Abstract：
OBJECTIVES:Mismatches frequently occur between information system (IS) dictated workflows and actual workflows of IS users. The resulting impeded workflows negatively influence the efficiency with which goods or services are produced and delivered to customers. Within a healthcare context, impeded workflows can additionally have a negative impact on the safety and effectiveness of care delivered to patients. METHODS:This study evaluates the impact of an electronic health record system of a large university hospital on workflows of healthcare professionals from a lean management waste perspective. Workflow mismatches were identified from direct observations and follow-up semi-structured interviews with physicians and nurses and assessed in terms of waste generated. RESULTS:In total, 241 manifestations of waste were identified and classified according to 8 types of waste. Furthermore, noteworthy relationships among the identified manifestations of waste were found. These include differences in frequency per type of waste, certain types of waste having a cascading effect, and waste proliferating as a result of mimicked and routinized behavior. CONCLUSIONS:The knowledge obtained from this study can support (re)design of IS to better match workflows which may subsequently lead to more safe, effective and efficient patient care.
journal_name
Int J Med Informjournal_title
International journal of medical informaticsauthors
Blijleven V,Koelemeijer K,Jaspers Mdoi
10.1016/j.ijmedinf.2017.08.005subject
Has Abstractpub_date
2017-11-01 00:00:00pages
40-47eissn
1386-5056issn
1872-8243pii
S1386-5056(17)30204-6journal_volume
107pub_type
杂志文章abstract：PURPOSE:Collecting and analyzing findings constitute the basis of medical activity. Computer assisted medical activity raises the problem of modelling findings. We propose a unified representation of findings integrating the representations of findings in the GAMUTS in Radiology [M.M. Reeder, B. Felson, GAMUTS in radio...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2007.11.003
更新日期：2008-09-01 00:00:00
abstract：:In this paper, we present a model that describes the stages of the implementation of an information system in a health care organization. The model offers no explanation of the implementation process but rather describes in a cyclic order the domains that are relevant when implementing a system. The model offers thus ...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/s1386-5056(98)00142-7
更新日期：1998-10-01 00:00:00
abstract：INTRODUCTION:Physicians encounter a large number of questions during patient care. Therefore, finding high-quality evidence provides a good opportunity to improve patient care and continue learning. OBJECTIVES:The present study aims to obtain a comprehensive understanding of the physicians' clinical information-seekin...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2020.104144
更新日期：2020-07-01 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：BACKGROUND:Evidence-based therapy for heart failure remains underutilized at hospital discharge, particularly for patients with heart failure who are hospitalized for another cause. We developed clinical decision support (CDS) to recommend an angiotensin converting enzyme (ACE) inhibitor during hospitalization to promo...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2019.103956
更新日期：2019-11-01 00:00:00
abstract：OBJECTIVE:To investigate the rate of automation bias - the propensity of people to over rely on automated advice and the factors associated with it. Tested factors were attitudinal - trust and confidence, non-attitudinal - decision support experience and clinical experience, and environmental - task difficulty. The par...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2014.01.001
更新日期：2014-05-01 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：CONTEXT:Data mining (DM) provides the methodology and technology needed to transform huge amounts of data into useful information for decision making. It is a powerful process employed to extract knowledge and discover new patterns embedded in large data sets. Data mining has been increasingly used in medicine, particu...
journal_title：International journal of medical informatics
pub_type： 杂志文章,评审
doi：10.1016/j.ijmedinf.2016.09.005
更新日期：2017-01-01 00:00:00
abstract：PURPOSE:Patients have the most to gain from reducing medical errors; yet, little research has been done to investigate the role they could or already do play in detecting and preventing errors in their own health care. The purpose of this study is to examine patient's role in detecting, preventing, and recovering from ...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2006.05.021
更新日期：2007-06-01 00:00:00
abstract：PURPOSE:Clear and adequate communication between physicians is essential in modern medicine. Nevertheless, the medical curricula in The Netherlands lack an identifiable part in their education concerning inter-physician communication training. To train medical students in inter-physician communication skills using the ...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2007.01.007
更新日期：2007-05-01 00:00:00
abstract：BACKGROUND:Recent advances in artificial intelligence (AI) have shown great promise in detecting some diseases based on medical images. Most studies developed AI diagnostic systems only using eligible images. However, in real-world settings, ineligible images (including poor-quality and poor-location images) that can c...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2020.104363
更新日期：2021-03-01 00:00:00
abstract：INTRODUCTION:Telehealth is an important tool for ensuring accessible healthcare access particularly over geographical distances. Videoconference and telephone are two common telehealth modalities, yet little is known as to the relative advantage of these modalities. Synthesizing evidence as to the impact of these modal...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2018.07.007
更新日期：2018-10-01 00:00:00
abstract：:In order to increase the number of practical and discussion classes offered to students in the traditional-curriculum scenario, while decreasing the lecture-based ones and to create an online community to share knowledge on surgery, we developed and assessed the first online course for undergraduate medical students o...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2004.06.002
更新日期：2004-09-01 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：:The process of generating a clinical referral for a patient, and the resulting transfer of information from the primary care physician to the specialist and back again, are key components in the struggle to deliver less costly and more effective clinical care. We have created a computer-based, outpatient clinical refe...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/s1386-5056(99)00027-1
更新日期：1999-08-01 00:00:00
abstract：:This article considers the 26 years history of an integrated hospital information system (HIS). The system emerged from an experimental government sponsored project in the Leiden University Hospital and is now the leading HIS in The Netherlands. The evolution during these 26 years is presented and discussed in this ar...
journal_title：International journal of medical informatics
pub_type： 历史文章,杂志文章
doi：10.1016/s1386-5056(99)00008-8
更新日期：1999-06-01 00:00:00
abstract：OBJECTIVE:Children are an important portion of the population of the territories covered by Primary Health Care (PHC), with needs and characteristics that can be managed at this level of care. Therefore, it is essential that professionals working in PHC be capable of providing child care. The aim of this study was to e...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2019.06.014
更新日期：2019-09-01 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：:The SHARE(1) project (http://www.eu-share.org) was asked to identify the key developments needed to achieve wide adoption and deployment of HealthGrids throughout Europe. The project was asked to organise these as milestones on a road map, so that all technical advances, social actions, economic investments and ethica...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2008.10.003
更新日期：2009-04-01 00:00:00
abstract：OBJECTIVE:The aims of this paper were to study the reporting rate and completeness of data reported from primary healthcare centres (PHCCs) in Sweden to the Swedish National Diabetes Register (NDR), with a special attention on the relation between these measures and the reporting system used by the PHCCs. METHOD:A nat...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2011.06.006
更新日期：2011-09-01 00:00:00
abstract：BACKGROUND:Poor usability is one of the major barriers for optimally using electronic health records (EHRs). Dentists are increasingly adopting EHRs, and are using structured data entry interfaces to enter data such that the data can be easily retrieved and exchanged. Until recently, dentists have lacked a standardized...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2012.05.018
更新日期：2013-02-01 00:00:00
abstract：BACKGROUND:With age reaction time, coordination and cognition tend to deteriorate, which may lead to gait impairments, falls and injuries. To reduce this problem in elderly and to improve health, well-being and independence, regular balance and strength exercises are recommended. However, elderly face strong barriers t...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2012.11.015
更新日期：2013-05-01 00:00:00
abstract：BACKGROUND:The electronic health record (EHR) has become a fundamental tool in health care. The ordering and inclusion of lab tests and results is one of the most frequently requested services by EHR users. We have designed, developed and implemented in Andalusia, an autonomous community in the south of Spain (8.3 mill...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2013.03.006
更新日期：2013-06-01 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: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:To examine the effectiveness of delivering of computer-generated discharge summaries to general practice by email, fax, post and patient hand delivery. DESIGN:Blinded, randomized controlled trial. A pre-study audit ascertaining baseline statistics and a follow-up survey were conducted with general practice t...
journal_title：International journal of medical informatics
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.ijmedinf.2009.12.006
更新日期：2010-03-01 00:00:00
abstract：:This paper describes a new distributed Master of Science degree program stream in health informatics (HI) at the University of Victoria, Canada, aimed at healthcare and information technology professionals working in the health setting. This is a part-time graduate program where students are required to complete 10 co...
journal_title：International journal of medical informatics
pub_type： 杂志文章,评审
doi：10.1016/j.ijmedinf.2007.01.008
更新日期：2007-05-01 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：BACKGROUND:In recent years, the development and application of emerging information technologies, such as artificial intelligence, cloud computing, Internet of Things, and wearable devices, has expanded the content of electronic health (e-health). Electronic health has become a research focus, but few studies have expl...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2019.08.007
更新日期：2019-10-01 00:00:00
abstract：:Due to its complexity intensive care is vulnerable to errors. On the ICU adults of the AMC (Amsterdam, The Netherlands) the available registries used for error reporting did not give insight in the occurrence of unwanted events, and did not lead to preventive measures. Therefore, a new registry has been developed on t...
journal_title：International journal of medical informatics
pub_type： 杂志文章
doi：10.1016/j.ijmedinf.2006.08.003
更新日期：2007-02-01 00:00:00
