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PubMed1999

Barriers for dissemination of a national health care data network. A list of recommendations for better dissemination.

Establishment of a Danish Nation-wide Health Care Data Network for exchange of health care related information using standardised EDIFACT messages is agreed between the Danish Government, the Hospital Owners and the GPs organisations. The aim is, within year 2000 in the MedCom project, to reach a level of 66% of all messages between the secondary and primary health sector must be send electronically using EDIFACT. There are many barriers for reaching this goal, and to reveal this barriers an investigation was done, and a list of recommendations are set up. The investigation was based upon literature, interviews and most important a questionnaire among 200 GPs and specialists all over the country. After 6 months where the recommendations have been handled there is seen an increase in communicated messages on 40%, and from January 1999 more than 1.1 mill messages are exchanged each month.

Communication Barriers↗
PubMed1999

Medical informatics in the medical curriculum--when?

Undergraduate teaching of medical informatics (MI) at the Medical School University of Zagreb has been changing its position in the medical curriculum. Nowadays, this subject is positioned in the second year of the medical curriculum. The aim of this paper is to find out what the students of the second year (S2Y) and of the sixth year (S6Y) think about the position of MI in the medical curriculum. The results of students' opinions have shown that MI should be positioned: in the last two years (63% of S2Y, 36% of S6Y), in the middle (11% of S2Y, 21% of S6Y), and at the beginning of the medical curriculum (26% of S2Y, 43% of S6Y). However, analysing this question according to previous experience of the students of both groups, it can be concluded that: the S6Y with more previous experience shift the subject towards the end of the medical curriculum, and the S2Y with more previous experience shift the subject towards the beginning of the medical curriculum. According to our long-term experience and students' opinion, the most relevant MI subjects, any kind of medical application, should necessarily come at the end of the medical curriculum.

Computer Literacy↗
PubMed1999

Clinicians must invest resources when implementing electronic patient records.

Most often the investment in Electronic Patient Records (EPR) is decided upon on the basis of descriptions of all the advantages this new technology will bring. However, most of these advantages from EPR's are only obtainable if the clinicians are motivated to invest their knowledge and resources in this implementation process. This paper proposes a simple method to qualify the decision making process by introducing the "price to pay" concept.

Computer Literacy↗
PubMed2000

Applied medical informatics and computing skills of students, residents, and faculty.

BACKGROUND AND OBJECTIVES: Little is known regarding the applied medical informatics and computing skills of family practice residents and faculty, yet such information is critical when planning a medical informatics curriculum. We conducted a survey at our institution to collect this information. METHODS: An applied medical informatics and computing skills survey was administered to 93 first-year medical students, 42 family practice residents, and 14 family medicine faculty. Responses were compared between groups before and after stratification by age and gender. RESULTS: A total of 92% of students, 100% of residents, and 79% of faculty responded. Faculty had the highest rate of computer ownership (91%), followed by students (86%) and family practice residents (79%). Students and interns had the highest overall confidence using computers, followed by faculty and then senior residents. Faculty, students, and junior residents were significantly more confident than senior residents in their ability to perform several specific tasks, such as conducting a MEDLINE search. Residents perceived lack of money and time as barriers to improving their skills. CONCLUSIONS: Current senior residents may require remedial training to graduate with the computer skills specified in curricular guidelines. While upcoming medical students and interns will demand more advanced training, faculty may not have the skills to provide it.

Adult↗
PubMedDate not supplied

TIQ (Technical IQ)--a survival skill for the new millennium.

Managing in the new technocracy of the new millennium will be challenging but also much more exciting than the work we do now. Twenty years ago, nurse managers weren't held accountable for the level of knowledge about financial outcomes that is expected now. The same will be true for technology. With electronic medical records, innovations in medical treatments, and the impact of the information and technologic revolution on the entire world, the interface between technology assessment, operationalizing technology, and continually upgrading staff to know what the implications of the technology revolution are will be imperative for success. That means that we must influence schools of nursing to include technology in their content now, and to help us prepare this generation of health care leaders to take a full seat at the leadership table to manage these complexities in the future. The success of the leader of the future will be measured by that person's ability to integrate the very complex issues of patient care and technology in a way that makes sense for patients, the organization, and the staff who will be working in a very complex environment. The leader's TIQ will be as important as other intelligences in the next 20 years.

Computer Literacy↗
PubMed2000

Factors associated with successful answering of clinical questions using an information retrieval system.

OBJECTIVES: Despite the growing use of online databases by clinicians, there has been very little research documenting how effectively they are used. This study assessed the ability of medical and nurse-practitioner students to answer clinical questions using an information retrieval system. It also attempted to identify the demographic, experience, cognitive, personality, search mechanics, and user-satisfaction factors associated with successful use of a retrieval system. METHODS: Twenty-nine students completed questionnaires of clinical and computer experience as well as tests of cognitive abilities and personality type. They were then administered three clinical questions to answer in a medical library setting using the MEDLINE database and electronic and print full-text resources. RESULTS: Medical students were able to answer more questions correctly than nurse-practitioner students before and after searching, but both had comparable improvements in the number of correct questions before and after searching. Successful ability to answer questions was also associated with having experience in literature searching and higher standardized test-score percentiles. CONCLUSIONS: Medical and nurse-practitioner students obtained comparable benefits in the ability to answer clinical questions from use of the information retrieval system. Future research must examine strategies that improve successful search and retrieval of clinical questions posed by clinicians in practice.

Adult↗
PubMed2000

Information needs of rural health professionals: a review of the literature.

This review analyzes the existing research on the information needs of rural health professionals and relates it to the broader information-needs literature to establish whether the information needs of rural health professionals differ from those of other health professionals. The analysis of these studies indicates that rural health practitioners appear to have the same basic needs for patient-care information as their urban counterparts, and that both groups rely on colleagues and personal libraries as their main sources of information. Rural practitioners, however, tend to make less use of journals and online databases and ask fewer clinical questions; a difference that correlates with geographic and demographic factors. Rural practitioners experience pronounced barriers to information access including lack of time, isolation, inadequate library access, lack of equipment, lack of skills, costs, and inadequate Internet infrastructure. Outreach efforts to this group of underserved health professionals must be sustained to achieve equity in information access and to change information-seeking behaviors.

Computer Literacy↗
PubMed2000

Introduction of a clinical information system in a regional general state hospital of Athens, Greece.

The introduction of a Clinical Information System (CIS) in a healthcare organisation is a particularly complex process, requiring thorough design and the close co-operation of many key-position people within the organisation. Moreover the whole process is extremely time-consuming. This contribution presents the first phases of such an introduction in a regional state hospital in Greece. During these phases a number of preparatory actions took place in order to establish and set available in the hospital all the necessary infrastructure. Then the CIS was introduced in two pilot clinics, interconnected with the existed administrative system and customised in order to meet the needs of the various clinical departments.

Computer Communication Networks↗
PubMed2000

Physicians' attitudes towards health telematics--an empirical survey.

Telemedical networks and services have received high attention in professional and scientific media in the recent past. In Germany some institutions and few physicians volunteer in experimenting with diverse telemedical service offerings. However, much is speculated but little is known about attitudes and expectations of the majority of physicians in local offices towards this new medium. Therefore we conducted an empirical survey using a random regional sample to poll the respective opinions. Encouraged by a high response rate to our paper questionnaire, we offer as conclusion: that physicians are surprisingly realistic about costs and benefits and can therefore be expected to subscribe as soon as benefits become obvious; that this trend increases with offices being taken over or newly established by younger physicians; and that the establishment of networks of comprehensive care offered by health care professionals from different disciplines is regarded as essential future advantage of telemedical networks.

Adult↗