Studies in health technology and informatics
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Our main objective is to detect adverse drug events (ADEs) in former hospital stays. As ADEs are rare, that supposes to screen thousands of electronic health records (EHRs). For that purpose, we need to define a data model that has two main objectives: (1) being able to describe hospital stays from various hospitals (2) being tuned so as to prepare the data mining process: as ADEs are not flagged in the datasets, the data model must be optimized for ADE detection. ⋯ It is compatible with many hospitals. It deals with diagnoses, drug prescriptions, lab results and administrative information. It allows for data mining and ADE detection in EHRs.
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Stud Health Technol Inform · Jan 2009
A standard operating protocol (SOP) and minimum data set (MDS) for nursing and medical handover: considerations for flexible standardization in developing electronic tools.
As part of Australia's participation in the World Health Organization, the Australian Commission on Safety and Quality in Health Care (ACSQHC) is the leading federal government technical agency involved in the area of clinical handover improvement. The ACSQHC has funded a range of handover improvement projects in Australia including one at the Royal Hobart Hospital (RHH), Tasmania. The RHH project aims to investigate the potential for generalizable and transferable clinical handover solutions throughout the medical and nursing disciplines. ⋯ It considers the implications of these standardized operating protocols and minimum data sets for developing electronic clinical handover support tools. Significantly, the paper highlights a human-centred design approach that actively involves medical and nursing staff in data collection, analysis, interpretation, and systems design. This approach reveals the dangers of info-centrism when considering electronic tools, as information emerges as the only factor amongst many others that influence the efficiency and effectiveness of clinical handover.
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A study of Australian nurses on their use of information technology in the workplace was undertaken by the Australian Nursing Federation (ANF) in 2007. This study of over 4000 nurses highlighted that nurses recognise benefits to adopting more information technology in the workplace although there are significant barriers to their use. It also identified gross deficits in the capacity of the nursing workforce to engage in the digital processing of information. ⋯ This project is being developed in collaboration with the ANF and the Queensland University of Technology. This paper will discuss the methodology, development and publication of the Australian Nursing Informatics Competency Standards Project which is currently underway and due for completion in May 2009. The Australian Nursing Informatics Competencies will be presented at the conference.
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Integrated care pathways, a fine-grained form of medical guideline including the explicit recording of any deviation, or 'variance', have been perceived by some as overly prescriptive, limiting clinical freedom and promoting 'cookbook medicine'. However, feeding the results of the analysis of variance back into the development of a pathway could be an effective way of capturing evidence from practice. This paper summarizes research into the development and use of ICPs, and includes some initial findings from a qualitative study involving clinicians that have helped develop or have used ICPs professionally.
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Stud Health Technol Inform · Jan 2009
Interoperable electronic patient records for health care improvement.
Pressing needs of cost-effectiveness in healthcare and opportunities of emerging electronic health record technologies offer unprecedented chance for progress. Ongoing health care improvement and patient safety initiatives demand new information collection and communication technologies (e.g., Centers for Medicaid and Medicare Services, Joint Commission, National Patient Safety Foundation, public health surveillance). Particularly, desire for faster action and cost-effective health care drive unprecedented investments in electronic patient records worldwide. ⋯ Regional health information networks and other information sharing initiatives depend on the interoperability of systems. Ultimately, the recent flood of health information standards needs to be balanced with actual interoperability opportunities. It is anticipated that the current policy discussions on the "meaningful use" of electronic health records will have major beneficial technical and also reimbursement implications.