scholarly journals Nurturing the digital baby: Open innovation for development and optimization

2020 ◽  
Vol 26 (4) ◽  
pp. 2407-2421
Author(s):  
Brendan Paul Murphy ◽  
Paidi O’Raghallaigh ◽  
Michelle Carr
Keyword(s):  
Information System ◽  
Action Research ◽  
Electronic Health Record ◽  
Design Research ◽  
System Development ◽  
Research Approach ◽  
Health Record ◽  
Information System Development ◽  
Action Research Approach ◽  
Electronic Health

The primary aim around developing and optimizing an electronic health record is to improve patient care and population health. The objective of this study is to design and evaluate an action research approach for the optimization of the design of a summary page artefact within an electronic health record for newborn healthcare. An action research approach was chosen for its participatory democratic process for developing practical knowledge and solutions. Collaborative workshops lead by an independent graphic facilitator with a ‘bottom up’ approach, involving self-selected motivated members from multidisciplinary healthcare teams, were designed and conducted. To evaluate this approach, insights were drawn from behavioural and design science paradigms to demonstrate that knowledge and understanding of the design problem and its solution were acquired in building the optimized summary page artefact. Information system development for healthcare requires consideration not just of what we do but how and why we do things. Our analysis demonstrates that action design research represents an agile and lean approach for successful optimization and implementation of information system development in healthcare.

scholarly journals Tensions in Representing Behavioral Data in an Electronic Health Record

2021 ◽  
Author(s):  
Gabriela Marcu ◽  
Anind K. Dey ◽  
Sara Kiesler
Keyword(s):  
Electronic Health Record ◽  
Behavioral Health Care ◽  
Behavioral Data ◽  
Research Approach ◽  
Prototype System ◽  
Health Record ◽  
Record Keeping ◽  
Action Research Approach ◽  
Electronic Health ◽  
The Moment

AbstractTaking an action research approach, we engaged in fieldwork with school-based behavioral health care teams to: observe record keeping practices, design and deploy a prototype system addressing key challenges, and reflect on its use. We describe the challenges of capturing behavioral data using both paper and electronic records. Creating records of behaviors requires direct observation, and as a result the record keeping responsibility is challenging to distribute across a care team. Behavioral data on paper must be transferred and prepared for reporting, both inside the organization and to stakeholders outside of the organization. In prototyping a computerized working record, we targeted user needs for capturing details of a behavioral incident in the moment. Challenges persisted through the transition from paper to our prototype, and based on these empirical findings over two years of fieldwork, we present five tensions in representing behavioral data in an electronic health record. These tensions reflect the differences between entering behavioral data into the record for intraorganizational use versus interorganizational use.

An integrated electronic health record and information system for Australia?

2000 ◽  
Vol 172 (1) ◽  
pp. 25-27 ◽  
Author(s):  
Christopher D Mount ◽  
Christopher W Kelman ◽  
Leonard R Smith ◽  
Robert M Douglas
Keyword(s):  
Information System ◽  
Electronic Health Record ◽  
Health Record ◽  
Electronic Health

scholarly journals Creation and Use of an Electronic Health Record Reporting Database to Improve a Laboratory Test Utilization Program

2018 ◽  
Vol 09 (03) ◽  
pp. 519-527 ◽  
Author(s):  
Danielle Kurant ◽  
Jason Baron ◽  
Genti Strazimiri ◽  
Kent Lewandrowski ◽  
Joseph Rudolf ◽  
...  
Keyword(s):  
Information System ◽  
Laboratory Test ◽  
Electronic Health Record ◽  
Health Care Systems ◽  
Management Program ◽  
Health Record ◽  
Laboratory Information System ◽  
Utilization Management ◽  
Laboratory Utilization ◽  
Electronic Health

Objectives Laboratory-based utilization management programs typically rely primarily on data derived from the laboratory information system to analyze testing volumes for trends and utilization concerns. We wished to examine the ability of an electronic health record (EHR) laboratory orders database to improve a laboratory utilization program. Methods We obtained a daily file from our EHR containing data related to laboratory test ordering. We then used an automated process to import this file into a database to facilitate self-service queries and analysis. Results The EHR laboratory orders database has proven to be an important addition to our utilization management program. We provide three representative examples of how the EHR laboratory orders database has been used to address common utilization issues. We demonstrate that analysis of EHR laboratory orders data has been able to provide unique insights that cannot be obtained by review of laboratory information system data alone. Further, we provide recommendations on key EHR data fields of importance to laboratory utilization efforts. Conclusion We demonstrate that an EHR laboratory orders database may be a useful tool in the monitoring and optimization of laboratory testing. We recommend that health care systems develop and maintain a database of EHR laboratory orders data and integrate this data with their laboratory utilization programs.

scholarly journals The Benefits and Challenges of an Interfaced Electronic Health Record and Laboratory Information System: Effects on Laboratory Processes

2017 ◽  
Vol 141 (3) ◽  
pp. 410-417 ◽  
Author(s):  
Athena K. Petrides ◽  
Ida Bixho ◽  
Ellen M. Goonan ◽  
David W. Bates ◽  
Shimon Shaykevich ◽  
...  
Keyword(s):  
Information System ◽  
Electronic Health Record ◽  
Government Regulation ◽  
Turnaround Time ◽  
Health Record ◽  
Laboratory Information System ◽  
Before And After ◽  
Electronic Health ◽  
Ordered Data ◽  
The Impact

Context.— A recent government regulation incentivizes implementation of an electronic health record (EHR) with computerized order entry and structured results display. Many institutions have also chosen to interface their EHR with their laboratory information system (LIS). Objective.— To determine the impact of an interfaced EHR-LIS on laboratory processes. Design.— We analyzed several different processes before and after implementation of an interfaced EHR-LIS: the turnaround time, the number of stat specimens received, venipunctures per patient per day, preanalytic errors in phlebotomy, the number of add-on tests using a new electronic process, and the number of wrong test codes ordered. Data were gathered through the LIS and/or EHR. Results.— The turnaround time for potassium and hematocrit decreased significantly (P = .047 and P = .004, respectively). The number of stat orders also decreased significantly, from 40% to 7% for potassium and hematocrit, respectively (P < .001 for both). Even though the average number of inpatient venipunctures per day increased from 1.38 to 1.62 (P < .001), the average number of preanalytic errors per month decreased from 2.24 to 0.16 per 1000 specimens (P < .001). Overall there was a 16% increase in add-on tests. The number of wrong test codes ordered was high and it was challenging for providers to correctly order some common tests. Conclusions.— An interfaced EHR-LIS significantly improved within-laboratory turnaround time and decreased stat requests and preanalytic phlebotomy errors. Despite increasing the number of add-on requests, an electronic add-on process increased efficiency and improved provider satisfaction. Laboratories implementing an interfaced EHR-LIS should be cautious of its effects on test ordering and patient venipunctures per day.

scholarly journals Overcoming barriers to implementing patient-reported outcomes in an electronic health record: a case report

2015 ◽  
Vol 23 (1) ◽  
pp. 74-79 ◽  
Author(s):  
Christopher A Harle ◽  
Alyson Listhaus ◽  
Constanza M Covarrubias ◽  
Siegfried OF Schmidt ◽  
Sean Mackey ◽  
...  
Keyword(s):  
Case Report ◽  
Electronic Health Record ◽  
Patient Reported Outcomes ◽  
System Development ◽  
Lessons Learned ◽  
Health Record ◽  
Patient Reported ◽  
Electronic Health ◽  
Clinical Tools ◽  
The Right

Abstract In this case report, the authors describe the implementation of a system for collecting patient-reported outcomes and integrating results in an electronic health record. The objective was to identify lessons learned in overcoming barriers to collecting and integrating patient-reported outcomes in an electronic health record. The authors analyzed qualitative data in 42 documents collected from system development meetings, written feedback from users, and clinical observations with practice staff, providers, and patients. Guided by the Unified Theory on the Adoption and Use of Information Technology, 5 emergent themes were identified. Two barriers emerged: (i) uncertain clinical benefit and (ii) time, work flow, and effort constraints. Three facilitators emerged: (iii) process automation, (iv) usable system interfaces, and (v) collecting patient-reported outcomes for the right patient at the right time. For electronic health record-integrated patient-reported outcomes to succeed as useful clinical tools, system designers must ensure the clinical relevance of the information being collected while minimizing provider, staff, and patient burden.

scholarly journals Users As Developers In Information System Projects

1970 ◽  
Vol 1 (3) ◽  
Author(s):  
Raija Halonen
Keyword(s):  
Information System ◽  
System Development ◽  
Research Approach ◽  
Development Projects ◽  
Working Process ◽  
Information System Development ◽  
Flexible Working ◽  
System Project ◽  
Empirical Material

Users have been described as necessary experts in information system developments. This research introduces a viewpoint that the users are the main actors in development projects and the other participants only give their experience for the use of the actual developers. In addition to the strong involvement of users, our research emphasises the special nature of the information system project with earlier-made specifications. This article suggests that in order to achieve a successful output, a reflective and flexible working process is needed. This suggestion is valid especially in a case that is out of the line of common approaches that are described in the literature. The research approach in this study was qualitative and the empirical material was gathered from a case study. The approach was subjective and it necessitated interpretation when analysing the results. The case included an information system development that was carried out to produce an inter-organisational information system to support certain functionality between organisations. Despite the output was an information system, we argue that the approach with active users is also applicable in the development of any other artefact.

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