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Information Systems for Disability Determination: A Multi-Stakeholder Assessment of Electronic Medical Evidence Needs and Processes
Communications of the Association for Information Systems
  • Sue S. Feldman, Kay Center for E-Health Research, Claremont Graduate University
  • Thomas A. Horan, Kay Center for E-Health Research, Claremont Graduate University
  • Fadi Al-Buhairan, Kay Center for E-Health Research, Claremont Graduate University
  • Nicole Lytle-Kosola, Kay Center for E-Health Research, Claremont Graduate University
  • Bengisu Tulu, School of Business, and Center for e-Health Innovation and Process Transformation (CeHIPT), Worcester Polytechnic University
Publication Date
10-1-2011
Abstract

This study focuses on Health Information Technology (Health IT) in improving the decision-making process concerning disability benefits. Using a multimethod, multilevel approach that includes case analysis and semi-structured interviews, this study examines the practices, challenges, and potential solutions or methods involved in adequate and timely collection of medical evidence through information technology (IT) to support disability determination. Researchers collected qualitative data through fifty-six semi-structured thirty-minute interviews with Disability Determination Services (DDS) personnel in three states. Based on site observations, interviews, and document analysis, they developed two provider case studies. To demonstrate the adequacy and timeliness of medical evidence collection, the study also examined and reviewed twelve disability claimant cases. Findings suggest that, at the payer and provider levels, electronic solutions provide more adequate and timely responses to medical evidence requests. Based on the case studies, implemented Health IT reduces incomplete medical evidence and decreases provider turnaround time in processing a payer’s requests. Among the claims examined, 50 percent received low scores for adequacy of medical evidence and 33 percent received high or medium scores for delay of return of medical evidence of record. This examination of disability determination demonstrated that Health IT holds promise for clinical data use in this context.

Citation Information
Sue S. Feldman, Thomas A. Horan, Fadi Al-Buhairan, Nicole Lytle-Kosola, et al.. "Information Systems for Disability Determination: A Multi-Stakeholder Assessment of Electronic Medical Evidence Needs and Processes" (2011)
Available at: http://works.bepress.com/sue_s_feldman/3/