Children as design partners in the development of a support system for children with cancer.

Children with cancer experience many symptoms and problems that often remain unreported and untreated. We therefore, developed PedsChoice, a support system for pediatric cancer symptom assessment and management to provide children with a "voice," and assist nurses and physicians to better address children's symptoms and problems in patient care. We used participatory design techniques where healthy children joined our design team.

A survey about the usefulness of computerized systems to support illness management in clinical practice.

Purpose: This survey among an interdisciplinary group of clinicians was conducted to obtain their opinions about the usefulness of decision support systems (DSS) for evidence- and patient preference-based illness management, factors important to their implementation, and criteria for evaluating their effectiveness.

Methods: A questionnaire was sent by mail or electronically to a convenience sample of 184 nurses, physicians and other health care professionals.

Results: The DSS ability to provide information about potential benefits and harms of intervention options and reports on patient outcomes of symptom relief, functional status and preference achievement was considered most useful among DSS features.

Improving patient safety through informatics tools for shared decision making and risk communication.

This paper describes how informatics tools can support shared decision making and risk communication and thereby play an important role in enhancing patient safety. Using preference elicitation techniques and knowledge on risk communication, such tools can help patients understand their treatment options and associated short- and long-term benefits and risks, assist in the elicitation of patient preferences, and help patients and clinicians in making treatment choices with the highest likelihood of achieving desired patient outcomes. Important features of such tools are proposed, including: (1) Interactive tutorials to improve risk comprehension and prepare patients and clinicians for the decision making task; (2) choices between different presentation modes to meet patients' individual reading levels and presentation preferences; (3) risk calculations that account for individual risk profiles; (4) performance of necessary calculations to reach the actual decision; (5) automatic updates of evidence; and (6) the use of different preference-elicitation techniques.

Developing, implementing, and evaluating decision support systems for shared decision making in patient care: a conceptual model and case illustration.

The importance of including patient preferences in decisions regarding their care has received increased emphasis over recent years. Medical informatics can play an important role in improving patient-centered care by developing decision support systems to support the inclusion of patient preferences in clinical decision making. However, development of such systems is a complex task that requires the integration of knowledge from four major research areas: (1) the clinical domain, for understanding of the decision problem, (2) decision science and research on shared decision making, to provide the theoretical underpinnings and techniques for eliciting patient preferences; (3) medical informatics, to provide the technology and algorithms for the collection, processing, structure, presentation and integration of patient preferences into patient care; and (4) organizational knowledge, to adapt the decision support system to the practices and work flows of clinicians and the organizational and professional context of the clinical practice settings.

Effects of a computerized system to support shared decision making in symptom management of cancer patients: preliminary results.

Objective: (1) To evaluate preliminary effects of a computerized support system on congruence between patients' reported symptoms and preferences and those addressed in the patient consultation and (2) to investigate the system's ease of use, time requirements, and patient satisfaction.

Design: Fifty-two patients were randomly assigned to intervention or control conditions.

Measurements: Cancer patients scheduled for an outpatient visit used the system on a tablet computer to report their symptoms and preferences prior to their consultation.

Usefulness and effects on costs and staff management of a nursing resource management information system.

While administrative information systems can assist nurse managers to improve cost containment and resource management of their units, such effects cannot be known without rigorous evaluations. This article presents evaluation results of CLASSICA, an information system designed to provide decision support for nurse managers in financial management, resource allocation, and activity planning. CLASSICA demonstrated a 41% reduction in expenditures for overtime and extra hours during the evaluation period as compared with a 1.