Formatively evaluating the importance of different aspects of an electronic blood transfusion system from the end users' point of view: a questionnaire study.

Blood transfusion is a process in which potential errors may result in serious adverse events to patients. To help improve the safety and efficiency of the blood transfusion process an electronic clinical transfusion management system is being piloted by NHS Connecting for Health. Evaluation of the implementation is being carried out in parallel. One component of the evaluation project aims to assess the importance placed in the various potential benefits of this new system by patients and healthcare workers. A questionnaire was generated and completed by healthcare workers and patients. Results indicate respondents viewing all factors as at least "important". "System" factors were deemed most important. Overall, clinical workers expressed the lowest importance to new process factors. Ultimately these results will be measured against final satisfaction with the system to assess 'fit' between perceived importance and satisfaction to guide areas for attention and resource allocation.

The Oxford clinical intranet: providing clinicians with access to patient records and multiple knowledge bases with internet technology.

The Oxford Clinical Intranet provides clinicians in primary and secondary care across Oxfordshire with: Access to information about their patients held on multiple remote disparate computer systems, including admissions and episodes, Laboratory Medicine reports, Radiology reports and hospital discharge letters. The patient records are managed using CSW Case Notes. Access to support and advisory information, developed both within the organization and collected from other sites and projects, a wide range of internal handbooks, directories and guidelines and links to external resources, including evidence-based resources, the Cochrane Collaboration and the NHS National electronic Library of Health. Automated retrieval and presentation of the support information that is contextually appropriate to the task being carried out by the clinician and the information held about the patient. For example laboratory reports are linked to handbooks and other reference sources using eLABook, a web-interfaced database subsystem. Internet technology has been used throughout, thus providing a thin-client architecture with cross-platform ability. Appropriate data standards have been used across the communicating systems and the intranet is compliant with the UK eGovernment Interoperability Framework. The intranet was developed at low cost and is now in routine use. This approach appears to be transferable across systems and organisations.

An integrated knowledge management system for the clinical laboratories: an initial application of an architectural model.

eLABook is a web-distributed knowledge management system designed to support the needs of clinicians and laboratory staff in the selection and interpretation of investigations in laboratory medicine. Access can be by hyperlinks at any point through the request-report cycle, by browsing down a hierarchy, and by various search approaches. The information describes service issues, which are predominantly locally determined, and clinical implications, which may be local, national, governmental and international. The application has been implemented across the Oxford Clinical Intranet to support secondary care in the four hospital sites of the Oxford Radcliffe Hospitals and by general practitioners in Oxfordshire. The knowledge base is capable of rapid changes in response to input from both developers and users. It supports authoring, editing and a full audit trail of changes. The selected architecture allows very large scale hierarchical structures and is designed to accommodate future needs for an object-distributed processing deployment.