PubMed Health⌕ Search

PubMed · 16505871

[A new tool for retrieving clinical data from various sources].

Abstract

BACKGROUND: A doctor's tool for extracting clinical data from various sources on groups of hospital patients into one file has been in demand. For this purpose we evaluated Qlikview. MATERIAL AND METHODS: Based on clinical information required by two cardiologists, an IT specialist with thorough knowledge of the hospital's data system (www.dips.no) used 30 days to assemble one Qlikview file. Data was also assembled from a pre-hospital ambulance system. RESULTS: The 13 Mb Qlikview file held various information on 12430 patients admitted to the cardiac unit 26,287 times over the last 21 years. Included were also 530,912 clinical laboratory analyses from these patients during the past five years. Some information required by the cardiologists was inaccessible due to lack of coding or data storage. Some databases could not export their data. Others were encrypted by the software company. A major part of the required data could be extracted to Qlikview. Searches went fast in spite of the huge amount of data. Qlikview could assemble clinical information to doctors from different data systems. Doctors from different hospitals could share and further refine empty Qlikview files for their own use. When the file is assembled, doctors can, on their own, search for answers to constantly changing clinical questions, also at odd hours.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Erik Waage Nielsen, Anders Hovland, Oddgeir Strømsnes. 2006-02-23. [A new tool for retrieving clinical data from various sources].. https://pubmed.ncbi.nlm.nih.gov/16505871/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Cognitive analysis of physicians and nurses cooperation in the medication ordering and administration process.

The objective of this study was to analyse physician-nurse cooperation in the medication ordering and administration process from a cognitive point of view. In this paper, we compared two work organizations characterized by: (1) a synchronous cooperation engendered by common doctor-nurse medical rounds and (2) an asynchronous situation characterized by split physician's and nurse's rounds. Both organizations worked with paper-based documentation systems. We relied on a cooperation cognitive architecture model and used specific methods from cognitive ergonomics to analyse physicians' and nurses' activity, communications and cooperation. The analysis of doctor-nurse dialogues during the medical rounds demonstrated that in the synchronous situation, the nurses actively participated in the medication ordering process. Such dialogues supported the elaboration of shared knowledge in the form of a common frame of reference (COFOR) which both actors rely on to control the entire medication process, and more precisely the coordination of their actions. Document analysis showed that the orders were far from exhaustively documented. However, self-confrontation interviews with the nurses demonstrated that, except for a small number of ill-documented orders, they were able to accurately retrieve the physician's complete intended orders. In this work organization, the nurse was able to control the medication administration process at a high level, because she understood the highest level of strategic control of the medication ordering carried out by the physician. In the asynchronous situation, the results were reversed. The nurses no longer participated in the decision making phase of the medication process. Doctor-nurse communications were rare, and their shared knowledge about the patient was weakened. Although written orders proved to be better documented, the nurses suffered from a lack of knowledge on the patient's medical case and the particular context of the medical decision making when confronted with incomplete or ambiguous orders. In this work organization, the nurse would find herself restrained to low level process control and confined in a reactive, instead of anticipative, management mode. This latter work organization is very similar to the CPOE situation we observed in previous studies, where the coordination of physicians' and nurses' actions was delegated to the system. We suggest that it is essential to take these organizational and cognitive aspects into account when (re-)designing CPOE applications.

Cardiology Service, Hospital↗

Managed Care Network for the assessment of cardiac problems in children in a district general hospital: a working model.

AIM: To assess a model for cardiology assessments in children with suspected heart disease by a general paediatrician with special expertise in paediatric cardiology (PsePC) in a district general hospital. METHODS: A new monthly "screening" clinic was established in May 2004 by the PsePC to reduce the burden of new referrals on outreach tertiary paediatric cardiology services. All patients were to have echocardiograms as part of their referral for cardiac assessment. Over a one year period (May 2004-April 2005), through audit, details of referrers, indications for referral, echocardiography assessments, and subsequent management were recorded. This was compared with the pattern of patients seen in the joint paediatric cardiology outreach clinics over a two year period (May 2003-April 2005). RESULTS: In the "screening" clinic, there were 75 appointments for 65 patients seen in 12 months. Fifty five of these patients had normal echocardiographic studies. Of the 47 referrals with heart murmurs in asymptomatic children, four had structurally abnormal hearts on echocardiographic assessment. Between May-October 2003 and November 2003-April 2004, the number of new patients with normal echocardiographic studies seen in the paediatric cardiology outreach clinic was 33/106 (31%) and 28/110 (25.4%) respectively. Following the introduction of the "screening" clinic, the number decreased to 21/99 (21%) during May-October 2004, and 10/102 (9.8%) during November 2004-April 2005. CONCLUSION: This model can work effectively in order to identify pathology requiring input of a paediatric cardiologist more appropriately. Paediatricians with specific training in paediatric cardiology are potentially well equipped to provide this basic screening service.

Cardiology Service, Hospital↗

Improved compliance with quality measures at hospital discharge with a computerized physician order entry system.

BACKGROUND: Most measures used to assess the quality of care of hospitalized patients with congestive heart failure (CHF) and acute myocardial infarction (AMI) involve discharge medications and instructions. Implementation of disease-specific computerized physician order entry (CPOE) discharge tools may improve compliance with these measures. METHODS: We studied 286 versus 290 AMI and 595 versus 656 CHF discharges in the pre-CPOE (July 2001 to June 2002) and CPOE (October 2002 to September 2003) periods, respectively. Compliance with chosen quality measures (aspirin and beta-blocker use for AMI, ejection fraction determination and discharge instructions for CHF, and angiotensin-converting enzyme inhibitor use, and smoking cessation counseling for both) was assessed. RESULTS: Compliance with recommended discharge medications was high at baseline and did not change significantly. Smoking cessation counseling (43% vs 1% for CHF and 62% vs 21% for AMI) and discharge instructions for CHF (56% vs 3%) improved significantly in the CPOE period. Overall, 63% of patients with CHF and AMI in the CPOE period were discharged using the tools. Compliance with prescription of recommended medications was 100% among eligible patients when CPOE was used; however, this improvement was due entirely to better documentation of contraindications in the CPOE period. The actual proportion of patients who received discharge prescriptions between the pre-CPOE and CPOE periods did not change: beta-blockers (85% vs 84%), angiotensin-converting enzyme inhibitor for AMI (77% vs 76%), and for CHF (56% vs 61%). However, nonmedication measures significantly improved when CPOE was used. CONCLUSIONS: Implementation of a CPOE discharge tool improved compliance with selected quality measures in patients with AMI and CHF. Effective methods of rapid implementation and acceptance of these tools by providers require further study.

Cardiology Service, Hospital↗