Search

Many see the role of health informatics research as informing the development and implementation of information technology in clinical practice. The aim of this study is to see if this role is realized in the ongoing implementation of a large-scale health information system in central Norway. By doing a document analysis of the planning documents for the implementation, we assess to what extend evidence from the scientific community is explicitly referenced and used in the implementation planning. We found that evidence available is not explicitly used, and that evidence required is not widely available.

This paper reports on the experiences with establishing a multidisciplinary healthcare informatics research community at the Norwegian University of Science and Technology (NTNU) in Trondheim, Norway. A multidisciplinary research group in healthcare informatics must maintain strong connections to computer science, social science, biomedicine and healthcare researchers. Those organizing the research must create a milieu that fosters true collaboration across disciplines. The researchers must have good access to healthcare institutions, to healthcare professionals as well as to patients. A healthcare informatics laboratory creates an arena for experiments as well as for validation of health-it technologies.

Large wall-mounted screens placed at locations where health personnel pass by will assist in self-coordination and improve utilisation of both resources and staff at hospitals. The sensitivity level of the information visible on these screens must be adapted to a close-to-public setting, as passers-by may not have the right or need to know anything about patients being treated. We have conducted six informal interviews with health personnel in order to map what kind of information they use when identifying their patients and their next tasks. We have compared their practice and needs to legislative requirements and conclude that it is difficult, if not impossible, to fulfil all requirements from all parties.

The Internet is nowadays a powerful medium and can help patients to become better-informed citizens. Increasingly, citizens are searching for health information on the Internet. The Internet-based resource often acts as a virtual healthcare professional. The effectiveness of the communication between the patient and the virtual healthcare professional depends partly upon the presence of contextual information. The issue here is to what extent the contextualization of information is needed for effective information seeking and for the person's understanding of the retrieved/received information. The impact of contextualization on information search also closely relates to the person's cognitive resources. Using a theoretical communication framework (Te'eni 2001), we explore contextualization in a health website, and discuss the above issues and the possible relevance of contextualized information on the informed patient.

Objectives: An inherent part of nurses' work is to handle nurse calls that often cause challenging interruptions to ongoing activities. In situations when nurses are interrupted by a nurse call, they need to decide whether to continue focusing on the task at hand or to abort and respond to the nurse call. The difficult decision is often influenced by a number of factors and can have implications for patient safety and quality of care. The study investigates how technology could be designed to support nurses' handling of nurse calls by allowing patients to communicate a more contextualised message revealing their intention to the nurse when issuing a nurse call.Methods: Through a qualitative methodology employing a scenario-based design approach, three different nurse call system concepts are evaluated by nurses from different departments of a Norwegian university hospital.Results: Nurses find the uncertainty of not knowing the reason behind a nurse call stressful in situations where they are required to prioritise either the calling patient or a patient they are currently nursing. Providing information about a patient's intention behind a nurse call influences the nurse's decision to various degrees depending on the situation in which they find themselves and the information that is communicated. The nurses' reflections suggested that the message communicated should be designed to contain neither too little nor too much information about the patient's needs.Conclusions: A nurse call system that allows nurses to discern the reason behind a nurse call allows them to make a more accurate decision and relieves stress. In particular, the information communicated would reduce uncertainty and lessen nurses' dependence on other factors in their decision. The design of such a system should, however, carefully consider the needs of the department in which it is deployed. [ABSTRACT FROM AUTHOR]

In the context of patients communicating about their disease, there are several channels along which this can be done. Most of these channels do not take the patient as primary input, but provide authoritative information. The Narrator system supplies patients with information extracted from personal stories in plain text format called "narratives". These will be processed and stored using techniques from both Information Retrieval and Natural Language Processing. As such, the system will be set up as a toolbox implementing different approaches while a Service Oriented Architecture provides the framework for integration. In this paper such approaches are described together with efforts to combine them within a suitable architecture. Furthermore, some of the important implementation details are discussed. As a starting point for the system, experiments have been carried out with initial narratives, the results of which are discussed. [ABSTRACT FROM AUTHOR]

The recognition that restructuring care processes is central to effective and efficient health care will result in the emergence of process-oriented electronic patient records (EPRs). How will these technologies come into being? Within informatics, it is often stated that to informate something, we should first model it. This paper queries whether a detailed modeling of work processes and data flows is the primary step that needs to be completed before such EPRs can be developed or tailored. Building upon a sociotechnical understanding of ICT development, we argue for a reinterpretation of ‘models’ in such development processes. We do so through a reverse engineering of parts of the paper-based medical record, which has received little attention in medical informatics. In process-oriented EPR design, we argue, modeling should not be conceived as the crucial first step in this design, but rather as an intervention in the organizational change-processes that constitute proper ICT development. [Copyright &y& Elsevier]

Presents the Synapses approach to sharing based on a standardized shared record, the Federated Healthcare Record, which is implemented in an open and flexible manner using the Common Object Request Broker Architecture (CORBA). Architecture proposed by the Technical Committee 251 of the European Committee for Standardization; Electronic healthcare records; health informatics.

Abstract: Introduction: In surgical work there is a need for ‘continuous planning’ among staff to handle the frequently occurring variations from the planned patient treatment. In this paper, we present how three hospital information systems have support for three common patient trajectory variations. Purpose: Highlight how deviations from a plan cause different information needs and implications for design of awareness supporting computer systems. Methods: Participant observations and semi-structured interviews with stakeholders involved in peri-operative work. Results: When trajectories progress according to plan, information needs of staff seem to be minimal, as everything is “running to plan”. However, when variations occur the information need increases. In order to provide better support for variations, awareness-support systems need to inform colleagues and other stakeholders about deviations from the plan. Plans and trajectories also need to be connected by projecting estimations of incidental time of ongoing relevant events. Additionally, end-users should have the option to switch between information-sparse and information-rich computer support. [Copyright &y& Elsevier]