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Biomedical subjects

Sheila Teasdale

Publications and source records attributed to Sheila Teasdale.

11 recordsLinked to original sources
PubMed2005

Identifying and establishing consensus on the most important safety features of GP computer systems: e-Delphi study.

Our objective was to identify and establish consensus on the most important safety features of GP computer systems, with a particular emphasis on medicines management. We used a two-round electronic Delphi survey, completed by a 21-member multidisciplinary expert panel, all from the UK. The main outcome measure was percentage agreement of the panel members on the importance of the presence of a number of different safety features (presented as clinical statements) on GP computer systems. We found 90% or greater agreement on the importance of 32 (58%) statements. These statements, indicating issues considered to be of considerable importance (rated as important or very important), related to: computerised alerts; the need to avoid spurious alerts; making it difficult to override critical alerts; having audit trails of such overrides; support for safe repeat prescribing; effective computer-user interface; importance of call and recall management; and the need to be able to run safety reports. The high level of agreement among the expert panel members indicates clear themes and priorities that need to be addressed in any further improvement of safety features in primary care computing systems.

Decision Support Systems, Clinical↗
PubMed2004

Comprehensive computerised primary care records are an essential component of any national health information strategy: report from an international consensus conference.

In many countries, primary care informatics has developed to the point that it is recognised as an important enabler of quality improvement; this has not occurred to date in the United States. With this conference, we aimed to build an international consensus as to whether primary care has unique characteristics that require an informatics subspecialty; and, if so, to establish the role of primary care informatics in improving patient care, and to enable its recognition in the national strategy.The conference was organised by the primary care informatics working groups of AMIA, EFMI, IMIA and Wonca and took place at Medinfo 2004 in San Francisco. It consisted of two plenary lectures, two small-group work sessions and a panel discussion to summarise the day. It was attended by an international audience of 53 health informaticians, mostly working in primary care. There was consensus among the participants that primary care has many unique characteristics that justify the existence of an informatics subspecialty: primary care informatics (PCI). The conference identified principles and practical examples of: (1) the effective deployment of information technology to underpin the provision of records, communication and access to information; (2) the need to harness the extensive knowledge base about the practice of PCI; and (3) the contribution of the experimental work and theory that underpins the science of PCI. These principles and examples of their practical application were largely derived from the extensive knowledge base which has been built up in countries that have developed PCI over the last one to two decades.

Health Policy↗
PubMed2003

The electronic patient record in primary care--regression or progression? A cross sectional study.

OBJECTIVES: To determine whether paperless medical records contained less information than paper based medical records and whether that information was harder to retrieve. DESIGN: Cross sectional study with review of medical records and interviews with general practitioners. SETTING: 25 general practices in Trent region. PARTICIPANTS: 53 British general practitioners (25 using paperless records and 28 using paper based records) who each provided records of 10 consultations. MAIN OUTCOME MEASURES: Content of a sample of records and doctor recall of consultations for which paperless or paper based records had been made. RESULTS: Compared with paper based records, more paperless records were fully understandable (89.2% v 69.9%, P=0.0001) and fully legible (100% v 64.3%, P < 0.0001). Paperless records were significantly more likely to have at least one diagnosis recorded (48.2% v 33.2%, P=0.05), to record that advice had been given (23.7% vs 10.7%, P=0.017), and, when a referral had been made, were more likely to contain details of the specialty (77.4% v 59.5%, P=0.03). When a prescription had been issued, paperless records were more likely to specify the drug dose (86.6% v 66.2%, P=0.005). Paperless records contained significantly more words, abbreviations, and symbols (P < 0.01 for all). At doctor interview, there was no difference between the groups for the proportion of patients or consultations that could be recalled. Doctors using paperless records were able to recall more advice given to patients (38.6% v 26.8%, P=0.03). CONCLUSION: We found no evidence to support our hypotheses that paperless records would be truncated and contain more local abbreviations; and that the absence of writing would decrease subsequent recall. Conversely we found that the paperless records compared favourably with manual records.

Adult↗
PubMed2003

Moving toward a United States strategic plan in primary care informatics: a White Paper of the Primary Care Informatics Working Group, American Medical Informatics Association.

The Primary Care Informatics Working Group (PCIWG) of the American Medical Informatics Association (AMIA) has identified the absence of a national strategy for primary care informatics. Under PCIWG leadership, major national and international societies have come together to create the National Alliance for Primary Care Informatics (NAPCI), to promote a connection between the informatics community and the organisations that support primary care. The PCIWG clinical practice subcommittee has recognised the necessity of a global needs assessment, and proposed work in point-of-care technology, clinical vocabularies, and ambulatory electronic medical record development. Educational needs include a consensus statement on informatics competencies, recommendations for curriculum and teaching methods, and methodologies to evaluate their effectiveness. The research subcommittee seeks to define a primary care informatics research agenda, and to support and disseminate informatics research throughout the primary care community. The AMIA board of directors has enthusiastically endorsed the conceptual basis for this White Paper.

Humans↗
PubMed2003

Generating information from electronic patient records in general practice: a description of clinical care and gender inequalities in coronary heart disease using data from over two million patient records.

OBJECTIVES: To describe the epidemiology of coronary heart disease (CHD) in England and the activity of primary healthcare teams in managing patients with CHD, and also to demonstrate the utility of computerised patient records in providing access to epidemiological data and data reflecting healthcare activity. DESIGN: A descriptive survey of CHD and related clinical data, recorded using computerised clinical records, entered by primary healthcare teams. Aspects reported include prevalence of CHD, together with additional data reflecting clinical monitoring activity, therapeutic interventions and comorbidity in patients affected by CHD. SETTING: 317 general practices in 23 English primary care trusts (PCTs). DATA ACQUISITION: MIQUEST was used to interrogate 2 252 274 computerised patient records. Data were extracted in the form of sex and age aggregated counts of patients meeting a range of extraction criteria. RESULTS: The observed crude prevalence of CHD is 40.3 per 1000 (males 46.6, females 34.2). A variety of findings are presented relating to the treatment, monitoring and comorbidities of CHD. Significant and systematic gender inequalities are demonstrated to exist in the monitoring and treatment of CHD. CONCLUSIONS: Extraction of data from computerised patient records is a valuable and practicable method of generating information to inform clinicians and National Health Service (NHS) organisations. Systematic gender disparities exist in the care delivered to patients with CHD.

Coronary Disease↗
PubMed2003

Improving the safety features of general practice computer systems.

General practice computer systems already have a number of important safety features. However, there are problems in that general practitioners (GPs) have come to rely on hazard alerts when they are not foolproof. Furthermore, GPs do not know how to make best use of safety features on their systems. There are a number of solutions that could help to improve the safety features of general practice computer systems and also help to improve the abilities of healthcare professionals to use these safety features.

Computer Literacy↗