'You can't just hit a button': an ethnographic study of strategies to repurpose data from advanced clinical information systems for clinical process improvement.

Abstract:

BACKGROUND:Current policies encourage healthcare institutions to acquire clinical information systems (CIS) so that captured data can be used for secondary purposes, including clinical process improvement. Such policies do not account for the extra work required to repurpose data for uses other than direct clinical care, making their implementation problematic. This paper aims to analyze the strategies employed by clinical units to use data effectively for both direct clinical care and clinical process improvement. METHODS:Ethnographic methods were employed. A total of 54 contextual interviews with health professionals spanning various disciplines and 18 hours of observation were carried out in 5 intensive care units in England using an advanced CIS. Case studies of how the extra work was achieved in each unit were derived from the data and then compared. RESULTS:We found that extra work is required to repurpose CIS data for clinical process improvement. Health professionals must enter data not required for clinical care and manipulation of this data into a machine-readable form is often necessary. Ambiguity over who should be responsible for this extra work hindered CIS data usage for clinical process improvement. We describe 11 strategies employed by units to accommodate this extra work, distributing it across roles. Seven of these motivated data entry by health professionals and four addressed the machine readability of data. Many of the strategies relied heavily on the skill and leadership of local clinical customizers. CONCLUSIONS:To realize the expected clinical process improvements by the use of CIS data, clinical leaders and policy makers need to recognize and support the redistribution of the extra work that is involved in data repurposing. Adequate time, funding, and appropriate motivation are needed to enable units to acquire and deliver the necessary skills in CIS customization.

journal_name

BMC Med

journal_title

BMC medicine

authors

Morrison C,Jones M,Jones R,Vuylsteke A

doi

10.1186/1741-7015-11-103

subject

Has Abstract

pub_date

2013-04-10 00:00:00

pages

103

issn

1741-7015

pii

1741-7015-11-103

journal_volume

11

pub_type

杂志文章
  • Spectrum of gluten-related disorders: consensus on new nomenclature and classification.

    abstract::A decade ago celiac disease was considered extremely rare outside Europe and, therefore, was almost completely ignored by health care professionals. In only 10 years, key milestones have moved celiac disease from obscurity into the popular spotlight worldwide. Now we are observing another interesting phenomenon that i...

    journal_title:BMC medicine

    pub_type: 杂志文章,评审

    doi:10.1186/1741-7015-10-13

    authors: Sapone A,Bai JC,Ciacci C,Dolinsek J,Green PH,Hadjivassiliou M,Kaukinen K,Rostami K,Sanders DS,Schumann M,Ullrich R,Villalta D,Volta U,Catassi C,Fasano A

    更新日期:2012-02-07 00:00:00

  • Hair regrowth in alopecia areata patients following Stem Cell Educator therapy.

    abstract:BACKGROUND:Alopecia areata (AA) is one of the most common autoimmune diseases and targets the hair follicles, with high impact on the quality of life and self-esteem of patients due to hair loss. Clinical management and outcomes are challenged by current limited immunosuppressive and immunomodulating regimens. METHODS...

    journal_title:BMC medicine

    pub_type: 杂志文章

    doi:10.1186/s12916-015-0331-6

    authors: Li Y,Yan B,Wang H,Li H,Li Q,Zhao D,Chen Y,Zhang Y,Li W,Zhang J,Wang S,Shen J,Li Y,Guindi E,Zhao Y

    更新日期:2015-04-20 00:00:00

  • Hospital care for children and young adults in the last year of life: a population-based study.

    abstract:BACKGROUND:To help design population-based pediatric palliative care services, we sought to describe the hospital care received in the last year of life by children and young adults who died. We also determined the proportion with complex chronic conditions (CCCs) and tested whether the use of hospital services increas...

    journal_title:BMC medicine

    pub_type: 杂志文章

    doi:10.1186/1741-7015-1-3

    authors: Feudtner C,DiGiuseppe DL,Neff JM

    更新日期:2003-12-23 00:00:00

  • Reduced perinatal mortality following enhanced training of birth attendants in the Democratic Republic of Congo: a time-dependent effect.

    abstract:BACKGROUND:In many developing countries, the majority of births are attended by traditional birth attendants, who lack formal training in neonatal resuscitation and other essential care required by the newly born infant. In these countries, the major causes of neonatal mortality are birth asphyxia, infection, and low-b...

    journal_title:BMC medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/1741-7015-9-93

    authors: Matendo R,Engmann C,Ditekemena J,Gado J,Tshefu A,Kinoshita R,McClure EM,Moore J,Wallace D,Carlo WA,Wright LL,Bose C

    更新日期:2011-08-04 00:00:00

  • Is inhibition of kinase activity the only therapeutic strategy for LRRK2-associated Parkinson's disease?

    abstract::Mutations in the leucine-rich repeat kinase 2 (LRRK2) gene are a common cause of familial Parkinson's disease (PD). Variation around the LRRK2 locus also contributes to the risk of sporadic PD. The LRRK2 protein contains a central catalytic region, and pathogenic mutations cluster in the Ras of complex protein C termi...

    journal_title:BMC medicine

    pub_type: 杂志文章,评审

    doi:10.1186/1741-7015-10-20

    authors: Rudenko IN,Chia R,Cookson MR

    更新日期:2012-02-23 00:00:00

  • Lactate dehydrogenase and susceptibility to deterioration of mild COVID-19 patients: a multicenter nested case-control study.

    abstract:BACKGROUND:Coronavirus disease 2019 (COVID-19) has infected more than 4 million people within 4 months. There is an urgent need to properly identify high-risk cases that are more likely to deteriorate even if they present mild diseases on admission. METHODS:A multicenter nested case-control study was conducted in four...

    journal_title:BMC medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1186/s12916-020-01633-7

    authors: Shi J,Li Y,Zhou X,Zhang Q,Ye X,Wu Z,Jiang X,Yu H,Shao L,Ai JW,Zhang H,Xu B,Sun F,Zhang W

    更新日期:2020-06-03 00:00:00

  • A cluster randomized trial to assess the effect of clinical pathways for patients with stroke: results of the clinical pathways for effective and appropriate care study.

    abstract:BACKGROUND:Clinical pathways (CPs) are used to improve the outcomes of acute stroke, but their use in stroke care is questionable, because the evidence on their effectiveness is still inconclusive. The objective of this study was to evaluate whether CPs improve the outcomes and the quality of care provided to patients ...

    journal_title:BMC medicine

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1186/1741-7015-10-71

    authors: Panella M,Marchisio S,Brambilla R,Vanhaecht K,Di Stanislao F

    更新日期:2012-07-10 00:00:00

  • Novel pharmacotherapeutic treatments for cocaine addiction.

    abstract::Cocaine is a stimulant that leads to the rapid accumulation of catecholamines and serotonin in the brain due to prevention of their re-uptake into the neuron that released the neurotransmitter. Cocaine dependence is a public health concern and cause of significant morbidity and mortality worldwide. At present, there a...

    journal_title:BMC medicine

    pub_type: 杂志文章,评审

    doi:10.1186/1741-7015-9-119

    authors: Shorter D,Kosten TR

    更新日期:2011-11-03 00:00:00

  • Collectives of diagnostic biomarkers identify high-risk subpopulations of hematuria patients: exploiting heterogeneity in large-scale biomarker data.

    abstract:BACKGROUND:Ineffective risk stratification can delay diagnosis of serious disease in patients with hematuria. We applied a systems biology approach to analyze clinical, demographic and biomarker measurements (n = 29) collected from 157 hematuric patients: 80 urothelial cancer (UC) and 77 controls with confounding patho...

    journal_title:BMC medicine

    pub_type: 杂志文章

    doi:10.1186/1741-7015-11-12

    authors: Emmert-Streib F,Abogunrin F,de Matos Simoes R,Duggan B,Ruddock MW,Reid CN,Roddy O,White L,O'Kane HF,O'Rourke D,Anderson NH,Nambirajan T,Williamson KE

    更新日期:2013-01-17 00:00:00

  • NMR-based metabolomics identifies patients at high risk of death within two years after acute myocardial infarction in the AMI-Florence II cohort.

    abstract:BACKGROUND:Risk stratification and management of acute myocardial infarction patients continue to be challenging despite considerable efforts made in the last decades by many clinicians and researchers. The aim of this study was to investigate the metabolomic fingerprint of acute myocardial infarction using nuclear mag...

    journal_title:BMC medicine

    pub_type: 杂志文章

    doi:10.1186/s12916-018-1240-2

    authors: Vignoli A,Tenori L,Giusti B,Takis PG,Valente S,Carrabba N,Balzi D,Barchielli A,Marchionni N,Gensini GF,Marcucci R,Luchinat C,Gori AM

    更新日期:2019-01-07 00:00:00

  • Evidence for placebo effects on physical but not on biochemical outcome parameters: a review of clinical trials.

    abstract:BACKGROUND:Recent reviews on placebo effects in clinical trials suggest that objective changes following placebo treatments may not exist or, at least, have been considerably overestimated. However, the possibility that yet unidentified subsets of parameters are responsive to placebo treatments has not been taken into ...

    journal_title:BMC medicine

    pub_type: 杂志文章,meta分析,评审

    doi:10.1186/1741-7015-5-3

    authors: Meissner K,Distel H,Mitzdorf U

    更新日期:2007-03-19 00:00:00

  • EEG complexity as a biomarker for autism spectrum disorder risk.

    abstract:BACKGROUND:Complex neurodevelopmental disorders may be characterized by subtle brain function signatures early in life before behavioral symptoms are apparent. Such endophenotypes may be measurable biomarkers for later cognitive impairments. The nonlinear complexity of electroencephalography (EEG) signals is believed t...

    journal_title:BMC medicine

    pub_type: 杂志文章

    doi:10.1186/1741-7015-9-18

    authors: Bosl W,Tierney A,Tager-Flusberg H,Nelson C

    更新日期:2011-02-22 00:00:00

  • Serum magnesium levels and risk of coronary artery disease: Mendelian randomisation study.

    abstract:BACKGROUND:Observational studies have shown that serum magnesium levels are inversely associated with risk of cardiovascular disease, but whether this association is causal is unknown. We conducted a Mendelian randomisation study to investigate whether serum magnesium levels may be causally associated with coronary art...

    journal_title:BMC medicine

    pub_type: 杂志文章

    doi:10.1186/s12916-018-1065-z

    authors: Larsson SC,Burgess S,Michaëlsson K

    更新日期:2018-05-17 00:00:00

  • Reductions in sugar sales from soft drinks in the UK from 2015 to 2018.

    abstract:BACKGROUND:The consumption of free sugars in the UK is more than double the guideline intake for adults and close to triple for children, with soft drinks representing a significant proportion. The aim of this study was to assess how individual soft drink companies and consumers have responded to calls to reduce sugar ...

    journal_title:BMC medicine

    pub_type: 历史文章,杂志文章

    doi:10.1186/s12916-019-1477-4

    authors: Bandy LK,Scarborough P,Harrington RA,Rayner M,Jebb SA

    更新日期:2020-01-13 00:00:00

  • Sex dependent risk factors for mortality after myocardial infarction: individual patient data meta-analysis.

    abstract:BACKGROUND:Although a number of risk factors are known to predict mortality within the first years after myocardial infarction, little is known about interactions between risk factors, whereas these could contribute to accurate differentiation of patients with higher and lower risk for mortality. This study explored th...

    journal_title:BMC medicine

    pub_type: 杂志文章

    doi:10.1186/s12916-014-0242-y

    authors: van Loo HM,van den Heuvel ER,Schoevers RA,Anselmino M,Carney RM,Denollet J,Doyle F,Freedland KE,Grace SL,Hosseini SH,Parakh K,Pilote L,Rafanelli C,Roest AM,Sato H,Steeds RP,Kessler RC,de Jonge P

    更新日期:2014-12-17 00:00:00

  • Peer review for biomedical publications: we can improve the system.

    abstract::The lack of formal training programs for peer reviewers places the scientific quality of biomedical publications at risk, as the introduction of 'hidden' bias may not be easily recognized by the reader. The exponential increase in the number of manuscripts submitted for publication worldwide, estimated in the millions...

    journal_title:BMC medicine

    pub_type: 杂志文章

    doi:10.1186/s12916-014-0179-1

    authors: Stahel PF,Moore EE

    更新日期:2014-09-26 00:00:00

  • Safety of occasional ingestion of gluten in patients with celiac disease: a real-life study.

    abstract:BACKGROUND:Gluten-free diet (GFD) decreases the quality of life of celiac disease (CD) patients, who frequently ask to occasionally ingest gluten-containing food. We evaluated CD patients reporting voluntary and occasional transgressions to their GFD. METHODS:From October 2017 to September 2018, the patients reporting...

    journal_title:BMC medicine

    pub_type: 杂志文章

    doi:10.1186/s12916-020-1511-6

    authors: Elli L,Bascuñán K,di Lernia L,Bardella MT,Doneda L,Soldati L,Orlando S,Ferretti F,Lombardo V,Barigelletti G,Scricciolo A,Fabiano S,Vecchi M,Roncoroni L

    更新日期:2020-03-16 00:00:00

  • The TransEurope FootRace Project: longitudinal data acquisition in a cluster randomized mobile MRI observational cohort study on 44 endurance runners at a 64-stage 4,486 km transcontinental ultramarathon.

    abstract:BACKGROUND:The TransEurope FootRace 2009 (TEFR09) was one of the longest transcontinental ultramarathons with an extreme endurance physical load of running nearly 4,500 km in 64 days. The aim of this study was to assess the wide spectrum of adaptive responses in humans regarding the different tissues, organs and functi...

    journal_title:BMC medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/1741-7015-10-78

    authors: Schütz UH,Schmidt-Trucksäss A,Knechtle B,Machann J,Wiedelbach H,Ehrhardt M,Freund W,Gröninger S,Brunner H,Schulze I,Brambs HJ,Billich C

    更新日期:2012-07-19 00:00:00

  • Recent advances in triple negative breast cancer: the immunotherapy era.

    abstract:BACKGROUND:Several accomplishments have been achieved in triple-negative breast cancer (TNBC) research over the last year. The phase III IMpassion130 trial comparing chemotherapy plus atezolizumab versus chemotherapy plus placebo brought breast cancer into the immunotherapy era. Nevertheless, despite encouraging result...

    journal_title:BMC medicine

    pub_type: 杂志文章,评审

    doi:10.1186/s12916-019-1326-5

    authors: Marra A,Viale G,Curigliano G

    更新日期:2019-05-09 00:00:00

  • An adjustable fetal weight standard for twins: a statistical modeling study.

    abstract:BACKGROUND:It is a common practice to use a singleton fetal growth standard to assess twin growth. We aim to create a twin fetal weight standard which is also adjustable for race/ethnicity and other factors. METHODS:Over half a million twin births of low risk pregnancies in the US, from 1995 to 2004, were used to cons...

    journal_title:BMC medicine

    pub_type: 杂志文章

    doi:10.1186/s12916-015-0401-9

    authors: Zhang J,Mikolajczyk R,Lei X,Sun L,Yu H,Cheng W

    更新日期:2015-07-03 00:00:00

  • Reporting of statistically significant results at ClinicalTrials.gov for completed superiority randomized controlled trials.

    abstract:BACKGROUND:Publication bias and other reporting bias have been well documented for journal articles, but no study has evaluated the nature of results posted at ClinicalTrials.gov. We aimed to assess how many randomized controlled trials (RCTs) with results posted at ClinicalTrials.gov report statistically significant r...

    journal_title:BMC medicine

    pub_type: 杂志文章

    doi:10.1186/s12916-016-0740-1

    authors: Dechartres A,Bond EG,Scheer J,Riveros C,Atal I,Ravaud P

    更新日期:2016-11-30 00:00:00

  • Antimalarial drugs for preventing malaria during pregnancy and the risk of low birth weight: a systematic review and meta-analysis of randomized and quasi-randomized trials.

    abstract:BACKGROUND:It is known that antimalarial drugs reduce the risk of low birth weight (LBW) in pregnant patients. However, a previous Cochrane review did not evaluate whether the level of antimalarial drug resistance could modify the protective effect of antimalarial drugs in this regard. In addition, no systematic review...

    journal_title:BMC medicine

    pub_type: 杂志文章,meta分析,评审

    doi:10.1186/s12916-015-0429-x

    authors: Muanda FT,Chaabane S,Boukhris T,Santos F,Sheehy O,Perreault S,Blais L,Bérard A

    更新日期:2015-08-14 00:00:00

  • What is next after the genes for autoimmunity?

    abstract::Clinical pathologies draw us to envisage disease as either an independent entity or a diverse set of traits governed by common physiopathological mechanisms, prompted by environmental assaults throughout life. Autoimmune diseases are not an exception, given they represent a diverse collection of diseases in terms of t...

    journal_title:BMC medicine

    pub_type: 杂志文章,评审

    doi:10.1186/1741-7015-11-197

    authors: Castiblanco J,Arcos-Burgos M,Anaya JM

    更新日期:2013-09-04 00:00:00

  • Associations of six adiposity-related markers with incidence and mortality from 24 cancers-findings from the UK Biobank prospective cohort study.

    abstract:BACKGROUND:Adiposity is a strong risk factor for cancer incidence and mortality. However, most of the evidence available has focused on body mass index (BMI) as a marker of adiposity. There is limited evidence on relationships of cancer with other adiposity markers, and if these associations are linear or not. The aim ...

    journal_title:BMC medicine

    pub_type: 杂志文章

    doi:10.1186/s12916-020-01848-8

    authors: Parra-Soto S,Cowley ES,Rezende LFM,Ferreccio C,Mathers JC,Pell JP,Ho FK,Celis-Morales C

    更新日期:2021-01-11 00:00:00

  • The implications of three major new trials for the effect of water, sanitation and hygiene on childhood diarrhea and stunting: a consensus statement.

    abstract:BACKGROUND:Three large new trials of unprecedented scale and cost, which included novel factorial designs, have found no effect of basic water, sanitation and hygiene (WASH) interventions on childhood stunting, and only mixed effects on childhood diarrhea. Arriving at the inception of the United Nations' Sustainable De...

    journal_title:BMC medicine

    pub_type: 共识发展会议,杂志文章

    doi:10.1186/s12916-019-1410-x

    authors: Cumming O,Arnold BF,Ban R,Clasen T,Esteves Mills J,Freeman MC,Gordon B,Guiteras R,Howard G,Hunter PR,Johnston RB,Pickering AJ,Prendergast AJ,Prüss-Ustün A,Rosenboom JW,Spears D,Sundberg S,Wolf J,Null C,Luby SP,Hum

    更新日期:2019-08-28 00:00:00

  • Plasmodium falciparum dihydroartemisinin-piperaquine failures in Cambodia are associated with mutant K13 parasites presenting high survival rates in novel piperaquine in vitro assays: retrospective and prospective investigations.

    abstract:BACKGROUND:The declining efficacy of dihydroartemisinin-piperaquine against Plasmodium falciparum in Cambodia, along with increasing numbers of recrudescent cases, suggests resistance to both artemisinin and piperaquine. Available in vitro piperaquine susceptibility assays do not correlate with treatment outcome. A nov...

    journal_title:BMC medicine

    pub_type: 杂志文章

    doi:10.1186/s12916-015-0539-5

    authors: Duru V,Khim N,Leang R,Kim S,Domergue A,Kloeung N,Ke S,Chy S,Eam R,Khean C,Loch K,Ken M,Lek D,Beghain J,Ariey F,Guerin PJ,Huy R,Mercereau-Puijalon O,Witkowski B,Menard D

    更新日期:2015-12-22 00:00:00

  • What can we offer to 3 million MDRTB household contacts in 2016?

    abstract::The diagnosis of multidrug resistant tuberculosis (MDR-TB) in any individual is the beginning of a prolonged and difficult therapeutic journey. It also marks the moment from which to begin consideration of how to manage close contacts. Preventive therapy for drug-susceptible latent tuberculosis infection has been demo...

    journal_title:BMC medicine

    pub_type: 杂志文章,评审

    doi:10.1186/s12916-016-0610-x

    authors: Moore DA

    更新日期:2016-04-01 00:00:00

  • Use of email in a family practice setting: opportunities and challenges in patient- and physician-initiated communication.

    abstract:BACKGROUND:Electronic mail (email) has the potential to improve communication between physicians and patients. METHODS:We conducted two research studies in a family practice setting: 1) a brief, anonymous patient survey of a convenience sample to determine the number of clinic patients receptive to communicating with ...

    journal_title:BMC medicine

    pub_type: 杂志文章

    doi:10.1186/1741-7015-4-18

    authors: Virji A,Yarnall KS,Krause KM,Pollak KI,Scannell MA,Gradison M,Østbye T

    更新日期:2006-08-15 00:00:00

  • Superior efficacy of St John's wort extract WS 5570 compared to placebo in patients with major depression: a randomized, double-blind, placebo-controlled, multi-center trial [ISRCTN77277298].

    abstract:BACKGROUND:The aim of the current study was to assess the antidepressant efficacy and safety of Hypericum perforatum (St. John's wort) extract WS 5570 at doses of 600 mg/day in a single dose and 1200 mg/day in two doses. METHODS:The participants in this double-blind, randomized, placebo-controlled, multi-center clinic...

    journal_title:BMC medicine

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1186/1741-7015-4-14

    authors: Kasper S,Anghelescu IG,Szegedi A,Dienel A,Kieser M

    更新日期:2006-06-23 00:00:00

  • Healthcare system responses to intimate partner violence in low and middle-income countries: evidence is growing and the challenges become clearer.

    abstract::The damage to health caused by intimate partner violence demands effective responses from healthcare providers and healthcare systems worldwide. To date, most evidence for the few existing, effective interventions in use comes from high-income countries. Gupta et al. provide rare evidence of a nurse-delivered intimate...

    journal_title:BMC medicine

    pub_type: 评论,信件

    doi:10.1186/s12916-017-0886-5

    authors: Taft A,Colombini M

    更新日期:2017-07-12 00:00:00