Biomedical subjects

Christian Nøhr

Publications and source records attributed to Christian Nøhr.

10 recordsLinked to original sources

PubMed2006

Development of methods for usability evaluations of EHR systems.

Developing electronic health record (EHR) systems in Denmark is an on going, iterative process, where also a maturation process for clinical use should be considered. Convincing methodology for collecting and incorporating in the soft- and hardware knowledge and robustness for the clinical environments is not on hand. A way to involve the clinicians in the development process is conducting usability evaluations. The complexity of the clinical use of the systems is difficult to transmit to a usability laboratory, and due to ethical issues a traditional field study can be impossible to carry out. The aim of this study has been to investigate how it is possible to identify usability problems in an EHR system by combining methods from laboratory tests and field studies. The methods selected for the test design are: the think aloud method, video and screen recording, debriefing, a scenario based on an authentic patient record, and testing on the normal production system. The reliability and validity of the results is increased due to the application of method- and data-triangulation. The results of the usability evaluation include problems in the categories: system response time, GUI-design, functionality, procedures, and error messages. The problems were classified as cosmetic, severe, or critical according to a rating scale. The experience with each method is discussed. It is concluded that combining methods from laboratory test and field study makes it possible to identify usability problems. There are indications that some of the usability problems only occurred due to the establishment of an authentic scenario.

Denmark↗

PubMed2005

Development, implementation and diffusion of EHR systems in Denmark.

The Danish EHR-Observatory has monitored Danish EHR projects for several years with respect to a number of parameters such as diffusion, diffusion rate, barriers and limitations, and experience gained. The results of the 2002 monitoring reveal that investment in IT is relatively low and the diffusion rate is below the estimated level. The EHR projects gain a lot of valuable experience, but the coordination of evaluation results should be improved.

Denmark↗

PubMed2005

Modelling and implementing electronic health records in Denmark.

The Danish Health IT strategy [Danish Ministry of Interior and Health, National Strategy for IT in the Health Sector 2003-2007, Copenhagen, 2003 (in Danish). http://www.im.dk/publikationer/itstrategi/itstrategi.pdf. notes that integration between electronic health records (EHR) systems has a high priority. A prerequisite for real integration and semantic interoperability is agreement of the data content and the information models. The National Board of Health is working on a common model for EHR, and its adoption is now being promoted through pilot projects. At the same time, several development and implementation projects are taking place at a regional level. These EHRs are built on information models from different vendors and are based on different integration platforms. The Danish EHR observatory, which has been monitoring the development of EHRs in Denmark since 1998, has analysed the challenges of using different information models and integration platforms. This paper also maps the development in Denmark to the new paradigms in modelling techniques and integration technology.

Computer Simulation↗

PubMed2005

Quality labelling and certification of electronic health record systems.

The Danish Health IT strategy 2003-2007 demands implementation of Electronic Health Records (EHR) in all Hospitals based on common standards. The aim is to achieve integration and semantic interoperability between different EHR systems in order to support a better communication and coherence between the health care parties. The National Board of Health has developed a common model, which is a prerequisite for the development and implementation of interoperable EHR systems. The adoption of the common EHR model has been promoted and validated through a number of pilot projects in different Hospitals. The Danish EHR Observatory, which has been monitoring the development of EHR in Denmark since 1998, have developed a methodology for Quality labelling and certification of EHR systems. The methodology for certification of EHR systems has been used to validate EHR systems from different vendors to document to which extent the systems are based on the national requirements for EHR.

Certification↗

PubMed2004

Dealing with organizational change when implementing EHR systems.

Over the past years researchers at Aalborg University have been developing a method for examining change readiness of hospital staff during the implementation of new IT-systems. (CRR; Change readiness-research). The aim is to provide the hospital-management with a tool that will lead to an optimal implementation of new IT-systems. The method has recently been used in department Y at Skejby Hospital, Skejby, Denmark. 81% out of 241 employees answered the distributed questionnaire, and the results showed, that the employees have some expectations to the new EHR-system, which are important to either confirm or reject; on the other hand a great part of the employees lack basic computer skills. Thus the CRR-method has provided the Organization with important information before the implementation of the new EHR-system.

Attitude of Health Personnel↗

PubMed2004

Patient opinion--EHR assessment from the users perspective.

Electronic Health Records (EHR) are becoming an integrated part of modern health care. The introduction of EHR in healthcare has been evaluated by many actors and from many perspectives. However, there is hardly any study exploring the opinion of the ultimate users of the system, the patients. This study aims to provide information about patient values and communication that will be useful in the design of a more patient friendly health system. We have asked patients in three different hospitals about their opinions about EHR, using semi structured individual interviews and focus groups. The patients are open to the use of EHR, but they have some concerns: they want their privacy to be respected, and the systems to be safe from the intrusion from outsiders. These results underline the general societal tendencies of citizen accepting the use of new technology, but being very keen to protect their privacy.

Adolescent↗

PubMed2003

Modelling and implementing electronic health records in Denmark.

The Danish Health IT strategy [1] points out that integration between electronic health records (EHR) systems has a high priority. A prerequisite for real integration and semantic interoperability is agreement of the data content and the information models. The National Board of Health is working on a common model for EHR, but it is not yet fully developed. At the same time several development and implementation projects are taking place at a regional level. These EHRs are built on information models from different vendors and are based on different integration platforms. The Danish EHR observatory, which has been monitoring the development of EHRs in Denmark since 1998, have analysed the challenges of using different information models and integration platforms. This paper also reports new tendencies in modelling and integration platforms globally and how this is reflected in the National development.

Denmark↗

PubMed2003

Patient demands and the development of EHR systems.

Patient demands to the development and implementation of electronic health care records (EHR) are rarely considered in professional health informatics societies. This project has investigated the citizens' opinion in Denmark by means of a newly developed methodology "development space". A group of citizens form a lay panel and are briefed on the fundamental issues in the development and strategies for EHR. They confront an expert panel with a number of questions and on the basis of the answers they write a report. The results show that the citizens in the lay panel demanded clear answers to strategic, technical and attitudinal questions. They demonstrated an ability to see through relatively complex relations and formulate multifaceted opinions, which can add valuable input to the development and implementation process of EHR in the professional environments.

Attitude to Computers↗

PubMed2003

Monitoring the development and diffusion of EHR systems in Denmark.

The Danish EHR Observatory has monitored Danish EHR projects for several years with respect to a number of parameters such as diffusion, diffusion rate, barriers and limitations, and experience gained. The results of the 2002 monitoring reveal that investment in IT is relatively low and the diffusion rate is below the estimated level. The EHR projects gain a lot of valuable experience, but the coordination of evaluation results should be improved.

Denmark↗

PubMed2002

A comparative study of EPR projects in Denmark.

The EPR-Observatory--a public funded project organization--has monitored Danish EPR-projects with respect to various parameters such as diffusion and diffusion rate, barriers and limitations, experience gained. Furthermore, the Observatory has aggregated and disseminated the results and has established a constructive dialogue between the Danish EPR projects. The Observatory has also focused in the later years on analysis of common frames of reference for EPR systems. The National Board of Health and some of the larger counties have developed such frames. First generation systems have been implemented in a few counties with moderate coverage, but a number of projects developing second generation systems are making progress, and the market situation is quickly maturing. There are still, however, major problems in the practical implementation of the systems.

Denmark↗