrawal signs were recorded. Results Conditioned preference for the heroin-paired context was strong in rats that received chronic homecage exposure to escalating-dose heroin and were tested in acute withdrawal. Behavioral responses to heroin (e.g., stereotypy) varied widely across individuals, with rats that expressed stronger heroin preference also expressing stronger behavioral activation in response to heroin. Individual differences in preference were also related to locomotor responses to heroin but not to overt somatic withdrawal signs. Conclusions Escalating doses of heroin evoked place preference in rats, suggesting that positive incentive-motivational value is attributed to this clinically relevant pattern of drug exposure. This study offers an improved preclinical model for studying dependence and withdrawal and provides insight into individual vulnerabilities to addiction-like behavior. PMID:21748254

Alaska's renewable energy potential.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

2009-02-01

This paper delivers a brief survey of renewable energy technologies applicable to Alaska's climate, latitude, geography, and geology. We first identify Alaska's natural renewable energy resources and which renewable energy technologies would be most productive. e survey the current state of renewable energy technologies and research efforts within the U.S. and, where appropriate, internationally. We also present information on the current state of Alaska's renewable energy assets, incentives, and commercial enterprises. Finally, we escribe places where research efforts at Sandia National Laboratories could assist the state of Alaska with its renewable energy technology investment efforts.

Solar geoengineering economics: From incredible to inevitable and half-way back

NASA Astrophysics Data System (ADS)

Harding, Anthony; Moreno-Cruz, Juan B.

2016-12-01

Solar geoengineering technologies are unique in many ways, and the economic incentives they could unleash are just as interesting. Since their introduction as a potential alternative, economists have been intrigued by the potential of these technologies to dramatically alter the way we think about climate policy. As our scientific understanding of the technologies evolve, so does the way economists think about them. In this paper, we document the evolution of economic thinking around these technologies since before Crutzen (2006) until today and provide some fruitful areas for further research.

Does the Effort of Processing Potential Incentives Influence the Adaption of Context Updating in Older Adults?

PubMed Central

Schmitt, Hannah; Kray, Jutta; Ferdinand, Nicola K.

2017-01-01

A number of aging studies suggest that older adults process positive and negative information differently. For instance, the socioemotional selectivity theory postulates that older adults preferably process positive information in service of emotional well-being (Reed and Carstensen, 2012). Moreover, recent research has started to investigate whether incentives like gains or losses can influence cognitive control in an ongoing task. In an earlier study (Schmitt et al., 2015), we examined whether incentive cues, indicating potential monetary gains, losses, or neutral outcomes for good performance in the following trial, would influence older adults’ ability to exert cognitive control. Cognitive control was measured in an AX-Continuous-Performance-Task (AX-CPT) in which participants had to select their responses to probe stimuli depending on a preceding context cue. In this study, we did not find support for a positivity effect in older adults, but both gains and losses led to enhanced context processing. As the trial-wise presentation mode may be too demanding on cognitive resources for such a bias to occur, the main goal of the present study was to examine whether motivational mindsets, induced by block-wise presentation of incentives, would result in a positivity effect. For this reason, we examined 17 older participants (65–76 years) in the AX-CPT using a block-wise presentation of incentive cues and compared them to 18 older adults (69–78 years) with the trial-wise presentation mode from our earlier study (Schmitt et al., 2015). Event-related potentials were recorded to the onset of the motivational cue and during the AX-CPT. Our results show that (a) older adults initially process cues signaling potential losses more strongly, but later during the AX-CPT invest more cognitive resources in preparatory processes like context updating in conditions with potential gains, and (b) block-wise and trial-wise presentation of incentive cues differentially influenced cognitive control. When incentives were presented block-wise, the above described valence effects were consistently found. In contrast, when incentives were presented trial-wise, the effects were mixed and salience as well as valence effects can be obtained. Hence, how positive and negative incentive cues influence cognitive control in older adults is dependent on demands of cue processing. PMID:29170649

Does the Effort of Processing Potential Incentives Influence the Adaption of Context Updating in Older Adults?

PubMed

Schmitt, Hannah; Kray, Jutta; Ferdinand, Nicola K

2017-01-01

A number of aging studies suggest that older adults process positive and negative information differently. For instance, the socioemotional selectivity theory postulates that older adults preferably process positive information in service of emotional well-being (Reed and Carstensen, 2012). Moreover, recent research has started to investigate whether incentives like gains or losses can influence cognitive control in an ongoing task. In an earlier study (Schmitt et al., 2015), we examined whether incentive cues, indicating potential monetary gains, losses, or neutral outcomes for good performance in the following trial, would influence older adults' ability to exert cognitive control. Cognitive control was measured in an AX-Continuous-Performance-Task (AX-CPT) in which participants had to select their responses to probe stimuli depending on a preceding context cue. In this study, we did not find support for a positivity effect in older adults, but both gains and losses led to enhanced context processing. As the trial-wise presentation mode may be too demanding on cognitive resources for such a bias to occur, the main goal of the present study was to examine whether motivational mindsets, induced by block-wise presentation of incentives, would result in a positivity effect. For this reason, we examined 17 older participants (65-76 years) in the AX-CPT using a block-wise presentation of incentive cues and compared them to 18 older adults (69-78 years) with the trial-wise presentation mode from our earlier study (Schmitt et al., 2015). Event-related potentials were recorded to the onset of the motivational cue and during the AX-CPT. Our results show that (a) older adults initially process cues signaling potential losses more strongly, but later during the AX-CPT invest more cognitive resources in preparatory processes like context updating in conditions with potential gains, and (b) block-wise and trial-wise presentation of incentive cues differentially influenced cognitive control. When incentives were presented block-wise, the above described valence effects were consistently found. In contrast, when incentives were presented trial-wise, the effects were mixed and salience as well as valence effects can be obtained. Hence, how positive and negative incentive cues influence cognitive control in older adults is dependent on demands of cue processing.

The journey of primary care practices to meaningful use: a Colorado Beacon Consortium study.

PubMed

Fernald, Douglas H; Wearner, Robyn; Dickinson, W Perry

2013-01-01

The Health Information Technology for Economic and Clinical Health Act of 2009 provides for incentive payments through Medicare and Medicaid for clinicians who implement electronic health records (EHRs) and use this technology meaningfully to improve patient care. There are few comprehensive descriptions of how primary care practices achieve the meaningful use of clinical data, including the formal stage 1 meaningful use requirements. Evaluation of the Colorado Beacon Consortium project included iterative qualitative analysis of practice narratives, provider and staff interviews, and separate focus groups with quality improvement (QI) advisors and staff from the regional health information exchange (HIE). Most practices described significant realignment of practice priorities and aims, which often required substantial education and training of physicians and staff. Re-engineering office processes, data collection protocols, EHRs, staff roles, and practice culture comprised the primary effort and commitment to attest to stage 1 meaningful use and subsequent meaningful use of clinical data. While realizing important benefits, practices bore a significant burden in learning the true capabilities of their EHRs with little effective support from vendors. Attestation was an important initial milestone in the process, but practices faced substantial ongoing work to use their data meaningfully for patient care and QI. Key resources were instrumental to these practices: local technical EHR expertise; collaborative learning mechanisms; and regular contact and support from QI advisors. Meeting the stage 1 requirements for incentives under Medicare and Medicaid meaningful use criteria is the first waypoint in a longer journey by primary care practices to the meaningful use of electronic data to continuously improve the care and health of their patients. The intensive re-engineering effort for stage 1 yielded practice changes consistent with larger practice aims and goals. While many of these practices are now poised to use data meaningfully, faster progress will likely come with continued local QI and technical support and planned community-wide learning.

A Study of China s Explosive Growth in the Plug-in Electric Vehicle Market

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ou, Shawn; Lin, Zhenhong; Wu, Zhixin

The year 2015 marks a turning point in China s plug-in electric vehicle (PEV) or new energy vehicle (NEV) industry, with an explosive growth in both productions and sales, following the gloomy period of 2009-2012. The PEV production in 2015 reached a record level of nearly 380,000 units, a 352 % increase from 2014, making China the largest PEV market in the world. For the potential implications on energy and the environment, it is worth studying the driving forces of China s PEV market and understanding its future trajectory and dynamics. The key findings of this report are listed inmore » the following. Though controversial, the government monetary incentives have played a significant role to impel China to be the largest light PEV (191,100 units) market in the world. Chinese vehicle buyers appear more price sensitive on PEVs. Inexpensive low-cost micro electric vehicles are the most popular vehicle model in China s PEV market (38.9 % of the PEV market in 2015). In contrast, the premium or luxury vehicles are more popular in the gasoline vehicle segment. In fact, China is expected to be the largest premium car market in 2016. The PEV sales growth is primarily possible because of the young domestic private-owned auto manufacturers, which are mostly located in south China. Top-tier conventional vehicle automakers in China appear to be less proactive in the PEV market, based on market shares. This is in clear contrast to the U.S. market, where major automakers are generally the primary players in the PEV market. The PEVs produced by the domestic automakers are concentrated in the low-end market segment, while the high-end vehicle segment is dominated by the foreign brands. At present, the substantial market growth and government subsidies afford the domestic entrants to quickly gain profits in the low-end segment. The PEV consumers in China are very sensitive to the vehicle price, thus prefer the PEVs with cheaper prices after government subsidies, and care less about the driving quality and comfort. In contrast, most PEV consumers in the United States (U.S.) have higher incomes, view the PEVs as a high-status symbol, and care less about the vehicle prices, and therefore welcome the premium PEVs more in the U.S. The PEV financial subsidies by the Chinese government are divided into three stages based on the strategic directions and policies. In 2009 2012, government incentives concentrated on the public fleet vehicles, while excluding the individual consumers from the subsidies in most cities. In 2013 2015, comprehensive central/local government incentives were extended to all vehicle purchasers including the individual buyers in most cities, which was conducive to the phenomenal growth of the PEV sales. For years 2016 to 2020, monetary incentives are being phased out and will be substituted by other non-monetary incentives (such as the standards for Chinese Cooperate Average Fuel Consumption and New Energy Vehicle Credits) for the sustainable development of the PEV market. The PEV subsidy fraud has drawn attention by the central government, which prompts the government to be more prudent about monetary incentives. With the advantage of high acceptance in the PEV market and integrated EV charging infrastructure, the region with better economic development brings a more aggressive PEV roll-out plan to the municipalities who are more willing to solve the local urban pollution while keeping the automotive market in sustainable growth. On the one hand, the local automakers are offered abundant subsidies from the Chinese government to those who intend to help the Chinese automotive industry seize the industrial upgrading opportunity to transform its manufacturing sector, and they have taken most shares of the PEV market. On the other hand, facing the trade barriers, the foreign automakers have dominated the premium PEV sales in China, although their total market shares in the PEV market are much less than the domestic automakers. In diverse selectable alternative fuel vehicle technologies, China has put its focus on the PEV technologies for the technological modernization in the automotive industry; the research and development in fuel cell vehicle technologies in China is less competitive compared with other countries such as Japan and the U.S. With the demand of batteries from the PEV automakers, the Chinese EV battery industry is aggressively expanding. It has risks in excessive production capacity, and faces the challenges from the competitors from Japan and South Korea.« less

A Profile of Tax Subsidies and Investment Behavior in Six Major Polluting Industries (1997)

EPA Pesticide Factsheets

Reviews investment trends in pollution control technology to determine existing patterns and to highlight the likely investment incentives that six industries, metals mining, petroleum, primary metals, pulp and paper, chemicals, and electric utilities.

MIT Experiments with Joint Venture Contract.

ERIC Educational Resources Information Center

American School and University, 1981

1981-01-01

A new dormitory at Massachusetts Institute of Technology was constructed using a joint venture contract with safeguards and incentives that brought university, architect, and building contractor into a closer and more productive relationship than under conventional contract arrangements. (Author/MLF)

Clean Energy Application Center

DOE Office of Scientific and Technical Information (OSTI.GOV)

Freihaut, Jim

2013-09-30

The Mid Atlantic Clean Energy Application Center (MACEAC), managed by The Penn State College of Engineering, serves the six states in the Mid-Atlantic region (Pennsylvania, New Jersey, Delaware, Maryland, Virginia and West Virginia) plus the District of Columbia. The goals of the Mid-Atlantic CEAC are to promote the adoption of Combined Heat and Power (CHP), Waste Heat Recovery (WHR) and District Energy Systems (DES) in the Mid Atlantic area through education and technical support to more than 1,200 regional industry and government representatives in the region. The successful promotion of these technologies by the MACEAC was accomplished through the followingmore » efforts; (1)The MACEAC developed a series of technology transfer networks with State energy and environmental offices, Association of Energy Engineers local chapters, local community development organizations, utilities and, Penn State Department of Architectural Engineering alumni and their firms to effectively educate local practitioners about the energy utilization, environmental and economic advantages of CHP, WHR and DES; (2) Completed assessments of the regional technical and market potential for CHP, WHR and DE technologies application in the context of state specific energy prices, state energy and efficiency portfolio development. The studies were completed for Pennsylvania, New Jersey and Maryland and included a set of incentive adoption probability models used as a to guide during implementation discussions with State energy policy makers; (3) Using the technical and market assessments and adoption incentive models, the Mid Atlantic CEAC developed regional strategic action plans for the promotion of CHP Application technology for Pennsylvania, New Jersey and Maryland; (4) The CHP market assessment and incentive adoption model information was discussed, on a continuing basis, with relevant state agencies, policy makers and Public Utility Commission organizations resulting in CHP favorable incentive programs in New Jersey, Pennsylvania, Maryland and Delaware; (5) Developed and maintained a MACEAC website to provide technical information and regional CHP, WHR and DE case studies and site profiles for use by interested stakeholders in information transfer and policy discussions; (6) Provided Technical Assistance through feasibility studies and on site evaluations. The MACEAC completed 28 technical evaluations and 9 Level 1 CHP analyses ; and (7) the MACEAC provided Technical Education to the region through a series of 29 workshops and webinars, 37 technical presentations, 14 seminars and participation in 13 CHP conferences.« less

Financial incentives to improve adherence to antipsychotic maintenance medication in non-adherent patients: a cluster randomised controlled trial.

PubMed

Priebe, Stefan; Bremner, Stephen A; Lauber, Christoph; Henderson, Catherine; Burns, Tom

2016-09-01

Poor adherence to long-term antipsychotic injectable (LAI) medication in patients with psychotic disorders is associated with a range of negative outcomes. No psychosocial intervention has been found to be consistently effective in improving adherence. To test whether or not offering financial incentives is effective and cost-effective in improving adherence and to explore patient and clinician experiences with such incentives. A cluster randomised controlled trial with economic and nested qualitative evaluation. The intervention period lasted for 12 months with 24 months' follow-up. The unit of randomisation was mental health teams in the community. Community teams in secondary mental health care. Patients with a diagnosis of schizophrenia, schizoaffective psychosis or bipolar illness, receiving ≤ 75% of their prescribed LAI medication. In total, 73 teams with 141 patients (intervention n = 78 and control n = 63) were included. Participants in the intervention group received £15 for each LAI medication. Patients in the control group received treatment as usual. adherence to LAI medication (the percentage of received out of those prescribed). percentage of patients with at least 95% adherence; clinical global improvement; subjective quality of life; satisfaction with medication; hospitalisation; adverse events; and costs. Qualitative evaluation: semistructured interviews with patients in the intervention group and their clinicians. outcome data were available for 131 patients. Baseline adherence was 69% in the intervention group and 67% in the control group. During the intervention period, adherence was significantly higher in the intervention group than in the control group (85% vs. 71%) [adjusted mean difference 11.5%, 95% confidence interval (CI) 3.9% to 19.0%; p = 0.003]. Secondary outcome: patients in the intervention group showed statistically significant improvement in adherence of at least 95% (adjusted odds ratio 8.21, 95% CI 2.00 to 33.67; p = 0.003) and subjective quality of life (difference in means 0.71, 95% CI 0.26 to 1.15; p = 0.002). Follow-ups: after incentives stopped, adherence did not differ significantly between groups, neither during the first 6 months (adjusted difference in means -7.4%, 95% CI -17.0% to 2.1%; p = 0.175) nor during the period from month 7 to month 24 (difference in means -5.7%, 95% CI -13.1% to 1.7%; p = 0.130). Cost-effectiveness: the average costs of the financial incentives was £303. Overall costs per patient were somewhat higher in the intervention group, but the difference was not significant. Semistructured interviews: the majority of patients and clinicians reported positive experiences with the incentives beyond their monetary value. These included improvement in the therapeutic relationship. The majority of both patients and clinicians perceived no negative impact after the intervention was stopped after 1 year. Financial incentives are effective in improving adherence to LAI medication. Health-care costs (including costs of the financial incentive) are unlikely to be increased substantially by this intervention. Once the incentives stop, the advantage is not maintained. The experiences of both patients and clinicians are largely, but not exclusively, positive. Whether or not financial incentives are effective for patients with more favourable background, those on oral mediation or for shorter or longer time periods remains unknown. Current Controlled Trials ISRCTN77769281. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 20, No. 70. See the NIHR Journals Library website for further project information.

Our leadership in science and technology as provided by the national space program

NASA Technical Reports Server (NTRS)

Kock, W. E.

1972-01-01

The contributions of science and technology to the success of the United States as a world leader are discussed. Specific instances of the manner in which science advances and new technologies resulting from space research have contributed to a higher standard of living are presented. It is concluded that the benefits of the space program are not reflected only in the material advancements, but that intangible results have also been achieved in greater incentives to improve the present culture.

A Family Medicine Health Technology Strategy for Achieving the Triple Aim for US Health Care.

PubMed

Phillips, Robert L; Bazemore, Andrew W; DeVoe, Jennifer E; Weida, Thomas J; Krist, Alex H; Dulin, Michael F; Biagioli, Frances E

2015-09-01

Health information technology (health IT) and health technology, more broadly, offer tremendous promise for connecting, synthesizing, and sharing information critical to improving health care delivery, reducing health system costs, and achieving personal and community health. While efforts to spur adoption of electronic health records (EHRs) among US practices and hospitals have been highly successful, aspirations for effective data exchanges and translation of data into measureable improvements in health outcomes remain largely unrealized. There are shining examples of health enhancement through new technologies, and the discipline of family medicine is well poised to take advantage of these innovations to improve patient and population health. The Future of Family Medicine led to important family medicine health IT initiatives over the past decade. For example, the American Academy of Family Physicians (AAFP) Center for Health Information Technology and the Robert Graham Center provided important leadership for informing health IT policy and standard-setting, such as the Centers for Medicare and Medicaid Services EHR incentives programs (often referred to as "meaningful use."). As we move forward, there is a need for a new and more comprehensive family medicine strategy for technology. To inform the Family Medicine for America's Health (FMAHealth) initiative, this paper explores strategies and tactics that family medicine could pursue to improve the utility of technology for primary care and to help primary care become a leader in rapid development, testing, and implementation of new technologies. These strategies were also designed with a broader stakeholder audience in mind, intending to reach beyond the work being done by FMAHealth. Specific suggestions include: a shared primary care health IT center, meaningful primary care quality measures and capacity to assess/report them, increased primary care technology research, a national family medicine registry, enhancement of family physicians' technology leadership, and championing patient-centered technology functionality.

Analysis of Project Finance | Energy Analysis | NREL

Science.gov Websites

project finance is complex, requiring knowledge of federal tax credits, state-level incentives, renewable and in lieu of the 30% federal investment tax credit, as follows: Less-established renewable power that lack extensive operational track records may be slowed because many tax equity investors are seen

Parental Vaccine Beliefs and Child's School Type

ERIC Educational Resources Information Center

Kennedy, Allison M.; Gust, Deborah A.

2005-01-01

The school system plays an important role in a child's vaccination status, whether by directly offering immunization services, maintaining immunization records, or providing an incentive for up-to-date immunizations through the enforcement of school entry laws. Within the American educational system, however, children do not all attend the same…

5 CFR 575.111 - Termination of a service agreement.

Code of Federal Regulations, 2010 CFR

2010-01-01

...., for unacceptable performance or conduct), if the employee receives a rating of record (or an official... management needs of the agency. For example, an agency may terminate a service agreement when the employee's... incentive payments, or when the agency assigns the employee to a different position (if the different...

5 CFR 575.211 - Termination of a service agreement.

Code of Federal Regulations, 2010 CFR

2010-01-01

...., for unacceptable performance or conduct), if the employee receives a rating of record (or an official... needs of the agency. For example, an agency may terminate a service agreement when the employee's... incentive payments, or when the agency assigns the employee to a different position (if the different...

48 CFR 1552.216-78 - Award term incentive plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

... NIHCPS is an interactive database located on the Internet which EPA uses to record contractor performance... evaluation of performance, and, together with Agency need and availability of funding, serves as the basis.... Typically, the performance standards and AQLs will be defined in the QASP] (End of clause) Alternate 1 (FEB...

78 FR 30899 - Agency Information Collection Activities; Comment Request; NCES Cognitive, Pilot, and Field Test...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

...; Comment Request; NCES Cognitive, Pilot, and Field Test Studies System AGENCY: Institute of Education... in response to this notice will be considered public records. Title of Collection: NCES Cognitive... with levels of incentives for various types of survey operations, focus groups, cognitive laboratory...

76 FR 30150 - Establishment of a New System of Records for Personal Information Collected by the Environmental...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-24

... the entire information system with respect to computer security, prohibition and detection of any.... Safeguards: --Computer-stored information is protected in accordance with the Agency's security requirements..., loaner car agreement, cash incentives agreement (includes social security number for mandatory tax...

20 CFR 628.325 - Incentive grants, capacity building, and technical assistance.

Code of Federal Regulations, 2011 CFR

2011-04-01

... for the development of Statewide communications and training mechanisms involving computer-based communication technologies that directly facilitate interaction with the National Capacity Building and... section 205(a) of the Act, in developing electronic communications, training mechanisms and/or...

20 CFR 628.325 - Incentive grants, capacity building, and technical assistance.

Code of Federal Regulations, 2012 CFR

2012-04-01

... for the development of Statewide communications and training mechanisms involving computer-based communication technologies that directly facilitate interaction with the National Capacity Building and... section 205(a) of the Act, in developing electronic communications, training mechanisms and/or...

Benefits of Incentives for Breastfeeding and Smoking cessation in pregnancy (BIBS): a mixed-methods study to inform trial design.

PubMed

Morgan, Heather; Hoddinott, Pat; Thomson, Gill; Crossland, Nicola; Farrar, Shelley; Yi, Deokhee; Hislop, Jenni; Moran, Victoria Hall; MacLennan, Graeme; Dombrowski, Stephan U; Rothnie, Kieran; Stewart, Fiona; Bauld, Linda; Ludbrook, Anne; Dykes, Fiona; Sniehotta, Falko F; Tappin, David; Campbell, Marion

2015-04-01

Smoking in pregnancy and/or not breastfeeding have considerable negative health outcomes for mother and baby. To understand incentive mechanisms of action for smoking cessation in pregnancy and breastfeeding, develop a taxonomy and identify promising, acceptable and feasible interventions to inform trial design. Evidence syntheses, primary qualitative survey, and discrete choice experiment (DCE) research using multidisciplinary, mixed methods. Two mother-and-baby groups in disadvantaged areas collaborated throughout. UK. The qualitative study included 88 pregnant women/recent mothers/partners, 53 service providers, 24 experts/decision-makers and 63 conference attendees. The surveys included 1144 members of the general public and 497 health professionals. The DCE study included 320 women with a history of smoking. (1) Evidence syntheses: incentive effectiveness (including meta-analysis and effect size estimates), delivery processes, barriers to and facilitators of smoking cessation in pregnancy and/or breastfeeding, scoping review of incentives for lifestyle behaviours; (2) qualitative research: grounded theory to understand incentive mechanisms of action and a framework approach for trial design; (3) survey: multivariable ordered logit models; (4) DCE: conditional logit regression and the log-likelihood ratio test. Out of 1469 smoking cessation and 5408 breastfeeding multicomponent studies identified, 23 smoking cessation and 19 breastfeeding studies were included in the review. Vouchers contingent on biochemically proven smoking cessation in pregnancy were effective, with a relative risk of 2.58 (95% confidence interval 1.63 to 4.07) compared with non-contingent incentives for participation (four studies, 344 participants). Effects continued until 3 months post partum. Inconclusive effects were found for breastfeeding incentives compared with no/smaller incentives (13 studies) but provider commitment contracts for breastfeeding show promise. Intervention intensity is a possible confounder. The acceptability of seven promising incentives was mixed. Women (for vouchers) and those with a lower level of education (except for breastfeeding incentives) were more likely to disagree. Those aged ≤ 44 years and ethnic minority groups were more likely to agree. Agreement was greatest for a free breast pump and least for vouchers for breastfeeding. Universal incentives were preferred to those targeting low-income women. Initial daily text/telephone support, a quitting pal, vouchers for > £20.00 per month and values up to £80.00 increase the likelihood of smoking cessation. Doctors disagreed with provider incentives. A 'ladder' logic model emerged through data synthesis and had face validity with service users. It combined an incentive typology and behaviour change taxonomy. Autonomy and well-being matter. Personal difficulties, emotions, socialising and attitudes of others are challenges to climbing a metaphorical 'ladder' towards smoking cessation and breastfeeding. Incentive interventions provide opportunity 'rungs' to help, including regular skilled flexible support, a pal, setting goals, monitoring and outcome verification. Individually tailored and non-judgemental continuity of care can bolster women's capabilities to succeed. Rigid, prescriptive interventions placing the onus on women to behave 'healthily' risk them feeling pressurised and failing. To avoid 'losing face', women may disengage. Included studies were heterogeneous and of variable quality, limiting the assessment of incentive effectiveness. No cost-effectiveness data were reported. In surveys, selection bias and confounding are possible. The validity and utility of the ladder logic model requires evaluation with more diverse samples of the target population. Incentives provided with other tailored components show promise but reach is a concern. Formal evaluation is recommended. Collaborative service-user involvement is important. This study is registered as PROSPERO CRD42012001980. The National Institute for Health Research Health Technology Assessment programme.

Maximizing Energy Savings Reliability in BC Hydro Industrial Demand-side Management Programs: An Assessment of Performance Incentive Models

NASA Astrophysics Data System (ADS)

Gosman, Nathaniel

For energy utilities faced with expanded jurisdictional energy efficiency requirements and pursuing demand-side management (DSM) incentive programs in the large industrial sector, performance incentive programs can be an effective means to maximize the reliability of planned energy savings. Performance incentive programs balance the objectives of high participation rates with persistent energy savings by: (1) providing financial incentives and resources to minimize constraints to investment in energy efficiency, and (2) requiring that incentive payments be dependent on measured energy savings over time. As BC Hydro increases its DSM initiatives to meet the Clean Energy Act objective to reduce at least 66 per cent of new electricity demand with DSM by 2020, the utility is faced with a higher level of DSM risk, or uncertainties that impact the costeffective acquisition of planned energy savings. For industrial DSM incentive programs, DSM risk can be broken down into project development and project performance risks. Development risk represents the project ramp-up phase and is the risk that planned energy savings do not materialize due to low customer response to program incentives. Performance risk represents the operational phase and is the risk that planned energy savings do not persist over the effective measure life. DSM project development and performance risks are, in turn, a result of industrial economic, technological and organizational conditions, or DSM risk factors. In the BC large industrial sector, and characteristic of large industrial sectors in general, these DSM risk factors include: (1) capital constraints to investment in energy efficiency, (2) commodity price volatility, (3) limited internal staffing resources to deploy towards energy efficiency, (4) variable load, process-based energy saving potential, and (5) a lack of organizational awareness of an operation's energy efficiency over time (energy performance). This research assessed the capacity of alternative performance incentive program models to manage DSM risk in BC. Three performance incentive program models were assessed and compared to BC Hydro's current large industrial DSM incentive program, Power Smart Partners -- Transmission Project Incentives, itself a performance incentive-based program. Together, the selected program models represent a continuum of program design and implementation in terms of the schedule and level of incentives provided, the duration and rigour of measurement and verification (M&V), energy efficiency measures targeted and involvement of the private sector. A multi criteria assessment framework was developed to rank the capacity of each program model to manage BC large industrial DSM risk factors. DSM risk management rankings were then compared to program costeffectiveness, targeted energy savings potential in BC and survey results from BC industrial firms on the program models. The findings indicate that the reliability of DSM energy savings in the BC large industrial sector can be maximized through performance incentive program models that: (1) offer incentives jointly for capital and low-cost operations and maintenance (O&M) measures, (2) allow flexible lead times for project development, (3) utilize rigorous M&V methods capable of measuring variable load, process-based energy savings, (4) use moderate contract lengths that align with effective measure life, and (5) integrate energy management software tools capable of providing energy performance feedback to customers to maximize the persistence of energy savings. While this study focuses exclusively on the BC large industrial sector, the findings of this research have applicability to all energy utilities serving large, energy intensive industrial sectors.

Western municipal water conservation policy: The case of disaggregated demand

NASA Astrophysics Data System (ADS)

Burness, Stuart; Chermak, Janie; Krause, Kate

2005-03-01

We investigate aspects of the felicity of both incentive-based and command and control policies in effecting municipal water conservation goals. When demand can be disaggregated according to uses or users, our results suggest that policy efforts be focused on the submarket wherein demand is more elastic. Under plausible consumer parameters, a household production function approach to water utilization prescribes the nature of demand elasticities in alternative uses and squares nicely with empirical results from the literature. An empirical example illustrates. Overall, given data and other informational limitations, extant institutional structures, and in situ technology, our analysis suggests a predisposition for command and control policies over incentive-based tools.

How to successfully implement extended producer responsibility: considerations from an economic point of view.

PubMed

Wiesmeth, Hans; Häckl, Dennis

2011-09-01

This paper investigates the concept of extended producer responsibility (EPR) from an economic point of view. Particular importance will be placed on the concept of 'economic feasibility' of an EPR policy, which should guide decision-making in this context. Moreover, the importance of the core EPR principle of 'integrating signals throughout the product chain' into the incentive structure will be demonstrated with experiences from Germany. These examples refer to sales packaging consumption, refillable drinks packages and waste electrical and electronic equipment collection. As a general conclusion, the interaction between economic principles and technological development needs to be observed carefully when designing incentive-compatible EPR policies.

Understanding the Adoption Process of National Security Technology: An Integration of Diffusion of Innovations and Volitional Behavior Theories.

PubMed

Iles, Irina A; Egnoto, Michael J; Fisher Liu, Brooke; Ackerman, Gary; Roberts, Holly; Smith, Daniel

2017-11-01

After the 9/11 terrorist attacks, the U.S. government initiated several national security technology adoption programs. The American public, however, has been skeptical about these initiatives and adoption of national security technologies has been mandated, rather than voluntary. We propose and test a voluntary behavioral intention formation model for the adoption of one type of new security technology: portable radiation detectors. Portable radiation detectors are an efficient way of detecting radiological and nuclear threats and could potentially prevent loss of life and damage to individuals' health. However, their functioning requires that a critical mass of individuals use them on a daily basis. We combine the explanatory advantages of diffusion of innovation with the predictive power of two volitional behavior frameworks: the theory of reasoned action and the health belief model. A large sample survey (N = 1,482) investigated the influence of factors identified in previous diffusion of innovation research on portable radiation detector adoption intention. Results indicated that nonfinancial incentives, as opposed to financial incentives, should be emphasized in persuasive communications aimed at fostering adoption. The research provides a new integration of diffusion of innovation elements with determinants of volitional behavior from persuasion literature, and offers recommendations on effective communication about new security technologies to motivate public adoption and enhance national safety. © 2017 Society for Risk Analysis.

Incentives for telehealthcare deployment that support integrated care: a comparative analysis across eight European countries

PubMed Central

Lluch, Maria

2013-01-01

Introduction Health care systems are struggling to deal with the increasing demands of an older population. In an attempt to find a solution to these demands, there has been a shift towards integrated care supported by information and communication technologies. However, little is understood about the role played by incentives and reimbursement schemes in the development of integrated care and information and communication technologies uptake. The objective of this paper is to investigate this question, specifically as regards telehealthcare. Methods In order to identify the deployment of telehealthcare applications and their role in supporting integrated care, a case study approach was used. A clustering exercise was carried out and eight European countries were selected for in-depth study: Denmark, Estonia, Germany, France, Italy, the Netherlands, Spain and the UK. In total, 31 telehealthcare initiatives across eight countries involving over 20,000 patients were investigated. Results Reflecting on specific examples in each initiative, drivers promoting integrated care delivery supported by telehealthcare mainstreaming and associated incentive mechanisms were identified. Attention was also paid to other factors which acted as barriers for widespread deployment. Discussion and conclusions Trends towards telehealthcare mainstreaming were found in Denmark, the UK, and in some regions of Spain, Italy and France. Mainstreaming often went hand-in-hand with progress towards integrated care delivery and payment reforms. A general trend was found towards outcomes-based payments and bundled payment schemes, which aimed to promote integrated care supported by telehealthcare deployment. Their effectiveness in achieving these goals remains to be seen. In addition, a form of outpatient diagnostic-related group reimbursement for telehealthcare services was found to have emerged in a few countries. However, it is questionable how this incentive could promote integrated care delivery on its own. This research suggests that incentives which align social, primary and hospital care are rare and there is a need to design new payment paradigms. Finally, eHealth penetration, interoperability, governance, availability of evidence and reorganisation of services represent additional factors which can act as drivers or barriers for integrated care delivery. PMID:24250282

Combined heat and power systems: economic and policy barriers to growth

PubMed Central

2012-01-01

Background Combined Heat and Power (CHP) systems can provide a range of benefits to users with regards to efficiency, reliability, costs and environmental impact. Furthermore, increasing the amount of electricity generated by CHP systems in the United States has been identified as having significant potential for impressive economic and environmental outcomes on a national scale. Given the benefits from increasing the adoption of CHP technologies, there is value in improving our understanding of how desired increases in CHP adoption can be best achieved. These obstacles are currently understood to stem from regulatory as well as economic and technological barriers. In our research, we answer the following questions: Given the current policy and economic environment facing the CHP industry, what changes need to take place in this space in order for CHP systems to be competitive in the energy market? Methods We focus our analysis primarily on Combined Heat and Power Systems that use natural gas turbines. Our analysis takes a two-pronged approach. We first conduct a statistical analysis of the impact of state policies on increases in electricity generated from CHP system. Second, we conduct a Cost-Benefit analysis to determine in which circumstances funding incentives are necessary to make CHP technologies cost-competitive. Results Our policy analysis shows that regulatory improvements do not explain the growth in adoption of CHP technologies but hold the potential to encourage increases in electricity generated from CHP system in small-scale applications. Our Cost-Benefit analysis shows that CHP systems are only cost competitive in large-scale applications and that funding incentives would be necessary to make CHP technology cost-competitive in small-scale applications. Conclusion From the synthesis of these analyses we conclude that because large-scale applications of natural gas turbines are already cost-competitive, policy initiatives aimed at a CHP market dominated primarily by large-scale (and therefore already cost-competitive) systems have not been effectively directed. Our recommendation is that for CHP technologies using natural gas turbines, policy focuses should be on increasing CHP growth in small-scale systems. This result can be best achieved through redirection of state and federal incentives, research and development, adoption of smart grid technology, and outreach and education. PMID:22540988

EDUCATION IN BUSINESS AND INDUSTRY.

ERIC Educational Resources Information Center

DECARLO, CHARLES R.; ROBINSON, ORMSBEE W.

CONTINUING EDUCATION IS DISCUSSED AS VITAL TO THE PROSPERITY OF BUSINESS AND INDUSTRY WHEN TECHNOLOGICAL CHANGES REQUIRE CONTINUAL READJUSTMENT OF JOB REQUIREMENTS. ROLES OF INDUSTRY, UNIVERSITIES, AND GOVERNMENT COOPERATING TO PROVIDE THE RESOURCES, MATERIALS, AND INCENTIVES FOR CONTINUING EDUCATION ARE PROPOSED. DISCUSSIONS INCLUDE--(1) PROBLEMS…

The 'cultural inflation of morbidity' during the English mortality decline: a new look.

PubMed

Gorsky, Martin; Guntupalli, Aravinda; Harris, Bernard; Hinde, Andrew

2011-12-01

This article contributes to the debate about using insurance records to reconstruct historical experiences of sickness during the Western mortality transition. Critics regard these sources as problematic as they measure morbidity indirectly through absences from work; these might be determined not by timeless biological criteria but by more contingent factors, notably shifting norms surrounding the sick role and responses to economic incentives (for which we adopt the generic term 'cultural inflation of morbidity'). We review historical demographers' contributions to this literature and discuss the concepts of moral hazard and the principal/agent problem as developed by health economists. This leads us to frame three empirical tests for 'cultural inflation' which allow us to assess the validity of insurance records for deriving morbidity trends: was there an increasing frequency of claims for complaints of diminishing severity; were unduly prolonged claims noticeable, particularly by older people for whom sickness benefit may have compensated for income insecurity; and did the insurer satisfactorily manage the agency problem to ensure reliable physician gatekeeping? We analyse records of the Hampshire Friendly Society, an exceptionally well-documented fund operational in Southern England, 1825-1989. Findings are based on a dataset of individual sickness histories of a sample of 5552 men and on qualitative documentary analysis of administrative records. On each count our results fail to demonstrate a cultural inflation of morbidity, except perhaps for those aged over 65. However, occasional discussion in the administrative records of economic incentives encouraging unnecessary prolongation of claims means we cannot rule it out entirely. Copyright © 2011 Elsevier Ltd. All rights reserved.

Adding home health care to the discussion on health information technology policy.

PubMed

Ruggiano, Nicole; Brown, Ellen L; Hristidis, Vagelis; Page, Timothy F

2013-01-01

The potential for health information technology to improve the efficiency and effectiveness of health care has resulted in several U.S. policy initiatives aimed at integrating health information technology into health care systems. However, home health care agencies have been excluded from incentive programs established through policies, raising concerns on the extent to which health information technology may be used to improve the quality of care for older adults with chronic illness and disabilities. This analysis examines the potential issues stemming from this exclusion and explores potential opportunities of integrating home health care into larger initiatives aimed at establishing health information technology systems for meaningful use.

A consensus action agenda for achieving the national health information infrastructure.

PubMed

Yasnoff, William A; Humphreys, Betsy L; Overhage, J Marc; Detmer, Don E; Brennan, Patricia Flatley; Morris, Richard W; Middleton, Blackford; Bates, David W; Fanning, John P

2004-01-01

Improving the safety, quality, and efficiency of health care will require immediate and ubiquitous access to complete patient information and decision support provided through a National Health Information Infrastructure (NHII). To help define the action steps needed to achieve an NHII, the U.S. Department of Health and Human Services sponsored a national consensus conference in July 2003. Attendees favored a public-private coordination group to guide NHII activities, provide education, share resources, and monitor relevant metrics to mark progress. They identified financial incentives, health information standards, and overcoming a few important legal obstacles as key NHII enablers. Community and regional implementation projects, including consumer access to a personal health record, were seen as necessary to demonstrate comprehensive functional systems that can serve as models for the entire nation. Finally, the participants identified the need for increased funding for research on the impact of health information technology on patient safety and quality of care. Individuals, organizations, and federal agencies are using these consensus recommendations to guide NHII efforts.

Making User-Generated Content Communities Work in Higher Education - The Importance of Setting Incentives

NASA Astrophysics Data System (ADS)

Vom Brocke, Jan; White, Cynthia; Walker, Ute; Vom Brocke, Christina

The concept of User-Generated Content (UGC) offers impressive potential for innovative learning and teaching scenarios in higher education. Examples like Wikipedia and Facebook illustrate the enormous effects of multiple users world-wide contributing to a pool of shared resources, such as videos and pictures and also lexicographical descriptions. Apart from single examples, however, the systematic use of these virtual technologies in higher education still needs further exploration. Only few examples display the successful application of UGC Communities at university scenarios. We argue that a major reason for this can be seen in the fact that the organizational dimension of setting up UGC Communities has widely been neglected so far. In particular, we indicate the need for incentive setting to actively involve students and achieve specific pedagogical objectives. We base our study on organizational theories and derive strategies for incentive setting that have been applied in a practical e-Learning scenario involving students from Germany and New Zealand.

Scientific Utopia: An agenda for improving scientific communication (Invited)

NASA Astrophysics Data System (ADS)

Nosek, B.

2013-12-01

The scientist's primary incentive is publication. In the present culture, open practices do not increase chances of publication, and they often require additional work. Practicing the abstract scientific values of openness and reproducibility thus requires behaviors in addition to those relevant for the primary, concrete rewards. When in conflict, concrete rewards are likely to dominate over abstract ones. As a consequence, the reward structure for scientists does not encourage openness and reproducibility. This can be changed by nudging incentives to align scientific practices with scientific values. Science will benefit by creating and connecting technologies that nudge incentives while supporting and improving the scientific workflow. For example, it should be as easy to search the research literature for my topic as it is to search the Internet to find hilarious videos of cats falling off of furniture. I will introduce the Center for Open Science (http://centerforopenscience.org/) and efforts to improve openness and reproducibility such as http://openscienceframework.org/. There will be no cats.

Under-reporting of work-related disorders in the workplace: a case study and review of the literature.

PubMed

Pransky, G; Snyder, T; Dembe, A; Himmelstein, J

1999-01-01

Accurate reporting of work-related conditions is necessary to monitor workplace health and safety, and to identify the interventions that are most needed. Reporting systems may be designed primarily for external agencies (OSHA or workers' compensation) or for the employer's own use. Under-reporting of workplace injuries and illnesses is common due to a variety of causes and influences. Based on previous reports, the authors were especially interested in the role of safety incentive programmes on under-reporting. Safety incentive programmes typically reward supervisors and employees for reducing workplace injury rates, and thus may unintentionally inhibit proper reporting. The authors describe a case study of several industrial facilities in order to illustrate the extent of under-reporting and the reasons for its occurrence. A questionnaire and interview survey was administered to 110 workers performing similar tasks and several managers, health, and safety personnel at each of three industrial facilities. Although less than 5% of workers had officially reported a work-related injury or illness during the past year, over 85% experienced work-related symptoms, 50% had persistent work-related problems, and 30% reported either lost time from work or work restrictions because of their ailment. Workers described several reasons for not reporting their injuries, including fear of reprisal, a belief that pain was an ordinary consequence of work activity or ageing, lack of management responsiveness after prior reports, and a desire not to lose their usual job. Interviews with management representatives revealed administrative and other barriers to reporting, stemming from their desire to attain a goal of no reported injuries, and misconceptions about requirements for recordability. The corporate and facility safety incentives appeared to have an indirect, but significant negative influence on the proper reporting of workplace injuries by workers. A variety of influences may contribute to under-reporting; because of under-reporting, worker surveys and symptom reports may provide more valuable and timely information on risks than recordable injury logs. Safety incentive programmes should be carefully designed to ensure that they provide a stimulus for safety-related changes, and to discourage under-reporting. A case-control study of similar establishments, or data before and after instituting safety incentives, would be required to more clearly establish the role of these programmes in under-reporting.

Health Information Exchange: The Determinants of Usage and the Impact on Utilization

ERIC Educational Resources Information Center

Vest, Joshua Ryan

2010-01-01

Health information exchange (HIE) is the process of electronically sharing patient-level information among different organizations with the objectives of quality and cost improvements. The adoption of HIE in the United States is not widespread, but numerous efforts at facilitating HIE exist and the incentives for electronic health record system…

75 FR 73095 - Privacy Act of 1974; Report of New System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-29

... Repository'' System No. 09-70-0587. The final rule for the Medicare and Medicaid EHR Incentive Program... primary purpose of this system, called the National Level Repository or NLR, is to collect, maintain, and... Maintenance of Data in the System The National Level Repository (NLR) contains information on eligible...

Meaningful Use of School Health Data

ERIC Educational Resources Information Center

Johnson, Kathleen Hoy; Bergren, Martha Dewey

2011-01-01

Meaningful use (MU) of Electronic Health Records (EHRs) is an important development in the safety and security of health care delivery in the United States. Advancement in the use of EHRs occurred with the passage of the American Recovery and Reinvestment Act of 2009, which provides incentives for providers to support adoption and use of EHRs.…

Inadequate Self-Discipline as a Causal Factor in Human Error Accidents

DTIC Science & Technology

1991-03-01

reasons for the effectiveness of the stimuli or incentives used are unknown. Moreover, Gebers and Peck (1987) conclude on the basis of a random sample...Research. 13, 141-156. 234 Gebers , M. A., & Peck, R. C. (1987). Basic California traffic conviction and accident record facts. (Report No. CAL-DMV- RSS

78 FR 43869 - Agency Information Collection Activities; Submission to the Office of Management and Budget for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-22

...; Submission to the Office of Management and Budget for Review and Approval; Comment Request; NCES Cognitive... notice will be considered public records. Title of Collection: NCES Cognitive, Pilot, and Field Test... with levels of incentives for various types of survey operations, focus groups, cognitive laboratory...

Workshop Summary for Maintaining Innovation and Security in Biotechnology: Lessons Learned from Nuclear, Chemical, and Informational Technologies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Althouse, Paris

In the fast-paced field of biotechnology where innovation has such far-reaching impacts on human health and the environment, dealing with the implications of possible illicit activities, accidents or unintended research consequences with potential detrimental societal impacts tends to remain in the background. While controls may be inevitable for the biotech industry, workshop attendees agreed that the way in which controls are implemented will play a major role in the agility and innovation of the biotechnology industry. There is little desire to slow down the pace of the gains while dealing with the security issues that arise. As was seen frommore » the brief examinations of the Nuclear, Chemical, and Information Technology sectors explored in this workshop, establishing a regulatory regime needs to be a partnership between the public, corporate interests, scientists, and the government. Regulation is often written to combat perceived risk rather than actual risk—the public’s perceptions (occasionally even fictional portrayals) can spur regulatory efforts. This leads to the need for a thorough and continuing assessment of the risks posed by modern biotechnology. Inadequate or minimal risk assessment might expedite development in the short term but has potential negative long-term security and economic consequences. Industry and the technical community also often have a large role in setting regulatory policy, especially when well-crafted incentives are incorporated into the regulations. Such incentives might actually lead to enhanced innovation while poorly designed incentives can actually reduce safety and security. Any regulations should be as agile and flexible as the technology they regulate and when applied to biotechnologies they will need a new framework for thinking and implementing. The new framework should consider biotechnology as a technology and not simply a science since it is an extremely complex and adaptive system. This suggests the need to invest in social and political systems, rather than exclusively in technology, as a part of maintaining not only robust, but agile regulation. Modeling and simulations to illustrate how the biotech ecosystem might respond to new policies may be a promising approach to crafting regulations.« less

Collective Bargaining As an Instrument of Change.

ERIC Educational Resources Information Center

Ayers, Steven V.

1998-01-01

The Hilton Central School District, New York, utilized the collective bargaining process to create a financial incentive that would motivate teachers to achieve a baseline level of technological competency. Describes the negotiated agreement, results obtained during the initial year of implementation, and future plans. (MLF)

Prize-Winning Money Savers

ERIC Educational Resources Information Center

AGB Reports, 1978

1978-01-01

Thirteen ideas from the NACUBO-U.S. Steel Foundation "Cost Reduction Incentive Awards" of the past three years are presented. Among them are: Rochester Institute of Technology's employee assistance plan (counseling for drug or alcohol abuse or family or financial problems); and Duke's Consolidation of duplicating services. (Author/LBH)

Tapping Resources in Municipal Solid Waste

ERIC Educational Resources Information Center

Blum, S. L.

1976-01-01

Municipal solid waste disposal is becoming complex as costs, wastes, and environmental restrictions increase. Recovery and recycling of materials presents problems of financing, ownership, and operation, technology, and marketing. Energy and materials recovery offers long-term economic and environmental incentives in terms of growing shortages and…

76 FR 14379 - Advanced Placement Incentive Program; Office of Elementary and Secondary Education; Overview...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-16

... competitive preference priority. Absolute Priority 1: Promoting Science, Technology, Engineering, and... applications that meet these priorities. These priorities are: Absolute Priority 1: Promoting Science... participation in the core academic areas of English, mathematics, and science; (4) Involving business and...

A Data Envelopment Analysis Approach to Prioritize Renewable Energy Technologies

USDA-ARS?s Scientific Manuscript database

Due to growing financial and environmental concerns, governmental rules, regulations and incentives alternative energy sources will soon grow at a much faster pace than conventional sources of energy. However, the current body of research providing comparative decision making models that either rank...

Comparison of Flow and Volume Incentive Spirometry on Pulmonary Function and Exercise Tolerance in Open Abdominal Surgery: A Randomized Clinical Trial.

PubMed

Kumar, Amaravadi Sampath; Alaparthi, Gopala Krishna; Augustine, Alfred Joseph; Pazhyaottayil, Zulfeequer Chundaanveetil; Ramakrishna, Anand; Krishnakumar, Shyam Krishnan

2016-01-01

Surgical procedures in abdominal area lead to changes in pulmonary function, respiratory mechanics and impaired physical capacity leading to postoperative pulmonary complications, which can affect up to 80% of upper abdominal surgery. To evaluate the effects of flow and volume incentive spirometry on pulmonary function and exercise tolerance in patients undergoing open abdominal surgery. A randomized clinical trial was conducted in a hospital of Mangalore city in Southern India. Thirty-seven males and thirteen females who were undergoing abdominal surgeries were included and allocated into flow and volume incentive spirometry groups by block randomization. All subjects underwent evaluations of pulmonary function with measurement of Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), Peak Expiratory Flow (PEF). Preoperative and postoperative measurements were taken up to day 5 for both groups. Exercise tolerance measured by Six- Minute Walk Test during preoperative period and measured again at the time of discharge for both groups. Pulmonary function was analysed by post-hoc analysis and carried out using Bonferroni's 't'-test. Exercise tolerance was analysed by Paired 'T'-test. Pulmonary function (FVC, FEV1, and PEFR) was found to be significantly decreased in 1(st), 2(nd) and 3(rd) postoperative day when compared with preoperative day. On 4(th) and 5(th) postoperative day the pulmonary function (FVC, FEV1, and PEFR) was found to be better preserved in both flow and volume incentive spirometry groups. The Six-Minute Walk Test showed a statistically significant improvement in pulmonary function on the day of discharge than in the preoperative period. In terms of distance covered, the volume- incentive spirometry group showed a greater statistically significant improvement from the preoperative period to the time of discharge than was exhibited by the flow incentive spirometry group. Flow and volume incentive spirometry can be safely recommended to patients undergoing open abdominal surgery as there have been no adverse events recorded. Also, these led to a demonstrable improvement in pulmonary function and exercise tolerance.

Comparison of Flow and Volume Incentive Spirometry on Pulmonary Function and Exercise Tolerance in Open Abdominal Surgery: A Randomized Clinical Trial

PubMed Central

Kumar, Amaravadi Sampath; Augustine, Alfred Joseph; Pazhyaottayil, Zulfeequer Chundaanveetil; Ramakrishna, Anand; Krishnakumar, Shyam Krishnan

2016-01-01

Introduction Surgical procedures in abdominal area lead to changes in pulmonary function, respiratory mechanics and impaired physical capacity leading to postoperative pulmonary complications, which can affect up to 80% of upper abdominal surgery. Aim To evaluate the effects of flow and volume incentive spirometry on pulmonary function and exercise tolerance in patients undergoing open abdominal surgery. Materials and Methods A randomized clinical trial was conducted in a hospital of Mangalore city in Southern India. Thirty-seven males and thirteen females who were undergoing abdominal surgeries were included and allocated into flow and volume incentive spirometry groups by block randomization. All subjects underwent evaluations of pulmonary function with measurement of Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), Peak Expiratory Flow (PEF). Preoperative and postoperative measurements were taken up to day 5 for both groups. Exercise tolerance measured by Six- Minute Walk Test during preoperative period and measured again at the time of discharge for both groups. Pulmonary function was analysed by post-hoc analysis and carried out using Bonferroni’s ‘t’-test. Exercise tolerance was analysed by Paired ‘T’-test. Results Pulmonary function (FVC, FEV1, and PEFR) was found to be significantly decreased in 1st, 2nd and 3rd postoperative day when compared with preoperative day. On 4th and 5th postoperative day the pulmonary function (FVC, FEV1, and PEFR) was found to be better preserved in both flow and volume incentive spirometry groups. The Six-Minute Walk Test showed a statistically significant improvement in pulmonary function on the day of discharge than in the preoperative period. In terms of distance covered, the volume- incentive spirometry group showed a greater statistically significant improvement from the preoperative period to the time of discharge than was exhibited by the flow incentive spirometry group. Conclusion Flow and volume incentive spirometry can be safely recommended to patients undergoing open abdominal surgery as there have been no adverse events recorded. Also, these led to a demonstrable improvement in pulmonary function and exercise tolerance. PMID:26894090

Incentives in Diabetic Eye Assessment by Screening (IDEAS): study protocol of a three-arm randomized controlled trial using financial incentives to increase screening uptake in London.

PubMed

Judah, Gaby; Vlaev, Ivo; Gunn, Laura; King, Dominic; King, Derek; Valabhji, Jonathan; Darzi, Ara; Bicknell, Colin

2016-03-18

Diabetes is an increasing public health problem in the UK and globally. Diabetic retinopathy is a microvascular complication of diabetes, and is one of the leading causes of blindness in the UK working age population. The diabetic eye screening programme in England aims to invite all people with diabetes aged 12 or over for retinal photography to screen for the presence of diabetic retinopathy. However, attendance rates are only 81 %, leaving many people at risk of preventable sight loss. This is a three arm randomized controlled trial to investigate the impact of different types of financial incentives (based on principles from behavioral economics) on increasing attendance at diabetic eye screening appointments in London. Eligible participants will be aged 16 or over, and are those who have been invited to screening appointments annually, but who have not attended, or telephoned to rearrange an appointment, within the last 24 months. Eligible participants will be randomized to one of three conditions: 1. Control condition (usual invitation letter) 2. Fixed incentive condition (usual invitation letter, including a voucher for £10 if they attend their appointment) 3. Probabilistic incentive condition (invitation letter, including a voucher for a 1 in 100 chance of winning £1000 if they attend their appointment). Participants will be sent invitation letters, and the primary outcome will be whether or not they attend their appointment. One thousand participants will be included in total, randomized with a ratio of 1.4:1:1. In order to test whether the incentive scheme has a differential impact on patients from different demographic or socio-economic groups, information will be recorded on age, gender, distance from screening center, socio-economic status and length of time since they were last screened. A cost-effectiveness analysis will also be performed. This study will be the first trial of financial incentives for improving uptake of diabetic eye screening. If effective, the intervention may suggest a cost-effective way to increase screening rates, thus reducing unnecessary blindness. ISRCTN14896403, 25 February 2016.

Integrating novel data streams to support biosurveillance in commercial livestock production systems in developed countries: challenges and opportunities.

PubMed

Gates, M Carolyn; Holmstrom, Lindsey K; Biggers, Keith E; Beckham, Tammy R

2015-01-01

Reducing the burden of emerging and endemic infectious diseases on commercial livestock production systems will require the development of innovative technology platforms that enable information from diverse animal health resources to be collected, analyzed, and communicated in near real-time. In this paper, we review recent initiatives to leverage data routinely observed by farmers, production managers, veterinary practitioners, diagnostic laboratories, regulatory officials, and slaughterhouse inspectors for disease surveillance purposes. The most commonly identified challenges were (1) the lack of standardized systems for recording essential data elements within and between surveillance data streams, (2) the additional time required to collect data elements that are not routinely recorded by participants, (3) the concern over the sharing and use of business sensitive information with regulatory authorities and other data analysts, (4) the difficulty in developing sustainable incentives to maintain long-term program participation, and (5) the limitations in current methods for analyzing and reporting animal health information in a manner that facilitates actionable response. With the significant recent advances in information science, there are many opportunities to develop more sophisticated systems that meet national disease surveillance objectives, while still providing participants with valuable tools and feedback to manage routine animal health concerns.

Integrating Novel Data Streams to Support Biosurveillance in Commercial Livestock Production Systems in Developed Countries: Challenges and Opportunities

PubMed Central

Gates, M. Carolyn; Holmstrom, Lindsey K.; Biggers, Keith E.; Beckham, Tammy R.

2015-01-01

Reducing the burden of emerging and endemic infectious diseases on commercial livestock production systems will require the development of innovative technology platforms that enable information from diverse animal health resources to be collected, analyzed, and communicated in near real-time. In this paper, we review recent initiatives to leverage data routinely observed by farmers, production managers, veterinary practitioners, diagnostic laboratories, regulatory officials, and slaughterhouse inspectors for disease surveillance purposes. The most commonly identified challenges were (1) the lack of standardized systems for recording essential data elements within and between surveillance data streams, (2) the additional time required to collect data elements that are not routinely recorded by participants, (3) the concern over the sharing and use of business sensitive information with regulatory authorities and other data analysts, (4) the difficulty in developing sustainable incentives to maintain long-term program participation, and (5) the limitations in current methods for analyzing and reporting animal health information in a manner that facilitates actionable response. With the significant recent advances in information science, there are many opportunities to develop more sophisticated systems that meet national disease surveillance objectives, while still providing participants with valuable tools and feedback to manage routine animal health concerns. PMID:25973416

Key enablers to facilitate healthy behavior change: workshop summary.

PubMed

Teyhen, Deydre S; Aldag, Matt; Centola, Damon; Edinborough, Elton; Ghannadian, Jason D; Haught, Andrea; Jackson, Theresa; Kinn, Julie; Kunkler, Kevin J; Levine, Betty; Martindale, Valerie E; Neal, David; Snyder, Leslie B; Styn, Mindi A; Thorndike, Frances; Trabosh, Valerie; Parramore, David J

2014-05-01

The increases in preventable chronic diseases and the rising costs of health care are unsustainable. The US Army Surgeon General's vision to transition from a health care system to a system of health requires the identification of key health enablers to facilitate the adoption of healthy behaviors. In support of this vision, the US Army Telemedicine and Advanced Technology Research Center hosted a workshop in April 2013 titled "Incentives to Create and Sustain Change for Health." Members of government and academia participated to identify key health enablers that could ultimately be leveraged by technology. The key health enablers discussed included (1) public health messaging, (2) changing health habits and the environmental influence on health, (3) goal setting and tracking, (4) the role of incentives in behavior-change intervention, and (5) the role of peer and social networks on change. This report summarizes leading evidence and the group consensus on evidence-based practices with respect to the key enablers in creating healthy behavior change.

Using Publicly Available Data to Characterize Consumers Use of Email to Communicate with Healthcare Providers.

PubMed

Sandefer, Ryan H; Khairat, Saif S; Pieczkiewicz, David S; Speedie, Stuart M

2015-01-01

The use of patient focused technology has been proclaimed as a means to improve patient satisfaction and improve care outcomes. The Center for Medicaid/Medicare Services, through its EHR Incentive Program, has required eligible hospitals and professionals to send and receive secure messages from patients in order to receive financial incentives and avoid reimbursement penalties. Secure messaging between providers and patients has the potential to improve communication and care outcomes. The purpose of this study was to use National Health Interview Series (NHIS) data to identify the patient characteristics associated with communicating with healthcare providers via email. Individual patient characteristics were analyzed to determine the likelihood of emailing healthcare providers. The use of email for this purpose is associated with educational attainment, having a usual place of receiving healthcare, income, and geography. Publicly available data such as the NHIS may be used to better understand trends in adoption and use of consumer health information technologies.

An examination of automation and robotics in the context of Space Station operations

NASA Technical Reports Server (NTRS)

Criswell, David R.; Lee, Douglas S.; Ragusa, James; Starks, Scott A.; Woodruff, John; Paules, Granville

1988-01-01

A NASA-sponsored review of Space Station automation and robotics (A&R) applications from an operations and utilization perspective is presented. The goals of the A&R panel and this report are to identify major suggestions for advanced A&R operations application in Space Station as well as key technologies that have emerged or gained prominence since the completion of previous reports; to review and incorporate the range of possible Space Station A&R applications into a framework for evaluation of A&R opportunities; and to propose incentives for the government, work packages, and subcontractors to more aggressively identify, evaluate, and incorporate advanced A&R in Space Station Operations. The suggestions for A&R focused on narrow objectives using a conservative approach tuned to Space Station at IOC and limiting the Station's growth capabilities. A more aggressive stance is to identify functional needs over the Program's life, exploit and leverage available technology, and develop the key advanced technologies permitting effective use of A&R. The challenge is to systematically identify candidate functions to be automated, provide ways to create solutions resulting in savings or increased capabilities, and offer incentives that will promote the automation.

Medicaid Stage 1 Meaningful Use EHR Incentive Payments Are Associated With Higher Quality but Not Improvements in Quality.

PubMed

Grinspan, Zachary M; Bao, Yuhua; Edwards, Alison; Johnson, Phyllis; Kaushal, Rainu; Kern, Lisa M

This was a retrospective cohort study of ambulatory care quality by physicians who received payment for Medicaid Stage 1 Meaningful Use (MU) in 2012 using New York State Medicaid Claims (2010-2013). Eight quality measures were used to compare performance of physicians who received payments to Adopt, Implement, or Use (AIU) an electronic health record in 2011 but not for MU in 2012 (AIU-only group) and physicians who cared for Medicaid patients but received no payments (no-incentive group), using propensity score-weighted difference-in-difference logistic regression analyses, clustering by physician. In all, 13 697 physicians and 913 476 patients were studied. In 2010, the MU group scored higher than both groups (vs AIU-only in 3 of 8 measures, 0.8-1.3 adjusted percentage points; vs no-incentive, 2 of 8 measures, 0.9-2.0 adjusted percentage points). The difference-in-difference analysis found no additional improvements in quality over time relative to either control group. Longer follow-up is needed to determine the effects of Stage 2 MU.

Incentive Mechanism for P2P Content Sharing over Heterogenous Access Networks

NASA Astrophysics Data System (ADS)

Sato, Kenichiro; Hashimoto, Ryo; Yoshino, Makoto; Shinkuma, Ryoichi; Takahashi, Tatsuro

In peer-to-peer (P2P) content sharing, users can share their content by contributing their own resources to one another. However, since there is no incentive for contributing contents or resources to others, users may attempt to obtain content without any contribution. To motivate users to contribute their resources to the service, incentive-rewarding mechanisms have been proposed. On the other hand, emerging wireless technologies, such as IEEE 802.11 wireless local area networks, beyond third generation (B3G) cellular networks and mobile WiMAX, provide high-speed Internet access for wireless users. Using these high-speed wireless access, wireless users can use P2P services and share their content with other wireless users and with fixed users. However, this diversification of access networks makes it difficult to appropriately assign rewards to each user according to their contributions. This is because the cost necessary for contribution is different in different access networks. In this paper, we propose a novel incentive-rewarding mechanism called EMOTIVER that can assign rewards to users appropriately. The proposed mechanism uses an external evaluator and interactive learning agents. We also investigate a way of appropriately controlling rewards based on the system service's quality and managing policy.

Neural Activity in the Ventral Pallidum Encodes Variation in the Incentive Value of a Reward Cue

PubMed Central

Meyer, Paul J.; Ferguson, Lindsay M.; Robinson, Terry E.; Aldridge, J. Wayne

2016-01-01

There is considerable individual variation in the extent to which reward cues are attributed with incentive salience. For example, a food-predictive conditioned stimulus (CS; an illuminated lever) becomes attractive, eliciting approach toward it only in some rats (“sign trackers,” STs), whereas others (“goal trackers,” GTs) approach the food cup during the CS period. The purpose of this study was to determine how individual differences in Pavlovian approach responses are represented in neural firing patterns in the major output structure of the mesolimbic system, the ventral pallidum (VP). Single-unit in vivo electrophysiology was used to record neural activity in the caudal VP during the performance of ST and GT conditioned responses. All rats showed neural responses to both cue onset and reward delivery but, during the CS period, STs showed greater neural activity than GTs both in terms of the percentage of responsive neurons and the magnitude of the change in neural activity. Furthermore, neural activity was positively correlated with the degree of attraction to the cue. Given that the CS had equal predictive value in STs and GTs, we conclude that neural activity in the VP largely reflects the degree to which the CS was attributed with incentive salience. SIGNIFICANCE STATEMENT Cues associated with reward can acquire motivational properties (i.e., incentive salience) that cause them to have a powerful influence on desire and motivated behavior. There are individual differences in sensitivity to reward-paired cues, with some individuals attaching greater motivational value to cues than others. Here, we investigated the neural activity associated with these individual differences in incentive salience. We found that cue-evoked neural firing in the ventral pallidum (VP) reflected the strength of incentive motivation, with the greatest neural responses occurring in individuals that demonstrated the strongest attraction to the cue. This suggests that the VP plays an important role in the process by which cues gain control over motivation and behavior. PMID:27466340

Cost-effectiveness analysis of malaria rapid diagnostic test incentive schemes for informal private healthcare providers in Myanmar.

PubMed

Chen, Ingrid T; Aung, Tin; Thant, Hnin Nwe Nwe; Sudhinaraset, May; Kahn, James G

2015-02-05

The emergence of artemisinin-resistant Plasmodium falciparum parasites in Southeast Asia threatens global malaria control efforts. One strategy to counter this problem is a subsidy of malaria rapid diagnostic tests (RDTs) and artemisinin-based combination therapy (ACT) within the informal private sector, where the majority of malaria care in Myanmar is provided. A study in Myanmar evaluated the effectiveness of financial incentives vs information, education and counselling (IEC) in driving the proper use of subsidized malaria RDTs among informal private providers. This cost-effectiveness analysis compares intervention options. A decision tree was constructed in a spreadsheet to estimate the incremental cost-effectiveness ratios (ICERs) among four strategies: no intervention, simple subsidy, subsidy with financial incentives, and subsidy with IEC. Model inputs included programmatic costs (in dollars), malaria epidemiology and observed study outcomes. Data sources included expenditure records, study data and scientific literature. Model outcomes included the proportion of properly and improperly treated individuals with and without P. falciparum malaria, and associated disability-adjusted life years (DALYs). Results are reported as ICERs in US dollars per DALY averted. One-way sensitivity analysis assessed how outcomes depend on uncertainty in inputs. ICERs from the least to most expensive intervention are: $1,169/DALY averted for simple subsidy vs no intervention, $185/DALY averted for subsidy with financial incentives vs simple subsidy, and $200/DALY averted for a subsidy with IEC vs subsidy with financial incentives. Due to decreasing ICERs, each strategy was also compared to no intervention. The subsidy with IEC was the most favourable, costing $639/DALY averted compared with no intervention. One-way sensitivity analysis shows that ICERs are most affected by programme costs, RDT uptake, treatment-seeking behaviour, and the prevalence and virulence of non-malarial fevers. In conclusion, private provider subsidies with IEC or a combination of IEC and financial incentives may be a good investment for malaria control.

Financial Incentives and Inequalities in Smoking Cessation Interventions in Primary Care: Before-and-After Study.

PubMed

Hamilton, Fiona L; Laverty, Anthony A; Huckvale, Kit; Car, Josip; Majeed, Azeem; Millett, Christopher

2016-03-01

The Quality and Outcomes Framework (QOF) is a financial incentive scheme that rewards UK general practices for providing evidence-based care, including smoking cessation advice mainly as a secondary prevention intervention. We examined the effects on smoking outcomes and inequalities of a local version of QOF (QOF+), which ran from 2008 to 2011 and extended financial incentives to the provision of cessation advice as a primary prevention intervention. Before-and-after study using data from 28 general practices in Hammersmith & Fulham, London, United Kingdom. We used logistic regression to examine changes in smoking outcomes associated with QOF+ within and between sociodemographic groups. Recording of smoking status increased from 55.5% to 64.3% for men (P < .001) and from 67.9% to 75.8% for women (P < .001). All groups benefitted from the increase, but younger patients remained less likely to be asked about smoking than older patients. White patients were less likely to be asked than those from other ethnic groups. Smoking cessation advice increased from 32.7% to 54.0% for men (P < .001) and from 35.4% to 54.1% for women (P < .01) and there was little variation between groups for this outcome. Recorded smoking prevalence reduced from 25.0% to 20.8% for men (P < .001) and from 16.1% to 12.5% for women (P < .001). White patients and those from more deprived areas remained more likely to be smokers than other groups. The introduction of QOF+ was associated with general improvements in recording of smoking outcomes, but inequalities in ascertainment and smoking prevalence with respect to age, ethnicity, and deprivation persisted. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Using Peer-Referral Chains with Incentives to Promote HIV Testing and Identify Undiagnosed HIV Infections Among Crack Users in San Salvador

PubMed Central

Glasman, Laura R.; Dickson-Gomez, Julia; Lechuga, Julia; Tarima, Sergey; Bodnar, Gloria; de Mendoza, Lorena Rivas

2016-01-01

In El Salvador, crack users are at high risk for HIV but they are not targeted by efforts to promote early HIV diagnosis. We evaluated the promise of peer-referral chains with incentives to increase HIV testing and identify undiagnosed HIV infections among networks of crack users in San Salvador. For 14 months, we offered HIV testing in communities with a high prevalence of crack use. For the following 14 months, we promoted chains in which crack users from these communities referred their peers to HIV testing and received a small monetary incentive. We recorded the monthly numbers of HIV testers, and their crack use, sexual risk behaviors and test results. After launching the referral chains, the monthly numbers of HIV testers increased significantly (Z = 6.90, p < .001) and decayed more slowly (Z = 5.93, p < .001), and the total number of crack-using testers increased nearly fourfold. Testers in the peer-referral period reported fewer HIV risk behaviors, but a similar percentage (~5 %) tested HIV positive in both periods. More women than men received an HIV-positive diagnosis throughout the study (χ2(1, N = 799) = 4.23, p = .040). Peer-referral chains with incentives can potentially increase HIV testing among networks of crack users while retaining a focus on high-risk individuals. PMID:26687093

Effectiveness and acceptability of parental financial incentives and quasi-mandatory schemes for increasing uptake of vaccinations in preschool children: systematic review, qualitative study and discrete choice experiment.

PubMed

Adams, Jean; Bateman, Belinda; Becker, Frauke; Cresswell, Tricia; Flynn, Darren; McNaughton, Rebekah; Oluboyede, Yemi; Robalino, Shannon; Ternent, Laura; Sood, Benjamin Gardner; Michie, Susan; Shucksmith, Janet; Sniehotta, Falko F; Wigham, Sarah

2015-11-01

Uptake of preschool vaccinations is less than optimal. Financial incentives and quasi-mandatory policies (restricting access to child care or educational settings to fully vaccinated children) have been used to increase uptake internationally, but not in the UK. To provide evidence on the effectiveness, acceptability and economic costs and consequences of parental financial incentives and quasi-mandatory schemes for increasing the uptake of preschool vaccinations. Systematic review, qualitative study and discrete choice experiment (DCE) with questionnaire. Community, health and education settings in England. Qualitative study - parents and carers of preschool children, health and educational professionals. DCE - parents and carers of preschool children identified as 'at high risk' and 'not at high risk' of incompletely vaccinating their children. Qualitative study - focus groups and individual interviews. DCE - online questionnaire. The review included studies exploring the effectiveness, acceptability or economic costs and consequences of interventions that offered contingent rewards or penalties with real material value for preschool vaccinations, or quasi-mandatory schemes that restricted access to 'universal' services, compared with usual care or no intervention. Electronic database, reference and citation searches were conducted. Systematic review - there was insufficient evidence to conclude that the interventions considered are effective. There was some evidence that the quasi-mandatory interventions were acceptable. There was insufficient evidence to draw conclusions on economic costs and consequences. Qualitative study - there was little appetite for parental financial incentives. Quasi-mandatory schemes were more acceptable. Optimising current services was consistently preferred to the interventions proposed. DCE and questionnaire - universal parental financial incentives were preferred to quasi-mandatory interventions, which were preferred to targeted incentives. Those reporting that they would need an incentive to vaccinate their children completely required around £110. Those who did not felt that the maximum acceptable incentive was around £70. Systematic review - a number of relevant studies were excluded as they did not meet the study design inclusion criteria. Qualitative study - few partially and non-vaccinating parents were recruited. DCE and questionnaire - data were from a convenience sample. There is little current evidence on the effectiveness or economic costs and consequences of parental financial incentives and quasi-mandatory interventions for preschool vaccinations. Universal incentives are likely to be more acceptable than targeted ones. Preferences concerning incentives versus quasi-mandatory interventions may depend on the context in which these are elicited. Further evidence is required on (i) the effectiveness and optimal configuration of parental financial incentive and quasi-mandatory interventions for preschool vaccinations - if effectiveness is confirmed, further evidence is required on how to communicate this to stakeholders and the impact on acceptability; and (ii) the acceptability of parental financial incentive and quasi-mandatory interventions for preschool vaccinations to members of the population who are not parents of preschool children or relevant health professionals. Further consideration should be given to (i) incorporating reasons for non-vaccination into new interventions for promoting vaccination uptake; and (ii) how existing services can be optimised. This study is registered as PROSPERO CRD42012003192. The National Institute for Health Research Health Technology Assessment programme.

Captivate: Building Blocks for Implementing Active Learning

ERIC Educational Resources Information Center

Kitchens, Brent; Means, Tawnya; Tan, Yinliang

2018-01-01

In this study, the authors propose a set of key elements that impact the success of an active learning implementation: content delivery, active learning methods, physical environment, technology enhancement, incentive alignment, and educator investment. Through a range of metrics the authors present preliminary evidence that students in courses…

Incentive Analysis for Clean Water Act Reauthorization: Point Source/Nonpoint Source Trading for Nutrient Discharge Reductions (1992)

EPA Pesticide Factsheets

Paper focuses on trading schemes in which regulated point sources are allowed to avoid upgrading their pollution control technology to meet water quality-based effluent limits if they pay for equivalent (or greater) reductions in nonpoint source pollution.

Cooperation in the Classroom: Experimenting with R&D Cooperatives

ERIC Educational Resources Information Center

Goeree, Michelle S.; Hinloopen, Jeroen

2008-01-01

The authors describe a classroom experiment that illustrates the research and development investment incentives facing firms when technological spillovers are present. The game involves two stages in which student "sellers" first make investment decisions and then production decisions. The classroom game can be used to motivate…

Charting a New Path: Modernizing the U.S. Air Force Fighter Pilots Career Development

DTIC Science & Technology

2015-12-01

truly provides no new incentives for undecided fighter pilots and is proving to be an antiquated attempt to maintain the fighter pilot force...growing technological requirements. Weapons shops are responsible for a growing number of responsibilities to support combat operations. Crypto

For the last time: stock options are an expense.

PubMed

Bodie, Zvi; Kaplan, Robert S; Merton, Robert C

2003-03-01

Should stock options be recorded as an expense on a company's income statement and balance sheet, or should they remain where they are, relegated to footnotes? The extraordinary boom in share prices during the Internet bubble made critics of option expensing look like spoilsports. But since the crash, the debate has returned with a vengeance. And no wonder: The authors believe the case for expensing options is overwhelming. In this article, Nobel Iaureate Robert Merton, one of the inventors of the Black-Scholes option-pricing model; his coauthor on the classic textbook Finance, Zvi Bodie; and Robert Kaplan, creator of the Balanced Scorecard, examine and dismiss the principal claims put forward by those who continue to oppose options expensing. They demonstrate that stock-option grants do indeed have real cash-flow implications that need to be reported. They show that effective ways certainly exist to quantify those implications. They detail the distortions that relegating stock-option accounting to footnotes creates. And they show why reporting option costs should in no way hamper young companies in their efforts to provide incentives. Options are indeed a powerful incentive, the authors agree, and failing to record a transaction that creates such powerful effects is economically indefensible. Worse, it encourages companies to favor options over alternative incentive systems. It is not the proper role of accounting standards, the authors argue, to distort executive and employee compensation by subsidizing one particular form of compensation and no other. Companies should choose compensation methods according to their economic benefits--not the way they are reported.

Specific Reaction Patterns to Distinct Positive Emotional Cues Related to Incentive Motivation in Dependence of the Taq1A-Polymorphism: Molecular Genetic Associations of Early and Late Event-Related Potentials.

PubMed

Munk, Aisha J L; Wielpuetz, Catrin; Osinsky, Roman; Müller, Erik M; Grant, Phillip; Hennig, Jürgen

2016-01-01

Early and late event-related potential (ERP) responses, representing early subconscious and late motivational processes, were recorded for positive emotional words related to 'wanting' and 'liking', in dependence of the dopamine-related Taq1A genotype (ANKK1/DRD2). Research suggests that 'wanting' as opposed to 'liking' is related to dopaminergic processes. Therefore, it was hypothesized that risk allele carriers of the Taq1A polymorphism exhibit late ERP changes in reaction to words representing incentive motivation, i.e. 'wanting' (word categories 'lust' and 'anticipation'), but not to words representing 'liking' ('closeness'). Seventy-two male participants performed an emotional-word Stroop task during EEG recording and were genotyped according to the Taq1A polymorphism of ANKK1/DRD2. Positive emotional words related to anticipation and lust revealed blunted responses in the late positive potential (LPP) in carriers of the A1 allele, an effect absent in response to 'liking'-related words. These differences were not evident in the earlier posterior negativity (EPN). As no differences in dependence of the Taq1A genotype were observed in reaction to 'wanting'- and 'liking'-related words in the EPN, but merely in the LPP, it can be assumed that incentive-motivational stimuli only modify motivation-related ERP responses in carriers of the A1 allele of the Taq1A polymorphism, indicating the role of dopamine in late ERP components. © 2016 S. Karger AG, Basel.

Policy brief on the current status of certification of electronic Health Records in the US and Europe.

PubMed

De Moor, Georges; O'Brien, John; Fridsma, Doug; Bean, Carol; Devlies, Jos; Cusack, Caitlin M; Bloomrosen, Meryl; Lorenzi, Nancy; Coorevits, Pascal

2011-01-01

If Electronic Health Record systems are to provide an effective contribution to healthcare, a set of benchmarks need to be set to ensure quality control and interoperability of systems. This paper outlines the prevailing status of EHR certification in the US and the EU, compares and contrasts established schemes and poses opportunities for convergence of activity in the domain designed to advance certification endeavours generally. Several EU Member States have in the past proceeded with EHR systems quality labeling and/or certification, but these differ in scope, in legal framework under which they operate, in policies (legislation and financial incentives), in organization, and perhaps most importantly in the quality criteria used for benchmarking. Harmonization, therefore, became a must. Now, through EuroRec (with approaches ranging from self-assessment to third party certification depending on the level of confidence needed) and its Seals, the possibility to achieve this for EHR systems has started in the whole of Europe. The US HITECH Act also attempts to create incentives for all hospitals and eligible providers to adopt and use electronic information. A centerpiece of the Act is to put in place strong financial incentives to adopt and meaningfully use EHRs. The HHS/EHR Certification Programme makes use of ISO/IEC 170XX standards for accreditation, testing and certification. The approved test method addresses the functional and the interoperability requirements defined in the Final Rule criteria and standards. To date six Authorized Testing and Certification Bodies (ATCBs) are testing and certifying products in the US.

Attitudes on Technological, Social, and Behavioral Economic Strategies to Reduce Cellphone Use While Driving in Teens.

PubMed

Delgado, M Kit; McDonald, Catherine C; Winston, Flaura K; Halpern, Scott D; Buttenheim, Alison M; Setubal, Claudia; Huang, Yanlan; Saulsgiver, Kathryn A; Lee, Yi-Ching

2018-04-13

The majority of U.S. teens admit to handheld cellphone use while driving, an increasingly common cause of crashes. Attitudes towards novel cellphone applications and settings that block use while driving are poorly understood, potentially limiting uptake. We examined teens' willingness to reduce cellphone use while driving and perceptions of potential strategies to limit this behavior. Teen drivers (n = 153) aged 16-17 who owned smartphones and admitted to texting while driving completed an online survey. Survey instruments measured willingness to give up cellphone use and perceptions of technological and behavioral economic strategies to reduce cellphone use while driving. We used Chi-square tests to test the hypothesis that willingness to give up certain types of cellphone use while driving and the perceptions of strategies to reduce cellphone use while driving would differ by self-reported frequency of texting while driving in the past 30 days (low [1-5 days] vs. high [6 or more days]. Most teens were willing or somewhat willing to give up reading texts (90%), sending texts (95%), and social media (99%) while driving. However they were not willing to give up navigation (59%) and music applications (43%). Those who engaged in high-frequency texting while driving were more likely to say they were not willing to give up navigation applications (73% vs. 44%, P <0.001), music applications (54% vs. 32%, P <0.001), and reading texts (15% vs. 4%) (P = 0.029). Overall, the following strategies where rated as likely to be "very effective" for reducing texting while driving: gain-framed financial incentives (75%), loss-framed financial incentives (63%), group-based financial incentives (58%), insurance discounts (53%), automatic phone locking while driving (54%), email notifications to parents (47%), automated responses to incoming texts (42%), peer concern (18%), and parental concern (15%). Those who engaged in high-frequency texting while driving were less likely to say that following strategies would be very effective: automated responses to incoming texts (33% vs. 53%, P = 0.016), peer concern (9% vs. 29%, P = 0.002), and parental concern (9% vs. 22%, P = 0.025). The strongest perceived benefit of cellphone blocking apps was decreasing distraction (86%). The predominant reason for not wanting to use this technology was not wanting parents to monitor their behavior (60%). Promising strategies for increasing acceptance of cellphone blocking technology among teen drivers include automated screen locking and permitting hands-free navigation and music combined with behavioral economic incentives to sustain engagement.

Beyond Widgets -- Systems Incentive Programs for Utilities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Regnier, Cindy; Mathew, Paul; Robinson, Alastair

Utility incentive programs remain one of the most significant means of deploying commercialized, but underutilized building technologies to scale. However, these programs have been largely limited to component-based products (e.g., lamps, RTUs). While some utilities do provide ‘custom’ incentive programs with whole building and system level technical assistance, these programs require deeper levels of analysis, resulting in higher program costs. This results in custom programs being restricted to utilities with greater resources, and are typically applied mainly to large or energy-intensive facilities, leaving much of the market without cost effective access and incentives for these solutions. In addition, with increasinglymore » stringent energy codes, cost effective component-based solutions that achieve significant savings are dwindling. Building systems (e.g., integrated façade, HVAC and/or lighting solutions) can deliver higher savings that translate into large sector-wide savings if deployed at the scale of these programs. However, systems application poses a number of challenges – baseline energy use must be defined and measured; the metrics for energy and performance must be defined and tested against; in addition, system savings must be validated under well understood conditions. This paper presents a sample of findings of a project to develop validated utility incentive program packages for three specific integrated building systems, in collaboration with Xcel Energy (CO, MN), ComEd, and a consortium of California Public Owned Utilities (CA POUs) (Northern California Power Agency(NCPA) and the Southern California Public Power Authority(SCPPA)). Furthermore, these program packages consist of system specifications, system performance, M&V protocols, streamlined assessment methods, market assessment and implementation guidance.« less

Evaluation of Mobil OCTGAIN{trademark} technology for the manufacture of reformulated gasoline via LP modeling

DOE Office of Scientific and Technical Information (OSTI.GOV)

Poddar, S.K.; Chum, K.; Ragsdale, R.

1995-09-01

Sulfur and olefins content of gasoline come primarily from the cat-cracked blendstock. Therefore hydrotreating cat cracked naphtha is a straight forward approach to reduce sulfur and olefin contents of gasoline and thereby reduce auto exhaust emission. However, this approach reduces the Octane number of gasoline which requires addition of Octane enhancer like MTBE to meet the stringent requirement of 1990 Clean Air Act Amendments and to produce Reformulated Gasoline (RFG). The paper examines the economic incentives of an innovative process technology which was developed and commercialized by Mobil known as OCTGAIN. The process utilizes fixed bed low pressure hardware andmore » uses a Mobil proprietary catalyst system to produce catalytically cracked (CC) gasoline component with thorough desulfurization and olefin reduction and practically no loss in Octane number. The economic evaluation of the OCTGAIN technology was conducted with Bechtel`s proprietary linear programming software, Process Industry Modeling System by introducing an OCTGAIN process block to a typical PADD-3 refinery configuration for gasoline production and satisfying RFG specifications. The results of the evaluation which involved twenty case studies, show that within the limitations of the study scope, the introduction of OCTGAIN technology creates a definite economic incentive over conventional hydrofinishing of CC naphtha. The profitability of OCTGAIN technology is dependent on the aromatics component of the gasoline pool. The economic advantage of OCTGAIN technology is realized primarily by higher production of premium gasoline and the ability to process lower cost high sulfur crude. The process also allows a better utilization of the FCCU and hydrocracker, if the refinery operation permits.« less

75 FR 81885 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program; Correcting Amendment

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-29

... ``Therefore, we revise this measure to require that at least one of the five rules be related to a clinical quality measure, assuming the EP, eligible hospital or CAH has at least one clinical quality measure... rule to a specific clinical quality measure.'' 4. On page 44359, a. First column, first partial...

Enhancing Incentives to Improve Performance in the Education System in France. OECD Economics Department Working Papers, No. 570

ERIC Educational Resources Information Center

O'Brien, Paul

2007-01-01

The French education system has a mixed record. A generally very successful pre-school and primary school level contrasts with underfunded public universities with high dropout rates which exist alongside very successful higher education institutions for elites. Initial education, especially secondary education and the universities, along with…

Counting on commitment; the quality of primary care-led diabetes management in a system with minimal incentives.

PubMed

Mc Hugh, Sheena; Marsden, Paul; Brennan, Carmel; Murphy, Katie; Croarkin, Celine; Moran, Joe; Harkins, Velma; Perry, Ivan J

2011-12-28

The aim of the present study was to assess the performance of three primary care-led initiatives providing structured care to patients with Type 2 diabetes in Ireland, a country with minimal incentives to promote the quality of care. Data, from three primary care initiatives, were available for 3010 adult patients with Type 2 diabetes. Results were benchmarked against the national guidelines for the management of Type 2 diabetes in the community and results from the National Diabetes Audit (NDA) for England (2008/2009) and the Scottish Diabetes Survey (2009). The recording of clinical processes of care was similar to results in the UK however the recording of lifestyle factors was markedly lower. Recording of HbA1c, blood pressure and lipids exceeded 85%. Recording of retinopathy screening (71%) was also comparable to England (77%) and Scotland (90%). Only 63% of patients had smoking status recorded compared to 99% in Scotland while 70% had BMI recorded compared to 89% in England. A similar proportion of patients in this initiative and the UK achieved clinical targets. Thirty-five percent of patients achieved a target HbA1c of < 6.5% (< 48 mmol/mol) compared to 25% in England. Applying the NICE target for blood pressure (≤ 140/80 mmHg), 54% of patients reached this target comparable to 60% in England. Slightly less patients were categorised as obese (> 30 kg/m²) in Ireland (50%, n = 1060) compared to Scotland (54%). This study has demonstrated what can be achieved by proactive and interested health professionals in the absence of national infrastructure to support high quality diabetes care. The quality of primary care-led diabetes management in the three initiatives studied appears broadly consistent with results from the UK with the exception of recording lifestyle factors. The challenge facing health systems is to establish quality assurance a responsibility for all health care professionals rather than the subject of special interest for a few.

Perceptions of primary care staff on a regional data quality intervention in Australian general practice: a qualitative study.

PubMed

Ghosh, Abhijeet; McCarthy, Sandra; Halcomb, Elizabeth

2016-04-26

Technological advances in clinical data capturing and storage systems have led to recent attempts at disease surveillance and region specific population health planning through regularly collected primary care administrative clinical data. However the accuracy and comprehensiveness of primary care health records remain questionable. We aimed to explore the perceptions and experiences of general practice staff in maintaining accurate patient health data within clinical software used in primary care settings of regional NSW. Focus groups were conducted with general practitioners, practice nurses and practice administrative staff from 17 practices in the Illawarra-Shoalhaven region of the state of New South Wales (NSW) in Australia that had participated in the Sentinel Practices Data Sourcing (SPDS) project - a general practice based chronic disease surveillance and data quality improvement study. A total of 25 respondents that included 12 general practitioners (GPs) and 13 practice staff participated in the 6 focus groups. Focus groups were audio-recorded and transcribed verbatim. Thematic analysis of the data was undertaken. Five key themes emerged from the data. Firstly, the theme of resourcing data management raised issues of time constraints, the lack of a dedicated data management role and the importance of multidisciplinary involvement, including a data champion. The need for incentives was identified as being important to motivate ongoing commitment to maintaining data quality. However, quality of software packages, including coding issues and software limitations and information technology skills were seen as key barriers. The final theme provided insight into the lessons learnt from the project and the increased awareness of the importance of data quality amongst practice staff. The move towards electronic methods of maintaining general practice patient records offers significant potential benefits in terms of both patient care and monitoring of health status and health needs within the community. However, this study has reinforced the importance of human factors in the maintenance of such datasets. To achieve optimal benefits of electronic health and medical records for patient care and for population health planning purposes, it is extremely essential to address the barriers that clinicians and other staff face in maintaining complete and correct primary care patient electronic health and medical information.

Open Access Initiatives in Africa--Structure, Incentives and Disincentives

ERIC Educational Resources Information Center

Nwagwu, Williams E.

2013-01-01

Building open access in Africa is imperative not only for African scholars and researchers doing scientific research but also for the expansion of the global science and technology knowledgebase. This paper examines the structure of homegrown initiatives, and observes very low level of awareness prevailing in the higher educational institutions…

NREL Suite of Tools for PV and Storage Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Elgqvist, Emma M; Salasovich, James A

Many different factors such as the solar resource, technology costs and incentives, utility cost and consumption, space available, and financial parameters impact the technical and economic potential of a PV project. NREL has developed techno-economic modeling tools that can be used to evaluate PV projects at a site.

Exploring CHP: What It Is and How It Is Used (Webinar) – May 20 and June 17, 2015

EPA Pesticide Factsheets

This is a two-part webinar. Part 1 provides information about the benefits of CHP systems and the state and federal policies and incentives that support their development. Part 2 describes the various CHP technologies and their applications.

Implementing Computer Integrated Manufacturing Technician Program.

ERIC Educational Resources Information Center

Gibbons, Roger

A computer-integrated manufacturing (CIM) technician program was developed to provide training and technical assistance to meet the needs of business and industry in the face of the demands of high technology. The Computer and Automated Systems Association (CASA) of the Society of Manufacturing Engineers provided the incentive and guidelines…

49 CFR 350.105 - What definitions are used in this part?

Code of Federal Regulations, 2010 CFR

2010-10-01

... activities and projects that improve CMV safety and compliance with CMV safety regulations (including activities and projects that are national in scope), increase public awareness and education, demonstrate new technologies, and reduce the number and rate of accidents involving CMVs. Incentive Funds means funds awarded...

Why Mobile Is a Must

ERIC Educational Resources Information Center

McCaffrey, Mary

2011-01-01

There is a need for a new educational model that makes learning personal and motivating, and helps secure students' future in the knowledge economy. Mobile technology opens the door to it. Mobile devices provide the platform and, as importantly, the incentive for students to take personal ownership of the learning experience. The lessons absorbed…

A data envelopment analysis approach to compare the environmental efficiency of energy technologies and countries

USDA-ARS?s Scientific Manuscript database

Due to increasing financial and environmental concerns, governmental rules, regulations and incentives alternative energy sources are soon expected to grow at a much faster pace than conventional sources of energy. However, the current body of research providing comparative decision making models fo...

Bioethics and international human rights.

PubMed

Thomasma, D C

1997-01-01

Noting how the spread of medical technology is creating clashes with traditional values and within cultures, the author addresses the clash between Western rights-based incentives, as used by the United Nations to guarantee respect for life and dignity, and communitarian traditions. He proposes a mean between wholesale cultural relativism and international absolutism.

Assessment of the Incentives, Disincentives, and Alternatives for Steel Industry CO2 Reduction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Paul T. Leuchte; DR. John Stubbles; Professor Fruehan

This report presents the results of the third element of a trilogy of studies sponsored by the U.S. Department of Energy's Office of Industrial Technologies on the consumption of energy and the emissions of carbon dioxide in the U.S. steel industry

Can You Keep Learners Online?

ERIC Educational Resources Information Center

Zielinski, Dave

2000-01-01

Reasons people do not complete online training courses include (1) no incentives, (2) lack of connectedness, (3) learner preference for instructor-led courses, (4) poor course design, (5) "some is enough," and (6) lack of perks. Course delivery must consider three elements: the technology, course design, and the learning environment. (JOW)

Faculty and Administrators Collaborating for E-Learning Courseware

ERIC Educational Resources Information Center

Donohue, Brian C.; Howe-Steiger, Linda

2005-01-01

To soothe faculty distrust and encourage engagement, or reengagement, in exploring applications of digital technology for teaching, the authors believe it is necessary to do three things: (1) create incentives for faculty that balance public service goals with professional and entrepreneurial rewards; (2) clarify ownership and usage rights of…

Institutions, Innovation, and Incentives.

ERIC Educational Resources Information Center

Levien, Roger E.

It is important to achieve effective innovation in computer-assisted instruction (CAI). Meaningful innovation can be achieved only by changing the system--that is, by changing not only the technology, but also the institutions and persons involved. Two institutions are proposed: a National Institute of Education which would support creation of a…

A methodology for fostering commercialization of electric and hybrid vehicle propulsion systems

NASA Technical Reports Server (NTRS)

Thollot, P. A.; Musial, N. T.

1980-01-01

The rationale behind, and a proposed approach for, application of government assistance to accelerate the process of moving a new electric vehicle propulsion system product from technological readiness to profitable marketplace acceptance and utilization are described. Emphasis is on strategy, applicable incentives, and an implementation process.

Determinants of a successful problem list to support the implementation of the problem-oriented medical record according to recent literature.

PubMed

Simons, Sereh M J; Cillessen, Felix H J M; Hazelzet, Jan A

2016-08-02

A problem-oriented approach is one of the possibilities to organize a medical record. The problem-oriented medical record (POMR) - a structured organization of patient information per presented medical problem- was introduced at the end of the sixties by Dr. Lawrence Weed to aid dealing with the multiplicity of patient problems. The problem list as a precondition is the centerpiece of the problem-oriented medical record (POMR) also called problem-oriented record (POR). Prior to the digital era, paper records presented a flat list of medical problems to the healthcare professional without the features that are possible with current technology. In modern EHRs a POMR based on a structured problem list can be used for clinical decision support, registries, order management, population health, and potentially other innovative functionality in the future, thereby providing a new incentive to the implementation and use of the POMR. On both 12 May 2014 and 1 June 2015 a systematic literature search was conducted. From the retrieved articles statements regarding the POMR and related to successful or non-successful implementation, were categorized. Generic determinants were extracted from these statements. In this research 38 articles were included. The literature analysis led to 12 generic determinants: clinical practice/reasoning, complete and accurate problem list, data structure/content, efficiency, functionality, interoperability, multi-disciplinary, overview of patient information, quality of care, system support, training of staff, and usability. Two main subjects can be distinguished in the determinants: the system that the problem list and POMR is integrated in and the organization using that system. The combination of the two requires a sociotechnical approach and both are equally important for successful implementation of a POMR. All the determinants have to be taken into account, but the weight given to each of the determinants depends on the organizationusing the problem list or POMR.

Qualifying Examination Intended to Promote Students‧ Interest in Basic Engineering Course

NASA Astrophysics Data System (ADS)

Yamada, Kenji

In order to develop self-affirmation and confidence, all the third year students in the Department of Electronics and Information Engineering at Ishikawa National College of Technology have been assigned to take a qualifying examination : the Digital Technology Certificate Examination, which is supported by the Ministry of Education, Culture, Sports, Science and Technology. The students who have passed it have gained self-assurance, while the unsuccessful candidates need close attention. This paper discusses the effects of the examination, which was introduced as an incentive for the students to have interest in the specialized course.

Health information technology: a few years of magical thinking?

PubMed

Diamond, Carol C; Shirky, Clay

2008-01-01

One of the biggest obstacles to expanding the use of information technology (IT) in health care may be the current narrow focus on how to stimulate its adoption. The challenge of thinking of IT as a tool to improve quality requires serious attention to transforming the U.S. health care system as a whole, rather than simply computerizing the current setup. Proponents of health IT must resist "magical thinking," such as the notion that technology will transform our broken system, absent integrated work on policy or incentives. The alternative route to transforming the system sets all of its sights on the destination.

Effect of non-monetary incentives on uptake of couples' counselling and testing among clients attending mobile HIV services in rural Zimbabwe: a cluster-randomised trial.

PubMed

Sibanda, Euphemia L; Tumushime, Mary; Mufuka, Juliet; Mavedzenge, Sue Napierala; Gudukeya, Stephano; Bautista-Arredondo, Sergio; Hatzold, Karin; Thirumurthy, Harsha; McCoy, Sandra I; Padian, Nancy; Copas, Andrew; Cowan, Frances M

2017-09-01

Couples' HIV testing and counselling (CHTC) is associated with greater engagement with HIV prevention and care than individual testing and is cost-effective, but uptake remains suboptimal. Initiating discussion of CHTC might result in distrust between partners. Offering incentives for CHTC could change the focus of the pre-test discussion. We aimed to determine the impact of incentives for CHTC on uptake of couples testing and HIV case diagnosis in rural Zimbabwe. In this cluster-randomised trial, 68 rural communities (the clusters) in four districts receiving mobile HIV testing services were randomly assigned (1:1) to incentives for CHTC or not. Allocation was not masked to participants and researchers. Randomisation was stratified by district and proximity to a health facility. Within each stratum random permutation was done to allocate clusters to the study groups. In intervention communities, residents were informed that couples who tested together could select one of three grocery items worth US$1·50. Standard mobilisation for testing was done in comparison communities. The primary outcome was the proportion of individuals testing with a partner. Analysis was by intention to treat. 3 months after CHTC, couple-testers from four communities per group individually completed a telephone survey to evaluate any social harms resulting from incentives or CHTC. The effect of incentives on CHTC was estimated using logistic regression with random effects adjusting for clustering. The trial was registered with the Pan African Clinical Trial Registry, number PACTR201606001630356. From May 26, 2015, to Jan 29, 2016, of 24 679 participants counselled with data recorded, 14 099 (57·1%) were in the intervention group and 10 580 (42·9%) in the comparison group. 7852 (55·7%) testers in the intervention group versus 1062 (10·0%) in the comparison group tested with a partner (adjusted odds ratio 13·5 [95% CI 10·5-17·4]). Among 427 (83·7%) of 510 eligible participants who completed the telephone survey, 11 (2·6%) reported that they were pressured or themselves pressured their partner to test together; none regretted couples' testing. Relationship unrest was reported by eight individuals (1·9%), although none attributed this to incentives. Small non-monetary incentives, which are potentially scalable, were associated with significantly increased CHTC and HIV case diagnosis. Incentives did not increase social harms beyond the few typically encountered with CHTC without incentives. The intervention could help achieve UNAIDS 90-90-90 targets. The study was funded by the UK Department for International Development, Irish AID, and Swedish SIDA, through Population Services International Zimbabwe under the Integrated Support Program. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Environmental policies to enhance technological change in the electricity sector

NASA Astrophysics Data System (ADS)

Sunol Del Rio, Eric

International agreements on climate change mitigation set quantitative carbon emission reduction targets in a country for a given year with respect to a given base year. A central question is then on what time do the new clean and costly technologies need to start functioning to comply with the agreed targets, and under what incentive does the market implement them. The planner's economic problem is to design an incentive that makes the new clean technology less costly than the vintage polluting facility, at the precise time in order to comply with the agreements at minimum cost. Chapter 1 reviews the literature on efficient allocation of pollution, discussing its validity to explain induced technological change. It then presents a simple model of technological change showing that market power determes the optimal adoption time of a new technology. Chapter 2 analyzes the effectiveness of carbon costs in accelerating technological change under different paths of technological progress. Furthermore, the paper examines the influence of market conditions. It shows that emission charges do reduce the firm's optimal adoption time when investment cost paths for the new technology are convex. On the contrary, emission charges may delay the optimal the switching time of a technology when the investment cost path is concave. Chapter 3 explores the results of Chapter 2 in an agent-based model. Simulations of firms adjusting their output a la Cournot show that the effectiveness of carbon costs in accelerating technological change is highly dependant on the number of firms in the market. Moreover, the shape of the technological progress curve is determinant: the effects of carbon charges are not linear on carbon price, and become more uncertain the more concave the investment cost path is. These results show that policies aiming at internalizing pollution costs enhance technological change at very different rates, depending on the actual market conditions in the industry and the dynamics of technological progress. This has profound implications in policy design: not only do carbon charges need to be used with precaution in oligopolistic industries, but also its effectiveness depends on the inner dynamics of cleaner technological alternatives.

Re-examining Potential for Geothermal Energy in United States

NASA Astrophysics Data System (ADS)

Showstack, Randy

New technological initiatives, along with potential policy and economic incentives, could help to bring about a resurgence in geothermal energy development in the United States, said several experts at a 22 May forum in Washington, D.C. The forum was sponsored by the House and Senate Renewable Energy and Energy Efficiency Caucuses, the Sustainable Energy Coalition, and the Environmental and Energy Study Institute. Among these initiatives is an ambitious program of the U.S. Department of Energy to expand existing geothermal energy fields and potentially create new fields through ``enhanced geothermal systems.'' In addition, a program of the Bush administration encourages geothermal development on some public lands, and current legislation would provide tax credits and other incentives for geothermal development.

Potential Avenues for Significant Biofuels Penetration in the U.S. Aviation Market

DOE Office of Scientific and Technical Information (OSTI.GOV)

Newes, Emily; Han, Jeongwoo; Peterson, Steve

Industry associations have set goals to reduce greenhouse gas (GHG) emissions and increase fuel efficiency. One focal area for reducing GHG emissions is in the use of aviation biofuel. This study examines assumptions under which the United States could see large production in aviation biofuel. Our results suggest that a high penetration (6 billion gallons) of aviation biofuels by 2030 could be possible, but factors around policy design (in the absence of high oil prices) contribute to the timing and magnitude of aviation biofuels production: 1) Incentives targeted towards jet fuel production such as financial incentives (e.g., producer tax credit,more » carbon tax) can be sufficient; 2) Investment in pre-commercial cellulosic technologies is needed to reduce the cost of production through learning-by-doing; 3) Reduction of investment risk through loan guarantees may allow production to ramp up more quickly through accelerating industry learning. In cases with high levels of incentives and investment in aviation biofuels, there could be a 25 percent reduction in overall GHG emissions from the aviation sector.« less

Investigating Group Contingencies to Promote Brief Abstinence from Cigarette Smoking

PubMed Central

Meredith, Steven E.; Dallery, Jesse

2013-01-01

In contingency management (CM), monetary incentives are contingent on evidence of drug abstinence. Typically, incentives (e.g., “vouchers” exchangeable for goods or services) are contingent on individual performance. We programmed vouchers contingent on group performance to investigate whether these contingencies would promote brief abstinence from cigarette smoking. Thirty-two participants were divided into small teams (n = 3 per team). During three 5-day within-subject experimental conditions, participants submitted video recordings of breath carbon monoxide (CO) measures twice daily via Mōtiv8 Systems™, an Internet-based remote monitoring application. During the interdependent contingency condition, participants earned vouchers each time they and their teammates submitted breath CO samples indicative of abstinence (i.e., negative samples). During the independent contingency condition, participants earned vouchers each time they submitted negative samples, regardless of their teammates' performance. During the no vouchers condition, no monetary incentives were contingent on abstinence. In addition, half of the participants (n = 16) could communicate with their teammates through an online peer support forum. Although forum access did not appear to promote smoking abstinence, monetary incentives did promote brief abstinence. Significantly more negative samples were submitted when vouchers were contingent on individual performance (56%) or team performance (53%) relative to when no vouchers were available (35%; F = 6.9, p = 0.002). The results show that interdependent contingencies can promote brief abstinence from cigarette smoking. Moreover, the results suggest that these contingencies may help lower treatment costs and promote social support. PMID:23421358

Using Peer-Referral Chains with Incentives to Promote HIV Testing and Identify Undiagnosed HIV Infections Among Crack Users in San Salvador.

PubMed

Glasman, Laura R; Dickson-Gomez, Julia; Lechuga, Julia; Tarima, Sergey; Bodnar, Gloria; de Mendoza, Lorena Rivas

2016-06-01

In El Salvador, crack users are at high risk for HIV but they are not targeted by efforts to promote early HIV diagnosis. We evaluated the promise of peer-referral chains with incentives to increase HIV testing and identify undiagnosed HIV infections among networks of crack users in San Salvador. For 14 months, we offered HIV testing in communities with a high prevalence of crack use. For the following 14 months, we promoted chains in which crack users from these communities referred their peers to HIV testing and received a small monetary incentive. We recorded the monthly numbers of HIV testers, and their crack use, sexual risk behaviors and test results. After launching the referral chains, the monthly numbers of HIV testers increased significantly (Z = 6.90, p < .001) and decayed more slowly (Z = 5.93, p < .001), and the total number of crack-using testers increased nearly fourfold. Testers in the peer-referral period reported fewer HIV risk behaviors, but a similar percentage (~5 %) tested HIV positive in both periods. More women than men received an HIV-positive diagnosis throughout the study (χ(2)(1, N = 799) = 4.23, p = .040). Peer-referral chains with incentives can potentially increase HIV testing among networks of crack users while retaining a focus on high-risk individuals.

Effects of an Informational Brochure, Lottery-Based Financial Incentive, and Public Posting on Absenteeism of Direct-Care Human Services Employees

ERIC Educational Resources Information Center

Luiselli, James K.; DiGennaro Reed, Florence D.; Christian, Walter P.; Markowski, Andrea; Rue, Hanna C.; St. Amand, CarrieAnne; Ryan, Chad J.

2009-01-01

Chronic absenteeism is a problem encountered by many human services organizations. Large-scale intervention projects to reduce staff absences have incorporated applied behavior analysis methods but there are few studies in the extant literature. In the present study, the authors record staff absenteeism at a specialized school for students with…

State Merit-Based Aid and Enrolling in Graduate Study: Evidence from the Kentucky Educational Excellence Scholarship

ERIC Educational Resources Information Center

Delaney, Jennifer A.

2011-01-01

This study considers the effect of a state merit-based aid program for undergraduate students on subsequent enrollment in graduate school. It uses student unit record data to analyze the impact of the Kentucky Educational Excellence Scholarship (KEES). Price theory is used as a framework for understanding the incentives provided by KEES. Using a…

Relativistic generalization of the incentive trap of interstellar travel with application to Breakthrough Starshot

NASA Astrophysics Data System (ADS)

Heller, René

2017-09-01

As new concepts of sending interstellar spacecraft to the nearest stars are now being investigated by various research teams, crucial questions about the timing of such a vast financial and labour investment arise. If humanity could build high-speed interstellar lightsails and reach α Centauri 20 yr after launch, would it be better to wait a few years, then take advantage of further technology improvements and arrive earlier despite waiting? The risk of being overtaken by a future, faster probe has been described earlier as the incentive trap. Based on 211 yr of historical data, we find that the speed growth of artificial vehicles, from steam-driven locomotives to Voyager 1, is much faster than previously believed, about 4.72 per cent annually or a doubling every 15 yr. We derive the mathematical framework to calculate the minimum of the wait time to launch t plus travel time τ(t) and extend it into the relativistic regime. We show that the t + τ(t) minimum disappears for nearby targets. There is no use of waiting once we can reach an object within about 20 yr of travel, irrespective of the actual speed. In terms of speed, the t + τ(t) minimum for a travel to α Centauri occurs at 19.6 per cent the speed of light (c), in agreement with the 20 per cent c proposed by the Breakthrough Starshot initiative. If interstellar travel at 20 per cent c could be achieved within 45 yr from today and the kinetic energy be increased at a rate consistent with the historical record, then humans can reach the 10 most nearby stars within 100 yr from today.

Incentivizing primary care providers to innovate: building medical homes in the post-Katrina New Orleans safety net.

PubMed

Rittenhouse, Diane R; Schmidt, Laura A; Wu, Kevin J; Wiley, James

2014-02-01

To evaluate safety-net clinics' responses to a novel community-wide Patient-Centered Medical Home (PCMH) financial incentive program in post-Katrina New Orleans. Between June 2008 and June 2010, we studied 50 primary care clinics in New Orleans receiving federal funds to expand services and improve care delivery. Multiwave, longitudinal, observational study of a local safety-net primary care system. Clinic-level data from a semiannual survey of clinic leaders (89.3 percent response rate), augmented by administrative records. Overall, 62 percent of the clinics responded to financial incentives by achieving PCMH recognition from the National Committee on Quality Assurance (NCQA). Higher patient volume, higher baseline PCMH scores, and type of ownership were significant predictors of achieving NCQA recognition. The steepest increase in adoption of PCMH processes occurred among clinics achieving the highest, Level 3, NCQA recognition. Following NCQA recognition, 88.9 percent stabilized or increased their use of PCMH processes, although several specific PCMH processes had very low rates of adoption overall. Findings demonstrate that widespread PCMH implementation is possible in a safety-net environment when external financial incentives are aligned with the goal of practice innovation. © Health Research and Educational Trust.

Effects of sucrose concentration and water deprivation on Pavlovian conditioning and responding for conditioned reinforcement.

PubMed

Tabbara, Rayane I; Maddux, Jean-Marie N; Beharry, Priscilla F; Iannuzzi, Jessica; Chaudhri, Nadia

2016-04-01

An appetitive Pavlovian conditioned stimulus (CS) can predict an unconditioned stimulus (US) and acquire incentive salience. We tested the hypothesis that US intensity and motivational state of the subject would influence Pavlovian learning and impact the attribution of incentive salience to an appetitive Pavlovian CS. To this end, we examined the effects of sucrose concentration and water deprivation on the acquisition of Pavlovian conditioning and responding for a conditioned reinforcer. Male Long-Evans rats (Harlan; 220-240 g) receiving 3% (3S) or 20% (20S) sucrose were either non-water deprived or given water for 1 hr per day. During Pavlovian conditioning sessions, half the rats in each concentration and deprivation condition received a 10-s CS paired with 0.2 ml of sucrose (16 trials/session; 3.2 ml/session). The remainder received unpaired CS and US presentations. Entries into a port where sucrose was delivered were recorded. Next, responding for conditioned reinforcement was tested, wherein pressing an active lever produced the CS and pressing an inactive lever had no consequences. CS-elicited port entries increased, and latency to the first CS-elicited port entry decreased across sessions in paired groups. Water deprivation augmented these effects, whereas sucrose concentration had no significant impact on behavior. Responding for conditioned reinforcement was observed in the 20S water-deprived, paired group. Thus, water deprivation can facilitate the acquisition of Pavlovian conditioning, potentially by enhancing motivational state, and a high-intensity US and a high motivational state can interact to heighten the attribution of incentive salience to an appetitive Pavlovian CS. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Instructional Technology and Media for Postsecondary Alternatives: Meeting California's Educational Needs. A Feasibility Study.

ERIC Educational Resources Information Center

Clark, Richard E.; Rubin, David P.

This report characterizes the resources that exist in the state of California which might be more fully utilized through legislation providing incentives for its development. Selected existing postsecondary education programs and selected information systems are reviewed to exemplify successful uses of instructional and informational media. An…

Advancing the Growth of the U.S. Wind Industry: Federal Incentives, Funding, and Partnership Opportunities

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

The U.S. Department of Energy’s (DOE’s) Wind Energy Technologies Office (WETO) works to accelerate the development and deployment of wind power. The office provides information for researchers, developers,businesses, manufacturers, communities, and others seeking various types of federal assistance available for advancing wind projects.

Nature and Extent of iPad Use among Freshmen Honors Students

ERIC Educational Resources Information Center

Maxwell, Patricia; Banerjee, Priya

2013-01-01

On the heels of national studies reporting that college students believe tablet computers will "transform" learning, many colleges have begun to use mobile technology like the iPad and laptop as recruitment tools. The effectiveness of such incentives can be tested by determining whether enrollment increased as a result, and whether or…

Topological horseshoe analysis and field-programmable gate array implementation of a fractional-order four-wing chaotic attractor

NASA Astrophysics Data System (ADS)

Dong, En-Zeng; Wang, Zhen; Yu, Xiao; Chen, Zeng-Qiang; Wang, Zeng-Hui

2018-01-01

Not Available Project supported by the National Natural Science Foundation of China (Grant Nos. 61502340 and 61374169), the Application Base and Frontier Technology Research Project of Tianjin, China (Grant No. 15JCYBJC51800), and the South African National Research Foundation Incentive Grants (Grant No. 81705).

Agroforestry adoption in the Calakmul biosphere reserve, Campeche, Mexico

Treesearch

D. Evan Mercer; Jeremy Haggar; Ann Snook; Mauricio Sosa

2005-01-01

Since farmers engage in a complex, dynamic process of learning-by-doing, evaluating economic incentives, and assessing risks in deciding whether to adopt agroforestry systems, a multi-pronged research approach is required for a complete analysis of adoption potential and to develop effective technological and institutional interventions. A case study is presented for...

Beyond meaningful use: getting meaningful value from IT.

PubMed

Fortin, Jason; Zywiak, Walt

2010-02-01

The HITECH provisions of ARRA include financial incentives for providers to demonstrate meaningful use of certified EHR technology. However, to maximize the value of IT under new payment models, provider organizations will need to go beyond meaningful use criteria in three key areas: Delivering high-quality care. Ensuring coordinated care. Integrating financial systems.

Assessment of a WIN Quality Training Demonstration Project. Phase 1 Report: Characteristics of Participants.

ERIC Educational Resources Information Center

White, Richard N.

A group of interested and academically qualified female Aid to Families with Dependent Children recipients was identified to participate in the assessment of a demonstration program to train female Work incentive Program (WIN) participants. Training for electronics technicians was conducted at DeVry Institute of Technology (Chicago) and Ohio…

What Makes Small-Scale Farmers Participate in Financing Agricultural Research and Extension? Analysis of Three Case Studies from Benin

ERIC Educational Resources Information Center

Moumouni, Ismail M.; Vodouhe, Simplice D.; Streiffeler, Friedhelm

2009-01-01

This paper analyses the organizational, financial and technological incentives that service organizations used to motivate farmers to finance agricultural research and extension in Benin. Understanding the foundations and implications of these motivation systems is important for improving farmer financial participation in agricultural research and…

Environmental Justice and Green-Technology Adoption

ERIC Educational Resources Information Center

Ong, Paul

2012-01-01

This paper presents an analysis of an environmental justice (EJ) program adopted by the South Coast Air Quality Management District (SCAQMD) as a part of its regulation to phase out a toxic chemical used by dry cleaners. SCAQMD provided financial incentives to switch early and gave establishments in EJ neighborhoods priority in applying for…

Special Issue: Learning Analytics in Higher Education

ERIC Educational Resources Information Center

Lester, Jaime; Klein, Carrie; Rangwala, Huzefa; Johri, Aditya

2017-01-01

The purpose of this monograph is to give readers a practical and theoretical foundation in learning analytics in higher education, including an understanding of the challenges and incentives that are present in the institution, in the individual, and in the technologies themselves. Among questions that are explored and answered are: (1) What are…

Using Group Explorer in Teaching Abstract Algebra

ERIC Educational Resources Information Center

Schubert, Claus; Gfeller, Mary; Donohue, Christopher

2013-01-01

This study explores the use of Group Explorer in an undergraduate mathematics course in abstract algebra. The visual nature of Group Explorer in representing concepts in group theory is an attractive incentive to use this software in the classroom. However, little is known about students' perceptions on this technology in learning concepts in…

Reducing marine mammal bycatch in global fisheries: An economics approach

NASA Astrophysics Data System (ADS)

Lent, Rebecca; Squires, Dale

2017-06-01

The broader ecosystem impacts of fishing continue to present a challenge to scientists and resource managers around the world. Bycatch is of greatest concern for marine mammals, for which fishery bycatch and entanglement is the number one cause of direct mortality. Climate change will only add to the challenge, as marine species and fishing practices adapt to a changing environment, creating a dynamic pattern of overlap between fishing and species (both target and bycatch). Economists suggest policy instruments for reducing bycatch that move away from top-down, command-and-control measures (e.g. effort reduction, time/area closures, gear restrictions, bycatch quotas) towards an approach that creates incentives to reduce bycatch (e.g. transferable bycatch allowances, taxes, and other measures). The advantages of this flexible, incentive-oriented approach are even greater in a changing and increasingly variable environment, as regulatory measures would have to be adapted constantly to keep up with climate change. Unlike the regulatory process, individual operators in the fishery sector can make adjustments to their harvesting practices as soon as the incentives for such changes are apparent and inputs or operations can be modified. This paper explores policy measures that create economic incentives not only to reduce marine mammal bycatch, but also to increase compliance and induce technological advances by fishery operators. Economists also suggest exploration of direct economic incentives as have been used in other conservation programs, such as payments for economic services, in an approach that addresses marine mammal bycatch as part of a larger conservation strategy. Expanding the portfolio of mandatory and potentially, voluntary, measures to include novel approaches will provide a broader array of opportunities for successful stewardship of the marine environment.

HIT: time to end behavioral health discrimination.

PubMed

Rosenberg, Linda

2012-10-01

While the Health Information Technology for Economic and Clinical Health Act, enacted as part of the American Recovery and Reinvestment Act of 2009, provided $20.6 billion for incentive payments to support the adoption and meaningful use of health information technology (HIT), behavioral health organizations were not eligible to receive facility payments. The consequences of excluding behavioral health from HIT incentive payments are found in the results of the "HIT Adoption and Meaningful Use Readiness in Community Behavioral Health" survey. The survey found that only 2% of community behavioral health organizations are able to meet federal meaningful use (MU) requirements-compare this to the 27% of Federally Qualified Health Centers and 20% of hospitals that already meet some level of MU requirements. Behavioral health organizations, serving more than eight million adults, children, and families with mental illnesses and addiction disorders, are ready and eager to adopt HIT to meet the goals of better healthcare, better health, and lower costs. But reaching these goals may prove impossible unless behavioral health achieves "parity" within healthcare and receives resources for the adoption of HIT.

Kidney disease management in UK primary care: guidelines, incentives and information technology.

PubMed

Klebe, Bernhard; Farmer, Chris; Cooley, Roger; de Lusignan, Simon; Middleton, Rachel; O'Donoghue, Donal; New, John; Stevens, Paul

2007-09-01

The last few years have seen new developments to understand and tackle the significant public health issue posed by chronic kidney disease (CKD). Established renal disease currently consumes 2% of the UK National Health Service budget and predictions are that this figure will increase significantly due to the rising number of people requiring renal replacement therapy fuelled by the ageing population and the diabetes mellitus epidemic. This paper reviews the scale of CKD and discusses the new developments such as staging, referral guidelines and new Department of Health incentives brought about to improve awareness. The importance of Information Technology in assisting the management of renal disease is also outlined. We identify various types of intervention which might be used to do this: feedback in an educational context, the establishment of computerized decision support and enhancement of the patient journey. Many principles may be extended to the management of any chronic disease. While new developments are necessary to improve care, wider implementation is required to be able to see if improved outcomes are achieved.

Mission & Role | NCI Technology Transfer Center | TTC

Cancer.gov

The NCI TTC serves as the focal point for implementing the Federal Technology Transfer Act to utilize patents as incentive for commercial development of technologies and to establish research collaborations and licensing among academia, federal laboratories, non-profit organizations, and industry. The TTC supports technology development activities for the National Cancer Institute and nine other NIH Institutes and Centers. TTC staff negotiate co-development agreements and licenses with universities, non-profit organizations, and pharmaceutical and biotechnology companies to ensure compliance with Federal statutes, regulations and the policies of the National Institutes of Health. TTC also reviews employee invention reports and makes recommendations concerning filing of domestic and foreign patent applications. | [google6f4cd5334ac394ab.html

Neural Activity in the Ventral Pallidum Encodes Variation in the Incentive Value of a Reward Cue.

PubMed

Ahrens, Allison M; Meyer, Paul J; Ferguson, Lindsay M; Robinson, Terry E; Aldridge, J Wayne

2016-07-27

There is considerable individual variation in the extent to which reward cues are attributed with incentive salience. For example, a food-predictive conditioned stimulus (CS; an illuminated lever) becomes attractive, eliciting approach toward it only in some rats ("sign trackers," STs), whereas others ("goal trackers," GTs) approach the food cup during the CS period. The purpose of this study was to determine how individual differences in Pavlovian approach responses are represented in neural firing patterns in the major output structure of the mesolimbic system, the ventral pallidum (VP). Single-unit in vivo electrophysiology was used to record neural activity in the caudal VP during the performance of ST and GT conditioned responses. All rats showed neural responses to both cue onset and reward delivery but, during the CS period, STs showed greater neural activity than GTs both in terms of the percentage of responsive neurons and the magnitude of the change in neural activity. Furthermore, neural activity was positively correlated with the degree of attraction to the cue. Given that the CS had equal predictive value in STs and GTs, we conclude that neural activity in the VP largely reflects the degree to which the CS was attributed with incentive salience. Cues associated with reward can acquire motivational properties (i.e., incentive salience) that cause them to have a powerful influence on desire and motivated behavior. There are individual differences in sensitivity to reward-paired cues, with some individuals attaching greater motivational value to cues than others. Here, we investigated the neural activity associated with these individual differences in incentive salience. We found that cue-evoked neural firing in the ventral pallidum (VP) reflected the strength of incentive motivation, with the greatest neural responses occurring in individuals that demonstrated the strongest attraction to the cue. This suggests that the VP plays an important role in the process by which cues gain control over motivation and behavior. Copyright © 2016 the authors 0270-6474/16/367957-14$15.00/0.

Embracing the Importance of FAIR Research Products - Findable, Accessible, Interoperable, and Reusable

NASA Astrophysics Data System (ADS)

Stall, S.

2017-12-01

Integrity and transparency within research is solidified by a complete set of research products that are findable, accessible, interoperable, and reusable. In other words, they follow the FAIR Guidelines developed by FORCE11.org. Your datasets, images, video, software, scripts, models, physical samples, and other tools and technology are an integral part of the narrative you tell about your research. These research products increasingly are being captured through workflow tools and preserved and connected through persistent identifiers across multiple repositories that keep them safe. They help secure, with your publications, the supporting evidence and integrity of the scientific record. This is the direction that Earth and space science as well as other disciplines is moving. Within our community, some science domains are further along, and others are taking more measured steps. AGU as a publisher is working to support the full scientific record with peer reviewed publications. Working with our community and all the Earth and space science journals, AGU is developing new policies to encourage researchers to plan for proper data preservation and provide data citations along with their research submission and to encourage adoption of best practices throughout the research workflow and data life cycle. Providing incentives, community standards, and easy-to-use tools are some important factors for helping researchers embrace the FAIR Guidelines and support transparency and integrity.

Technology-neutral green procurement in practice - an example from Swedish waste management.

PubMed

Arvidsson, Anders; Stage, Jesper

2012-05-01

Green public procurement has been criticized for its excessive reliance on detailed technology specifications, which can distort incentives in the short term and discourage innovation in the longer term. Economists therefore tend to prefer technology-neutral procurement, which rewards outcomes rather than technologies. However, technology-neutral procurement can also be problematic in practice. The present study investigated green public procurement of waste management, a rapidly growing field. In one of the most sophisticated models for technology-neutral procurement applied in Sweden in recent years, different environmental impacts were assigned weights, but no weight was given to the particular technology employed. Even here, however, potential inefficiencies were found where the scoring rule could have led to arbitrary, and presumably unwanted, outcomes. Explicitly assigning monetary surcharges to desirable and undesirable environmental effects may be a better way to reach environmental targets.

Optimizing diabetes management: managed care strategies.

PubMed

Tzeel, E Albert

2013-06-01

Both the prevalence of type 2 diabetes mellitus (DM) and its associated costs have been rising over time and are projected to continue to escalate. Therefore, type 2 DM (T2DM) management costs represent a potentially untenable strain on the healthcare system unless substantial, systemic changes are made. Managed care organizations (MCOs) are uniquely positioned to attempt to make the changes necessary to reduce the burdens associated with T2DM by developing policies that align with evidence-based DM management guidelines and other resources. For example, MCOs can encourage members to implement healthy lifestyle choices, which have been shown to reduce DM-associated mortality and delay comorbidities. In addition, MCOs are exploring the strengths and weaknesses of several different benefit plan designs. Value-based insurance designs, sometimes referred to as value-based benefit designs, use both direct and indirect data to invest in incentives that change behaviors through health information technologies, communications, and services to improve health, productivity, quality, and financial trends. Provider incentive programs, sometimes referred to as "pay for performance," represent a payment/delivery paradigm that places emphasis on rewarding value instead of volume to align financial incentives and quality of care. Accountable care organizations emphasize an alignment between reimbursement and implementation of best practices through the use of disease management and/ or clinical pathways and health information technologies. Consumer-directed health plans, or high-deductible health plans, combine lower premiums with high annual deductibles to encourage members to seek better value for health expenditures. Studies conducted to date on these different designs have produced mixed results.

Funding health technologies in decentralized systems: A comparison between Italy and Spain.

PubMed

Cappellaro, Giulia; Fattore, Giovanni; Torbica, Aleksandra

2009-10-01

Although cost-containment policies in Europe are focusing increasingly on medical devices, the impact of these policies has yet to be fully investigated, particularly in cross-country settings. This paper analyses coverage, procurement, and reimbursement of three inpatient medical devices (coronary stent, knee endoprosthesis and implantable cardioverter defibrillator) in the Italian and Spanish healthcare systems. The research was carried out by reviewing published and grey literature, as well as national and regional legislation; in addition, 19 experts from hospitals and the industry were interviewed. In both countries, there has been a shift in political power from the national to the regional level. At the same time, the content of public coverage has become more explicit. A major issue in both systems is reimbursement, i.e. the rules about funding the delivery of services included in the benefit baskets. The differences in procurement and funding mechanisms create different incentives that may have an impact on the uptake and diffusion of technologies. These mechanisms, however, can only partially explain organizational and professional behaviour, as the use of technologies in both countries is mainly left to professionals who are exposed to a variety of incentives. There is limited direct and indirect guidance of national and regional authorities over the use of technologies in both countries. It is likely that the difficult search for a balance between introducing innovations, containing costs and assuring equity will require stronger regulatory action in the next future.

Decision to adopt medical technology: case study of breast cancer radiotherapy techniques.

PubMed

Gold, Heather Taffet; Pitrelli, Kimberly; Hayes, Mary Katherine; Murphy, Madhuvanti Mahadeo

2014-11-01

To understand decision making concerning adoption and nonadoption of accelerated partial breast radiotherapy (RT) prior to long-term randomized trial evidence. A total of 36 radiation oncologists and surgeons were recruited through purposive and snowball sampling strategies from September 2010 through January 2013. Semistructured phone interviews were conducted and audio-recorded and lasted 20-45 minutes. Qualitative analysis was conducted using a framework approach, iteratively exploring key concepts and emerging issues raised by subjects. Interviews were transcribed and imported into Atlas.ti v6. Transcripts were independently coded by 3 researchers shortly after each interview, followed by consensus development on each coded transcript. Barriers and facilitators of adoption, practice patterns, and informational/educational sources concerning accelerated partial breast RT were all assessed to determine major themes. Nearly half of physicians were surgeons (47%), and half were radiation oncologists (53%), with 61% overall in urban settings. Twenty-nine of the 36 physicians interviewed used brachytherapy-based partial breast RT. Five major factors were involved in physicians' decisions to adopt accelerated partial breast RT: facilitators encouraging adoption (e.g., enthusiastic colleagues and patient convenience), financial and prestige incentives, pressures to adopt (e.g., potential declines in referrals), judgment concerning acceptable level of scientific evidence, and barriers (e.g., not having appropriate machinery or referral mechanism in place). If technology was adopted, clinical guideline adherence varied. Technology adoption is based on financial and social pressures, along with often-limited scientific evidence and what seems "best" for patients. For technology adoption and diffusion to be rational and evidence-based, we must encourage appropriate financial payment models to curb use outside of research studies and promote development of additional treatment registries until sufficient evidence is gathered. © The Author(s) 2014.

A Consensus Action Agenda for Achieving the National Health Information Infrastructure

PubMed Central

Yasnoff, William A.; Humphreys, Betsy L.; Overhage, J. Marc; Detmer, Don E.; Brennan, Patricia Flatley; Morris, Richard W.; Middleton, Blackford; Bates, David W.; Fanning, John P.

2004-01-01

Background: Improving the safety, quality, and efficiency of health care will require immediate and ubiquitous access to complete patient information and decision support provided through a National Health Information Infrastructure (NHII). Methods: To help define the action steps needed to achieve an NHII, the U.S. Department of Health and Human Services sponsored a national consensus conference in July 2003. Results: Attendees favored a public–private coordination group to guide NHII activities, provide education, share resources, and monitor relevant metrics to mark progress. They identified financial incentives, health information standards, and overcoming a few important legal obstacles as key NHII enablers. Community and regional implementation projects, including consumer access to a personal health record, were seen as necessary to demonstrate comprehensive functional systems that can serve as models for the entire nation. Finally, the participants identified the need for increased funding for research on the impact of health information technology on patient safety and quality of care. Individuals, organizations, and federal agencies are using these consensus recommendations to guide NHII efforts. PMID:15187075

Incorporating ideas from computer-supported cooperative work.

PubMed

Pratt, Wanda; Reddy, Madhu C; McDonald, David W; Tarczy-Hornoch, Peter; Gennari, John H

2004-04-01

Many information systems have failed when deployed into complex health-care settings. We believe that one cause of these failures is the difficulty in systematically accounting for the collaborative and exception-filled nature of medical work. In this methodological review paper, we highlight research from the field of computer-supported cooperative work (CSCW) that could help biomedical informaticists recognize and design around the kinds of challenges that lead to unanticipated breakdowns and eventual abandonment of their systems. The field of CSCW studies how people collaborate with each other and the role that technology plays in this collaboration for a wide variety of organizational settings. Thus, biomedical informaticists could benefit from the lessons learned by CSCW researchers. In this paper, we provide a focused review of CSCW methods and ideas-we review aspects of the field that could be applied to improve the design and deployment of medical information systems. To make our discussion concrete, we use electronic medical record systems as an example medical information system, and present three specific principles from CSCW: accounting for incentive structures, understanding workflow, and incorporating awareness.

Avenues and incentives for commercial use of a low-g environment

NASA Technical Reports Server (NTRS)

Brown, R. L.; Zoller, L. K.

1981-01-01

The processing of materials in a low-gravity (low-g) or microgravity environment is investigated by NASA for scientific and commercial utilization, and process and product development. The elimination of gravity is shown to create unique materials, and improve ground-based processes, such as convection, sedimentation, buoyancy, and containerless processing. Commercial applications are discussed, including the manufacturing of silicon ribbon, turbine blades, and various pharmaceuticals in space. Commercial incentives and needs are also discussed, including the technical exchange agreement, in which NASA and a company agree to cooperate in the conduct and analysis of research programs. In addition to establishing and demonstrating scientific and technological precepts for analyzing and using low-g environments, NASA is establishing legal and management mechanisms to share cost and risk of early commercial ventures.

Contingency management in the 21st century: technological innovations to promote smoking cessation.

PubMed

Dallery, Jesse; Raiff, Bethany R

2011-01-01

Information technology represents an excellent medium to deliver contingencies of reinforcement to change behavior. Recently, we have linked the Internet with a science-based, behavioral treatment for cigarette smoking: abstinence reinforcement therapy. Under abstinence reinforcement interventions, incentives are provided for objective evidence of abstinence. Several studies suggest that the intervention is effective in initiating abstinence. The intervention addresses limitations (access, cost, sustainability, and dissemination potential) inherent in traditional abstinence reinforcement delivery models. It can also be applied to vulnerable, at-risk populations, and to other behavior to promote health. Information technologies offer unprecedented and rapidly expanding opportunities to facilitate behavior change.

Implementation of electronic medical records

PubMed Central

Greiver, Michelle; Barnsley, Jan; Glazier, Richard H.; Moineddin, Rahim; Harvey, Bart J.

2011-01-01

Abstract Objective To study the effect of electronic medical record (EMR) implementation on preventive services covered by Ontario’s pay-for-performance program. Design Prospective double-cohort study. Participants Twenty-seven community-based family physicians. Setting Toronto, Ont. Intervention Eighteen physicians implemented EMRs, while 9 physicians continued to use paper records. Main outcome measure Provision of 4 preventive services affected by pay-for-performance incentives (Papanicolaou tests, screening mammograms, fecal occult blood testing, and influenza vaccinations) in the first 2 years of EMR implementation. Results After adjustment, combined preventive services for the EMR group increased by 0.7%, a smaller increase than that seen in the non-EMR group (P = .55, 95% confidence interval −2.8 to 3.9). Conclusion When compared with paper records, EMR implementation had no significant effect on the provision of the 4 preventive services studied. PMID:21998246

76 FR 57677 - Defense Federal Acquisition Regulation Supplement; Increase the Use of Fixed-Price Incentive...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-16

... Under Secretary of Defense for Acquisition, Technology, & Logistics (USD(AT&L)), dated November 3, 2010... cost, share lines, and ceiling price. This regulation is not a ``one-size- fits-all'' mandate. However.../optimistic weighted average and ensure that their cost curves do not mirror cost-plus-fixed-fee cost curves...

Developing Confidence in the Use of Digital Tools in Teaching

ERIC Educational Resources Information Center

Greener, Sue; Wakefield, Craig

2015-01-01

In this study Higher Education teachers were offered new mobile devices with very few conditions attached. The aim was to introduce staff to mobile technology and how it could be used to support teaching and learning within a small, interdisciplinary campus. The study hypothesized that by offering staff the simple incentive of new mobile devices…

Solar/hydrogen systems for the 1985-2000 time frame - A review and assessment

NASA Technical Reports Server (NTRS)

Hanson, J. A.; Foster, R. W.; Escher, W. J. D.; Tison, R. R.

1982-01-01

A comprehensive state-of-the-art review of solar/hydrogen technologies has been conducted. From this, solar/hydrogen production systems which could be commercialized by the year 2000 have been characterized technically and economically. Incentives and disincentives for the early commercialization of four solar/hydrogen systems have been explored, conclusions drawn and recommendations made.

Economic impacts on irrigated agriculture of water conservation programs in drought

NASA Astrophysics Data System (ADS)

Ward, Frank A.

2014-01-01

This study analyzes vulnerability, impacts, and adaptability by irrigation to drought.It accounts for economic incentives affecting choices on irrigation technology, crop mix, and water sources.When surface water supplies fall, farmers increase pumping, even when pumping raises production costs.Conservation program subsidies raise the value of food production but can increase crop water depletions.

Using Assistive Technology Outcomes Research to Inform Policy Related to the Employment of Individuals with Disabilities

ERIC Educational Resources Information Center

Mendelsohn, Steven; Edyburn, Dave L.; Rust, Kathy L.; Schwanke, Todd D.; Smith, Roger O.

2008-01-01

We know that work is recognized as a central component of life for individuals with and without disabilities. It yields many physical and psychological benefits to the individual while simultaneously contributing numerous benefits to society. Lawmakers have enacted a plethora of laws designed to prevent discrimination, provide incentives for…

AIDS: An ICT Model for Integrating Teaching, Learning and Research in Technical University Education in Ghana

ERIC Educational Resources Information Center

Asabere, Nana; Togo, Gilbert; Acakpovi, Amevi; Torby, Wisdom; Ampadu, Kwame

2017-01-01

Information and Communication Technologies (ICT) has changed the way we communicate and carry out certain daily activities. Globally, ICT has become an essential means for disseminating information. Using Accra Technical University in Ghana as a case study, this paper proposes an ICT model called Awareness Incentives Demand and Support (AIDS). Our…

Cooperation as a Strategy for Rural Economic Development. Rural Research Report. Volume 19, Issue 2, Spring 2008

ERIC Educational Resources Information Center

Kuhn, Bill

2008-01-01

Cooperative behaviors among private investors, local entities and a county can create significant efficiencies and resources to achieve a countywide vision. A county willing to take on this leadership role can provide technology and creates incentives for cooperation, supports opportunistic action, and regulates a balance between private sector…

Open Technology Development: Roadmap Plan

DTIC Science & Technology

2006-04-01

65 RECOMMENDATION 1: APPROVE AND FUND AN OTD STRIKE TEAM................. 67 Senior Leadership...negotiated, rather than an innate property of the product. Software’s replicability also means it can be incorporated into other software systems without...to leverage an open code development model, DoD would provide the market incentives to increase the agility and competitiveness of the industrial

Manufacturing Technology and Industrial Modernization Incentive Programs

DTIC Science & Technology

1991-07-01

report are those of the contractors and should not be Interpreted as representing the official policies, either expressed or Impli.d, of tte Naval Ocean...Countaermeaue * Undersea countermeasures. special warfare, amphibious warfare. tamc mine countermeasures, and diving Dkected energy . Naval Surface Warfare...Insensitie highly energetic materials -Command control, commiunications, ocean surveillance, surface- and air-launched undersea weapons, and submarine arctic

The Race Against Nuclear Terror

DTIC Science & Technology

2005-09-01

orientation (central planning vs . market economy); or (3) systemic or state-specific incentives, such as new norms, emerge that diminish the appeal of... franchised version of the nuclear “Wal-Mart” cannot be discounted. Yet, if we are 49 Christopher Clary. “Dr... independent capability. To do so would require specific enrichment technology developed indigenously or obtained illegally. Most exporters of nuclear

Retooling for the future.

PubMed

Andrews, D

1999-04-01

Several trends will accelerate changes in the industry initiated by Medicare's change in payment methodology, including explosive growth fueled by changing demographics, patient preferences, and technological advances; altered customer buying incentives created by managed care organization-provider partnerships; and accelerated consolidation. Home care agencies should "take inventory" of current practices and systems to determine capability gaps for competing in the new environment.

So much to do, so little time. To accomplish the mandatory initiatives of ARRA, healthcare organizations will require significant and thoughtful planning, prioritization and execution.

PubMed

Klein, Kimberly

2010-01-01

The American Recovery and Reinvestment Act of 2009 (ARRA) has set forth legislation for the healthcare community to achieve adoption of electronic health records (EHR), as well as form data standards, health information exchanges (HIE) and compliance with more stringent security and privacy controls under the HITECH Act. While the Office of the National Coordinator for Health Information Technology (ONCHIT) works on the definition of both "meaningful use" and "certification" of information technology systems, providers in particular must move forward with their IT initiatives to achieve the basic requirements for Medicare and Medicaid incentives starting in 2011, and avoid penalties that will reduce reimbursement beginning in 2015. In addition, providers, payors, government and non-government stakeholders will all have to balance the implementation of EHRs, working with HIEs, at the same time that they must upgrade their systems to be in compliance with ICD-10 and HIPAA 5010 code sets. Compliance deadlines for EHRs and HIEs begin in 2011, while ICD-10 diagnosis and procedure code sets compliance is required by October 2013 and HIPAA 5010 transaction sets, with one exception, is required by January 1, 2012. In order to accomplish these strategic and mandatory initiatives successfully and simultaneously, healthcare organizations will require significant and thoughtful planning, prioritization and execution.

The contributions of digital technologies in the teaching of nursing skills: an integrative review.

PubMed

Silveira, Maurício de Souza; Cogo, Ana Luísa Petersen

2017-07-13

To analyze the contributions of digital educational technologies used in teaching nursing skills. Integrative literature review, search in five databases, from 2006 to 2015 combining the descriptors 'education, nursing', 'educational technology', 'computer-assisted instruction' or related terms in English. Sample of 30 articles grouped in the thematic categories 'technology in the simulation with manikin', 'incentive to learning' and 'teaching of nursing skills'. It was identified different formats of digital educational technologies used in teaching Nursing skills such as videos, learning management system, applications, hypertext, games, virtual reality simulators. These digital materials collaborated in the acquisition of theoretical references that subsidize the practices, enhancing the teaching and enable the use of active learning methods, breaking with the traditional teaching of demonstrating and repeating procedures.

Do positive spontaneous thoughts function as incentive salience?

PubMed

Rice, Elise L; Fredrickson, Barbara L

2017-08-01

The present work explores the theoretical relationship between positive spontaneous thoughts and incentive salience-a psychological property thought to energize wanting and approach motivation by rendering cues that are associated with enjoyment more likely to stand out to the individual when subsequently encountered in the environment (Berridge, 2007). We reasoned that positive spontaneous thoughts may at least be concomitants of incentive salience, and as such, they might likewise mediate the effect of liking on wanting. In Study 1, 103 adults recruited via Amazon's Mechanical Turk reported on key aspects of 10 everyday activities. As predicted, positive spontaneous thoughts mediated the relationship between liking an activity in the past and wanting to engage in it in the future. In Study 2, 99 undergraduate students viewed amusing and humorless cartoons and completed a thought-listing task, providing experimental evidence for the causal effect of liking on positive spontaneous thoughts. In Study 3, we tested whether positive spontaneous thoughts play an active role in energizing wanting rather than merely co-occurring with (inferred) incentive salience. In that experiment involving 80 undergraduates, participants who were led to believe that their spontaneous thoughts about a target activity were especially positive planned to devote more time to that activity over the coming week than participants who received no such information about their spontaneous thoughts. Collectively, these findings suggest that positive spontaneous thoughts may play an important role in shaping approach motivation. Broader implications and future directions in the study of positive spontaneous thoughts are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Agricultural Incentives: Implications for Small-Scale and Subsistence Farming in the US Caribbean Islands

NASA Astrophysics Data System (ADS)

Alvarez-Berrios, N.; Parés-Ramos, I.; Gould, W. A.

2017-12-01

The effects of climate change threaten the world's most sensitive agroecosystems and our potential to reach agricultural productivity levels needed to feed a projected global population of 9.7 billion people by 2050. The US Caribbean agriculture is especially vulnerable to the effects of climate change, due to the region's frequent exposure to extreme weather events, its geographic and economic scale, shortage of labor force, and rapid urban expansion. Currently, agriculture contributes less than 1% of the island's GDP, and over 80% of the food consumed in the region is imported. Despite low production levels, there is widespread interest in reinvigorating the agricultural sector's contribution to the economy. Local and federal institutions play a major role strengthening the agricultural sector by providing access to incentives, loans, and education for best management practices. However, many of these efforts conform to agricultural systems of larger scale of production and temperate environments. In this study, we explore agricultural incentives programs and their implication for highly diverse, small-scale, and subsistence operations that characterize agricultural systems in Puerto Rico and the US Virgin Islands. We analyze records and maps from the USDA Farm Service Agency, to typify participating farms, and to track changes in land cover, farm size, crop diversity, practices, and production levels resulting from their enrollment in such programs. Preliminary results indicate that many incentives programs are not tailored to agricultural tropical systems and prescribe alternatives that exclude traditional farming methods employed in small-scale and subsistence farms (e.g. crop insurance that benefit monoculture over intercropped systems). Moreover, many of the incentives are contradictory in their recommendations (e.g., crop insurance benefit sun-grown coffee production, while best agricultural practices recommend agroforestry with shade-grown coffee). Understanding the characteristics that underlie the resilience of traditional agriculture is an urgent matter, as they can serve as the basis for the design of agricultural systems that mitigate projected climate changes.

[Brazilian technological output in the area of nursing: advances and challenges].

PubMed

Koerich, Micheline Henrique Araujo da Luz; Vieira, Raquel Heloisa Guedes; Silva, Daniela Eda; Erdmann, Alacoque Lorenzini; Meirelles, Betina Horner Shlindwein

2011-12-01

This article aims to analyze the patents registered in the nursing area, since these patents may be used as an indicator of the technological development in the area. It presents and discusses national technological productions, tracked through the "nursing" keyword, patented in the period from 1990-2009. This is a retrospective documental research, using, as a source, data from the National Industrial Property Institute (INPI). The information gathered is discussed in relation to the appropriation of the technologies, the incentive to develop them and register them as a source of knowledge in the nursing field, aiming the practice of care. Light and light hard technology productions are increasing in the nursing field. However, these are not registered and patented. The technological advance in the nursing field is emergent and needs policies for its development.

Managing the patent thicket and maximizing patent lifetime in vaccine technology.

PubMed

Mertes, Maria M M; Stötter, Gerd

2010-10-01

Patents are exclusive rights for a limited period of time that are granted to provide an incentive for innovation and in exchange for the public disclosure of an invention. Patenting in the medical field, especially in the field of human vaccine technologies, is full of pitfalls, because the products that finally access the market are often covered by a multitude of exclusive IP rights. This commentary gives an overview on obstacles in vaccine patenting and how to overcome them, and intends to provide a patenting guideline for researchers.

Electric and Hybrid Vehicles Program. Sixteenth annual report to Congress for fiscal year 1992

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1993-08-01

This report describes the progress achieved in developing electric and hybrid vehicle technologies, beginning with highlights of recent accomplishments in FY 1992. Detailed descriptions are provided of program activities during FY 1992 in the areas of battery, fuel cell, and propulsion system development, and testing and evaluation of new technology in fleet site operations and in laboratories. This Annual Report also contains a status report on incentives and use of foreign components, as well as a list of publications resulting from the DOE program.

Wyoming Carbon Capture and Storage Institute

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nealon, Teresa

This report outlines the accomplishments of the Wyoming Carbon Capture and Storage (CCS) Technology Institute (WCTI), including creating a website and online course catalog, sponsoring technology transfer workshops, reaching out to interested parties via news briefs and engaging in marketing activities, i.e., advertising and participating in tradeshows. We conclude that the success of WCTI was hampered by the lack of a market. Because there were no supporting financial incentives to store carbon, the private sector had no reason to incur the extra expense of training their staff to implement carbon storage. ii

Counting on commitment; the quality of primary care-led diabetes management in a system with minimal incentives

PubMed Central

2011-01-01

Background The aim of the present study was to assess the performance of three primary care-led initiatives providing structured care to patients with Type 2 diabetes in Ireland, a country with minimal incentives to promote the quality of care. Methods Data, from three primary care initiatives, were available for 3010 adult patients with Type 2 diabetes. Results were benchmarked against the national guidelines for the management of Type 2 diabetes in the community and results from the National Diabetes Audit (NDA) for England (2008/2009) and the Scottish Diabetes Survey (2009). Results The recording of clinical processes of care was similar to results in the UK however the recording of lifestyle factors was markedly lower. Recording of HbA1c, blood pressure and lipids exceeded 85%. Recording of retinopathy screening (71%) was also comparable to England (77%) and Scotland (90%). Only 63% of patients had smoking status recorded compared to 99% in Scotland while 70% had BMI recorded compared to 89% in England. A similar proportion of patients in this initiative and the UK achieved clinical targets. Thirty-five percent of patients achieved a target HbA1c of < 6.5% (< 48 mmol/mol) compared to 25% in England. Applying the NICE target for blood pressure (≤ 140/80 mmHg), 54% of patients reached this target comparable to 60% in England. Slightly less patients were categorised as obese (> 30 kg/m2) in Ireland (50%, n = 1060) compared to Scotland (54%). Conclusions This study has demonstrated what can be achieved by proactive and interested health professionals in the absence of national infrastructure to support high quality diabetes care. The quality of primary care-led diabetes management in the three initiatives studied appears broadly consistent with results from the UK with the exception of recording lifestyle factors. The challenge facing health systems is to establish quality assurance a responsibility for all health care professionals rather than the subject of special interest for a few. PMID:22204759

Monetary payments for the procurement of oocytes for stem cell research: In search of ethical and political consistency.

PubMed

Isasi, Rosario M; Knoppers, Bartha M

2007-10-01

The debate on both the appropriateness of allowing healthy women to provide oocytes for research use and the use of financial incentives is increasingly reduced to a confrontation between ethics, science, and the welfare of women. It is plausible that the expansion of national and international research efforts, paired with the growing trend toward liberalizing stem cell research policies, will inevitably result in increased demand for the materials needed to conduct such research. The scarcity of human reproductive materials that are available for research generates concerns over, the emergence of a "black market", an increase in financial incentives for donors, and the appropriateness of current regulatory frameworks that aim to safeguard donors. In this article we explore the conceptual models for categorizing oocyte donors and analyze the use of financial incentives as well as the compensation models proposed and implemented in various jurisdictions. Finally, we propose the adoption of a mixed model that both respects altruism and provides a feasible solution to an issue that could be situated only in the context of the overall acceptability of providing financial rewards to donors of human reproductive materials for assisted reproductive technologies.

The Effect of Incentives and Meta-incentives on the Evolution of Cooperation.

PubMed

Okada, Isamu; Yamamoto, Hitoshi; Toriumi, Fujio; Sasaki, Tatsuya

2015-05-01

Although positive incentives for cooperators and/or negative incentives for free-riders in social dilemmas play an important role in maintaining cooperation, there is still the outstanding issue of who should pay the cost of incentives. The second-order free-rider problem, in which players who do not provide the incentives dominate in a game, is a well-known academic challenge. In order to meet this challenge, we devise and analyze a meta-incentive game that integrates positive incentives (rewards) and negative incentives (punishments) with second-order incentives, which are incentives for other players' incentives. The critical assumption of our model is that players who tend to provide incentives to other players for their cooperative or non-cooperative behavior also tend to provide incentives to their incentive behaviors. In this paper, we solve the replicator dynamics for a simple version of the game and analytically categorize the game types into four groups. We find that the second-order free-rider problem is completely resolved without any third-order or higher (meta) incentive under the assumption. To do so, a second-order costly incentive, which is given individually (peer-to-peer) after playing donation games, is needed. The paper concludes that (1) second-order incentives for first-order reward are necessary for cooperative regimes, (2) a system without first-order rewards cannot maintain a cooperative regime, (3) a system with first-order rewards and no incentives for rewards is the worst because it never reaches cooperation, and (4) a system with rewards for incentives is more likely to be a cooperative regime than a system with punishments for incentives when the cost-effect ratio of incentives is sufficiently large. This solution is general and strong in the sense that the game does not need any centralized institution or proactive system for incentives.

The Effect of Incentives and Meta-incentives on the Evolution of Cooperation

PubMed Central

Okada, Isamu; Yamamoto, Hitoshi; Toriumi, Fujio; Sasaki, Tatsuya

2015-01-01

Although positive incentives for cooperators and/or negative incentives for free-riders in social dilemmas play an important role in maintaining cooperation, there is still the outstanding issue of who should pay the cost of incentives. The second-order free-rider problem, in which players who do not provide the incentives dominate in a game, is a well-known academic challenge. In order to meet this challenge, we devise and analyze a meta-incentive game that integrates positive incentives (rewards) and negative incentives (punishments) with second-order incentives, which are incentives for other players’ incentives. The critical assumption of our model is that players who tend to provide incentives to other players for their cooperative or non-cooperative behavior also tend to provide incentives to their incentive behaviors. In this paper, we solve the replicator dynamics for a simple version of the game and analytically categorize the game types into four groups. We find that the second-order free-rider problem is completely resolved without any third-order or higher (meta) incentive under the assumption. To do so, a second-order costly incentive, which is given individually (peer-to-peer) after playing donation games, is needed. The paper concludes that (1) second-order incentives for first-order reward are necessary for cooperative regimes, (2) a system without first-order rewards cannot maintain a cooperative regime, (3) a system with first-order rewards and no incentives for rewards is the worst because it never reaches cooperation, and (4) a system with rewards for incentives is more likely to be a cooperative regime than a system with punishments for incentives when the cost-effect ratio of incentives is sufficiently large. This solution is general and strong in the sense that the game does not need any centralized institution or proactive system for incentives. PMID:25974684

Ventral Pallidum Neurons Encode Incentive Value and Promote Cue-Elicited Instrumental Actions.

PubMed

Richard, Jocelyn M; Ambroggi, Frederic; Janak, Patricia H; Fields, Howard L

2016-06-15

The ventral pallidum (VP) is posited to contribute to reward seeking by conveying upstream signals from the nucleus accumbens (NAc). Yet, very little is known about how VP neuron responses contribute to behavioral responses to incentive cues. Here, we recorded activity of VP neurons in a cue-driven reward-seeking task previously shown to require neural activity in the NAc. We find that VP neurons encode both learned cue value and subsequent reward seeking and that activity in VP neurons is required for robust cue-elicited reward seeking. Surprisingly, the onset of VP neuron responses occurs at a shorter latency than cue-elicited responses in NAc neurons. This suggests that this VP encoding is not a passive response to signals generated in the NAc and that VP neurons integrate sensory and motivation-related information received directly from other mesocorticolimbic inputs. Copyright © 2016 Elsevier Inc. All rights reserved.