Paola Russo, Miriam Piazza, Giorgio Leonardi, Layla Roncoroni, Carlo Russo, Salvatore Spadaro, Silvana Quaglini
1168 - 1170
The blood transfusion is a complex activity subject to a high risk of eventually fatal errors. The development and application of computer-based systems could help reducing the error rate, playing a fundamental role in the improvement of the quality of care. This poster presents an under development eLearning tool formalizing the guidelines of the transfusion process. This system, implemented in YAWL (Yet Another Workflow Language), will be used to train the personnel in order to improve the efficiency of care and to reduce errors.
Carla Rognoni, Gabriella Fizzotti, Caterina Pistarini, M. Cristina Mazzoleni
1171 - 1173
Regarding the impact of visceral dysfunction on quality of life, bowel and bladder management is a very important problem. The management of the patient with neurological bladder is often a source of uncertainty for both patients and healthcare personnel. Since the need of specialized training is growing, two CME e-learning courses have been developed to provide physicians and nurses competencies for the enhancement of the daily life of the patients. The present study aims at evaluating courses attendance and outcomes. Attendance data confirm the interest for both courses. The results document a pretty good objective and subjective effectiveness of the e-learning courses but low attitude to exploit he support of an asynchronous tutor. The analysis of test results gives some hints for eventual quality improvement of the courses themselves.
A national patient portal for secure communication between the patients/citizens and primary care (Mina vårdkontakter) is available in Sweden. This system was used in a pilot project in the Stockholm County where patients were invited to prepare the visit to their physician for the discussion on the need for prolonged sickness leave by filling out a web based questionnaire on their current health status and working conditions. The opinions of the patients and their primary care physicians about the system were analyzed with positive feedback.
Eunhye Kim, Sooyoung Yoo, Hwang Hee, Hyunchul Park, Gunhee Kim, Sungdo Ha
1177 - 1179
This paper presents the design of a system for a context-aware guidance service for hospital outpatients. Many patients have difficulties in knowing what to do and where to go due to the complexity of hospital-related processes and building structures. The intelligent hospital of the future will evolve in a smart way to automatically provide patients' smart mobile devices with relevant guidance information regarding their tasks, location, and process. In this study, we developed a context-aware-based hospital digital guidance system and evaluated ser satisfaction with respect to outpatient visits. From our pilot experiments with 15 outpatients, they were satisfied with the service. We believe that such a smart system would be a promising model for developing the intelligent hospitals of the future.
Mithat Koca, Gabriele Husmann, Jürgen Jesgarz, Martin Overath, Christian Brandts, Hubert Serve
1180 - 1181
A powerful hospital information system (HIS) contains information about diagnostic and disease data of all patients in a hospital. In the university hospital in Frankfurt / Main Germany more than 80% of all wards are completely “paperless”. But the identification of patients for clinical trials is very difficult. We developed a special query and reporting tool in the HIS to recognize patients with a specific disease and with basic inclusion and exclusion criteria for a specific clinical trial. With the help of this query tool it is possible to increase significantly the patient numbers for clinical trials in a short period.
SunHee Lee, KiHyuk Lee, Eun-Young Cho, Hee Hwang, KiDong Kim, Young-Jae Cho, JungEun Kim, Jae Hyuk Lee, Rong Min Baek, YoungSik Jeon
1182 - 1184
With the developments in medical information systems and the widespread establishment of medical information systems that include computerized order communication systems (OCSs), there has been an increase in the establishment of computerized chemotherapy order systems. In this study, we aim to design an improved computerized provider order entry (CPOE) system that integrates a chemotherapy ordering system that can issue a customized order in response to a provider's diverse chemotherapy prescription needs with an automated issuance of dosage, treatment schedule, and treatment method. We expect the newly designed system to be able to prevent the common errors in complex chemotherapy ordering systems and reduce the time required for ordering.
This paper presents the development of an expert system for the diagnosis of child autism and discusses potential benefits of its implementation in a clinical environment. The development of the expert system was based on a diagnostic algorithm supported by a developmental scale (PEDS) and a diagnostic tool of autism (CARS). Twelve nurses who work in pediatric hospital were asked to use the expert system for a session of 30 minutes and were asked to assess its usefulness, usability and diagnostic value. The majority of nurses agree that it is a useful and promising diagnostic tool for the clinical practice and for the identification of potential child autism cases.
The International Classification of Functioning, Disability and Health (ICF) is a WHO classification for health and health-related issues. In order to foster ICF application in information systems, we devised an implementation profile in ClaML (Classification Markup Language) that allows for representation of ICF subsets and we developed a web-based system for collecting ICF data based on from their ClaML representation. The implementation profile and the application have been tested on 17 subsets, which have been translated into ClaML and then submitted to the web application, to produce test documents.
The National Chemotherapy Advisory Group report has recommended that all hospitals in the UK with an Emergency Department should establish an acute oncology (AO) service. Acute oncology, when implemented at a clinical network level, presents significant challenges for informatics, including the requirement for ‘onco alerts’ – automated notification of admission of potential cancer patients, whose diagnosis may not be recorded on the admitting hospital's IT systems. In this short paper we present a case study and describe an approach to supporting the development of AO services with cross-organisational information systems.
Sameer Malhotra, Jessica S. Ancker, J. Travis Gossey, Curtis L. Cole, Rainu Kaushal, Adam D Cheriff
1194 - 1196
Prescription drugs are a significant component of the ever increasing health care costs. We describe the effects on generic medication prescribing behavior achieved through redesign of the order entry interface of our institutions ambulatory electronic health record. The redesign involved custom programming that automatically substituted brand medications with their generic equivalents and only allowed continuation with the brand medication if the clinician made an extra mouse click selecting “dispense as written”. We conducted a before-after retrospective study around the time of the redesign and witnessed a net 36.9% percentage increase in the number of generic medications prescribed.
Mohammad Zare, Abolfazl Rezaee, Sholeh Zakiani, Amir Zare
1197 - 1199
The present paper reports the results of a project aimed at providing Iran with a an online registry for breast cancer patients. A new ad hoc system/software has been developed in order to collect patients' data from the first visit to follow-up visits, including tests and Herceptin based therapy. The system has been designed to address both healthcare personnel needs, but also decision makers' information needs. After having identified in the country the laboratories performing the specific tests and the pharmacies that distribute Hercepting, the developed software have been installed in order to build the operational network representing the input points for the register. In 8 months of usage the results are:
• Total number of Patients: 2240 inhabitant
• Total number of doctors have participated in the program: 229 persons
• Number of provinces contributing to the project: 17 provinces out of 30.
Online registry of breast cancer is country's requirement because this system not only delivers services for laboratories, pharmacies and all physicians for their patients' follow up and monitoring, but also provides ability to access and analyze collected data for managers and experts.
Emmanuel Eschmann, Patrick E. Beeler, Vladimir Kaplan, Markus Schneemann, Gregor Zünd, Jürg Blaser
1200 - 1202
Computer-triggered reminders alerting physicians on every potentially harmful drug-drug-interaction (DDI) induce alert fatigue due to frequent messages of limited clinical relevance. On demand DDI-checks, however, are not commonly used by physicians. Optimal strategies for sustained quality assurance have to consider patients' risk factors and focus on the most significant DDIs only. An approach is proposed based on the analysis of concurrent prescription of potassium-sparing diuretics and potassium supplements (CPPP), which are the most frequent DDIs classified as contraindicated. Although the frequency of monitoring potassium serum levels declined during prolonged periods of CPPP, the likelihood of observing a hyperkalaemia increased. The median treatment period of CPPP was 3.3 days, whereas hyperkalaemia occurred after a median observation time of 4.5 days of CPPP. Thus, computer-triggered reminders for ordering potassium serum levels may be indicated if monitoring has been discontinued after 48h of CPPP.
Nassim Douali, Jos De Roo, Marie-Christine Jaulent
1203 - 1205
Personalized medicine may be considered an extension of traditional approaches to understanding and treating diseases, but with greater precision. A profile of a patient's genetic variation can guide the selection of drugs or treatment protocols that minimize harmful side effects or ensure a more successful outcome. In this paper we describe a decision support system designed to assist physicians for personalized care, and methodology for integration in the clinical workflow. A reasoning method for interacting heterogeneous knowledge and data is a necessity in the context of personalized medicine. Development of clinical decision support based semantic web for personalized patient care is to achieve its potential and improve the quality, safety and efficiency of healthcare.
Hyeoun-Ae Park, Yul Ha Min, Eunjoo Jeon, Younglan Kim, Hyun-Young Km
1206 - 1208
The purpose of this study was to test the feasibility of an electronic nursing records system for perinatal care that is based on information models and clinical practice guidelines in perinatal care. We first generated 799 nursing statements describing nursing assessment, diagnoses, interventions, and outcomes using the entities, attributes, and value sets of detailed clinical models for perinatal care that we developed in a previous study. We then extracted 506 detailed recommendations from clinical practice guidelines. Finally, we created sets of nursing statements to be used for nursing documentation by grouping nursing statements based on these detailed recommendations. A prototype electronic nursing records system providing nurses with detailed recommendations for nursing practice and sets of nursing statements based on the detailed recommendations to guide nursing documentation was developed and evaluated.
Wouter T. Gude, Airin C.R. Simon, Linda W.P. Peute, Frits Holleman, Joost B.L. Hoekstra, Niels Peek, Monique W.M. Jaspers
1209 - 1211
We developed a web-based system supporting patients in insulin self-titration and their caregivers in monitoring patients' self-management activities. Since usability flaws could cause user attrition and compromise patient safety, we evaluated the system's usability prior to its implementation in practice. Two pairs of researchers conducted cognitive walkthrough sessions and identified 81 unique usability problems, including four with a potential impact on patient safety. Usability evaluations could reveal many usability problems and allow solving the problems while avoiding user attrition and potential adverse patient events.
Visually-impaired people can develop several unhealthy behaviors, including the lack of physical activity or sports, due to the incomplete maturity in the control of their body in the space. This research focuses on the creation of an “exergame” – a videogame especially designed to stimulate physical exercise – that, through voice commands, allows the visually impaired users to practice physical activity and train their abilities. This tool has been developed starting from an existing dance-game, by generating some appropriate interfaces that also involve the sensory channel of sight. Our research aims to study the effects related to this exergame on the motor control mechanism in a blind children's group, aged between 8 and 13 years: it focuses also on the joint use of movement analysis systems and of videogames in order to stimulate the physical activity in these subjects.
Carina Zetterberg, Karin Ahlzén, Erika Ericsson, Bengt Kron
1215 - 1217
Structured code-based documentation, i.e. templates which restrain the user with predetermined terms/phrases bound to terminologies, offers opportunities for advanced types of retrieval and guides the user in multiple ways; to act in accordance with evidence, for decision support and to achieve adequate documentation for the condition in question. This type of documentation is especially appropriate in health care processes which are nearly the same every time. A template for documentation of the family planning process (abortion) was elaborated at a Swedish hospital. It uses both structured elements and free-text and covers all information needed in the process. The predetermined terms and phrases were bound to SNOMED CT concepts. After the template has been completed, it forms the basis for a customary free-text note in the record. The structured information is also stored in its original form and can be used for different kinds of advanced data retrieval. The documentation is completed during the visit and there is no need for additional secretarial work. The implementation has reduced the total time used for documentation, reporting and follow up and shows that process-oriented structured documentation bound to SNOMED CT improves the documentation, supports advanced retrieval of data and reduces resource utilization.
Videoconferencing may help reduce traveling and may save time and money for patients and the health care system. Despite the fact that studies have found videoconferencing as good as face-to-face interactions for certain therapies, few in northern Norway use this tool routinely for the assessment and treatment of patients. We examined clinicians‘ experiences with videoconferencing and their attitudes to using this tool for psychiatric consultations, and discussed the findings in light of the Technology Acceptance Model. Obstacles to use and how they may be overcome are discussed.
Myungja Koh, Parvati Dev, Eun-Jung Lee, Byung-Ki Koo, Kyung-Oak Lee, Kukhwa Ha, Heesun Yang, Gilwon Kang, Youngsung Lee
1221 - 1223
With recent spread of infectious diseases, worldwide emergency strategies against them have been made. As one of such efforts we planned to develop an educational program for public health manpower using IT, and produced 4 to 8 minute-long flash animations of the following subjects selected by Education Training Expert Committee: Self-care guideline on H1N1; Instruction for medical hospital; Prevention of hospital acquired infections; Method of sampling & transporting. Demonstrative education using an online education system was conducted targeting 10 doctors working in a rural health center to evaluate the developed animations. They received good marks in the factors of credibility and accuracy, but needed to improve in that of interaction with educatees. Our suggestion is that we use the result of our study as a prototype of education contents on infectious diseases, and modify its contents accordingly when a specific disease breaks out.
Amina Chniti, Abdelali Boussadi, Patrice Degoulet, Patrick Albert, Jean Charlet
1224 - 1226
In this paper we present an application of pharmaceutical validation of medication based on an OWL ontology and business rules or more specifically clinical decision rules. This application has been developed based on a prototype that enables business users to author, execute and manage their Business Rules over OWL Ontology. This prototype is based on the Business Rule Management System (BRMS) IBM WebSphere ILOG JRules.
The Common Medicine card (CMC) is a new national service in Denmark which aim is to ensure better patient care and minimize medication errors. All health professionals as well as authorities have to use this system. CMC requires changing the organization of work for both physicians and clinical staff in General Practice (GP). Commissioning of CMC in GP requires a significant effort beyond the technical installation of the solution. Finding the right way to implement a new service in a busy GP has been the main focus of the national project organization MedCom. MedCom has in collaboration with the five regions in Denmark, established a joint plan and has created an implementation model contraining various initiatives including “after hours” meetings for each service provider of EMR (Electronic Medicine Records) in order to disseminate and support the new CMC service. This paper shows the status of the “after hours” meetings effect in dissemination of CMC from August to November 2011.
The aim of this study was to validate a specially designed electronic medical records (EMRs) questionnaire for use in Taiwan. Published reviews of national trends and EMRs characteristics from seven countries in the Americas, Oceania, Europe, and Asia were used to design the Google-based document. This questionnaire is intended for use by medical institutions, government health units, manufacturers, academic institutions, and the public, and may be administered by information officers, non-IT staff (physicians, nurses, policymakers, vendors), and even people. A modified Delphi method was employed to determine the most appropriate content for the questionnaire. In conclusion, this research demonstrated trend analysis of several national EMRs, and also identified the meaningful use of EMR and establishing governmental EMR office are the important directions for Taiwan EMRs.