Research limitations. During the research period of this Research, without the prior written consent of Party B, Party A, the PI, the Co-PI, and personnel participating in this Research may not engage in work similar to the content of this Research for any third party.
Research limitations. Perhaps the largest limitation in the research is the inability to develop a framework which is useful to all provider types and practice sizes. Given the wide variation in organization size, services provided and analytic capability, it is difficult to develop a framework that is feasible across all care settings. However, it is anticipated that any provider who services a diabetic population will find at least one component of the current framework useful for evaluation purposes. For instance, even if a provider does not have a patient portal, at a minimum, the practice could implement the XXX and target those patients who have low scores to encourage use of EHR or other activities to increase engagement. Ideally, however, a provider will have a patient portal and the capability to capture some of the proposed metrics. Further, the proposed methodology, a quasi-experimental study design, which includes both intervention and comparison groups, may not be feasible for all providers. This type of study requires dedicated resources to implement, manage and report on the evaluation. Selection bias is also an issue with this study since the intervention group is not selected randomly and because participants are self-selected into the study by their enrollment in the patient portal. Other studies have also found that portal users may differ from non-portal users in other ways that may introduce additional bias. Tenforde, et al found that compared to non-users, PHR users were younger, had higher incomes and educational attainment, were more likely to identify as Caucasian, and had better unadjusted and adjusted diabetes quality measure profiles (Tenforde, 2012). These differences may have the potential to skew some of the evaluation results although this can be mitigated some by controlling for these variables in analysis. Public Health Implications & Areas of Future Research As a growing number of providers transition to electronic health records, understanding the impact of these public health informatics systems is critical. Research that identifies how to increase patient engagement through the EHR may have substantial benefit for public health practitioners. By understanding the relationships between use of the patient portal features available in the EHR and how these play a role increasing patient engagement and health outcomes, practitioners can provide better quality services. While the main focus of this thesis is the role of technology and the patien...
Research limitations. 1. This research on intercultural premarital couples counseling initially set out to examine at least eight couples, four couples who were currently in premarital counseling and four who are now married but previously received premarital counseling. However, I was unable to find eight couples and had to select the four couples that responded.
Research limitations. The research concentrates only on four Finnish nearby suppliers because the very spe- cific information is considered to be most important in this thesis. In this case confiden- tial face to face interviews are the best way to get this information. It would be great to include more supply companies to this thesis but because of nature of the interviews it would require more time and recourses to conduct that kind of a study. Hopefully findings from this thesis will give useful information to the case com- pany but also to future researches to dig even more deeper on this subject. It is known that there are researches studying supplier cooperation but most of those are done for large amount of companies by structured interviews in which answers are given for example by scale from one to five like in Likert scale. In those studies, there is no possibility to give any detailed explanations to answers. The analysis is done based on the answers from interviews of supply companies intro- duced in this thesis and the literature reviewed. Information is very important to case company but also some suggestions can be made on more general level. Also, it has to be remembered that there are cultural differences in cooperation between countries. So, in this case findings are best relevant in Finland, but it would be great to compare this kind of researches from different countries.
