Voice Capture of Medical Residents' Clinical Information Needs During an Inpatient Rotation

This chapter presents results and experiences from the MOBEL (MOBile ELectronic patient record) project at the Norwegian University of Science and Technology (NTNU) in Trondheim, Norway. MOBEL was a multidisciplinary research project established in 2000. The problem area of the project was communication and information needs in hospital wards, and the aim of the project was to develop and explore methods and prototypes for point of care clinical information systems (PoCCS) that support clinicians in their patient-centered activities. The chapter summarizes four sub studies performed during the project. Each study presents different approaches to user-centered design of PoCCS. Findings from these studies confirm the need for mobile information and communication technology (ICT) in hospitals. Furthermore, the studies demonstrate how more user involvement and complementary approaches to traditional requirements engineering (RE) and system development methods can be useful when developing mobile information and communication systems for clinicians.

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The MOBEL Project

Handbook of Research on Advances in Health Informatics and Electronic Healthcare Applications ◽

10.4018/978-1-60566-030-1.ch004 ◽

2010 ◽

pp. 52-73

Author(s):

Inger Dybdahl Sorby ◽

Line Melby ◽

Yngve Dahl ◽

Gry Seland

Keyword(s):

Communication Systems ◽

Information Needs ◽

System Development ◽

Point Of Care ◽

User Involvement ◽

Clinical Information ◽

Problem Area ◽

Patient Centered ◽

Mobile Information ◽

Information And Communication

This chapter presents results and experiences from the MOBEL (MOBile ELectronic patient record) project at the Norwegian University of Science and Technology (NTNU) in Trondheim, Norway. MOBEL was a multidisciplinary research project established in 2000. The problem area of the project was communication and information needs in hospital wards, and the aim of the project was to develop and explore methods and prototypes for point of care clinical information systems (PoCCS) that support clinicians in their patient-centered activities. The chapter summarizes four sub studies performed during the project. Each study presents different approaches to user-centered design of PoCCS. Findings from these studies confirm the need for mobile information and communication technology (ICT) in hospitals. Furthermore, the studies demonstrate how more user involvement and complementary approaches to traditional requirements engineering (RE) and system development methods can be useful when developing mobile information and communication systems for clinicians.

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Using spaced education to deliver clinical information to medical residents: A mixed methods pilot study

Education for Information ◽

10.3233/efi-190339 ◽

2020 ◽

Vol 36 (1) ◽

pp. 29-50

Author(s):

Maria Kluchnyk ◽

Roland Grad ◽

Pierre Pluye ◽

Aliki Thomas

Keyword(s):

Mixed Methods ◽

Pilot Study ◽

Clinical Information ◽

Medical Residents ◽

Spaced Education

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Understanding Public Health Informatics in Context of Health in Low and Middle-Income Countries

10.1093/med/9780198758778.003.0002 ◽

2017 ◽

Author(s):

Sundeep Sahay ◽

T Sundararaman ◽

Jørn Braa

Keyword(s):

Public Health ◽

Health Systems ◽

Health Informatics ◽

Information Needs ◽

Clinical Information ◽

Population Based ◽

Public Health Informatics ◽

Middle Income ◽

Context Specific ◽

Health Programmes

This chapter places public health informatics within a public health context. An understanding of PHI must be built on the perspective of public health as the health of populations. In LMICs it is closely related to an understanding of the primary healthcare approach, and the role and functions of public health systems, including the measurement of health status and equity, the effective coverage of different health programmes, and the utilization of different health services. This requires an understanding of the social and environmental determinants of healthcare, which need relevant data from other sectors as well. The architecture and development of public health informatics varies across nations and is path-dependent and context-specific. Many have evolved as monitoring support to externally financed vertical programmes, some as support for comprehensive primary health programmes and some from support systems for health insurance. The current information needs of health systems, transcends their respective origins, and requires both individual-based clinical information and aggregate population-based data.

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Clinical information needs and access in primary health care: a comparative cross-sectional study of rural and non-rural primary care physicians

Health Information & Libraries Journal ◽

10.1111/hir.12121 ◽

2015 ◽

Vol 32 (4) ◽

pp. 287-299 ◽

Cited By ~ 10

Author(s):

Salman Bin Naeem ◽

Rubina Bhatti

Keyword(s):

Primary Care ◽

Health Care ◽

Primary Care Physicians ◽

Information Needs ◽

Clinical Information ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Rural Primary Care ◽

Primary Health

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Searching for Answers on a Clinical Information System

Methods of Information in Medicine ◽

10.1055/s-0038-1634587 ◽

1995 ◽

Vol 34 (01/02) ◽

pp. 79-84 ◽

Cited By ~ 1

Author(s):

C. Safran

Keyword(s):

Information Systems ◽

Hiv Infection ◽

Information Needs ◽

Electronic Mail ◽

Clinical Medicine ◽

Clinical Information System ◽

Clinical Information ◽

Computing System ◽

Medical Visits ◽

Order Of Magnitude

Abstract:We examined observational data on the use of a clinical computing system in an effort to develop an empirical model of clinicians’ information needs. Clinicians turn to information systems most often to review the results of diagnostic studies. After that clinicians turn to information systems most often for communication. Bibliographic retrieval is the third most frequent reason for use, but is an order of magnitude less frequent than either results inquiry or electronic mail. Secondary retrieval of aggregate data from a clinical database is two orders of magnitude less common than primary retrieval. In a study at our hospital, clinicians gained access to an information resource during 16% of all general medical visits of patients with human immunodeficiency virus (HIV) infection while the patient was present. Insofar as our narrow focus on the primary care of HIV infection models the larger context of clinical medicine, clinicians are most often looking at information relating to therapeutics. Whatever knowledge structures are adopted, they must accommodate this observed need for therapeutic information.

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Information needs for the OR and PACU electronic medical record

Applied Clinical Informatics ◽

10.4338/aci-2014-02-ra-0015 ◽

2014 ◽

Vol 05 (03) ◽

pp. 630-641 ◽

Cited By ~ 7

Author(s):

V. Herasevich ◽

J.R. Hebl ◽

M.J. Brown ◽

B.W. Pickering ◽

M.A. Ellsworth

Keyword(s):

Medical Record ◽

Electronic Medical Record ◽

Medical Error ◽

Information Needs ◽

Clinical Decision Making ◽

Information Overload ◽

Clinical Information ◽

Clinical Decision ◽

Anesthesia Providers ◽

Survey Responses

Summary Objective: The amount of clinical information that anesthesia providers encounter creates an environment for information overload and medical error. In an effort to create more efficient OR and PACU EMR viewer platforms, we aimed to better understand the intraoperative and post-anesthesia clinical information needs among anesthesia providers. Materials and Methods: A web-based survey to evaluate 75 clinical data items was created and distributed to all anesthesia providers at our institution. Participants were asked to rate the importance of each data item in helping them make routine clinical decisions in the OR and PACU settings. Results: There were 107 survey responses with distribution throughout all clinical roles. 84% of the data items fell within the top 2 proportional quarters in the OR setting compared to only 65% in the PACU. Thirty of the 75 items (40%) received an absolutely necessary rating by more than half of the respondents for the OR setting as opposed to only 19 of the 75 items (25%) in the PACU. Only 1 item was rated by more than 20% of respondents as not needed in the OR compared to 20 data items (27%) in the PACU. Conclusion: Anesthesia providers demonstrate a larger need for EMR data to help guide clinical decision making in the OR as compared to the PACU. When creating EMR platforms for these settings it is important to understand and include data items providers deem the most clinically useful. Minimizing the less relevant data items helps prevent information overload and reduces the risk for medical error. Citation: Herasevich V, Ellsworth MA, Hebl JR, Brown MJ, Pickering BW. Information needs for the OR and PACU electronic medical record. Appl Clin Inf 2014; 5: 630–641http://dx.doi.org/10.4338/ACI-2014-02-RA-0015

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Workflow Differences Affect Data Accuracy in Oncologic EHRs: A First Step Toward Detangling the Diagnosis Data Babel

JCO Clinical Cancer Informatics ◽

10.1200/cci.19.00114 ◽

2020 ◽

pp. 529-538

Author(s):

Franck Diaz-Garelli ◽

Roy Strowd ◽

Virginia L. Lawson ◽

Maria E. Mayorga ◽

Brian J. Wells ◽

...

Keyword(s):

Data Quality ◽

Clinical Data ◽

Information Needs ◽

Clinical Information ◽

Data Reuse ◽

Outcome Variable ◽

Cancer Center ◽

Anatomic Site ◽

Secondary Analyses ◽

Logistic Regressions

PURPOSE Diagnosis (DX) information is key to clinical data reuse, yet accessible structured DX data often lack accuracy. Previous research hints at workflow differences in cancer DX entry, but their link to clinical data quality is unclear. We hypothesized that there is a statistically significant relationship between workflow-describing variables and DX data quality. METHODS We extracted DX data from encounter and order tables within our electronic health records (EHRs) for a cohort of patients with confirmed brain neoplasms. We built and optimized logistic regressions to predict the odds of fully accurate (ie, correct neoplasm type and anatomic site), inaccurate, and suboptimal (ie, vague) DX entry across clinical workflows. We selected our variables based on correlation strength of each outcome variable. RESULTS Both workflow and personnel variables were predictive of DX data quality. For example, a DX entered in departments other than oncology had up to 2.89 times higher odds of being accurate ( P < .0001) compared with an oncology department; an outpatient care location had up to 98% fewer odds of being inaccurate ( P < .0001), but had 458 times higher odds of being suboptimal ( P < .0001) compared with main campus, including the cancer center; and a DX recoded by a physician assistant had 85% fewer odds of being suboptimal ( P = .005) compared with those entered by physicians. CONCLUSION These results suggest that differences across clinical workflows and the clinical personnel producing EHR data affect clinical data quality. They also suggest that the need for specific structured DX data recording varies across clinical workflows and may be dependent on clinical information needs. Clinicians and researchers reusing oncologic data should consider such heterogeneity when conducting secondary analyses of EHR data.

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A Survey of Methodologies for Assessing Mast Cell Density and Activation in Patients with Functional Abdominal Pain Disorders

Gastrointestinal Disorders ◽

10.3390/gidisord3040016 ◽

2021 ◽

Vol 3 (4) ◽

pp. 142-155

Author(s):

Hunter Friesen ◽

Meenal Singh ◽

Vivekanand Singh ◽

Jennifer V. Schurman ◽

Craig A. Friesen

Keyword(s):

Mast Cell ◽

Abdominal Pain ◽

Cell Density ◽

Information Needs ◽

Cell Activation ◽

Clinical Information ◽

Mast Cell Activation ◽

Functional Abdominal Pain ◽

Mast Cell Density ◽

Selection Of

The aim was to assess methods utilized in assessing mast cell involvement in functional abdominal pain disorders (FAPDs), specifically to describe variability in methods utilized to assess both mast cell density and activation and determine if a consensus exists. After a literature search identified 70 manuscripts assessing mast cell density, data were extracted including FAPD diagnosis, site of biopsy, selection of microscopic fields analyzed, selection of mucosal region analyzed, method of mast cell identification, method to assess mast cell density, and if performed, method to assess mast cell activation. There appears to be some consensus favoring inmmunohistochemical stains over histochemical stains for identifying mast cells. Otherwise, considerable variability exists in methodology for assessing mast cell density and activation. Regardless of method, approximately 80% of studies found increased mast cell density and/or activation in comparison to controls with no method being superior. A wide variety of methods have been employed to assess mast cell density and activation with no well-established consensus and inadequate data to recommend specific approaches. The current methodology providing physiologic information needs to be translated to a standard methodology providing clinical information with the development of criteria establishing abnormal density and/or activation, and more importantly, predicting treatment response.

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