Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2012
An aneurysm clipping training module for the neurosurgical training simulator NeuroSim.
Having introduced NeuroSim, the prototype of a neurosurgical training simulator at MMVR18, we present our first medical training module. NeuroSim is based on virtual reality and uses real-time algorithms for simulating tissue. ⋯ Having implemented some abstract tasks to train basic skills like hand-eye coordination or the handling of the microscope last year, we now present a medical module where an aneurysm has to be clipped. NeuroSim has been developed in cooperation with the neurosurgical clinic of the University of Heidelberg and VRmagic GmbH in Mannheim.
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Stud Health Technol Inform · Jan 2012
Evidence based electronic system to ensure quality of care in trauma patients.
Electronic patient records are important for quality health services. Aim of this study is to support the trauma patient care with the development of an electronic system. A survey was conducted in the Emergency Department (ED) of a University hospital to study the effectiveness of an electronic monitoring system in a group of trauma patients, as well as the acceptance of this electronic system by the health professionals of the ED. ⋯ The severity, length of care and the health outcomes of 200 trauma patients, were investigated. Half of the patients (N=100) have been monitored by the electronic system and the other 100 were monitored without the use of the system. The time between the admission and completion of the planned care was significantly lower in the electronic monitoring patient group (100±92 minutes) compared to the control group (149±29 minutes).
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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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Stud Health Technol Inform · Jan 2012
Identifying types and causes of errors in mortality data in a clinical registry using multiple information systems.
Errors may occur in the registration of in-hospital mortality, making it less reliable as a quality indicator. We assessed the types of errors made in in-hospital mortality registration in the clinical quality registry National Intensive Care Evaluation (NICE) by comparing its mortality data to data from a national insurance claims database. Subsequently, we performed site visits at eleven Intensive Care Units (ICUs) to investigate the number, types and causes of errors made in in-hospital mortality registration. ⋯ The remaining 20% were five types of manual transcription errors and human failures to record outcome data. Clinical registries should be aware of the possible existence of errors in recorded outcome data and understand their causes. In order to prevent errors, we recommend to thoroughly verify the software that is used in the registration process.
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Electronic Health Record (EHR) data has the potential to track patients' journeys through healthcare systems. Many of those journeys are supposed to follow Integrated Care Pathways (ICPs) built on evidence based guidelines. An ICP for a particular condition sets out "what should happen", whereas the EHR records "what did happen". ⋯ By performing variance analysis over multiple patients, patterns of deviation from idealised care are revealed. The use of ICP variance analysis, however, is not as widespread as it could be in healthcare quality improvement processes - we argue that this is due to the difficulty of combining the required specialist knowledge and skills from different disciplines. COCPIT (Collaborative Online Care Pathway Investigation Tool) was developed to overcome this difficulty and provides clinicians and health service managers with a web-based tool for Care Pathway Variance Analysis.