Security approaches in using tablet computers for primary data collection in clinical research.

Next-generation tablets (iPads and Android tablets) may potentially improve the collection and management of clinical research data. The widespread adoption of tablets, coupled with decreased software and hardware costs, has led to increased consideration of tablets for primary research data collection. When using tablets for the Washington Heights/Inwood Infrastructure for Comparative Effectiveness Research (WICER) project, we found that the devices give rise to inherent security issues associated with the potential use of cloud-based data storage approaches.

Advanced practice nursing students' identification of patient safety issues in ambulatory care.

Despite more than a decade of patient safety initiatives in our health care system, nurses (N = 172) identified a large number of safety issues in the ambulatory care setting, including issues in their own practice (50.7% of the encounters), feeling rushed or hurried (34.8% of encounters), and being interrupted (27.

An initial log analysis of usage patterns on a research networking system.

Usage data for research networking systems (RNSs) are valuable but generally unavailable for understanding scientific professionals' information needs and online collaborator seeking behaviors. This study contributes a method for evaluating RNSs and initial usage knowledge of one RNS obtained from using this method. We designed a log for an institutional RNS, defined categories of users and tasks, and analyzed correlations between usage patterns and user and query types.

Processes and outcomes of developing a continuity of care document for use as a personal health record by people living with HIV/AIDS in New York City.

Purpose: To describe the processes and outcomes of developing and implementing a Continuity of Care Document (CCD), My Health Profile, as a personal health record for persons living with HIV (PLWH) in an HIV/AIDS Special Needs Plan in New York City.

Methods: Multiple qualitative and quantitative data sources were used to describe the processes and outcomes of implementing My Health Profile including focus groups, Audio Computer Assisted Self Interview (ACASI) surveys, administrative databases, chart abstraction, usage logs, and project management records. Qualitative data were thematically analyzed.

Employing the FITT framework to explore HIV case managers' perceptions of two electronic clinical data (ECD) summary systems.

Purpose: Case managers facilitate continuity of care for persons living with HIV (PLWH) by coordination of resources and referrals to social services and medical care. The complexity of HIV care and associated comorbidities drives the need for medical and psychosocial care coordination, which may be achieved through health information exchange (HIE) systems. However, the use of HIE has not been well studied in the context of HIV services.

Research data collection methods: from paper to tablet computers.

Background: Primary data collection is a critical activity in clinical research. Even with significant advances in technical capabilities, clear benefits of use, and even user preferences for using electronic systems for collecting primary data, paper-based data collection is still common in clinical research settings. However, with recent developments in both clinical research and tablet computer technology, the comparative advantages and disadvantages of data collection methods should be determined.

Development of a prototype continuity of care record with context-specific links to meet the information needs of case managers for persons living with HIV.

Objectives: (1) To develop a prototype Continuity of Care Record (CCR) with context-specific links to electronic HIV information resources; and (2) to assess case managers' perceptions regarding the usability of the prototype.

Methods: We integrated context-specific links to HIV case management information resources into a prototype CCR using the Infobutton Manager and Librarian Infobutton Tailoring Environment (LITE). Case managers (N=9) completed a think-aloud protocol and the Computer System Usability Questionnaire (CSUQ) to evaluate the usability of the prototype.

Assessing Electronic Note Quality Using the Physician Documentation Quality Instrument (PDQI-9).

OBJECTIVE: To refine the Physician Documentation Quality Instrument (PDQI) and test the validity and reliability of the 9-item version (PDQI-9). METHODS: Three sets each of admission notes, progress notes and discharge summaries were evaluated by two groups of physicians using the PDQI-9 and an overall general assessment: one gold standard group consisting of program or assistant program directors (n=7), and the other of attending physicians or chief residents (n=24). The main measures were criterion-related validity (correlation coefficients between Total PDQI-9 scores and 1-item General Impression scores for each note), discriminant validity (comparison of PDQI-9 scores on notes rated as best and worst using 1-item General Impression score), internal consistency reliability (Cronbach's alpha), and inter-rater reliability (intraclass correlation coefficient (ICC)).

Health literacy screening instruments for eHealth applications: a systematic review.

Objective: To systematically review current health literacy (HL) instruments for use in consumer-facing and mobile health information technology screening and evaluation tools.

Design: The databases, PubMed, OVID, Google Scholar, Cochrane Library and Science Citation Index, were searched for health literacy assessment instruments using the terms "health", "literacy", "computer-based," and "psychometrics". All instruments identified by this method were critically appraised according to their reported psychometric properties and clinical feasibility.

Methods of knowledge discovery in tweets.

1) to describe web mining methods for knowledge discovery in Tweets, and 2) to illustrate application of the methods using the topic of physical activity. Methods described include: 1) structure mining to discover structures (macro-, meso-, and micro-level) of Tweet networks using social network analysis, and 2) content mining to discover Tweet contents using n-gram based text analysis and sentiment analysis. Specific web mining tools for each step of the web mining process (e.

Approaches to workflow analysis in healthcare settings.

Attention to workflow is an important component of a comprehensive approach to designing usable information systems. In healthcare, inattention to workflow is associated with poorly accepted systems and unforeseen effects of use. How best to examine workflow for the purpose of system design is in itself the subject of scientific inquiry.

Barriers and Facilitators of Implementing Electronic Data Summaries in HIV/AIDS Care.

The purpose of this study was to describe case managers' perceptions of the barriers and facilitators to implementing two different electronic data summaries (EDS), a USB-based and Web-based Continuity of Care Document (CCD) for patients living with HIV/AIDS (PLWH) in New York City. The primary aim of this descriptive qualitative study was to understand case managers' perceptions of the two systems. Focus group methodology was used to gather perceptions from 48 participants.

Developing Self-Management Tools with Vulnerable Populations for use in Personal Health Information Management Systems.

Vulnerable populations have potential to be significant partners and informants in the development of health information technology. We describe our experience in conducting human-centered participatory design methods with community-dwelling elders in the development of a computer-based falls prevention self-management tool for use in a personal health information management system. Community-dwelling elders contributed significantly to understanding appropriate content and functions; task performance; and graphical representations that should be considered in designing our self-management tool.

Predictors of health information-seeking behaviors in hispanics.

The objective of this study was to examine factors predicting use of the Internet to seek health information among Hispanics in the Washington Heights and Inwood areas of New York City. Data were collected by community health workers through the Washington Heights/Inwood Informatics Infrastructure for Community-Centered Comparative Effectiveness Research (WICER) community survey and a random sample of 100 surveys was selected for analysis. Binary logistic regression (N=100) was used to examine predictors of online health information-seeking behaviors (HISBs) of respondent and household members (dependent variables).

Use of the isabel decision support system to improve diagnostic accuracy of pediatric nurse practitioner and family nurse practitioner students.

Patient safety is a priority for healthcare today. Despite a large proportion of malpractice claims the result of diagnostic error, the use of diagnostic decision support to improve diagnostic accuracy has not been widely used among healthcare professionals. Moreover, while the use of diagnostic decision support has been studied in attending physicians, residents, medical students and advanced practice nurses, the use of decision support among Advanced Practice Nurse (APN) students has not been studied.

Using the LOINC Semantic Structure to Integrate Community-based Survey Items into a Concept-based Enterprise Data Dictionary to Support Comparative Effectiveness Research.

In designing informatics infrastructure to support comparative effectiveness research (CER), it is necessary to implement approaches for integrating heterogeneous data sources such as clinical data typically stored in clinical data warehouses and those that are normally stored in separate research databases. One strategy to support this integration is the use of a concept-oriented data dictionary with a set of semantic terminology models. The aim of this paper is to illustrate the use of the semantic structure of Clinical LOINC (Logical Observation Identifiers, Names, and Codes) in integrating community-based survey items into the Medical Entities Dictionary (MED) to support the integration of survey data with clinical data for CER studies.

What am I giving tonight? Information needs of nurses related to patient medications administration while using a clinical information system.

This study examined the information needs of nurses using a Clinical Information System (CIS) to review medications that they have to administer for their shift. In a laboratory setting, nurses were asked to follow a speak-aloud protocol while reviewing a scripted medication list. We coded the nurses' information seeking behavior utilizing a previously described framework.

Perceptions of predisposing, enabling, and reinforcing factors influencing the use of a continuity of care document in special needs PLWH.

The provision of personal health information through electronic personal health management tools (EPHMT) has the potential to improve health outcomes. However, little is known about factors that affect EPHMT use in special needs people living with HIV/AIDS (PLWH). The purpose of this study was to describe PLWH perceptions of predisposing, enabling, and reinforcing factors affecting use of one type of EPHMT, a continuity of care document (CCD).

Cognitive analysis of decision support for antibiotic ordering in a neonatal intensive care unit.

Background: Clinical decision support systems (CDSS) are a method used to support prescribing accuracy when deployed within a computerized provider order entry system (CPOE). Divergence from using CDSS is exemplified by high alert override rates. Excessive cognitive load imposed by the CDSS may help to explain such high rates.

A tablet computer application for patients to participate in their hospital care.

Building on our institution's commercial electronic health record and custom personal health record Web portal, we developed a tablet computer application to provide interactive information to hospital patients. Using Apple iPad devices, the prototype application was provided to five patients in a cardiology step-down unit. We conducted detailed interviews to assess patients' knowledge of their inpatient care, as well as their perceptions of the usefulness of the application.

Development and evaluation of an ontology for guiding appropriate antibiotic prescribing.

Objectives: To develop and apply formal ontology creation methods to the domain of antimicrobial prescribing and to formally evaluate the resulting ontology through intrinsic and extrinsic evaluation studies.

Methods: We extended existing ontology development methods to create the ontology and implemented the ontology using Protégé-OWL. Correctness of the ontology was assessed using a set of ontology design principles and domain expert review via the laddering technique.

Temporal lobe epilepsy surgery: what do patients want to know?

Patients with pharmacoresistant temporal lobe epilepsy (TLE) contemplating brain surgery must make a complex treatment decision involving trade-offs. Patient decision aids, containing information on the risks and benefits of treatment interventions, increase patient knowledge and facilitate shared decision making between patients and physicians. We conducted five focus groups to describe the information patients need to make informed decisions about TLE surgery.

Patient safety issues in advanced practice nursing students' care settings.

The purpose of this project was to identify and characterize patient safety issues across advanced practice nursing (APN) care settings including ambulatory care visits. A total of 162 registered nurses enrolled in an APN education program completed an online survey. Respondents reported patient safety issues related to diagnosis or management and treatment in almost half of 489 encounters.

Reporting of hazards and near-misses in the ambulatory care setting.

The purpose of this study was to describe the frequency and types of hazard and near-miss events in the ambulatory setting. Nursing students (N = 566) submitted 9272 reports while in their ambulatory care rotation. Of these, 1624 were hazards and 985 were near-misses.