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PubMedDate not supplied

Recommendations for responsible monitoring and regulation of clinical software systems. American Medical Informatics Association, Computer-based Patient Record Institute, Medical Library Association, Association of Academic Health Science Libraries, American Health Information Management Association, American Nurses Association.

In mid-1996, the FDA called for discussions on regulation of clinical software programs as medical devices. In response, a consortium of organizations dedicated to improving health care through information technology has developed recommendations for the responsible regulation and monitoring of clinical software systems by users, vendors, and regulatory agencies. Organizations assisting in development of recommendations, or endorsing the consortium position include the American Medical Informatics Association, the Computer-based Patient Record Institute, the Medical Library Association, the Association of Academic Health Sciences Libraries, the American Health Information Management Association, the American Nurses Association, the Center for Healthcare Information Management, and the American College of Physicians. The consortium proposes four categories of clinical system risks and four classes of measured monitoring and regulatory actions that can be applied strategically based on the level of risk in a given setting. The consortium recommends local oversight of clinical software systems, and adoption by healthcare information system developers of a code of good business practices. Budgetary and other constraints limit the type and number of systems that the FDA can regulate effectively. FDA regulation should exempt most clinical software systems and focus on those systems posing highest clinical risk, with limited opportunities for competent human intervention.

Clinical Medicine↗
PubMed1994

The Staggers Nursing Computer Experience Questionnaire.

This report described the development and initial psychometric testing for an instrument measuring nurses' perceived computer experience. The instrument's theoretical basis was psychometric theory and innovation adoption, specifically innovation use and knowledge. The scored portion of the instrument asks nurses to rate their past or present computer use and knowledge for general computer and HIS applications as well as participation in and knowledge about informatics role activities. A descriptive section of the tool asks nurses to indicate the number of formal courses and college-level computer/informatics courses they have taken. A novice-to-expert scale allows nurses to indicate their overall computer experience. Additionally, nurses list reasons, if any, that they might not use computers often. Content and construct validity were adequate for the instrument. Test-retest reliability indicated beginning reliability for the tool. The SNCEQ provides a reliable and valid measure for assessing nurses' past and present computer experience.

Adult↗
PubMed1998

A study on home health care support information system for health evaluation.

The need for home health care has been increasing in Japan and the application of various techniques such as medical informatics are desired to support home health care services. Therefore, we developed an information system for health evaluation of the elderly including patients at home by applying multifunctional telephone set and an IC memory card, by which complaints, symptoms, and conditions by them can be collected, recorded, and transmitted to medical facilities. We also conducted an experiment for trial use of the system with the cooperation of elderly female volunteers. It was recognized that the elderly volunteers could operate the system with the help of public health nurses and their health information could be collected by the system. Although the developed system has some problems, it was suggested that the system would be useful for the support of health evaluation of elderly at home.

Aged↗
PubMed1998

Health informatics education for undergraduates: teaching experiences with multi media.

In a global information society all students regardless of discipline need to have or acquire basic computing and information literacy skills. The Faculty of Health Science at the Central Queensland University now includes a compulsory and introductory course in Health Informatics at the undergraduate level for all its first year students to meet these educational needs for the future health industry workforce. This paper describes the teacher and student lived experiences encountered throughout the concurrent use of a variety of delivery modes to teach an introductory unit of health informatics to this varied student population. It will include a discussion about the unit itself, educational philosophy adopted, strengths and weaknesses of the technologies and delivery methods adopted and the results of the student evaluation.

Computer User Training↗
PubMed1996

A national model for participative management and policy development.

This article describes the virtual application of an innovative administrative model that addresses national nursing policy issues in the Department of Veterans Affairs. Using a constituency center model of organization, nurse and interdisciplinary experts in the areas of clinical, education, administration, research and informatics are drawn from throughout the country to manage projects that meet the specifications of the national nursing service strategic plan. The impetus for the development of the model, examples products developed and areas of interest explored to date, and an evaluation of the first 18 months of experience are discussed.

Decision Making, Organizational↗
PubMed2002

Development and evaluation of public health informatics at University of Washington.

Public Health Informatics (PHI) education began at the University of Washington (UW) with a Summer Institute in 1995. The Biomedical and Health Informatics graduate program, which is housed in the School of Medicine, is an interdisciplinary, multi-school program. It demonstrates the UW's cooperative efforts in advancing informatics, encompassing the schools of public health, medicine, nursing, dentistry, pharmacy, information and graduate schools in computer science. This article provides an overview of the developmental milestones related to activities in PHI and describes the evaluation strategy and assessment plan for PHI training at the UW (http://phig.washington.edu).

Curriculum↗
PubMed2007

Interdisciplinary innovations in biomedical and health informatics graduate education.

OBJECTIVES: Biomedical and health informatics (BHI) is a rapidly growing domain that relies on the active collaboration with diverse disciplines and professions. Educational initiatives in BHI need to prepare students with skills and competencies that will allow them to function within and even facilitate interdisciplinary teams (IDT). This paper describes an interdisciplinary educational approach introduced into a BHI graduate curriculum that aims to prepare informatics researchers to lead IDT research. METHODS: A case study of the "gerontechnology" research track is presented which highlights how the curriculum fosters collaboration with and understanding of the disciplines of Nursing, Engineering, Computer Science, and Health Administration. Gerontechnology is a new interdisciplinary field that focuses on the use of technology to support aging. Its aim is to explore innovative ways to use information technology and develop systems that support independency and increase quality of life for senior citizens. As a result of a large research group that explores "smart home" technologies and the use of information technology, we integrated this new domain into the curriculum providing a platform for computer scientists, engineers, nurses and physicians to explore challenges and opportunities with our informatics students and faculty. RESULTS: The interdisciplinary educational model provides an opportunity for health informatics students to acquire the skills for communication and collaboration with other disciplines. Numerous graduate and postgraduate students have already participated in this initiative. The evaluation model of this approach is presented. CONCLUSION: Interdisciplinary educational models are required for health informatics graduate education. Such models need to be innovative and reflect the needs and trends in the domains of health care and information technology.

Aged↗
PubMedDate not supplied

An informatics approach to complex research problems. Dynamic process modeling.

In the nursing literature, the term computer simulation refers exclusively to an educational tool that requires the user to respond to simulated events and to engage in the decision-making process. However, computer simulations are frequently constructed to model dynamic systems (systems that change with time) and to randomly simulate real life events in an effort to study complex problems. In this context, computer simulation is a research methodology and is used in a wide variety of disciplines including the behavioral sciences and business management. Nurses will inevitably encounter research studies where computer simulation has been employed. It is also very likely that this methodology will be used as a nursing research tool in the near future. This article introduces and describes the use of computers to model dynamic systems, the theory that supports simulation modeling as a research methodology, and the issues of model validation. Included are examples of four different research problems from diverse fields of study where computer simulation has been applied.

Computer Simulation↗
PubMed2005

Clinician style and examination room computers: a video ethnography.

BACKGROUND AND OBJECTIVES: The use of computers in medical examination rooms is growing. Advocates of this technology suggest that all family physicians should have and use examination room computers (ERCs) within the near future. This study explored how family physicians incorporate the use of ERCs in their interactions with patients. METHODS: This qualitative study involved five family physicians, one family nurse practitioner, and a convenience sample of 29 patients. Data included videotaped visits, clinician interviews, and videotape reviews. The setting was an urban family practice with a 7-year history of viewing electronic medical records. The main outcome measures were themes emergent from videotaped data. RESULTS: We identified three distinct practice styles that shaped the use of the ERC: informational, interpersonal, and managerial styles. Clinicians with an informational style are guided by their attention to gathering data as prompted by the computer screen. Clinicians with an interpersonal style focus their attention and body language on patients. Clinicians with a managerial style bridge informational and interpersonal styles by alternating their attention in defined intervals between patients and the computer. CONCLUSIONS: Family physicians have varying practice styles that affect the way they use examination room computers during visits with patients.

Adolescent↗
PubMed1997

Retrieving cases for treatment advice in nursing using text representation and structured text retrieval.

A nursing database which records patient details and treatments as fields in a standard database format is transformed into a collection, in text form, of patient case days with history. Each case is represented as text strings encoding the patient details, the current problems, treatments and their associated history. The cosine measure of similarity is used to compute a whole case similarity between a text query and the cases in text form. This standard text retrieval technique is used and compared to a simple rule base. In case-based reasoning, the similarity of cases is often computed by combining similarities of the case features involved. In this work the standard text retrieval function is modified to incorporate this case structure by combining individual matches of case components based on the cosine measure. The combination is based on a linear regression model for learning the weights assigned to the components of this retrieval function. For the 1355 records two tasks were tried: predicting the treatment for a new problem and predicting the treatment for a continuing problem when a change of treatment is required. Simple text retrieval was better than the rule base for one task and case structured retrieval was at least 18% better on both tasks. Further techniques are discussed.

Age Factors↗
PubMed1988

Computerized telephone assessment of the "concrete" needs of chemotherapy outpatients: a feasibility study.

The feasibility of using a computer-automated telephone outreach system to routinely assess the needs of chemotherapy outpatients was evaluated. The automated intervention was designed as a cost-efficient strategy for assessing patients' needs on a periodic basis so that emerging needs could be identified in a timely way. Ninety-seven chemotherapy outpatients were surveyed at least once over the telephone by a computer in a high-quality, digitally stored voice asking 12 questions regarding the patients' "concrete" needs. Early results of this larger ongoing study, in which patients are scheduled to be called every 4 to 6 weeks for approximately four months, indicated that computer-automated surveys had broad-based acceptance among our outpatients and that patients were able to comply accurately with the survey's instructions. Furthermore, the speech recognition system was found to be reliable, and patients' response patterns to the automated surveys valid. Nonparticipation in this study (28.0%) was not substantially higher than in our previous research within this patient population and neither nonparticipation nor attrition appeared significantly attributable to the automation itself. This method offers the potential for cost-efficient, universal, and ongoing assessment of patient needs, facilitating timely intervention, and efficient use of professional staff.

Ambulatory Care↗