Using Health Information Technology to Support Evidence-Based Practice

2015 ◽  
Vol 12 (3) ◽  
pp. 129-130
Author(s):  
Dawn Dowding
Author(s):  
Catherine Han-Lin ◽  
Angela Wei Hong Yang ◽  
Siddhi Pittayachawan ◽  
Nilmini Wickramasinghe

Chinese Medicine (CM) has become increasingly demanding globally. Recent World Health Organisation traditional and complementary medicine strategy of integrating CM to Western Medicine (WM) indicates that it is crucial that CM developments have strong literature, scientific, and evidence-based medical approval and support. To achieve this, there is a need to form a synthesis foundation or platform for future studies. This chapter serves to discover this synthesis that is suitable for CM by discussing the basics of inquiring and Knowledge Management (KM) systems. It suggests that CM should follow a combination of Hegelian and Kantian inquiring systems with the support of Singerian and Leibnizian inquiring systems and KM features. This proposed synthesis is one of the first, if not the first study to apply Churchman's inquiring systems into the context of CM and differentiate them from WM.


2013 ◽  
Vol 22 (01) ◽  
pp. 20-27 ◽  
Author(s):  
A. Kushniruk ◽  
C. Nohr ◽  
H. Takeda ◽  
S. Kuwata ◽  
C. Carvalho ◽  
...  

Summary Objectives: Issues related to lack of system usability and potential safety hazards continue to be reported in the health information technology (HIT) literature. Usability engineering methods are increasingly used to ensure improved system usability and they are also beginning to be applied more widely for ensuring the safety of HIT applications. These methods are being used in the design and implementation of many HIT systems. In this paper we describe evidence- based approaches to applying usability engineering methods. Methods: A multi-phased approach to ensuring system usability and safety in healthcare is described. Usability inspection methods are first described including the development of evidence-based safety heuristics for HIT. Laboratory-based usability testing is then conducted under artificial conditions to test if a system has any base level usability problems that need to be corrected. Usability problems that are detected are corrected and then a new phase is initiated where the system is tested under more realistic conditions using clinical simulations. This phase may involve testing the system with simulated patients. Finally, an additional phase may be conducted, involving a naturalistic study of system use under real-world clinical conditions. Results: The methods described have been employed in the analysis of the usability and safety of a wide range of HIT applications, including electronic health record systems, decision support systems and consumer health applications. It has been found that at least usability inspection and usability testing should be applied prior to the widespread release of HIT. However, wherever possible, additional layers of testing involving clinical simulations and a naturalistic evaluation will likely detect usability and safety issues that may not otherwise be detected prior to widespread system release. Conclusion: The framework presented in the paper can be applied in order to develop more usable and safer HIT, based on multiple layers of evidence.


2019 ◽  
Author(s):  
Anastasia Mallidou ◽  
Dzifa Dordunoo ◽  
Elizabeth Borycki ◽  
Andre Kushniruk ◽  
Kirsten Sadeghi-Yekta ◽  
...  

BACKGROUND Evidence-based health policy (EBHP) development is critical to the judicious use of public funds. EBHPs increase transparency, accountability, effectiveness, and efficiency of policies. Encouraging collaboration between researchers or knowledge producers and policy makers is important because both communities have distinct professional cultures, resulting in them working separately without understanding each other. Knowledge sharing is a complex process that requires understanding of cultural aspects that may reduce cultural differences and increase the use of common language. Health information technology (HIT) is a useful tool to increase knowledge translation, which may result in the transparent use of evidence and networking in developing EBHPs. Our vision is to leverage HIT tools for a better health system that includes digitalized, open source, evidence-based, and transparent ways for collaboration and development of robust mechanisms and for sharing of synthesized evidence with knowledge user–friendly forms. OBJECTIVE The aim of this study is to develop a conceptual framework on Knowledge translation and health Information Technology for Transparency (KhITT) in policy making and EBHPs (ie, the KhITT framework). The framework will be informed by the views of four key stakeholder groups (ie, policy makers, knowledge producers, HIT professionals, and the public) toward EBHP. The informants may also describe practices that demonstrate the EBHP development process and suggest technology platforms to enable this process. METHODS We propose an exploratory, descriptive qualitative study to take place in British Columbia, Canada, using in-depth semistructured interviews. To ensure data saturation and trustworthiness, we will use a nonprobability, purposive snowball sample of up to 15 eligible participants in each of the four stakeholder groups. We will analyze the data using content analysis. RESULTS The KhITT framework focuses on various stakeholders’ perspectives to better understand their perceived needs and priorities in identifying issues with EBHP, in order to make informed recommendations. Ethics approval has been obtained by the harmonized Behavioural Research Ethics Board at the University of British Columbia. We anticipate that we will complete data collection and analysis by December 2020. Preliminary results will be published in summer 2021. CONCLUSIONS Our ultimate goal of this study is to develop a conceptual framework and describe the technology platforms that would enable the EBHP process. We anticipate that our rigorous content analysis will be able to produce insights and themes that are able to address our objectives, contribute to an in-depth understanding of the EBHP process within British Columbia, highlight all influential factors, explicitly disseminate and communicate the study results, identify issues with EBHP and provide informed recommendations to address them, and enhance efforts toward transparent EBHPs. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/16268


10.2196/16268 ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. e16268
Author(s):  
Anastasia Mallidou ◽  
Dzifa Dordunoo ◽  
Elizabeth Borycki ◽  
Andre Kushniruk ◽  
Kirsten Sadeghi-Yekta ◽  
...  

Background Evidence-based health policy (EBHP) development is critical to the judicious use of public funds. EBHPs increase transparency, accountability, effectiveness, and efficiency of policies. Encouraging collaboration between researchers or knowledge producers and policy makers is important because both communities have distinct professional cultures, resulting in them working separately without understanding each other. Knowledge sharing is a complex process that requires understanding of cultural aspects that may reduce cultural differences and increase the use of common language. Health information technology (HIT) is a useful tool to increase knowledge translation, which may result in the transparent use of evidence and networking in developing EBHPs. Our vision is to leverage HIT tools for a better health system that includes digitalized, open source, evidence-based, and transparent ways for collaboration and development of robust mechanisms and for sharing of synthesized evidence with knowledge user–friendly forms. Objective The aim of this study is to develop a conceptual framework on Knowledge translation and health Information Technology for Transparency (KhITT) in policy making and EBHPs (ie, the KhITT framework). The framework will be informed by the views of four key stakeholder groups (ie, policy makers, knowledge producers, HIT professionals, and the public) toward EBHP. The informants may also describe practices that demonstrate the EBHP development process and suggest technology platforms to enable this process. Methods We propose an exploratory, descriptive qualitative study to take place in British Columbia, Canada, using in-depth semistructured interviews. To ensure data saturation and trustworthiness, we will use a nonprobability, purposive snowball sample of up to 15 eligible participants in each of the four stakeholder groups. We will analyze the data using content analysis. Results The KhITT framework focuses on various stakeholders’ perspectives to better understand their perceived needs and priorities in identifying issues with EBHP, in order to make informed recommendations. Ethics approval has been obtained by the harmonized Behavioural Research Ethics Board at the University of British Columbia. We anticipate that we will complete data collection and analysis by December 2020. Preliminary results will be published in summer 2021. Conclusions Our ultimate goal of this study is to develop a conceptual framework and describe the technology platforms that would enable the EBHP process. We anticipate that our rigorous content analysis will be able to produce insights and themes that are able to address our objectives, contribute to an in-depth understanding of the EBHP process within British Columbia, highlight all influential factors, explicitly disseminate and communicate the study results, identify issues with EBHP and provide informed recommendations to address them, and enhance efforts toward transparent EBHPs. International Registered Report Identifier (IRRID) PRR1-10.2196/16268


2021 ◽  
Vol 3 ◽  
Author(s):  
Maura M. Kepper ◽  
Callie Walsh-Bailey ◽  
Ross C. Brownson ◽  
Bethany M. Kwan ◽  
Elaine H. Morrato ◽  
...  

Health information technology (HIT) has not been broadly adopted for use in outpatient healthcare settings to effectively address obesity in youth, especially among disadvantaged populations that face greater barriers to good health. A well-designed HIT tool can deliver behavior change recommendations and provide community resources to address this gap, and the Obesity-Related Behavioral Intervention Trials (ORBIT) model can guide its development and refinement. This article reports the application of the ORBIT model to (1) describe the characteristics and design of a novel HIT tool (the PREVENT tool) using behavioral theory, (2) illustrate the use of stakeholder-centered “designing for dissemination and sustainability” principles, and (3) discuss the practical implications and directions for future research. Two types of stakeholder engagement (customer discovery and user testing) were conducted with end users (outpatient healthcare teams). Customer discovery interviews (n = 20) informed PREVENT tool components and intervention targets by identifying (1) what healthcare teams (e.g., physicians, dietitians) identified as their most important “jobs to be done” in helping adolescents who are overweight/obese adopt healthy behaviors, (2) their most critical “pains” and “gains” related to overweight/obesity treatment, and (3) how they define success compared to competing alternatives. Interviews revealed the need for a tool to help healthcare teams efficiently deliver tailored, evidence-based behavior change recommendations, motivate patients, and follow-up with patients within the constraints of clinic schedules and workflows. The PREVENT tool was developed to meet these needs. It facilitates prevention discussions, delivers tailored, evidence-based recommendations for physical activity and food intake, includes an interactive map of community resources to support behavior change, and automates patient follow-up. Based on Self-Determination Theory, the PREVENT tool engages the patient to encourage competence and autonomy to motivate behavior change. The use of this intentional, user-centered design process should increase the likelihood of the intended outcomes (e.g., behavior change, weight stabilization/loss) and ultimately increase uptake, implementation success, and long-term results. After initial tool development, user-testing interviews (n = 13) were conducted using a think-aloud protocol that provided insight into users' (i.e., healthcare teams) cognitive processes, attitudes, and challenges when using the tool. Overall, the PREVENT tool was perceived to be useful, well-organized, and visually appealing.


Author(s):  
Catherine Han-Lin ◽  
Angela Wei Hong Yang ◽  
Siddhi Pittayachawan ◽  
Nilmini Wickramasinghe

Chinese Medicine (CM) has become increasingly demanding globally. Recent World Health Organisation traditional and complementary medicine strategy of integrating CM to Western Medicine (WM) indicates that it is crucial that CM developments have strong literature, scientific, and evidence-based medical approval and support. To achieve this, there is a need to form a synthesis foundation or platform for future studies. This chapter serves to discover this synthesis that is suitable for CM by discussing the basics of inquiring and Knowledge Management (KM) systems. It suggests that CM should follow a combination of Hegelian and Kantian inquiring systems with the support of Singerian and Leibnizian inquiring systems and KM features. This proposed synthesis is one of the first, if not the first study to apply Churchman's inquiring systems into the context of CM and differentiate them from WM.


Healthcare ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. 109 ◽  
Author(s):  
Stella Christopoulou ◽  
Theodore Kotsilieris ◽  
Ioannis Anagnostopoulos

Background: The application of Health Information Technologies (HITs) can be an effective way to advance medical research and health services provision. The two-fold objective of this work is to: (i) identify and review state-of-the-art HITs that facilitate the aims of evidence-based medicine and (ii) propose a methodology for HIT assessment. Methods: The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Furthermore, we consolidated existing knowledge in the field and proposed a Synthesis Framework for the Assessment of Health Information Technology (SF/HIT) in order to evaluate the joint use of Randomized Controlled Trials (RCTs) along with HITs in the field of evidence-based medicine. Results: 55 articles met the inclusion criteria and refer to 51 (RCTs) published between 2008 and 2016. Significant improvements in healthcare through the use of HITs were observed in the findings of 31 out of 51 trials—60.8%. We also confirmed that RCTs are valuable tools for assessing the effectiveness, acceptability, safety, privacy, appropriateness, satisfaction, performance, usefulness and adherence. Conclusions: To improve health service delivery, RCTs apply and exhibit formalization by providing measurable outputs. Towards this direction, we propose the SF/HIT as a framework which may help researchers to carry out appropriate evaluations and extend their studies.


2013 ◽  
Vol 22 (01) ◽  
pp. 04-06 ◽  
Author(s):  
B. Séroussi ◽  
M.-C. Jaulent ◽  
C.U. Lehmann

Summary Objectives: To provide an editorial introduction to the 2013 IMIA Yearbook of Medical Informatics with an overview of its contents and contributors. Methods: A brief overview of the main theme, and an outline of the purposes, contents, format, and acknowledgment of contributions. Results: Health information technology (HIT) is currently widely implemented to improve healthcare quality and patient safety while reducing costs. Although these benefits are expected and largely advertised, the evidence for these benefits is still missing. Unintended consequences are often reported and some applications have been shown to be wasteful, harmful, and even fatal. Evidence-based health informatics has been defined as “the conscientious, explicit and judicious use of current best evidence when making decisions about the introduction and operation of information technology in a given health care setting”. The 2013 issue of the IMIA Yearbook highlights important contributions about the significant challenges that arise from the assessment of HIT solutions. Progress towards evidence-based health informatics is identified to elicit what works, what doesn't work, and why. In an environment where resources are limited, budgets lower than in past years, and the need to improve care is becoming ever more pressing, focusing on this topic should guide institutions and providers in the implementation of the best health information technology. Conclusion: This overview of progress and current challenges across the spectrum of the discipline shows many great examples of evidence that have been gathered on the effectiveness of HIT. However, evidence remains limited and a significant work should be conducted to improve the development, testing, and implementation of HIT applications.


2018 ◽  
Vol 09 (04) ◽  
pp. 817-830 ◽  
Author(s):  
Pritma Dhillon-Chattha ◽  
Ruth McCorkle ◽  
Elizabeth Borycki

Background Electronic health records (EHRs) are transforming the way health care is delivered. They are central to improving the quality of patient care and have been attributed to making health care more accessible, reliable, and safe. However, in recent years, evidence suggests that specific features and functions of EHRs can introduce new, unanticipated patient safety concerns that can be mitigated by safe configuration practices. Objective This article outlines the development of a detailed and comprehensive evidence-based checklist of safe configuration practices for use by clinical informatics professionals when configuring hospital-based EHRs. Methods A literature review was conducted to synthesize evidence on safe configuration practices; data were analyzed to elicit themes of common EHR system capabilities. Two rounds of testing were completed with end users to inform checklist design and usability. This was followed by a four-member expert panel review, where each item was rated for clarity (clear, not clear), and importance (high, medium, low). Results An expert panel consisting of three clinical informatics professionals and one health information technology expert reviewed the checklist for clarity and importance. Medium and high importance ratings were considered affirmative responses. Of the 870 items contained in the original checklist, 535 (61.4%) received 100% affirmative agreement among all four panelists. Clinical panelists had a higher affirmative agreement rate of 75.5% (656 items). Upon detailed analysis, items with 100% clinician agreement were retained in the checklist with the exception of 47 items and the addition of 33 items, resulting in a total of 642 items in the final checklist. Conclusion Safe implementation of EHRs requires consideration of both technical and sociotechnical factors through close collaboration of health information technology and clinical informatics professionals. The recommended practices described in this checklist provide systems implementation guidance that should be considered when EHRs are being configured, implemented, audited, or updated, to improve system safety and usability.


2009 ◽  
Vol 38 (3) ◽  
pp. 26-37 ◽  
Author(s):  
Aziz Jamal ◽  
Kirsten McKenzie ◽  
Michele Clark

The aim of this study was to systematically review the published evidence of the impact of health information technology (HIT) or health information systems (HIS) on the quality of healthcare, focusing on clinicians' adherence to evidence-based guidelines and the corresponding impact this had on patient clinical outcomes. The review covered the use of health information technologies and systems in both medical care (i.e. clinical and surgical) and other areas such as allied health and preventive services. Studies were included in the review if they examined the impact of Electronic Health Record (EHR), Computerised Provider Order-Entry (CPOE), or Decision Support System (DS); and if the primary outcomes of the studies were focused on the level of compliance with evidence-based guidelines among clinicians. Measurements considered relevant to the review were either of changes in clinical processes resulting from a change of the providers' behaviour, or of specific patient outcomes that demonstrated the effectiveness of a particular treatment given by providers. Of 23 studies included in the current review, 17 assessed the impact of HIT/HIS on health care practitioners' performance. A positive improvement, in relation to their compliance with evidence-based guidelines, was seen in 14 studies. Studies that included an assessment of patient outcomes, however, showed insufficient evidence of either clinically or statistically important improvements. Although the number of studies reviewed was relatively small, the findings demonstrated consistency with similar previous reviews of this nature in that wide scale use of HIT has been shown to increase clinician's adherence to guidelines.


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