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| 2. |
- Carlsson, Mats, 1965-, et al.
(författare)
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Modelling and reclassification of surgical procedures : experiences from the use of GALEN methods in the domain of thoracic surgery
- 2000
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Ingår i: Medical informatics and the Internet in medicine (Print). - : Informa UK Limited. - 1463-9238 .- 1464-5238. ; 25:2, s. 109-122
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Tidskriftsartikel (refereegranskat)abstract
- This paper reports on experiences fromthe evaluation of GALEN methods for mapping of follow-up categories in the domain of thoracic surgery to an existing classification of surgical procedures. The mapping of the aggregated levels or groups of thoracic procedures presents a genuine problem in relation to strict hierarchical classifications, since the follow-up categories do not necessarily fit in the pre-set structure of the classification. Experiences from modelling of the traditional classification and of the follow-up categories are reported, and an analysis of the results is presented along with a discussion of opportunities and potential problems and pitfalls when applying GALEN models and tools.
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| 3. |
- Ekdahl, Christer, et al.
(författare)
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A study of the usage of a decision-support system for infective endocarditis
- 2000
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Ingår i: Medical informatics and the Internet in medicine (Print). - : Informa UK Limited. - 1463-9238 .- 1464-5238. ; 25:1, s. 1-18
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to examine a design for a World Wide Web-based decision-support system in use by clinically active physicians. A prototype implementation of the design concerned management of infective endocarditis patient cases. The design was based on an integration of hypertext and rule-based knowledge. In the study sessions, physicians in the field of internal medicine worked on managing authentic patient cases in a laboratory setting. Data was collected from interviews with the physicians using video recordings and stimulated recall technique. The qualitative data was analysed according to the constant comparative method in order to develop a model of the physicians' usage of the system. The resulting model describes perceived contributions and criteria for usefulness of the system. The ways the physicians used the system showed that it was able to provide patient-specific support for confirming clinical decisions, for higher-level patient management, and for preparing for and initiating expert consultations. Users also stated that new medical knowledge could be gained as a side effect of using the system.
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| 4. |
- Karlsson, Daniel, 1969-, et al.
(författare)
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Medical decision-support systems and the concept of context
- 2004
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Ingår i: Medical informatics and the Internet in medicine (Print). - : Informa UK Limited. - 1463-9238 .- 1464-5238. ; 29:2, s. 109-118
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Tidskriftsartikel (refereegranskat)abstract
- Medical decision-support systems are of necessity multi-contextual in nature. There are always at least two contexts involved in the use of such systems: the expert knowledge-provider context and the end-user context. To show this, we present examples of context-dependent aspects significant to the use of decision-support systems. The existence of discrepancies between the contexts threatens to disrupt the rationale for using decision-support systems: for the system to transfer knowledge from the expert to the end-user. Both theoretical and empirical studies show that such discrepancies exist and that they may be detrimental to the use of decision-support systems. Systems must thus give support in interpreting the output produced by the system in the context of the end-user. © 2004 Taylor and Francis Ltd.
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| 5. |
- Lind, Leili, et al.
(författare)
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A system for symptom assessment in advanced palliative home healthcare using digital pens
- 2004
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Ingår i: Medical informatics and the Internet in medicine (Print). - : Informa UK Limited. - 1463-9238 .- 1464-5238. ; 29:3-4, s. 199-210
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Tidskriftsartikel (refereegranskat)abstract
- Symptom control is one of the most important components of delivering effective palliative care, and adequate symptom assessment is a prerequisite for good symptom control. Patients receiving treatment in palliative home healthcare is geographically separated from the caregivers making symptom control a challenge, a challenge that could be met by the use of information and communication technology. Technologies of today offer different ways for patients to assess their symptoms at home and send the assessments to the healthcare provider. Examples are the use of a PC, a touch-tone telephone, and a digital pen, which require different kinds of infrastructure in the patient’s home, and which differ in strengths and weaknesses. As part of an ongoing quality assurance work within the hospital-based home care clinic at Linköping University Hospital, the project has designed, developed and implemented an IT-support system for pain assessments for patients at home using digital pen and mobile Internet technology. A questionnaire study indicated that pain assessment using digital pens was accepted by patients and that problems mainly arose from the use of the visual-analogue scale.
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| 6. |
- Lind, Leili, et al.
(författare)
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Digital pens and pain diaries in palliative home healthcare: Professional caregivers’ experiences.
- 2007
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Ingår i: Medical Informatics and the Internet in Medicine. - : Informa UK Limited. - 1753-8157 .- 1753-8165 .- 1463-9238 .- 1464-5238. ; 32:4, s. 287-296
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Tidskriftsartikel (refereegranskat)abstract
- Frequent pain assessment by the use of pain diaries for the follow-up of pain treatment can facilitate the caregivers' work with pain control in home health care. The aim was to explore and describe professional caregivers' experiences of palliative home health-care patients' use of pain diaries and digital pen technology for frequent pain assessment. A system for the follow-up of pain treatment was implemented in routine care and evaluated by means of a qualitative content analysis. Three nurses, two physicians and one secretary were interviewed. Additional analysis data were collected from patients' medical records, and the system log. The caregivers showed a shifting outlook towards the pain-assessment method, an initial cautious outlook due to low expectations of the patients' abilities to use the pain assessment method. Despite this, the caregivers experienced positive outcomes in terms of an increased awareness of pain, and positive patient influences including increased participation in their care, increased security, and improved changes in pain treatment as a response to reported pain assessments. Pain assessment by the use of pain diaries and digital pen technology has positive influences on palliative home-care patients and supports the caregivers' focus on the pain.
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| 7. |
- Moidu, Khalid, 1950-, et al.
(författare)
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Computers and physicians - an appraisal study
- 1989
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Ingår i: Medical informatics and the Internet in medicine (Print). - Oxfordshire : Taylor & Francis. - 1463-9238 .- 1464-5238. ; 14:1, s. 63-70
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Tidskriftsartikel (refereegranskat)
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| 8. |
- Olve, Nils-Göran, et al.
(författare)
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Locating ICT's benefits in elderly care
- 2005
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Ingår i: Medical informatics and the Internet in medicine (Print). - : Informa UK Limited. - 1463-9238 .- 1464-5238. ; 30:4, s. 297-308
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Tidskriftsartikel (refereegranskat)abstract
- The impact of information and communication technology (ICT) is indirect and depends on redesign of practices and structures also outside health care. Improvements will only be realized if all parties involved can coordinate their efforts to take advantage of new technology. A 'package' of changed work practices and structures extending across organizational boundaries needs to be designed and implemented. This is very different from the common conception of introducing new ICT tools. Calls for 'evaluation of benefits' before new ICT systems are introduced need to recognize this complexity. This article investigates how analysis and economic evaluations can be used to improve decision-making when new applications are proposed. This is done by drawing parallels with experiences from other industries. We conclude that the entire 'change package' should be analysed for its consequences on the well-being of care recipients, and the requirements it presents for capital investments and changed labour inputs, in particular changed competence needs. Some concepts and structures are suggested for such evaluations. © 2005 Taylor & Francis.
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| 9. |
- Petersson, Håkan, 1972-, et al.
(författare)
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The connection between terms used in medical records and coding system : a study on Swedish primary health care data
- 2001
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Ingår i: Medical informatics and the Internet in medicine (Print). - : Informa UK Limited. - 1463-9238 .- 1464-5238. ; 26:2, s. 87-99
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Tidskriftsartikel (refereegranskat)abstract
- Implementation of problem lists and their relation to standardized coding systems have been approached and analysed in different ways. Most evaluations concern quantitative aspects such as content coverage in a specific domain. In order to reveal the qualitative aspects of diagnostic coding, medical record texts from primary health care encounters were compared with terms from a coding system that was used for describing them statistically. The records were coded by six general practitioners, and in some cases, an applied diagnostic term was found within the text, while other record text-coding system relationships were categorized as synonyms, alternative terms, and interpretations. Thus, the categories roughly corresponded to a measure of semantic distance between the terms in the record text and the rubrics of the coding system, and there was a correlation between semantic distance and inter-rater agreement. The subcategories of this scheme corresponded fairly well to recently published desiderata for clinical terminology servers, including functionality such as word normalization and spelling correction. However, not all problems could have been automatically coded by means of lexical methods, which can be partly explained by the fact that diagnostic coding also relies on clinical knowledge. In addition, proper automation relies on context representation within the records.
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