Studies in health technology and informatics
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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
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
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.
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Stud Health Technol Inform · Jan 2013
Proposal of the patient location tracking and query (PLQ) of IHE integration profile for the better patient tracking.
The Patient Location Tracking Query (PLQ) is the IHE integration profile in order to find the location of patient only in a hospital, not for cross-referencing between multiple hospitals. In Japan, it is common for elderly patients to consult multiple departments in one hospital visit. To find the location of patients quickly is very important for productivity and use of resources in a hospital. ⋯ In order to collect the location of patients, multiple systems must provide the location into central management system. We proposed PLQ for the better patient care in hospitals. We believe that by using this PLQ profile hospital staffs are able to utilize the resource more efficiently.
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Stud Health Technol Inform · Jan 2013
Exploring the potential of an electronic documentation system to reduce length of stay.
Electronic patient records are important in patient data management. Aim of this 2-year study was to investigate the effect of an e-documentation system on the ED length of stay. The study compared three length of stay parameters with and without the use of a prototype e-documentation system. 99 of trauma patients were monitored with the use of the electronic system and 101 patients (control group) were monitored with traditional methods. ⋯ Similar effect was also found to the total ED length of stay (127±93 vs. 206±41 minutes) and time between completion of care and ED exit (26±10 vs. 57±23 minutes). LOS was reduced with the e-documentation system. This is important for the quality of trauma patient care, since saving time during the first hours after the accident usually determines the outcome of trauma patients.