Depression screening for prescribed medications with mental health risk: Considerations for clinical decision support, workflow redesign, and health information exchange arrangements

2017 ◽  
Vol 13 (3) ◽  
pp. 485-493
Author(s):  
Michael J. Miller ◽  
Craig F. Burns ◽  
Joan Kapusnik-Uner ◽  
Roberto Carreno ◽  
Karl A. Matuszewski
Keyword(s):  
Mental Health ◽  
Decision Support ◽  
Health Risk ◽  
Health Information ◽  
Clinical Decision Support ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Clinical Decision ◽  
Depression Screening

scholarly journals IT-Enabled Clinical Decision Support: An Empirical Study on Antecedents and Mechanisms

2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Rogier van de Wetering
Keyword(s):  
Clinical Practice ◽  
Decision Support ◽  
Health Information ◽  
Clinical Decision Support ◽  
Information Exchange ◽  
Large Scale ◽  
Health Information Exchange ◽  
Clinical Decision ◽  
Future Research ◽  
Cross Sectional

Modern hospitals increasingly make use of innovations and information technology (IT) to improve workflow and patient’s clinical journey. Typical innovative solutions include patient records and clinical decision support systems to enhance the process of decision making by doctors and other healthcare practitioners. However, currently, it remains unclear how hospitals could facilitate and enable such a decision support capability in clinical practice. We ground our work on the resource-based view of the firm and put forth the notion of IT-enabled capabilities which emphasizes critical IT investment and capability development areas that hospitals could exploit in their quest to improve clinical decision support. We develop a research model that explains how “health information exchange” and enhanced “information capability” collectively drive a hospital’s “clinical decision support capability.” We used partial least squares path modeling on large-scale cross-sectional data from 720 European hospitals. Outcomes suggest that health information exchange positively impacts information capability. In turn, information capability complementary partially mediates the relationship between information exchange and clinical decision support. Hence, this research contributes to the literature on clinical decision support and provides valuable insights into how to support such innovative technologies and capabilities in clinical practice. We conclude with a discussion and conclusion. Also, we outline the inherent limitations of this study and outline directions for future research.

scholarly journals Clinical Information Systems – Seen through the Ethics Lens

2020 ◽  
Vol 29 (01) ◽  
pp. 104-114
Author(s):  
Ursula H. Hübner ◽  
Nicole Egbert ◽  
Georg Schulte
Keyword(s):  
Information Systems ◽  
Health Information ◽  
Information Exchange ◽  
Ethics Education ◽  
Health Information Exchange ◽  
Evaluation Studies ◽  
Clinical Information ◽  
Clinical Decision ◽  
Clinical Information Systems ◽  
Smart Systems

Objective: The more people there are who use clinical information systems (CIS) beyond their traditional intramural confines, the more promising the benefits are, and the more daunting the risks will be. This review thus explores the areas of ethical debates prompted by CIS conceptualized as smart systems reaching out to patients and citizens. Furthermore, it investigates the ethical competencies and education needed to use these systems appropriately. Methods: A literature review covering ethics topics in combination with clinical and health information systems, clinical decision support, health information exchange, and various mobile devices and media was performed searching the MEDLINE database for articles from 2016 to 2019 with a focus on 2018 and 2019. A second search combined these keywords with education. Results: By far, most of the discourses were dominated by privacy, confidentiality, and informed consent issues. Intertwined with confidentiality and clear boundaries, the provider-patient relationship has gained much attention. The opacity of algorithms and the lack of explicability of the results pose a further challenge. The necessity of sociotechnical ethics education was underpinned in many studies including advocating education for providers and patients alike. However, only a few publications expanded on ethical competencies. In the publications found, empirical research designs were employed to capture the stakeholders’ attitudes, but not to evaluate specific implementations. Conclusion: Despite the broad discourses, ethical values have not yet found their firm place in empirically rigorous health technology evaluation studies. Similarly, sociotechnical ethics competencies obviously need detailed specifications. These two gaps set the stage for further research at the junction of clinical information systems and ethics.

scholarly journals Exploring the role of the Care and Health Information Exchange (CHIE) in clinical decision-making: a realist evaluation

2020 ◽  
Author(s):  
Philip Scott ◽  
Elisavet Andrikopoulou ◽  
Haythem Nakkas ◽  
Paul Roderick
Keyword(s):  
Decision Making ◽  
Health Information ◽  
Information Exchange ◽  
Healthcare Professionals ◽  
Clinical Decision Making ◽  
Social Care ◽  
Health Information Exchange ◽  
Clinical Decision ◽  
Health And Social Care ◽  
The Impact

Background: The overall evidence for the impact of electronic information systems on cost, quality and safety of healthcare remains contested. Whilst it seems intuitively obvious that having more data about a patient will improve care, the mechanisms by which information availability is translated into better decision-making are not well understood. Furthermore, there is the risk of data overload creating a negative outcome. There are situations where a key information summary can be more useful than a rich record. The Care and Health Information Exchange (CHIE) is a shared electronic health record for Hampshire and the Isle of Wight that combines key information from hospital, general practice, community care and social services. Its purpose is to provide clinical and care professionals with complete, accurate and up-to-date information when caring for patients. CHIE is used by GP out-of-hours services, acute hospital doctors, ambulance service, GPs and others in caring for patients. Research questions: The fundamental question was How does awareness of CHIE or usage of CHIE affect clinical decision-making? The secondary questions were What are the latent benefits of CHIE in frontline NHS operations? and What is the potential of CHIE to have an impact on major NHS cost pressures? The NHS funders decided to focus on acute medical inpatient admissions as the initial scope, given the high costs associated with hospital stays and the patient complexities (and therefore information requirements) often associated with unscheduled admissions. Methods: Semi-structured interviews with healthcare professionals to explore their experience about the utility of CHIE in their clinical scenario, whether and how it has affected their decision-making practices and the barriers and facilitators for their use of CHIE. The Framework Method was used for qualitative analysis, supported by the software tool Atlas.ti. Results: 21 healthcare professionals were interviewed. Three main functions were identified as useful: extensive medication prescribing history, information sharing between primary, secondary and social care and access to laboratory test results. We inferred two positive cognitive mechanisms: knowledge confidence and collaboration assurance, and three negative ones: consent anxiety, search anxiety and data mistrust. Conclusions: CHIE gives clinicians the bigger picture to understand the patient's health and social care history and circumstances so as to make confident and informed decisions. CHIE is very beneficial for medicines reconciliation on admission, especially for patients that are unable to speak or act for themselves or who cannot remember their precise medication or allergies. We found no clear evidence that CHIE has a significant impact on admission or discharge decisions. We propose the use of recommender systems to help clinicians navigate such large volumes of patient data, which will only grow as additional data is collected.

Mental Health Clinical Decision Support Exploiting Big Data

2019 ◽  
pp. 160-184 ◽  
Author(s):  
Jan Kalina
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Big Data ◽  
Decision Support ◽  
Decision Support Systems ◽  
Clinical Decision Support ◽  
Clinical Decision Making ◽  
Support Systems ◽  
Clinical Decision Support Systems ◽  
Clinical Decision

The complexity of clinical decision-making is immensely increasing with the advent of big data with a clinical relevance. Clinical decision systems represent useful e-health tools applicable to various tasks within the clinical decision-making process. This chapter is devoted to basic principles of clinical decision support systems and their benefits for healthcare and patient safety. Big data is crucial input for clinical decision support systems and is helpful in the task to find the diagnosis, prognosis, and therapy. Statistical challenges of analyzing big data in psychiatry are overviewed, with a particular interest for psychiatry. Various barriers preventing telemedicine tools from expanding to the field of mental health are discussed. The development of decision support systems is claimed here to play a key role in the development of information-based medicine, particularly in psychiatry. Information technology will be ultimately able to combine various information sources including big data to present and enforce a holistic information-based approach to psychiatric care.

scholarly journals Informatics and interaction: Applying human factors principles to optimize the design of clinical decision support for sepsis

2019 ◽  
Vol 26 (1) ◽  
pp. 642-651
Author(s):  
Laura Schubel ◽  
Danielle L Mosby ◽  
Joseph Blumenthal ◽  
Muge Capan ◽  
Ryan Arnold ◽  
...  
Keyword(s):  
Information Technology ◽  
Decision Support ◽  
Human Factors ◽  
Organ Failure ◽  
Health Information Technology ◽  
Health Information ◽  
Clinical Decision Support ◽  
Clinical Care ◽  
Clinical Decision ◽  
Wide Range

In caring for patients with sepsis, the current structure of electronic health record systems allows clinical providers access to raw patient data without imputation of its significance. There are a wide range of sepsis alerts in clinical care that act as clinical decision support tools to assist in early recognition of sepsis; however, there are serious shortcomings in existing health information technology for alerting providers in a meaningful way. Little work has been done to evaluate and assess existing alerts using implementation and process outcomes associated with health information technology displays, specifically evaluating clinician preference and performance. We developed graphical model displays of two popular sepsis scoring systems, quick Sepsis Related Organ Failure Assessment and Predisposition, Infection, Response, Organ Failure, using human factors principles grounded in user-centered and interaction design. Models will be evaluated in a larger research effort to optimize alert design to improve the collective awareness of high-risk populations and develop a relevant point-of-care clinical decision support system for sepsis.

scholarly journals State of the Art in Clinical Informatics: Evidence and Examples

2013 ◽  
Vol 22 (01) ◽  
pp. 13-19 ◽  
Author(s):  
A. B. McCoy ◽  
A. Wright ◽  
G. Eysenbach ◽  
B. A. Malin ◽  
E. S. Patterson ◽  
...  
Keyword(s):  
Health Information ◽  
Language Processing ◽  
Information Exchange ◽  
Health Informatics ◽  
Health Information Exchange ◽  
Clinical Decision ◽  
The United States ◽  
Clinical Informatics ◽  
Privacy And Security ◽  
Health Records

Summary Objective: The field of clinical informatics has expanded substantially in the six decades since its inception. Early research focused on simple demonstrations that health information technology (HIT) such as electronic health records (EHRs), computerized provider order entry (CPOE), and clinical decision support (CDS) systems were feasible and potentially beneficial in clinical practice. Methods: In this review, we present recent evidence on clinical informatics in the United States covering three themes: 1) clinical informatics systems and interventions for providers, including EHRs, CPOE, CDS, and health information exchange; 2) consumer health informatics systems, including personal health records and web-based and mobile HIT; and 3) methods and governance for clinical informatics, including EHR usability; data mining, text mining, natural language processing, privacy, and security. Results: Substantial progress has been made in demonstrating that various clinical informatics methodologies and applications improve the structure, process, and outcomes of various facets of the healthcare system. Conclusion: Over the coming years, much more will be expected from the field. As we move past the “early adopters” in Rogers' diffusion of innovations' curve through the “early majority” and into the “late majority,” there will be a crucial need for new research methodologies and clinical applications that have been rigorously demonstrated to work (i.e., to improve health outcomes) in multiple settings with different types of patients and clinicians.

Sign in / Sign up

Export Citation Format

Share Document