Defining the role of anatomic pathology images in the multimedia electronic medical record--a preliminary report.
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The development of the Multimedia Electronic Medical Record System (MEMRS) offers new opportunities for integrating medical imaging data with text-based clinical data. The effective integration of pathology images into the patient's medical record poses some significant technical and organizational challenges. Before these challenges can be met, it is imperative that we investigate the value and utility of providing these images to clinicians. In this study we examined attitudes towards use of pathology images in Image Engine, a MEMRS under development at the University of Pittsburgh Cancer Institute (UPCI). We conducted semi-structured standardized interviews with a cohort of practicing oncologists, all of whom had significant experience with Image Engine. This study is a first step towards elucidating the potential barriers, uses, and value of anatomic pathology images in the MEMRS. (+info)
Exploring information technology adoption by family physicians: survey instrument valuation.
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As the information needs of family physicians become more complex, there will be a greater need to successfully implement the technologies needed to manage that information. The ability to stratify primary care physicians can enable the implementation process to be more efficient. This research tested a new instrument on 101 family physicians, and was able to stratify physicians into high, intermediate, and low information technology (IT) usage groups. It is expected that this stratification would allow managers of IT implementation to target specific adoption strategies for each group. The instrument is available from [email protected]. (+info)
Dichotomy between physicians' and patients' attitudes regarding EMR use during outpatient encounters.
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Detrimental effects on physician-patient rapport are an often-voiced concern regarding the impacts of implementing an EMR in busy outpatient healthcare environments. Our objectives in this study were to: 1) identify significant concerns of physicians regarding implementation of an EMR in an outpatient clinic, both prior to implementation and after 6 months of use, and 2) assess patients' satisfaction with their outpatient encounters in this clinic, including general and EMR-specific factors. For physicians, physician-patient rapport was a concern prior to EMR implementation and increased with use of the system. In contrast, patients did not indicate a sense of loss of rapport with their physicians when an EMR was used during their outpatient visits. However, physicians and patients shared a concern about the privacy of medical information contained in an EMR. (+info)
Computer needs assessment based on nursing tasks.
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The purpose of this paper was to validate the Nurse Task Computer Use (NTCU) scale as a measure of the impact of computer use on tasks performed by nurses. It was expected that evaluation of a computer system by tasks is a better measure of nursing satisfaction. We used four strategies to accomplish validation. Initially, we used taxonomy of nursing interventions developed by Susan Grobe as a basis for identifying tasks. Next, using factor analysis, the results of the NTCU was compared to two validated user satisfaction scales. The third validation strategy consisted of comparing responses to the survey with interview findings for similarity, additional responses, and reoccurring patterns. Finally, findings from the results of the NTCU were compared to the Computers in Medical Care values survey. Results generally supported the validity and reliability of this instrument. (+info)
The CISQ: a tool to measure staff involvement in and attitudes toward the implementation of a clinical information system.
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The Clinical Information System Questionnaire (CISQ-15) is a new 15-item tool designed to measure staff involvement in and attitudes towards CIS implementations. It was developed during a clinical trial which tested the effects of a combined managerial and IT intervention on staff attitudes and patient outcomes. The CISQ-15 appears to have high construct validity and internal consistency, although further studies are needed. Such studies are under way, and an expanded 36-item version, the CISQ-36, is now being evaluated. (+info)
Increasing productivity and reducing errors through usability analysis: a case study and recommendations.
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The usability problems of a system often occur due to inattention to well-documented and well-established design guidelines and heuristics. These problems often lead to increased errors, user dissatisfaction, and often user abandonment. Although there are a plethora of design principles, programs are still being constructed without integration of these principles. One family history-tracking program was examined for usability compliance. In addition to a user analysis, a task analysis was conducted comparing the designers' conceptualization of tasks with the users' conceptualization of these tasks. A cognitive walk-through was then conducted on these tasks. Finally, a keystroke level model was used to show the differences between the execution times of these tasks. This model showed a serious mismatch between the designers and users conceptions of the task. The suggested redesign showed timesaving for each of these tasks. (+info)
Evaluation of Web-based patient information resources: application in the assessment of a patient clinical information system.
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The advent of Internet-based information systems has provided unprecedented opportunity for the widespread access to medical information. However, issues related to the evaluation of such systems to ensure their usability, effectiveness and to assess their effect on the provider-patient relationship pose a considerable challenge. This paper describes a framework for the distance evaluation of web-based information technologies. The methods are described in the context of an ongoing evaluation of a system known as PatCIS, designed to be accessed by patients from home for obtaining health information, and for management of chronic diseases. We employ a multi-method approach that involves collection of a rich data set, including Web-based questionnaires, automatic logging of user activity and e-mail communication with users. Our work in evaluation design is influenced from research in the areas of cognitive science and the field of usability engineering which aims to characterize the interaction of users with information technologies. (+info)
Computer use and needs of internists: a survey of members of the American College of Physicians-American Society of Internal Medicine.
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The American College of Physicians-American Society of Internal Medicine conducted a membership survey in late 1998 to assess their activities, needs, and attitudes. A total of 9,466 members (20.9% response rate) reported on 198 items related to computer use and needs of internists. Eighty-two percent of the respondents reported that they use computers for personal or professional reasons. Physicians younger than 50 years old who had full- or part-time academic affiliation reported using computers more frequently for medical applications. About two thirds of respondents who had access to computers connected to the Internet at least weekly, with most using the Internet from home for e-mail and nonmedical uses. Physicians expressed concerns about Internet security, confidentiality, and accuracy, and the lack of time to browse the Internet. In practice settings, internists used computers for administrative and financial functions. Less than 19% of respondents had partial or complete electronic clinical functions in their offices. Less than 7% of respondents exchanged e-mail with their patients on a weekly or daily basis. Also, less than 15% of respondents used computers for continuing medical education (CME). Respondents reported they wanted to increase their general computer skills and enhance their knowledge of computer-based information sources for patient care, electronic medical record systems, computer-based CME, and telemedicine While most respondents used computers and connected to the Internet, few physicians utilized computers for clinical management. Medical organizations face the challenge of increasing physician use of clinical systems and electronic CME. (+info)