Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2013
Clinical handover improvement in context: exploring tensions between user-centred approaches and standardisation.
User-centred approaches in the development and evaluation of health information systems promote the importance of involving users and understanding their social contexts to optimise the quality and safety of these systems for patient care. Simultaneously, the standardisation of clinical practices has also been advocated to improve the quality and safety of patient care. In the context of clinical handover improvement within three different departments in one tertiary teaching hospital, this paper highlights the potential for tensions between these two approaches and explores their implications. ⋯ This led to the project developing distinct minimum data sets for each of the three departments that posed challenges for efforts to standardise handover practices across the hospital and for building an integrated information system. While on the one hand accommodating unique departmental user requirements was valuable, they revealed the potential for the introduction of quality and safety risks at the organisational level. To resolve these tensions, the project team developed an approach called flexible standardisation that has now been embedded in Australia' s national guidelines on clinical handover improvement.
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Stud Health Technol Inform · Jan 2013
Drugs don't work in patients who don't take them: Dr. Drin, the new ICT paradigm for chronic therapies.
Poor adherence to drug therapies still represents an unsolved problem. In order to provide a useful solution to chronic patients of all ages--with particular attention to the elderly--who are subjected to complex therapeutic regimen, an innovative ICT solution, called Dr. Drin, has been designed and tested. ⋯ Drin over a three-months period. In the following, preliminary results from the first twelve patients are presented and analyzed to prove the effectiveness of Dr. Drin in supporting patients adherence to therapies.
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Stud Health Technol Inform · Jan 2013
Observational StudyDeveloping and applying a cross-disciplinary team handover information system.
In order to avoid medical errors, it is very important to communicate with the medical team correctly, timely and efficiently. One of main reasons for the poor outcome of multidisciplinary handover in hospital is lacking effective tools for multidisciplinary handover. The project aimed to develop a workflow-based multidisciplinary handover information system, integrated with medical record browsing, multidisciplinary handover and event tracking, to improve the correctness and effectiveness of communication among the medical team members.
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Stud Health Technol Inform · Jan 2013
Observational StudyEfficiency strategies for facilitating computerized clinical documentation in ambulatory care.
Most providers have experienced increased documentation demands with the use of electronic health records (EHRs). We sought to identify efficiency strategies that providers use to complete clinical documentation tasks in ambulatory care. Two observers performed ethnographic observations and interviews with 22 ambulatory care providers in a U. ⋯ Findings included: the use of paper artifacts for handwritten notations; electronic templates for automation of certain parts of the note; use of shorthand and phrases rather than narrative writing; copying and pasting from previous EHR notes; directly entering information into the EHR note during the patient encounter; reliance on memory; and pre-populating an EHR note prior to seeing the patient. We discuss the findings in the context of distributed cognition to understand how clinical information is propagated and represented toward completion of a progress note. The study findings have important implications for improving and streamlining clinical documentation related to human factors workload management strategies.
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Stud Health Technol Inform · Jan 2013
Do electronic health records help undergraduate health informatics students to develop health informatics competencies?
The purpose of this paper is to determine the effects of hands-on exposure to an educational electronic health record (EHR) system upon undergraduate health informatics (HI) student competency development. We undertook a quasi-experimental study (i.e. pre-test, post-test design), where students were given the opportunity to do hands-on work with an educational EHR over a 10 week period. ⋯ Several HI student competencies improved significantly following hands-on work with the EHR. As well, students provided more higher quality case study answerfollowing EHR use.