Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2010
Discuss now, document later: CIS/CPOE perceived to be a 'shift behind' in the ICU.
Effective communication is essential to safe and efficient patient care. We aimed to understand the current patterns and perceptions of communication of common goals in the ICU using the distributed cognition and clinical communication space theoretical frameworks. ⋯ These perceptions that the CIS/CPOE is a "shift behind" may lead to a further reliance on verbal information exchange, which is a valuable clinical communication activity, yet, is subject to information loss. Electronic documentation tools that, in real time, capture information that is currently verbally communicated may increase the effectiveness of communication.
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Stud Health Technol Inform · Jan 2010
The illusion of presence influences VR distraction: effects on cold-pressor pain.
This study investigated whether VR presence influences how effectively VR distraction reduces pain intensity during a cold-pressor experience. Thirty-seven healthy students underwent a cold pressor task while interacting with a VR distraction world. ⋯ Results showed that the amount of VR presence reported correlated significantly and negatively with ratings of pain intensity. The importance of using an appropriately designed VR to achieve effective VR analgesia is highlighted.
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Stud Health Technol Inform · Jan 2010
Medical education & health informatics: time to join the 21st century?
This paper reports a component of a larger study, Informatics: enhancing the Clinical Experience? (ICE), which explored the impact on the therapeutic relationship of the implementation and use of Electronic Medical Records (EMR) in British Columbia, Canada. As anticipated, EMRs were found to negatively affect the relationship in many clinics. ⋯ This led to an interesting finding; that as a result of this difficulty few family care providers actually chart when their patients are with them, preferring to build rapport and chart at a later time. Consequently three recommendations are made: 1) Improve medical education in the area of charting (paper & EMR-based) with the patient present; 2) Explore the affect different technologies and skills have on the ability of providers to chart with the patient present and 3) Develop an understanding that unless the technology and training improve Canadian family medicine will never gain the asserted benefits of EMRs, and that other incentives are needed if Canada is to meet its target of delivering Electronic Health Records (EHR) to 100% of all Canadians by 2015.
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Stud Health Technol Inform · Jan 2010
MET3-AE system to support management of pediatric asthma exacerbation in the emergency department.
A decision making process behind the management of pediatric patients with asthma exacerbations in the Emergency Department includes three stages: data collection, diagnosis formulation and treatment planning. These stages are associated with activities involving different types of clinical knowledge: factual, conceptual and procedural. Effective decision support should span over the entire decision making process and facilitate the use of diversified clinical knowledge. ⋯ It was developed using ontology-driven and multi-agent methodologies and implemented with open source software. The system is accessible on tablet and desktop computers and smartphones, and it interacts with other hospital information systems. It was successfully verified in a simulated clinical setting and now it is undergoing testing in a teaching hospital.
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Stud Health Technol Inform · Jan 2010
Patient safety and sociotechnical considerations for electronic handover tools in an Australian ehealth landscape.
The Australian Commission for Safety and Quality in Health Care (ACSQHC) coordinates national improvements in a range of complex health system problems including clinical handover, and has funded a range of handover improvement projects in Australia. One of these, the SafeTECH project in South Australia has developed guidelines for safe use of electronic handover tools. These guidelines were developed using evidence from three hospital case studies into the use of an electronic tool to support different types of shift-to-shift handover. ⋯ The paper then considers these challenges within the broader context of the Australian ehealth landscape. Australia's National eHealth Transition Authority (NEHTA) is actively developing ehealth standards and infrastructure requirements for the electronic collection and secure exchange of health information. The paper argues for flexible standardisation in the design and implementation of electronic handover tools to ensure that all key dimensions of the challenges faced in ensuring patient safety are addressed.