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. Sun, 07 Feb 2010 14:33:11 +0100 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 http://www.medworm.com/index.php?rid=21538&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F11%2F4%2F295%3Frss%3D1 Analysis of human genetic data promises to uncover important disease targets. Genes known to cause or increase susceptibility for various diseases are being identified through analysis of genetic data, expression and metabolites. Future benefits to individuals are far-reaching, including improved gene therapy strategies, better drug development for disease treatment, pre-symptomatic disease intervention and risk susceptibility information. The rapid expansion of genetic databases has resulted in the emerging areas of genomics, transcriptomics, proteomics and metabolomics. The article presents a comprehensive overview of Internet databases, their trends over time and what 'omics' type they embody. With... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21538 Thu, 03 Nov 2005 07:00:00 +0100 21538 http://www.medworm.com/index.php?rid=21537&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F11%2F4%2F275%3Frss%3D1 Communication and information technologies can reduce the barriers of distance and space that disadvantage communities in Australia's underserved rural areas, where the health status of residents is often worse than that of their urban counterparts. ACROSSnet (Australians Creating Rural Online Support Systems) is a 3 year collaborative action research project that aims to design and develop an online support system that will assist rural communities in accessing information, education and support regarding suicide and its prevention, whilst considering the challenges of Internet speed, cost and availability that can impede the delivery of online services. The site provides three distinct levels of acc... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21537 Thu, 03 Nov 2005 07:00:00 +0100 21537 http://www.medworm.com/index.php?rid=21536&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F11%2F4%2F259%3Frss%3D1 This article looks at the operationalization of race and ethnicity concepts in medical classification systems, notably the main bibliographical databases of MEDLINE and EMBASE. In particular, an attempt is made to assess recent changes, including the impact of the 2004 major changes to the MeSH headings for race and ethnic groups, and the introduction of 'Continental Population Groups'. The underlying conceptual basis of the typologies, their relevance for capturing specific population groups, and their overall usefulness in appraising the literature on ethnic/racial disparities in health are examined. The bibliographical database thesauri reveal the pervasiveness of the notion of the biological basis... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21536 Thu, 03 Nov 2005 07:00:00 +0100 21536 http://www.medworm.com/index.php?rid=21535&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F11%2F4%2F243%3Frss%3D1 A symptom management system was developed and implemented on personal digital assistants (PDAs) for use by cancer outpatients in their daily management of chemotherapy symptoms. The system allowed patients to record their symptoms at home and send these data to their cancer centre. Patients could view personalized self-care advice and more general medical information. In addition, cancer care nurses were alerted about significantly high symptom scores and could contact the patient by phone. The system was distributed to a group of patients during two of their chemotherapy cycles. Patient interaction with the system was logged, and both patients and cancer nurses were surveyed via questionnaires and in... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21535 Thu, 03 Nov 2005 07:00:00 +0100 21535 http://www.medworm.com/index.php?rid=21544&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F11%2F3%2F225%3Frss%3D1 A survey of nurses attending a Weekend Immersion in Nursing Informatics (WINI) program showed a statistically significant change in the nurses’ perception of information technology (IT) and of their ability to apply IT to affect the quality of patient care. Attendees first identified their level of expertise based on the Informatics Competencies for Nurses at Four Levels of Nursing Practice, and then completed surveys pre- and postprogram attendance to measure their personal assessments of their knowledge and abilities in specific areas of nursing informatics, information technology, and healthcare information systems. Such personal assessments are mandated in the professional standards of nursi... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21544 Tue, 09 Aug 2005 06:00:00 +0100 21544 http://www.medworm.com/index.php?rid=21543&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F11%2F3%2F211%3Frss%3D1 Disparities that exist for racial and ethnic minority groups in healthcare status and access are compounded in the presence of Alzheimer’s disease (AD). Recent improvements in the diagnosis and care of persons with AD need to be paralleled in minority communities with early recognition and timely evaluation. Innovative information technologies can help reduce health disparities. A qualitative study was conducted with 48 participants: to understand how cultural values influence responses to signs of memory loss and to critique a CD-ROM memory loss educational program for the purpose of tailoring it to better meet the needs and preferences of African American and Chinese American users. Traditions... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21543 Tue, 09 Aug 2005 06:00:00 +0100 21543 http://www.medworm.com/index.php?rid=21542&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F11%2F3%2F201%3Frss%3D1 Between 1998 and 2003 a number of European countries, the UK, Canada, Australia and the US all introduced data privacy legislation that sought to comply with the European Data Privacy Directive of 1995 in protecting the privacy of individuals undergoing treatment in large hospitals. In 2004 we find that hospital administrators within these jurisdictions are still struggling to find ways to implement and maintain hospital databases while complying with the given legislation - where compliance seems to require a whole new approach to database management. This research examines the UK Data Protection Act 1998 and considers whether current database management systems allow the EU Directives contained in t... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21542 Tue, 09 Aug 2005 06:00:00 +0100 21542 http://www.medworm.com/index.php?rid=21541&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F11%2F3%2F179%3Frss%3D1 The effects of electronic appointment booking systems on the time management activities of health professionals have received little attention to date. We report on time management practices in three outpatient physiotherapy departments with different paper and electronic systems. The study has identified a set of time management activities and associated social behaviours common to physiotherapy departments. The convenience, flexibility and expressive nature of paper diary systems is of significant value to users, whilst the clarity and superior database functionality of electronic systems are valued by staff using this medium. The study highlights several potential barriers to the effective deployme... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21541 Tue, 09 Aug 2005 06:00:00 +0100 21541 http://www.medworm.com/index.php?rid=21540&cid=s_32979_21_f&fid=32979&url=http%3A%2F%2Fjhi.sagepub.com%2Fcgi%2Fcontent%2Fabstract%2F11%2F3%2F163%3Frss%3D1 This article highlights how a screen saver application, initially designed to increase privacy and security, developed into a new communication medium improving corporate communication across the organization. An ethnographic study of the application within a hospital setting, analysed using grounded theory methods, details the iterative and organic development of the design through ‘community of practice’ involvement. This application and the evolutionary process through which it was developed were found to not only increase awareness of resources, activities and hospital changes but also positively influence users’ perceptions of, involvement in and ownership of general IT developm... Health Informatics Journal journals http://www.medworm.com/rss/comments.php?id=21540 Tue, 09 Aug 2005 06:00:00 +0100 21540