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Grosjean J, Dufour F, Benis A, Januel JM, Staccini P, Darmoni SJ. Digital Health Education for the Future: The SaNuRN (Santé Numérique Rouen-Nice) Consortium's Journey. JMIR MEDICAL EDUCATION 2024; 10:e53997. [PMID: 38693686 PMCID: PMC11082434 DOI: 10.2196/53997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 03/16/2024] [Accepted: 03/21/2024] [Indexed: 05/03/2024]
Abstract
SaNuRN is a five-year project by the University of Rouen Normandy (URN) and the Côte d’Azur University (CAU) consortium to optimize digital health education for medical and paramedical students, professionals, and administrators. The project includes a skills framework, training modules, and teaching resources. In 2027, SaNuRN is expected to train a significant portion of the 400,000 health and paramedical professions students at the French national level. Our purpose is to give a synopsis of the SaNuRN initiative, emphasizing its novel educational methods and how they will enhance the delivery of digital health education. Our goals include showcasing SaNuRN as a comprehensive program consisting of a proficiency framework, instructional modules, and educational materials and explaining how SaNuRN is implemented in the participating academic institutions. SaNuRN is a project aimed at educating and training health-related and paramedics students in digital health. The project results from a cooperative effort between URN and CAU, covering four French departments. The project is based on the French National Referential on Digital Health (FNRDH), which defines the skills and competencies to be acquired and validated by every student in the health, paramedical, and social professions curricula. The SaNuRN team is currently adapting the existing URN and CAU syllabi to FNRDH and developing short-duration video capsules of 20 to 30 minutes to teach all the relevant material. The project aims to ensure that the largest student population earns the necessary skills, and it has developed a two-tier system involving facilitators who will enable the efficient expansion of the project’s educational outreach and support the students in learning the needed material efficiently. With a focus on real-world scenarios and innovative teaching activities integrating telemedicine devices and virtual professionals, SaNuRN is committed to enabling continuous learning for healthcare professionals in clinical practice. The SaNuRN team introduced new ways of evaluating healthcare professionals by shifting from a knowledge-based to a competencies-based evaluation, aligning with the Miller teaching pyramid and using the Objective Structured Clinical Examination and Script Concordance Test in digital health education. Drawing on the expertise of URN, CAU, and their public health and digital research laboratories and partners, the SaNuRN project represents a platform for continuous innovation, including telemedicine training and living labs with virtual and interactive professional activities. The SaNuRN project provides a comprehensive, personalized 30-hour training package for health and paramedical students, addressing all 70 FNRDH competencies. The program is enhanced using AI and NLP to create virtual patients and professionals for digital healthcare simulation. SaNuRN teaching materials are open-access. The project collaborates with academic institutions worldwide to develop educational material in digital health in English and multilingual formats. SaNuRN offers a practical and persuasive training approach to meet the current digital health education requirements.
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Affiliation(s)
- Julien Grosjean
- Department of Biomedical Informatics, Rouen University Hospital, Rouen, France
- Laboratory of Medical Informatics and Knowledge Engineering in e-Health (LIMICS), INSERM U1142, Sorbonne Université, Paris, France
| | - Frank Dufour
- URE Risk Epidemiology Territory INformatics Education and Health (RETINES), Université Côte d’Azur, Nice, France
| | - Arriel Benis
- Department of Digital Medical Technologies, Holon Institute of Technology, Holon, Israel
| | - Jean-Marie Januel
- Department of Biomedical Informatics, Rouen University Hospital, Rouen, France
| | - Pascal Staccini
- URE Risk Epidemiology Territory INformatics Education and Health (RETINES), Université Côte d’Azur, Nice, France
| | - Stéfan Jacques Darmoni
- Department of Biomedical Informatics, Rouen University Hospital, Rouen, France
- Laboratory of Medical Informatics and Knowledge Engineering in e-Health (LIMICS), INSERM U1142, Sorbonne Université, Paris, France
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Chen W, O’Bryan CM, Gorham G, Howard K, Balasubramanya B, Coffey P, Abeyaratne A, Cass A. Barriers and enablers to implementing and using clinical decision support systems for chronic diseases: a qualitative systematic review and meta-aggregation. Implement Sci Commun 2022; 3:81. [PMID: 35902894 PMCID: PMC9330991 DOI: 10.1186/s43058-022-00326-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 07/10/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Clinical decision support (CDS) is increasingly used to facilitate chronic disease care. Despite increased availability of electronic health records and the ongoing development of new CDS technologies, uptake of CDS into routine clinical settings is inconsistent. This qualitative systematic review seeks to synthesise healthcare provider experiences of CDS-exploring the barriers and enablers to implementing, using, evaluating, and sustaining chronic disease CDS systems. METHODS A search was conducted in Medline, CINAHL, APA PsychInfo, EconLit, and Web of Science from 2011 to 2021. Primary research studies incorporating qualitative findings were included if they targeted healthcare providers and studied a relevant chronic disease CDS intervention. Relevant CDS interventions were electronic health record-based and addressed one or more of the following chronic diseases: cardiovascular disease, diabetes, chronic kidney disease, hypertension, and hypercholesterolaemia. Qualitative findings were synthesised using a meta-aggregative approach. RESULTS Thirty-three primary research articles were included in this qualitative systematic review. Meta-aggregation of qualitative data revealed 177 findings and 29 categories, which were aggregated into 8 synthesised findings. The synthesised findings related to clinical context, user, external context, and technical factors affecting CDS uptake. Key barriers to uptake included CDS systems that were simplistic, had limited clinical applicability in multimorbidity, and integrated poorly into existing workflows. Enablers to successful CDS interventions included perceived usefulness in providing relevant clinical knowledge and structured chronic disease care; user confidence gained through training and post training follow-up; external contexts comprised of strong clinical champions, allocated personnel, and technical support; and CDS technical features that are both highly functional, and attractive. CONCLUSION This systematic review explored healthcare provider experiences, focussing on barriers and enablers to CDS use for chronic diseases. The results provide an evidence-base for designing, implementing, and sustaining future CDS systems. Based on the findings from this review, we highlight actionable steps for practice and future research. TRIAL REGISTRATION PROSPERO CRD42020203716.
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Affiliation(s)
- Winnie Chen
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT 0811 Australia
| | - Claire Maree O’Bryan
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT 0811 Australia
| | - Gillian Gorham
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT 0811 Australia
| | - Kirsten Howard
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW Australia
| | - Bhavya Balasubramanya
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT 0811 Australia
| | - Patrick Coffey
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT 0811 Australia
| | - Asanga Abeyaratne
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT 0811 Australia
| | - Alan Cass
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT 0811 Australia
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Liu CF, Cheng TJ. Exploring critical factors influencing physicians' acceptance of mobile electronic medical records based on the dual-factor model: a validation in Taiwan. BMC Med Inform Decis Mak 2015; 15:4. [PMID: 25889506 PMCID: PMC4333263 DOI: 10.1186/s12911-014-0125-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 08/01/2014] [Accepted: 12/17/2014] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND With respect to information management, most of the previous studies on the acceptance of healthcare information technologies were analyzed from "positive" perspectives. However, such acceptance is always influenced by both positive and negative factors and it is necessary to validate both in order to get a complete understanding. This study aims to explore physicians' acceptance of mobile electronic medical records based on the dual-factor model, which is comprised of inhibitors and enablers, to explain an individual's technology usage. Following an earlier healthcare study in the USA, the researchers conducted a similar survey for an Eastern country (Taiwan) to validate whether perceived threat to professional autonomy acts as a critical inhibitor. In addition, perceived mobility, which is regarded as a critical feature of mobile services, was also evaluated as a common antecedent variable in the model. METHODS Physicians from three branch hospitals of a medical group were invited to participate and complete questionnaires. Partial least squares, a structural equation modeling technique, was used to evaluate the proposed model for explanatory power and hypotheses testing. RESULTS 158 valid questionnaires were collected, yielding a response rate of 33.40%. As expected, the inhibitor of perceived threat has a significant impact on the physicians' perceptions of usefulness as well as their intention to use. The enablers of perceived ease of use and perceived usefulness were also significant. In addition, as expected, perceived mobility was confirmed to have a significant impact on perceived ease of use, perceived usefulness and perceived threat. CONCLUSIONS It was confirmed that the dual-factor model is a comprehensive method for exploring the acceptance of healthcare information technologies, both in Western and Eastern countries. Furthermore, perceived mobility was proven to be an effective antecedent variable in the model. The researchers believe that the results of this study will contribute to the research on the acceptance of healthcare information technologies, particularly with regards to mobile electronic medical records, based on the dual-factor viewpoints of academia and practice.
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Affiliation(s)
- Chung-Feng Liu
- Department of Information Management, Chia Nan University of Pharmacy and Science, No.60, Erh-Jen Rd., Sec.1, Jen-Te District, Tainan City, 71710, Taiwan.
| | - Tain-Junn Cheng
- Department of Neurology, Occupational Medicine, Management in Medical Records and Information, Chi Mei Medical Center, No.901, Chung-Hwa Rd., Yong-Kang District, Tainan City, 710, Taiwan.
- Department of Occupational Safety/Institute of Industrial Safety and Disaster Prevention, College of Sustainable Environment, Chia Nan University of Pharmacy and Science, No.60, Erh-Jen Rd., Sec.1, Jen-Te District, Tainan City, 71710, Taiwan.
- Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, No.138, Sheng Li Road, Tainan City, 704, Taiwan.
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Periyasamy M, Dhanasekaran R. Assessment of safety and interference issues of radio frequency identification devices in 0.3 Tesla magnetic resonance imaging and computed tomography. ScientificWorldJournal 2014; 2014:735762. [PMID: 24701187 PMCID: PMC3948589 DOI: 10.1155/2014/735762] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 12/24/2013] [Indexed: 11/17/2022] Open
Abstract
The objective of this study was to evaluate two issues regarding magnetic resonance imaging (MRI) including device functionality and image artifacts for the presence of radio frequency identification devices (RFID) in association with 0.3 Tesla at 12.7 MHz MRI and computed tomography (CT) scanning. Fifteen samples of RFID tags with two different sizes (wristband and ID card types) were tested. The tags were exposed to several MR-imaging conditions during MRI examination and X-rays of CT scan. Throughout the test, the tags were oriented in three different directions (axial, coronal, and sagittal) relative to MRI system in order to cover all possible situations with respect to the patient undergoing MRI and CT scanning, wearing a RFID tag on wrist. We observed that the tags did not sustain physical damage with their functionality remaining unaffected even after MRI and CT scanning, and there was no alternation in previously stored data as well. In addition, no evidence of either signal loss or artifact was seen in the acquired MR and CT images. Therefore, we can conclude that the use of this passive RFID tag is safe for a patient undergoing MRI at 0.3 T/12.7 MHz and CT Scanning.
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Affiliation(s)
- M. Periyasamy
- Syed Ammal Engineering College, Ramanathapuram, Tamil Nadu 623 502, India
| | - R. Dhanasekaran
- Syed Ammal Engineering College, Ramanathapuram, Tamil Nadu 623 502, India
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Handel DA, Wears RL, Nathanson LA, Pines JM. Using information technology to improve the quality and safety of emergency care. Acad Emerg Med 2011; 18:e45-51. [PMID: 21676049 DOI: 10.1111/j.1553-2712.2011.01070.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
With the 2010 federal health care reform passage, a renewed focus has emerged for the integration of electronic health records (EHRs) into the U.S. health care system. A consensus conference in October 2009 met to discuss the future research agenda with regard to using information technology (IT) to improve the future quality and safety of emergency department (ED) care. The literature is mixed as to how the use of computerized provider order entry (CPOE), clinical decision support (CDS), EHRs, and patient tracking systems has improved or degraded the safety and quality of ED care. Such mixed findings must be considered in the national push for rapid implementation of health IT. We present a research agenda addressing the major questions that are posed by the introduction of IT into ED care; these questions relate to interoperability, patient flow and integration into clinical work, real-time decision support, handoffs, safety-critical computing, and the interaction between IT systems and clinical workflows.
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Affiliation(s)
- Daniel A Handel
- Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, USA.
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Kaplan B, Harris-Salamone KD. Health IT success and failure: recommendations from literature and an AMIA workshop. J Am Med Inform Assoc 2009; 16:291-9. [PMID: 19261935 PMCID: PMC2732244 DOI: 10.1197/jamia.m2997] [Citation(s) in RCA: 120] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2008] [Accepted: 02/10/2009] [Indexed: 11/10/2022] Open
Abstract
With the United States joining other countries in national efforts to reap the many benefits that use of health information technology can bring for health care quality and savings, sobering reports recall the complexity and difficulties of implementing even smaller-scale systems. Despite best practice research that identified success factors for health information technology projects, a majority, in some sense, still fail. Similar problems plague a variety of different kinds of applications, and have done so for many years. Ten AMIA working groups sponsored a workshop at the AMIA Fall 2006 Symposium. It was entitled "Avoiding The F-Word: IT Project Morbidity, Mortality, and Immortality" and focused on this under-addressed problem. PARTICIPANTS discussed communication, workflow, and quality; the complexity of information technology undertakings; the need to integrate all aspects of projects, work environments, and regulatory and policy requirements; and the difficulty of getting all the parts and participants in harmony. While recognizing that there still are technical issues related to functionality and interoperability, discussion affirmed the emerging consensus that problems are due to sociological, cultural, and financial issues, and hence are more managerial than technical. Participants drew on lessons from experience and research in identifying important issues, action items, and recommendations to address the following: what "success" and "failure" mean, what contributes to making successful or unsuccessful systems, how to use failure as an enhanced learning opportunity for continued improvement, how system successes or failures should be studied, and what AMIA should do to enhance opportunities for successes. The workshop laid out a research agenda and recommended action items, reflecting the conviction that AMIA members and AMIA as an organization can take a leadership role to make projects more practical and likely to succeed in health care settings.
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Affiliation(s)
- Bonnie Kaplan
- Yale Center for Medical Informatics, Yale University, New Haven, CT, USA.
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Chiasson M, Reddy M, Kaplan B, Davidson E. Expanding multi-disciplinary approaches to healthcare information technologies: what does information systems offer medical informatics? Int J Med Inform 2008; 76 Suppl 1:S89-97. [PMID: 16769245 DOI: 10.1016/j.ijmedinf.2006.05.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2006] [Accepted: 05/11/2006] [Indexed: 10/24/2022]
Abstract
The effective use of information technology (IT) is a crucial component for the delivery of effective services in health care. Current approaches to medical informatics (MI) research have significantly contributed to the success of IT use in health care but important challenges remain to be addressed. We believe that expanding the multi-disciplinary basis for MI research is important to meeting these research challenges. In this paper, we outline theories and methods used in information systems (IS) research that we believe can inform our understanding of health care IT applications and outcomes. To do so, we discuss some general differences in the focus and methods of MI and IS research to identify broad opportunities. We then review conceptual and methodological approaches in IS that have been applied in health care IT research. These include: technology-use mediation, collaborative work, genre theory, interpretive research, action research, and modeling. Examples of these theories and methods in healthcare IS research are illustrated.
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Affiliation(s)
- Mike Chiasson
- Management School, Lancaster University, Lancaster, UK.
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Johnston AC, Warkentin M. Information privacy compliance in the healthcare industry. ACTA ACUST UNITED AC 2008. [DOI: 10.1108/09685220810862715] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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9
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Connell N, Young T. Evaluating healthcare information systems through an “enterprise” perspective. INFORMATION & MANAGEMENT 2007. [DOI: 10.1016/j.im.2007.04.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kaplan B. Evaluating informatics applications--some alternative approaches: theory, social interactionism, and call for methodological pluralism. Int J Med Inform 2001; 64:39-56. [PMID: 11673101 DOI: 10.1016/s1386-5056(01)00184-8] [Citation(s) in RCA: 188] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A review of evaluation literature concerning CDSSs indicates that randomized controlled clinical trials (RCTs) are the 'gold standard' for evaluation. While this approach is excellent for studying system or clinical performance, it is not well suited to answering questions concerning whether systems will be used or how they will be used. Because lack of use of CDSS has been of concern for some years, other evaluation research designs are needed to address those issues. This paper critiques RCT and experimental evaluation approaches and presents alternative approaches to evaluation that address questions outside the scope of the usual RCT and experimental designs. A wide range of literature is summarized to illustrate the value of evaluations that take into account social, organizational, professional, and other contextual considerations. Many of these studies go beyond the usual measures of systems performance or physicians' behavior by focusing on 'fit' of the system with other aspects of professional and organizational life. Because there is little explicit theory that informs many evaluations, the paper then reviews CDSS evaluations informed by social science theories. Lastly, it proposes a theoretical social science base of social interactionism. An example of such an approach is given. It involves a CDSS in psychiatry and is based on Kaplan's 4Cs, which focus on communication, control, care, and context. Although the example is a CDSS, the evaluation approach also is useful for clinical guideline implementation and other medical informatics applications. Similarly, although the discussion is about social interactionism, the more important point is the need to broaden evaluation through a variety of methods and approaches that investigate social, cultural, organizational, cognitive, and other contextual concerns. Methodological pluralism and a variety of research questions can increase understanding of many influences concerning informatics applications development and deployment.
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Affiliation(s)
- B Kaplan
- Center for Medical Informatics, Yale University School of Medicine, New Haven, CT, USA.
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Abstract
This paper reviews clinical decision support systems (CDSS) literature, with a focus on evaluation. The literature indicates a general consensus that clinical decision support systems are thought to have the potential to improve care. Evidence is more equivocal for guidelines and for systems to aid physicians with diagnosis. There also is general consensus that a variety of systems are little used despite demonstrated or potential benefits. In the evaluation literature, the main emphasis is on how clinical performance changes. Most studies use an experimental or randomized controlled clinical trials design (RCT) to assess system performance or to focus on changes in clinical performance that could affect patient care. Few studies involve field tests of a CDSS and almost none use a naturalistic design in routine clinical settings with real patients. In addition, there is little theoretical discussion, although papers are permeated by a rationalist perspective that excludes contextual issues related to how and why systems are used. The studies mostly concern physicians rather than other clinicians. Further, CDSS evaluation studies appear to be insulated from evaluations of other informatics applications. Consequently, there is a lack of information useful for understanding why CDSSs may or may not be effective, resulting in making less informed decisions about these technologies and, by extension, other medical informatics applications.
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Affiliation(s)
- B Kaplan
- Center for Medical Informatics, Yale University School of Medicine, New Haven, CT, USA.
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13
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Abstract
New system design and evaluation methodologies are being developed to address social, organizational, political, and other non-technological issues in medical informatics. This paper describes a social interactionist framework for researching these kinds of organizational issues, based on research within medical informatics and other disciplines over the past 20 years. It discusses how effective evaluation strategies may be undertaken to address organizational issues concerning computer information systems in medicine and health care. The paper begins with a theoretical framework for evaluation. It then describes the 4Cs of evaluation: communication, care, control, and context. Five methodological guidelines are given for conducting comprehensive evaluations that address these 4Cs. An example of an evaluation research design that fits the guidelines and was used in an evaluation of an on-line clinical imaging system is discussed. Results of the evaluation study illustrate how this approach addresses organizational concerns and the 4Cs.
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Affiliation(s)
- B Kaplan
- Quinnipiac College, Hamden, CT 06518, USA.
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Kaplan B. Objectification and negotiation in interpreting clinical images: implications for computer-based patient records. Artif Intell Med 1995; 7:439-54. [PMID: 8547967 DOI: 10.1016/0933-3657(95)00014-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
This paper concerns the role of images and visualization in clinical practice and decision making. In particular, how physicians talk about and use images are discussed. Findings from evaluation studies of clinical imaging computer information systems suggest that the role and interpretation of images is negotiated, an example of how what is seen is influenced by the practice community, and, therefore is situated in specific instances of clinical decision making. An understanding of professional vision with respect to how physicians use and think about images may aid in developing clinical imaging systems, computer-based patient records, and other clinical information systems that could integrate well with clinical work practice.
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Affiliation(s)
- B Kaplan
- Department of Computer Science, School of Business, Quinnipiac College, Hamden, CT 06518, USA
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Jousimaa J, Kunnamo I. PDRD--a computer-based primary care decision support system. MEDICAL INFORMATICS = MEDECINE ET INFORMATIQUE 1993; 18:103-12. [PMID: 8231420 DOI: 10.3109/14639239309034473] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
This article identifies the current stage of development and assessment of computer-assisted decision support systems in the domain of general practice. Physician's Desk Reference and Database (PDRD), an electronic medical database, is presented, and a plan for assessment of PDRD is briefly discussed.
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Affiliation(s)
- J Jousimaa
- Finnish Medical Society Duodecim, University of Kuopio
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Forsythe DE, Buchanan BG, Osheroff JA, Miller RA. Expanding the concept of medical information: an observational study of physicians' information needs. COMPUTERS AND BIOMEDICAL RESEARCH, AN INTERNATIONAL JOURNAL 1992; 25:181-200. [PMID: 1582194 DOI: 10.1016/0010-4809(92)90020-b] [Citation(s) in RCA: 75] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Obtaining and managing clinically relevant information constitutes a major problem for physicians, for which the development of automated tools is often proposed as a solution. However, designing and implementing appropriate automated solutions presumes knowledge of physicians' information needs. We describe an empirical study of information needs in four clinical settings in internal medicine in a university teaching hospital. In contrast to the retrospective data often used in previous studies, this research used ethnographic techniques to facilitate direct observation of communication about information needs. On the basis of this experience, we address two main issues: how to identify and interpret expressions of information needs in medicine and how to broaden our conception of "information needs" to account for the empirical data.
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Affiliation(s)
- D E Forsythe
- Department of Computer Science, University of Pittsburgh, Pennsylvania 15260
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Abstract
Clinical information systems (CIS) are health care technologies that can assist clinicians and clinical managers to improve the performance of health care organizations. However, failure to consider scientific evidence of efficacy, effectiveness, and efficiency when selecting CISs is one factor explaining the adoption of systems that do not improve either the quality or efficiency of patient care. This paper discusses a technology assessment framework that can assist decision-makers to evaluate alternative CISs. Existing methodologies developed to evaluate diagnostic and therapeutic technologies can be used by researchers to provide evidence needed by decision-makers at each step of the framework. The rigorous evaluation of CISs prior to their implementation can help decision-makers to avoid adopting "white elephants."
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Affiliation(s)
- R Wall
- Faculty of Medicine, University of Manitoba, Winnipeg, Canada
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Harvey JD. Towards a user-friendly future. The impact of information technology within primary health care. Int J Technol Assess Health Care 1988; 5:79-89. [PMID: 10292545 DOI: 10.1017/s0266462300005973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The use of computers in primary care in the United Kingdom has developed without coordination. The present situation is described. The proposal is that policies for improving primary care will be enhanced by appropriate application of information technology. Benefits and obstacles are identified; practical proposals for effective development are listed.
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