Enhancing learning through use of interactive tools on health-related websites.
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The Internet offers a unique means of health promotion through the use of interactive tools like chat rooms, E-mail, hyperlinks and the like. This paper reports a study examining links between learning and interactivity of health-related websites. We address three research questions. First, are tools of interactivity present in health-related websites? Second, how prevalent is the occurrence of these interactive tools for three relevant top level domains (TLD) (e.g. .com, .gov and .org)? Finally, are there differences in how representative websites of diverse TLDs employ these interactive tools along nine dimensions of interactivity? A content analysis of 30 websites revealed that while the majority of sites in our sample do use interactive tools, overall the occurrence is quite low. An examination of the use of tools of interactivity across three different TLDs revealed that .com sites used a greater number of tools, followed by .gov sites and, lastly, .org sites. We also found support for our third research question, that different TLDs employ these tools of interactivity differently. How these differences may impact learning are discussed. (+info)
Why British GPs use computers and hospital doctors do not.
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Almost all general medical practitioners (GPs) in the UK use computers, compared with less than one in ten of hospital doctors. This paper explains how this unexpected situation came about over a thirty-year period, identifying some of the successes and failures of British medical computing along the way. Twelve separate factors are considered. The major determinants have not been technical, but rather a strong tide of political backing for general practice and leadership from the profession at the highest level, which have combined to build an appropriate regulatory framework and financial incentives that have encouraged GPs to embrace computers. Hospital computing has some difficulties not met by GPs, but the main factor preventing progress has been the lack of any real incentive positive (carrot) or negative (stick), for hospital doctors to use computers. (+info)
Assessing physician attitudes regarding use of an outpatient EMR: a longitudinal, multi-practice study.
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A pre- and post-implementation assessment of physician attitudes was undertaken as part of the evaluation of the pilot implementations of an outpatient EMR in 6 practices of a large academic health system. Our results show that these physicians are ready adopters of computer technology when it demonstrates value-added for the effort required to use it. These physicians utilize email, the Internet, remote access to computer systems, and personal productivity software because they serve a valuable purpose in their academic and clinical work and in their personal lives. Much more critical to the acceptance of an EMR by physicians is its ability to facilitate efficient clinical workflows without negative effects on the valued relationships physicians have with their patients--those that are based on rapport, quality of care, and privacy. (+info)
Measuring the success of electronic medical record implementation using electronic and survey data.
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Computerization of physician practices is increasing. Stakeholders are demanding demonstrated value for their Electronic Medical Record (EMR) implementations. We developed survey tools to measure medical office processes, including administrative and physician tasks pre- and post-EMR implementation. We included variables that were expected to improve with EMR implementation and those that were not expected to improve, as controls. We measured the same processes pre-EMR, at six months and 18 months post-EMR. Time required for most administrative tasks decreased within six months of EMR implementation. Staff time spent on charting increased with time, in keeping with our anecdotal observations that nurses were given more responsibility for charting in many offices. Physician time to chart increased initially by 50%, but went down to original levels by 18 months. However, this may be due to the drop-out of those physicians who had a difficult time charting electronically. (+info)
Subjective assessment of usefulness and appropriate presentation mode of alerts and reminders in the outpatient setting.
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There is very little known about the limits of alerting in the setting of the outpatient Electronic Medical Record (EMR). We are interested in how users value and prefer such alerts. One hundred Kaiser Permanente primary care clinicians were sent a four-page questionnaire. It contained questions related to the usability and usefulness of different approaches to presenting reminder and alert information. The survey also contained questions about the desirability of six categories of alerts. Forty-three of 100 questionnaires were returned. Users generally preferred an active, more intrusive interaction model for "alerts" and a passive, less intrusive model for order messages and other types of reminders and notifications. Drug related alerts were more highly rated than health maintenance or disease state reminders. Users indicated that more alerts would make the system "more useful" but "less easy to use". (+info)
Introducing handheld computing into a residency program: preliminary results from qualitative and quantitative inquiry.
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Although published reports describe specific handheld computer applications in medical training, we know very little yet about how, and how well, handheld computing fits into the spectrum of information resources available for patient care and physician training. This paper reports preliminary quantitative and qualitative results from an evaluation study designed to track changes in computer usage patterns and computer-related attitudes before and after introduction of handheld computing. Pre-implementation differences between residents and faculty s usage patterns are interpreted in terms of a "work role" construct. We hypothesize that over time residents and faculty will adopt, adapt, or abandon handheld computing according to how, and how well, this technology supports their successful completion of work role-related tasks. This hypothesis will be tested in the second phase of this pre- and post-implementation study. (+info)
Evaluation of a filmless radiology pilot--a preliminary report.
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The development of the Multimedia Electronic Medical Record System (MEMRS) promises new opportunities to significantly reduce the routine use of film as the medium for viewing radiological medical images. The effect of this change to digital media on physician workflow and the perceived value and utility of medical images is an area of ongoing investigation. In this study we examined oncology clinicians use of medical images in a MEMRS. We conducted observational studies of clinicians during a filmless radiology pilot study in which a filmless environment was simulated but the actual film was available on request. This observational study was the first step in a comprehensive evaluation designed to elucidate the issues surrounding the implementation of a filmless radiology environment. We identified and examined several of these issues, including physician concern regarding the utility of digital images for clinical use and comparison with film, the need to address the effects of image compression with clinicians, and the workflow changes necessary to incorporate digital image use into a clinical practice. (+info)
Attitudes of academic-based and community-based physicians regarding EMR use during outpatient encounters.
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Physician satisfaction with EMR implementations has been reported in a number of recent studies. Most of these have reported on implementation of an EMR in a uniform practice setting rather than comparing satisfaction with implementation between settings. Our objectives in this study were to: 1) compare and contrast the attitudes of academic-based and community-based primary care physicians toward EMR use 6 months after implementation, and 2) investigate some of the factors influencing their attitudes toward the EMR implementation. Although physicians in both settings regularly use computers, the academic-based physicians use computers for a wider range of activities. Both groups endorse improvements in quality and communication as well as concern over rapport with the patient and privacy. There is considerable discrepancy between the two settings in ratings of the impact on workflow, with the community-based physicians being much more positive about the EMR. Factors that may account for this discrepancy may include overall expectations of computer systems as well as different rates of adaptation to use of the system. (+info)