International journal of medical informatics
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To identify poisons information resources most commonly utilized by Australasian Emergency Department staff, and examine attitudes regarding the benefits and user experience of the electronic products used. ⋯ New Zealand ED staff favored electronic poisons information resources while Australians preferred discussion with a colleague. That Poisons Information Centers were the least utilized resource was surprising.
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The interest in cross-organizational Health Information Exchange (HIE) is increasing at regional, national and cross-European levels. The purpose of our study was to compare user experiences (usability) of different regional health information exchange system (RHIE) types as well as the factors related to the experienced level of success of different RHIE system types. ⋯ The study revealed User preferences for the integrated virtual RHIE-system (type 3) over the master index model (type 1) or web distribution model (type 2). Success of individual HIE tasks of writing, sending and reading were impacted by the way these functionalities were realized in the EHR systems. To meet the expectations of increased efficiency, continuity, safety and quality of care, designers of HIE systems also need to take into account the different HIE needs of primary care clinicians and their secondary care colleagues in hospitals. Both national legislation and local interpretations of data protection possibly hinder the full use of any RHIE systems. These findings should be taken into account when designing usable HIE systems. More qualitative research is needed on specific features of those local systems that are associated with positive or negative user experience.
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Ineffective handovers in patient care, including those where information loss occurs between care providers, have been identified as a risk to patient safety. Computerization of health information is often offered as a solution to improve the quality of care handovers and decrease adverse events related to patient safety. The purpose of this paper is to broaden our understanding of clinical handover as a patient safety issue, and to identify socio-technical issues which may come to bear on the success of computer based handover tools. ⋯ We suggest that the contextual nature of information, ethical and medico-legal issues arising in relation to information handover, and issues related to data standards and system interoperability must be addressed if computerized health information systems are to achieve improvements in patient safety related to handovers in care.
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The success of health information technology implementations is often tied to the impact the technical system will have on the work of the clinicians using them. Considering the role of nurses in healthcare, it is shocking that there is a lack of evaluations of nursing information systems in the literature. Here we report on how a human factors approach can be used to address barriers and facilitators to use of the nursing information system (NIS). Human factors engineering (HFE) approaches provide the theoretical and methodological underpinning to address these socio-technical issues. ⋯ This study examined the use of an NIS to standardize care and documentation in nursing. It used scenario-based usability testing, applying the "think-aloud" protocol technique to assess the use of the NIS in documenting patient care. This method of usability evaluation exposed an understanding of how nurses use the NIS and their perspective on the system. We hypothesize that this method will offer key insights into how the usability of the NIS not only impacts use but also informs redesign opportunities. In addition, this is one of the few rigorous studies of NIS and provides direction and recommendations for informaticians, developers and nurse decision makers.
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The article describes the methodological approach to, and results of an evaluation of a comprehensive electronic health record (EHR) in the shake down phase, shortly after its implementation at a regional hospital in Denmark. ⋯ Despite inherent limitations, evaluation of a comprehensive EHR shortly after implementation may be necessary, can be conducted, and may inform political decision making. The updated DeLone and McLean framework was constructive in the overall design of the evaluation of the EHR implementation, and allowed the model to be adapted to the health care domain by being methodological flexible. The mixed-methods case study produced valid and reliable results, and was accepted by staff, system providers, and political decision makers. The successful implementation may be attributed to the configurability of the EHR and to factors such as an experienced, competent implementation organization at the hospital, upgraded soft- and hardware, and a high degree of user involvement.