Studies in health technology and informatics
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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
Developing a multivariate electronic medical record integration model for primary health care.
This paper describes the development of a multivariate electronic medical record (EMR) integration model for the primary health care setting. Our working hypothesis is that an integrated EMR is associated with high quality primary health care. ⋯ To test the face validity of this model, a Delphi study is being planned where health care providers and information technology professionals involved with EMR adoption are polled for their feedback. This model has the potential to quantify and explain the factors that influence successful EMR integration to improve primary health care.
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Stud Health Technol Inform · Jan 2013
Moving mobile: using an open-sourced framework to enable a web-based health application on touch devices.
Computer devices using touch-enabled technology are becoming more prevalent today. The application of a touch screen high definition surgical monitor could allow not only high definition video from an endoscopic camera to be displayed, but also the display and interaction with relevant patient and health related data. ⋯ This paper describes an approach taken to overcome these problems. A real case study was used to demonstrate the novelty and efficiency of the proposed method.
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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
Overrides of clinical decision support alerts in primary care clinics.
Clinical Decision Support (CDS) systems can alert physicians about potential clinical risks and suggest suitable treatment alternatives at appropriate times in the health care process. We evaluated the frequency with which physicians overrode medication alerts and the override reasons provided. ⋯ Physicians overrode more than half of CDS medication alerts, with formulary, age-based, and renal substitutions the most likely. Many drug-drug and drug-allergy interactions overridden had the potential to cause patient harm.