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Article
Publication date: 8 February 2013

Ofir Ben‐Assuli and Moshe Leshno

Although very significant and applicable, there have been no formal justifications for the use of Monte‐Carlo models and Markov chains in evaluating hospital admission decisions…

Abstract

Purpose

Although very significant and applicable, there have been no formal justifications for the use of Monte‐Carlo models and Markov chains in evaluating hospital admission decisions or concrete data supporting their use. For these reasons, this research was designed to provide a deeper understanding of these models. The purpose of this paper is to examine the usefulness of a computerized Monte‐Carlo simulation of admission decisions under the constraints of emergency departments.

Design/methodology/approach

The authors construct a simple decision tree using the expected utility method to represent the complex admission decision process terms of quality adjusted life years (QALY) then show the advantages of using a Monte‐Carlo simulation in evaluating admission decisions in a cohort simulation, using a decision tree and a Markov chain.

Findings

After showing that the Monte‐Carlo simulation outperforms an expected utility method without a simulation, the authors develop a decision tree with such a model. real cohort simulation data are used to demonstrate that the integration of a Monte‐Carlo simulation shows which patients should be admitted.

Research limitations/implications

This paper may encourage researchers to use Monte‐Carlo simulation in evaluating admission decision implications. The authors also propose applying the model when using a computer simulation that deals with various CVD symptoms in clinical cohorts.

Originality/value

Aside from demonstrating the value of a Monte‐Carlo simulation as a powerful analysis tool, the paper's findings may prompt researchers to conduct a decision analysis with a Monte‐Carlo simulation in the healthcare environment.

Details

Journal of Enterprise Information Management, vol. 26 no. 1/2
Type: Research Article
ISSN: 1741-0398

Keywords

Article
Publication date: 20 July 2012

Ofir Ben‐Assuli and Moshe Leshno

The purpose of this paper is to evaluate the contribution of medical information systems (IS) to efficient use of information when diagnosing chest pain complaints with suspected…

564

Abstract

Purpose

The purpose of this paper is to evaluate the contribution of medical information systems (IS) to efficient use of information when diagnosing chest pain complaints with suspected acute myocardial infarction (AMI) as regards ordering of tests and accuracy of diagnosis.

Design/methodology/approach

In total, 102 physicians were asked to diagnose three cases of chest pain in patients consulting an emergency department (ED) in a simulation study. Half of the participants had access to a medical IS with complete patient information and the other half of the physicians did not.

Findings

It was found that participants who viewed the medical IS ordered fewer clinical examinations. Participants who viewed the medical histories made a more accurate main differential diagnosis (DD) of AMI. Physicians with access to the medical history reported significantly higher levels of confidence in their decisions, regardless of seniority.

Originality/value

The findings suggest that IS leads to better utilization of medical services, greater efficiency and lower costs and thus has implications for other healthcare sectors.

Details

Journal of Enterprise Information Management, vol. 25 no. 4
Type: Research Article
ISSN: 1741-0398

Keywords

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Article
Publication date: 20 July 2012

Zahir Irani and Yogesh Dwivedi

167

Abstract

Details

Journal of Enterprise Information Management, vol. 25 no. 4
Type: Research Article
ISSN: 1741-0398

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