Bmc Med Inform Decis
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Bmc Med Inform Decis · Jan 2012
The role of ICT in supporting disruptive innovation: a multi-site qualitative study of nurse practitioners in emergency departments.
The disruptive potential of the Nurse Practitioner (NP) is evident in their ability to offer services traditionally provided by primary care practitioners and their provision of a health promotion model of care in response to changing health trends. No study has qualitatively investigated the role of the Emergency NP in Australia, nor the impact of Information and Communication Technology (ICT) on this disruptive workforce innovation. This study aimed to investigate ways in which Nurse Practitioners (NP) have incorporated the use of ICT as a mechanism to support their new clinical role within Emergency Departments. ⋯ ICT is a facilitator through which the disruptive impact of NPs can be extended. However, integration of ICT into work practices without detracting from provider-patient interaction is crucial to ensure utilisation of such interventions and realisation of potential benefits.
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Bmc Med Inform Decis · Jan 2012
Randomized Controlled TrialShared decision making for prostate cancer screening: the results of a combined analysis of two practice-based randomized controlled trials.
Professional societies recommend shared decision making (SDM) for prostate cancer screening, however, most efforts have promoted informed rather than shared decision making. The objective of this study is to 1) examine the effects of a prostate cancer screening intervention to promote SDM and 2) determine whether framing prostate information in the context of other clearly beneficial men's health services affects decisions. ⋯ SDM interventions can increase men's knowledge, alter their perceptions of prostate cancer screening, and reduce actual screening. However, they may not guarantee an increase in shared decisions.
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Bmc Med Inform Decis · Jan 2012
CMDX©-based single source information system for simplified quality management and clinical research in prostate cancer.
Histopathological evaluation of prostatectomy specimens is crucial to decision-making and prediction of patient outcomes in prostate cancer (PCa). Topographical information regarding PCa extension and positive surgical margins (PSM) is essential for clinical routines, quality assessment, and research. However, local hospital information systems (HIS) often do not support the documentation of such information. Therefore, we investigated the feasibility of integrating a cMDX-based pathology report including topographical information into the clinical routine with the aims of obtaining data, performing analysis and generating heat maps in a timely manner, while avoiding data redundancy. ⋯ cMDX SSIS can be integrated into the local HIS and provides clinical routine data and timely heat maps for quality assessment and research purposes.
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Bmc Med Inform Decis · Jan 2012
Comparative StudyComparison of alphabetical versus categorical display format for medication order entry in a simulated touch screen anesthesia information management system: an experiment in clinician-computer interaction in anesthesia.
Anesthesia information management system (AIMS) records should be designed and configured to facilitate the accurate and prompt recording of multiple drugs administered coincidentally or in rapid succession. ⋯ The use of touch-screen user interfaces in healthcare is increasingly common. Arrangement of drugs names in a categorical display format in the medication order-entry touch screen of an AIMS can result in faster data entry compared to an alphabetical arrangement of drugs. Results of this quality improvement project were used in our department's design of our final intraoperative electronic anesthesia record. This testing approach using cognitive and usability engineering methods can be used to objectively design and evaluate many aspects of the clinician-computer interaction in electronic health records.
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Bmc Med Inform Decis · Jan 2012
A hybrid decision support model to discover informative knowledge in diagnosing acute appendicitis.
The aim of this study is to develop a simple and reliable hybrid decision support model by combining statistical analysis and decision tree algorithms to ensure high accuracy of early diagnosis in patients with suspected acute appendicitis and to identify useful decision rules. ⋯ The decision model developed in this study can be applied as an aid in the initial decision making of clinicians to increase vigilance in cases of suspected acute appendicitis.