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At least 343 records · Page 19Linked to original sources

IT-adoption and the interaction of task, technology and individuals: a fit framework and a case study.

BACKGROUND: Factors of IT adoption have largely been discussed in the literature. However, existing frameworks (such as TAM or TTF) are failing to include one important aspect, the interaction between user and task. METHOD: Based on a literature study and a case study, we developed the FITT framework to help analyse the socio-organisational-technical factors that influence IT adoption in a health care setting. RESULTS: Our FITT framework ("Fit between Individuals, Task and Technology") is based on the idea that IT adoption in a clinical environment depends on the fit between the attributes of the individual users (e.g. computer anxiety, motivation), attributes of the technology (e.g. usability, functionality, performance), and attributes of the clinical tasks and processes (e.g. organisation, task complexity). We used this framework in the retrospective analysis of a three-year case study, describing the adoption of a nursing documentation system in various departments in a German University Hospital. We will show how the FITT framework helped analyzing the process of IT adoption during an IT implementation: we were able to describe every found IT adoption problem with regard to the three fit dimensions, and any intervention on the fit can be described with regard to the three objects of the FITT framework (individual, task, technology). We also derive facilitators and barriers to IT adoption of clinical information systems. CONCLUSION: This work should support a better understanding of the reasons for IT adoption failures and therefore enable better prepared and more successful IT introduction projects. We will discuss, however, that from a more epistemological point of view, it may be difficult or even impossible to analyse the complex and interacting factors that predict success or failure of IT projects in a socio-technical environment.

Anxiety↗

Cardiological database management system as a mediator to clinical decision support.

An object-oriented medical database management system is presented for a typical cardiologic center, facilitating epidemiological trials. Object-oriented analysis and design were used for the system design, offering advantages for the integrity and extendibility of medical information systems. The system was developed using object-oriented design and programming methodology, the C++ language and the Borland Paradox Relational Data Base Management System on an MS-Windows NT environment. Particular attention was paid to system compatibility, portability, the ease of use, and the suitable design of the patient record so as to support the decisions of medical personnel in cardiovascular centers. The system was designed to accept complex, heterogeneous, distributed data in various formats and from different kinds of examinations such as Holter, Doppler and electrocardiography.

Cardiovascular Diseases↗

Medical informatics training programme to support the Romanian Health Care Management Information System.

The Health Management Information System (HMIS) project initiated by the Ministry of Health as a component of the healthcare reform is aiming to ensure the technical, functional and operative support for: i) a better overview of the population health status, of the medical care needs and of the Health System performances; ii) the improvement of the resource allocation and consumption; iii) reform support. This system is supposed to assure a better information flow from the lower to the upper levels of the healthcare network by help of a modern IT support. In the first development stage the system is planned to link the Ministry of Health with the 41 District Health Authorities (DHAs) and with more than 200 pilot health units. The implementation of such a large system raises serious problems of acceptability and a thorough training programme for both technical staff and end users must be considered in order to face this challenge.

Computer Literacy↗

Medical informatics: the substantive discipline behind health care computer systems.

The computer is rapidly becoming an interactive workstation for medical research and for clinical decision-making and it has become a preferred instrument for communication and documentation throughout health care. However, when the attempt is made to use the rigid conventions of information processing to impose order on the characteristically volatile and unpredictable phenomena encountered in the clinical setting, deep seated logical issues are uncovered. This challenge has generated the new field of Medical Informatics, one major goal of which is to formulate computer logics that can properly relate the idealized descriptions of disease, the rules for medical practice and the general guidelines for health care to the intricate diversities encountered in the care of individual patients. The Integrated Academic Information Management System (IAIMS) program of the National Library of Medicine provides the most ambitious environment for research in this new endeavor.

Expert Systems↗

Semantically assisted medical bibliographic retrieval: an experimental computer system.

An experimental computer-based bibliographic retrieval system has been implemented to explore how semantic (conceptual) relationships between MeSH terms might assist the retrieval process. To construct the experimental system's database, lists of abstracts were produced using MEDLINE. Each list contained papers discussing a specified pair of terms. Each abstract was then analyzed to determine the specific relationship(s) between the two terms discussed in that paper. The project then explored how these semantic relationships could be incorporated into the computer to enhance bibliographic retrieval.

Information Systems↗

Technology architecture guidelines for a health care system.

Although the demand for use of information technology within the healthcare industry is intensifying, relatively little has been written about guidelines to optimize IT investments. A technology architecture is a set of guidelines for technology integration within an enterprise. The architecture is a critical tool in the effort to control information technology (IT) operating costs by constraining the number of technologies supported. A well-designed architecture is also an important aid to integrating disparate applications, data stores and networks. The authors led the development of a thorough, carefully designed technology architecture for a large and rapidly growing health care system. The purpose and design criteria are described, as well as the process for gaining consensus and disseminating the architecture. In addition, the processes for using, maintaining, and handling exceptions are described. The technology architecture is extremely valuable to health care organizations both in controlling costs and promoting integration.

Computer Systems↗

Managed care and health information networks.

Communication and data exchange among existing health information systems is becoming increasingly important in the health care industry. In a managed care environment, the focus is on delivering value by providing consumers access to high-quality health care at reasonable cost. This article explains how the use of a health information network in the managed care system, which links all related entities, improves the quality of health care by allowing access to critical data on demand and decreases the cost of delivery by enhancing communication among managed care providers.

Computer Communication Networks↗

Advanced computer applications in radiology: clinical applications.

Computers play a major role in bridging the gap between image generation and patient care by providing enhanced images that better meet the needs of referring physicians. Spiral computed tomography allows generation of three-dimensional images that are not affected by motion artifact. Volume rendering, a three-dimensional reconstruction algorithm, yields images free of computer-generated artifacts and superior in quality. Currently, technologic computer advances play an important role in three clinical areas: orthopedic applications, oncologic applications, and prosthetic design. Three-dimensional imaging is especially valuable in fracture assessment because it allows exploration of image data to define the location of fracture fragments, the integrity of the joint space, and any possible displacement. With three-dimensional imaging, the extent of tumor spread into adjacent soft tissue or involvement of blood vessels can be determined, even in difficult anatomic areas. Volume rendering and increased computer speed allow greatly improved treatment planning for radiation therapy and custom design of orthopedic prostheses. Through the mutual understanding of goals between physicians and computer scientists, the computer can reach its full potential in medicine, resulting in improved patient care.

Diagnostic Imaging↗

Computational models of oral and craniofacial development, growth, and repair.

This paper illustrates how biological and clinical problems stimulate research in biomedical informatics and how such research contributes to their solution. The computational models described use techniques from Logic Programming, Machine Learning, Computer Vision, and Biomathematics. They address problems in the development, growth, and repair of oral and craniofacial tissues arising in cell biology, clinical genetics, and dentistry. At the micro-level, the dynamic interaction of cells in the oral epithelium is modeled. At the macro-level, models are constructed of either the craniofacial shape of an individual or the craniofacial shape differences within and between healthy and congenitally abnormal populations. In between, in terms of scale, there are models of normal dentition and the use of computerized expert knowledge to guide the design of dental prostheses used to restore function in partially edentulous patients.

Adult↗

[The role of the biostatistician in biomedical research].

Medical research projects that involve any aspect of the collection, summarization, analysis and/or interpretation of clinical quantitative information require statistical support. This input may be provided by the clinicians themselves if properly trained, but is most appropriately and commonly achieved by a relationship with a biostatistician. The biostatistician can be an assistant, a consultant, or a colleague co-investigator. The role of the biostatistician in the research endeavor is one that is partially dictated by the nature of this relationship, but also is one that has evolved considerably in the recent past. This paper reviews the role of the biostatistician in terms of the potential contribution to the research, with special attention to the evolution of this role in light of the fast changes in computation and in statistical methodology. Finally, a method for biostatistical critical appraisal of the biomedical literature is proposed.

Biometry↗

Computers: getting started.

Because there is not much written about computer application in the emergency department you will frequently find yourself reading about applications in other areas. It is up to you to apply this information in the emergency setting. This makes you pioneers, in search of a new and better tomorrow. Our future is not yet written. It is waiting on you and your creative ideas to keep the wagon rolling. Don't let the new territory of informatics, hardware hardships, and foreign computer languages get you down. Accept informatics as just another challenge, like the many we have faced successfully in the past. Use these resources and your expertise in emergency nursing to create innovative informatic systems.

Emergency Nursing↗

Computational and experimental identification of C. elegans microRNAs.

MicroRNAs (miRNAs) constitute an extensive class of noncoding RNAs that are thought to regulate the expression of target genes via complementary base-pair interactions. To date, cloning has identified over 200 miRNAs from diverse eukaryotic organisms. Despite their success, such biochemical approaches are skewed toward identifying abundant miRNAs, unlike genome-wide, sequence-based computational predictions. We developed informatic methods to predict miRNAs in the C. elegans genome using sequence conservation and structural similarity to known miRNAs and generated 214 candidates. We confirmed the expression of four new miRNAs by Northern blotting and used a more sensitive PCR approach to verify the expression of ten additional candidates. Based on hypotheses underlying our computational methods, we estimate that the C. elegans genome may encode between 140 and 300 miRNAs and potentially many more.

Algorithms↗