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Journal of Innovation in Health Informatics

Simon De Lusignan, John Williams, William Hinton, Neil Munro
No abstract text is available yet for this article.
2016: Journal of Innovation in Health Informatics
Simon De Lusignan
No abstract text is available yet for this article.
2016: Journal of Innovation in Health Informatics
Harshana Liyanage, Daniela Luzi, Simon De Lusignan, Fabrizio Pecoraro, Richard McNulty, Oscar Tamburis, Paul Krause, Michael Rigby, Mitch Blair
Background Modelling is an important part of information science. Models are abstractions of reality. We use models in the following contexts: (1) to describe the data and information flows in clinical practice to information scientists, (2) to compare health systems and care pathways, (3) to understand how clinical cases are recorded in record systems and (4) to model health care business models.Asthma is an important condition associated with a substantial mortality and morbidity. However, there are difficulties in determining who has the condition, making both its incidence and prevalence uncertain...
2016: Journal of Innovation in Health Informatics
Denice Colleen Lewis, Pierre Pluye, Charo Rodriguez, Roland Grad
A mixed methods research (sequential explanatory design) studied the potential of mining the data from the consumers of continuing medical education (CME) programs, for the developers of CME programs. The quantitative data generated by family physicians, through applying the information assessment method to CME content, was presented to key informants from the CME planning community through a qualitative description study.The data were revealed to have many potential applications including supporting the creation of CME content, CME program planning and personal learning portfolios...
2016: Journal of Innovation in Health Informatics
Ching-Pin Lin, Janelle Guirguis-Blake, Gina A Keppel, Sharon Dobie, Justin Osborn, Allison M Cole, Laura-Mae Baldwin
BACKGROUND: Adverse drug events (ADEs) are a leading cause of death in the United States. Patients with stage 3 and 4 chronic kidney disease (CKD) are at particular risk because many medications are cleared by the kidneys. Alerts in the electronic health record (EHR) about drug appropriateness and dosing at the time of prescription have been shown to reduce ADEs for patients with stage 3 and 4 CKD in inpatient settings, but more research is needed about the implementation and effectiveness of such alerts in outpatient settings...
2016: Journal of Innovation in Health Informatics
Yushi Yang, Onur Asan
UNLABELLED: HASH(0x3b6ab78) INTRODUCTION: The implementation of health information technologies (HITs) has changed the dynamics of doctor-patient communication in outpatient settings. Designing patient-facing HITs provides patients with easy access to healthcare information during the visit and has the potential to enhance the patient-centred care.  OBJECTIVES: The objectives of this study are to systematically review how the designs of patient-facing HITs have been suggested and evaluated, and how they may potentially affect the doctor-patient communication and patient-centred care...
2016: Journal of Innovation in Health Informatics
Quynh Nguyen, Gillian Bartlett, Charo Rodriguez, Pierre-Paul Tellier
BACKGROUND: Personal health records (PHRs) are tools that allow individuals to access, share and manage their health information online. Despite apparent interest, adoption rates remain low. There is a gap in our understanding as to what different populations of users, in particular young adults, might want from such a tool. OBJECTIVE: To describe and interpret the views and expectations of young healthy adults about using an online PHR. METHODS: A qualitative descriptive study was carried out...
2016: Journal of Innovation in Health Informatics
Richard Schreiber, Steven H Shaha
Background Research regarding return on investment for electronic health records (EHRs) is sparse.Objective To extend previously established research and examine rigorously whether increasing the adoption of computer-based provider/prescriber order entry (CPOE) leads to a decrease in length of stay (LOS), and to demonstrate that the two are inversely and bidirectionally proportional even while other efforts to decrease LOS are in place.Method The study assessed CPOE, LOS and case mix index (CMI) data in a community hospital in the United States, using a mature and nearly fully deployed vendor product EHR...
2016: Journal of Innovation in Health Informatics
Harry B Burke, Dorothy A Becher, Albert Hoang, Ronald W Gimbel
BACKGROUND: A major justification for the clinical adoption of electronic health records (EHRs) was the expectation that it would improve the quality of medical care. No longitudinal study has tested this assumption. OBJECTIVE: We used hemoglobin A1c, a recognized clinical quality measure directly related to diabetes outcomes, to assess the effect of EHR use on clinical quality. METHODS: We performed a five-and-one-half-year multicentre longitudinal retrospective study of the A1c values of 537 type 2 diabetic patients...
2016: Journal of Innovation in Health Informatics
Simon De Lusignan
No abstract text is available yet for this article.
2015: Journal of Innovation in Health Informatics
Simon De Lusignan, Harshana Liyanage, Concetta Tania Di Iorio, Tom Chan, Siaw-Teng Liaw
BACKGROUND: The use of health data for public health, surveillance, quality improvement and research is crucial to improve health systems and health care. However, bodies responsible for privacy and ethics often limit access to routinely collected health data. Ethical approvals, issues around protecting privacy and data access are often dealt with by different layers of regulations, making approval processes appear disjointed. OBJECTIVE: To create a comprehensive framework for defining the ethical and privacy status of a project and for providing guidance on data access...
2015: Journal of Innovation in Health Informatics
James Hayward, Susan Buckingham, Fionagh Thomson, Heather Milne, Aziz Sheikh, Bernard Fernando, Kathrin Cresswell, Robin Williams, Hilary Pinnock
BACKGROUND: Systematic reviews have suggested that time spent on computer-related tasks increases consultation length. However, these reviews pre-date the current ubiquitous use of computers in U.K. general practice. OBJECTIVE: As part of a U.K. national study of the influence of information technology (IT) on the interaction between patients and healthcare professionals during consultations, we explored how IT functions affected time allocation and styles of computer use during general practitioner (GP) consultations...
2015: Journal of Innovation in Health Informatics
James Brennan, Annette McElligott, Norah Power
OBJECTIVE: Recent research from the European Commission (EC) suggests that the development and adoption of eHealth in primary care is significantly influenced by the context of the national health model in operation. This research identified three national health models in Europe at this time - the National Health Service (NHS) model, the social insurance system (SIS) model and the transition country (TC) model, and found a strong correlation between the NHS model and high adoption rates for eHealth...
2015: Journal of Innovation in Health Informatics
Lisa Lee, Robin Williams, Aziz Sheikh
BACKGROUND: Hospital ePrescribing systems are expected to improve quality of care for patients, yet the perspectives of patients themselves have seldom been explored in the context of ePrescribing deployments. OBJECTIVE: We sought to understand the significance of ePrescribing for patients through a case study of renal in-patients on a hospital ward, before and after the introduction of an ePrescribing system. METHODS: Three data sources were drawn on as part of the case study: interviews with representatives from national patient groups (n = 10), in-patients on a renal ward (n = 11 pre-implementation; n = 12 post-implementation) and fieldnotes (n = 25) of observations made on the case study ward...
2015: Journal of Innovation in Health Informatics
Ferran Ariza, Dipak Kalra, Henry Ww Potts
BACKGROUND: Clinical information systems in the National Health Service do not need to conform to any explicit usability requirements. Poor usability can increase the mental workload experienced by clinicians and cause fatigue, increase error rates and impact the overall patient safety. Mental workload can be used as a measure of usability. OBJECTIVE: To assess the subjective cognitive workload experienced by general practitioners (GPs) with their systems. To raise awareness of the importance of usability in system design among users, designers, developers and policymakers...
2015: Journal of Innovation in Health Informatics
Marium Gul Muhammad
No abstract text is available yet for this article.
2015: Journal of Innovation in Health Informatics
Carol S Bond
Health informatics is a relatively young discipline, bringing together professionals with a range of backgrounds, including management professionals, computer specialists and health care professionals. A lot of focus has been on developing systems such as medical records and information sharing, and it also has the potential to span the boundaries between health care professionals and patients. This is especially true for people living with a long-term condition.
2015: Journal of Innovation in Health Informatics
Simon de Lusignan
Informaticians continue to rise to the challenge, set by the English Health Minister, of trying to replace doctors' judgement with computers. This issue describes successes and where there are barriers. However, whilst there is progress this tends to be incremental and there are grand challenges to be overcome before computers can replace clinician. These grand challenges include: (1) improving usability so it is possible to more readily incorporate technology into clinical workflow; (2) rigorous new analytic methods that make use of the mass of available data, 'Big data', to create real-world evidence; (3) faster ways of meeting regulatory and legal requirements including ensuring privacy; (4) provision of reimbursement models to fund innovative technology that can substitute for clinical time and (5) recognition that innovations that improve quality also often increase cost...
2015: Journal of Innovation in Health Informatics
Simon de Lusignan, Laura Crawford, Neil Munro
New forms of evidence are needed to complement evidence generated from randomised controlled trials (RCTs). Real-World Evidence (RWE) is a potential new form of evidence, but remains undefined. This paper sets to fill that gap by defining RWE as the output from a rigorous research process which: (1) includes a clear a priori statement of a hypothesis to be tested or research question to be answered; (2) defines the data sources that will be used and critically appraises their strengths and weaknesses; and (3) applies appropriate methods, including advanced analytics...
2015: Journal of Innovation in Health Informatics
Marie-Pierre Gagnon, Julie Payne-Gagnon, Claude Sicotte, Julie-Alexandra Langué-Dubé, Aude Motulsky
BACKGROUND: The use of medication is at the heart of primary care, but is also the cause for major health concerns. It is therefore important to examine the prescription of medication process. OBJECTIVE: This study identifies the barriers and facilitators perceived by community pharmacists and primary care physicians concerning the adoption of a nationwide electronic prescribing (e-prescribing) network in the province of Quebec, Canada. METHODS: We used purposive sampling to identify the most intensive users of the e-prescribing network...
2015: Journal of Innovation in Health Informatics
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