Nancy Crawford Shank

University of Nebraska
Public Policy Center

215 Centennial Mall South
Suite 401
Lincoln, NE
68588-0228 |  Visit Personal Website

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Dr. Shank's applied research focuses on technology adoption, interoperability for information sharing between organizations, information and referral, organizational systems and behavior, and health and human services systems.

Shank, Nancy, Elizabeth Willborn, Lisa PytlikZillig, and HarmoniJoie Noel. 2011. "Electronic health records: Eliciting behavioral health providers’ beliefs." Community Mental Health Journal.
Abstract: Interviews with 32 community behavioral health providers elicited perceived benefits and barriers of using electronic health records. Themes identified were (a) quality of care, (b) privacy and security, and (c) delivery of services. Benefits to quality of care were mentioned by 100% of the providers, and barriers by 59% of providers. Barriers involving privacy and security concerns were mentioned by 100% of providers, and benefits by 22%. Barriers to delivery of services were mentioned by 97% of providers, and benefits by 66%. Most providers (81%) expressed overall positive support for electronic behavioral health records.
Tomkins, Alan., Nancy Shank, Darcy Tromanhauser, Sandra Rupp, and Robing Mahoney. 2005. "United Way and University partnerships in community-wide human services planning and plan implementation: The case of Lincoln/Lancaster County, Nebraska." Journal of Community Practice 13 (3): 55-72.
Abstract: Given the similar interests of United Way organizations and universities in planning, implementation, and evaluation of human services, the two social institutions could be extensively and effectively partnering with one another. However, there is little documentation that such cooperative efforts are taking place. This article describes one such collaboration in Lincoln, Nebraska. The purpose of the article is to show the potential of such collaboration to improve community-wide coordination and outcomes by following the principles of a community-engagement model, to generate more effective use of evaluative tools that can assist in developing evidence-based practices in community planning, and to connect areas of study within the university to United Wayrnefforts.
Nancy Shank. 2012. "A review of the role of cost benefit analyses in 2-1-1diffusion. American Journal of Preventive Medicine 43 (6S5) S497-S505.
Abstract: Context: The 2-1-1 helpline is a social services innovation that has spread rapidly throughout the U.S. Policy diffusion theory suggests that policymakers seek to reduce uncertainty by anticipating the effects of a proposed innovation through tools such as cost– benefit analyses. Few policy diffusion studies have examined use of information, such as cost–benefit analyses, in the diffusion process. The purpose of this study is to examine how cost–benefit analyses were used during the rapid diffusion of 2-1-1 across states. The paper also describes components of 2-1-1 cost–benefit analyses. Evidence acquisition: In 2011, cost–benefit analyses of 2-1-1 and substantive citations of them were identified through scholarly key word searches using Academic Search Premier and Web of Science, general Internet searches using Google search terms, and communications with academicians and 2-1-1 practitioners through personal contact and e-mail discussion groups. To be included in this study, documents had to be related to 2-1-1 helplines, present information about their costs and benefits, and be formal documents. The documents were cataloged and analyzed for cost–benefit analyses or references to analyses, and stated purpose. Evidence synthesis: Of the 19 documents that met eligibility inclusion criteria, nine were original cost–benefit analyses and ten referenced analyses conducted for other jurisdictions. Conclusions: The diffusion of 2-1-1 helplines in the U.S. has been influenced by inter jurisdictional exchange of cost–benefit analyses, in both the creation of original analyses and/or the referencing of previous work.
Mitchel N. Herian, Nancy C. Shank, and Tarik L. Abdel-Monem. 2012. "Trust in government and support for governmental regulation: the case of electronic health records." Health Expectations
Abstract: Background: This paper presents results from a public engagement effort in Nebraska, USA, which measured public opinions about governmental involvement in encouraging the use of electronic health records (EHRs). Objective: We examine the role of trust in government in contributing to public support for government involvement in the development of EHR technologies. We hypothesize that trust in government will lead to support for federal and state governmental encouragement of the use of EHRs among doctors and insurance companies. Further, because individual experiences with healthcare professionals will reduce perceptions of risk, we expect that support for governmental involvement will be tempered by greater personal experience with the health-care industry. Design and Results: Examining a small survey of individuals on the issue, we find general support for both of our hypotheses. The findings suggest that trust in government does have a positive relationship with support for government involvement in the policy domain, but that the frequency of personal experiences with healthcare providers reduces the extent to which the public supports governmental involvement in the development of EHR technology. Discussion and Conclusion: This inquiry contributes to our understanding of public attitudes towards government involvement in EHRs in the United States specifically and contributes to social science examining links between trust in government and support for governmental activity in the emerging policy domain regarding electronic health records systems.
DOI: 10.1111/j.1369-7625.2012.00803.x
Shank, Nancy. 2012. "Behavioral health providers’ beliefs about health information exchange: A statewide survey." JAMIA. 19: 562-569.
Abstract: Objective: To assess behavioral health providers’ beliefs about the benefits and barriers of health information exchange (HIE). Methods: Survey of a total of 2010 behavioral health providers in a Midwestern state (33% response rate), with questions based on previously reported open-ended beliefs elicitation interviews. Results: Factor analysis resulted in four groupings: beliefs that HIE would improve care and communication, add cost and time burdens, present access and vulnerability concerns, and impact workflow and control (positively and negatively). A regression model including all four factors parsimoniously predicted attitudes toward HIE. Providers clustered into two groups based on their beliefs: a majority (67%) were positive about the impact of HIE, and the remainder (33%) were negative. There were some professional/demographic differences between the two clusters of providers. Discussion: Most behavioral health providers are supportive of HIE; however, their adoption and use of it may continue to lag behind that of medical providers due to perceived cost and time burdens and concerns about access to and vulnerability of information.
DOI: 10.1136/amiajnl-2011-000374
Shank, Nancy. 2004. "Database interoperability: Technology and process for sharing resource information." Information & Referral 26: 45-54.
Abstract: Information and Referral (I&R) programs provide a critical connector in the health and human service delivery system. I&R programs include those that offer specialized information about services (such as respite services) or are targeted at a specific population (such as seniors), and those that offer comprehensive information about a broad range of health and human services. I&R services enable individuals, families, and staff from helping agencies to identify, understand, and access programs and services. However, I&Rs have struggled to easily share the information in these rich resource databases. Technical and process barriers have frustrated the exchange and merging of resource information. I&Rs who are committed to sharing data have been forced to use the same software product or to apply less than optimal technological solutions that result in lost data elements or time-consuming and awkward workarounds each time services or programs change rnBecause I&Rs are unable to easily share resource information with one another, multiple I&Rs may find themselves allocating scarce resources to identify and maintain the same resource information about services in their communities. Multiple, isolated databases may exacerbate the already complex system of health and human services, requiring persons (particularly those with complex access or service needs) to make numerous contacts before finding an appropriate referral. Data sharing between I&Rs would enable seamless provision of information. This article will explore the technical and process solutions that are being applied to enable sharing across software products.

Substantive Focus:
Health Policy PRIMARY
Social Policy SECONDARY

Theoretical Focus:
Agenda-Setting, Adoption, and Implementation PRIMARY
Policy Analysis and Evaluation SECONDARY