External validation of the unified model of information systems continuance (UMISC): An international comparison.

Context: The Unified Model of Information Systems Continuance (UMISC) is a metamodel for the evaluation of clinical information systems (CISs) that integrates constructs from five models that have previously been published in the literature. UMISC was developed at the Georges Pompidou University Hospital (HEGP) in Paris and was partially validated at the Saint Joseph Hospital Group (HPSJ), another acute care institution using the same CIS as HEGP.

Objective: The aim of this replication study was twofold: (1) to perform an external validation of UMISC in two different hospitals and country contexts: the Italian Hospital of Buenos Aires (HIBA) in Argentina and the Hospital Sirio Libanes in Sao Paulo, Brazil (HSL); (2) to compare, using the same evaluation model, the determinants of satisfaction, use, and continuance intention observed at HIBA and HSL with those previously observed at HEGP and HPSJ.

Designing a Coding Data Warehouse to Support and Enhance Medical Act Coding.

Standards Data Warehouse has been implemented in many hospitals. It has enormous potential to improve performance measurement and health care quality. Accessing, organizing, and using these data to optimize clinical coding are evolving challenges for hospital systems.

Evaluation of the unified model of information systems continuance (UMISC) in two hospital environments.

Context: The deployment and long-term acceptance of clinical information systems (CISs) are faced with multiple difficulties. They include insufficient quality of the systems in place and resistance to the multiple changes they induce in care processes. Permanent evaluation of deployed solutions is a prerequisite to their continuous improvement.

Design and Implementation of Big Data-Based Documents to Optimize Medical Coding.

Clinical information systems (CISs) in some hospitals streamline the data management from data warehouses. These warehouses contain heterogeneous information from all medical specialties that offer patient care services. It is increasingly difficult to manage large volumes of data in a specific clinical context such as quality coding of medical services.

The Georges Pompidou University Hospital Clinical Data Warehouse: A 8-years follow-up experience.

Background: When developed jointly with clinical information systems, clinical data warehouses (CDWs) facilitate the reuse of healthcare data and leverage clinical research.

Objective: To describe both data access and use for clinical research, epidemiology and health service research of the "Hôpital Européen Georges Pompidou" (HEGP) CDW.

Methods: The CDW has been developed since 2008 using an i2b2 platform.

The Virtuous Circles of Clinical Information Systems: a Modern Utopia.

Context: Clinical information systems (CIS) are developed with the aim of improving both the efficiency and the quality of care.

Objective: This position paper is based on the hypothesis that such vision is partly a utopian view of the emerging eSociety.

Methods: Examples are drawn from 15 years of experience with the fully integrated Georges Pompidou University Hospital (HEGP) CIS and temporal data series extracted from the data warehouses of Assistance Publique - Hôpitaux de Paris (AP-HP) acute care hospitals which share the same administrative organization as HEGP.

Constructing a Pre-Emptive System Based on a Multidimentional Matrix and Autocompletion to Improve Diagnostic Coding in Acute Care Hospitals.

Short-stay MSO (Medicine, Surgery, Obstetrics) hospitalization activities in public and private hospitals providing public services are funded through charges for the services provided (T2A in French). Coding must be well matched to the severity of the patient's condition, to ensure that appropriate funding is provided to the hospital. We propose the use of an autocompletion process and multidimensional matrix, to help physicians to improve the expression of information and to optimize clinical coding.

Information system end-user satisfaction and continuance intention: A unified modeling approach.

Context: Permanent evaluation of end-user satisfaction and continuance intention is a critical issue at each phase of a clinical information system (CIS) project, but most validation studies are concerned with the pre- or early post-adoption phases.

Objective: The purpose of this study was twofold: to validate at the Pompidou University Hospital (HEGP) an information technology late post-adoption model built from four validated models and to propose a unified metamodel of evaluation that could be adapted to each context or deployment phase of a CIS project.

Methods: Five dimensions, i.

14 Years longitudinal evaluation of clinical information systems acceptance: The HEGP case.

Context: Meaningful use and end-user satisfaction are two major components of the success of a clinical information system (CIS). The purpose of this study was to longitudinally measure and analyze the CIS use and satisfaction determinants in a multi-professional group at the Georges Pompidou university hospital (HEGP) in Paris.

Methods: From the different evaluation surveys performed at HEGP, three periods were considered corresponding to 4, 8 and over 10 years after the first CIS deployment in 2000, respectively.

Detection of Drug-Drug Interactions Inducing Acute Kidney Injury by Electronic Health Records Mining.

Background And Objective: While risk of acute kidney injury (AKI) is a well documented adverse effect of some drugs, few studies have assessed the relationship between drug-drug interactions (DDIs) and AKI. Our objective was to develop an algorithm capable of detecting potential signals on this relationship by retrospectively mining data from electronic health records.

Material And Methods: Data were extracted from the clinical data warehouse (CDW) of the Hôpital Européen Georges Pompidou (HEGP).

Using a snowflake data model and autocompletion to support diagnostic coding in acute care hospitals.

Purpose: Efficient and adequate coding is essential for all hospitals to optimize funding, follow activity, and perform epidemiological studies.

Objective: We propose an autocompletion method for optimizing diagnostic coding in acute care hospitals.

Methods: Using a terminology snowflake model integrating SNOMED 3.

Assessing the relationships between hospital resources and activities: a systematic review.

Face the challenge of minimizing their resource utilization without reducing the quality of healthcare. Achieving this aim requires precise analysis and optimization of various inputs and outputs. This paper presents a systematic review of the relationships between hospital resources (considered productivity inputs) and financial and activity outcomes (considered productivity outputs).

Determinants of continuance intention in a post-adoption satisfaction evaluation of a clinical information system.

Purpose: The evaluation of end-user satisfaction is an essential part of any clinical information system (CIS) project. The purpose of this study is to evaluate the determinants of CIS continuance intention in a late post-adoption phase at the Georges Pompidou University Hospital (HEGP) in Paris.

Methods: We designed an electronic survey instrument based on an IT post-adoption model (ITPAM) developed from three previous models, i.

Observations and lessons learnt from non health professionals evaluating a health search engine.

This article presents the results of one of the stages of the user-centered evaluation conducted in a framework of the EU project Khresmoi. In a controlled environment, users were asked to perform health-related tasks using a search engine specifically developed for trustworthy online health information. Twenty seven participants from largely the Czech Republic and France took part in the evaluation.

Translational research platforms integrating clinical and omics data: a review of publicly available solutions.

The rise of personalized medicine and the availability of high-throughput molecular analyses in the context of clinical care have increased the need for adequate tools for translational researchers to manage and explore these data. We reviewed the biomedical literature for translational platforms allowing the management and exploration of clinical and omics data, and identified seven platforms: BRISK, caTRIP, cBio Cancer Portal, G-DOC, iCOD, iDASH and tranSMART. We analyzed these platforms along seven major axes.

Phenome-wide association studies on a quantitative trait: application to TPMT enzyme activity and thiopurine therapy in pharmacogenomics.

Phenome-Wide Association Studies (PheWAS) investigate whether genetic polymorphisms associated with a phenotype are also associated with other diagnoses. In this study, we have developed new methods to perform a PheWAS based on ICD-10 codes and biological test results, and to use a quantitative trait as the selection criterion. We tested our approach on thiopurine S-methyltransferase (TPMT) activity in patients treated by thiopurine drugs.

Validity of a clinical decision rule-based alert system for drug dose adjustment in patients with renal failure intended to improve pharmacists' analysis of medication orders in hospitals.

Objective: The main objective of this study was to assess the diagnostic performances of an alert system integrated into the CPOE/EMR system for renally cleared drug dosing control. The generated alerts were compared with the daily routine practice of pharmacists as part of the analysis of medication orders.

Materials And Methods: The pharmacists performed their analysis of medication orders as usual and were not aware of the alert system interventions that were not displayed for the purpose of the study neither to the physician nor to the pharmacist but kept with associate recommendations in a log file.

Pharmaceutical validation of medication orders using an OWL Ontology and Business Rules.

In this paper we present an application of pharmaceutical validation of medication based on an OWL ontology and business rules or more specifically clinical decision rules. This application has been developed based on a prototype that enables business users to author, execute and manage their Business Rules over OWL Ontology. This prototype is based on the Business Rule Management System (BRMS) IBM WebSphere ILOG JRules.

A clinical data warehouse-based process for refining medication orders alerts.

The objective of this case report is to evaluate the use of a clinical data warehouse coupled with a clinical information system to test and refine alerts for medication orders control before they were fully implemented. A clinical decision rule refinement process was used to assess alerts. The criteria assessed were the frequencies of alerts for initial prescriptions of 10 medications whose dosage levels depend on renal function thresholds.

Clinical information system post-adoption evaluation at the georges pompidou university hospital.

The evaluation of a clinical information system (CIS) at different stages of deployment and routine use is a key factor to improve acceptability and use by health professionals. This paper examines on an expectation-confirmation model (ITPAM) the relationships between the determinants of success of a CIS in a cross-sectional survey performed at the Georges Pompidou University Hospital (HEGP). Results for the groups of physicians and nurses that replied to the survey (n=312) suggest that health professional satisfaction (overall R(2)=0.

A business rules design framework for a pharmaceutical validation and alert system.

Objectives: Several alert systems have been developed to improve the patient safety aspects of clinical information systems (CIS). Most studies have focused on the evaluation of these systems, with little information provided about the methodology leading to system implementation. We propose here an 'agile' business rule design framework (BRDF) supporting both the design of alerts for the validation of drug prescriptions and the incorporation of the end user into the design process.

Determinants of clinical information system post-adoption success.

The diffusion of information technology (IT) in healthcare systems to support clinical processes makes the evaluation of physician and nurse post-adoption an important challenge for clinical information systems (CIS). This paper examines the relationships between the determinants of success of a CIS based on an expectation-confirmation paradigm in a cross-sectional survey performed at the Sherbrooke University Hospital (CHUS). 32.

Methodology of integration of a clinical data warehouse with a clinical information system: the HEGP case.

Clinical Data Warehouses (CDW) can complement current Clinical Information Systems (CIS) with functions that are not easily implemented by traditional operational database systems. Here, we describe the design and deployment strategy used at the Pompidou University Hospital in southwest Paris. Four realms are described: technological realm, data realm, restitution realm, and administration realm.