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Benoit B, Frédéric B, Jean-Charles D. Current state of dental informatics in the field of health information systems: a scoping review. BMC Oral Health 2022; 22:131. [PMID: 35439988 PMCID: PMC9020044 DOI: 10.1186/s12903-022-02163-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 04/06/2022] [Indexed: 11/10/2022] Open
Abstract
Background Over the past 50 years, dental informatics has developed significantly in the field of health information systems. Accordingly, several studies have been conducted on standardized clinical coding systems, data capture, and clinical data reuse in dentistry. Methods Based on the definition of health information systems, the literature search was divided into three specific sub-searches: “standardized clinical coding systems,” “data capture,” and “reuse of routine patient care data.” PubMed and Web of Science were searched for peer-reviewed articles. The review was conducted following the PRISMA-ScR protocol. Results A total of 44 articles were identified for inclusion in the review. Of these, 15 were related to “standardized clinical coding systems,” 15 to “data capture,” and 14 to “reuse of routine patient care data.” Articles related to standardized clinical coding systems focused on the design and/or development of proposed systems, on their evaluation and validation, on their adoption in academic settings, and on user perception. Articles related to data capture addressed the issue of data completeness, evaluated user interfaces and workflow integration, and proposed technical solutions. Finally, articles related to reuse of routine patient care data focused on clinical decision support systems centered on patient care, institutional or population-based health monitoring support systems, and clinical research. Conclusions While the development of health information systems, and especially standardized clinical coding systems, has led to significant progress in research and quality measures, most reviewed articles were published in the US. Clinical decision support systems that reuse EDR data have been little studied. Likewise, few studies have examined the working environment of dental practitioners or the pedagogical value of using health information systems in dentistry. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02163-9.
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Affiliation(s)
- Ballester Benoit
- Pôle d'Odontologie, Assistance Publique des Hôpitaux de Marseille, Marseille, France. .,Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France.
| | - Bukiet Frédéric
- Pôle d'Odontologie, Assistance Publique des Hôpitaux de Marseille, Marseille, France.,Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France
| | - Dufour Jean-Charles
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France.,APHM, Hôpital de la Timone, Service Biostatistique et Technologies de l'Information et de la Communication, Marseille, France
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Ware P, Bartlett SJ, Paré G, Symeonidis I, Tannenbaum C, Bartlett G, Poissant L, Ahmed S. Using eHealth Technologies: Interests, Preferences, and Concerns of Older Adults. Interact J Med Res 2017; 6:e3. [PMID: 28336506 PMCID: PMC5383803 DOI: 10.2196/ijmr.4447] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 06/24/2016] [Accepted: 01/29/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The Internet and eHealth technologies represent new opportunities for managing health. Age, sex, socioeconomic status, and current technology use are some of the known factors that influence individuals' uptake of eHealth; however, relatively little is known about facilitators and barriers to eHealth uptake specific to older adults, particularly as they relate to their experiences in accessing health care. OBJECTIVE The aim of our study was to explore the interests, preferences, and concerns of older adults in using the Internet and eHealth technologies for managing their health in relation to their experiences with the current health care system. METHODS Two focus groups (n=15) were conducted with adults aged 50+ years. Pragmatic thematic analysis using an inductive approach was conducted to identify the interests, preferences, and concerns of using the Internet and eHealth technologies. RESULTS Five themes emerged that include (1) Difficulty in identifying credible and relevant sources of information on the Web; (2) Ownership, access, and responsibility for medical information; (3) Peer communication and support; (4) Opportunities to enhance health care interactions; and (5) Privacy concerns. These findings support the potential value older adults perceive in eHealth technologies, particularly in their ability to provide access to personal health information and facilitate communication between providers and peers living with similar conditions. However, in order to foster acceptance, these technologies will need to provide personal and general health information that is secure, readily accessible, and easily understood. CONCLUSIONS Older adults have diverse needs and preferences that, in part, are driven by their experiences and frustrations with the health care system. Results can help inform the design and implementation of technologies to address gaps in care and access to health information for older adults with chronic conditions who may benefit the most from this approach.
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Affiliation(s)
- Patrick Ware
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Susan J Bartlett
- Division of Clinical Epidemiology, McGill University, and McGill University Health Centre, Montreal, QC, Canada
| | - Guy Paré
- Research Chair in Digital Health, HEC Montréal, Montreal, QC, Canada
| | - Iphigenia Symeonidis
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Cara Tannenbaum
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Université de Montréal, Montreal, QC, Canada
| | - Gillian Bartlett
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Lise Poissant
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada.,Centre de recherche interdisciplinaire en réadaptation (CRIR), Institut de réadaptation Gingras-Lindsay-de-Montréal, Montreal, QC, Canada
| | - Sara Ahmed
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.,Division of Clinical Epidemiology, McGill University, and McGill University Health Centre, Montreal, QC, Canada.,Centre de recherche interdisciplinaire en réadaptation (CRIR), Constance-Lethbridge Rehabilitation Center, Montreal, QC, Canada
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Kannry J, Sengstack P, Thyvalikakath TP, Poikonen J, Middleton B, Payne T, Lehmann CU. The Chief Clinical Informatics Officer (CCIO): AMIA Task Force Report on CCIO Knowledge, Education, and Skillset Requirements. Appl Clin Inform 2016; 7:143-76. [PMID: 27081413 PMCID: PMC4817341 DOI: 10.4338/aci-2015-12-r-0174] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 12/11/2015] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The emerging operational role of the "Chief Clinical Informatics Officer" (CCIO) remains heterogeneous with individuals deriving from a variety of clinical settings and backgrounds. The CCIO is defined in title, responsibility, and scope of practice by local organizations. The term encompasses the more commonly used Chief Medical Informatics Officer (CMIO) and Chief Nursing Informatics Officer (CNIO) as well as the rarely used Chief Pharmacy Informatics Officer (CPIO) and Chief Dental Informatics Officer (CDIO). BACKGROUND The American Medical Informatics Association (AMIA) identified a need to better delineate the knowledge, education, skillsets, and operational scope of the CCIO in an attempt to address the challenges surrounding the professional development and the hiring processes of CCIOs. DISCUSSION An AMIA task force developed knowledge, education, and operational skillset recommendations for CCIOs focusing on the common core aspect and describing individual differences based on Clinical Informatics focus. The task force concluded that while the role of the CCIO currently is diverse, a growing body of Clinical Informatics and increasing certification efforts are resulting in increased homogeneity. The task force advised that 1.) To achieve a predictable and desirable skillset, the CCIO must complete clearly defined and specified Clinical Informatics education and training. 2.) Future education and training must reflect the changing body of knowledge and must be guided by changing day-to-day informatics challenges. CONCLUSION A better defined and specified education and skillset for all CCIO positions will motivate the CCIO workforce and empower them to perform the job of a 21st century CCIO. Formally educated and trained CCIOs will provide a competitive advantage to their respective enterprise by fully utilizing the power of Informatics science.
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Shanahan CW, Sorensen-Alawad A, Carney BL, Persand I, Cruz A, Botticelli M, Pressman K, Adams WG, Brolin M, Alford DP. The implementation of an integrated information system for substance use screening in general medical settings. Appl Clin Inform 2015; 5:878-94. [PMID: 25589904 DOI: 10.4338/aci-2014-03-ra-0025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 09/28/2014] [Indexed: 11/23/2022] Open
Abstract
UNLABELLED The Massachusetts Screening, Brief Intervention and Referral to Treatment (MASBIRT) Program, a substance use screening program in general medical settings, created a web-based, point-of-care (POC), application--the MASBIRT Portal (the "Portal") to meet program goals. OBJECTIVES We report on development and implementation of the Portal. METHODS Five year program process outcomes recorded by an independent evaluator and an anonymous survey of Health Educator's (HEs) adoption, perceptions and Portal use with a modified version of the Technology Readiness Index are described. [8] Specific management team members, selected based on their roles in program leadership, development and implementation of the Portal and supervision of HEs, participated in semi-structured, qualitative interviews. RESULTS At the conclusion of the program 73% (24/33) of the HEs completed a survey on their experience using the Portal. HEs reported that the Portal made recording screening information easy (96%); improved planning their workday (83%); facilitated POC data collection (84%); decreased time dedicated to data entry (100%); and improved job satisfaction (59%). The top two barriers to use were "no or limited wireless connectivity" (46%) and "the tablet was too heavy/bulky to carry" (29%). Qualitative management team interviews identified strategies for successful HIT implementation: importance of engaging HEs in outlining specifications and workflow needs, collaborative testing prior to implementation and clear agreement on data collection purpose, quality requirements and staff roles. DISCUSSION Overall, HEs perceived the Portal favorably with regard to time saving ability and improved workflow. Lessons learned included identifying core requirements early during system development and need for managers to institute and enforce consistent behavioral work norms. CONCLUSION Barriers and HEs' views of technology impacted the utilization of the MASBIRT Portal. Further research is needed to determine best approaches for HIT system implementation in general medical settings.
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Affiliation(s)
- C W Shanahan
- Boston University School of Medicine , Boston, MA ; Boston Medical Center , Boston, MA
| | | | | | | | - A Cruz
- Boston Medical Center , Boston, MA
| | - M Botticelli
- Massachusetts Department of Public Health , Boston, MA
| | - K Pressman
- Massachusetts Department of Public Health , Boston, MA
| | - W G Adams
- Boston University School of Medicine , Boston, MA ; Boston Medical Center , Boston, MA
| | - M Brolin
- Brandeis University , Waltham, MA
| | - D P Alford
- Boston University School of Medicine , Boston, MA ; Boston Medical Center , Boston, MA
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Walji MF, Kalenderian E, Piotrowski M, Tran D, Kookal KK, Tokede O, White JM, Vaderhobli R, Ramoni R, Stark PC, Kimmes NS, Lagerweij M, Patel VL. Are three methods better than one? A comparative assessment of usability evaluation methods in an EHR. Int J Med Inform 2014; 83:361-7. [PMID: 24583045 DOI: 10.1016/j.ijmedinf.2014.01.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 01/21/2014] [Accepted: 01/23/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To comparatively evaluate the effectiveness of three different methods involving end-users for detecting usability problems in an EHR: user testing, semi-structured interviews and surveys. MATERIALS AND METHODS Data were collected at two major urban dental schools from faculty, residents and dental students to assess the usability of a dental EHR for developing a treatment plan. These included user testing (N=32), semi-structured interviews (N=36), and surveys (N=35). RESULTS The three methods together identified a total of 187 usability violations: 54% via user testing, 28% via the semi-structured interview and 18% from the survey method, with modest overlap. These usability problems were classified into 24 problem themes in 3 broad categories. User testing covered the broadest range of themes (83%), followed by the interview (63%) and survey (29%) methods. DISCUSSION Multiple evaluation methods provide a comprehensive approach to identifying EHR usability challenges and specific problems. The three methods were found to be complementary, and thus each can provide unique insights for software enhancement. Interview and survey methods were found not to be sufficient by themselves, but when used in conjunction with the user testing method, they provided a comprehensive evaluation of the EHR. CONCLUSION We recommend using a multi-method approach when testing the usability of health information technology because it provides a more comprehensive picture of usability challenges.
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Affiliation(s)
- Muhammad F Walji
- The University of Texas Health Science Center at Houston, United States.
| | | | - Mark Piotrowski
- The University of Texas Health Science Center at Houston, United States
| | - Duong Tran
- The University of Texas Health Science Center at Houston, United States
| | - Krishna K Kookal
- The University of Texas Health Science Center at Houston, United States
| | | | - Joel M White
- University of California, San Francisco, United States
| | | | | | | | | | - Maxim Lagerweij
- Academic Centre for Dentistry at Amsterdam (ACTA), United States
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Dental practitioners and a digital future: an initial exploration of barriers and incentives to adopting digital technologies. Br Dent J 2013; 215:E21. [DOI: 10.1038/sj.bdj.2013.1146] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2013] [Indexed: 11/08/2022]
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Walji MF, Kalenderian E, Tran D, Kookal KK, Nguyen V, Tokede O, White JM, Vaderhobli R, Ramoni R, Stark PC, Kimmes NS, Schoonheim-Klein ME, Patel VL. Detection and characterization of usability problems in structured data entry interfaces in dentistry. Int J Med Inform 2012; 82:128-38. [PMID: 22749840 DOI: 10.1016/j.ijmedinf.2012.05.018] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Revised: 03/03/2012] [Accepted: 05/28/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Poor usability is one of the major barriers for optimally using electronic health records (EHRs). Dentists are increasingly adopting EHRs, and are using structured data entry interfaces to enter data such that the data can be easily retrieved and exchanged. Until recently, dentists have lacked a standardized terminology to consistently represent oral health diagnoses. OBJECTIVES In this study we evaluated the usability of a widely used EHR interface that allow the entry of diagnostic terms, using multi-faceted methods to identify problems and work with the vendor to correct them using an iterative design method. METHODS Fieldwork was undertaken at two clinical sites, and dental providers as subjects participated in user testing (n=32), interviews (n=36) and observations (n=24). RESULTS User testing revealed that only 22-41% of users were able to successfully complete a simple task of entering one diagnosis, while no user was able to complete a more complex task. We identified and characterized 24 high-level usability problems reducing efficiency and causing user errors. Interface-related problems included unexpected approaches for displaying diagnosis, lack of visibility, and inconsistent use of UI widgets. Terminology related issues included missing and mis-categorized concepts. Work domain issues involved both absent and superfluous functions. In collaboration with the vendor, each usability problem was prioritized and a timeline set to resolve the concerns. DISCUSSION Mixed methods evaluations identified a number of critical usability issues relating to the user interface, underlying terminology of the work domain. The usability challenges were found to prevent most users from successfully completing the tasks. Our further work we will determine if changes to the interface, terminology and work domain do result in improved usability.
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Schleyer TK, Thyvalikakath TP, Spallek H, Dziabiak MP, Johnson LA. From Information Technology to Informatics: The Information Revolution in Dental Education. J Dent Educ 2012. [DOI: 10.1002/j.0022-0337.2012.76.1.tb05241.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Titus K. Schleyer
- Center for Dental Informatics School of Dental Medicine University of Pittsburgh
| | | | - Heiko Spallek
- Center for Dental Informatics School of Dental Medicine University of Pittsburgh
| | - Michael P. Dziabiak
- Center for Dental Informatics School of Dental Medicine University of Pittsburgh
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Reeder B, Revere D, Olson DR, Lober WB. Perceived usefulness of a distributed community-based syndromic surveillance system: a pilot qualitative evaluation study. BMC Res Notes 2011; 4:187. [PMID: 21672242 PMCID: PMC3146436 DOI: 10.1186/1756-0500-4-187] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Accepted: 06/14/2011] [Indexed: 11/10/2022] Open
Abstract
Background We conducted a pilot utility evaluation and information needs assessment of the Distribute Project at the 2010 Washington State Public Health Association (WSPHA) Joint Conference. Distribute is a distributed community-based syndromic surveillance system and network for detection of influenza-like illness (ILI). Using qualitative methods, we assessed the perceived usefulness of the Distribute system and explored areas for improvement. Nine state and local public health professionals participated in a focus group (n = 6) and in semi-structured interviews (n = 3). Field notes were taken, summarized and analyzed. Findings Several emergent themes that contribute to the perceived usefulness of system data and the Distribute system were identified: 1) Standardization: a common ILI syndrome definition; 2) Regional Comparability: views that support county-by-county comparisons of syndromic surveillance data; 3) Completeness: complete data for all expected data at a given time; 4) Coverage: data coverage of all jurisdictions in WA state; 5) Context: metadata incorporated into the views to provide context for graphed data; 6) Trusted Data: verification that information is valid and timely; and 7) Customization: the ability to customize views as necessary. As a result of the focus group, a new county level health jurisdiction expressed interest in contributing data to the Distribute system. Conclusion The resulting themes from this study can be used to guide future information design efforts for the Distribute system and other syndromic surveillance systems. In addition, this study demonstrates the benefits of conducting a low cost, qualitative evaluation at a professional conference.
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Affiliation(s)
- Blaine Reeder
- Biobehavioral Nursing and Health Systems School of Nursing, Box 359442 University of Washington, Seattle, WA 98195, USA.
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