AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium
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AMIA Annu Symp Proc · Jan 2017
Big data in healthcare - the promises, challenges and opportunities from a research perspective: A case study with a model database.
Recent advances in data collection during routine health care in the form of Electronic Health Records (EHR), medical device data (e.g., infusion pump informatics, physiological monitoring data, and insurance claims data, among others, as well as biological and experimental data, have created tremendous opportunities for biological discoveries for clinical application. However, even with all the advancement in technologies and their promises for discoveries, very few research findings have been translated to clinical knowledge, or more importantly, to clinical practice. In this paper, we identify and present the initial work addressing the relevant challenges in three broad categories: data, accessibility, and translation. These issues are discussed in the context of a widely used detailed database from an intensive care unit, Medical Information Mart for Intensive Care (MIMIC III) database.
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AMIA Annu Symp Proc · Jan 2017
Interactive Visualization and Exploration of Patient Progression in a Hospital Setting.
As medical organizations increasingly adopt the use of electronic health records (EHRs), large volumes of clinical data are being captured on a daily basis. These data provide comprehensive information about patients and have the potential to improve a wide range of application domains in healthcare. Physicians and clinical researchers are interested in finding effective ways to understand this abundance of data. ⋯ Through the use of optimized data structures and progressive visualization techniques, we allow users to interactively explore how patients and their progression change over time. Compared to existing techniques, our work provides additional flexibility in analyzing patient data and has the potential to be used in a real-time hospital setting. Finally, we demonstrate the utility of our approach using a publicly available intensive care unit (ICU) database.
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AMIA Annu Symp Proc · Jan 2017
A Simulation Study on Handoffs and Cross-coverage: Results of an Error Analysis.
Handoffs and cross-coverage are necessary for maintaining the continuity of patient care, yet both are potential sources of error, and may threaten patient safety and care. Handoffs are the transfer of patient information and accountability from one provider to another. Cross-coverage is the management of patients, of whom physicians who have little or no prior knowledge of, during nightshifts. ⋯ We collected data from thirty physicians from an academic medical center as they signed out six patients after responding to nurse calls. An error analysis of the sign-out data revealed 42 errors overall, with 28 omissions and 14 "erroneous data" errors. We then propose ways to prevent these errors through modification of the electronic medical record and support tools, and through higher awareness of human factors.
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AMIA Annu Symp Proc · Jan 2016
Checklist as a Memory Externalization Tool during a Critical Care Process.
We analyzed user interactions with a paper-based checklist in a regional trauma center to inform the design of digital cognitive aids for safety-critical medical teamwork. An initial review of paper checklists from actual trauma resuscitations revealed that trauma team leaders frequently wrote notes on the checklist. To understand this notetaking practice, we performed content analysis of 163 checklists collected over the period of four months. ⋯ An analysis of types and amount of notes written by leaders of different experience levels showed that more experienced leaders recorded more patient values and physical findings, while less experienced leaders recorded more notes about their activities and task completion status. These findings suggested that a checklist designed for a high-risk, fast-paced medical event has evolved into a dual function tool, serving both as a compliance and memory aid. Based on these findings, we derived requirements for designing digital cognitive aids to support safety-critical medical teamwork.
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AMIA Annu Symp Proc · Jan 2015
Impact of Robotic Surgery on Decision Making: Perspectives of Surgical Teams.
There has been rapid growth in the purchase of surgical robots in both North America and Europe in recent years. Whilst this technology promises many benefits for patients, the introduction of such a complex interactive system into healthcare practice often results in unintended consequences that are difficult to predict. ⋯ Drawing on the approach of realist evaluation, we conducted a multi-site interview study across nine hospitals, interviewing 44 operating room personnel with experience of robotic surgery to gather their perspectives on how robotic surgery impacts surgeon decision making. The findings reveal both potential benefits and challenges of robotic surgery for decision making.