Stud Health Technol Inform
August 2024
This longitudinal, non-randomized, retrospective study uses the Kaplan-Meier estimates method and the Cox Proportional Hazard model to assess the risk of home support recipients' transitioning to a higher level of care after being hospitalized. The Kaplan-Meier survival analysis revealed that 50% of home support recipients were expected to move on to a higher level of care by day 1,374. The Cox Proportional Hazard model indicated that the risk of transitioning to a higher level of care increases by about 2% as a client ages by one year, and by about 10% if there were no emergency room visits in the last 12 months.
View Article and Find Full Text PDFSituation awareness (SA) is an important non-technical skill for nurses. Nurses interact directly with patients and review their clinical signs. If we improve nurses' SA, they will likely detect clinical changes and prevent patient harm.
View Article and Find Full Text PDFImproving nurses' situation awareness skills would likely improve patient status recognition and prevent adverse events. Technologies such as electronic health record dashboards can be a promising approach to support nurses' situation awareness. However, the effect of these dashboards on this skill is unknown.
View Article and Find Full Text PDFStud Health Technol Inform
August 2019
This methodological paper describes how system dynamics was applied in evaluating the effect of remote monitoring (RM) of cardiovascular implantable electronic device (CIED) workload on clinical resource utilization. The development of a causal loop diagram and a stock and flow diagram and the construction of the simulation model for comparison of an in-person clinic group and RM clinic group are described.
View Article and Find Full Text PDFLong wait times for elective services are seen as one of the major challenges for Canadian healthcare. Canadians report that they wait longer for specialists than citizens in other countries. The main reason for this is that the referral process is poorly coordinated and leads to delays in care.
View Article and Find Full Text PDFStud Health Technol Inform
April 2018
This paper outlines a systematic literature review undertaken to establish current evidence regarding the impact of Business Intelligence (BI) on health system decision making and organizational performance. The review also examined BI implementation factors contributing to these constructs. Following the systematic review, inductive content analysis was used to categorize themes within the eight articles identified.
View Article and Find Full Text PDFStud Health Technol Inform
April 2018
Engaging patients in the self-management decision-making provides opportunities for positive health outcomes. The process of shared decision making (SDM) is touted as the pinnacle of patient-centred care, yet it has been difficult to implement in practice. Access to tools resulting from the integration of all health data and clinical evidence, and an ease of communications with care providers are needed to engage patients in decision making.
View Article and Find Full Text PDFStud Health Technol Inform
June 2018
HL7 CDA, vMR, and openEHR archetypes have been utilized as standard information models for clinical decision support systems. Compared to openEHR archetypes, vMR typically requires less time to develop and extend which makes it a good fit for rapid prototyping and pilot projects, while openEHR archetypes handle the data and semantic specification better. Using CDA for clinical decision support systems is discouraged due to its complexity, steep learning curve, and potential safety issues.
View Article and Find Full Text PDFStud Health Technol Inform
August 2017
Engaging patients in the self-management decision-making provides opportunities for positive health outcomes. The process of shared decision-making (SDM) is touted as the pinnacle of patient-centred care, yet it has been difficult to implement in practice. Access to tools resulting from the integration of all health data and clinical evidence, and an ease of communications with care providers are needed to engage patients in self management decision-making.
View Article and Find Full Text PDFObjective: This scoping review aims to determine the size and scope of the published literature on shared decision-making (SDM) using personal health record (PHR) technology and to map the literature in terms of system design and outcomes.
Materials And Methods: Literature from Medline, Google Scholar, Cumulative Index to Nursing and Allied Health Literature, Engineering Village, and Web of Science (2005-2015) using the search terms "personal health records," "shared decision making," "patient-provider communication," "decision aid," and "decision support" was included. Articles ( n = 38) addressed the efficacy or effectiveness of PHRs for SDM in engaging patients in self-care and decision-making or ways patients can be supported in SDM via PHR.
Computerisation of quality indicators for the English National Health Service currently relies primarily on queries and clinical coding, with little use of ontologies. We created a searchable ontology for a diverse set of healthcare quality indicators. We investigated attributes and relationships in a set of 222 quality indicators, categorised by clinical pathway, inclusion and exclusion criteria and US Institute of Medicine purpose.
View Article and Find Full Text PDFStud Health Technol Inform
November 2016
Semantic interoperability, a popular research area for electronic health records, can also be a challenge for quality indicators. We analysed attributes and relationships in a diverse set of over 200 healthcare quality indicators and created a searchable ontology. The ontology is intended to help reduce duplication of effort in healthcare quality monitoring.
View Article and Find Full Text PDFStud Health Technol Inform
November 2016
Although many researches have been carried out to analyze laboratory test errors during the last decade, it still lacks a systemic view of study, especially to trace errors during test process and evaluate potential interventions. This study implements system dynamics modeling into laboratory errors to trace the laboratory error flows and to simulate the system behaviors while changing internal variable values. The change of the variables may reflect a change in demand or a proposed intervention.
View Article and Find Full Text PDFStud Health Technol Inform
January 2018
Computerisation of quality indicators for the English National Health Service currently relies primarily on queries and clinical coding, with little use of ontologies. We investigated attributes and relationships in a diverse set of over 200 healthcare quality indicators, categorising by clinical pathway, inclusion and exclusion criteria and Institute of Medicine purpose. Our results, some of which are described in this paper, were used to create an ontology that could reduce duplication of effort in healthcare quality monitoring.
View Article and Find Full Text PDFStud Health Technol Inform
January 2018
Handover from one healthcare professional is an essential component of patient care. This can be a challenge in the community setting where care occurs in the patient's home and clinicians do not have the benefit of face-to-face interactions with colleagues. The purpose of this study was to explore the nurses' perceptions of handover and their views on using an electronic application as opposed to their current email system.
View Article and Find Full Text PDFStud Health Technol Inform
April 2017
The diagnostic process involves a series of stages in the patient pathway. Any errors or misleading information from any stage could lead to errors in the final decision-making. System dynamics modeling maps the diagnostic process as a whole and seeks to provide a quantitative way of analyzing different errors at each stage as well as relevant key factors.
View Article and Find Full Text PDFStud Health Technol Inform
April 2017
Innovation in healthcare services and clinical service redesign is a must because currently gaps exist between the care that people should receive for disease management and the actual care they receive. Directors and other decision makers should be aware of key challenges in the design, implementation and deployment of telehealth. In this paper, we discuss how telehealth enable chronic disease management, population health management and patient engagement, and what are the biggest challenges with getting value out of telehealth.
View Article and Find Full Text PDFMissed, wrong or delayed diagnosis has a direct effect on patient safety. Diagnostic errors have been discussed at length, however it still lacks a systematic approach. This study proposed a more systematic way of studying diagnostic errors by using a causal loop diagram.
View Article and Find Full Text PDFStud Health Technol Inform
April 2017
In the United Kingdom's National Health Service, quality indicators are generally measured electronically by using queries and data extraction, resulting in overlap and duplication of query components. Electronic measurement of health care quality indicators could be improved through an ontology intended to reduce duplication of effort during healthcare quality monitoring. While much research has been published on ontologies for computer-interpretable guidelines, quality indicators have lagged behind.
View Article and Find Full Text PDFObjective: To investigate the rate of automation bias - the propensity of people to over rely on automated advice and the factors associated with it. Tested factors were attitudinal - trust and confidence, non-attitudinal - decision support experience and clinical experience, and environmental - task difficulty. The paradigm of simulated decision support advice within a prescribing context was used.
View Article and Find Full Text PDFStud Health Technol Inform
April 2015
Data warehouse projects are perceived to be risky and prone to failure due to many organizational and technical challenges. However, often iterative and lengthy processes of implementation of data warehouses at an enterprise level provide an opportunity for formative evaluation of these solutions. This paper describes lessons learned from successful development and implementation of the first phase of an enterprise data warehouse to support public health surveillance at British Columbia Centre for Disease Control.
View Article and Find Full Text PDFBackground: Kenya like other developing countries is low in resource setting and is facing a number of challenges in the management of cervical cancer. This study documents opportunities and challenges encountered in managing cervical cancer from the health care workers' perspectives. A qualitative study was conducted among cervical cancer managers who were defined as nurses and doctors involved in operational level management of cervical cancer.
View Article and Find Full Text PDFThis paper briefly describes the main characteristics of the TeMaD system, developed for the Saudi National Guard Hospital in Riyadh. TeMaD attempts to improve current healthcare services for diabetic patients, and assists healthcare givers in disease management. It strengthens communication channels between patients and their healthcare givers, possibly leading to better health.
View Article and Find Full Text PDFStud Health Technol Inform
July 2013
Data quality is an integral part of EHR systems. Quality assurance for these systems not only identifies the current defects in the data but also aims for minimizing the risk of their future occurrence. Previous studies for secondary use of data in research projects presented several dimensions for such defects and proposed few methods for identifying them.
View Article and Find Full Text PDFBackground: Cervical cancer remains a devastating disease in Kenya accounting for more than 2000 deaths each year. Lack of information on cervical cancer prevention and management has been attributed to the apathy among women in seeking health interventions. Use of internet-based and mobile e-health tools could increase information access among cervical cancer patients.
View Article and Find Full Text PDF