International journal of medical informatics
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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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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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Randomized Controlled Trial
An asthma management system in a pediatric emergency department.
Pediatric asthma exacerbations account for >1.8 million emergency department (ED) visits annually. Asthma guidelines are intended to guide time-dependent treatment decisions that improve clinical outcomes; however, guideline adherence is inadequate. We examined whether an automatic disease detection system increases clinicians' use of paper-based guidelines and decreases time to a disposition decision. ⋯ Despite a high level of support from the ED leadership and staff, a focused education effort, and implementation of an automated disease detection, the use of the paper-based asthma protocol remained low and time to patient disposition did not change.
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This paper analyses the problem of allocating beds among hospital wards in order to minimise crowding. ⋯ This model provides a powerful tool for optimising hospital bed utilisation, and the application showed an important reduction in crowding bed usage. The generic model is flexible, as the level of detail in the modelling of arrivals and length of stay can vary according to the data available and accuracy required.