Studies in health technology and informatics
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Automated encoding of free-text clinical narratives using concepts from terminological systems is widely performed. However, the majority of natural language processing (NLP) tools and terminological systems involve the English language. As parts of the NLP process are language independent, and tools for various languages are available, an overview is needed to determine the applicability to performing NLP of Dutch medical texts. ⋯ Most of them are suitable for English free text, some of them are (also) usable for Dutch. To enable automated encoding of Dutch free text narratives, further research is needed to create a spelling checker, a negation detector, a domain-specific abbreviation/acronym list, and a concept mapper (to map Dutch terms to concepts in a terminological system). Furthermore evaluation of performance for the Dutch 'medical' language is needed.
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Stud Health Technol Inform · Jan 2012
Envisioning electronic health record systems as change management: the experience of an English hospital joining the National Programme for Information Technology.
The historical National Programme for Information Technology (NPfIT) in England was the most expensive (~$20billion) and ambitious politically-driven IT-based transformations of public services ever undertaken. Nation-wide implementation of integrated electronic health record (EHR) systems in hospitals was at the heart of the NPfIT (~$10billion). We conducted the first longitudinal, prospective, and sociotechnical case study implementation and adoption of national EHRs implementations in 12 'early adopter' hospitals across England. ⋯ This led to greater local configuration and high sense of ownership among users, which transformed work practices towards overall better performance of the hospital. Contrary to painful and turbulent experiences of EHR implementation via NPfIT route in the English hospitals, this in-depth case study revealed the importance of vision (change management) and insightful leadership in 'working out' EHR. We advocate envisioning EHRs as change management endeavors to enhance their complex, multi-dimensional, and sociotechnical adoption in healthcare settings.
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Stud Health Technol Inform · Jan 2012
The use of linked registries to assess long-term mortality of ICU patients.
Clinical registries are frequently used to monitor and analyze the quality of health care by assessing the in-hospital mortality. However, long-term mortality is often ignored as it is rarely recorded in such clinical registries. In this study linkage of a clinical registry and administrative database is used to assess the longterm mortality of a large ICU sample. ⋯ In this study we have focused on the general ICU population, though linkage of clinical and administrative databases can also be used to perform analyses in specific diagnostic ICU populations or for non-ICU patients. In this study 71.4% of the clinical records could be linked with the administrative database. Future studies should focus on improving linkage of different registries.
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Stud Health Technol Inform · Jan 2012
Virtual medical record implementation for enhancing clinical decision support.
Development of clinical decision support systems (CDS) is a process which highly depends on the local databases, this resulting in low interoperability. To increase the interoperability of CDS a standard representation of clinical information is needed. ⋯ Beside the implementation of the vMR, the architecture integrates: a Data Manager, an interface, a decision making system (based on Egadss), a retrieving data module. Conclusions are issued.
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Mobile health apps are proliferating, but they fail to deliver on a key patient and caregiver requirement - the ability to collaborate using key phone features while leveraging existing web services. Typically, mobile health apps are for single use, proprietary, and deliver closed-world solutions. By making use of web services, both open and proprietary, mobile health apps can be created to support the caregiver network in the community. The full value of telehealth will only be achieved when the spectrum of trusted health care services (preventive, promotion, curative, and rehabilitative) is delivered to the collaborating network of caregivers.