International journal of medical informatics
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This study examined the current prevalence of electronic health records (EHRs) in Korea and identified the factors that impede or facilitate the adoption of EHRs. ⋯ The rate at which EHR and CPOE for medications systems have been adopted by Korean tertiary teaching and general hospitals was higher than the rate of adoption by US hospitals. Financial aspects are reported to be the most important facilitators of and barriers to EHR adoption. Government financial support, especially to small hospitals, seems to be essential to promoting the adoption of EHRs by Korean hospitals.
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Web sites with health-oriented content are potentially harmful if inaccurate or inappropriate medical information is used to make health-related decisions. Checklists, rating systems and guidelines have been developed to help people determine what is credible, but recent Internet technologies emphasize applications that are collaborative in nature, including tags and tag clouds, where site users 'tag' or label online content, each using their own labelling system. Concepts such as the date, reference, author, testimonial and quotations are considered predictors of credible content. An understanding of these descriptive tools, how they relate to the depiction of credibility and how this relates to overall efforts to label data in relation to the semantic web has yet to emerge. ⋯ Many participants in this study focused on assessing whether the information was relevant to their current circumstances, after which they would proceed to determine its credibility by corroborating with other sources. The use of structured tags to label information may not be a useful way to encourage the use of tagging, or to indicate credibility in this context. Current applications used in the semantic web automate this process. Therefore it may be useful to engage consumers of online content, in particular health-related content, to be more directly involved in the annotation of this content.
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Although the use of computerized decision support systems (CDSS) in glucose control in the ICU has been reported, little is known about the effect of the systems' operating modes on the quality of glucose control. The objective of this study was to evaluate the effect of providing patient-specific and patient non-specific computerized advice on timing of blood glucose level (BGL) measurements. Our hypothesis was that both levels of support would be effective for improving the quality of glucose regulation and safety, with patient specific advice being the most effective strategy. ⋯ Adherence to protocol sampling rules increased by using decision support with a larger effect at the patient specific level. This led to a decrease in the percentage of hypoglycemia events and improved safety. The use of the CDSS at both levels, however, did not improve the quality of glucose control as measured by our indicators. More research is needed to investigate whether other socio-technical factors are in play.
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Shift handover is seen as a key tool in ensuring continuity of care yet a number of studies have highlighted the role of shift handovers in adverse events. This, combined with the increased frequency of shift handovers, has led to interest in providing technological support for handover to enhance safety. The aim of this paper is to describe current practices for the conduct of shift handovers and to use this as a basis for considering the role that technology could play in supporting handover. ⋯ The benefits provided by a face to face handover suggest that technology should focus on supporting rather than replacing the verbal shift handover report, providing a flexible solution that allows handover participants to gather more information as it is required.
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In the health informatics field, usability studies typically focus on evaluating a single information system and involve a rather small group of end-users. However, little is known about the usability of clinical information and communication technology (ICT) environment in which healthcare professionals work daily. This paper aims at contributing to usability research and user-oriented development of healthcare technologies with three objectives: inform researchers and practitioners about the current state of usability of clinical ICT systems, increase the understanding of usability aspects specific for clinical context, and encourage a more holistic approach on studying usability issues in health informatics field. ⋯ The described study and related results are unique in several ways. A national usability study with nearly 4000 respondents had not been conducted in other countries in which healthcare technologies are widely adopted. The questionnaire study provided a generalized picture about the usability problems, however, it should be noted that there were significant differences between legacy systems in use. Previously, researchers had not approached contextual aspects of usability the context of clinical work, where numerous systems are in use. The described usability dimensions and the presented study results can be considered as the first step towards conceptualizing ICT usability in the unique setting of clinical work.