A Paradigm Shift: Sharing Patient Reported Outcome via a National Infrastructure.

Digital solutions transform the way clinical services can be provided and make it possible for patients to participate in decisions concerning their own treatment. With the aim to support a better and more efficient healthcare system in Denmark, it has been agreed among authorities and care providers to establish a national infrastructure for sharing data between hospitals, municipalities, general practitioners and patients and concurrently develop standardized national digital cross-sector questionnaires for the purpose. Sharing data via the national infrastructure enables proactive involvement through patient reported outcomes (PRO).

Establishing a Nation Wide Infrastructure for Systematic Use of Patient Reported Information.

In Denmark, we have set up a program to establish a nationwide infrastructure for Patient Reported Outcome (PRO) questionnaires. The effort is divided into an IT infrastructure part and a questionnaire development part. This paper describes how development and evaluation are closely knit together in the two tracks, as complexity is high in the PRO field and IT infrastructure, legal issues, various clinical workflows and the numerous stakeholders have to be taken into account concurrently.

Evaluation of a clinical simulation-based assessment method for EHR-platforms.

In a procurement process assessment of issues like human factors and interaction between technology and end-users can be challenging. In a large public procurement of an Electronic health record-platform (EHR-platform) in Denmark a clinical simulation-based method for assessing and comparing human factor issues was developed and evaluated. This paper describes the evaluation of the method, its advantages and disadvantages.

Clinical simulation as a boundary object in design of health IT-systems.

Healthcare organizations are very complex, holding numerous stakeholders with various approaches and goals towards the design of health IT-systems. Some of these differences may be approached by applying the concept of boundary objects in a participatory IT-design process. Traditionally clinical simulation provides the opportunity to evaluate the design and the usage of clinical IT-systems without endangering the patients and interrupting clinical work.

From clinical practice guidelines, to clinical guidance in practice - impacts for computerization.

This paper presents a case study of clinical guidance within oncology clinics. Close to all patients treated within the observed clinics were treated according to clinical practice guidelines in the form of either a research or a standard treatment protocol. The clinical practice guideline artifacts were however rarely applied in clinical practice.

Achieving IT-supported standardized nursing documentation through participatory design.

In the Capital Region of Denmark a full-scale pilot project on IT-supported nursing documentation is - after running for two months at one full university hospital - showing promising results. In this paper we discuss participatory design as a method to design clinical documentation templates that support guideline-based highly structured standard documentation in a large organization with many stakeholders. Applying a participatory design (PD) approach at many organizational levels has involved the stakeholders actively in the design process.

The role of simulation in clinical information systems development.

This paper describes the role of simulation involving end-users in Health Informatics. Simulation has long been established as a widely accepted method in clinical skills training. During the last decade simulation has also gained a place in the development and evaluation of clinical information systems.

From clinical practice guidelines, to clinical guidance in practice--implications for design of computerized guidance.

This paper presents a case study of clinical guidance within oncology clinics. Close to all patients treated within the observed clinics were treated according to a research or standard treatment protocol. The protocol artifacts were however rarely applied in clinical practice instead we found an extensive application of what we have named second order guiding artifacts.

IT for advanced life support in hospitals.

In this study we analyzed how IT support can be established for the treatment and documentation of advanced life support (ALS) in a hospital. In close collaboration with clinical researchers, a running prototype of an IT solution to support the clinical decisions in ALS was developed and tried out in a full scale simulation environment. We have named this IT solution the CardioData Prototype.

User driven, evidence based experimental design; a new method for interface design used to develop an interface for clinical overview of patient records.

A novel method of interface design--user driven, evidence based experimental design--was developed which approximates the usual clinical way of maturing science and technology in the healthcare domain. The method is user-driven and the clinician remains in control of gathering and evaluating evidence of relevance to the project--as well as specifying the details of the user interface. Information not obtainable from the literature was gained experimentally and used to achieve a deeper understanding of the problem before the design phase.