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1.
Appl Ergon ; 82: 102973, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31677422

RESUMO

Since the publication of "Health Information Technology: Fallacies and Sober Realities" in 2010, health information technology (HIT) has become nearly ubiquitous in US healthcare facilities. Yet, HIT has yet to achieve its putative benefits of higher quality, safer, and lower cost care. There has been variable but largely marginal progress at addressing the 12 HIT fallacies delineated in the original paper. Here, we revisit several of the original fallacies and add five new ones. These fallacies must be understood and addressed by all stakeholders for HIT to be a positive force in achieving the high value healthcare system the nation deserves. Foundational cognitive and human factors engineering research and development continue to be essential to HIT development, deployment, and use.


Assuntos
Aplicações da Informática Médica , Informática Médica/tendências , Esgotamento Profissional , Ergonomia , Humanos , Objetivos Organizacionais , Qualidade da Assistência à Saúde , Estados Unidos
4.
Stud Health Technol Inform ; 201: 211-8, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24943546

RESUMO

Telehealth services in the State of Pernambuco, Brazil are led by the Telehealth Center (RedeNUTES) and based on HealthNet 2.0 software. Among the tele-assistance services, health professionals have clinical discussions focused on second opinions. This paper reports the experience in a PhD study through mixed-methods, to evaluate the telehealth services, planning and modeling a new tool to improve a telehealth system. We described the nurse's role in each phase of this study. The method of User-Centered Design was explored in three phases as Identification of work process, User's perception and collaborative modeling, Observational usability study. The main frame was based on collaborative techniques as Collaborative Prototype Design Process, cognitive walkthrough, and thinking-aloud. The users also identified all usability problems identified by the evaluators. The methods were useful in identifying usability problems, and easy to employ using standard equipment and software thus a relatively low cost approach to usability testing.


Assuntos
Comportamento Cooperativo , Modelos Organizacionais , Design de Software , Software , Telemedicina/organização & administração , Brasil
5.
Int J Med Inform ; 83(7): e12-22, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24444700

RESUMO

OBJECTIVES: The intent of this paper is in the examination of health IT implementation processes - the barriers to and facilitators of successful implementation, identification of a beginning set of implementation best practices, the identification of gaps in the health IT implementation body of knowledge, and recommendations for future study and application. METHODS: A literature review resulted in the identification of six health IT related implementation best practices which were subsequently debated and clarified by participants attending the NI2012 Research Post Conference held in Montreal in the summer of 2012. Using the framework for implementation research (CFIR) to guide their application, the six best practices were applied to two distinct health IT implementation studies to assess their applicability. RESULTS: Assessing the implementation processes from two markedly diverse settings illustrated both the challenges and potentials of using standardized implementation processes. In support of what was discovered in the review of the literature, "one size fits all" in health IT implementation is a fallacy, particularly when global diversity is added into the mix. At the same time, several frameworks show promise for use as "scaffolding" to begin to assess best practices, their distinct dimensions, and their applicability for use. CONCLUSIONS: Health IT innovations, regardless of the implementation setting, requires a close assessment of many dimensions. While there is no "one size fits all", there are commonalities and best practices that can be blended, adapted, and utilized to improve the process of implementation. This paper examines health IT implementation processes and identifies a beginning set of implementation best practices, which could begin to address gaps in the health IT implementation body of knowledge.


Assuntos
Implementação de Plano de Saúde , Serviços de Saúde/normas , Informática Médica , Guias de Prática Clínica como Assunto , Desenvolvimento de Programas/métodos , Humanos , Desenvolvimento de Programas/normas
6.
Nurs Res Pract ; 2012: 307258, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22548159

RESUMO

Clinical environments are complex, stressful, and safety critical-heightening the demand for technological solutions that will help clinicians manage health information efficiently and safely. The industry has responded by creating numerous, increasingly compact and powerful health IT devices that fit in a pocket, hook to a belt, attach to eyeglasses, or wheel around on a cart. Untethering a provider from a physical "place" with compact, mobile technology while delivering the right information at the right time and at the right location are generally welcomed in clinical environments. These developments however, must be looked at ecumenically. The cognitive load of clinicians who are occupied with managing or operating several different devices during the process of a patient encounter is increased, and we know from decades of research that cognitive overload frequently leads to error. "Technology crowding," enhanced by the plethora of mobile health IT, can actually become an additional millstone for busy clinicians. This study was designed to gain a deeper understanding of clinicians' interactions with a mobile clinical computing appliance (Motion Computing C5) designed to consolidate numerous technological functions into an all-in-one device. Features of usability and comparisons to current methods of documentation and task performance were undertaken and results are described.

7.
Comput Inform Nurs ; 30(6): 300-11, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22411417

RESUMO

This multimethod study measured the impact of an electronic health record (EHR) on clinician satisfaction with clinical process. Subjects were 39 clinicians at a Program of All-inclusive Care for Elders (PACE) site in Philadelphia utilizing an EHR. Methods included the evidence-based evaluation framework, Health Information Technology Research-Based Evaluation Framework, which guided assessment of clinician satisfaction with surveys, observations, follow-up interviews, and actual EHR use at two points in time. Mixed-methods analysis of findings provided context for interpretation and improved validity. The study found that clinicians were satisfied with the EHR; however, satisfaction declined between time periods. Use of EHR was universal and wide and was differentiated by clinical role. Between time periods, EHR use increased in volume, with increased timeliness and decreased efficiency. As the first EHR evaluation at a PACE site from the perspective of clinicians who use the system, this study provides insights into EHR use in the care of older people in community-based healthcare settings.


Assuntos
Atitude do Pessoal de Saúde , Centros Comunitários de Saúde/organização & administração , Registros Eletrônicos de Saúde/organização & administração , Enfermagem Geriátrica/organização & administração , Recursos Humanos de Enfermagem/psicologia , Equipe de Assistência ao Paciente/organização & administração , Adulto , Registros Eletrônicos de Saúde/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente/normas
8.
J Am Med Inform Assoc ; 17(6): 617-23, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20962121

RESUMO

Current research suggests that the rate of adoption of health information technology (HIT) is low, and that HIT may not have the touted beneficial effects on quality of care or costs. The twin issues of the failure of HIT adoption and of HIT efficacy stem primarily from a series of fallacies about HIT. We discuss 12 HIT fallacies and their implications for design and implementation. These fallacies must be understood and addressed for HIT to yield better results. Foundational cognitive and human factors engineering research and development are essential to better inform HIT development, deployment, and use.


Assuntos
Atitude Frente a Saúde , Difusão de Inovações , Política de Saúde , Informática Médica/tendências , Avaliação da Tecnologia Biomédica , Humanos , Estados Unidos
9.
Nurs Outlook ; 56(5): 238-246.e2, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18922277

RESUMO

Globalization and information and communication technology (ICT) continue to change us and the world we live in. Nursing stands at an opportunity intersection where challenging global health issues, an international workforce shortage, and massive growth of ICT combine to create a very unique space for nursing leadership and nursing intervention. Learning from prior successes in the field can assist nurse leaders in planning and advancing strategies for global health using ICT. Attention to lessons learned will assist in combating the technological apartheid that is already present in many areas of the globe and will highlight opportunities for innovative applications in health. ICT has opened new channels of communication, creating the beginnings of a global information society that will facilitate access to isolated areas where health needs are extreme and where nursing can contribute significantly to the achievement of "Health for All." The purpose of this article is to discuss the relationships between globalization, health, and ICT, and to illuminate opportunities for nursing in this flattening and increasingly interconnected world.


Assuntos
Meios de Comunicação/tendências , Saúde Global , Sistemas de Informação/organização & administração , Informática em Enfermagem/organização & administração , Comportamento Cooperativo , Educação em Enfermagem/organização & administração , Previsões , Necessidades e Demandas de Serviços de Saúde , Humanos , Intercâmbio Educacional Internacional , Liderança , Sistemas Computadorizados de Registros Médicos/organização & administração , Papel do Profissional de Enfermagem , Informática em Enfermagem/educação , Registros de Enfermagem , Pesquisa em Enfermagem/organização & administração , Objetivos Organizacionais , Telenfermagem/organização & administração , Organização Mundial da Saúde/organização & administração
10.
Stud Health Technol Inform ; 122: 387-90, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17102285

RESUMO

Quick changes on the field of informational communication technologies forces educational and other institutions to think about different ways of teaching and learning in both formal and informal environments. It addition it is well known that due to fast advancement of science and technology the knowledge gained in schools is getting out-of-date rapidly, so life long learning is becoming an essential alternative. As a consequence we are facing a rapid development and use of new educational approaches such as e-learning, simulations, virtual reality, etc. They brought a revolution to learning and instruction. But in general the empirical results of e-learning studies are somewhat disappointing. They cannot prove the superiority of e-learning processes over traditional learning in general, neither in specific areas like nursing. In our international study we proved that e-Learning can have many benefits and that it can enhance learning experience in nursing education, but it has to be provided in correct manner.


Assuntos
Educação em Enfermagem , Internet , Educação a Distância , Humanos , Entrevistas como Assunto , Eslovênia , Estados Unidos
11.
AMIA Annu Symp Proc ; : 1008, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-16779295

RESUMO

A semi-automatic procedure that extracts metadata from MEDLINE was used to develop a search tool that facilitates online location and (free) access to full-text electronic documents from the Proceedings of the American Medical Informatics Association (AMIA) Annual Symposia (1997-2003). Log file analysis for six months showed steady use of the tool, with most queries originating from hosts in the US (60%), Canada (15.3%), Argentina (10.2%) and Australia (9.6%) for common informatics topics.


Assuntos
Congressos como Assunto , Informática Médica , Sistemas On-Line/estatística & dados numéricos , Sociedades Médicas , Armazenamento e Recuperação da Informação/estatística & dados numéricos , MEDLINE , Sistemas On-Line/organização & administração , Editoração
12.
J Biomed Inform ; 36(4-5): 389-99, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14643735

RESUMO

The growth of nursing databases necessitates new approaches to data analyses. These databases, which are known to be massive and multidimensional, easily exceed the capabilities of both human cognition and traditional analytical approaches. One innovative approach, knowledge discovery in large databases (KDD), allows investigators to analyze very large data sets more comprehensively in an automatic or a semi-automatic manner. Among KDD techniques, Bayesian networks, a state-of-the art representation of probabilistic knowledge by a graphical diagram, has emerged in recent years as essential for pattern recognition and classification in the healthcare field. Unlike some data mining techniques, Bayesian networks allow investigators to combine domain knowledge with statistical data, enabling nurse researchers to incorporate clinical and theoretical knowledge into the process of knowledge discovery in large datasets. This tailored discussion presents the basic concepts of Bayesian networks and their use as knowledge discovery tools for nurse researchers.


Assuntos
Inteligência Artificial , Pesquisa em Enfermagem , Teorema de Bayes , Biologia Computacional , Bases de Dados Factuais , Humanos , Modelos Estatísticos
14.
Int J Med Inform ; 69(1): 29-38, 2003 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-12485702

RESUMO

The application of information technology (IT) in health care has the potential to transform the delivery of care, as well as the health care work environment, by streamlining processes, making procedures more accurate and efficient, and reducing the risk of human error. For nurses, a major aspect of this transformation is the refocusing of their work on direct patient care and away from being a conduit of information and communication among departments. Several of the technologies discussed, such as physician order entry and bar code technology, have existed for years as standalone systems. Many others are just being developed and are being integrated into complex clinical information systems (CISs) with clinical decision support at their core. While early evaluation of these systems shows positive outcome measurements, financial, technical, and organizational hurdles to widespread implementation still remain. One major issue is defining the role nurses, themselves, will play in the selection and implementation of these systems as they become more steeped in the knowledge of nursing informatics. Other challenges revolve around issues of job satisfaction and the attraction and retention of nursing staff in the midst of a serious nursing shortage. Despite these concerns, it is expected that, in the long run, the creation of an electronic work environment with systems that integrate all functions of the health care team will positively impact cost-effectiveness, productivity, and patient safety while helping to revitalize nursing practice.


Assuntos
Sistemas de Apoio a Decisões Clínicas , Erros Médicos/prevenção & controle , Informática Médica , Sistemas Computadorizados de Registros Médicos/tendências , Enfermagem/normas , Segurança , Comunicação , Análise Custo-Benefício , Relações Interpessoais , Papel do Profissional de Enfermagem
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