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Article
Publication date: 17 October 2008

John Park, Catherine McAlaney and Moira Connolly

This paper seeks to provide an overview of how the involvement of clinicians in the design and implementation of an electronic clinical information system has contributed towards…

3125

Abstract

Purpose

This paper seeks to provide an overview of how the involvement of clinicians in the design and implementation of an electronic clinical information system has contributed towards more effective clinical governance, while improving the care of patients with a diagnosis of psychosis.

Design/methodology/approach

A data collection form was designed by a consultant in public health and a group of consultant psychiatrists to facilitate and standardise the data to be collected and stored on the information system. Two research nurses conducted a retrospective case note audit to record specified data on all existing patients from an inclusive diagnosis list in contact with CMHTs.

Findings

The establishment of PsyCIS has increased the understanding of the nature and prevalence of psychosis in Greater Glasgow for patients aged 18‐65. As well as giving some insight into how the needs of this patient group are being addressed, it has also provided clinicians with the ability to benefit from their collective experience on the treatment and support of this patient group.

Practical implications

To ensure excellent data quality and information management systems, it is essential to involve clinicians in their design and validation. The primary goal of information should be to aid clinical practice and patient care. Well designed datasets will also provide information that can inform clinical governance as well as the management of services and resources.

Originality/value

This paper supports the view that clinical audit and electronic clinical information systems are imperative for effective clinical governance.

Details

Clinical Governance: An International Journal, vol. 13 no. 4
Type: Research Article
ISSN: 1477-7274

Keywords

Article
Publication date: 3 October 2008

Jeffrey P. Harrison and Geoffrey M. McDowell

The purpose of this study was to evaluate the status of US hospital Laboratory Information Systems. Laboratory Information Systems are critical to high quality healthcare service…

3404

Abstract

Purpose

The purpose of this study was to evaluate the status of US hospital Laboratory Information Systems. Laboratory Information Systems are critical to high quality healthcare service provision. Data show that the need for these systems is growing to meet accompanying technological and workload demands. Additionally, laboratory tests provide the majority of information for clinical decision‐making. Laboratory processes automation, including patient result verification, has greatly improved laboratory test throughput while decreasing turn‐around‐times, enabling critical results to reach physicians rapidly for improved clinical outcomes.

Design/methodology/approach

Data were drawn from the 2007 Healthcare Information and Management Systems Society (HIMSS) Analytics Database, which includes over 5,000 US healthcare organizations and provides extensive data on the hardware, software, and information technology infrastructure within healthcare organizations.

Findings

US hospitals are actively involved in laboratory systems planning to improve health service quality. Specifically, data show 76 new laboratory information systems are currently being installed in 2007 with another 399 under contract for future installation. As a result, increasing investment in laboratory information systems is providing state‐of‐the‐art clinical laboratory support, which enhances clinical care processes and improves quality. These state‐of‐the‐art Laboratory Information Systems, when linked with other clinical information systems such as Computerized Physician Order Entry and Electronic Medical Record, will support further healthcare quality improvement.

Originality/value

This article includes the most current information available on the US hospital laboratory information system applications.

Details

International Journal of Health Care Quality Assurance, vol. 21 no. 7
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 27 January 2012

Céline Bérard, L. Martin Cloutier and Luc Cassivi

If the use of information technology (IT) supporting clinical trial projects offers opportunities to optimize the underlying information management process, the intricacy of the…

Abstract

Purpose

If the use of information technology (IT) supporting clinical trial projects offers opportunities to optimize the underlying information management process, the intricacy of the identification and evaluation of relevant IT options is generally seen as a complex task in healthcare. Hence, the purpose of this paper is to examine the problem of ex ante information system evaluation, and assess the impact of IT on the information management process underlying clinical trials.

Design/methodology/approach

Combining Unified Modeling Language (UML) and system dynamics modeling, a simulation model for evaluating IT was developed. This modeling effort relies on a case study conducted in a clinical research organization, which, at that time, faced an IT investment dilemma.

Findings

Some illustrative results of sensitivity analyzes conducted on error rates in clinical data transmission are presented. These simulation results allow for quantifying the impact of different IT options on human resources' efforts, time delays and costs of clinical trials projects. Notably, the results show that although the technology has no real influence on the duration of a clinical trial project, it impacts the number of projects that can be carried out simultaneously.

Originality/value

The research provides insights into the development of an innovative approach appropriate to the evaluation of IT supporting clinical trials, through the use of a mixed‐method based on qualitative and quantitative modeling. The results illustrate two critical issues addressed in the IS literature: the necessity to extend IT evaluation beyond the quantitative‐qualitative dichotomy; and the role of evaluation in organizational learning, and in learning about business dimensions.

Article
Publication date: 1 June 2005

Andrea Jones, Flis Henwood and Angie Hart

This paper examines the factors that made services more or less effective in using electronic patient record systems to produce clinical information for clinical audit and…

2041

Abstract

Purpose

This paper examines the factors that made services more or less effective in using electronic patient record systems to produce clinical information for clinical audit and research.

Design/methodology/approach

Case studies of the use of electronic patient record systems in three maternity services in England, using qualitative research methods (semi‐structured interviews, observations and shadowing).

Findings

There were many contributing factors in each case site. The three main groups of determining factors were these: the resources devoted to, and acceptability to midwives of, the “IT midwife”; maternity managers prioritisation of information related matters; the relationship of maternity information systems with Trust‐wide systems.

Originality/value

Provides services with lists of factors they need to consider if they want to maximise the benefits realised for clinical audit and research from existing and new electronic patient record systems.

Details

Clinical Governance: An International Journal, vol. 10 no. 2
Type: Research Article
ISSN: 1477-7274

Keywords

Article
Publication date: 1 April 1996

JENNIFER MACDOUGALL, J. MICHAEL BRITTAIN and ROBERT GANN

This paper provides an overview of the range and development of health informatics, with examples from the literature world wide covering the types of information involved, the…

Abstract

This paper provides an overview of the range and development of health informatics, with examples from the literature world wide covering the types of information involved, the areas of application, the impact of evidence based medicine and other professional issues, integrated information systems, and the needs of the public, patients and their carers. While medical informatics certainly comprises a major part of health informatics it is not the main focus of this paper. Medical informatics is the older term and involves the use of information technology and computing specifically for medical science research, and the diagnosis and treatment of disease involving, for example, X‐rays, imaging, resonance, and magnetic scanning techniques. Rather, the scope of this review is the literature relating to the wider concept of the management of information through the interdisciplinary application of information science and technology for the benefit of patients, scientists, managers, staff, and carers involved in the whole range of healthcare activity.

Details

Journal of Documentation, vol. 52 no. 4
Type: Research Article
ISSN: 0022-0418

Book part
Publication date: 1 November 2007

Irina Farquhar, Michael Kane, Alan Sorkin and Kent H. Summers

This chapter proposes an optimized innovative information technology as a means for achieving operational functionalities of real-time portable electronic health records, system

Abstract

This chapter proposes an optimized innovative information technology as a means for achieving operational functionalities of real-time portable electronic health records, system interoperability, longitudinal health-risks research cohort and surveillance of adverse events infrastructure, and clinical, genome regions – disease and interventional prevention infrastructure. In application to the Dod-VA (Department of Defense and Veteran's Administration) health information systems, the proposed modernization can be carried out as an “add-on” expansion (estimated at $288 million in constant dollars) or as a “stand-alone” innovative information technology system (estimated at $489.7 million), and either solution will prototype an infrastructure for nation-wide health information systems interoperability, portable real-time electronic health records (EHRs), adverse events surveillance, and interventional prevention based on targeted single nucleotide polymorphisms (SNPs) discovery.

Details

The Value of Innovation: Impact on Health, Life Quality, Safety, and Regulatory Research
Type: Book
ISBN: 978-1-84950-551-2

Article
Publication date: 1 October 1998

Christine Urquhart

The progress of initiatives concerned with implementing evaluated clinical research (such as evidence based medicine and clinical effectiveness) is dependent on the way individual…

831

Abstract

The progress of initiatives concerned with implementing evaluated clinical research (such as evidence based medicine and clinical effectiveness) is dependent on the way individual health professionals actually acquire, use and value clinical knowledge in routine practice. The findings of two research projects, the Value and EVINCE projects, are compared with studies of the consolidation and application of clinical knowledge in clinical decision making. The Value project was concerned with the ways in which information from NHS libraries might be used in present and future clinical decision making. EVINCE was a similar impact study for nursing professionals. Both studies confirmed the importance of personal clinical knowledge. Health information services need to use a variety of strategies and knowledge management skills to ensure that the evaluated research evidence is assimilated and implemented into practice.

Details

Journal of Documentation, vol. 54 no. 4
Type: Research Article
ISSN: 0022-0418

Keywords

Abstract

Details

Advances in Librarianship
Type: Book
ISBN: 978-0-12024-618-2

Book part
Publication date: 24 October 2019

Susan P. McGrath, Irina Perreard, Joshua Ramos, Krystal M. McGovern, Todd MacKenzie and George Blike

Failure to rescue events, or events involving preventable deaths from complications, are a significant contributor to inpatient mortality. While many interventions have been…

Abstract

Failure to rescue events, or events involving preventable deaths from complications, are a significant contributor to inpatient mortality. While many interventions have been designed and implemented over several decades, this patient safety issue remains at the forefront of concern for most hospitals. In the first part of this study, the development and implementation of one type of highly studied and widely adopted rescue intervention, algorithm-based patient assessment tools, is examined. The analysis summarizes how a lack of systems-oriented approaches in the design and implementation of these tools has resulted in suboptimal understanding of patient risk of mortality and complications and the early recognition of patient deterioration. The gaps identified impact several critical aspects of excellent patient care, including information-sharing across care settings, support for the development of shared mental models within care teams, and access to timely and accurate patient information.

This chapter describes the use of several system-oriented design and implementation activities to establish design objectives, model clinical processes and workflows, and create an extensible information system model to maximize the benefits of patient state and risk assessment tools in the inpatient setting. A prototype based on the product of the design activities is discussed along with system-level considerations for implementation. This study also demonstrates the effectiveness and impact of applying systems design principles and practices to real-world clinical applications.

Details

Structural Approaches to Address Issues in Patient Safety
Type: Book
ISBN: 978-1-83867-085-6

Keywords

Article
Publication date: 1 February 2013

Janis L. Gogan, Ryan J. Baxter, Scott R. Boss and Alina M. Chircu

Key findings from recent and relevant studies on patient safety and clinical handoffs are summarized and analyzed. After briefly reviewing process management and accounting…

2321

Abstract

Purpose

Key findings from recent and relevant studies on patient safety and clinical handoffs are summarized and analyzed. After briefly reviewing process management and accounting control theory, the aim of this paper is to discuss how these latter two disciplines can be combined to further improve patient safety in handoffs.

Design/methodology/approach

A literature review on studies of patient safety, clinical processes and clinical handoffs was conducted in leading medical, quality, and information systems journals.

Findings

This paper issues a call for research using a trans‐disciplinary methodology to shed new light on information quality issues in clinical handoff processes, which in turn should improve patient safety.

Research limitations/implications

The literature review employed systematic, heuristic, iterative and practical criteria for identifying and selecting papers, trading off completeness for multi‐disciplinarity. No prior empirical patient safety studies combined process management and accounting control theory.

Practical implications

The above‐noted trans‐disciplinary analytic approach may help medical professionals develop more effective handoff processes, checklists, standard operating procedures (SOPs), clinical pathways, and supporting software, and audit and continuously monitor their implementation.

Originality/value

This paper responds to recent calls for trans‐disciplinary research on healthcare quality improvement. The literature review is valuable for understanding clinical handoff problems and solutions from multiple perspectives. The proposed combination of two theories – accounting control theory and business process management – is novel and useful for describing, improving and monitoring handoff processes in the broader context of clinical processes, using a common terminology for information quality traits.

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