Abstract:
OBJECTIVES:Various computerized health risk appraisals (HRAs) are available, but few of them assess health-related quality of life (HRQoL) in a goal-directed framework. This study describes the user-centered development and usability testing of an innovative HRQoL module that extends a validated HRA tool in primary care settings. METHODS:Systematic user-centered design, usability testing, and qualitative methods were used to develop the HRQoL module in primary care practices. Twenty two patients and 5 clinicians participated in two rounds of interactive technology think-out-loud sessions (TOLs) and semi-structured interviews (SSIs) to iteratively develop a four-step, computerized process that collects information on patient goals for meaningful life activities and current level of disability and presents a personalized and prioritized list of preventive recommendations linked to online resources. RESULTS:Analysis of TOLs and SSIs generated 5 categories and 11 sub-categories related to facilitators and barriers to usability and human-technology interaction. The categories included: Understanding the Purpose, Usability, Perceived Value, Literacy, and Participant Motivation. Some categories were inter-connected. The technology was continually and iteratively improved between sessions until saturation of positive feedback was achieved in 4 categories (addressing motivation will require more research). Usability of all screen units of the module was improved substantially. Clinician feedback emphasized the importance of the module's ability to translate the patient-centered HRQoL Report into actionable items for clinicians to facilitate shared decision-making. Complete integration of the HRQoL module into the existing HRA will require further development and testing. CONCLUSIONS:Systematic application of user-centered design and human factors principles in technology development and testing may significantly improve the usability and clinical value of health information systems. This more sophisticated approach helped us translate complex clinical concepts, goal-setting steps, and decision-support processes into an accepted and value-added technology.
journal_name
Appl Clin Informjournal_title
Applied clinical informaticsauthors
Nagykaldi ZJ,Jordan M,Quitoriano J,Ciro CA,Mold JWdoi
10.4338/ACI-2014-08-RA-0067subject
Has Abstractpub_date
2014-12-10 00:00:00pages
958-70issue
4issn
1869-0327journal_volume
5pub_type
杂志文章abstract:BACKGROUND:Care plan concordance among patients and clinicians during hospitalization is suboptimal. OBJECTIVE:This article determines whether an electronic health record (EHR)-integrated patient portal was associated with increased understanding of the care plan, including the key recovery goal, among patients and cl...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1688831
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the health information technology (HIT) workforce knowledge and skills needed by HIT employers. METHODS:Statewide face-to-face and online focus groups of identified HIT employer groups in Austin, Brownsville, College Station, Dallas, El Paso, Houston, Lubbock, San Antonio, and webinars for rural ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2012-09-RA-0035
更新日期:2012-12-05 00:00:00
abstract:BACKGROUND:Hospitals across the country are investing millions of dollars to adopt new Health Insurance Portability and Accountability Act (HIPAA)-compliant secure text messaging systems. However, in nearly all cases, these implementations are occurring without evaluation of their impact on patient care. OBJECTIVE:To ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1700868
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Holistic, ubiquitous support of patient-centered health care (eHealth) at all health care institutions and in patients' homes through information processing is increasingly supplementing institution-centered care. While eHealth indicators may measure the transition from institution-centered (e.g., hospital-c...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0038-1669458
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Preoperative assessments are a required and essential element of anesthetic care, yet little is known about the utilization of these documents by clinicians who are not part of the anesthesia care team. As part of perioperative workflow restructuring, we implemented a data visualization technique of electron...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2015-02-CR-0022
更新日期:2015-10-21 00:00:00
abstract:OBJECTIVE:More than 70% of hospitals in the United States have electronic health records (EHRs). Clinical decision support (CDS) presents clinicians with electronic alerts during the course of patient care; however, alert fatigue can influence a provider's response to any EHR alert. The primary goal was to evaluate the...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-10-RA-0168
更新日期:2017-05-10 00:00:00
abstract::Patient-generated health data are coming into broader use across the health care spectrum and hold great promise as a means to improve care and health outcomes. At the same time, rapid evolution in the social media and mobile health (mHealth) market has promoted an environment in which creation and transmission of per...
journal_title:Applied clinical informatics
pub_type: 杂志文章,评审
doi:10.4338/ACI-2014-09-R-0082
更新日期:2015-01-14 00:00:00
abstract:BACKGROUND:Early detection and efficient management of sepsis are important for improving health care quality, effectiveness, and costs. Due to its high cost and prevalence, sepsis is a major focus area across institutions and many studies have emerged over the past years with different models or novel machine learning...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1710525
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Kidney disease is under-documented in physician notes. The use of template-guided notes may improve physician recognition of kidney disease early in training. OBJECTIVE:The objective of this study was to determine whether a computerized inpatient renal template note with clinical decision support improves r...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2013-07-RA-0048
更新日期:2013-11-13 00:00:00
abstract:BACKGROUND:Medication dose adjustment is crucial for patients with renal dysfunction (RD). The assessment of renal function is generally mandatory; however, the renal function may change during the hospital stay and the manual assessment is sometimes challenging. OBJECTIVE:We developed the clinical decision support sy...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1721056
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Several disease specific registers are operated by members of the 'TMF - Technology, Methods, and Infrastructure for Networked Medical Research', an umbrella organization of research networks in Germany. OBJECTIVE:To describe the coverage and the current state as well as financial and organizational issues ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2010-04-RA-0024
更新日期:2010-11-24 00:00:00
abstract:OBJECTIVE:With the increasing prevalence of type 2 diabetes (T2D) in youth, primary care providers must identify patients at high risk and implement evidence-based screening promptly. Clinical decision support systems (CDSSs) provide clinicians with personalized reminders according to best evidence. One example is the ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1710024
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVES:This study evaluates the accuracy and portability of a natural language processing (NLP) tool for extracting clinical findings of influenza from clinical notes across two large healthcare systems. Effectiveness is evaluated on how well NLP supports downstream influenza case-detection for disease surveillance...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-12-RA-0211
更新日期:2017-05-31 00:00:00
abstract:BACKGROUND:Prescribers' inappropriate use of the free-text Notes field in new electronic prescriptions can create confusion and workflow disruptions at receiving pharmacies that often necessitates contact with prescribers for clarification. The inclusion of inappropriate patient direction (Sig) information in the Notes...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2014-03-CR-0022
更新日期:2014-08-06 00:00:00
abstract:BACKGROUND:Important information to support healthcare quality improvement is often recorded in free text documents such as radiology reports. Natural language processing (NLP) methods may help extract this information, but these methods have rarely been applied outside the research laboratories where they were develop...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-08-RA-0129
更新日期:2016-11-09 00:00:00
abstract:BACKGROUND:Accurate prediction of future patient census in hospital units is essential for patient safety, health outcomes, and resource planning. Forecasting census in the Neonatal Intensive Care Unit (NICU) is particularly challenging due to limited ability to control the census and clinical trajectories. The fixed a...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2015-09-RA-0127
更新日期:2016-05-04 00:00:00
abstract:OBJECTIVES:To understand and build a collective vision of all existing institutions in the Portuguese National Health Service as well as to perceive how and how far the interaction between those multiple institutions is supported by Information Systems (IS). METHODS:Upon identification of the institutions involved in ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-08-RA-0135
更新日期:2016-12-21 00:00:00
abstract:BACKGROUND:The traditional concept of personalized nutrition is based on adapting diets according to individual needs and preferences. Discussions about personalized nutrition have been on since the Human Genome Project, which has sequenced the human genome. Thenceforth, topics such as nutrigenomics have been assessed ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0038-1635115
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Effective communication is essential to safe and efficient patient care. Additionally, many health information technology (HIT) developments, innovations, and standards aim to implement processes to improve data quality and integrity of electronic health records (EHR) for the purpose of clinical information ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2011-02-RA-0011
更新日期:2011-06-08 00:00:00
abstract:OBJECTIVES:Transitions in patient care pose an increased risk to patient safety. One way to reduce this risk is to ensure accurate medication reconciliation during the transition. Here we present an evaluation of an electronic medication reconciliation module we developed to reduce the transition risk in patients refer...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2015-11-RA-0154
更新日期:2016-05-25 00:00:00
abstract:BACKGROUND:Medical students may observe and subsequently perpetuate redundancy in clinical documentation, but the degree of redundancy in student notes and whether there is an association with scholastic performance are unknown. OBJECTIVES:This study sought to quantify redundancy, defined generally as the proportion o...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1692402
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Homecare is an important and effective way of managing chronic illnesses using skilled nursing care in the home. Unlike hospitals and ambulatory settings, clinicians visit patients at home at different times, independent of each other. Twenty-nine percent of 10,000 homecare agencies in the United States have...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2013-12-RA-0106
更新日期:2014-04-30 00:00:00
abstract:BACKGROUND:Sepsis is a serious medical condition that can lead to organ dysfunction and death. Research shows that each hour delay in antibiotic administration increases mortality. The Surviving Sepsis Campaign Bundles created standards to assist in the timely treatment of patients with suspected sepsis to improve outc...
journal_title:Applied clinical informatics
pub_type: 杂志文章,多中心研究
doi:10.1055/s-0038-1676040
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:The use of text messaging in clinical care has become ubiquitous. Due to security and privacy concerns, many hospital systems are evaluating secure text messaging applications. This paper highlights our evaluation process, and offers an overview of secure messaging functionalities, as well as a framework for ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1678607
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND: Prediabetes and type 2 diabetes mellitus (T2DM) are one of the major long-term health conditions affecting global healthcare delivery. One of the few effective approaches is to actively manage diabetes via a healthy and active lifestyle. OBJECTIVES: This research is focused on early detection of prediabete...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1719043
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:The assessment of user preferences for performance characteristics of patient-oriented clinical prediction models is lacking. It is unknown if complex statistical aspects of prediction models are readily understandable by a general audience. OBJECTIVE:A pilot study was conducted among nonclinical audiences ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0038-1669457
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVES:Discharging patients from the Neonatal Intensive Care Unit (NICU) can be delayed for non-medical reasons including the procurement of home medical equipment, parental education, and the need for children's services. We previously created a model to identify patients that will be medically ready for discharge...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2015-09-RA-0114
更新日期:2016-02-24 00:00:00
abstract:BACKGROUND:While evidence generally supports the use of medication management technology, systems are typically implemented and evaluated piecemeal rather than as part of a comprehensive model for medication management. Systems to support drug therapy optimization, increasingly a key role of pharmacists in our healthca...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0037-1620262
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Discrepancies in controlled substance documentation are common and can lead to legal and regulatory repercussions. We introduced a visual analytics dashboard to assist in a quality improvement project to reduce the discrepancies in controlled substance documentation in the operating room (OR) of our free-sta...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1693688
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND: Electronic health records (EHRs) are used in long-term care to document the patients' condition, medication, and care, thereby supporting communication among caregivers and counteracting adverse drug events. However, the use of EHRs in long-term care has lagged behind EHR use in hospitals. In addition, most...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1721013
更新日期:2021-01-01 00:00:00