| 1. |
- Bång, Magnus, 1967-, et al.
(author)
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Distributed user interfaces for clinical ubiquitous computing applications
- 2005
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In: International Journal of Medical Informatics. - : Elsevier BV. - 1386-5056 .- 1872-8243. ; 74:7-8, s. 545-551
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Journal article (peer-reviewed)abstract
- Objectives: Ubiquitous computing with multiple interaction devices requires new interface models that support user-specific modifications to applications and facilitate the fast development of active workspaces.Methods: We have developed NOSTOS, a computer-augmented work environment for clinical personnel to explore new user interface paradigms for ubiquitous computing. NOSTOS uses several devices such as digital pens, an active desk, and walk-up displays that allow the system to track documents and activities in the workplace.Results: We present the distributed user interface (DUI) model that allows standalone applications to distribute their user interface components to several devices dynamically at run-time. This mechanism permit clinicians to develop their own user interfaces and forms to clinical information systems to match their specific needs. We discuss the underlying technical concepts of DUIs and show how service discovery, component distribution, events and layout management are dealt with in the NOSTOS system.Conclusion: Our results suggest that DUIs - and similar network-based user interfaces - will be a prerequisite of future mobile user interfaces and essential to develop clinical multi-device environments. © 2005 Elsevier Ireland Ltd. All rights reserved.
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| 2. |
- Bång, Magnus, et al.
(author)
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Ubiquitous computing to support co-located clinical teams : Using the semiotics of physical objects in system design
- 2007
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In: International Journal of Medical Informatics. - : Elsevier BV. - 1386-5056 .- 1872-8243. ; 76:SUPPL. 1, s. 58-64
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Journal article (peer-reviewed)abstract
- Objectives: Co-located teams often use material objects to communicate messages in collaboration. Modern desktop computing systems with abstract graphical user interface (GUIs) fail to support this material dimension of inter-personal communication. The aim of this study is to investigate how tangible user interfaces can be used in computer systems to better support collaborative routines among co-located clinical teams. Methods: The semiotics of physical objects used in team collaboration was analyzed from data collected during 1 month of observations at an emergency room. The resulting set of communication patterns was used as a framework when designing an experimental system. Following the principles of augmented reality, physical objects were mapped into a physical user interface with the goal of maintaining the symbolic value of those objects. Results: NOSTOS is an experimental ubiquitous computing environment that takes advantage of interaction devices integrated into the traditional clinical environment, including digital pens, walk-up displays, and a digital desk. The design uses familiar workplace tools to function as user interfaces to the computer in order to exploit established cognitive and collaborative routines. Conclusion: Paper-based tangible user interfaces and digital desks are promising technologies for co-located clinical teams. A key issue that needs to be solved before employing such solutions in practice is associated with limited feedback from the passive paper interfaces. © 2006 Elsevier Ireland Ltd. All rights reserved.
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| 3. |
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| 4. |
- Florin, Jan, 1956-, et al.
(author)
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Developing a national integrated classification of health care interventions in Sweden
- 2005
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In: International Journal of Medical Informatics. - Clare, Ireland : Elsevier. - 1386-5056 .- 1872-8243. ; 74:11-12, s. 973-9
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Journal article (peer-reviewed)abstract
- Background: Existing classifications in Sweden of health care interventions used for quality assurance issues and for decisions on resource allocation does not capture all types of health care interventions. The work of professional groups like nurses, physiotherapists, and occupational therapists is partly invisible. There is a need to develop a classification of health care interventions that comprise all activity within the health care sector.Aim: To describe a multi-professional collaborative work on classification development and to provide suggestions for an organizing structure that can capture interventions in the health care services incorporating different professional perspectives.Results: The professional groups reached a common understanding about the use of the classification of The International Classification of Functioning, Disability and Health (ICF) as a unifying framework in the classification of health care interventions. Proposal was made for a revised structure of a current classification of interventions using ICD as unifying framework.Conclusion: The use of ICF as a unifying framework is seen as a fruitful way of overcoming professional differences, and by that supporting the process of reaching a common understanding and use of a common language when describing interventions in health care.
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| 6. |
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| 7. |
- Lind, Leili, et al.
(author)
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Patients’ use of digital pens for pain assessment in advanced palliative home healthcare
- 2008
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In: International Journal of Medical Informatics. - : Elsevier BV. - 1386-5056 .- 1872-8243. ; 77:2, s. 129-136
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Journal article (peer-reviewed)abstract
- Background: Appropriate pain assessment is a necessary prerequisite for adequate pain control. A way to follow-up on the pain is to let patients use paper-based or electronic pain diaries. Purpose: The aim was to explore and describe palliative home care patients’ experiences of assessing their pain by using a pain diary together with digital pen and mobile Internet technology. Methods: A system for the follow-up of pain treatment was developed and evaluated by means of a qualitative cross-case content analysis. From December 2002 until September 2003 12 palliative patients, who initially assessed VAS pain ≥ 35 mm (VAS 0-100 mm), used the system. Patients reported their momentary pain intensity and the number of consumed extra doses of analgesics three times per day. Analysis data were collected from interviews with patients and spouses, questionnaires, medical records, and the system log. Results: In spite of severe illness and difficulties in comprehending the technology and system intervention, patients found the pain diary and digital pen easy to use for pain assessment. Patients took a greater part in their own care and experienced an improved contact with their caregivers, which led to a sense of increased security. The medical records showed a quick response to variations in the patients’ health status by means of changes in medical treatment. Conclusions: The pain assessment system for palliative patients using pain diaries together with digital pen and wireless Internet technology constitutes an effortless method and has positive influences on the care.
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| 8. |
- Törnvall, Eva, et al.
(author)
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Advancing nursing documentation an intervention study using[X]patients with leg ulcer as an example
- 2009
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In: International Journal of Medical Informatics. - : Elsevier BV. - 1386-5056 .- 1872-8243. ; 78:9, s. 605-617
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Journal article (peer-reviewed)abstract
- Aim: The aim was to implement and evaluate a standardised nursing record, using patients with leg ulcer as an example, regarding the content of the nursing record and district nurses experiences of documentation. Method: This was a prospective, stratified and randomised intervention study, with one intervention group and one control group. A standardised nursing wound care record was designed and implemented in the electronic patient record in the intervention group for a period of 3 months. Pre- and post-intervention audits of nursing records [n = 102 and n = 92, respectively] were carried out and 126 district nurses answered questionnaires pre-intervention and 83 post-intervention. Result: The standardised nursing wound care record led to more informative, comprehensive and knowledge-intensive documentation according to the audit and district nurses opinions. Furthermore, the district nurses self-reported knowledge of nursing documentation increased in the intervention group. When the standardised nursing wound care record was not used, the documentation was mostly incomplete with a lack of nursing relevance. There were no differences in the district nurses experiences of documentation in general between the two groups. Conclusion: Using the standardised nursing wound care record improved nursing documentation meeting legal demands, which should increase the safety of patient. There was however a discrepancy between the nurses stated knowledge and how they carried out the documentation. Regular in-service training together with use of evidence based standardised nursing records, as a link to clinical reasoning about nursing care, could be ways effecting change.
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| 9. |
- Umefjord, Göran, et al.
(author)
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Medical text-based consultations on the Internet : a 4-year study.
- 2008
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In: International Journal of Medical Informatics. - : Elsevier BV. - 1386-5056 .- 1872-8243. ; 77:2, s. 114-121
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Journal article (peer-reviewed)abstract
- BACKGROUND: The Internet is increasingly used for health matters including Ask the doctor services. AIM: To describe users and usage pattern of text-based medical consultation with family physicians on the Internet. METHODS: Descriptive analysis of the first 4 years' use of a Swedish Ask the doctor service concerning number of inquiries, age and gender of inquirers. Time of day and week, types of medical inquiries, and use in relation to population density was analyzed during the last year of the study. RESULTS: We found a considerable number of users, with 38,217 inquiries submitted to the service. Three-fourths of the inquirers were women, thus exceeding the gender difference seen in regular health care. The typical user was a woman aged 21-60 years. The service was used any time day or night, 7 days a week. Almost half of the inquiries were submitted during evenings and nights. Most areas of medicine were represented in the inquiries, reflecting the fact that there was no control of what an inquiry should include. The use was widespread over the country but more frequent per capita in more densely populated areas as defined by postal code. CONCLUSION: In the study of a service for text-based consultations with family physicians on the Internet, we found a geographically widely distributed use, slowly but gradually increasing during a 4-year period. The use increased more rapidly among young and middle-aged women. Asynchronous text-based consultation is likely to expand in the near future.
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| 10. |
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| 11. |
- Velupillai, Sumithra, et al.
(author)
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Developing a standard for de-identifying electronic patient records written in Swedish : Precision, recall and F-measure in a manual and computerized annotation trial
- 2009
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In: International Journal of Medical Informatics. - : Elsevier. - 1386-5056 .- 1872-8243. ; 78:12, s. E19-E26
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Journal article (peer-reviewed)abstract
- Background: Electronic patient records (EPRs) contain a large amount of information written in free text. This information is considered very valuable for research but is also very sensitive since the free text parts may contain information that could reveal the identity of a patient. Therefore, methods for de-identifying EPRs are needed. The work presented here aims to perform a manual and automatic Protected Health Information (PHI)-annotation trial for EPRs written in Swedish. Methods: This study consists of two main parts: the initial creation of a manually PHI-annotated gold standard, and the porting and evaluation of an existing de-identification software written for American English to Swedish in a preliminary automatic deidentification trial. Results are measured with precision, recall and F-measure. Results: This study reports fairly high Inter-Annotator Agreement (IAA) results on the manually created gold standard, especially for specific tags such as names. The average IAA over all tags was 0.65 F-measure (0.84 F-measure highest pairwise agreement). For name tags the average IAA was 0.80 F-measure (0.91 F-measure highest pairwise agreement). Porting a de-identification software written for American English to Swedish directly was unfortunately non-trivial, yielding poor results. Conclusion: Developing gold standard sets as well as automatic systems for de-identification tasks in Swedish is feasible. However, discussions and definitions on identifiable information is needed, as well as further developments both on the tag sets and the annotation guidelines, in order to get a reliable gold standard. A completely new de-identification software needs to be developed.
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| 12. |
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| 13. |
- Kyhlbäck, Hans, et al.
(author)
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What does it take to replace an old functioning information system with a new one? : A case study
- 2007
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In: International Journal of Medical Informatics. - : ELSEVIER SCI IRELAND LTD. - 1386-5056. ; 76, s. S149-S158
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Journal article (peer-reviewed)abstract
- The first claim we make in the paper is that an old-fashioned information system within health care work will not successfully be replaced by a new one, unless the new is better “as a whole”, that is, better supports work practices of a range of occupational and professional workers. The second claim is that the dilemmas system designers almost always will face when designing information system for the public sector is based on a contradiction between central, high level interest and a local level work-practice perspective. If the discontinuities in the design activity can be exposed and analyzed a better match to the socio-technical system as constituted by the work practice in question will be accomplished. We underpin our arguments and relate them to a case study of municipal wound care work. Our study reveals that work practice of the municipal nurses is characterized by three distinctive features: High mobility, the need for face-to-face interaction in different locations, and a great variety of artefact usage. Finally we suggest a methodology that might help system designers to get a better understanding of what socio-technical system they are supposed to further develop.
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| 14. |
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| 15. |
- Åkesson, Kerstin, 1952-, et al.
(author)
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Health care consumers' experiences of information communication technology : A summary of litterature
- 2007
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In: International Journal of Medical Informatics. - 1386-5056. ; 76:9, s. 633-645
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Journal article (peer-reviewed)abstract
- Background: There is an increasing interest in reaching consumers directly through the Internet and different telecommunication systems. The most important contacts in health care will always be the face-to-face meetings, but the tools of health informatics can be seen as a means to an end, which is to provide the best possible health care. A variety of applications have been described in different references. To our knowledge there has been no review of a research-based state of the art in the field of consumers’ experiences in using different applications in health informatics. According to the benefits in using information communication technology (ICT) as being cost-effective and timesaving it is of great importance to focus on and examine consumers’ experiences. It is important that it is user friendly and regarded as valuable and useful.Aim: The aim of this study was to describe consumers’ subjective experiences of using electronic resources with reference to health and illness.Design and/or method: A systematic literature search was performed in databases CINAHL, Medline and Cochrane, as well as a manual search. Retrieved references (n = 14) were appraised according to their scientific structure and quality. A broad search was performed in order to find as many different applications as possible. Our primary intention was to identify existing references describing consumers’ experiences with ICT.Results: In spite of this broad search few references were found. Twelve references remained and three themes were identified: support and help, education and information, and telecommunication instead of on-site visiting. Consumers felt more confident and empowered, their knowledge increased and their health status improved due to the ICT resources. Lack of face-to-face meetings or privacy did not appear to be a problem.Conclusion: ICT can improve the nurse–patient relationship and augment well-being for consumers. More research is needed to measure consumers’ experiences and factors that influence it.
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