In this project we sought to qualitatively describe clinician's search for information related to the complex construct of adherence. Nineteen think aloud observations and semi-structured interviews were conducted with mental health providers as they prepared for a patient visit. The transcripts were coded according to constructs from information foraging theory (information goal, patch, scent, enrichment, and opportunity cost).
View Article and Find Full Text PDFBackground And Objectives: It is not known what proportion of United States patients with advanced CKD go on to receive RRT. In other developed countries, receipt of RRT is highly age dependent and the exception rather than the rule at older ages.
Design, Setting, Participants, & Measurements: We conducted a retrospective study of a national cohort of 28,568 adults who were receiving care within the US Department of Veteran Affairs and had a sustained eGFR <15 ml/min per 1.
Free text in electronic health records resists large-scale analysis. Text records facts of interest not found in encoded data, and text mining enables their retrieval and quantification. The U.
View Article and Find Full Text PDFObjective: Clinical documentation is central to the medical record and so to a range of healthcare and business processes. As electronic health record adoption expands, computerized provider documentation (CPD) is increasingly the primary means of capturing clinical documentation. Previous CPD studies have focused on particular stakeholder groups and sites, often limiting their scope and conclusions.
View Article and Find Full Text PDFBackground: Concerns exist about the quality of electronic health care documentation. Prior studies have focused on physicians. This investigation studied document quality perceptions of practitioners (including physicians), nurses and administrative staff.
View Article and Find Full Text PDFPurpose: The purpose of this study was to explore the experience of experienced users of computerized patient documentation for the purpose of collaboration and coordination. A secondary analysis of qualitative data using Clark's theoretical framework of communication was conducted with the goal of bringing research findings into design.
Methods: Physicians, nurses and administrative staff volunteered to participate in focus groups at 4 VA sites.
This project investigated the use of electronic patient documentation in the work context of VA nurses, guided by cognitive work analysis methodology. Prominent themes in nursing workflow and documentation usage identifed in previous research were summarized and presented in detail to a focus group of practicing nurses. The group validated a need for integrated access to order, prescription and document information.
View Article and Find Full Text PDFInt J Med Inform
June 2007
Electronic patient records often include text that has been copied and pasted from other records. A type of copying that involves the highest risk for confusion, medical error, and medico-legal harm is the copying of the clinical examination. We studied this phenomenon using an automated text categorization algorithm to detect copied exams in a set of 167,076 VA records.
View Article and Find Full Text PDFAs routine use of on-line progress notes in US Department of Veterans Affairs facilities grew rapidly in the past decade, health information managers and clinicians began to notice that authors sometimes copied text from old notes into new notes. Other sources of duplication were document templates that inserted boilerplate text or patient data into notes. Word-processing and templates aided the transition to electronic notes, but enabled author copying and sometimes led to lengthy, hard-to-read records stuffed with data already available on-line.
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