1.
Hoffmann, Mikael, et al.
(författare)
Guiding principles for the use of knowledge bases and real-world data in clinical decision support systems : report by an international expert workshop at Karolinska Institutet
2020
Ingår i: Expert Review of Clinical Pharmacology. - : Taylor & Francis. - 1751-2433 .- 1751-2441. ; 13:9, s. 925-934
Tidskriftsartikel (refereegranskat) abstract
Introduction Technical and logical breakthroughs have provided new opportunities in medicine to use knowledge bases and large-scale clinical data (real-world) at point-of-care as part of a learning healthcare system to diminish the knowledge-practice gap. Areas covered The article is based on presentations, discussions and recommendations from an international scientific workshop. Value, research needs and funding avenues of knowledge bases and access to real-world data as well as transparency and incorporation of patient perspectives are discussed. Expert opinion Evidence-based, publicly funded, well-structured and curated knowledge bases are of global importance. They ought to be considered as a public responsibility requiring transparency and handling of conflicts of interest. Information has to be made accessible for clinical decision support systems (CDSS) for healthcare staff and patients. Access to rich and real-world data is essential for a learning health care ecosystem and can be augmented by data on patient-reported outcomes and preferences. This field can progress by the establishment of an international policy group for developing a best practice guideline on the development, maintenance, governance, evaluation principles and financing of open-source knowledge bases and handling of real-world data.
2.
Scandurra, Isabella, et al.
(författare)
Heuristic evaluation performed by usability-educated clinicians : education and attitudes
2007
Ingår i: INFORMATION TECHNOLOGY IN HEALTH CARE 2007. - : IOS Press. - 9781586037772 - 9781607502685 ; , s. 205-216
Konferensbidrag (refereegranskat) abstract
Heuristic evaluation is a usability testing method aiming to improve the user interface design. Traditionally, a panel of experts in usability and human factor issues evaluate and judge the compliance of computer software according to recognized usability principles, the heuristics. In this paper, we investigate clinicians' attitudes towards learning and performing a heuristic evaluation and present the procedure of educating the healthcare staff and their accomplishment of the evaluation. 18 clinicians were recruited for a 2-hours education and filled in a post-education questionnaire regarding their opinions of the evaluation method when applied by clinicians. Six of the clinicians participated later in a heuristic evaluation of a web-based virtual health record,Their time spent for evaluation and analysis of results was approximately four hours each. Opinions from the six "clinical evaluators" were gathered in an post-evaluation form and compared to the post-education questionnaire. The results of 18 clinicians indicate that there is an interest in learning and participating in such evaluations. Our interpretation is that it is feasible to educate healthcare staff to perform rapid usability inspections to locate usability defects and additionally emphasize the domain specific problems residing in health information systems.
3.
Hägglund, Maria, et al.
(författare)
Bridging the gap : a virtual health record for integrated home care
2007
Ingår i: International Journal of Integrated Care. - : Ubiquity Press, Ltd.. - 1568-4156 .- 1568-4156. ; 7:June, s. e26-
Tidskriftsartikel (refereegranskat) abstract
INTRODUCTION: The coexistence of different information systems that are unable to communicate is a persistent problem in healthcare and in integrated home care in particular. THEORY AND METHODS: Physically federated integration is used for design of the underlying technical architecture to implement a mobile virtual health record for integrated home care. A user centered system development approach is followed during design and development of the system. RESULTS: A technical platform based on a service-oriented approach where database functionality and services are separated has been developed. This guarantees flexibility with regard to changed functional demands and allows third party systems to interact with the platform in a standardized way. A physically federated integration enables point-of-care documentation, integrated presentation of information from different feeder systems, and offline access to data on handheld devices. Feeder systems deliver information in XML-files that are mapped against an ideal XML schema, published as an interface for integration with the information broker, and inserted into the mediator database. CONCLUSIONS: A seamless flow of information between both different care professionals involved in integrated home care and patients and relatives is provided through mobile information access and interaction with different feeder systems using the virtual health record.
4.
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6.
Scott Duncan, Therese, et al.
(författare)
From Information Seekers to Innovators : Qualitative Analysis Describing Experiences of the Second Generation of E-Patients
2019
Ingår i: Journal of Medical Internet Research. - Stockholm : JMIR Publications Inc.. - 1438-8871. ; 21:8
Tidskriftsartikel (refereegranskat) abstract
BACKGROUND: Current health care systems are rarely designed to meet the needs of people living with chronic conditions. However, some patients and informal caregivers are not waiting for the health care system to redesign itself. These individuals are sometimes referred to as e-patients. The first generation of e-patients used the internet for finding information and for communicating with peers. Compared with the first generation, the second generation of e-patients collects their own health data and appears to be more innovative.OBJECTIVE: The aim of this study was to describe the second generation of e-patients through exploration of their active engagement in their self-care and health care.METHODS: Semistructured interviews were conducted with 10 patients with chronic conditions and 5 informal caregivers. They were all recruited through a Web-based advertisement. Data were analyzed according to the framework analysis approach, using the 3 concepts of the self-determination theory-autonomy, relatedness, and competence-at the outset.RESULTS: Study participants were actively engaged in influencing their self-care and the health care system to improve their own health, as well as the health of others. This occurred at different levels, such as using their own experience when giving presentations and lectures to health care professionals and medical students, working as professional peers in clinical settings, performing self-tracking, contributing with innovations, and being active on social media. When interaction with health care providers was perceived as being insufficient, the participants sought support through their peers, which showed strong relatedness. Competence increased through the use of technology and learning experiences with peers. Their autonomy was important but was sometimes described as involuntary and to give up was not an option for them.CONCLUSIONS: Like the first generation of e-patients, the participants frequently searched for Web-based information. However, the second generation of e-patients also produce their own health data, which they learn from and share. They also engage in the innovation of digital tools to meet health-related needs. Utilizing technological developments comes naturally to the second generation of e-patients, even if the health care system is not prepared to support them under these new circumstances.
7.
Vikström, Anna, et al.
(författare)
Coding of procedures documented by general practitioners in Swedish primary care - an explorative study using two procedure coding systems.
2012
Ingår i: BMC family practice. - : Springer Science and Business Media LLC. - 1471-2296. ; 13:1
Tidskriftsartikel (refereegranskat) abstract
ABSTRACT: BACKGROUND: Procedures documented by general practitioners in primary care have not been studied in relation to procedure coding systems. We aimed to describe procedures documented by Swedish general practitioners in electronic patient records and to compare them to the Swedish Classification of Health Interventions (KVA) and SNOMED CT. METHODS: Procedures in 200 record entries were identified, coded, assessed in relation to two procedure coding systems and analysed. RESULTS: 417 procedures found in the 200 electronic patient record entries were coded with 36 different Classification of Health Interventions categories and 148 different SNOMED CT concepts. 22.8% of the procedures could not be coded with any Classification of Health Interventions category and 4.3% could not be coded with any SNOMED CT concept. 206 procedure-concept/category pairs were assessed as a complete match in SNOMED CT compared to 10 in the Classification of Health Interventions. CONCLUSIONS: Procedures documented by general practitioners were present in nearly all electronic patient record entries. Almost all procedures could be coded using SNOMED-CT. Classification of Health Interventions covered the procedures to a lesser extent and with a much lower degree of concordance. SNOMED CT is a more flexible terminology system that can be used for different purposes for procedure coding in primary care.
8.
Scott Duncan, Therese, et al.
(författare)
Empowered patients and informal care-givers as partners? : A survey study of healthcare professionals' perceptions
2023
Ingår i: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 23:1
Tidskriftsartikel (refereegranskat) abstract
BACKGROUND: More knowledge is needed regarding the perceptions of healthcare professionals when encountering empowered patients and informal caregivers in clinical settings. This study aimed to investigate healthcare professionals' attitudes towards and experiences of working with empowered patients and informal caregivers, and perception of workplace support in these situations. METHODS: A multi-centre web survey was conducted using a non-probability sampling of both primary and specialized healthcare professionals across Sweden. A total of 279 healthcare professionals completed the survey. Data was analysed using descriptive statistics and Thematic analysis. RESULTS: Most respondents perceived empowered patients and informal caregivers as positive and had to some extent experience of learning new knowledge and skills from them. However, few respondents stated that these experiences were regularly followed-up at their workplace. Potentially negative consequences such as increased inequality and additional workload were, however, mentioned. Patients' engagement in the development of clinical workplaces was seen as positive by the respondents, but few had own experience of such engagement and considered it difficult to be achieved. CONCLUSION: Overall positive attitudes of healthcare professionals are a fundamental prerequisite to the transition of the healthcare system recognizing empowered patients and informal caregivers as partners.
9.
Koch, Sabine, et al.
(författare)
Towards a virtual health record for mobile home care of elderly citizens
2004
Ingår i: MEDINFO 2004. - Amsterdam : IOS Press. - 9781586034443 - 9781607509493 ; , s. 960-963, s. 960-963
Bokkapitel (refereegranskat) abstract
Mobile work situations within home care of the elderly require immediate and ubiquitous access to patient-oriented data. The ongoing Swedish research project “Technical support for Mobile CloseCare” focuses on the development and evalua-tion of work-scenario oriented ICT support for enhanced home care of elderly citizens. The aim of the project is to pro-vide a seamless and consistent information flow between dif-ferent health care providers and to give intuitive access to information services for the elderly and their relatives. For that purpose, different independent software components are connected through a mobile communication platform. Flexible access to prioritized information for different users in different work situations will be given through a virtual health record. In order to obtain both usable and clinically relevant systems, a user centered system development approach is followed. Evaluation of the project results will be based on usability tests and quasi-experimental studies on how system implemen-tation influences quality of care and job- and life satisfaction for care providers, patients and relatives.
10.
Hägglund, Maria, et al.
(författare)
Integrated Care Plan for Shared Home Care : the technical architecture
2005
Ingår i: Journal on Information Technology in Healthcare. - Wallington : Optimum. - 1479-649X. ; 3:5, s. 287-294
Tidskriftsartikel (refereegranskat) abstract
The move towards decentralising healthcare services from traditional care settings towards home care has produced new requirements for care planning and documentation of procedures performed in the home environment. To meet these requirements, a virtual care plan (VCP) has been developed that gives both district nurses and home help service personnel (HHS) access to their respective care plans in a mobile work situation. In this paper we present the technical architecture of this VCP, and describe how it integrates information from different feeder systems and allows for documentation at the point of care (POC) using mobile devices.
