Abstract：
OBJECTIVES:To assess the impact of a CPOE system on medication-related communication of nurses and physicians. METHODS:In six internal medicine wards of an academic medical center, two questionnaires were used to evaluate nurses' attitudes toward the impact of a paper-based medication system and then a CPOE system on their communication in medication-related-activities (medication work). The questionnaires were analyzed using t-tests, followed by Bonferroni correction. Nine nurses and six physicians in the same wards were interviewed after the implementation to determine how their communication and their work have been impacted by the system. RESULTS:The total response rates were 54% and 52% for pre- and post-implementation questionnaires. It was shown that after implementation, the legibility and completeness of prescriptions were significantly improved (P <.001) and the administration system had a more intelligible layout (P <.001), with a more reliable overview (P <.001). The analysis of the interviews supported and confirmed the findings of the surveys. Moreover, they showed communication problems that caused difficulties in integrating medication work of nurses into physicians'. To compensate for these, nurses and physicians devised informal interactions and practices (workarounds), which often represented risks for medication errors. CONCLUSION:The introduction of CPOE system with paper-based medication administration system improved prescription legibility and completeness but introduced many workflow impediments and as a result error-inducing conditions. In order to prevent such an effect, CPOE systems have to support the level of communication which is necessary to integrate the work of nurses and physicians.
journal_name
Methods Inf Medjournal_title
Methods of information in medicineauthors
Pirnejad H,Niazkhani Z,van der Sijs H,Berg M,Bal Rdoi
10.3414/ME0572subject
Has Abstractpub_date
2009-01-01 00:00:00pages
350-60issue
4eissn
0026-1270issn
2511-705Xpii
0572journal_volume
48pub_type
杂志文章abstract：:Pathfinder is an expert system that assists surgical pathologists with the diagnosis of lymph-node diseases. The program is one of a growing number of normative expert systems that use probability and decision theory to acquire, represent, manipulate, and explain uncertain medical knowledge. In this article, we descri...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1992-06-01 00:00:00
abstract：OBJECTIVES:As a preliminary for the design of Computer-Based Patient Records, the aim of this paper is to build an understanding of the roles physical artifacts like paper-based patient records play in supporting cognition and collaboration in the health-care settings. METHOD:A small ethnographically-informed study wa...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：2003-01-01 00:00:00
abstract：:To display multidimensional laboratory measurements, Hoeke et al. (1991) proposed a technique that uses plotting axes radiating from a point, assigns each test to a separate axis, and links the test results with line segments. A special nonlinear scaling ensures that a patient whose results all fall in the normal rang...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1993-11-01 00:00:00
abstract：BACKGROUND:Studying workflow is a critical step in designing, implementing and evaluating informatics interventions in complex sociotechnical settings, such as hospital emergency departments (EDs). Known approaches to studying workflow in clinical settings attend to the activities of individual clinicians, thus being i...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：10.3414/ME12-01-0079
更新日期：2013-01-01 00:00:00
abstract：:Reliable record linkage is a prerequisite for high-quality population-based disease registration. Rapid developments in computer processing have made record linkage both more efficient and more reliable in recent years. At the same time, concerns about confidentiality increasingly hinder record linkage in many disease...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1998-01-01 00:00:00
abstract：OBJECTIVES:Our objective is to investigate diabetes-related alteration of glucose control in diurnal fluctuations in normal daily life by detrended fluctuation analysis (DFA). METHODS:The fluctuations of glucose of 12 non-diabetic subjects and 15 diabetic patients were measured using a continuous glucose monitoring sy...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：2007-01-01 00:00:00
abstract：:A tree-based method for estimating time-varying effects of baseline patient characteristics on survival is introduced. A Cox-type model for censored survival data is used in which the time-varying relative risks are modelled as piecewise constants. The tree method consists of three steps: 1. Growing the tree, in which...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：2001-05-01 00:00:00
abstract：OBJECTIVES:EEG scalp potential distributions recorded in humans are affected by low spatial resolution and by the dependence on the electrical reference used. High resolution EEG technologies are available to drastically increase the spatial resolution of the raw EEG. Such technologies include the computation of surfac...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：2004-01-01 00:00:00
abstract：:It is estimated that, in Japan, several million people suffer from urinary incontinence caused by, e.g., cerebrovascular disease, abdominal operations, spinal-cord damage, etc. Urinary incontinence is said to be a 'hidden' disease. When no adequate treatment is given, a serious situation may arise for both patients an...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1994-03-01 00:00:00
abstract：OBJECTIVES:This paper aims to present an activity-theoretical method for studying the effects of user participation in IS development. METHODS:This method is developed through a case study of the process of designing a diabetes database. RESULTS AND CONCLUSIONS:The method consists of a historical analysis of the desi...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：2003-01-01 00:00:00
abstract：:A Bayesian decision support system was developed for the diagnosis of rheumatic disorders. Knowledge in this system is represented as evidential weights of findings. Simple weights were calculated as the logarithm of likelihood ratios on the basis of 1,000 consecutive patients from a rheumatological clinic. The effect...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1991-08-01 00:00:00
abstract：:This paper is concerned with a comparison of two broad classes of mathematical models, additive and multiplicative, for selecting the best among a number of competing project proposals addressed to a defined research objective. The analysis is predicated on the view that, though additive models are widely utilized, th...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1989-07-01 00:00:00
abstract：:In this paper we describe LIED (Liver: Information, Education and Diagnosis), a diagnostic expert system devoted to medical education in the field of hepatology. LIED combines the facilities of a traditional expert system for clinical diagnosis with several modules designed for educational purposes. The goal of such m...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1992-11-01 00:00:00
abstract：:A non-parametric method is presented for modelling nonlinear dynamic mechanisms of respiratory sinus arrhythmia (RSA) in anesthesia caused by positive pressure ventilation. RR interval sequences are shown with Tsay's linearity test to contain both short-term and long-term nonlinear components, which cannot completely ...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1994-03-01 00:00:00
abstract：:Tumor documentation is an important task for both clinical research and patient care. Documentation systems for these purposes have to be planned systematically and should be goal oriented. We applied the method of a so-called 'standardized documentation protocol' for systematically planning two documentation systems ...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：2001-05-01 00:00:00
abstract：:The increased use of computers is a response to the considerable growth in information in all fields of activities. Related to this, in the field of medicine a new component appeared about 40 years ago: Medical Informatics. Its goals are to assist health care professionals in the choice of data to manage and in the ch...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1997-02-01 00:00:00
abstract：OBJECTIVES:The aging of the population creates pressure on the healthcare systems in various ways. A massive increase of chronic disease conditions and age-related illness are predicted as the dominant forces driving the future health care. The objective of this paper is to present future research demands in pervasive ...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：10.3414/ME09-02-0044
更新日期：2010-01-01 00:00:00
abstract：:Rapid development of community health information networks raises the issue of semantic interoperability between distributed and heterogeneous systems. Indeed, operational health information systems originate from heterogeneous teams of independent developers and have to cooperate in order to exchange data and service...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1998-11-01 00:00:00
abstract：:Informatisation of drug prescription is an important topic in medical informatics. For several years now, computerized drug databases have been implemented. Usually only a small part of the prescriptions can be stored in prescription systems because of the format of the included information; prescriptions contain esse...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1999-03-01 00:00:00
abstract：:Continuous recording of intraluminal pressures for extended periods of time is currently regarded as a valuable method for detection of esophageal motor abnormalities. A subsequent automatic analysis of the resulting motility data relies on strict mathematical criteria for recognition of pressure events. Due to great ...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1994-03-01 00:00:00
abstract：OBJECTIVES:This paper illustrates a high speed clinical data retrieving system, from 10 years of data of operating hospital information system for the purposes of research, evidence creation, patient safety, etc., even incorporating time sequence of causal relations. METHODS:Total of 73,709,298 records of 10 years at ...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：10.3414/ME9125
更新日期：2008-01-01 00:00:00
abstract：BACKGROUND:ICT based solutions are increasingly introduced for active and healthy ageing. In this context continuous monitoring of older adults with domestic sensor systems has been suggested to provide important information about their functional health. However, there is not yet a solid model for the interpretation o...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：10.3414/ME15-01-0072
更新日期：2016-12-07 00:00:00
abstract：OBJECTIVES:In this study, we evaluated the internal validity of EPICON, an application for grouping ICPC-coded diagnoses from electronic medical records into episodes of care. These episodes are used to estimate morbidity rates in general practice. METHODS:Morbidity rates based on EPICON were compared to a gold standa...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：2008-01-01 00:00:00
abstract：OBJECTIVES:The analysis of energetic ventricular variable changes during artificial ventilation, obtained by numerical simulation was done. Twenty-one sets of hemodynamic parameters for eight cardiosurgical patients were used to estimate left and right stroke work. The data were collected for three methods of ventilati...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：2005-01-01 00:00:00
abstract：:While the design of a fully general procedure for semantico-pragmatic interpretation of natural language texts does not seem to be feasible with current scientific knowledge and technology, the more practical microworld based approaches lack generality and portability. A compromise between generality and practicality ...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1995-03-01 00:00:00
abstract：BACKGROUND:The availability of large amounts of data in heterogeneous formats and the rapid progress in fields such as computer based drug design, medical imaging and medical simulations have lead to a growing demand for large computational power and easy accessibility to heterogeneous data sources. OBJECTIVES:The goa...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：2003-01-01 00:00:00
abstract：OBJECTIVES:(1) Creation of an expressive language for specification of temporal patterns in clinical domains, (2) Development of a graphical knowledge-acquisition tool allowing expert physicians to define meaningful domain-specific patterns, (3) Implementation of an interpreter capable of detecting such patterns in cli...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：2001-01-01 00:00:00
abstract：:A Bonhoeffer-van der Pol equation with a stable limit cycle is proposed as a model of the pacemaker in the sino-atrial node to explain heart rate regulation. Standard tools, such as the phase transition curve in nonlinear dynamic system theory, are used to analyze the model and results are compared with other studies ...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1994-03-01 00:00:00
abstract：:A problem of identifying the phase response curve of the myocardial pacemaker was investigated using a simple dynamic system model of cardiac arrhythmia. A hybrid optimization method of a genetic algorithm and a local optimization technique was employed to obtain a solution of the model fitting. The method was applied...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：1997-12-01 00:00:00
abstract：:A few years ago, a new method of survival analysis, denoted period analysis, has been developed to derive more up-to-date estimates of long-term survival rates of cancer patients, but this method has rarely been applied so far. Using empirical examples from the Saarland Cancer Registry, we illustrate how seriously tra...
journal_title：Methods of information in medicine
pub_type： 杂志文章
doi：
更新日期：2001-07-01 00:00:00
