Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2013
Multicenter StudyExamination of changes in pathology tests ordered by Diagnosis-Related Group (DRGs) following CPOE introduction.
Electronic test ordering, via the Electronic Medical Record (EMR), which incorporates computerised provider order entry (CPOE), is widely considered as a useful tool to support appropriate pathology test ordering. Diagnosis-related groups (DRGs) are clinically meaningful categories that allow comparisons in pathology utilisation by patient groups by controlling for many potentially confounding variables. This study used DRG data linked to pathology test data to examine changes in rates of test ordering across four years coinciding with the introduction of an EMR in six hospitals in New South Wales, Australia. ⋯ We investigated patients with a Chest pain DRG to examine whether tests rates changed for specific test groups by hospital emergency department (ED) pre- and post-EMR. There was little change in testing rates between EDs or between time periods pre- and post-EMR. This is a valuable method for monitoring the impact of EMR and clinical decision support on test order rates.
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Smartphones have become increasingly popular among every segment of the population. Caregivers do not want to miss out on this evolution and express interest in using mobile devices to perform their everyday care. This tendency has been well understood by many software providers who have produced many medical applications for smartphones. ⋯ In this paper, we look to adopt a rigorous approach to acquire evidence about these concerns through a prospective study. In order to get this evidence, the study compares several input interfaces in the context of recording vital signs on mobile devices. We would like to discover not only which interface is the most efficient, but also which one is the least prone to errors.
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Stud Health Technol Inform · Jan 2013
Clinical handover improvement in context: exploring tensions between user-centred approaches and standardisation.
User-centred approaches in the development and evaluation of health information systems promote the importance of involving users and understanding their social contexts to optimise the quality and safety of these systems for patient care. Simultaneously, the standardisation of clinical practices has also been advocated to improve the quality and safety of patient care. In the context of clinical handover improvement within three different departments in one tertiary teaching hospital, this paper highlights the potential for tensions between these two approaches and explores their implications. ⋯ This led to the project developing distinct minimum data sets for each of the three departments that posed challenges for efforts to standardise handover practices across the hospital and for building an integrated information system. While on the one hand accommodating unique departmental user requirements was valuable, they revealed the potential for the introduction of quality and safety risks at the organisational level. To resolve these tensions, the project team developed an approach called flexible standardisation that has now been embedded in Australia' s national guidelines on clinical handover improvement.
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Stud Health Technol Inform · Jan 2013
Using the intubating laryngeal tube in a manikin - user evaluation of a new airway device.
This work describes the use of a new intubation device, the intubating laryngeal tube (iLTA) as developed by Boedeker. Emergency Department residents and staff from the University of Nebraska Medical Center performed intubations using the Laerdal Difficult Airway Trainer Manikin(TM). The participants' perceived value of the intubating laryngeal tube as well as its efficacy in intubation performance were measured and found to be highly favorable.
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Stud Health Technol Inform · Jan 2013
Analysis of the interface and data transfer from ICU to normal wards in a German University Hospital.
Typically general wards and intensive care units (ICU) have very different labor organizations, structures and IT-systems in Germany. There is a need for coordination, because of the different working arrangements. Our team investigated the interface between ICU and general ward and especially the respective information transfer in the University hospital in Erlangen (Bavaria, Germany). ⋯ In a second step, we investigate the requirements of data transmission in expert interviews. A data transfer concept from the perspective of the nurses and physicians was developed and we formulated recommendations for improvements of process and communication for this interface. Finally the data transfer concept was evaluated by the respondents.