MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Health Informatics Journal' source. Wed, 08 Feb 2012 18:41:21 +0100 http://www.medworm.com/index.php?rid=5526425&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F17%2F4%2F294%3Frss%3D1 This study uses hospital administrative data to ascertain the differences in the patient characteristics, process and outcomes of care between the Emergency Department (ED) triage categories of patients admitted from an ED presentation into a large metropolitan teaching hospital with a Stroke Care Unit. Bayesian Networks (BNs) derived from the administrative data were used to provide the descriptive models. Nearly half the patients in each stroke subtype were triaged as ‘Urgent’ (to be seen within 30 minutes). With a decrease in the urgency of triage categories, the proportion admitted within 8 hours decreased dramatically and the proportion of formal discharge increased. Notably, 45% of transient ischaemic attacks (TIAs) were categorized as ‘Semi-urgent’ (to be att... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=5526425 Wed, 21 Dec 2011 05:00:00 +0100 5526425 http://www.medworm.com/index.php?rid=5526424&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F17%2F4%2F277%3Frss%3D1 There is mounting pressure on healthcare planners to manage and contain costs. In rural regions, there is a particular need to rationalize health service allocation to ensure the best possible coverage for a dispersed population. Rural health administrators need to be able to quantify the population affected by their allocation decisions and, therefore, need the capacity to incorporate spatial analyses into their decision-making process. Spatial decision support systems (SDSS) can provide this capability. In this article, we combine geographical information systems (GIS) with a web-based graphical user interface (webGUI) in a SDSS tool that enables rural decision-makers charged with service allocation, to estimate population catchments around specific health services in rural and remote ar... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=5526424 Wed, 21 Dec 2011 05:00:00 +0100 5526424 http://www.medworm.com/index.php?rid=5526423&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F17%2F4%2F266%3Frss%3D1 Short message service (SMS) and email reminders have the potential to improve adherence to appointments and medication taking. Within the UK, information and communication technology (ICT) is widely used with a very high proportion of people having access to the internet and mobile phones. Little is known about ICT use by older adults and those with chronic illness. A feasibility survey was carried out with 112 rheumatology patients in Hertfordshire, UK to determine their current use of the internet, email and SMS and their willingness to receive electronic reminders in the future. A high proportion of patients up to age 65 are successfully using ICT despite older age or functional disability caused by rheumatic disease. Forty-four percent would be willing to receive an electronic appointm... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=5526423 Wed, 21 Dec 2011 05:00:00 +0100 5526423 http://www.medworm.com/index.php?rid=5526422&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F17%2F4%2F256%3Frss%3D1 This article describes the changes made in five state data systems to monitor wait times and outlines lessons learned that could be applied to other health data tracking systems. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=5526422 Wed, 21 Dec 2011 05:00:00 +0100 5526422 http://www.medworm.com/index.php?rid=5526421&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F17%2F4%2F247%3Frss%3D1 E-health is seen as an important technological tool in achieving self-management; however, there is little evidence of how effective e-health is for self-management. Example tools remain experimental and there is limited knowledge yet about the design, use, and effects of this class of tools. By way of introducing a new view on the development of e-health tools dedicated to self-management we aim to contribute to the discussion for further research in this area. Our assumption is that patient empowerment is an important mechanism of e-health self-management and we suggest incorporating it within the development of self-management tools. Important components of empowerment selected from literature are: communication, education and health literacy, information, self-care, decision aids and c... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=5526421 Wed, 21 Dec 2011 05:00:00 +0100 5526421 http://www.medworm.com/index.php?rid=5239294&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F17%2F3%2F224%3Frss%3D1 This study reveals interesting patterns in technology adoption, some of which are in line with previous studies, while others are less clear. Whether these patterns indicate early evidence of a narrowing divide in eHealth technology use across population groups as a result of the narrowing divide in Internet access and computer ownership warrants further exploration. In particular, the findings emphasize the need to explore differences in the use of eHealth tools by medically underserved and disadvantaged groups. In so doing, it will be important to explore other psychosocial variables, such as health literacy, that may be better predictors of health consumers’ eHealth technology adoption. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=5239294 Tue, 20 Sep 2011 04:00:00 +0100 5239294 http://www.medworm.com/index.php?rid=5239293&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F17%2F3%2F209%3Frss%3D1 The objective of this study was to examine handoffs and nurses’ use of computerized patient summary reports in an electronic health record after computerized provider order entry (CPOE) was installed. We observed and audio taped 93 patient handoffs on 25 occasions on 5 acute care units in 2 different facilities sharing a vendor’s electronic health record. We found that the computerized patient summary report and the electronic health record were minimally used during the handoff and that the existing patient summary reports did not provide adequate cognitive support for nurses. The patient summary reports were incomplete, rigid and did not offer "at a glance" information, or help nurses encode information. We make recommendations about a redesign of patient summary reports and ... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=5239293 Tue, 20 Sep 2011 04:00:00 +0100 5239293 http://www.medworm.com/index.php?rid=5239292&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F17%2F3%2F191%3Frss%3D1 Interactive mapping and spatial analysis tools are under-utilized by health researchers and decision-makers as a result of scarce training materials, few examples demonstrating the successful use of geographic visualization, and poor mechanisms for sharing results generated by geovisualization. Here, we report on the development of the Geovisual EXplication(G-EX) Portal, a web-based application designed to connect researchers in geovisualization and related mapping sciences, to users who are working in public health and epidemiology. This paper focuses on the design and development of the G-EX Portal Learn module, a set of tools intended to disseminate learning artifacts. Initial design and development of the G-EX Portal has been guided by our past research on the use and usability of geov... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=5239292 Tue, 20 Sep 2011 04:00:00 +0100 5239292 http://www.medworm.com/index.php?rid=5239291&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F17%2F3%2F173%3Frss%3D1 Patients with chronic disease may suffer frequent acute deteriorations and associated increased risk of hospitalisation. Earlier detection of these could enable successful intervention, improving patients’ well-being and reducing costs; however, current telemonitoring systems do not achieve this effectively. We conducted a qualitative study using stakeholder interviews to define current standards of care and user requirements for improved early detection telemonitoring. We determined that early detection is not a concept that has informed technology or service design and that telemonitoring is driven by the available technology rather than by users’ needs. We have described a set of requirements questions to inform the design and implementation of telemonitoring systems and sug... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=5239291 Tue, 20 Sep 2011 04:00:00 +0100 5239291 http://www.medworm.com/index.php?rid=5239290&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F17%2F3%2F161%3Frss%3D1 Whereas in most sectors, technology has taken over trivial and labour consuming tasks, this transformation has been delayed in the healthcare sector. Although appropriate technology is available, there is general resistance to substituting ‘warm’ hands with ‘cold’ technology. In the future, this may change as the number of elderly people increases relative to the people in the work force. In combination with an increasing demand for healthcare services, there are calls for efforts to increase productivity in the sector. Based on experience data from previous studies on information and communication technology efforts in the healthcare sector, we quantitatively assess the use of smart house technology and video visits in home care. Having identified healthcare provid... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=5239290 Tue, 20 Sep 2011 04:00:00 +0100 5239290 http://www.medworm.com/index.php?rid=4978290&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F17%2F2%2F140%3Frss%3D1 Researchers have applied increasing efforts towards providing formal computational frameworks to consolidate the plethora of concepts and relations used in the medical domain. In the domain of skin related diseases, the variability of semantic features contained within digital skin images is a major barrier to the medical understanding of the symptoms and development of early skin cancers. The desideratum of making these standards machine-readable has led to their formalization in ontologies. In this work, in an attempt to enhance an existing Core Ontology for skin lesion images, hand-coded from image features, high quality images were analyzed by an autonomous ontology creation engine. We show that by exploiting agglomerative clustering methods with distance criteria upon the existing ont... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4978290 Mon, 27 Jun 2011 23:00:00 +0100 4978290 http://www.medworm.com/index.php?rid=4978289&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F17%2F2%2F127%3Frss%3D1 This paper presents the design and implementation of terminological and specialized textual resources that were produced in the framework of the Greek research project "IATROLEXI". The aim of the project was to create the critical infrastructure for the Greek language, i.e. linguistic resources and tools for use in high level Natural Language Processing (NLP) applications in the domain of biomedicine. The project was built upon existing resources developed by the project partners and further enhanced within its framework, i.e. a Greek morphological lexicon of about 100,000 words, and language processing tools such as a lemmatiser and a morphosyntactic tagger. Christos Tsalidis, Additionally, it developed new assets, such as a specialized corpus of biomedical texts and an ontology of medica... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4978289 Mon, 27 Jun 2011 23:00:00 +0100 4978289 http://www.medworm.com/index.php?rid=4978288&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F17%2F2%2F116%3Frss%3D1 We present an experimental mechanism for enriching web content with quality metadata. This mechanism is based on a simple and well-known initiative in the field of the health-related web, the HONcode. The Resource Description Framework (RDF) format and the Dublin Core Metadata Element Set were used to formalize these metadata. The model of trust proposed is based on a quality model for health-related web pages that has been tested in practice over a period of thirteen years. Our model has been explored in the context of a project to develop a research tool that automatically detects the occurrence of quality criteria in health-related web pages. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4978288 Mon, 27 Jun 2011 23:00:00 +0100 4978288 http://www.medworm.com/index.php?rid=4978287&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F17%2F2%2F95%3Frss%3D1 The number of health-related websites is increasing day-by-day; however, their quality is variable and difficult to assess. Various "trust marks" and filtering portals have been created in order to assist consumers in retrieving quality medical information. Consumers are using search engines as the main tool to get health information; however, the major problem is that the meaning of the web content is not machine-readable in the sense that computers cannot understand words and sentences as humans can. In addition, trust marks are invisible to search engines, thus limiting their usefulness in practice. During the last five years there have been different attempts to use Semantic Web tools to label health-related web resources to help internet users identify trustworthy resources. This pape... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4978287 Mon, 27 Jun 2011 23:00:00 +0100 4978287 http://www.medworm.com/index.php?rid=4978286&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Freprint%2F17%2F2%2F91%3Frss%3D1 (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4978286 Mon, 27 Jun 2011 23:00:00 +0100 4978286 http://www.medworm.com/index.php?rid=4978298&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F17%2F1%2F72%3Frss%3D1 The objective was to describe the utility of mixed methods to inform the development of an automated telephone intervention to improve patients’ compliance with asthma medication. As part of intervention development for a larger trial, we conducted 15 focus groups (n = 53) to design and develop calls, and to identify factors influencing intervention acceptability and usefulness. We piloted four call types and interviewed 64 participants to further improve call content and receptivity to the intervention. Feedback led to several changes to the intervention scripts and eventual calls, and an initial pilot led us to drop one of the calls. During the pilot, we reached 43 percent of target participants; 74 percent of those stayed on the call until it ended. This process provided key insig... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4978298 Wed, 30 Mar 2011 23:00:00 +0100 4978298 http://www.medworm.com/index.php?rid=4978297&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F17%2F1%2F63%3Frss%3D1 Personal health record (PHR) systems are a subject of intense interest in the move to improve healthcare accessibility and quality. Although a number of vendors continue to put forward PHR systems, user-centered design research has lagged, and it has not been clear what features are important to prospective PHR users. Here, we report on a user-centered design study that combines qualitative and quantitative approaches to investigate several dimensions relevant to PHR design, and to look at the effect of health status on user needs. The results indicate that health status, especially disability and chronic illness, is relevant to PHR design. Further, the results provide empirical evidence about the role of privacy and security in users’ attitudes toward PHR use. The exact nature of th... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4978297 Wed, 30 Mar 2011 23:00:00 +0100 4978297 http://www.medworm.com/index.php?rid=4978296&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F17%2F1%2F51%3Frss%3D1 The implementation of generic models for organizing information in complex institutions like those in healthcare creates a gap between standardization and the need for locally relevant knowledge. The present study addresses how this gap can be bridged by focusing on the practical work of healthcare staff in transforming information in EPRs into knowledge that is useful for everyday work. Video recording of shift handovers on a rehabilitation ward serves as the empirical case. The results show how extensive selections and reorganizations of information in EPRs are carried out in order to transform information into professionally relevant accounts. We argue that knowledge about the institutional obligations and professional ways of construing information are fundamental for these transitions... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4978296 Wed, 30 Mar 2011 23:00:00 +0100 4978296 http://www.medworm.com/index.php?rid=4978295&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F17%2F1%2F41%3Frss%3D1 The purpose of this study was to evaluate the sensitivity and positive predictive value (PPV) of a registry data linkage procedure used in the California AIDS and Tuberculosis (TB) Registry Data Linkage Study to identify AIDS/TB comorbidity cases in California. The California AIDS registry data from 1981 to 2006 were linked to the California TB registry data from 1996 to 2006 using LinkPlus, a probabilistic record linkage program developed by the Centers for Disease Control and Prevention, and matched results were manually reviewed to determine true or false matches. We estimated the sensitivity of this procedure to range from 98.0 per cent (95% confidence interval, CI: 97.3%, 98.7%) to 98.8 per cent (95% CI: 98.1%, 99.2%), and the PPV to be 100 per cent (95% CI: 96.8%, 100.0%). Our study ... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4978295 Wed, 30 Mar 2011 23:00:00 +0100 4978295 http://www.medworm.com/index.php?rid=4978294&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F17%2F1%2F33%3Frss%3D1 Researchers in robotics have been increasingly focusing on robots as a means of supporting older people with cognitive impairment at home. The aim of this study is to explore the elderly’s needs and preferences towards having an assistive robot in the home. In order to ensure the appropriateness of this technology, 30 subjects aged 60 and older with memory complaints were recruited from the Memory Clinic of the Broca Hospital. We conducted an interview-administered questionnaire that included questions about their needs and preferences concerning robot functions and modes of action. The subjects reported a desire to retain their capacity to manage their daily activities, to maintain good health and to stimulate their memory. Regarding robot functions, the cognitive stimulation progra... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4978294 Wed, 30 Mar 2011 23:00:00 +0100 4978294 http://www.medworm.com/index.php?rid=4978293&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F17%2F1%2F24%3Frss%3D1 In conclusion, we suggest the development of a knowledge-sharing format that does not demand expert skills for safe usage: WYSIWYS (What You See Is What You Store). (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4978293 Wed, 30 Mar 2011 23:00:00 +0100 4978293 http://www.medworm.com/index.php?rid=4978292&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F17%2F1%2F15%3Frss%3D1 This article describes the rationale, processes, technology, and results of creating of a paper-based rounds report that is now used by our entire institution for efficient inpatient work rounds and checkout rounds that are routinely done in virtually every hospital, both academic and private, in the US. The results of a survey of clinicians suggests that printed rounds reports have markedly improved rounding efficiency, saved substantial amounts of physician time, standardized checkout processes, and improved patient safety. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4978292 Wed, 30 Mar 2011 23:00:00 +0100 4978292 http://www.medworm.com/index.php?rid=4978291&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F17%2F1%2F5%3Frss%3D1 Patient self-reporting of symptoms and quality of life following surgical interventions is generally delivered in the form of paper-based questionnaires to be completed in the outpatient clinic or at home. A commonly used tool for patient self-reporting of quality of life is the EQ5D health status questionnaire which, while limited in scope, has general applicability across a range of health interventions. In this article we examine the issues relating to online patient self-reporting using this questionnaire and the wider implications for the online reporting of health status. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4978291 Wed, 30 Mar 2011 23:00:00 +0100 4978291 http://www.medworm.com/index.php?rid=4319511&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F4%2F306%3Frss%3D1 This article examines EMR system efforts, benefits, and barriers, as well as steps needed to move the US closer to a nationwide EMR system. The analysis includes a blueprint for implementation of EMR, industry comparisons to highlight the differences between successful and non-successful EMR ventures, references to costs and benefit information, and identification of root causes. ‘Poka-yokes’ (avoid (yokeru) mistakes (poka)) will be inserted to provide insight into how to systematically overcome challenges. Implementation will require upfront costs including patient privacy that must be addressed early in the development process. Government structure, incentives and mandates are required for nationwide EMR system in the US. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4319511 Fri, 07 Jan 2011 00:00:00 +0100 4319511 http://www.medworm.com/index.php?rid=4319510&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F4%2F287%3Frss%3D1 The aim of this investigation was to assess helpful and challenging aspects of electronic health information with respect to clinical workflow and identify a set of characteristics that support patient care processes. We conducted 20 semi-structured interviews at a Veterans Affairs Medical Center, with a fully implemented electronic health record (EHR), and elicited positive and negative examples of how information technology (IT) affects the work of healthcare employees. Responses naturally shed light on information characteristics that aid work processes. We performed a secondary analysis on interview data and inductively identified characteristics of electronic information that support healthcare workflow. Participants provided 199 examples of how electronic information affects workflow... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4319510 Fri, 07 Jan 2011 00:00:00 +0100 4319510 http://www.medworm.com/index.php?rid=4319509&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F4%2F274%3Frss%3D1 The Veterans Affairs Hypertension Primary Care Longitudinal Cohort (VAHC) was initiated in 2003 as a pilot study designed to link the VA electronic medical record system with individual genetic data. Between June 2003 and December 2004, 1,527 hypertensive participants were recruited. Protected health information (PHI) was extracted from the regional VA data warehouse. Differences between the clinic and mail recruits suggested that clinic recruitment resulted in an over-sampling of African Americans. A review of medical records in a random sample of study participants confirmed that the data warehouse accurately captured most selected diagnoses. Genomic DNA was acquired non-invasively from buccal cells in mouthwash; ~ 96.5 per cent of samples contained DNA suitable for genotyping, with an a... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4319509 Fri, 07 Jan 2011 00:00:00 +0100 4319509 http://www.medworm.com/index.php?rid=4319508&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F4%2F260%3Frss%3D1 Treatment and survival for patients with lung cancer vary between and within countries. We have undertaken a multifaceted study of a clinical dataset of 635 patients, to see if clinician treatment decisions were being made consistently and in accordance with the appropriate Scottish Intercollegiate Guidelines Network (SIGN) document. Subsequently, we created a dataset of 117 patients who should have undergone surgery according to the SIGN guideline. As analyses of this dataset did not provide clear distinctions between the main treatment groups, a clinician reviewed the case notes and dataset, checking for inconsistencies. The revised dataset was processed by a decision tree algorithm which suggests clinically plausible decisions. Further, statistical analyses compared the 54 patients offe... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4319508 Fri, 07 Jan 2011 00:00:00 +0100 4319508 http://www.medworm.com/index.php?rid=4319507&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F4%2F246%3Frss%3D1 This study used information on scheduled outpatient appointments collected over a three-year period at a Veterans Affairs medical center. The call-in process for 400 clinic days was simulated and for each day two schedules were created: the traditional method that assigned one patient per appointment slot, and the proposed method that scheduled patients according to their no-show probability to balance patient waiting, overtime and revenue. Combining patient no-show models with advanced scheduling methods would allow more patients to be seen a day while improving clinic efficiency. Clinics should consider the benefits of implementing scheduling software that includes these methods relative to the cost of no-shows. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4319507 Fri, 07 Jan 2011 00:00:00 +0100 4319507 http://www.medworm.com/index.php?rid=4319506&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F4%2F235%3Frss%3D1 Managing patients’ length of stay is a critical task for healthcare organizations. In order to better manage the processes impacting this performance metric, providers can leverage data resources describing the network of activities that impact a patient’s stay with analytic methods. Interdependencies between departmental activities exist within the patient treatment process, where inefficiency in one element of the patient care network of activities can adversely affect process outcomes.This work utilizes the method of neural networks to analyze data describing inpatient cases that incorporate radiology process variables to determine their effect on patient length of stay excesses for a major NJ based healthcare provider. The results indicate that inefficiencies at the radiolo... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4319506 Fri, 07 Jan 2011 00:00:00 +0100 4319506 http://www.medworm.com/index.php?rid=4024254&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F3%2F225%3Frss%3D1 This article considers what additional support healthcare teams will require beyond the cross-discipline unified EPR. A system that considers practitioners as part of a patient’s care team and which tracks teams and professional roles is proposed and evaluated as a means to provide each practitioner with a view of the EPR appropriate to his/her professional role and to provide improved support for collaboration among team members. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4024254 Fri, 01 Oct 2010 16:34:09 +0100 4024254 http://www.medworm.com/index.php?rid=4024253&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F3%2F211%3Frss%3D1 Medical information is extremely sensitive in nature — a compromise, such as eavesdropping or tampering by a malicious third party, may result in identity theft, incorrect diagnosis and treatment, and even death. Therefore, it is important to secure the transfer of medical information from the patient to the recording system. We consider a portable, wireless device transferring medical information to a remote server. We decompose this problem into two sub-problems and propose security solutions to each of them: (1) to secure the link between the patient and the portable device, and (2) to secure the link between the portable device and the network. Thus we push the limits of the network security to the edge by authenticating the user using their biometric information; authenticating ... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4024253 Fri, 01 Oct 2010 16:34:09 +0100 4024253 http://www.medworm.com/index.php?rid=4024252&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F3%2F201%3Frss%3D1 This article attempts to investigate the various types of threats that exist in healthcare information systems (HIS). A study has been carried out in one of the government-supported hospitals in Malaysia.The hospital has been equipped with a Total Hospital Information System (THIS). The data collected were from three different departments, namely the Information Technology Department (ITD), the Medical Record Department (MRD), and the X-Ray Department, using in-depth structured interviews. The study identified 22 types of threats according to major threat categories based on ISO/IEC 27002 (ISO 27799:2008). The results show that the most critical threat for the THIS is power failure followed by acts of human error or failure and other technological factors. This research holds significant v... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4024252 Fri, 01 Oct 2010 16:34:09 +0100 4024252 http://www.medworm.com/index.php?rid=4024251&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F3%2F189%3Frss%3D1 Investigating factors influencing the use of clinical information systems can help to develop a strategy to improve user acceptance of a given system or similar ones in the future. In this research, we investigated factors influencing the use of information technology in the emergency department (ED). We undertook a qualitative study in which data were collected using semi-structured interviews with the ED staff. In total, 34 interviews were conducted and data were analysed using framework analysis. The results showed that user characteristics and perception of task, technology, environment, and impact of technology could influence people’s use of IT in the ED. Of these, the usefulness of the systems, the impact of technology, IT training, and the feasibility of using IT by all membe... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4024251 Fri, 01 Oct 2010 16:34:09 +0100 4024251 http://www.medworm.com/index.php?rid=4024250&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F3%2F177%3Frss%3D1 Patient care based on best available evidence is increasingly viewed as the hallmark of good quality medical diagnosis and treatment, yet its uptake is often slow and uneven and the reasons underlying the slow diffusion of evidence-based guidelines remain elusive. The authors report a qualitative study conducted at a major US teaching hospital which sought to discover the reasons why an evidence-based anticoagulation guideline appeared to be applied irregularly, with problematic results. Using a theoretical framework derived from Rogers’ work on the diffusion of innovation, this article describes the ways in which a group of residents evaluated and applied evidence in the context of caring for their patients. Future work in evidence-based practice can benefit from a greater emphasis ... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4024250 Fri, 01 Oct 2010 16:34:09 +0100 4024250 http://www.medworm.com/index.php?rid=4024249&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F3%2F165%3Frss%3D1 The aim of the article is to explore and explain some of the controversies around home uterine monitoring, using a socio-technical interaction networks (STIN) approach. A Cochrane systematic review identified 15 included studies. A critique of these studies, using the eight components of the STIN framework, illustrated very clearly the different assumptions made about the purpose of home uterine monitoring, and helped to explain the different outcomes. The final mapping stage suggested that systems architecture choices included that of the role of monitoring support, to complement patient education or to enhance education for provider and patient. A similar choice concerned the type and extent of patient—care-provider contacts to be used. Using the STIN framework provided a useful pe... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4024249 Fri, 01 Oct 2010 16:34:09 +0100 4024249 http://www.medworm.com/index.php?rid=4024248&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Freprint%2F16%2F3%2F161%3Frss%3D1 (No abstract is available for this citation) (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=4024248 Fri, 01 Oct 2010 16:34:09 +0100 4024248 http://www.medworm.com/index.php?rid=3688867&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F2%2F145%3Frss%3D1 The aim of this study was to gain insight into people’s drives, or motives, for seeking health information on the Internet. A systematic literature review, restricted to handbooks and reviews, was conducted by searching the databases of various disciplines. Each drive was translated into the context of health information. Five drives were retrieved from the fields of psychology, mass communication, library and information science, and medical science: drives regarding the retrieval of knowledge, social contact or support, tempering uncertainty, entertainment, and self-actualization. Based on these results, three hypotheses were generated for future research: (1) drives are interconnected and may be present simultaneously in the process of seeking information; (2) they not only serve ... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=3688867 Wed, 23 Jun 2010 09:09:35 +0100 3688867 http://www.medworm.com/index.php?rid=3688866&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F2%2F129%3Frss%3D1 The objective of this article is to describe a prototype model to support integrative planning for local stroke care services.The model maps the flow of care in the acute and community segments of the care pathway for stroke patients and allows exploring alternatives for care provision. Simulation modelling can help to develop an understanding of the systemic impact of service change and improve the design and targeting of future services. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=3688866 Wed, 23 Jun 2010 09:09:35 +0100 3688866 http://www.medworm.com/index.php?rid=3688865&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F2%2F115%3Frss%3D1 We examined agreement on visits (weighted kappa) and predictors of a match between EFs and claims (multinomial logit model with practice-level clustering). In total, 34,171 matches occurred between 41,252 EFs and 40,909 claims, representing 82.8 per cent of EFs and 83.5 per cent of claims. Agreement on visits was 56 per cent (weighted kappa = 0.66). Pediatric practices provided the majority of visits (82.4%) and matches. Increasing age of child and residence in same county as the medical practice increased the likelihood of a match. Structured checklists can be combined with claims to better assess provision of preventive dental services in pediatric primary care. However, future research should examine strategies to improve the completion of structured checklists by primary care providers... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=3688865 Wed, 23 Jun 2010 09:09:35 +0100 3688865 http://www.medworm.com/index.php?rid=3688864&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F2%2F101%3Frss%3D1 In conclusion, poorly documented hospital charts tend to be translated into invalid administrative data, which reduces the communication of clinical information among healthcare providers. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=3688864 Wed, 23 Jun 2010 09:09:35 +0100 3688864 http://www.medworm.com/index.php?rid=3688863&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F2%2F87%3Frss%3D1 Efforts to improve healthcare by reducing medical errors often center on the accuracy of medical records. At the same time, the impact of new technologies such as speech recognition technology on the process of producing medical records has not been sufficiently examined. In this article we analyzed interview data from medical transcriptionists (MTs) describing how they do the work of transcription to produce accurate medical records from doctors’ dictation. We found that medical transcriptionists rely on several types of skills that current speech recognition technology lacks. We conclude with a discussion of the implications of these findings for the design and implementation of SRT systems for the production of medical records and for how the work of MTs can help reduce medical er... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=3688863 Wed, 23 Jun 2010 09:09:35 +0100 3688863 http://www.medworm.com/index.php?rid=3688862&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F2%2F75%3Frss%3D1 This study highlights both impediments and pathways to the implementation of PACS in primary care, and illustrates the importance of regarding PACS as socially embedded and users as culturally disparate. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=3688862 Wed, 23 Jun 2010 09:09:35 +0100 3688862 http://www.medworm.com/index.php?rid=3492142&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F1%2F63%3Frss%3D1 This study aimed to review current research on how nurses experience using the EPR for documentation. A literature search was conducted in Medline and Cinahl of original, peer-reviewed articles from 2000 to 2009, focusing on nurses in acute/ inpatient ward settings. After critical assessment, two quantitative and three qualitative articles were included in the study. Results showed that nurses experience widespread dissatisfaction with systems. Current systems are not designed to meet the needs of clinical practice as they are not user-friendly, resulting in a potentially negative impact on individualized care and patient safety. There is an urgent need for nurses to be directly involved in software design to ensure that the essence and complexity of nursing is not lost in the system. (Sou... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=3492142 Thu, 22 Apr 2010 08:39:43 +0100 3492142 http://www.medworm.com/index.php?rid=3492141&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F1%2F58%3Frss%3D1 This study aims to determine whether patients are satisfied with their current communication or prefer alternative modes, overall and between different specialty clinics. A questionnaire was given to outpatients attending clinics in November to December 2006. A total of 483 patients returned the questionnaire, giving a 95 per cent response rate. Overall, 85 per cent of patients were satisfied with the current method of communication, and a significant number did want a copy of GP letters. Trend analysis suggests that, as the number of clinic visits increased, requests for copies of letters decreased (p = 0.02). Paediatric and psychiatric patients were more likely to want letters than medical and surgical patients (p = 0.003). Thus communication needs may differ between departments. Opt-in ... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=3492141 Thu, 22 Apr 2010 08:39:43 +0100 3492141 http://www.medworm.com/index.php?rid=3492140&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F1%2F49%3Frss%3D1 While decision analysis has the potential to improve treatment decisions, the quality of patient specific data has hindered its development. Experience with the General Practice Research Database (GPRD) indicated the possibility of generating such data. The example developed concerns the probability of recurrent stroke and the risks and benefits of treatment with aspirin. Eight criteria were systematically applied to identify suitable patients from the 664,241 cohort of patients in the West Midlands GPRD. The risk of recurrent stroke was estimated using survival analysis, yielding multivariate hazard ratios for 960 patient profiles. These were used to populate a decision analysis model. The study highlights how decision analysis can introduce evidence-based information into the consultatio... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=3492140 Thu, 22 Apr 2010 08:39:43 +0100 3492140 http://www.medworm.com/index.php?rid=3492139&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F1%2F35%3Frss%3D1 The aim was to demonstrate the performance of a modified version of the Sequential Organ Failure Assessment (SOFA) score to predict mortality in medical and surgical patients with cancer. We performed an electronic retrospective review of databases. We included adult patients with cancer admitted into a 53-bed ICU over 28 months. We electronically calculated a modified SOFA (mSOFA) score at admission. A majority of the patients were admitted into the surgical ICU. Of 328 nonsurvivors, 85.1 per cent were medical patients and only 14.9 per cent surgical patients. The mean admission mSOFA scores for medical and surgical patients were 4.7 ± 3.2 and 1.7 ± 1.9, respectively. The overall area under the curve (AUC) of the mSOFA score was 0.84. The AUCs for medical and surgical patien... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=3492139 Thu, 22 Apr 2010 08:39:43 +0100 3492139 http://www.medworm.com/index.php?rid=3492138&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F1%2F25%3Frss%3D1 Various vaccination rates are mathematically modeled as if they simply spread from area to next nearest area across a ‘constructed landscape’ of developing countries. A technique that had previously been used to model the spread of diseases effectively models the spread of disease prevention. Multidimensional scaling successfully summarizes complex patterns in vaccination rates in developing countries as a ‘constructed chart’ from ‘functional distances’. Countries that have similar vaccination rates are close together in this constructed chart, and countries that have different rates are far apart, regardless of the physical distance between the countries. A statistically significant (p <... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=3492138 Thu, 22 Apr 2010 08:39:43 +0100 3492138 http://www.medworm.com/index.php?rid=3492137&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F1%2F15%3Frss%3D1 This article describes how Web 2.0 technology could impact on the quality of life of individuals with LTCs and suggests a starting point for developing a theoretically informed patient centred framework. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=3492137 Thu, 22 Apr 2010 08:39:43 +0100 3492137 http://www.medworm.com/index.php?rid=3492136&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F16%2F1%2F5%3Frss%3D1 The internet, though an invaluable and ubiquitous resource for health-related information, is perceived as being undermined by concerns about quality and reliability. Some recent developments, by permitting so-called user-generated content to be published on the internet, exacerbate these concerns. The impact of these developments, mostly characterized as Web 2.0, on the use of healthcare educational and information resources is explored in this article. There is a recognized need for an authoritative service that can address issues of quality. Intute: Health and Life Sciences is one such service, and its design in the context of meeting current Web 2.0 expectations and addressing concerns about quality is the focus of the article. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=3492136 Thu, 22 Apr 2010 08:39:43 +0100 3492136 http://www.medworm.com/index.php?rid=3073238&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F4%2F305%3Frss%3D1 The use of clinical data from electronic medical records (EMRs) for clinical research and for evaluation of quality of care requires an extraction process. Many efforts have failed because the extracted data seemed to be unstructured, incomplete and ridden by errors. We have developed and tested a concept of extracting semi-structured EMRs (Journal III®, Profdoc®) data from 776 diabetes patients in a general practice clinic over a 5 year period. We used standard database management techniques commonly applied in clinical research in the pharmaceutical industry to clean up the data and make the data available for statistical analysis. The key problem was difficulties locating the data, as no standard way to enter the data in the EMR system was reinforced. Furthermore, no built-in ed... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=3073238 Wed, 09 Dec 2009 17:34:32 +0100 3073238 http://www.medworm.com/index.php?rid=3073237&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F4%2F296%3Frss%3D1 The purpose of this study was to assess whether an electronic prompt promoting BMD testing affected the proportion of patients who received BMD and/or bone health medication. Rheumatology providers of patients 40+, on prednisone, with no record of BMD testing in the past 2 years, were targeted with the message: ‘This patient is at risk for osteoporosis due to prednisone use. We have no record of a recent Dexa scan.’ We also surveyed providers on the prompt’s value. The use of prednisone remained stable; BMD testing was quite low in all periods but increased slightly (non-statistically) over time, as did bone health medication use. Providers found the prompt not tailored enough to be clinically meaningful. Electronic prompts seem beneficial in theory; however, putting them... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=3073237 Wed, 09 Dec 2009 17:34:32 +0100 3073237 http://www.medworm.com/index.php?rid=3073236&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F4%2F282%3Frss%3D1 The study objective was to describe the prospective use of an interactive Patient Education and Motivation Tool (PEMT) placed within a pediatric emergency department (ED). A touch screen computer was utilized to deliver asthma education to children and their parents/guardians during their acute asthma visit between November 2006 and April 2007. Ninety-nine participants were enrolled in this prospective non-randomized pre—post study. PEMT comprised three key components: screening, learning and evaluation. The tool tracked the date the system was used, user characteristics, asthma knowledge, amount of time spent on each screen, and navigational patterns of individuals using the program. The results showed that baseline asthma knowledge had positive association with age and negative ass... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=3073236 Wed, 09 Dec 2009 17:34:32 +0100 3073236 http://www.medworm.com/index.php?rid=3073235&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F4%2F267%3Frss%3D1 This article presents some early, design-oriented research findings from a study that introduced mobile blogging technologies to four people who wished to make a health-related life change — giving up smoking. We wanted to establish the nature of the relationship between blogging and quitting smoking (if any), inspired by some earlier work in the domain showing that social technologies may help with the quit process. We present an account of three participants, documenting details of how blogging technologies fitted into their (changing) lives and examples of digital content they produced. We describe, using examples from participant blogs, instances of self-expression, replacement and self-awareness. We suggest, despite all participants failing in their quit attempts, that there are... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=3073235 Wed, 09 Dec 2009 17:34:32 +0100 3073235 http://www.medworm.com/index.php?rid=2739374&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F3%2F254%3Frss%3D1 In today’s fast changing healthcare sector, decision makers are facing a growing demand for both clinical and administrative information in order to comply with legal and customer-specific requirements. The use of business intelligence (BI) is seen as a possible solution to this actual challenge. As the existing research about BI is primarily focused on the industrial sector, it is the aim of this contribution to translate and adapt the current findings for the healthcare context. For this purpose, different definitions of BI are examined and condensed in a framework. Furthermore, the sector-specific preconditions for the effective use and future role of BI are discussed. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=2739374 Wed, 26 Aug 2009 23:00:00 +0100 2739374 http://www.medworm.com/index.php?rid=2739373&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F3%2F244%3Frss%3D1 This article proposes a strategic framework or road map for sustainable m-health. The drivers and critical success factors of this framework are identified from the literature and a survey of the views of senior strategists in the New Zealand health sector. The success factors are associated with key tasks in the framework that identify suitable applications, channel development activity, and confirm activity by continued support of innovation whilst moving successful applications into the mainstream. The two most important outcomes from the research are that m-health has a crucial, even inevitable, role to play in future healthcare, and the development and exploitation of m-health demands a top-down strategy or framework to match and encourage bottom-up innovation by healthcare practioner... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=2739373 Wed, 26 Aug 2009 23:00:00 +0100 2739373 http://www.medworm.com/index.php?rid=2739372&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F3%2F229%3Frss%3D1 This article looks at the issue of informed consent internationally, and goes further to explain some of the inequalities across the world with respect to informed consent and patients’ rights legislation via an analysis of the take-up of key legislative attributes in patient consent. Specifically, the effect that national culture, as defined by the GLOBE variables, has on the rate and pattern of adoption of these consent elements is analysed using binary logistic regression to provide evidence of the existence or otherwise of a cultural predicate of the legislative approach. The article concludes by outlining the challenges presented by these differences. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=2739372 Wed, 26 Aug 2009 23:00:00 +0100 2739372 http://www.medworm.com/index.php?rid=2739371&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F3%2F212%3Frss%3D1 This article presents preliminary results from the first 1828 respondents. Respondents were most willing to share their information for the purpose of providing care. However, removing their name and address greatly increased the acceptability of sharing information for other purposes. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=2739371 Wed, 26 Aug 2009 23:00:00 +0100 2739371 http://www.medworm.com/index.php?rid=2739370&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F3%2F199%3Frss%3D1 Although the potential benefits of computer-based records have been identified in different areas of the healthcare environment, in many settings paper-based records and computer-based records are still used in parallel. In this article, emergency department (ED) staff perspectives about the use of paper- or computer-based records are presented. This was a qualitative study in which data were collected using in-depth semi-structured interviews with the ED staff. The interviews were transcribed verbatim and data were analysed using framework analysis. In total, 34 interviews were undertaken. The study identified a number of factors which might encourage or discourage the use of paper-based and computer-based records in the ED. Users also expressed their concerns and expectations. Although t... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=2739370 Wed, 26 Aug 2009 23:00:00 +0100 2739370 http://www.medworm.com/index.php?rid=2739369&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F3%2F191%3Frss%3D1 The study compared paper-based and electronic-based medical handover with respect to quality of information transfer during hospital out-of-hours shifts, and analysed the caseload burden of the hospital night team. The participants were 1645 hospital patients transferred from the day team to the out-of-hours team over four months in 2006. Quality of information transfer was determined by clinical data handed over within pre-set fields, and caseload burden by the frequency of tasks required at handover. Handover information fields comprised patient’s demographics and location, primary diagnosis, current problem, plan of action and primary care team details. Electronic handover achieved a significantly higher number of completed fields than paper-based handover. Blood collection, check... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=2739369 Wed, 26 Aug 2009 23:00:00 +0100 2739369 http://www.medworm.com/index.php?rid=2739368&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F3%2F179%3Frss%3D1 This article reports a study that employs a contextual inquiry method to study the prevailing dictation procedures and solutions in a hospital from the physician’s perspective. The goal was to empirically evaluate digital dictation and the other three currently used methods for making dictations, thereby eliciting information for supporting the hospital administration in their decisions concerning the further development of a dictation solution. The research indicated a number of user requirements for a dictation solution. The main conclusions were: (1) the currently used information systems need extensive improvements and redesign; (2) the observed process of digital dictation does not seem applicable for its intended context of use; (3) for future solutions, it is important to unde... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=2739368 Wed, 26 Aug 2009 23:00:00 +0100 2739368 http://www.medworm.com/index.php?rid=2739367&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F3%2F167%3Frss%3D1 In England, the Choose and Book service, a main component of the England National Programme for IT (NPfIT), aims at empowering patients. Little research has been performed to evaluate clinicians’ perceptions of, and satisfaction with, the Choose and Book service. The aim of the research was to examine clinicians’ perceptions of, and satisfaction with, the Choose and Book service. A qualitative approach, using in-depth, semi-structured interviews, was used to collect data. Framework analysis was used to analyse the data. Twenty clinicians were interviewed, including 14 general practitioners (GPs) and six hospital consultants. Although clinicians were positive about the benefits of the Choose and Book service, they were concerned about the adverse impact of the electronic referra... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=2739367 Wed, 26 Aug 2009 23:00:00 +0100 2739367 http://www.medworm.com/index.php?rid=2739366&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Freprint%2F15%2F3%2F163%3Frss%3D1 (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=2739366 Wed, 26 Aug 2009 23:00:00 +0100 2739366 http://www.medworm.com/index.php?rid=2437866&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F2%2F147%3Frss%3D1 This study explored views of www.dipex.org/arthritis, a website based on, and featuring, clips from interviews about experiences of rheumatoid arthritis (RA). Thirty-seven rheumatology outpatients viewed the site and completed a questionnaire. Overall the website appeared relevant and understandable and could be recommended. Comments highlighted the need to update the site regularly with experiences of new treatments; to ensure positive and negative experiences are balanced; and to ensure information is easy to find. The site has since been updated with new experiences and rewritten summaries that present a better balance of experiences. Changes were incorporated in an entire site redesign launched in autumn 2008 as www.healthtalkonline.org. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=2437866 Wed, 27 May 2009 04:00:00 +0100 2437866 http://www.medworm.com/index.php?rid=2437865&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F2%2F122%3Frss%3D1 This article presents a systematic literature review done to evaluate the feasibility and benefits of home-based information and communications technology enabled interventions for chronic disease management, with emphasis on their impact on health outcomes and costs. Relevant articles were retrieved from PubMed and evaluated using quality worksheets with pre-identified inclusion and exclusion criteria. Of the 256 articles retrieved, 27 were found to concord with the study criteria. Evaluation of the identified articles was conducted irrespective of study design, type of home-based intervention or chronic disease involved. The review demonstrates that HBIs applied to chronic disease management improve functional and cognitive patient outcomes and reduce healthcare spending. However, furthe... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=2437865 Wed, 27 May 2009 04:00:00 +0100 2437865 http://www.medworm.com/index.php?rid=2437864&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F2%2F108%3Frss%3D1 We describe the approaches taken to ensure compliance with the Health Insurance Portability and Accountability Act (HIPAA) and to leverage the vast stores of structured and unstructured data that are currently underused. We conclude by reflecting on what we would have done differently and by making recommendations to streamline the process. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=2437864 Wed, 27 May 2009 04:00:00 +0100 2437864 http://www.medworm.com/index.php?rid=2437863&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F2%2F95%3Frss%3D1 This article critically examines the challenges associated with demand for immunization, including the interplay of political, social, economic and technological forces that influence the level of immunization coverage. The article suggests a framework to capture the complex and dynamic nature of the immunization process and tests its effectiveness using a case study of Ugandan healthcare provision. Field study research methods and qualitative system dynamics, a feedback and control theory based modelling approach, are used to capture the complexity and dynamic nature of the immunization process, to enhance a deeper understanding of the immunization organizational environment. A model showing the dynamic influences associated with demand and provision of immunization services, with the aim... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=2437863 Wed, 27 May 2009 04:00:00 +0100 2437863 http://www.medworm.com/index.php?rid=2437862&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F2%2F86%3Frss%3D1 The post-take ward round (PTWR) involves the assessment of the latest intake of patients into the hospital. At a busy 400-bed city hospital it had been noted that PTWR notes had, in some cases, become overly brief and uninformative. Previous research had shown that proformas can improve the completeness of the records. So a new proforma was designed and introduced. Its impact on completeness of information was assessed by carrying out an audit of PTWR notes both with and without the proforma. The results showed statistically significant improvements in documentation when the proforma was used. They also showed an improvement in areas of efficiency of record management: for example, the proforma reduced the time taken to retrieve information from the notes, and most users said it saved them... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=2437862 Wed, 27 May 2009 04:00:00 +0100 2437862 http://www.medworm.com/index.php?rid=2437861&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F2%2F75%3Frss%3D1 This article presents an analysis of 410 nurse—patient consultations and interviews with 76 primary care nurses, and explores nurses' information needs and their use of electronic information tools. The findings suggest that, if we wish to encourage nurses to use research information in clinical practice, we need to move from `pull' to `push' technology. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=2437861 Wed, 27 May 2009 04:00:00 +0100 2437861 http://www.medworm.com/index.php?rid=2186212&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F1%2F65%3Frss%3D1 The objective of the study was to determine awareness of the ECDL amongst members of the Royal College of Obstetricians and Gynaecologists. An anonymous postal survey was conducted with members and fellows of the College in three UK regions. A total of 720 questionnaires were posted, and the response rate was 47.9 per cent. A fifth of all respondents were not aware of the ECDL at all, and only 10 per cent were trained in the ECDL. However, more than third had some other formal training in IT skills. Half the respondents suggested that the questionnaire had prompted them to train for the ECDL. Much needs to be done to increase awareness of the ECDL and offer incentives for its takeup. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=2186212 Fri, 13 Feb 2009 05:00:00 +0100 2186212 http://www.medworm.com/index.php?rid=2186211&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F1%2F55%3Frss%3D1 This article argues that nurses are not currently adequately prepared to work with information and technology through their pre-registration education. Reflecting the lack of nursing informatics expertise, it is recommended that all pre-registration nursing programmes should have access to a nursing informatics specialist. A prescription to meet the informatics needs of the newly qualified nurse is proposed. This places the areas that need to be included in pre-registration education into broad groups that both articulate the competencies that nurses need to develop, and indicate why they are needed, rather than providing context-free checklists of skills. This is presented as a binary scatter chart with two axes, skill to knowledge and technology to information. (Source: Health Informatic... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=2186211 Fri, 13 Feb 2009 05:00:00 +0100 2186211 http://www.medworm.com/index.php?rid=2186210&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F1%2F41%3Frss%3D1 This article reports on a large not-for-profit home-based palliative care service in Australia, which embarked on a project to develop an electronic data management system specifically designed to meet the needs of the palliative care sector. This web-based client information management system represents a joint venture between the organization and a commercial company and has been a very successful project. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=2186210 Fri, 13 Feb 2009 05:00:00 +0100 2186210 http://www.medworm.com/index.php?rid=2186209&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F1%2F27%3Frss%3D1 This article presents the usability and acceptability of a website that provides older people with tailored advice to help motivate them to undertake physical activities that prevent falls. Views on the website from interviews with 16 older people and 26 sheltered housing wardens were analysed thematically. The website was well received with only one usability difficulty with the action plan calendar. The older people selected balance training activities out of interest or enjoyment, and appeared to carefully add them into their current routine. The wardens were motivated to promote the website to their residents, particularly those who owned a computer, had balance problems, or were physically active. However, the participants noted that currently a minority of older people use the Intern... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=2186209 Fri, 13 Feb 2009 05:00:00 +0100 2186209 http://www.medworm.com/index.php?rid=2186208&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F1%2F17%3Frss%3D1 This study demonstrated early feasibility and acceptability of text messaging as a method for promoting healthy behaviors for weight maintenance. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=2186208 Fri, 13 Feb 2009 05:00:00 +0100 2186208 http://www.medworm.com/index.php?rid=2186207&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F15%2F1%2F5%3Frss%3D1 This article presents an analysis of 410 nurse—patient consultations and interviews with 76 primary care nurses, and explores the nature of the decisions that primary care nurses make and the impact of that on their use of and attitudes towards decision tools. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=2186207 Fri, 13 Feb 2009 05:00:00 +0100 2186207 http://www.medworm.com/index.php?rid=1958500&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F4%2F323%3Frss%3D1 In light of the mass media coverage that the MMR (measles, mumps and rubella) vaccine received as a result of questions raised about its safety, a content analysis of mass media articles about the MMR vaccine was undertaken. The analysis examined 227 articles published in five different information sources in a 2 month period. The analysis looked at 94 content-based variables and the key attributes of these articles including word count and date of publication. Descriptive and analytical statistics relating to both article content and format were produced. The analysis showed that the content and format of articles between different information sources varied widely. These differences can be attributed to the information source in which they are published, but the variability in the conten... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1958500 Thu, 13 Nov 2008 05:00:00 +0100 1958500 http://www.medworm.com/index.php?rid=1958499&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F4%2F309%3Frss%3D1 Ageing populations and unhealthy lifestyles have led to some chronic conditions such as diabetes and heart disease reaching epidemic proportions in many developed nations. This paper explores the potential of mobile technologies to improve this situation. The pervasive nature of these technologies can contribute holistically across the whole spectrum of chronic care ranging from public information access and awareness, through monitoring and treatment of chronic disease, to support for patient carers. A related study to determine the perceptions of healthcare providers to m-health confirmed the view that attitudes were likely to be more important barriers to progress than technology. A key finding concerned the importance of seamless and integrated m-health processes across the spectrum of... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1958499 Thu, 13 Nov 2008 05:00:00 +0100 1958499 http://www.medworm.com/index.php?rid=1958498&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F4%2F297%3Frss%3D1 Cancer is the second most threatening disease in the world today, not only because of its mortality rate, but also due to the brutal changes it imposes on the patient's life, and the fact that its exact causes of progression remain to be discovered. Recent evolution in computer technology has resulted in the emergence of a combined approach to the diagnosis and prognosis process, with a data driven analytical approach complementing biomedical and clinical methods. Cost-sensitive learning is one such data mining method, particularly well suited for medical problems. This paper investigates the performance of a new system based on a hybrid cost-sensitive algorithm (ProICET) on a prostate cancer medical dataset, while trying to produce new medical knowledge. The target of such a system is to ... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1958498 Thu, 13 Nov 2008 05:00:00 +0100 1958498 http://www.medworm.com/index.php?rid=1958497&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F4%2F279%3Frss%3D1 This paper describes the experiences of the Eastern Head Injury Study in creating a strategic regional head injury service framework using a collaborative action research methodology. The types of data, information and knowledge required to develop and support such a framework for both development and successful implementation are identified. This includes the identification of existing knowledge/information systems, the variability and gaps in these, and how the systems fit together, using a number of evidence-gathering and knowledge-sharing methods. The discussion debates the value of the action research approach and what principles are necessary in developing and maintaining knowledge networks. The project demonstrates that an understanding of the social learning cycle can help in under... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1958497 Thu, 13 Nov 2008 05:00:00 +0100 1958497 http://www.medworm.com/index.php?rid=1958496&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F4%2F267%3Frss%3D1 A topic map is implemented for learning about clinical data associated with a hospital stay for patients diagnosed with chronic kidney disease, diabetes and hypertension. The question posed is: how might a topic map help bridge perspectival differences among communities of practice and help make commensurable the different classifications they use? The knowledge layer of the topic map was generated from existing ontological relationships in nosological, lexical, semantic and HL7 boundary objects. Discharge summaries, patient charts and clinical data warehouse entries reified the clinical knowledge used in practice. These clinical data were normalized to HL7 Clinical Document Architecture (CDA) markup standard and stored in the Clinical Document Repository. Each CDA entry was given a subjec... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1958496 Thu, 13 Nov 2008 05:00:00 +0100 1958496 http://www.medworm.com/index.php?rid=1958495&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F4%2F259%3Frss%3D1 This research extends and tests principles to establish good practice and overcome practical barriers in the strategic management of data quality. The research explores the issues that define and control data quality in national health data collections and the mechanisms and frameworks that can be developed to achieve and sustain good data quality. The aim is to make the strategic management of data quality, and the prevention of persistent errors, everyday, `institutionalized' activities. Using action research methodology and a combination of interpretive and positivist data collection and analysis methods, this research provides the health informatics community with an understanding of the issues related to developing and implementing programmes to improve data quality. Healthcare is a c... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1958495 Thu, 13 Nov 2008 05:00:00 +0100 1958495 http://www.medworm.com/index.php?rid=1958494&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F4%2F247%3Frss%3D1 This study considers how to integrate research knowledge effectively into healthcare managers' decision making, and how to manage and integrate information that will include community data. This first phase in a two-phase mixed methods research study used a qualitative, multiple case studies design. Nineteen semi-structured interviews were undertaken using the critical incident technique. Interview transcripts were analysed using the NatCen Framework. One theme represented `information and decisions'. Cases were determined to involve complex multi-level, multi-situational decisions with participants in practical rather than ceremonial work roles. Most considered organizational knowledge in the first two decision phases and external knowledge, including research, in the third phase. All par... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1958494 Thu, 13 Nov 2008 05:00:00 +0100 1958494 http://www.medworm.com/index.php?rid=1958493&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Freprint%2F14%2F4%2F243%3Frss%3D1 (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1958493 Thu, 13 Nov 2008 05:00:00 +0100 1958493 http://www.medworm.com/index.php?rid=1713011&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Freprint%2F14%2F3%2F237%3Frss%3D1 (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1713011 Mon, 18 Aug 2008 04:00:00 +0100 1713011 http://www.medworm.com/index.php?rid=1713010&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F3%2F223%3Frss%3D1 The notion of `integration' in the context of health information systems is ill-defined yet in widespread use. We identify a variety of meanings ranging from the purely technical integration of information systems to the integration of services. This ambiguity (or interpretive flexibility), we argue, is inherent rather than accidental: it is a necessary prerequisite for mobilizing political and ideological support among stakeholders for integrated health information systems. Building on this, our aim is to trace out the career dynamics of the vision of `integration/ integrated'. The career dynamics is the transformation of both the imaginary and the material (technological) realizations of the unfolding implementation of the vision of integrated care. Empirically we draw on a large, ongoin... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1713010 Mon, 18 Aug 2008 04:00:00 +0100 1713010 http://www.medworm.com/index.php?rid=1713009&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F3%2F211%3Frss%3D1 Primary care medical practices fail to recognize the seriousness of security threats to their patient and practice information. This can be attributed to a lack of understanding of security concepts, underestimation of potential threats and the difficulty in configuration of security technology countermeasures. To appreciate the factors contributing to such problems, research into general practitioner security practice and perceptions of security was undertaken. The investigation focused on demographics, actual practice, issues and barriers, and practitioner perception. Poor implementation, lack of relevant knowledge and inconsistencies between principles and practice were identified as key themes. Also the results revealed an overwhelming reliance on trust in staff and in computer informa... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1713009 Mon, 18 Aug 2008 04:00:00 +0100 1713009 http://www.medworm.com/index.php?rid=1713008&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F3%2F195%3Frss%3D1 The use of information and communication technology (ICT) to support integrated healthcare services in elderly homecare is becoming more established. In particular, ICT can enable information exchange, knowledge sharing and documentation at the point-of-care (POC). The aim of this study was to explore these effects using the Old@Home prototype. Old@Home was perceived to contribute in developing horizontal links for communication between individuals who work together, independent of geographical distance or organizational affiliation, and to contribute to increased work efficiency. The prototype was further seen to reduce professional isolation by providing a holistic overview of the care process. User centred design and implementation of Old@Home was considered key to facilitating acceptan... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1713008 Mon, 18 Aug 2008 04:00:00 +0100 1713008 http://www.medworm.com/index.php?rid=1713007&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F3%2F183%3Frss%3D1 The international Safe Community programme was used as the setting for a case study to explore the need for information system support in health promotion programmes. The 14 Safe Communities active in Sweden during 2002 were invited to participate and 13 accepted. A questionnaire on computer usage and a critical incident technique instrument were distributed. Sharing of management information, creating social capital for safety promotion, and injury data recording were found to be key areas that need to be further supported by computer-based information systems. Most respondents reported having access to a personal computer workstation with standard office software. Interest in using more advanced computer applications was low, and there was considerable need for technical user support. Ar... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1713007 Mon, 18 Aug 2008 04:00:00 +0100 1713007 http://www.medworm.com/index.php?rid=1713006&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F3%2F175%3Frss%3D1 This prospective questionnaire study investigated access to the Internet and use of the Internet for health related information. Patients attending the senior author's ENT clinic (204 in 2000; 209 in 2006) were asked two questions: do you have access to the Internet? Have you used the Internet to find health related information? Access to the Internet rose from 43 per cent (88) in 2000 to 70 per cent (147) in 2006, a significant increase (p < 0.001). The Internet was used for health related information by only 32 patients (16%) in 2000 but by 114 (55%) in 2006, a dramatic and significant increase (p < 0.001). Clearly patients and their families are increasingly using the Internet to access and seek health information. Clinicians cannot overlook this aspect of health provision when se... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1713006 Mon, 18 Aug 2008 04:00:00 +0100 1713006 http://www.medworm.com/index.php?rid=1713005&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F3%2F155%3Frss%3D1 In studies of web-based consumer health information, scant attention has been paid to the selective development of differential methodologies for website quality evaluation, or to selective grouping and analysis of specific `domains of uncertainty' in healthcare. Our objective is to introduce a more refined model for website evaluation, and illustrate its application using assessment of websites within an area of ongoing medical uncertainty, back pain. In this exploratory technology assessment, we suggest a model for assessing these `domains of uncertainty' within healthcare, using qualitative assessment of websites and hierarchical concepts. Using such a hierarchy of quality criteria, we review medical information provided by the most frequently accessed websites related to back pain. Web... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1713005 Mon, 18 Aug 2008 04:00:00 +0100 1713005 http://www.medworm.com/index.php?rid=1559352&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F2%2F95%3Frss%3D1 An integrated health record (IHR) that enables clinical data to be shared at a national level has profound implications for medical research. Data that have been useful primarily within a single clinic will instead be free to move rapidly around a national network infrastructure. This raises challenges for technologists, clinical practice, and for the governance of these data. This article considers one specific issue that is currently poorly understood: how intellectual property (IP) relates to the sharing of medical data for research on large-scale electronic networks. Based on an understanding of current practices, this article presents recommendations for the governance of IP in an integrated heal... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1559352 Tue, 13 May 2008 04:00:00 +0100 1559352 http://www.medworm.com/index.php?rid=1438394&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F2%2F141%3Frss%3D1 This article presents the findings of an ethnographic study of patient identification at a walk-in centre in the UK. We offer a view of patient identifiers as used in practice and show how seemingly simple data, such as a person's name or date of birth, are more complex than they may at first appear and how they potentially pose problems for the use of integrated health records. We further report and discuss a dichotomy between the identifiers needed to access health records and the identifiers used by practitioners in their everyday work. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1438394 Tue, 13 May 2008 04:00:00 +0100 1438394 http://www.medworm.com/index.php?rid=1438393&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F2%2F125%3Frss%3D1 This article reports on the project management and Culture Change Programme adopted by the NHS Greater Glasgow Health Board to deliver an electronic patient record (EPR) to support cardiology and stroke clinical services. To achieve its vision for the EPR (`to "really make a difference" to patient care by providing to the right person, the right information, under the right safeguards') the Board recognized that attending to social and organizational issues is at least of equal importance to addressing strictly technical concerns. Consequently, an ICT Culture Change Programme (ICT CCP) was devised and implemented to assist in the management of change, and in particular to facilitate a visionary clinical and cultural environment operating in conjunction with the evolving technical environme... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1438393 Tue, 13 May 2008 04:00:00 +0100 1438393 http://www.medworm.com/index.php?rid=1438392&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F2%2F113%3Frss%3D1 This article explores the changes in these relationships by drawing on comparisons with the previous system for procurement of primary care computing systems, which ran for much of the 1990s. The article also comments on characteristics of the CfH procurement/ contracting process, the differing responses of suppliers, and the role of the existing installed base as an actor in building a new infrastructure for health records. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1438392 Tue, 13 May 2008 04:00:00 +0100 1438392 http://www.medworm.com/index.php?rid=1438391&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F2%2F95%3Frss%3D1 This article considers one specific issue that is currently poorly understood: how intellectual property (IP) relates to the sharing of medical data for research on large-scale electronic networks. Based on an understanding of current practices, this article presents recommendations for the governance of IP in an integrated health record. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1438391 Tue, 13 May 2008 04:00:00 +0100 1438391 http://www.medworm.com/index.php?rid=1438390&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F2%2F79%3Frss%3D1 A computational infrastructure to underpin complex clinical trials and medical population studies is highly desirable. This should allow access to a range of distributed clinical data sets; support the efficient processing and analysis of the data obtained; have security at its heart; and ensure that authorized individuals are able to see privileged data and no more. Each clinical trial has its own requirements on data sets and how they are used; hence a reusable and flexible framework offers many advantages. The MRC funded Virtual Organisations for Trials and Epidemiological Studies (VOTES) is a collaborative project involving several UK universities specifically to explore this space. This article p... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1438390 Tue, 13 May 2008 04:00:00 +0100 1438390 http://www.medworm.com/index.php?rid=1438389&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Freprint%2F14%2F2%2F75%3Frss%3D1 (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1438389 Tue, 13 May 2008 04:00:00 +0100 1438389 http://www.medworm.com/index.php?rid=1214456&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F1%2F59%3Frss%3D1 This article explores informal information exchange in social care, and implications for formal monitoring with an electronic social care record (ESCR). Six homecare settings were studied over 14 months between 2001 and 2002. Participant observation methods were used with the recipients of homecare (n = 7) and in-depth interviews plus participant observation with formal care workers (n = 31). Allied healthcare professionals (n = 9) and homecare managers (n = 5) were interviewed, as were two family members. The findings show that assumptions about monitoring of care processes may be faulty, and that trust and negotiation are important aspects of the care delivery. Modelling of the business processes indicates that roles and responsibilities for managing a care plan may shift, with the conse... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1214456 Thu, 07 Feb 2008 05:00:00 +0100 1214456 http://www.medworm.com/index.php?rid=1214455&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F1%2F39%3Frss%3D1 Health registries from multiple jurisdictions often include terms that are assumed to be semantically equivalent (e.g. fetal death and stillbirth). Closer examination reveals that such attributes have near — but non-equivalent — semantics. Thus their degree of semantic heterogeneity is an important indicator of uncertainty associated with data integration between registries. We build an OWL-encoded ontology which formalizes the relationships between similar perinatal concepts found in different databases. We also introduce the concept of ontology-based metadata as a means of contextualizing such terms and linking context to the attribute data. This extended metadata are exported as XML from the health registries, and it — along with the OWL ontology — is interfaced ... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1214455 Thu, 07 Feb 2008 05:00:00 +0100 1214455 http://www.medworm.com/index.php?rid=1214454&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F1%2F29%3Frss%3D1 The Internet is an oft-cited learning resource, useful to consumers who seek to educate themselves on specific technical issues or knowledge-intensive topics. Availability of public-access Internet portals and decreasing costs of personal computers have created a consensus that unequal access to information, or a "Digital Divide", presents a like problem specific to information for uninsured or under-insured healthcare consumers. Access to information, however, is now an essential part of consumer-centric healthcare management. To date little research has been done to differentiate levels of health information access on the Web by different subgroups, linking online socioeconomic characteristics and health seeking behaviors. This analysis of a landmark Pew Foundation survey seeks to differ... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1214454 Thu, 07 Feb 2008 05:00:00 +0100 1214454 http://www.medworm.com/index.php?rid=1214453&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F1%2F17%3Frss%3D1 The aim of this research is to determine the kinds of health-related information that patients seek more often from websites written in English, and at which stages of the healthcare decisional process they use this information more intensively. A quantitative study was performed. Canadian English-speaking patients who have long-term diseases and who use the Internet completed an 18-item questionnaire online. Respondents were questioned about the categories of health-related websites they visit the most (scientific, general, commercial websites, or discussion groups) and the stages of the medical decisional process during which they use the information obtained (identification of possible treatments, treatment choice, and treatment application or follow-up). Results show that respondents u... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1214453 Thu, 07 Feb 2008 05:00:00 +0100 1214453 http://www.medworm.com/index.php?rid=1214452&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F14%2F1%2F5%3Frss%3D1 The study objective was to compare the accuracy of a deterministic record linkage algorithm and two public domain software applications for record linkage (The Link King and Link Plus). The three algorithms were used to unduplicate an administrative database containing personal identifiers for over 500,000 clients. Subsequently, a random sample of linked records was submitted to four research staff for blinded clerical review. Using reviewers' decisions as the `gold standard', sensitivity and positive predictive values (PPVs) were estimated. Optimally, sensitivity and PPVs in the mid 90s could be obtained from both The Link King and Link Plus. Sensitivity and PPVs using a basic deterministic algorithm were 79 and 98 per cent respectively. Thus the full feature set of The Link King makes it... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1214452 Thu, 07 Feb 2008 05:00:00 +0100 1214452 http://www.medworm.com/index.php?rid=1039096&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F13%2F4%2F303%3Frss%3D1 As increasing amounts of complex health information become available via the Internet, providers frequently advise that it is important for health consumers to carefully consider the source of lay information, as well as discuss the clinical information they find with their healthcare provider. Beyond clinical indicators and standards, however, there exist few evaluative frameworks for assessing health information, especially within peer-to-peer networks. Traditional methods of analyzing online discussion content, such as keyword examination or network structure analysis, have proven largely unsatisfactory for unstructured health data analysis. Using a disease-specific illustration, this study propose... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1039096 Tue, 20 Nov 2007 05:00:00 +0100 1039096 http://www.medworm.com/index.php?rid=1039095&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F13%2F4%2F283%3Frss%3D1 This article provides a historical review of five long-term interventions which were undertaken within the NHS. The objective of the exercise was to examine how information systems (IS) were introduced into operational environments. The length of the interventions ranged from 9 months to almost 3 years. The five sites were all at different stages of system development and the research was carried out using a combination of participant observation and action research. The research question asks, `How can organizations think about and hence go about their information provision in such a way that successful IS are introduced?' (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1039095 Tue, 20 Nov 2007 05:00:00 +0100 1039095 http://www.medworm.com/index.php?rid=1039094&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F13%2F4%2F267%3Frss%3D1 The study objective was to gain a better understanding of the level of literacy in information technology across the dental team within Scotland, thus allowing appropriate planning of education and training for effective use of information technology. In May 2004 a postal questionnaire survey was undertaken of all dentists (2679) and professionals complementary to dentistry (2861) within primary care in Scotland, in both general dental practice and the salaried dental service. Online reply was also an option. Results showed that 43 per cent of respondents considered their IT skills as `moderate' with a further one-third reporting `nil' or `low' skill level. Only one quarter of respondents had accessed a learning programme by PC. The majority of IT competence was self-acquired. Hence `upski... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1039094 Tue, 20 Nov 2007 05:00:00 +0100 1039094 http://www.medworm.com/index.php?rid=1039093&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F13%2F4%2F255%3Frss%3D1 Knowledge is a critical element in the delivery of quality healthcare. In a busy emergency department (ED) clinicians attempting clinically relevant discussion with their peers face multiple interruptions and a lack of sustained meaningful interactions. Information and communication technologies such as online discussion forums enable practitioners to share practice knowledge at times that fit into their daily workflow. We conducted an experiment in which we provided emergency clinicians with access to an asynchronous discussion forum as a medium to support development of an online social network for information exchange. The outcomes were evaluated using a social network perspective to better understand the knowledge seeking and sharing behaviors among rural and urban emergency practition... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1039093 Tue, 20 Nov 2007 05:00:00 +0100 1039093 http://www.medworm.com/index.php?rid=1039092&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F13%2F4%2F243%3Frss%3D1 Computer illiteracy is diminishing as a new generation of retirees become the younger old and display more up-to-date knowledge and skills. However, there are questions about whether this group will be able to continue to update their skills as they get older, and whether it is appropriate to develop technology solutions specifically for this age group or to concentrate on accessible designs for the whole population. We propose that older people may be empowered through involvement in the design and provision of accessible information and technology solutions and through training opportunities in information seeking skills. Access, involvement and training need to be provided in everyday locations, and training needs to be closely related to people's physical, cognitive and information nee... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=1039092 Tue, 20 Nov 2007 05:00:00 +0100 1039092 http://www.medworm.com/index.php?rid=813334&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Freprint%2F13%2F3%2F237%3Frss%3D1 (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=813334 Tue, 21 Aug 2007 04:00:00 +0100 813334 http://www.medworm.com/index.php?rid=813333&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F13%2F3%2F223%3Frss%3D1 To date most of the research concerning consumer health information has focused on trust and quality of health information websites. In this research, we observed 48 consumers searching for four health-related topics (some of their own choosing) using Google. Using transaction logs, video screen capture, retrospective verbal protocols and self-reported questionnaires, we examined holistically the consumer's search process. Results indicate significant problems in query formulation and in making efficient selections from results lists. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=813333 Tue, 21 Aug 2007 04:00:00 +0100 813333 http://www.medworm.com/index.php?rid=813332&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F13%2F3%2F207%3Frss%3D1 This study aimed to contribute to this research by testing the validity and reliability of existing tools, through their application to websites that provided information about multiple sclerosis. Furthermore, a specific tool for evaluating multiple sclerosis information was developed, contributing to the debate about suitable criteria for measuring the `quality' of health information on the web. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=813332 Tue, 21 Aug 2007 04:00:00 +0100 813332 http://www.medworm.com/index.php?rid=813331&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F13%2F3%2F195%3Frss%3D1 This article describes a study of a major change management project involving the establishment of a shared services organization to align the information services functions for two district health boards in New Zealand. The research uncovered a capability crisis that many people experienced when they realized the magnitude of the task they were involved in. Not everyone experienced the crisis and it seems that learning, especially in a complex healthcare environment, plays an important role in reducing the negative impact of change. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=813331 Tue, 21 Aug 2007 04:00:00 +0100 813331 http://www.medworm.com/index.php?rid=813330&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F13%2F3%2F179%3Frss%3D1 Hospitals everywhere are integrating health data using electronic health record (EHR) systems, and disparate and multimedia patient data can be input by different caregivers at different locations as encapsulated patient profiles. Healthcare institutions are also using the flexibility and speed of wireless computing to improve quality and reduce costs. We are developing a mobile application that allows doctors to efficiently record and access complete and accurate real-time patient information. The system integrates medical imagery with textual patient profiles as well as expert interactions by healthcare personnel using knowledge management and case-based reasoning techniques. The application can assist other caregivers in searching large repositories of previous patient cases. Patients' ... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=813330 Tue, 21 Aug 2007 04:00:00 +0100 813330 http://www.medworm.com/index.php?rid=813329&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F13%2F3%2F163%3Frss%3D1 This article presents a study to evaluate the accuracy of drug interaction (DI) alerts triggered by two electronic medical record (EMR) systems in primary healthcare. A scenario-based software architecture analysis methodology (SAAM) was used with drug—drug interaction (DDI) pairs in hypothetical patient scenarios. A literature search identified common drugs used in the management of conditions in the elderly population. Three reference programs determined the level of severity of drug interactions, and a common severity rating scale was adapted. The EMR systems showed a limited potential to identify `severe' clinically significant DDIs and considerable probability for triggering spurious alerts. This may explain the overriding of DI alerts and the interruption of the workflow of use... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=813329 Tue, 21 Aug 2007 04:00:00 +0100 813329 http://www.medworm.com/index.php?rid=606543&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F13%2F2%2F155%3Frss%3D1 The Patient Access to Electronic Healthcare Records System (PAERS) allows patients to register their arrival at a GP's surgery and to view their healthcare record electronically whilst in the waiting area. The research reported in this short article was carried out to identify potential changes in clinical and administrative workflow resulting from the introduction of the system. The study considers workflow pre and post the implementation of PAERS. It also makes comparisons between two UK London-based surgeries, one with PAERS (Wells Park Practice) and one without such a system (South Lewisham Group Practice). The impact of PAERS on workflow and the potential benefits for GPs, administrative staff and patients are highlighted. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=606543 Thu, 17 May 2007 04:00:00 +0100 606543 http://www.medworm.com/index.php?rid=606542&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F13%2F2%2F135%3Frss%3D1 Conclusions are that the standards developed through the review should improve data collection practice, and rehabilitation codes should assist in tracking patient pathways through care. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=606542 Thu, 17 May 2007 04:00:00 +0100 606542 http://www.medworm.com/index.php?rid=606541&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F13%2F2%2F119%3Frss%3D1 The study attempts to unify prior research and develop a comprehensive, empirically based conceptual model of the barriers to EHR adoption among community physicians. The model uses concept mapping, which taps the shared expertise of a group and provides reliable estimates with relatively small sample sizes. The methodology includes brainstorming of barrier statements and sorting and rating of issue statements. The model illuminates the larger structure of barriers as well as the finer details of constituent issues. Core issues are standardization and interoperability; also important are technical issues and the cost—benefit of adopting EHRs. However, psychosocial issues, the main focus of diffusion research, seem relatively peripheral. We believe the development of this model is an ... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=606541 Thu, 17 May 2007 04:00:00 +0100 606541 http://www.medworm.com/index.php?rid=606540&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F13%2F2%2F105%3Frss%3D1 This study examined nonverbal communication in relation to electronic medical record (EMR) use during the medical interview. Six physicians were videotaped during their consultations with 50 different patients at a single setting Veterans Administration Hospital. Three different office spatial designs were identified and named `open,' `closed' and `blocked'. The `open' arrangement put physicians in a position to establish better eye contact and physical orientation than did the alternative `closed' and `blocked' office configurations. Physicians who accessed the EMR and took `breakpoints' (short periods of no computer use and sustained eye contact with patients) used more nonverbal cues than physicians who tended to talk with their patients while continuously working on the computer. Long ... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=606540 Thu, 17 May 2007 04:00:00 +0100 606540 http://www.medworm.com/index.php?rid=606539&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F13%2F2%2F89%3Frss%3D1 This study investigated the recommended competencies for health and medical informatics, aiming to develop a framework for use in curricular development. Current health and medical programmes around the world were analysed to assess how these competencies are reflected in current curricula and to identify new competencies. Several preferred skills and knowledge sets were identified and 40 programs were analysed. Diverse curricular designs were found in these programmes. Competencies such as research skills, knowledge in health information systems and methods for informatics/computer science were the most frequently taught. Knowledge or skills in interpersonal communications, social impact of IT on hea... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=606539 Thu, 17 May 2007 04:00:00 +0100 606539 http://www.medworm.com/index.php?rid=606538&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F13%2F2%2F75%3Frss%3D1 This study aims to understand IT investment decisions from the perspective of senior health system executives. A two-stage study was used to investigate this highly influential, very specialized and small population of interest. The first stage involved qualitative interviews with top health executives and analysed their opinions and beliefs using an innovation diffusion theory framework. The second stage involved quantitative surveys of senior health executives to gain an understanding of their opinions regarding the organizational and technological drivers (the independent variables) and the level of IT adoption (the dependent variable). It was found that the majority of drivers identified as being ... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=606538 Thu, 17 May 2007 04:00:00 +0100 606538 http://www.medworm.com/index.php?rid=420845&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F13%2F1%2F57%3Frss%3D1 Following developments in the use of ethnographies in systems design, this article illustrates an investigation into using ethnography for healthcare system implementation, change management and benefits realization. The article illustrates the possibility of creating ethnographically enriched process maps. These are process maps that are created for specific implementation sites to facilitate the locally situated work of implementation, change management and benefits realization teams. The simple premise is that, to change and improve what you are doing, you need to know what you are currently doing. Reported are the pros and cons of a potential solution and, importantly, why it was not adopted. While not producing a ... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=420845 Mon, 12 Feb 2007 07:00:00 +0100 420845 http://www.medworm.com/index.php?rid=420844&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F13%2F1%2F47%3Frss%3D1 This article uses an ethnographic study of the design and deployment of an electronic patient record (EPR) system in the UK NHS to document some of the difficulties of integrating new IT systems with existing and developing practices, technologies and regulatory requirements. It highlights that `integration' in this situation produces a variety of different but connected and potentially competing requirements that create difficulties in achieving artful and successful system deployment. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=420844 Mon, 12 Feb 2007 07:00:00 +0100 420844 http://www.medworm.com/index.php?rid=420843&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F13%2F1%2F37%3Frss%3D1 In this article we explore the practical aspects of providing mental health information over the telephone, and discuss how this may be used to inform the creation of a website. We draw from an ethnographic study of an `information and listening helpline'. By paying close attention to how the helpline operators `take seriously' their callers' problems and requests - indeed, by taking the work of the phone operators seriously - we show that the operators artfully talk, categorize and translate to help the individual caller and to satisfy organizational demands. A website is seen by the helpline in question as a logical move to providing accessible information to a wider audience. Whilst web-based and phone-based service... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=420843 Mon, 12 Feb 2007 07:00:00 +0100 420843 http://www.medworm.com/index.php?rid=420842&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F13%2F1%2F23%3Frss%3D1 Recent advances in medical imaging, information and communication technology promise to support medical visual practice as well as everyday healthcare experience. However, this potential is not easy to realize. A better understanding of existing practices can inform socio-technical innovation. We draw on ethnographic observations and our involvement in the design of `palpable computing' to examine the use of ultrasound imaging technologies in consultations with pregnant women with a view to ideas and implications for socio-technical innovation. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=420842 Mon, 12 Feb 2007 07:00:00 +0100 420842 http://www.medworm.com/index.php?rid=420841&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F13%2F1%2F9%3Frss%3D1 In this article we examine how one of the most pervasive technological implementations in the healthcare domain - the alarm system - is used in anaesthesiology as part of patient monitoring. The utility and appropriateness of alarms in healthcare domains have been widely addressed in the literature. However, we argue that we still know little about the practical use of alarm systems in actual healthcare practice. Studies rarely examine in detail the everyday monitoring practices during normal operations in the absence of, or before, problems become critical and alarming. They have mainly considered how medical professionals manage the interpretation of and response to alarms. Rather than examining how the anaesthesiolo... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=420841 Mon, 12 Feb 2007 07:00:00 +0100 420841 http://www.medworm.com/index.php?rid=420840&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Freprint%2F13%2F1%2F5%3Frss%3D1 (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=420840 Mon, 12 Feb 2007 07:00:00 +0100 420840 http://www.medworm.com/index.php?rid=269204&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Freprint%2F12%2F4%2F319%3Frss%3D1 (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=269204 Wed, 08 Nov 2006 07:00:00 +0100 269204 http://www.medworm.com/index.php?rid=269203&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F12%2F4%2F304%3Frss%3D1 Effective self-management of diabetes requires considerable behavioural change and continuous support from health professionals, which can be expensive. Information technology has the potential to offer cost-effective patient support, but internet use mostly relies on the active seeking of information. Text messaging offers an ideal channel for delivering ‘push’ support and facilitating reciprocal communication between patient and health professional. This paper describes a participatory design methodology to develop a text message scheduling system for supporting young people with diabetes. The project illustrates how this familiar design approach can be used in a short-term project to deliver a successful ... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=269203 Wed, 08 Nov 2006 07:00:00 +0100 269203 http://www.medworm.com/index.php?rid=269202&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F12%2F4%2F293%3Frss%3D1 Technical aspects of the National Programme for IT in the National Health Service have run ahead of genuine engagement with front-line users. We have explored with front-line NHS staff the factors which limit their contribution to management information from operational systems. Staff place psychological distance between ‘the real job’ and the reporting of information. Even where accurate reporting is heavily incentivized, and operational control is shared between staff and shift leader, the reporting of information to the computer represents a division between caregiving and computer input, and between information openly declared and that waiting to be disclosed. The Programme needs to reconsider how clini... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=269202 Wed, 08 Nov 2006 07:00:00 +0100 269202 http://www.medworm.com/index.php?rid=269201&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F12%2F4%2F274%3Frss%3D1 The National electronic Library for Health (NeLH) is an Internet medical information resources portal, principally for healthcare professionals, within which the National electronic Library of Infection (NeLI) is one of NeLH Specialist Libraries providing evidence on infectious diseases. In this article, we describe a systems-based evaluation of NeLI based on a soft systems methodology. User feedback and other data for the analysis were obtained using online questionnaires. This evaluation, which is a pilot study aimed at demonstrating proof of concept, provided evidence for improving three systems that are crucial to effective NeLI provision. These are navigation of the site, quality and tagging of information provided by ... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=269201 Wed, 08 Nov 2006 07:00:00 +0100 269201 http://www.medworm.com/index.php?rid=269200&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F12%2F4%2F259%3Frss%3D1 Clinical guidelines can assist in the management of asthma. Decision support systems (DSSs) can enhance adherence to clinical guidelines but tend not to provide clinicians with cues for behavioral change strategies to promote patient self-management. The Stop Asthma Clinical System (SACS) is a DSS designed for this purpose. To assess feasibility, seven clinicians used SACS to guide well visits with 26 predominantly persistent pediatric asthma patients. Data were collected via survey and in-depth semi-structured interviews. SACS improved assessment of asthma severity and control, classification of and intervention in medicine and environmental trigger management problems, and development of an action p... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=269200 Wed, 08 Nov 2006 07:00:00 +0100 269200 http://www.medworm.com/index.php?rid=145424&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F12%2F3%2F239%3Frss%3D1 This article describes users’ responses to human-like characteristics of two health promotion IVR systems. We conducted a qualitative evaluation of two systems that promoted physical activity and healthy dietary behavior respectively. Two themes that emerged dealt with favorable responses of the users to the machine’s intrinsic qualities of being insentient and non-judgmental, and the users’ precarious sensitivity to certain human-like characteristics of the systems, namely, the content of the scripts and the recorded human voice. The article suggests that design factors that are intended to enhance human-like characteristics of these applications elicit both positive and negative re... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=145424 Mon, 14 Aug 2006 06:00:00 +0100 145424 http://www.medworm.com/index.php?rid=145423&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F12%2F3%2F227%3Frss%3D1 This article explores the impact health reforms had on geographical accessibility to hospital emergency department (ED) services in New Zealand from 1991 to 2001. Travel time was calculated using least-cost path analysis, which identified the shortest travel time from each census enumeration district through a road network to the nearest ED. This research found that the population further than 60 minutes from an ED has increased with some areas being affected more than others. Some of this increase is attributed to increases in population rather than the closing of hospitals. The findings will be discussed within the context of the health policy reform era and changes to health service provision. (Sou... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=145423 Mon, 14 Aug 2006 06:00:00 +0100 145423 http://www.medworm.com/index.php?rid=145422&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F12%2F3%2F213%3Frss%3D1 The study investigated the effect of different input selections on the performance of artificial neural networks in screening for acute myocardial infarction (AMI) in Malaysian patients complaining of chest pain. We used hospital data to create neural networks with four input selections and used these to diagnose AMI. A 10-fold cross-validation and committee approach was used. All the neural networks using various input selections outperformed a multiple logistic regression model, although the difference was not statistically significant. The neural networks achieved an area under the ROC curve of 0.792 using nine inputs, whereas multiple logistic regression achieved 0.739 using 64 inputs. Sensitivity... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=145422 Mon, 14 Aug 2006 06:00:00 +0100 145422 http://www.medworm.com/index.php?rid=145421&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F12%2F3%2F199%3Frss%3D1 Using a factorial vignette survey and modeling methodology, we developed clinical and information models -incorporating evidence base, key concepts, relevant terms, decision-making and workflow needed to practice safely and effectively -to guide the development of an integrated rule-based knowledge module to support prescribing decisions in asthma. We identified workflows, decision-making factors, factor use, and clinician information requirements. The Unified Modeling Language (UML) and public domain software and knowledge engineering tools (e.g. Protégé) were used, with the Australian GP Data Model as the starting point for expressing information needs. A Web Services service-oriented ... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=145421 Mon, 14 Aug 2006 06:00:00 +0100 145421 http://www.medworm.com/index.php?rid=145420&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F12%2F3%2F187%3Frss%3D1 We examined the introduction of a computerized corollary order for aminoglycoside blood level monitoring. The study was divided into baseline (BP) and corollary order (CP) periods. In the CP, we implemented a workflow-integrated reminder to order blood levels and presented this to the clinician during each aminoglycoside ordering session. Appropriate laboratory monitoring was 128/159 (80.5%) courses in the BP and 146/177 (82.5%) courses in the CP. Thus introduction of the order did not significantly improve laboratory monitoring rates, nor did it result in a reduction in the rate of either toxic or subtherapeutic levels. However, aminoglycoside corollary orders may have an important role in institutio... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=145420 Mon, 14 Aug 2006 06:00:00 +0100 145420 http://www.medworm.com/index.php?rid=21527&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F12%2F2%2F165%3Frss%3D1 This paper presents findings from a study of information seeking behaviour by National Health Service patients which explored motivational triggers for infor- mation needs. Previous research has highlighted the importance of contextual elements in users' changing information needs. This paper highlights how those needs may centre on specific events: in particular, a patient's consultation with their doctor. Patients initiate information seeking to assess whether they need clinical intervention, in preparation for the patient–doctor consultation and to verify the diagnosis or treatment stemming from that consultation. The study has revealed that having confidence in health practitioners is one key motiva- tion for... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21527 Thu, 27 Apr 2006 06:00:00 +0100 21527 http://www.medworm.com/index.php?rid=21526&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F12%2F2%2F153%3Frss%3D1 This paper presents findings from observational studies of work practice in two ‘information giving’ services – a poisons information service and a mental health helpline – as a precursor to informing the design of such services. Our work high- lights the interactions that constitute the requesting and giving of information and the role of intermediaries in the delivery of recipient-designed information. We propose a shift of focus from the logic of information in system design to one that encompasses the practicalities of information giving. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21526 Thu, 27 Apr 2006 06:00:00 +0100 21526 http://www.medworm.com/index.php?rid=21525&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F12%2F2%2F137%3Frss%3D1 The National electronic Library of Infection (NeLI: http://www.neli.org.uk) in the UK is a freely available portal to key evidence and guidelines in the infectious disease field. This paper discusses 5 years of evaluation of the pilot library and how this evaluation informed design of the new library website. The importance of combining qualitative and quantitative evaluation is highlighted and the results of web access logs analysis, free text search query analysis and an online user survey are compared. The paper concludes with a discussion of lessons learned for future development and evaluation of this Internet digital library. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21525 Thu, 27 Apr 2006 06:00:00 +0100 21525 http://www.medworm.com/index.php?rid=21524&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F12%2F2%2F121%3Frss%3D1 In the health domain, there are many circumstances where clinicians (i.e. doctors, nurses, allied health professionals) and patients wish to track changes in medical knowledge. However, existing ‘news’ or ‘alert’ services provide relatively limited means for selecting which information to receive. The result is that clinicians and patients often receive information that is inappropriate, irrelevant or simply too much. In this paper, we detail alert-relevant findings from several international user studies (e.g. UK, Germany and New Zealand) incorporating both clinical staff (across several hospitals) and patients’ perceptions. These findings demonstrate the importance of context, in terms o... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21524 Thu, 27 Apr 2006 06:00:00 +0100 21524 http://www.medworm.com/index.php?rid=21523&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F12%2F2%2F107%3Frss%3D1 Healthcare digital libraries (DLs) increasingly make use of dedicated services to access functionality and/or data. Semantic (web) services enhance single services and facilitate compound services, thereby supporting advanced applications on top of a DL. The traditional process management approach tends to focus on process definition at build time rather than on actual service events in run time, and to anticipate failures in order to define appropriate strategies. This paper presents a novel approach where service coordination is distributed among a set of agents. A dedicated component plans compound semantic services on demand for a particular application. In failure, the planner is reinvoked to define contin- gency ... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21523 Thu, 27 Apr 2006 06:00:00 +0100 21523 http://www.medworm.com/index.php?rid=21522&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F12%2F2%2F93%3Frss%3D1 A digital archive, together with its users and its contents, does not exist in isolation; there is a cycle of activities which provides the context for the archive's existence. In arguing for the broadening of the traditional view of digital libraries as merely collections towards the processes of collecting and deploying, we have developed an extend ed digital library environment for orthopaedic surgeons which bridges the gap between the undertaking of experimental work and the dissemination of its results through electronic publication. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21522 Thu, 27 Apr 2006 06:00:00 +0100 21522 http://www.medworm.com/index.php?rid=21521&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Freprint%2F12%2F2%2F91%3Frss%3D1 (No abstract is available for this citation) (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21521 Thu, 27 Apr 2006 06:00:00 +0100 21521 http://www.medworm.com/index.php?rid=21534&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F12%2F1%2F81%3Frss%3D1 As the number of medical websites in various languages increases, it is increasingly necessary to establish specific criteria and control measures that give consumers some guarantee that the health websites they are visiting meet a minimum level of quality standards. Further, reassurance is needed that the professionals offering the information are suitably qualified. The paper briefly presents the current mechanisms for labelling medical web content and introduces the work done in the EC-funded project Quatro. This has defined a vocabulary for quality labels and a schema to deliver them in a machine-processable format. In addition, the paper proposes the development of a labelling platform that will ... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21534 Wed, 25 Jan 2006 07:00:00 +0100 21534 http://www.medworm.com/index.php?rid=21533&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F12%2F1%2F65%3Frss%3D1 The paper presents a spatial microsimulation approach to the analysis of health inequalities. A dynamic spatial microsimulation model of Britain, under development at the Universities of Leeds and Sheffield, uses data from the censuses of 1971, 1981 and 1991 and the British Household Panel Survey to simulate urban and regional populations in Britain. Geographical information systems and spatial microsimulation are used for the analysis of health inequalities in British regions in a 30 year simulation. The interdependencies between socio-economic characteristics and health variables such as limiting long-term illness are discussed. One of the innovative features of the model is the estimation of variab... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21533 Wed, 25 Jan 2006 07:00:00 +0100 21533 http://www.medworm.com/index.php?rid=21532&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F12%2F1%2F49%3Frss%3D1 Anecdotal evidence suggests that consultants have a low level of confidence in routinely collected clinical data. The aims of this study were to assess the actual levels of confidence in clinical information experienced by consultants and to understand the factors affecting confidence. A questionnaire was devised incorporating a scale to measure levels of confidence. This was disseminated to 506 consultants and achieved a 57 per cent response rate. The confidence scale showed good internal reliability and the influential factors were modelled using multilinear regression. Consultant specialty, increased involvement in clinical coding, and participation in service planning/monitoring all had a significant ... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21532 Wed, 25 Jan 2006 07:00:00 +0100 21532 http://www.medworm.com/index.php?rid=21531&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F12%2F1%2F41%3Frss%3D1 We describe the literature and discussions that led to the proposal of this new role, and offer a description of the steps being taken to further elaborate this career. In particular, we describe efforts at Johns Hopkins to train informationists and informaticists and to offer services that lead to the integration of these and other information professionals into clinical care, public health and research. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21531 Wed, 25 Jan 2006 07:00:00 +0100 21531 http://www.medworm.com/index.php?rid=21530&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F12%2F1%2F27%3Frss%3D1 This paper describes ongoing study that examines problems with existing patient health information sources and investigates an approach for linking (i.e. integrating) data from a patient’s medical record(s) with relevant health information on the web. The aim is to provide patients with simplified, customized and controlled access to web information. Data from patient medical records are extracted and linked with relevant health information on the web through a web search service. These are made available to patients through a web portal that we refer to as the patient knowledge base (PatientKB). Our integration approach utilizes term semantics (i.e. meaning) to enrich the web search and simplif... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21530 Wed, 25 Jan 2006 07:00:00 +0100 21530 http://www.medworm.com/index.php?rid=21529&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F12%2F1%2F13%3Frss%3D1 This article describes a project to develop a shared services information technology infrastructure across two district health boards in New Zealand. The study reveals valuable insight into the crisis issues that accompany change management and identifies emergent themes that can be used to reduce negative impact. (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21529 Wed, 25 Jan 2006 07:00:00 +0100 21529 http://www.medworm.com/index.php?rid=21528&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Freprint%2F12%2F1%2F5%3Frss%3D1 (No abstract is available for this citation) (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21528 Wed, 25 Jan 2006 07:00:00 +0100 21528 http://www.medworm.com/index.php?rid=128426&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Freprint%2F11%2F4%2F323%3Frss%3D1 (No abstract is available for this citation) (Source: Health Informatics Journal) Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=128426 Thu, 03 Nov 2005 07:00:00 +0100 128426 http://www.medworm.com/index.php?rid=21539&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F11%2F4%2F309%3Frss%3D1 Elderly healthcare is a likely arena for extensive change in years to come, and information and communication technology (ICT) will be an important enabler of such change. Before investing in new systems and practices, there will be a call for evaluations. To date, economic evaluations of ICT applications in healthcare have been rare, and a literature review did not turn up any examples of such evaluations of elderly care. The options for elderly care will often have to transcend organization boundaries, as the point of many ICT initiatives now being discussed is to make healthcare institutions, home care, and self-administered care interact in new ways. Analysts performing evaluations of such complex... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21539 Thu, 03 Nov 2005 07:00:00 +0100 21539