Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2012
Identifying types and causes of errors in mortality data in a clinical registry using multiple information systems.
Errors may occur in the registration of in-hospital mortality, making it less reliable as a quality indicator. We assessed the types of errors made in in-hospital mortality registration in the clinical quality registry National Intensive Care Evaluation (NICE) by comparing its mortality data to data from a national insurance claims database. Subsequently, we performed site visits at eleven Intensive Care Units (ICUs) to investigate the number, types and causes of errors made in in-hospital mortality registration. ⋯ The remaining 20% were five types of manual transcription errors and human failures to record outcome data. Clinical registries should be aware of the possible existence of errors in recorded outcome data and understand their causes. In order to prevent errors, we recommend to thoroughly verify the software that is used in the registration process.
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Stud Health Technol Inform · Jan 2012
Challenges of the e-Health curricular education in bio-medical engineering and in medicine.
Curricular recommendations coming from highly respectable associations are highly useful. Nevertheless, they show fatigue in keeping the pace of any fast evolution, as in the ICT happens. So we do the attempt to disclose the emerging challenges affecting e-Health curricular education.
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Stud Health Technol Inform · Jan 2012
The use of linked registries to assess long-term mortality of ICU patients.
Clinical registries are frequently used to monitor and analyze the quality of health care by assessing the in-hospital mortality. However, long-term mortality is often ignored as it is rarely recorded in such clinical registries. In this study linkage of a clinical registry and administrative database is used to assess the longterm mortality of a large ICU sample. ⋯ In this study we have focused on the general ICU population, though linkage of clinical and administrative databases can also be used to perform analyses in specific diagnostic ICU populations or for non-ICU patients. In this study 71.4% of the clinical records could be linked with the administrative database. Future studies should focus on improving linkage of different registries.
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Stud Health Technol Inform · Jan 2012
Use of a virtual integrated environment in prosthetic limb development and phantom limb pain.
Patients face two major difficulties following limb loss: phantom limb pain (PLP) in the residual limb and limited functionality in the prosthetic limb. Many studies have focused on decreasing PLP with mirror therapy, yet few have examined the same visual ameliorating effect with a virtual or prosthetic limb. ⋯ Preliminary results show an overall reduction in PLP and a trend toward improvement in signal-to-motion accuracy over time. These signals allowed MPL users to perform a wide range of hand motions.
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Electronic Health Record (EHR) data has the potential to track patients' journeys through healthcare systems. Many of those journeys are supposed to follow Integrated Care Pathways (ICPs) built on evidence based guidelines. An ICP for a particular condition sets out "what should happen", whereas the EHR records "what did happen". ⋯ By performing variance analysis over multiple patients, patterns of deviation from idealised care are revealed. The use of ICP variance analysis, however, is not as widespread as it could be in healthcare quality improvement processes - we argue that this is due to the difficulty of combining the required specialist knowledge and skills from different disciplines. COCPIT (Collaborative Online Care Pathway Investigation Tool) was developed to overcome this difficulty and provides clinicians and health service managers with a web-based tool for Care Pathway Variance Analysis.