International journal of medical informatics
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The paper focuses on how new, poorly charted complexities emerge when disparate systems in healthcare are integrated across organizational, geographical or professional boundaries. ⋯ The analytical concept of information infrastructure proves useful in dismantling a local/global separation, as it supports an empirical strategy of tracing out the concrete manifestations of how, where and when the "local" and the "global" are interdependent.
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Comparative Study
Description and comparison of quality of electronic versus paper-based resident admission forms in Australian aged care facilities.
To describe the paper-based and electronic formats of resident admission forms used in several aged care facilities in Australia and to compare the extent to which resident admission information was documented in paper-based and the electronic health records. ⋯ Better quality of documentation in resident admission forms was identified in the electronic documentation systems than in previous paper-based systems, but still needs to be further improved in practice. The quality of documentation of resident admission data should be further analysed in relation to its specific content.
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Although the adoption rates for Electronic Health Records (EHRs) are growing, significant opportunities for further advances in EHR system design remain. The goal of this study was to identify issues that should be considered in the design process for the successful development of future systems by analyzing end users' service requests gathered during a recent three-year period after a comprehensive EHR system was implemented at Seoul National University's Bundang Hospital in South Korea. ⋯ Users have continued to make suggestions about their needs and requirements, and the EHR system has evolved to optimize ease of use and special functionalities for particular groups of users and particular subspecialties. Based on our experiences and the lessons we have learned in the course of maintaining full-EHR systems, we suggest that the key goals to be considered for future EHR systems include innovative new user-interface technologies; special extended functions for each user group's specific task-oriented requirements; powerful, easy-to-use functions to support research; new flexible system architecture; and patient-directed functions.
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This paper explores the implications that different technical strategies for sharing patient information have for healthcare workers and, as a consequence, for the extent to which these systems provide support for integrated care. ⋯ The UK national strategy to deliver single shared database systems requires tight coupling between many users and has led to poor adoption because of the diverse needs of healthcare agencies. Sharing patient information has been more successful when local systems have been developed to serve particular healthcare pathways or when separate databases are viewable through a portal. On the basis of this evidence technical strategies that permit the local design of tight coupling are necessary if information systems are to support integrated care in healthcare pathways.