BMC Med Inform Decis Mak - Recommended practices for computerized clinical decision support and knowledge management in community settings: a qualitative study.

Tópicos

{ care(1570) inform(1187) nurs(1089) }
{ clinic(1479) use(1117) guidelin(835) }
{ import(1318) role(1303) understand(862) }
{ research(1218) medic(880) student(794) }
{ use(1733) differ(960) four(931) }
{ studi(2440) review(1878) systemat(933) }
{ framework(1458) process(801) describ(734) }
{ concept(1167) ontolog(924) domain(897) }
{ data(3963) clinic(1234) research(1004) }
{ health(1844) social(1437) communiti(874) }
{ decis(3086) make(1611) patient(1517) }
{ implement(1333) system(1263) develop(1122) }
{ spatial(1525) area(1432) region(1030) }
{ patient(2837) hospit(1953) medic(668) }
{ data(3008) multipl(1320) sourc(1022) }
{ inform(2794) health(2639) internet(1427) }
{ bind(1733) structur(1185) ligand(1036) }
{ method(1219) similar(1157) match(930) }
{ imag(2830) propos(1344) filter(1198) }
{ patient(2315) diseas(1263) diabet(1191) }
{ perform(999) metric(946) measur(919) }
{ ehr(2073) health(1662) electron(1139) }
{ activ(1138) subject(705) human(624) }
{ survey(1388) particip(1329) question(1065) }
{ model(3404) distribut(989) bayesian(671) }
{ method(1557) propos(1049) approach(1037) }
{ visual(1396) interact(850) tool(830) }
{ group(2977) signific(1463) compar(1072) }
{ use(2086) technolog(871) perceiv(783) }
{ structur(1116) can(940) graph(676) }
{ activ(1452) weight(1219) physic(1104) }
{ can(774) often(719) complex(702) }
{ imag(1947) propos(1133) code(1026) }
{ data(1737) use(1416) pattern(1282) }
{ system(1976) rule(880) can(841) }
{ measur(2081) correl(1212) valu(896) }
{ imag(1057) registr(996) error(939) }
{ sequenc(1873) structur(1644) protein(1328) }
{ featur(3375) classif(2383) classifi(1994) }
{ network(2748) neural(1063) input(814) }
{ imag(2675) segment(2577) method(1081) }
{ take(945) account(800) differ(722) }
{ motion(1329) object(1292) video(1091) }
{ assess(1506) score(1403) qualiti(1306) }
{ treatment(1704) effect(941) patient(846) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ problem(2511) optim(1539) algorithm(950) }
{ error(1145) method(1030) estim(1020) }
{ chang(1828) time(1643) increas(1301) }
{ learn(2355) train(1041) set(1003) }
{ algorithm(1844) comput(1787) effici(935) }
{ extract(1171) text(1153) clinic(932) }
{ data(1714) softwar(1251) tool(1186) }
{ design(1359) user(1324) use(1319) }
{ control(1307) perform(991) simul(935) }
{ model(2220) cell(1177) simul(1124) }
{ general(901) number(790) one(736) }
{ method(984) reconstruct(947) comput(926) }
{ search(2224) databas(1162) retriev(909) }
{ featur(1941) imag(1645) propos(1176) }
{ case(1353) use(1143) diagnosi(1136) }
{ howev(809) still(633) remain(590) }
{ studi(1410) differ(1259) use(1210) }
{ risk(3053) factor(974) diseas(938) }
{ research(1085) discuss(1038) issu(1018) }
{ system(1050) medic(1026) inform(1018) }
{ model(2341) predict(2261) use(1141) }
{ compound(1573) activ(1297) structur(1058) }
{ perform(1367) use(1326) method(1137) }
{ studi(1119) effect(1106) posit(819) }
{ blood(1257) pressur(1144) flow(957) }
{ record(1888) medic(1808) patient(1693) }
{ health(3367) inform(1360) care(1135) }
{ model(3480) simul(1196) paramet(876) }
{ monitor(1329) mobil(1314) devic(1160) }
{ state(1844) use(1261) util(961) }
{ model(2656) set(1616) predict(1553) }
{ data(2317) use(1299) case(1017) }
{ age(1611) year(1155) adult(843) }
{ medic(1828) order(1363) alert(1069) }
{ signal(2180) analysi(812) frequenc(800) }
{ cost(1906) reduc(1198) effect(832) }
{ sampl(1606) size(1419) use(1276) }
{ gene(2352) biolog(1181) express(1162) }
{ first(2504) two(1366) second(1323) }
{ intervent(3218) particip(2042) group(1664) }
{ time(1939) patient(1703) rate(768) }
{ patient(1821) servic(1111) care(1106) }
{ can(981) present(881) function(850) }
{ analysi(2126) use(1163) compon(1037) }
{ high(1669) rate(1365) level(1280) }
{ cancer(2502) breast(956) screen(824) }
{ use(976) code(926) identifi(902) }
{ drug(1928) target(777) effect(648) }
{ result(1111) use(1088) new(759) }
{ estim(2440) model(1874) function(577) }
{ process(1125) use(805) approach(778) }
{ method(1969) cluster(1462) data(1082) }
{ method(2212) result(1239) propos(1039) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

CKGROUND: The purpose of this study was to identify recommended practices for computerized clinical decision support (CDS) development and implementation and for knowledge management (KM) processes in ambulatory clinics and community hospitals using commercial or locally developed systems in the U.S.METHODS: Guided by the Multiple Perspectives Framework, the authors conducted ethnographic field studies at two community hospitals and five ambulatory clinic organizations across the U.S. Using a Rapid Assessment Process, a multidisciplinary research team: gathered preliminary assessment data; conducted on-site interviews, observations, and field surveys; analyzed data using both template and grounded methods; and developed universal themes. A panel of experts produced recommended practices.RESULTS: The team identified ten themes related to CDS and KM. These include: 1) workflow; 2) knowledge management; 3) data as a foundation for CDS; 4) user computer interaction; 5) measurement and metrics; 6) governance; 7) translation for collaboration; 8) the meaning of CDS; 9) roles of special, essential people; and 10) communication, training, and support. Experts developed recommendations about each theme. The original Multiple Perspectives framework was modified to make explicit a new theoretical construct, that of Translational Interaction.CONCLUSIONS: These ten themes represent areas that need attention if a clinic or community hospital plans to implement and successfully utilize CDS. In addition, they have implications for workforce education, research, and national-level policy development. The Translational Interaction construct could guide future applied informatics research endeavors.

Resumo Limpo

ckground purpos studi identifi recommend practic computer clinic decis support cds develop implement knowledg manag km process ambulatori clinic communiti hospit use commerci local develop system usmethod guid multipl perspect framework author conduct ethnograph field studi two communiti hospit five ambulatori clinic organ across us use rapid assess process multidisciplinari research team gather preliminari assess data conduct onsit interview observ field survey analyz data use templat ground method develop univers theme panel expert produc recommend practicesresult team identifi ten theme relat cds km includ workflow knowledg manag data foundat cds user comput interact measur metric govern translat collabor mean cds role special essenti peopl communic train support expert develop recommend theme origin multipl perspect framework modifi make explicit new theoret construct translat interactionconclus ten theme repres area need attent clinic communiti hospit plan implement success util cds addit implic workforc educ research nationallevel polici develop translat interact construct guid futur appli informat research endeavor

Resumos Similares

Int J Med Inform - Evaluation of a comprehensive EHR based on the DeLone and McLean model for IS success: approach, results, and success factors. ( 0,722980601993488 )
Appl Clin Inform - Lessons learned for collaborative clinical content development. ( 0,707265057136171 )
J. Med. Internet Res. - Researchers' needs for resource discovery and collaboration tools: a qualitative investigation of translational scientists. ( 0,69438596442269 )
Comput Methods Programs Biomed - Supporting a distributed execution of clinical guidelines. ( 0,69118607393702 )
Health Informatics J - Accessibility, usability, and usefulness of a Web-based clinical decision support tool to enhance provider-patient communication around Self-management TO Prevent (STOP) Stroke. ( 0,690817866951606 )
J Am Med Inform Assoc - Health information exchange technology on the front lines of healthcare: workflow factors and patterns of use. ( 0,684371592088161 )
BMC Med Inform Decis Mak - Quality of prenatal and maternal care: bridging the know-do gap (QUALMAT study): an electronic clinical decision support system for rural Sub-Saharan Africa. ( 0,681512443982853 )
Health Info Libr J - The academic librarian as co-investigator on an interprofessional primary research team: a case study. ( 0,673801308911551 )
BMC Med Inform Decis Mak - A study of clinical and information management processes in the surgical pre-assessment clinic. ( 0,671624131332804 )
Health Info Libr J - Information professionals' participation in interdisciplinary research: a preliminary study of factors affecting successful collaborations. ( 0,670679444266439 )
BMC Med Inform Decis Mak - The role of ICT in supporting disruptive innovation: a multi-site qualitative study of nurse practitioners in emergency departments. ( 0,668628468823974 )
Int J Med Inform - Towards an understanding of the information dynamics of the handover process in aged care settings--a prerequisite for the safe and effective use of ICT. ( 0,66418446915092 )
J Biomed Inform - Computer-interpretable clinical guidelines: a methodological review. ( 0,660502368030076 )
Int J Med Inform - Guidelines for maternal and neonatal point of care: needs of and attitudes towards a computerized clinical decision support system in rural Burkina Faso. ( 0,660071447120445 )
BMC Med Inform Decis Mak - From design to implementation--the Joint Asia Diabetes Evaluation (JADE) program: a descriptive report of an electronic web-based diabetes management program. ( 0,656353576431809 )
Inform Health Soc Care - Specifying process requirements for holistic care. ( 0,650551938942485 )
BMC Med Inform Decis Mak - Development of a prototype clinical decision support tool for osteoporosis disease management: a qualitative study of focus groups. ( 0,645740844207392 )
AMIA Annu Symp Proc - SRCAST-Diagnosis: understanding how different members of a patient-care team interact with clinical decision support system. ( 0,645509467754764 )
Appl Clin Inform - Dealing with the archetypes development process for a regional EHR system. ( 0,642910139079743 )
Int J Med Inform - The effect of computerized decision support on barriers to guideline implementation: a qualitative study in outpatient cardiac rehabilitation. ( 0,641161072233767 )
BMC Med Inform Decis Mak - Lessons learned from implementation of computerized provider order entry in 5 community hospitals: a qualitative study. ( 0,63833495911461 )
Telemed J E Health - International trauma teleconference: evaluating trauma care and facilitating quality improvement. ( 0,635148163394194 )
Int J Med Inform - Nurses' experiences of using an interactive tailored patient assessment tool one year past implementation. ( 0,628278009836185 )
Healthc (Amst) - The EFECT framework for interprofessional education in the patient centered medical home. ( 0,627820860381899 )
AMIA Annu Symp Proc - Multiple perspectives on the meaning of clinical decision support. ( 0,627338778882153 )
Health Info Libr J - The Clinical Relevance of Information Index (CRII): assessing the relevance of health information to the clinical practice. ( 0,624638972888016 )
Healthc (Amst) - Flexible implementation and integration of new team members to support patient-centered care. ( 0,620591120108311 )
AMIA Annu Symp Proc - GEM at 10: a decade's experience with the Guideline Elements Model. ( 0,617849636899935 )
J. Med. Internet Res. - WikiBuild: a new application to support patient and health care professional involvement in the development of patient support tools. ( 0,617144930454897 )
Int J Med Inform - Health information exchange interventions can enhance quality and continuity of HIV care. ( 0,615533250540868 )
Inform Health Soc Care - 'The web is not enough, it's a base'--an explorative study of what needs a web-based support system for young carers must meet. ( 0,614616344919841 )
Int J Med Inform - Use of electronic information systems in nursing management. ( 0,61424120273257 )
J Biomed Inform - Informing the design of clinical decision support services for evaluation of children with minor blunt head trauma in the emergency department: a sociotechnical analysis. ( 0,607974721460709 )
Int J Med Inform - Multi-disciplinary communication networks for skin risk assessment in nursing homes with high IT sophistication. ( 0,607630614284589 )
Health Info Libr J - Information needs of clinicians and non-clinicians in the Emergency Department: a qualitative study. ( 0,606568923493852 )
Int J Med Inform - Using Cognitive Work Analysis to fit decision support tools to nurse managers' work flow. ( 0,606146641098188 )
Healthc (Amst) - Aligning emergency care with the triple aim: Opportunities and future directions after healthcare reform. ( 0,605607277876508 )
Methods Inf Med - An observation tool for studying patient-oriented workflow in hospital emergency departments. ( 0,602516007222475 )
Int J Med Inform - Dashboards for improving patient care: review of the literature. ( 0,601553897524888 )
J Biomed Inform - Bridging gaps in handoffs: a continuity of care based approach. ( 0,598504411817919 )
J. Med. Internet Res. - Perceived barriers and facilitators of using a Web-based interactive decision aid for colorectal cancer screening in community practice settings: findings from focus groups with primary care clinicians and medical office staff. ( 0,597398108123408 )
BMC Med Inform Decis Mak - Improving the effectiveness of electronic health record-based referral processes. ( 0,59707427404145 )
Int J Med Inform - The use of technology for urgent clinician to clinician communications: a systematic review of the literature. ( 0,594296986061862 )
AMIA Annu Symp Proc - A Framework for Incorporating Patient Preferences to Deliver Participatory Medicine via Interdisciplinary Healthcare Teams. ( 0,594260659067083 )
J Biomed Inform - In search of common ground in handoff documentation in an Intensive Care Unit. ( 0,591577052863203 )
BMC Med Inform Decis Mak - Methods to identify, study and understand end-user participation in HIT development. ( 0,590015998559787 )
BMC Med Inform Decis Mak - What is needed to implement a computer-assisted health risk assessment tool? An exploratory concept mapping study. ( 0,588449997400206 )
Inform Health Soc Care - The importance of interaction in the implementation of information technology in health care: a symbolic interactionism study on the meaning of accessibility. ( 0,586566057474124 )
J Med Syst - An architecture model for multiple disease management information systems. ( 0,586447069978378 )
Int J Med Inform - Going paperless at the emergency department: a socio-technical study of an information system for patient tracking. ( 0,585511156082989 )
J Am Med Inform Assoc - Content and functional specifications for a standards-based multidisciplinary rounding tool to maintain continuity across acute and critical care. ( 0,58543934977308 )
J Am Med Inform Assoc - Social but safe? Quality and safety of diabetes-related online social networks. ( 0,585243239623876 )
Int J Med Inform - The integration of Information and Communication Technology into nursing. ( 0,583456356657559 )
J Am Med Inform Assoc - Intensive care unit nurses' information needs and recommendations for integrated displays to improve nurses' situation awareness. ( 0,581681864129331 )
BMC Med Inform Decis Mak - The status of IT service management in health care - ITIL? in selected European countries. ( 0,581592810939304 )
J Med Syst - Characteristics of successful technological interventions in mental resilience training. ( 0,5802426178545 )
Int J Med Inform - A model of awareness to enhance our understanding of interprofessional collaborative care delivery and health information system design to support it. ( 0,578939296913611 )
Health Info Libr J - The application and value of information sources in clinical practice: an examination of the perspective of naturopaths. ( 0,577583946645662 )
J. Med. Internet Res. - Experiences of multidisciplinary development team members during user-centered design of telecare products and services: a qualitative study. ( 0,577572164611415 )
AMIA Annu Symp Proc - To talk or not to talk: exploring culturally diverse patients' health information communication choices. ( 0,577434022657513 )
J Am Med Inform Assoc - Computerized provider documentation: findings and implications of a multisite study of clinicians and administrators. ( 0,576727352909301 )
J Am Med Inform Assoc - A multi-layered framework for disseminating knowledge for computer-based decision support. ( 0,575568187719499 )
J Am Med Inform Assoc - CAPriCORN: Chicago Area Patient-Centered Outcomes Research Network. ( 0,574970620763418 )
Perspect Health Inf Manag - Leadership's role in support of online academic programs: implementing an administrative support matrix. ( 0,573693319817219 )
Telemed J E Health - The practice of telehealth by nurses: an experience in primary healthcare in Brazil. ( 0,573578514939243 )
J Am Med Inform Assoc - The intended and unintended consequences of communication systems on general internal medicine inpatient care delivery: a prospective observational case study of five teaching hospitals. ( 0,572969543452229 )
Health Info Libr J - Health education for Somali Bantu refugees via home visits. ( 0,572811088813885 )
Health Info Libr J - Leisure reading collections in academic health sciences and science libraries: results of visits to seven libraries. ( 0,571922845560846 )
BMC Med Inform Decis Mak - Many miles to go ?: a systematic review of the implementation of patient decision support interventions into routine clinical practice. ( 0,570346865266288 )
J Am Med Inform Assoc - The impact of PACS on clinician work practices in the intensive care unit: a systematic review of the literature. ( 0,570245205820509 )
AMIA Annu Symp Proc - Development of a nursing handoff tool: a web-based application to enhance patient safety. ( 0,568800373487238 )
J Telemed Telecare - The compatibility of telehealth with health-care delivery. ( 0,568219416759265 )
Appl Clin Inform - CAH to CAH: EHR implementation advice to critical access hospitals from peer experts and other key informants. ( 0,566969211828777 )
Telemed J E Health - Implementing home blood glucose and blood pressure telemonitoring in primary care practices for patients with diabetes: lessons learned. ( 0,563857005332032 )
J Telemed Telecare - Telehealth in palliative care in the UK: a review of the evidence. ( 0,563658901686041 )
Appl Clin Inform - Insight into the sharing of medical images: physician, other health care providers, and staff experience in a variety of medical settings. ( 0,563278378352663 )
J Med Syst - Understanding critical barriers to implementing a clinical information system in a nursing home through the lens of a socio-technical perspective. ( 0,562369255977594 )
Appl Clin Inform - A case report in health information exchange for inter-organizational patient transfers. ( 0,562283101271863 )
Telemed J E Health - Task-technology fit of video telehealth for nurses in an outpatient clinic setting. ( 0,562134542568889 )
Telemed J E Health - A systematic review of clinician and staff views on the acceptability of incorporating remote monitoring technology into primary care. ( 0,561307668255229 )
BMC Med Inform Decis Mak - Deficiencies in the transfer and availability of clinical trials evidence: a review of existing systems and standards. ( 0,559701720152597 )
J Am Med Inform Assoc - Evaluating health information technology in community-based settings: lessons learned. ( 0,558872666895547 )
Healthc (Amst) - Implementing a patient centered medical home in the Veterans health administration: Perspectives of primary care providers. ( 0,556660127519092 )
J Am Med Inform Assoc - Effect of clinical decision support on documented guideline adherence for head CT in emergency department patients with mild traumatic brain injury. ( 0,556434775577727 )
Int J Med Inform - Organizational routines, innovation, and flexibility: the application of narrative networks to dynamic workflow. ( 0,555000321700296 )
J Telemed Telecare - The effect of PACS on the practice of orthopaedic surgeons. ( 0,554988972348604 )
J Med Syst - EHR implementation in a new clinic: a case study of clinician perceptions. ( 0,554793707643826 )
Telemed J E Health - Standardizing sepsis screening and management via a tele-ICU program improves patient care. ( 0,553577463335696 )
J Med Syst - Data envelopment analysis model for the appraisal and relative performance evaluation of nurses at an intensive care unit. ( 0,552956041792434 )
Int J Med Inform - The importance of the verbal shift handover report: a multi-site case study. ( 0,552488304137271 )
Int J Med Inform - The impact of medical record technologies on collaboration in emergency medicine. ( 0,551676959908483 )
Int J Med Inform - Evaluation of the national nursing model and four nursing documentation systems in Finland--lessons learned and directions for the future. ( 0,551632192742492 )
Methods Inf Med - From bench to bed: bridging from informatics theory to practice. An exploratory analysis. ( 0,551620693082499 )
Healthc (Amst) - Doubling down: Lessons learned from building a new electronic health record as part of primary care practice redesign. ( 0,551098187808439 )
Appl Clin Inform - A proposal for an Austrian Nursing Minimum Data Set (NMDS): a Delphi study. ( 0,550889557714408 )
Inform Health Soc Care - Patients' contribution to the development of a web-based plan for integrated care - a participatory design study. ( 0,550624462131748 )
Health Informatics J - The coordination hub: Toward patient-centered and collaborative care processes. ( 0,548974387965715 )
Inform Health Soc Care - Developing nurse educators' computer skills towards proficiency in nursing informatics. ( 0,548757641030464 )
J Med Syst - Mobile technology use in medical education. ( 0,548303613000811 )
Telemed J E Health - Provider barriers to telemental health: obstacles overcome, obstacles remaining. ( 0,547889642679054 )