Proceedings / AMIA ... Annual Symposium. AMIA Symposium
-
In intensive care physiological variables of the critically ill are measured and recorded in short time intervals. The proper extraction and interpretation of the information contained in this flood of information can hardly be done by experience alone. Intelligent alarm systems are needed to provide suitable bedside decision support. ⋯ Graphical models provide information on the relationships among physiological variables that is helpful e.g. for variable selection. Separate analyses for different pathophysiological states show that distinct clinical states are characterized by distinct partial correlation structures. Hence, this technique can provide new insights into physiological mechanisms.
-
Even in the information-rich environment of hospitals, health-care providers face challenges in addressing their various information needs. Through a study of a patient-care team in a tertiary care Surgical Intensive Care Unit (SICU), we expanded our understanding of health-care providers' information needs in two important ways. ⋯ We found that organizational information was extremely important to SICU team members. Furthermore, the first resource that team members utilized was not electronic or paper but rather human: another team member.
-
Collaboration is an important part of healthcare delivery. However, in home care, collaboration is difficult due to the mobility and schedule variability of the workers. ⋯ We present recommendations for incorporating support for each of these areas into point-of-care clinical information systems that provide access to shared patient records. Finally, we discuss general design approaches for incorporating this type of support, including the need for workers to maintain awareness of the activities of others, and the need to integrate communication with the presentation of the health record.
-
Comparative Study
Does size matter?--Evaluation of value added content of two decades of successive coding schemes in secondary care.
Over the last two decades there has been a gradual evolution from the use of simple coding schemes to controlled clinical terminologies within clinical information systems in secondary care. This evolution has required significant resources in both the development of the different coding schemes and the cost of hardware, software and human effort in implementation. During this time there has been successively larger and more complex coding schemes available for use in the UK Health Service: Read Codes 4 byte set, Read Codes 5 byte set, ICD-10 and Clinical Terms Version 3. ⋯ The schemes are quantitatively evaluated by measuring their success in providing a concept match for every notion from the CIS and their relative merits are compared. Significant added value has accrued over the years in completeness of the schemes reflected in their increased size. There appears to be justification for the continued development of clinical terminologies to support secondary care.
-
Patient safety has become a major public concern. Human factors research in other high-risk fields has demonstrated how rigorous study of factors that affect job performance can lead to improved outcome and reduced errors after evidence-based redesign of tasks or systems. These techniques have increasingly been applied to the anesthesia work environment. ⋯ A novel concept of "non-routine events" is introduced and pilot data are presented. The results support the assertion that human factors research can make important contributions to patient safety. Information technologies play a key role in these efforts.