Abstract：
OBJECTIVE:To explore the use of user-centered design techniques for developing the requirements for an antibiotic decision support system (DSS) in an intensive care unit (ICU). DESIGN AND METHODOLOGY:The setting was a 21-bed mixed medical/surgical adult ICU. This was an observational study with unstructured interviews and participatory design process. Models were constructed to demonstrate cultural, workflow, sequence/trigger events and other artefacts used to support antibiotic prescribing in the ICU. Using participatory design, a paper prototype was developed and case studies were used to simulate antibiotic prescribing for bacterial isolates. This information was used to design and pilot the decision support tool. RESULTS:The key users were identified as residents, registrars and the unit pharmacist. They identified the major requirements: ability to collate and print microbiology results, and to provide education and antibiotic advice for isolates. The final product was a real time microbiology browser and decision support tool for antibiotic prescribing (ADVISE). Uptake of the system was rapid with over 6000 encounters in the first 6 months. An audit of antibiotic use performed on all consecutive patients 6 months before and after introducing the DSS demonstrated a reduction in total and broad-spectrum antibiotics. CONCLUSION:Contextual design methodology in conjunction with participatory design was an effective method to design this antibiotic decision support tool. The process facilitated physician and pharmacist ownership of the system that resulted in immediate uptake and ongoing use.
journal_name
Int J Med Informjournal_title
International journal of medical informaticsauthors
Thursky KA,Mahemoff Mdoi
10.1016/j.ijmedinf.2006.07.011subject
Has Abstractpub_date
2007-10-01 00:00:00pages
760-8issue
10eissn
1386-5056issn
1872-8243pii
S1386-5056(06)00201-2journal_volume
76pub_type
杂志文章abstract：:A computerised record hash coding and linkage procedure is proposed to allow the chaining of medical information within the framework of epidemiological follow-up. Before their extraction, files are rendered anonymous using a one-way hash coding based on the standard hash algorithm (SHA) function, in order to respect ...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/s1386-5056(98)00019-7
更新日期：1998-03-01 00:00:00
abstract：INTRODUCTION:Physician satisfaction with electronic medical records has often been poor. Usability has frequently been identified as a source for decreased satisfaction. While surveys can identify many issues, and are logistically easier to administer, they may miss issues identified using other methods This study soug...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2018.01.010
更新日期：2018-04-01 00:00:00
abstract：PURPOSE:Computerized clinical decision support systems (CDSSs) for intensive insulin therapy (IIT) are increasingly common. However, recent studies question IIT's safety and mortality benefit. Researchers have identified factors influencing IIT performance, but little is known about how workflow affects computer-based ...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2011.10.003
更新日期：2011-12-01 00:00:00
abstract：PURPOSE:This report describes an ongoing transition from the HELP Hospital Information System to HELP II, a replacement Health Information System built to manage clinical information captured in a variety of medical settings. The focus of the article is on the medical decision support provided by this system and studie...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/s1386-5056(02)00110-7
更新日期：2003-03-01 00:00:00
abstract：OBJECTIVE:The introduction of health information technologies (HIT) can lead to unintended consequences. We studied a newly introduced electronic messaging (e-messaging) system for communication between homecare providers and general practitioners (GPs) in Norway. The objective of this paper is to identify and discuss ...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2014.02.001
更新日期：2014-05-01 00:00:00
abstract：:The structure of healthcare systems in developed countries is changing to 'shared care', enforced by economic constraints and caused by a change in the basic conditions of care. That development results in co-operative health information systems across the boundaries of organisational, technological, and policy domain...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/s1386-5056(98)00122-1
更新日期：1998-10-01 00:00:00
abstract：BACKGROUND:Febrile neutropenia (FN) has been associated with high mortality among adults with cancer. Current systems for early detection of inpatient FN mortality are based on scoring indexes that require intensive physicians' subjective evaluation. OBJECTIVE:In this study, we leveraged machine learning techniques to...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2020.104140
更新日期：2020-07-01 00:00:00
abstract：PURPOSE:The present study evaluated whether an intervention using a short message service (SMS) by personal cellular phone and Internet would reduce cardiovascular risk factors in post-menopausal women with abdominal obesity over 12 weeks. METHODS:This is a quasi-experimental design with pre and post tests. Participan...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2011.12.011
更新日期：2012-06-01 00:00:00
abstract：OBJECTIVE:To carry out a systematic review of studies assessing the effects of chemotherapy prescription clinical decision-support systems (CDSSs) on the chemotherapy process. METHODS:Articles published in English before May 1, 2017 and indexed in the PubMed and Embase databases were reviewed systematically. Studies t...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2018.11.004
更新日期：2019-02-01 00:00:00
abstract：BACKGROUND:Predicting insulin-induced postprandial hypoglycemic events is critical for the safety of type 1 diabetes patients because an early warning of hypoglycemia facilitates correction of the insulin bolus before its administration. The postprandial hypoglycemic event counts can be lowered by reducing the size of ...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2019.03.008
更新日期：2019-06-01 00:00:00
abstract：OBJECTIVE:The adoption rate of electronic health record (EHR) systems in South Korea has continuously increased. However, in contrast to the situation in the United States (US), where there has been a national effort to improve and standardize EHR interoperability, no consensus has been established in South Korea. The ...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2017.02.009
更新日期：2017-05-01 00:00:00
abstract：BACKGROUND:Psychological support is available more widely supported by emerging technologies as an addition to face-to-face consultations, more and more people are accessing psychological support using online resources. OBJECTIVE:This research provides insights into the perception of the key factors that affect the ef...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2020.104367
更新日期：2021-03-01 00:00:00
abstract：:Health information system (HIS) architecture and socio-technical approaches for system deployment have been topics of systematic research for decades. Sustainable operation in gradually changing environments, however, has not yet received sufficient attention. Even HIS that have gone life to the satisfaction of their ...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2006.05.011
更新日期：2007-06-01 00:00:00
abstract：:This paper describes a methodology to assess health/medical informatics graduate-level education curricula. The authors used the Certified Professional in Healthcare Information Management Systems (CPHIMS) exam objectives published by the Healthcare Information and Management Systems Society (HIMSS) as the basis for t...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2003.12.002
更新日期：2004-03-18 00:00:00
abstract：OBJECTIVES:Electronic Medical Records (EMR) have the potential to improve the coordination of healthcare in this country, yet the field of psychiatry has lagged behind other medical disciplines in its adoption of EMR. METHODS:Psychiatrists at 18 of the top US hospitals completed an electronic survey detailing whether ...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2012.11.007
更新日期：2013-04-01 00:00:00
abstract：:The Health Service Reform Programme in Ireland will be the biggest change ever seen in the health service. This programme will be dependent on information structures that provide appropriate and timely information. The Nursing Informatics Project Team in the Mater Misericordiae University Hospital, Dublin is in the pr...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2005.07.041
更新日期：2005-12-01 00:00:00
abstract：:Many studies on the physiology of the cardiovascular system revealed that nonlinear chaotic dynamics govern the generation of the heart rate signal. This is also valid for the fetal heart rate (FHR) variability, where however the variability is affected by many more factors and is significantly more complicated than f...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/s1386-5056(98)00102-6
更新日期：1999-01-01 00:00:00
abstract：OBJECTIVE:To investigate factors influencing variations in clinicians' use of an online evidence retrieval system. SETTING:Public hospitals in New South Wales, Australia. METHOD:Web log analysis demonstrated considerable variation in rates of evidence use by clinicians at different hospitals. Focus groups and intervi...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/s1386-5056(02)00046-1
更新日期：2003-01-01 00:00:00
abstract：GOAL:To identify any major factors that could affect patients' perceptions of a Home Telecare Management System (HTMS) and use the findings to contribute to development of a theoretical framework for patient acceptance of HTMS. MATERIALS AND METHODS:Ten Focus Group Interviews (FGIs) were conducted with patients suffer...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2007.10.006
更新日期：2008-07-01 00:00:00
abstract：:Electronic cigarettes (e-cigarettes) usage has surged substantially across the globe, particularly among adolescents and young adults. The ever-increasing prevalence of social media makes it highly convenient to access and engage with content on numerous substances, including e-cigarettes. A comprehensive dataset of 5...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2020.104223
更新日期：2020-09-01 00:00:00
abstract：BACKGROUND:There is an increasing trend in using network science methods and algorithms, including community detection methods, in different areas of healthcare. These areas include protein networks, drug prescriptions, healthcare fraud detection, and drug abuse. Counterfeit drugs, off-label marketing issues, and findi...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2020.104161
更新日期：2020-08-01 00:00:00
abstract：INTRODUCTION:In January 2015, Rouen University Hospital's information system experienced serious issues. It was necessary to rapidly switch from the computerized provider order entry (CPOE) system towards a paper-based order entry (PBOE) system. This was an opportunity to evaluate prescriber opinion on the two provider...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2017.04.007
更新日期：2017-07-01 00:00:00
abstract：:The continuous increase in the complexity and the heterogeneity of corporate and healthcare telecommunications infrastructures will require new assessment methods of quality of service (QoS) provision that are capable of addressing all engineering and social issues with much faster speeds. Speed and accessibility to a...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2005.07.019
更新日期：2006-03-01 00:00:00
abstract：:In spite of over four decades of research into Electronic Healthcare Record Systems, the penetration of records which incorporate more than simply basic information, into the working life of healthcare organisations is relatively small. This paper discusses some of the key impediments to progress including in particul...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/s1386-5056(01)00205-2
更新日期：2001-12-01 00:00:00
abstract：PURPOSE:Despite the amount of health information available online, there are several barriers that limit the Internet from being adopted as a source of health information. The purpose of this study was to identify individual skill-related problems that users experience when accessing the Internet for health information...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2011.10.005
更新日期：2012-01-01 00:00:00
abstract：:This paper reflects some desiderata on the role of Natural Language Processing (NLP) in the coming years as foreseen in the medical domain. During the Medical Informatics Europe (MIE) conference in 1997, the NLP track was composed by numerous papers on natural language, knowledge representation, nomenclatures and clas...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/s1386-5056(98)00132-4
更新日期：1998-10-01 00:00:00
abstract：OBJECTIVE:There is a growing interest in using natural language processing (NLP) for healthcare-associated infections (HAIs) monitoring. A French project consortium, SYNODOS, developed a NLP solution for detecting medical events in electronic medical records for epidemiological purposes. The objective of this study was...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2018.06.002
更新日期：2018-09-01 00:00:00
abstract：OBJECTIVE:To develop and characterize a large, representative sample of guideline recommendations that can be used to better understand how current recommendations are written and to test the adequacy of guideline models. We refer to this sample as the Yale Guideline Recommendation Corpus (YGRC). METHOD:To develop the...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2008.11.001
更新日期：2009-05-01 00:00:00
abstract：BACKGROUND:Diagnosis coding percentages in the specialty training of general practitioners (GPs) are generally high, but not perfect, indicating barriers against coding still exist, possibly influencing the validity of data based on electronic patient records (EPRs). OBJECTIVE:To study the relationship between barrier...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2013.02.002
更新日期：2013-08-01 00:00:00
abstract：:This paper shortly describes an Infusion Toolbox and a blood pressure (BP) control application. It explains how we applied an agent model and client-server technology to integrate them. We show that by using this framework and object oriented technologies the necessary changes to the existing applications are reduced....
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/s1386-5056(98)00093-8
更新日期：1998-05-01 00:00:00
