Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.236
Filtrar
1.
Cochrane Database Syst Rev ; 8: CD012012, 2020 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-32803893

RESUMO

BACKGROUND: A well-functioning routine health information system (RHIS) can provide the information needed for health system management, for governance, accountability, planning, policy making, surveillance and quality improvement, but poor information support has been identified as a major obstacle for improving health system management. OBJECTIVES: To assess the effects of interventions to improve routine health information systems in terms of RHIS performance, and also, in terms of improved health system management performance, and improved patient and population health outcomes. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE Ovid and Embase Ovid in May 2019. We searched Global Health, Ovid and PsycInfo in April 2016. In January 2020 we searched for grey literature in the Grey Literature Report and in OpenGrey, and for ongoing trials using the International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov. In October 2019 we also did a cited reference search using Web of Science, and a 'similar articles' search in PubMed. SELECTION CRITERIA: Randomised and non-randomised trials, controlled before-after studies and time-series studies comparing routine health information system interventions, with controls, in primary, hospital or community health care settings. Participants included clinical staff and management, district management and community health workers using routine information systems. DATA COLLECTION AND ANALYSIS: Two authors independently reviewed records to identify studies for inclusion, extracted data from the included studies and assessed the risk of bias. Interventions and outcomes were too varied across studies to allow for pooled risk analysis. We present a 'Summary of findings' table for each intervention comparisons broadly categorised into Technical and Organisational (or a combination), and report outcomes on data quality and service quality. We used the GRADE approach to assess the certainty of the evidence. MAIN RESULTS: We included six studies: four cluster randomised trials and two controlled before-after studies, from Africa and South America. Three studies evaluated technical interventions, one study evaluated an organisational intervention, and two studies evaluated a combination of technical and organisational interventions. Four studies reported on data quality and six studies reported on service quality. In terms of data quality, a web-based electronic TB laboratory information system probably reduces the length of time to reporting of TB test results, and probably reduces the overall rate of recording errors of TB test results, compared to a paper-based system (moderate certainty evidence). We are uncertain about the effect of the electronic laboratory information system on the recording rate of serious (misidentification) errors for TB test results compared to a paper-based system (very low certainty evidence). Misidentification errors are inaccuracies in transferring test results between an electronic register and patients' clinical charts. We are also uncertain about the effect of the intervention on service quality (timeliness of starting or changing a patient's TB treatment) (very low certainty evidence). A hand-held electronic device probably improves the length of time to report TB test results, and probably reduces the total frequency of recording errors in TB test results between the laboratory notebook and the electronic information record system, compared to a paper-based system (moderate-certainty evidence). We are, however, uncertain about the effect of the intervention on the frequency of serious (misidentification) errors in recording between the laboratory notebook and the electronic information record, compared to a paper-based system (very low certainty evidence). We are uncertain about the effect of a hospital electronic health information system on service quality (length of time outpatients spend at hospital, length of hospital stay, and hospital revenue collection), compared to a paper-based system (very low certainty evidence). High-intensity brief text messaging (SMS) may make little or no difference to data quality (in terms of completeness of documentation of pregnancy outcomes), compared to low-intensity brief text messaging (low-certainty evidence). We are uncertain about the effect of electronic drug stock notification (with either data management support or product transfer support) on service quality (in terms of transporting stock and stock levels), compared to paper-based stock notification (very low certainty evidence). We are uncertain about the effect of health information strengthening (where it is part of comprehensive service quality improvement intervention) on service quality (health worker motivation, receipt of training by health workers, health information index scores, quality of clinical observation of children and adults) (very low certainty evidence). AUTHORS' CONCLUSIONS: The review indicates mixed effects of mainly technical interventions to improve data quality, with gaps in evidence on interventions aimed at enhancing data-informed health system management. There is a gap in interventions studying information support beyond clinical management, such as for human resources, finances, drug supply and governance. We need to have a better understanding of the causal mechanisms by which information support may affect change in management decision-making, to inform robust intervention design and evaluation methods.


Assuntos
Assistência à Saúde/organização & administração , Sistemas de Informação em Saúde/normas , Política Organizacional , Melhoria de Qualidade , Viés , Sistemas de Informação em Laboratório Clínico/organização & administração , Sistemas de Informação em Laboratório Clínico/normas , Computadores de Mão , Coleta de Dados/normas , Tomada de Decisões , Assistência à Saúde/normas , Serviços de Informação sobre Medicamentos/normas , Sistemas de Informação Hospitalar/normas , Testes de Sensibilidade Microbiana , Inovação Organizacional , Preparações Farmacêuticas/provisão & distribução , Ensaios Clínicos Controlados Aleatórios como Assunto , Envio de Mensagens de Texto/normas , Tuberculose/diagnóstico , Tuberculose/tratamento farmacológico
2.
Rev. cuba. inform. méd ; 12(1)ene.-jun. 2020. tab, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1126551

RESUMO

El Centro de Informática médica (CESIM) de la Universidad de las Ciencias Informáticas (UCI) desarrolla el Sistema de Información Hospitalaria XAVIA HIS. El éxito en la implantación es de gran importancia para el CESIM, no obstante, los proyectos de implantación se han visto incididos por un conjunto de insuficiencias. El objetivo de la investigación es desarrollar una estrategia que contribuya a aumentar el éxito en la definición del alcance de los proyectos de implantación del sistema XAVIA HIS, en instituciones de salud. Se realizó un estudio descriptivo, que incluyó como escenario de aplicación el Centro Nacional de Cirugía de Mínimo Acceso, entre 2015 y 2017. Como resultado se obtuvo una estrategia para la implantación del sistema XAVIA HIS en instituciones de salud, que impacta positivamente en la disminución del tiempo necesario para este fin(AU)


University of Computer Sciences (UCI) develops the XAVIA HIS Hospital Information System. The implement success of the system is of great importance for CESIM, however, this stage have been affected by a set of insufficiencies. The objective of the research is to develop a strategy that contributes to increasing success in defining the scope of projects to implement XAVIA HIS system in health institutions. A descriptive study was carried out, which included as an application scenario the National Center for Minimally Access Surgery, between 2015 and 2017. As a result, a strategy to implement XAVIA HIS system in health institutions was obtained, which positively impacts the decrease of time necessary for this purpose(AU)


Assuntos
Aplicações da Informática Médica , Design de Software , Epidemiologia Descritiva , Sistemas de Informação Hospitalar/normas
3.
J Med Syst ; 44(2): 53, 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31925566

RESUMO

The focus on personal data has merited the EU concerns and attention, resulting in the legislative change regarding privacy and the protection of personal data. The General Data Protection Regulation (GDPR) aims to reform existing measures on the protection of personal data of European Union citizens, with a strong impact on the rights and freedoms of individuals in establishing rules for the processing of personal data. The GDPR considers a special category of personal data, the health data, being these considered as sensitive data and subject to special conditions regarding treatment and access by third parties. This work presents the evolution of the applicability of the Regulation (EU) 2016/679 six months after its application in Portuguese health clinics. The results of the present study are discussed in the light of future literature and work are identified.


Assuntos
Acesso à Informação/legislação & jurisprudência , Segurança Computacional/legislação & jurisprudência , Registros Eletrônicos de Saúde/legislação & jurisprudência , Sistemas de Informação Hospitalar/legislação & jurisprudência , Segurança Computacional/normas , Registros Eletrônicos de Saúde/normas , União Europeia , Troca de Informação em Saúde/legislação & jurisprudência , Registros de Saúde Pessoal , Sistemas de Informação Hospitalar/normas , Humanos
4.
Comput Inform Nurs ; 37(11): 591-598, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31385815

RESUMO

An effective patient transfer, or handover, among healthcare professionals can help prevent communication-related medical errors, and a reliable electronic handover informatics system can standardize the handoff process. Adapting to a new handover system may cause stress for nurses. This descriptive qualitative study aimed to explore the perceptions and transition experiences of hospital nurses in adopting and adapting to a new handover informatics system. Thirty-eight nurses at a medical center in Taiwan participated in the study from December 2016 to January 2017. The researcher conducted five focus group interviews and analyzed all responses using content analysis. Results showed three major themes: "Perceptions of challenges and barriers related to the transition to a new handover informatics system," "Perceptions of benefits and strategies to the transition to a new handover informatics system," and "Suggestions for successful implementation of a new handover informatics system." Five subthemes emerged from the first theme, and six subthemes emerged from the second theme. The results of this study could enhance our understanding of nurses' perceptions and experiences with transition to a new handover informatics system and could provide a reference for hospitals to develop individualized strategies to facilitate the implementation of a handover informatics system.


Assuntos
Sistemas de Informação Hospitalar/normas , Enfermeiras e Enfermeiros/psicologia , Transferência da Responsabilidade pelo Paciente/normas , Percepção , Cuidado Transicional/normas , Grupos Focais/métodos , Sistemas de Informação Hospitalar/tendências , Humanos , Enfermeiras e Enfermeiros/tendências , Transferência da Responsabilidade pelo Paciente/tendências , Pesquisa Qualitativa , Taiwan , Cuidado Transicional/tendências
5.
JMIR Mhealth Uhealth ; 7(7): e14531, 2019 07 31.
Artigo em Inglês | MEDLINE | ID: mdl-31368444

RESUMO

BACKGROUND: Digital photography is crucial for electronic medical records (EMRs), particularly for documenting dermatological diseases and traumatic wounds. In modern emergency departments (EDs), digital cameras are commonly used for photography, but the process is time-consuming. The problems of addressing patient privacy issues and that of interruptions and heavy workloads can cause archival errors when uploading photos. However, smartphones are widely available and cheap, so with a suitable app many errors could be mitigated. OBJECTIVE: The aim of this study is to design and test a smartphone app to improve the efficiency of clinical photography and improve patient privacy in the ED. The app is connected to the hospital information system to verify patient identification and enable archiving, and the app can automatically delete images after upload to the patient's EMR. METHODS: This study enrolled 48 experienced ED nurses trained in clinical photography. Each nurse was first assigned a digital camera for photography and then a smartphone with the app preinstalled after it was launched. The time taken to upload images to a patient's EMR was then recorded and the efficiency of the digital camera and app groups were compared. RESULTS: The average time taken to upload images to a patient's EMR for the camera and app groups were 96.3 s (SD 19.3; P<.001) and 26.3 s (SD 4.7; P<.001), respectively. CONCLUSIONS: The app effectively reduced processing time and improved clinical photography efficiency in the ED. Some issues of patient privacy in the camera group were revealed and resolved in the app group.


Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Aplicativos Móveis/estatística & dados numéricos , Fotografação/instrumentação , Smartphone/instrumentação , Confidencialidade , Documentação/métodos , Registros Eletrônicos de Saúde/normas , Sistemas de Informação Hospitalar/normas , Humanos , Aplicativos Móveis/provisão & distribução , Enfermeiras e Enfermeiros/estatística & dados numéricos , Fotografação/estatística & dados numéricos , Fotografação/tendências , Exame Físico/métodos , Privacidade , Dermatopatias/diagnóstico , Dermatopatias/patologia , Fatores de Tempo , Carga de Trabalho , Ferimentos e Lesões/diagnóstico , Ferimentos e Lesões/patologia
6.
Enferm Clin ; 29 Suppl 2: 455-458, 2019 09.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31302019

RESUMO

OBJECTIVE: This study aimed to identify the supporting factors and the nurses' expectation related to the implementation of clinical pathway in nursing care at the hospital. METHODS: A quantitative, cross-sectional, descriptive study was conducted at a medical-surgical unit of a hospital in Jakarta Indonesia. Participants were 100 nurses with minimal one-year work experience, selected using proportional purposive sampling method. Data were collected using a questionnaire and were analyzed descriptively. RESULTS: The nursing care management factor was found to be of highest performance (90%), while the rest showed inadequate performances (24%, 14%, 39%, and 41%, respectively). Meanwhile, nurses expected to have improved nursing care information system (50%) and reward system (60%) to support the clinical pathway in nursing care. CONCLUSIONS: Most of the supporting factors in the implementation of clinical pathway in nursing care were still suboptimal. Nurses' expectations on this issue indicate that there will be an improvement.


Assuntos
Atitude do Pessoal de Saúde , Procedimentos Clínicos/organização & administração , Cuidados de Enfermagem/organização & administração , Recursos Humanos de Enfermagem no Hospital/psicologia , Procedimentos Clínicos/normas , Estudos Transversais , Equipamentos e Provisões Hospitalares , Feminino , Recursos em Saúde , Sistemas de Informação Hospitalar/normas , Humanos , Indonésia , Masculino , Relações Enfermeiro-Paciente , Cuidados de Enfermagem/normas , Recursos Humanos de Enfermagem no Hospital/organização & administração , Padrões de Prática em Enfermagem/normas , Pesquisa Qualitativa , Qualidade da Assistência à Saúde , Recompensa , Amostragem
7.
Rev Epidemiol Sante Publique ; 67(5): 337-344, 2019 Sep.
Artigo em Francês | MEDLINE | ID: mdl-31204149

RESUMO

BACKGROUND: Based on the observation of the misuse of ICD-10 to code the diagnoses in the RIM-P (lack of completeness, conformity and diversity), the Technical Agency for information on Hospital Care (ATIH), which provides tools for collecting medical information, conducted two actions in 2016. First, a chapter devoted to the instructions of coding has been written in the methodological guide of production of the RIM-P, second, a variable "type psy" was added to the ICD-10 nomenclature's file framing ICD-10 coding in the RIM-P. The purpose of this study is to describe the quality of diagnosis coding using ICD-10 in the RIM-P in 2015 and 2016. METHODS: The quality of diagnosis coding using ICD-10 in the summaries of activity of the RIM-P national databases was described in 2015 and 2016. The study focused on the completeness, the conformity and the diversity of coding. RESULTS: Between 2015 and 2016, the percentage of summaries without primary diagnosis ("DP") decreased slightly for full-time (5.2% vs. 3.8%), part-time (6.3% vs. 4.9%) inpatient stays and outpatient care (9.9% vs. 8.9%). ICD-10 codes used to code DP or associated diagnosis ("DA"), while prohibited, mainly belong to Chapter V Mental and behavioral disorders. Per year, only one-third of the summaries and one-half of patients had two or more ICD-10 codes reported for inpatient stays (one-fifth of the summaries and one-fourth of the patients for outpatient care). In addition, per year and per facility, the average number of distinct ICD-10 codes used to fill "DP" or "DA" was approximately half as important in part-time hospitalization, as in full-time hospitalization or for outpatient care. Moreover, 90% of the health facilities used<550 distinct ICD-10 codes in full-time inpatient stays,<270 in part-time inpatient stays and<950 for outpatient care to code the "DP" or the "DA". The diversity of ICD-10 codes used was low and similar between 2015 and 2016, especially to describe the socio-economic environment, resistance to treatment or non-compliance. CONCLUSION: This study emphasizes the need for a collective effort to improve the diversity of the diagnoses' coding in the RIM-P.


Assuntos
Confiabilidade dos Dados , Classificação Internacional de Doenças/normas , Sistemas Computadorizados de Registros Médicos/normas , Transtornos Mentais/diagnóstico , Transtornos Mentais/terapia , Assistência Ambulatorial/normas , Assistência Ambulatorial/estatística & dados numéricos , Bases de Dados Factuais/normas , Bases de Dados Factuais/estatística & dados numéricos , França/epidemiologia , Fidelidade a Diretrizes/normas , Fidelidade a Diretrizes/estatística & dados numéricos , Sistemas de Informação Hospitalar/organização & administração , Sistemas de Informação Hospitalar/normas , Hospitalização/estatística & dados numéricos , Humanos , Sistemas Computadorizados de Registros Médicos/organização & administração , Sistemas Computadorizados de Registros Médicos/estatística & dados numéricos , Transtornos Mentais/classificação , Alta do Paciente/normas , Alta do Paciente/estatística & dados numéricos , Qualidade da Assistência à Saúde/organização & administração , Qualidade da Assistência à Saúde/normas
8.
Anaesthesist ; 68(7): 436-443, 2019 07.
Artigo em Alemão | MEDLINE | ID: mdl-31168685

RESUMO

BACKGROUND: Critical care information systems (CCIS) are computer-based systems designed to process the growing amount of complex medical data in intensive care units (ICU). Previous studies have shown that CCICs can increase the quality of patient care by reducing errors and improving work efficiency; however, other studies have shown that CCISs can also cause harmful effects by disrupting workflow, facilitating medication errors or increasing charting time. The factors that decide whether a CCIS has a positive or negative impact on patient care are summarized under the term "usability". This article summarizes the results of three previously published papers on this topic. OBJECTIVE: The aim of the study was to identify which CCIS functions were considered useful by clinical ICU staff and how well these functions are implemented in the CCISs currently used in German ICUs. MATERIAL AND METHODS: An online survey was performed targeting nurses and physicians working in German ICUs using a previously validated questionnaire. The questionnaire included a list of functions (36 for physicians/31 for nurses) that were preselected by experts based on a comprehensive model of ICU work processes. Each of these functions was rated by the study participants on a Likert scale ranging from 0 (worst rating) to 5 (best rating) with respect to the usefulness to identify which functions of CCIS can truly be considered as useful by clinical ICU staff. Furthermore, the participants rated how well these functions were implemented in the CCIS currently in use on the ICU, also using a Likert scale of 0-5. Further questions were provided to rate specific technical usability aspects of the CCISs currently in use. In addition, to capture possible confounders the questionnaire recorded 18 individual and workspace characteristics which might influence the ratings. RESULTS: A total of 171 nurses and 741 physicians participated in the survey of which 535 used CCISs. Of the functions 33 were rated as useful for doctors and 28 functions for nurses with median scores between 4 and 5. Participants currently using CCISs gave higher ratings compared to participants not using CCISs. The quality of the functions was rated relatively lower than the usefulness and the availability. Furthermore, currently used CCISs in Germany differ greatly in their technical and task-specific usability. Of the CCISs investigated, the system ICUData had the best overall rating and technical usability followed by the systems ICM and MetaVision. The same three CCIS were rated best in task-specific functions without significant differences between them. CONCLUSION: Those functions that were identified as useful based on the ratings of clinical ICU staff should be implemented in current CCIS. The list of these functions might be regarded as a first step towards providing a catalog of functional requirements for CCISs. Furthermore, as the results show that the quality of the available functions was rated lower than the availability of the functions, manufacturers should shift more of the effort away from the development of new features and focus on improving the user-friendliness and quality of existing functions.


Assuntos
Cuidados Críticos/normas , Sistemas de Informação Hospitalar/normas , Unidades de Terapia Intensiva/normas , Alemanha , Sistemas de Informação Hospitalar/estatística & dados numéricos , Humanos , Médicos , Inquéritos e Questionários , Fluxo de Trabalho
9.
JAMA Netw Open ; 2(3): e190393, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30848810

RESUMO

Importance: Cybersecurity is an increasingly important threat to health care delivery, and email phishing is a major attack vector against hospital employees. Objective: To describe the practice of phishing simulation and the extent to which health care employees are vulnerable to phishing simulations. Design, Setting, and Participants: Retrospective, multicenter quality improvement study of a convenience sample of 6 geographically dispersed US health care institutions that ran phishing simulations from August 1, 2011, through April 10, 2018. The specific institutions are anonymized herein for security and privacy concerns. Exposures: Simulated phishing emails received by employees at US health care institutions. Main Outcomes and Measures: Date of phishing campaign, campaign number, number of emails sent, number of emails clicked, and email content. Emails were classified into 3 categories (office related, personal, or information technology related). Results: The final study sample included 6 anonymized US health care institutions, 95 simulated phishing campaigns, and 2 971 945 emails, 422 062 of which were clicked (14.2%). The median institutional click rates for campaigns ranged from 7.4% (interquartile range [IQR], 5.8%-9.6%) to 30.7% (IQR, 25.2%-34.4%), with an overall median click rate of 16.7% (IQR, 8.3%-24.2%) across all campaigns and institutions. In the regression model, repeated phishing campaigns were associated with decreased odds of clicking on a subsequent phishing email (adjusted OR, 0.511; 95% CI, 0.382-0.685 for 6-10 campaigns; adjusted OR, 0.335; 95% CI, 0.282-0.398 for >10 campaigns). Conclusions and Relevance: Among a sample of US health care institutions that sent phishing simulations, almost 1 in 7 simulated emails sent were clicked on by employees. Increasing campaigns were associated with decreased odds of clicking on a phishing email, suggesting a potential benefit of phishing simulation and awareness. With cyberattacks increasing against US health care systems, these click rates represent a major cybersecurity risk for hospitals.


Assuntos
Segurança Computacional , Correio Eletrônico , Sistemas de Informação Hospitalar/normas , Recursos Humanos em Hospital/estatística & dados numéricos , Gestão de Riscos , Segurança Computacional/normas , Segurança Computacional/estatística & dados numéricos , Coleta de Dados , Hospitais/estatística & dados numéricos , Humanos , Melhoria de Qualidade , Estudos Retrospectivos , Gestão de Riscos/métodos , Gestão de Riscos/estatística & dados numéricos , Estados Unidos
10.
N Z Med J ; 132(1490): 10-16, 2019 02 22.
Artigo em Inglês | MEDLINE | ID: mdl-30789884

RESUMO

BACKGROUND: Electronic whiteboards have largely replaced the use of traditional whiteboards in many hospital departments. They are used to electronically record and display a variety of patient information to streamline the admission process and the quality of handover between relevant staff. We assessed the impact of such a system upon the patient admission process in a busy general surgery department. METHODS: A survey of 12 qualitative questions was completed by surgical registrars working within a general surgery department in 2013 prior to the introduction of electronic whiteboards and again in 2016 after introduction. The questions compared the satisfaction of the admission process before and after its introduction. RESULTS: There was an improvement in staff satisfaction with the admissions process after the introduction of electronic whiteboards (78% vs 9% high level of satisfaction, p<0.05). A statistically non-significant rise was also seen in individual areas of the admissions and handover process. No change was seen in staff attitude to security of patient details (50% vs 42% high level of satisfaction, p=0.671). CONCLUSION: Electronic whiteboards assist in the process of admitting patients to a general surgical department. This strengthens the case for the introduction of electronic whiteboards across a range of hospital departments.


Assuntos
Eficiência Organizacional/estatística & dados numéricos , Registros Eletrônicos de Saúde/organização & administração , Admissão do Paciente/normas , Centro Cirúrgico Hospitalar , Atitude do Pessoal de Saúde , Sistemas de Informação Hospitalar/normas , Humanos , Comunicação Interdisciplinar , Nova Zelândia , Avaliação de Resultados em Cuidados de Saúde , Melhoria de Qualidade , Centro Cirúrgico Hospitalar/organização & administração , Centro Cirúrgico Hospitalar/normas , Inquéritos e Questionários
11.
Rev. cuba. inform. méd ; 10(2)jul.-dic. 2018. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1003908

RESUMO

Los sistemas de información hospitalaria cuentan con un volumen importante de datos, sin embargo, carecen de mecanismos que permitan analizar la ejecución de los procesos e identificar variabilidad. La variabilidad puede observarse en prácticamente cada paso del proceso asistencial y a varios niveles de agrupación: poblacional e individual. Desde el punto de vista poblacional se comparan tasas de realización de un procedimiento clínico, como pueden ser intervenciones quirúrgicas o ingresos hospitalarios en un período de tiempo. Las técnicas de minería de procesos analizan los datos reales de sistemas informáticos y son útiles para la detección de variabilidad en la ejecución de los procesos de negocio. La presente investigación propone la aplicación de técnicas de minería de procesos, seleccionadas a partir de un riguroso estudio del estado del arte, para el análisis de los procesos hospitalarios desde sus sistemas de información y materializadas en un modelo computacional. El Modelo para la Detección de Variabilidad (MDV) se instrumentó exitosamente en el sistema XAVIA HIS desarrollado por la Universidad de las Ciencias Informáticas UCI, donde fueron adaptadas e integradas las técnicas de minería de procesos. El modelo MDV contribuye al proceso de informatización de la salud en Cuba. La solución propicia la utilización de una tecnología emergente en áreas como la industrial y empresarial en el entorno sanitario. Esta beneficia importantes funciones gerenciales como la gestión, control y planificación de recursos y servicios sanitarios(AU)


The hospital information systems collect an important volume of data, however, they lack mechanisms to analyze the execution of the processes and identify variability. In practically every step of the care process and at various levels of grouping: population and individual the variability is present. From a population point of view, performance rates of a clinical procedure such as surgical interventions or hospital admissions, are compared over time. Process mining techniques analyze the real data of computer systems and are useful for the detection of variability in the execution of business processes. Based on a rigorous study of the state of the art, this research proposes the application of process mining techniques for the analysis of hospital processes from their information systems, providing a computational model. Model for Variability Detection (MDV) implemented successfully in the XAVIA HIS system developed by the UCI University of Informatics Sciences, where techniques of process mining were adapted and integrated. The MDV model contributes to the process of computerization of health in Cuba. The solution encourages the use of an emerging technology in areas such as industrial and business in the healthcare environment. This benefits important management functions such as control and planning of resources and health services(AU)


Assuntos
Humanos , Aplicações da Informática Médica , Linguagens de Programação , Sistemas de Informação Hospitalar/normas , Mineração de Dados/métodos , Cuba
12.
Rev. cuba. inform. méd ; 10(2)jul.-dic. 2018. tab, graf
Artigo em Espanhol | CUMED | ID: cum-74123

RESUMO

Los sistemas de información hospitalaria cuentan con un volumen importante de datos, sin embargo, carecen de mecanismos que permitan analizar la ejecución de los procesos e identificar variabilidad. La variabilidad puede observarse en prácticamente cada paso del proceso asistencial y a varios niveles de agrupación: poblacional e individual. Desde el punto de vista poblacional se comparan tasas de realización de un procedimiento clínico, como pueden ser intervenciones quirúrgicas o ingresos hospitalarios en un período de tiempo. Las técnicas de minería de procesos analizan los datos reales de sistemas informáticos y son útiles para la detección de variabilidad en la ejecución de los procesos de negocio. La presente investigación propone la aplicación de técnicas de minería de procesos, seleccionadas a partir de un riguroso estudio del estado del arte, para el análisis de los procesos hospitalarios desde sus sistemas de información y materializadas en un modelo computacional. El Modelo para la Detección de Variabilidad (MDV) se instrumentó exitosamente en el sistema XAVIA HIS desarrollado por la Universidad de las Ciencias Informáticas UCI, donde fueron adaptadas e integradas las técnicas de minería de procesos. El modelo MDV contribuye al proceso de informatización de la salud en Cuba. La solución propicia la utilización de una tecnología emergente en áreas como la industrial y empresarial en el entorno sanitario. Esta beneficia importantes funciones gerenciales como la gestión, control y planificación de recursos y servicios sanitarios(AU)


The hospital information systems collect an important volume of data, however, they lack mechanisms to analyze the execution of the processes and identify variability. In practically every step of the care process and at various levels of grouping: population and individual the variability is present. From a population point of view, performance rates of a clinical procedure such as surgical interventions or hospital admissions, are compared over time. Process mining techniques analyze the real data of computer systems and are useful for the detection of variability in the execution of business processes. Based on a rigorous study of the state of the art, this research proposes the application of process mining techniques for the analysis of hospital processes from their information systems, providing a computational model. Model for Variability Detection (MDV) implemented successfully in the XAVIA HIS system developed by the UCI University of Informatics Sciences, where techniques of process mining were adapted and integrated. The MDV model contributes to the process of computerization of health in Cuba. The solution encourages the use of an emerging technology in areas such as industrial and business in the healthcare environment. This benefits important management functions such as control and planning of resources and health services(AU)


Assuntos
Humanos , Aplicações da Informática Médica , Linguagens de Programação , Sistemas de Informação Hospitalar/normas , Mineração de Dados/métodos , Cuba
13.
J Healthc Eng ; 2018: 3689618, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30298099

RESUMO

The purpose of our study aimed to identify attributes capable of improving physicians' satisfaction levels with the use of a hospital information system (HIS). A model inclusive of system quality, information quality, and service quality related to an HIS is used to form antecedents of user satisfaction. Survey methodology was used to collect an attributive set representing the system quality, information quality, and service quality made available from 150 physicians at a large health-care system in southern Taiwan. Responses were segmented into low and high satisfaction and analyzed with partial least squares and importance-performance analysis. The results reveal that system quality, information quality, and service quality may be used to significantly predict physicians' satisfaction. Two system quality attributes (reliability and response time) were identified as the highest priorities for intervention by low- and high-satisfaction users. Low-satisfaction users further expect improvement of the HIS service quality to take place. The subject health-care system should produce coping interventions for those high priorities to enhance the satisfaction of physicians.


Assuntos
Sistemas de Informação Hospitalar/normas , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Médicos/psicologia , Médicos/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
14.
Int J Med Inform ; 119: 47-53, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30342685

RESUMO

INTRODUCTION: Failure in the communication of information and partial communication of information between hospital information systems (HIS) and the Iranian electronic health record (SEPAS) reduces the quality of information. The objective of this study was to identify the errors and causes of failure in the communication of patients' information from HISs to SEPAS. METHODOLOGY: This record-review study was conducted in the first quarter of 2016. In this study, 882 records which had failed to be sent from three hospital information systems to SEPAS were reviewed and data were collected using a data collection form. Data were analyzed using descriptive and inferential statistics with SPSS.18. RESULTS: The review of 882 hospital records resulted in the identification of 1256 errors of 41 different types. These errors were classified into 4 categories: administrative-financial errors (61%), errors related to national codes (23%), clinical errors (9%), and other errors (7%). In total, errors were categorized into two generic types: "system level errors (65%) and operator-dependent errors (35%)". The number of errors was a significant difference in the studied hospitals (p < 0.0001). CONCLUSIONS: This study identified a large number of system and operator-dependent errors hampering communication of information from HIS to SEPAS. Results revealed that the same hospital information systems used in different hospitals could face dissimilar types and levels of errors when communicating with other information systems. The results of this study can be used by system designers and health center policymakers to prevent the problems of information communication between health information systems.


Assuntos
Barreiras de Comunicação , Registros Eletrônicos de Saúde/normas , Sistemas de Informação Hospitalar/normas , Hospitais/normas , Disseminação de Informação/métodos , Erros Médicos/prevenção & controle , Registros Médicos/normas , Humanos
15.
Int J Med Inform ; 119: 88-93, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30342691

RESUMO

CONTEXT: Despite widespread efforts to improve the quality and safety of healthcare through use of hospital information systems (HIS), many healthcare organizations face challenges in implementation and effective use of these applications, in particular when systems have been developed internationally (mainly in the US). Suppliers of these technologies also find it challenging to produce systems that work effectively across a range of geographical, cultural and institutional boundaries. In this paper, we seek to understand the strategies used by suppliers and adopters of HIS to overcome the challenges involved in the development and adoption of generic overseas systems. METHODS: We conducted a qualitative study, by interviewing 176 individuals (eight organizations), observing two user groups, and running a supplier focus group. We used inductive thematic analysis to assess emerging strategies in developing and implementing overseas packaged HIS in English settings. FINDINGS: The health sector in England has entered a period of potentially transformative change with many international HIS suppliers entering the market. This has provoked call for the 'Anglicization' of generic systems. This endeavor, has resulted in emergence of more or less aligned supplier and user strategies to overcome the difficulties in the process. This includes a continuous process of identification and classification of requests (by suppliers), and unification and voicing of needs (by adopters). CONCLUSIONS: The complexity of health service provision, drives calls for customization of technologies in this sector. Consequent tensions between 'standardization' and 'localization' are requiring suppliers of generic solutions to develop more sophisticated strategies as they pursue international growth of their market.


Assuntos
Comportamento de Escolha , Coleta de Dados/métodos , Prescrição Eletrônica/normas , Sistemas de Informação Hospitalar/normas , Pesquisa Qualitativa , Inglaterra , Humanos
16.
Int J Med Inform ; 118: 16-28, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30153917

RESUMO

Information systems (ISs) are one of the most widely used systems in different organizations especially hospitals. Improving the performance of a hospital information system (HIS) is one of the most important tasks for patient satisfaction and health. To do this, a mixed sustainability-resilience framework for evaluating HISs is proposed in this study in order to enhance their performance from a mixed sustainability-resilience view. First, a comprehensive framework including suitable sustainable and resilience indicators for performance enhancement of HISs is provided. Then, the importance weight of each indicator is achieved by using the best-worst method (BWM). Required data is obtained through a standard questionnaire. A data envelopment analysis (DEA) is applied to evaluate HIS performance in different departments of a real case study. Additionally, improvement actions are obtained by considering the effect of each selected indicator on the HIS performance through a sensitivity analysis. Also, appropriate strategies for improving the resilience and sustainability aspects of the HIS are presented using strengths-weaknesses-opportunities-threats (SWOT) matrix. Using the results, designers can build more intelligent HISs from both sustainability and resilience perspectives.


Assuntos
Assistência à Saúde/organização & administração , Sistemas de Informação Hospitalar/normas , Avaliação de Programas e Projetos de Saúde/métodos , Humanos , Satisfação do Paciente
17.
Stud Health Technol Inform ; 250: 193-194, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29857428

RESUMO

Based on the process and framework of nursing quality management in the "Third-level General Ho Accreditation Criteria", with the help of computer and mobile information technology, development of nursing quality control informatics system computer operation and mobile operating. The system has implanted PDCA several scientific management tools into the mobile applications, insteads of replace traditional paper methods, improve working efficiency in process control and Data Operation.


Assuntos
Sistemas de Informação Hospitalar/normas , Aplicativos Móveis , Informática em Enfermagem , Controle de Qualidade , Sistemas Computacionais , Hospitais
18.
Rev Peru Med Exp Salud Publica ; 35(1): 25-31, 2018.
Artigo em Espanhol | MEDLINE | ID: mdl-29924273

RESUMO

OBJECTIVES: . To identify the barriers to the quality of information in health facilities in the Amazon region, exploring the case of three health information systems: the epidemiological vigilance, the daily recording of service, and the registry of deaths linked to HIV/AIDS, hepatitis B, and congenital syphilis. MATERIALS AND METHODS: . A quali-quantitative methodology was applied. On the one hand, 57 semi-structured interviews were conducted with administrative and assistance staff at health facilities; on the other hand, a survey was apyplied. One hundred and twenty health facilities in the regions of Amazonas, Huánuco, Loreto, Madre de Dios, San Martín, and Ucayali. RESULTS: . Eight barriers were identified, which were linked mainly to the human resource, to sociocultural aspects, and weaknesses of the health system. CONCLUSIONS: . The barriers identified for the quality of the information in the selected information systems in health facilities in the Amazon region reflect a multidimensional problem, so strategies for improvement in the subject should be considered.


Assuntos
Infecções por HIV , Hepatite B , Sistemas de Informação Hospitalar/normas , Sífilis Congênita , Estudos Transversais , Humanos , Índios Sul-Americanos , Peru
19.
Int J Med Inform ; 114: 88-100, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29673609

RESUMO

BACKGROUNDS: Nowadays developing smart and fast services for patients and transforming hospitals to modern hospitals is considered a necessity. Living in the world inundated with information systems, designing services based on information technology entails a suitable architecture framework. OBJECTIVES: This paper aims to present a localized enterprise architecture framework for the Iranian university hospital. METHODS AND RESULTS: Using two dimensions of implementation and having appropriate characteristics, the best 17 enterprises frameworks were chosen. As part of this effort, five criteria were selected according to experts' inputs. According to these criteria, five frameworks which had the highest rank were chosen. Then 44 general characteristics were extracted from the existing 17 frameworks after careful studying. Then a questionnaire was written accordingly to distinguish the necessity of those characteristics using expert's opinions and Delphi method. The result showed eight important criteria. In the next step, using AHP method, TOGAF was chosen regarding having appropriate characteristics and the ability to be implemented among reference formats. In the next step, enterprise architecture framework was designed by TOGAF in a conceptual model and its layers. For determining architecture framework parts, a questionnaire with 145 questions was written based on literature review and expert's opinions. The results showed during localization of TOGAF for Iran, 111 of 145 parts were chosen and certified to be used in the hospital. CONCLUSION: The results showed that TOGAF could be suitable for use in the hospital. So, a localized Hospital Enterprise Architecture Modelling is developed by customizing TOGAF for an Iranian hospital at eight levels and 11 parts. This new model could be used to be performed in other Iranian hospitals.


Assuntos
Sistemas de Gerenciamento de Base de Dados/normas , Prestação Integrada de Cuidados de Saúde/organização & administração , Sistemas de Informação Hospitalar/organização & administração , Sistemas de Informação Hospitalar/normas , Hospitais Universitários/normas , Aplicações da Informática Médica , Adulto , Prova Pericial , Humanos , Irã (Geográfico) , Pessoa de Meia-Idade , Adulto Jovem
20.
Anesth Analg ; 127(1): 105-114, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29596094

RESUMO

For this special article, we reviewed the computer code, used to extract the data, and the text of all 47 studies published between January 2006 and August 2017 using anesthesia information management system (AIMS) data from Thomas Jefferson University Hospital (TJUH). Data from this institution were used in the largest number (P = .0007) of papers describing the use of AIMS published in this time frame. The AIMS was replaced in April 2017, making this finite sample finite. The objective of the current article was to identify factors that made TJUH successful in publishing anesthesia informatics studies. We examined the structured query language used for each study to examine the extent to which databases outside of the AIMS were used. We examined data quality from the perspectives of completeness, correctness, concordance, plausibility, and currency. Our results were that most could not have been completed without external database sources (36/47, 76.6%; P = .0003 compared with 50%). The operating room management system was linked to the AIMS and was used significantly more frequently (26/36, 72%) than other external sources. Access to these external data sources was provided, allowing exploration of data quality. The TJUH AIMS used high-resolution timestamps (to the nearest 3 milliseconds) and created audit tables to track changes to clinical documentation. Automatic data were recorded at 1-minute intervals and were not editable; data cleaning occurred during analysis. Few paired events with an expected order were out of sequence. Although most data elements were of high quality, there were notable exceptions, such as frequent missing values for estimated blood loss, height, and weight. Some values were duplicated with different units, and others were stored in varying locations. Our conclusions are that linking the TJUH AIMS to the operating room management system was a critical step in enabling publication of multiple studies using AIMS data. Access to this and other external databases by analysts with a high degree of anesthesia domain knowledge was necessary to be able to assess the quality of the AIMS data and ensure that the data pulled for studies were appropriate. For anesthesia departments seeking to increase their academic productivity using their AIMS as a data source, our experiences may provide helpful guidance.


Assuntos
Anestesiologia/normas , Pesquisa Biomédica/normas , Confiabilidade dos Dados , Mineração de Dados , Registros Eletrônicos de Saúde/normas , Sistemas de Informação Hospitalar/normas , Informática Médica/normas , Registro Médico Coordenado , Acesso à Informação , Anestesiologia/organização & administração , Pesquisa Biomédica/organização & administração , Mineração de Dados/normas , Data Warehousing/normas , Bases de Dados Factuais , Registros Eletrônicos de Saúde/organização & administração , Sistemas de Informação Hospitalar/organização & administração , Humanos , Disseminação de Informação , Informática Médica/organização & administração , Registro Médico Coordenado/normas , Interface Usuário-Computador , Fluxo de Trabalho
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...