Abstract:
OBJECTIVE:The purpose of this paper is to demonstrate how current visual representations of organizational and technological processes do not fully account for the variability present in everyday practices. We further demonstrate how narrative networks can augment these representations to indicate potential areas for successful or problematic adoption of new technologies and potential needs for additional training. METHODS:We conducted a qualitative study of the processes and routines at a major academic medical center slated to be supported by the development and installation of a new comprehensive HIT system. We used qualitative data collection techniques including observations of the activities to be supported by the new system and interviews with department heads, researchers, and both clinical and non-clinical staff. We conducted a narrative network analysis of these data by choosing exemplar processes to be modeled, selecting and analyzing narrative fragments, and developing visual representations of the interconnection of these narratives. RESULTS:Narrative networks enable us to view the variety of ways work has been and can be performed in practice, influencing our ability to design for innovation in use. DISCUSSION:Narrative networks are a means for analyzing and visualizing organizational routines in concert with more traditional requirements engineering, workflow modeling, and quality improvement outcome measurement. This type of analysis can support a deeper and more nuanced understanding of how and why certain routines continue to exist, change, or stop entirely. At the same time, it can illuminate areas in which adoption may be slow, more training or communication may be needed, and routines preferred by the leadership are subverted by routines preferred by the staff.
journal_name
Int J Med Informjournal_title
International journal of medical informaticsauthors
Hayes GR,Lee CP,Dourish Pdoi
10.1016/j.ijmedinf.2011.01.005subject
Has Abstractpub_date
2011-08-01 00:00:00pages
e161-77issue
8eissn
1386-5056issn
1872-8243pii
S1386-5056(11)00028-1journal_volume
80pub_type
杂志文章abstract:BACKGROUND:The widespread adoption of electronic health records (EHRs) is accelerating the collection of sensitive clinical data. The availability of these data raises privacy concerns, yet sharing the data is essential for public health, longitudinal patient care, and clinical research. METHOD:Following previous work...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2012.11.003
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Mobile communication technologies may reduce maternal health disparities related to cost, distance, and infrastructure. However, the ability of mHealth initiatives to accelerate maternal health goals requires in part that women with the greatest health needs have access to mobile phones. OBJECTIVE:This stud...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2015.01.016
更新日期:2015-05-01 00:00:00
abstract::This paper reviews clinical decision support systems (CDSS) literature, with a focus on evaluation. The literature indicates a general consensus that clinical decision support systems are thought to have the potential to improve care. Evidence is more equivocal for guidelines and for systems to aid physicians with dia...
journal_title:International journal of medical informatics
pub_type: 杂志文章,评审
doi:10.1016/s1386-5056(01)00183-6
更新日期:2001-11-01 00:00:00
abstract:INTRODUCTION:Information extraction (IE) systems have been proposed in recent years to extract genic interactions from bibliographical resources. They are limited to single interaction relations, and have to face a trade-off between recall and precision, by focusing either on specific interactions (for precision), or g...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2009.03.005
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Hypoglycemia is a common safety event when attempting to optimize glycemic control in diabetes (DM). While electronic medical records provide a natural ground for detecting and analyzing hypoglycemia, ICD codes used in the databases may be invalid, insensitive or non-specific in detecting new h...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2019.06.020
更新日期:2019-09-01 00:00:00
abstract:INTRODUCTION:Many hospitals are increasing their efforts to improve processes because processes play an important role in enhancing work efficiency and reducing costs. However, to date, a quantitative tool has not been available to examine the before and after effects of processes and environmental changes, other than ...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2015.12.018
更新日期:2016-04-01 00:00:00
abstract:INTRODUCTION:Social distancing requirements during COVID-19 pose a challenge to conducting traditional academic detailing, which typically involves in-person peer education visits to improve patient outcomes. The main alternative is to conduct virtual academic detailing delivered through web-based technology, but this ...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2020.104365
更新日期:2021-03-01 00:00:00
abstract::With the growing concern about health issues and the emergence of online communities based on user-generated content (UGC), more and more people are participating in online health communities (OHCs) to exchange opinions and health information. This paper aims to examine whether and how male and female users behave dif...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2017.12.019
更新日期:2018-03-01 00:00:00
abstract:PURPOSE:The agent-oriented paradigm has emerged as a viable approach for the development of autonomic systems in the healthcare domain. This paper reviews representative works in this area in order to identify the main research lines and study their level of applicability. Moreover, from the analysis of those works and...
journal_title:International journal of medical informatics
pub_type: 杂志文章,评审
doi:10.1016/j.ijmedinf.2010.01.003
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Teamwork has become a modus operandi in healthcare and delivery of patient care by an interdisciplinary healthcare team (IHT) is now a prevailing modality of care. We argue that a formal and automated support framework is needed for an IHT to properly leverage information technology resources. Su...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2020.104075
更新日期:2020-04-01 00:00:00
abstract::In this paper we describe Tagged Information Management System (TIMS), an integrated knowledge management system for the domain of molecular biology and biomedicine, in which terminology-driven literature mining, knowledge acquisition (KA), knowledge integration (KI), and XML-based knowledge retrieval are combined usi...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/s1386-5056(02)00055-2
更新日期:2002-12-04 00:00:00
abstract::To assure sustainability of our health systems and improve quality, implementing integrated wellness, health and social care service models have been proposed. They will need the enabling power of Health ICT facilitated systems and applications. Such solutions support the efficient coordination of service provision ac...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2012.05.008
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVES:Since the launch of a nationwide general health check-up and instruction program in Japan in 2008, interest in strategies to improve implementation of the program based on predictive analytics has grown. We investigated the performance of prediction models developed to identify individuals classified as "req...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2017.12.009
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVES:To describe the range of patients' beliefs, attitudes, expectations, and experiences of remote monitoring for chronic conditions across different healthcare contexts and populations. DESIGN:We searched MEDLINE, Embase, PsychINFO, and CINAHL, Google Scholar, and reference lists of related studies through to ...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2019.01.013
更新日期:2019-04-01 00:00:00
abstract::Evidence-based dentistry has shown that different restorative materials have different survival times. Our primary hypothesis is that this should be revealed from normal dental records by the use of data mining technique and a practice-based dentistry approach analysed in a scientifically sound way. Dental records fro...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2009.04.004
更新日期:2009-12-01 00:00:00
abstract:INTRODUCTION:Detailed clinical models are necessary to exchange medical data between heterogeneous computer systems and to maintain consistency in a longitudinal electronic medical record system. At Intermountain Health Care (IHC), we have a history of designing detailed clinical models. The purpose of this paper is to...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/s1386-5056(02)00103-x
更新日期:2003-03-01 00:00:00
abstract:PURPOSE:Many criteria have been developed to rate the quality of online health information. To effectively evaluate quality, consumers must use quality criteria that can be reliably assessed. However, few instruments have been validated for inter-rater agreement. Therefore, we assessed the degree to which two raters co...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2005.02.002
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:Teamwork and interprofessional communication are important in addressing the comprehensive care needs of complex hospitalized patients. The objective of this study is to evaluate the impact of an electronic interprofessional communication and collaboration platform on teamwork, communication, and adverse eve...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2019.04.010
更新日期:2019-07-01 00:00:00
abstract::It is known that excessive levels of occupational stress affect professionals' technical and non-technical skills and surgeons are no exception. However, very few studies address this problem in neurosurgeons. A system for monitoring cardiovascular strain and autonomic imbalance during intracranial aneurysm procedures...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2019.05.028
更新日期:2019-09-01 00:00:00
abstract::In this contribution both the EDUCTRA project of the European Advanced Informatics in Medicine Programme and the IT-EDUCTRA project of the Telematics Applications Programme (Health Sector) are described. EDUCTRA had as aim to investigate which gaps in knowledge health professionals have with respect to health informat...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/s1386-5056(98)00066-5
更新日期:1998-06-01 00:00:00
abstract:OBJECTIVE:To investigate whether context-specific alerts for potassium-increasing drug-drug interactions (DDIs) in a clinical decision support system reduced the alert burden, increased alert acceptance, and had an effect on the occurrence of hyperkalemia. MATERIALS AND METHODS:In the pre-intervention period all alert...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2019.104013
更新日期:2020-01-01 00:00:00
abstract::Telemedicine systems have been considered as a necessary measure to alleviate the shortfall in skilled medical specialists in developing countries. However, the obvious challenge is whether clinicians are willing to use this technological innovation, which has aided medical practice globally. One factor which has rece...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2017.05.008
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:This work aims at extracting Adverse Drug Reactions (ADRs), i.e. a harm directly caused by a drug at normal doses, from Electronic Health Records (EHRs). The lack of readily available EHRs because of confidentiality issues and their lexical variability make the ADR extraction challenging. Furth...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2019.05.009
更新日期:2019-08-01 00:00:00
abstract:UNLABELLED:Given the increasing prevalence of multimorbidity in primary care (PC), interdisciplinary PC teams supported by appropriate clinical information systems (CIS) are needed in order to deal with the complexity of multimorbid patients' care. Our team has developed such a system, called the Da Vinci system. Howev...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2011.11.002
更新日期:2012-02-01 00:00:00
abstract::The goal of the German project "Standardization of Communication between Information Systems in Physician Offices and Hospitals using XML" (aka SCIPHOX) in its first phase is to provide information exchange based on the Extended Markup Language XML between Hospital Information Systems (HIS) and Physician Office System...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/s1386-5056(03)00036-4
更新日期:2003-07-01 00:00:00
abstract::This study evaluated the impact of telemedicine technology on the provision of neurosurgical health services. We focused on the differences between the use of real time audio-visual teleconferencing and teleradiology versus conventional telephone consultations in the referral of neurosurgical patients from a large dis...
journal_title:International journal of medical informatics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s1386-5056(01)00161-7
更新日期:2001-07-01 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::We describe the Security Plan for the 'MyAngelWeb' service. The different actors involved in the service are subject to different security procedures. The core of the security system is implemented at the host site by means of a DBMS and standard Information Technology tools. Hardware requirements for sustainable secu...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND:The authors have been conducting text mining analyses (extraction of useful information from text) of Medline records, using Abstracts as the main data source. For literature-based discovery, and other text mining applications as well, all records in a discipline need to be evaluated for determining prior ar...
journal_title:International journal of medical informatics
pub_type: 杂志文章
doi:10.1016/j.ijmedinf.2004.02.008
更新日期:2004-06-30 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