BMC Medical Informatics and Decision Making

http://www.biomedcentral.com/1472-6947

List of Papers (Total 1,178)

Naturalistic study of guideline implementation tool use via evaluation of website access and physician survey

Background Clinical guidelines support decision-making at the point-of-care but the onus is often on individual users such as physicians to implement them. Research shows that the inclusion of implementation tools in or with guidelines (GItools) is associated with guideline use. However, there is little research on which GItools best support implementation by individual...

Comorbidity study of borderline personality disorder: applying association rule mining to the Taiwan national health insurance research database

Background Borderline personality disorder (BPD) is a complex clinical state with highly polymorphic symptoms and signs. Studies have demonstrated that people with a BPD diagnosis are likely to have numerous co-occurring psychiatric disorders and physical comorbidities. The aim of our study was to obtain further insight about the associations among comorbidities of BPD and to...

Use of information and communication technology and retention of health workers in rural post-war conflict Northern Uganda: findings from a qualitative study

Background Information and communication technologies have become a vital infrastructural asset for use in the retention of rural health workers. However, little is known about the potential influence of ICT use, perceptions of health workers on ICT in healthcare delivery, and contribution of ICT to health care providers’ retention in rural and remote areas in rural post-war and...

Applying openEHR’s Guideline Definition Language to the SITS international stroke treatment registry: a European retrospective observational study

Background Interoperability standards intend to standardise health information, clinical practice guidelines intend to standardise care procedures, and patient data registries are vital for monitoring quality of care and for clinical research. This study combines all three: it uses interoperability specifications to model guideline knowledge and applies the result to registry...

Understanding how primary care practitioners perceive an online intervention for the management of hypertension

Background In order to achieve successful implementation an intervention needs to be acceptable and feasible to its users and must overcome barriers to behaviour change. The Person-Based Approach can help intervention developers to improve their interventions to ensure more successful implementation. This study provides an example of using the Person-Based Approach to refine a...

S2O – A software tool for integrating research data from general purpose statistic software into electronic data capture systems

Background Data capture for clinical registries or pilot studies is often performed in spreadsheet-based applications like Microsoft Excel or IBM SPSS. Usually, data is transferred into statistic software, such as SAS, R or IBM SPSS Statistics, for analyses afterwards. Spreadsheet-based solutions suffer from several drawbacks: It is generally not possible to ensure a sufficient...

Exploring the implementation of an electronic record into a maternity unit: a qualitative study using Normalisation Process Theory

Background To explore the benefits, barriers and disadvantages of implementing an electronic record system (ERS). The extent that the system has become ‘normalised’ into routine practice was also explored. Methods Qualitative semi-structured interviews were conducted with 19 members of NHS staff who represented a variety of staff groups (doctors, midwives of different grades...

Development of an algorithm for determining smoking status and behaviour over the life course from UK electronic primary care records

Background Patients’ smoking status is routinely collected by General Practitioners (GP) in UK primary health care. There is an abundance of Read codes pertaining to smoking, including those relating to smoking cessation therapy, prescription, and administration codes, in addition to the more regularly employed smoking status codes. Large databases of primary care data are...

Secure and scalable deduplication of horizontally partitioned health data for privacy-preserving distributed statistical computation

Background Techniques have been developed to compute statistics on distributed datasets without revealing private information except the statistical results. However, duplicate records in a distributed dataset may lead to incorrect statistical results. Therefore, to increase the accuracy of the statistical analysis of a distributed dataset, secure deduplication is an important...

Testing modes of computerized sepsis alert notification delivery systems

Background The number of electronic health record (EHR)-based notifications continues to rise. One common method to deliver urgent and emergent notifications (alerts) is paging. Despite of wide presence of smartphones, the use of these devices for secure alerting remains a relatively new phenomenon. Methods We compared three methods of alert delivery (pagers, EHR-based...

Influences on teleconsultation project utilization rates: the role of dominant logic

Background This research analyzes teleconsultation from both a mechanistic and complex adaptive system (CAS) dominant logic in order to further understand the influence of dominant logic on utilization rates of teleconsultation projects. In both dominant logics, the objective of teleconsultation projects is to increase access to and quality of healthcare delivery in a cost...

The impact of health information technologies on quality improvement methodologies’ efficiency, throughput and financial outcomes: a retrospective observational study

Background To evaluate whether or not the utilization of Health Information Technologies (HITs) in Quality Improvement Methodologies (QIMs) has impacts on QIMs’ efficiency, throughput and financial outcomes at healthcare organizations and physician practices in the United States. Methods This is a retrospective observational study that was conducted between the years of 2014 and...

Understanding clinical and non-clinical decisions under uncertainty: a scenario-based survey

Background Prospect theory suggests that when faced with an uncertain outcome, people display loss aversion by preferring to risk a greater loss rather than incurring certain, lesser cost. Providing probability information improves decision making towards the economically optimal choice in these situations. Clinicians frequently make decisions when the outcome is uncertain, and...

Time-to-event versus ten-year-absolute-risk in cardiovascular risk prevention – does it make a difference? Results from the Optimizing-Risk-Communication (OptRisk) randomized-controlled trial

Background The concept of shared-decision-making is a well-established approach to increase the participation of patients in medical decisions. Using lifetime risk or time-to-event (TTE) formats has been increasingly suggested as they might have advantages, e.g. in younger patients, to better show consequences of unhealthy behaviour. In this study, the most-popular ten-year risk...

Exploring the impact of word-of-mouth about Physicians’ service quality on patient choice based on online health communities

Background Health care service is a high-credence service and patients may face difficulties ascertaining service quality in order to make choices about their available treatment options. Online health communities (OHCs) provide a convenient channel for patients to search for physicians’ information, such as Word-of-Mouth (WOM), particularly on physicians’ service quality...

Operations research for resource planning and -use in radiotherapy: a literature review

Background The delivery of radiotherapy (RT) involves the use of rather expensive resources and multi-disciplinary staff. As the number of cancer patients receiving RT increases, timely delivery becomes increasingly difficult due to the complexities related to, among others, variable patient inflow, complex patient routing, and the joint planning of multiple resources. Operations...

Integral strategy to supportive care in breast cancer survivors through occupational therapy and a m-health system: design of a randomized clinical trial

Background Technological support using e-health mobile applications (m-health) is a promising strategy to improve the adherence to healthy lifestyles in breast cancer survivors (excess in energy intake or low physical activity are determinants of the risk of recurrence, second cancers and cancer mortality). Moreover, cancer rehabilitation programs supervised by health...

Electronic reminders to facilitate longitudinal care: a mixed-methods study in general practices

Background Longitudinal, patient-centered care represents a challenge for general practitioners (GPs), and in this context, reminder systems can offer targeted support. This study aimed to identify details of such reminders: (1) contents of care addressed, (2) their mode of display in the electronic health record (EHR), (3) their visual appearance, (4) personnel responsibilities...

Assessing the acceptability and feasibility of encounter decision aids for early stage breast cancer targeted at underserved patients

Background Women of low socioeconomic status (SES) diagnosed with early stage breast cancer are less likely to be involved in treatment decisions. They tend to report higher decisional regret and poorer communication. Evidence suggests that well-designed encounter decision aids (DAs) could improve outcomes and potentially reduce healthcare disparities. Our goal was to evaluate...

Understanding the barriers to successful adoption and use of a mobile health information system in a community health center in São Paulo, Brazil: a cohort study

Background Mobile technology to support community health has surged in popularity, yet few studies have systematically examined usability of mobile platforms for this setting. Methods We conducted a mixed-methods study of 14 community healthcare workers at a public healthcare clinic in São Paulo, Brazil. We held focus groups with community healthcare workers to elicit their ideas...

Nurses’ perceptions, acceptance, and use of a novel in-room pediatric ICU technology: testing an expanded technology acceptance model

Background The value of health information technology (IT) ultimately depends on end users accepting and appropriately using it for patient care. This study examined pediatric intensive care unit nurses’ perceptions, acceptance, and use of a novel health IT, the Large Customizable Interactive Monitor. Methods An expanded technology acceptance model was tested by applying stepwise...

A randomized wait-list control trial to evaluate the impact of a mobile application to improve self-management of individuals with type 2 diabetes: a study protocol

Background Management of diabetes through improved glycemic control and risk factor modification can help prevent long-term complications. Much diabetes management is self-management, in which healthcare providers play a supporting role. Well-designed e-Health solutions targeting behavior change can improve a range of measures, including glycemic control, perceived health, and a...

Measuring the operational impact of digitized hospital records: a mixed methods study

Background Digitized (scanned) medical records have been seen as a means for hospitals to reduce costs and improve access to records. However, clinical usability of digitized records can potentially have negative effects on productivity. Methods Data were collected during follow-up outpatient consultations in two NHS hospitals by non-clinical observers using a work sampling...

Feasibility of digital footprint data for health analytics and services: an explorative pilot study

Background As a result of digitalization, data is available about almost every aspect of our lives. Personal data collected by individuals themselves or stored by organizations interacting with people is known as a digital footprint. The purpose of this study was to identify prerequisites for collecting and using digital data that could be valuable for health data analytics and...

Patient and provider acceptance of telecoaching in type 2 diabetes: a mixed-method study embedded in a randomised clinical trial

Background Despite advances in diagnosis and treatment of type 2 diabetes, suboptimal metabolic control persists. Patient education in diabetes has been proved to enhance self-efficacy and guideline-driven treatment, however many people with type 2 diabetes do not have access to or do not participate in self-management support programmes. Tele-education and telecoaching have the...