Public health professionals in the Midwest: a profile of connectivity and information technology skills. (1/190)

OBJECTIVES: The aim of this study was to assess Internet connections and information technology skills of public health workers in the Midwest. METHODS: A questionnaire was mailed to 713 local health departments (LHDs) in the ten states of the Greater Midwest Region. RESULTS: Three hundred forty-four LHDs (48%) responded. Overall, 85% own a computer that would allow Internet access. Half provide Internet access to some or all staff. Of these, two-thirds use e-mail and half search the Web. One-half are linked to the State Health Department, and 30% are linked to other local health departments. Over half use CDC-Wonder; less than 20% search MEDLINE. Two-thirds of the respondents expressed an interest in MEDLINE training, and three-fourths are interested in learning more about the Internet. Sixty-nine percent of respondents planned to enhance electronic communication capacity within the next year. CONCLUSIONS: Public health practitioners need timely, convenient access to information to aid them in improving the health of the American public. A majority of public health departments in the Midwest are technically capable of connecting to the Internet. This technological capability, combined with an expressed desire by public health agencies to have workers become computer literate, suggests an important role for health sciences librarians.  (+info)

Users' evaluation of OncoDoc, a breast cancer therapeutic guideline delivered at the point of care. (2/190)

Despite the dissemination of computer-based "clinical practice guidelines" as decision support systems, low practical compliance rates are still observed. The reason commonly invoked is that such recommendations, suited to average patients, are not rules for all the patients. Rather than providing automatic decision support, OncoDoc allows the clinician to operationalize the implemented breast cancer therapeutic expertise through his hypertextual reading of the knowledge base. In this way, he has the opportunity to interpret the information provided in the context of his patient therefore controlling his categorization to the closest appropriate "average patient". After a four-month real-life experimentation of the system, a survey was conducted among the users. The observed compliance, significantly higher than the best figures found in the literature, and the clinicians objective and subjective evaluation of the system reinforced the implementation choices adopted in OncoDoc.  (+info)

Medcast: evaluation of an intelligent pull technology to support the information needs of physicians. (3/190)

This study reports the initial results of an evaluation of Medcast, a commercial medical information service that uses intelligent pull technology to deliver medical information to practicing physicians. Medical news, CME, and other information are transferred by modem nightly to the physician's computers where this information can be accessed at a convenient time. A survey was faxed to 195 subscribers to the system. A total of 73 (39%) responded. The results indicate that prior to implementation of the Medcast system, almost 40 percent of the respondents did not use their computers for professional activities because of time constraints, costs and computer literacy problems. After implementation of Medcast, almost 70 percent of the respondents used the system two or more hours per week. Ninety percent of the respondents felt that use of the system has enhanced their practice. These findings have important implications for future efforts to implement medical informatics applications to support the information needs of practicing physicians. Experience with intelligent pull technology that is relatively easy to use may be a good way to break down attitudes and barriers to the use of computer systems to support clinical practice and may prepare physicians for a wider use of the Internet to support their future information needs.  (+info)

Implementation and evaluation of a virtual learning center for distributed education. (4/190)

A number of tools are required to support a distributed education program. This paper will relate experiences in the development and implementation of a web-based Virtual Learning Center. Initial evaluation offers direction for further development, necessary university support, and faculty and student preparation.  (+info)

Organizational and technological insight as important factors for successful implementation of IT. (5/190)

Politicians and hospital management in Sweden and Denmark focus on IT and especially Electronic Patient Record, EPR as a tool for changes that will lead to better economy as well as better quality and service to the patients. These changes are not direct effects of the new medium for patient records but indirect effects due to the possibilities embedded in the new technology. To ensure that the implementation is successful, i.e. leads to changes in organization structure and workflow, we need tools to prepare clinicians and management. The focus of this paper is the individual insight in technology and organization and it proposes a model to assess and categorize the possibilities of individuals and groups to participate in and make an implementation process powerful.  (+info)

The accessibility of information systems for patients: use of touchscreen information systems by 345 patients with cancer in Scotland. (6/190)

AIM: To examine cancer patients' use, and satisfaction with touchscreen information systems. By examining the experience of subgroups, to address issues of equality of access. PATIENTS: 345 patients starting radiotherapy at the Beatson Oncology Centre (BOC), Glasgow. METHODS: Patients were invited to use a touchscreen computer at the start of treatment. They were sent a printout of what they saw on screen. Patients had open access to the system. Data were collected at recruitment, intervention, 3 weeks and 3 months. Predictor variables included: patients' demographics, information preferences, technology use, and psychological state. Outcome variables included: use and views of the computer and printout. RESULTS: Younger, broadsheet readers with previous computer use were more likely to find the system easy to use. Older, tabloid readers were more likely to find the content new and relevant. DISCUSSION: We need to make systems adapt to users' different needs. More effort should be made to provide affordable information for older, generally less literate and technologically less literate groups in suitable locations.  (+info)

Which literature retrieval method is most effective for GPs? (7/190)

BACKGROUND: Evidence-based medicine requires new skills of physicians, including literature searching. OBJECTIVE: To determine which literature retrieving method is most effective for GPs: the printed Index Medicus; Medline through Grateful Med; or Medline on CD-ROM. METHODS: The design was a randomized comparative study. In a continuing medical education course, three groups of health care professionals (87 GPs and 16 other health care professionals) used one of the literature retrieval methods to retrieve citations on four search topics related to general practice. For the analysis in pairs, we used the search results of the 75 participants who completed all four assignments. As outcome measures, we used precision, recall and an overall search quality score; we also had a post-course questionnaire on personal characteristics, experience with computers, handling medical literature and satisfaction with course instruction and search results. RESULTS: The recall and overall search quality scores in the Index Medicus groups (n = 32) were higher (P = <0.001) than those in the CD-ROM groups (n = 31). In addition, the search quality scores in the Grateful Med groups (n = 12) were higher (P < 0.003) than those in the CD-ROM groups. There were no differences in precision. CONCLUSION: In the period 1994-1997, the printed Index Medicus was the most effective literature retrieval method for GPs. For inexperienced GPs, there is a need for training in electronic literature retrieval methods.  (+info)

A two-year experience teaching computer literacy to first-year medical students using skill-based cohorts. (8/190)

Because it is widely accepted that providing information online will play a major role in both the teaching and practice of medicine in the near future, a short formal course of instruction in computer skills was proposed for the incoming class of students entering medical school at the State University of New York at Stony Brook. The syllabus was developed on the basis of a set of expected outcomes, which was accepted by the dean of medicine and the curriculum committee for classes beginning in the fall of 1997. Prior to their arrival, students were asked to complete a self-assessment survey designed to elucidate their initial skill base; the returned surveys showed students to have computer skills ranging from complete novice to that of a systems engineer. The classes were taught during the first three weeks of the semester to groups of students separated on the basis of their knowledge of and comfort with computers. Areas covered included computer basics, e-mail management, MEDLINE, and Internet search tools. Each student received seven hours of hands-on training followed by a test. The syllabus and emphasis of the classes were tailored to the initial skill base but the final test was given at the same level to all students. Student participation, test scores, and course evaluations indicated that this noncredit program was successful in achieving an acceptable level of comfort in using a computer for almost all of the student body.  (+info)