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PubMed2000

Dissemination of the use of the electronic patient record in high-quality workmanship: the regional IT consultant for primary care doctors.

The number of general practitioners in Denmark with electronic patient record systems is rising. More than 80% of all GP practices now have computerised patient record systems. These medical practices communicate electronically with hospitals, laboratories, pharmacies and county councils. With the procurement of electronic patient record systems and connection to the Danish Healthcare Data Network, the vast majority of patient data in medical practices is now held in electronic form. This offers good opportunities for the data to be used not just in the consultation situation but for quality development and the monitoring of quality targets in general practice as well. However, the individual medical practices do not utilise the opportunities presented to them by their computer systems. The Quality Development Committee in Funen County Council has therefore set up an IT consultant scheme to provide guidance and instruction in the various computer systems found in general practice today, in order to optimise the use of data for quality monitoring.

Computer Literacy↗
PubMedDate not supplied

Children and computers: new technology--old concerns.

Computer technology has ushered in a new era of mass media, bringing with it great promise and great concerns about the effect on children's development and well-being. Although we tend to see these issues as being new, similar promises and concerns have accompanied each new wave of media technology throughout the past century: films in the early 1900s, radio in the 1920s, and television in the 1940s. With the introduction of each of these technologies, proponents touted the educational benefits for children, while opponents voiced fears about exposure to inappropriate commercial, sexual, and violent content. This article places current studies on children and computers in a historical context, noting the recurrent themes and patterns in media research during the twentieth century. Initial research concerning each innovation has tended to focus on issues of access and the amount of time children were spending with the new medium. As use of the technology became more prevalent, research shifted to issues related to content and its effects on children. Current research on children's use of computers is again following this pattern. But the increased level of interactivity now possible with computer games and with the communication features of the Internet has heightened both the promise of greatly enriched learning and the concerns related to increased risk of harm. As a result, research on the effects of exposure to various types of content has taken on a new sense of urgency. The authors conclude that to help inform and sustain the creation of more quality content for children, further research is needed on the effects of media on children, and new partnerships must be forged between industry, academia, and advocacy groups.

Adolescent↗
PubMed2001

Electronic medical records: the family practice resident perspective.

BACKGROUND AND OBJECTIVES: Few studies have included family practice residents' perceptions regarding the use of electronic medical records (EMR) in a residency program. This study determined residents' perceptions of EMR systems and what variables influenced those perceptions. Specifically, we studied how EMR training and previous computer background influenced resident perception of difficulty in EMR implementation, time efficiency, preventive care opportunities, accuracy of medical records, and desired future use of EMR systems. Questions targeted the use of the EMR in the resident continuity clinic. METHODS: Survey questionnaires about the use of EMR systems in the residents' continuity clinic were mailed to residency directors and residents of 219 family practice residency programs. Respondents were given the opportunity to comment on benefits of and concerns about EMR. RESULTS: Resident response rate was 46% in programs using EMR systems. Findings revealed that the length of EMR training a resident received was unrelated to the perceived adequacy of training but was related to the residents' assessment of the difficulty of implementing the EMR in their continuity clinic. Residents who perceived training to be adequate and perceived a relative ease of implementing the EMR were more likely to perceive the EMR to be beneficial and were more likely to choose the EMR over traditional paper records for future use. Computer background/experience was not related to perceived satisfaction with the EMR, nor was it related to perceived difficulty of implementation, adequacy of training, or anticipated future use of an EMR system. CONCLUSIONS: Although residents recognize the benefits of the EMR, our study demonstrates an overall ambivalence and frustration toward EMR systems currently in use in family practice residency continuity clinics. However, the training they receive regarding EMR use in their residency may influence not only the perceived ease of EMR implementation but attitudes regarding the ability of the EMR to assist them with preventive opportunities, time management, and medical record accuracy. This may in turn have influence on the use of EMR systems in their practices after residency.

Attitude of Health Personnel↗
PubMed2001

Proofs of the necessity of medical informatics for the physicians in Bulgaria.

It is obvious that medical practice needs to sustain a radical quality change due the fast penetration of information technologies in medicine and healthcare. One of the major problems of this change is the adequate education of the medical specialists to use these information and communication technologies, including Hospital information systems and electronic medical records. A study has been carried out among the physicians in Bulgaria. The aim of the study was to check weather the Bulgarian physicians are ready to face the challenges of modern information technologies in their daily medical practice. The results show that although 97.5% of the Bulgarian physicians have a positive attitude to information technologies and 86.7% recognise the need of using computers in medicine, 84.1% of them do not have the necessary skills and knowledge to use computers in their daily medical practice. They are absolutely unaware what the electronic medical record might contribute to their practice. Their knowledge of the subject, principles and methods of medical informatics tends to nil. The study was the first of the kind carried out in Bulgaria. It proved our initial hypothesis that Bulgarian physicians need to be educated not only how to use computers, they are in badly need of education in medical informatics. The study proved that the adequate education in medical informatics is one of the most important parameters for the implementation of information technologies, especially electronic medical records in medical practice. Its result may form the background for the preparation of the strategy of teaching medical informatics in Bulgaria. The first step of the implementation of this strategy is to include medical informatics in the regular curriculum of students of medicine.

Attitude to Computers↗
PubMed2001

An adaptive medical e-learning environment: the MEDIDACTE project.

Most e-learning systems offer the same tools and resource materials to students who are different in terms of motivations, training backgrounds, technical skills and learning objectives. Adaptive systems development is a challenge intended to improve the efficiency of these systems. This communication presents the design and implementation of an adaptive medical e-learning environment. The authors describe the MEDIDACTE architecture developed in three levels namely, the educational resource, educational project and user level. Current MEDIDACTE implementation and integration in Marseille Medical University curriculum are presented.

Computer Literacy↗
PubMedDate not supplied

A study of factors related to the use of online resources by nurse educators.

A descriptive cross-sectional survey was used to collect data from nurse educators related to the use of online electronic resources for scholarly pursuits. The 35-question survey was divided into 4 sections, Environment, Stressor, Utilization, and Demographics information. Two open-ended questions were also included to allow respondents to elaborate on factors that they believed facilitated or detracted from use of online resources but were not adequately covered in the survey. Data were received from 489 respondents who were faculty members currently teaching in 1 of 38 colleges or universities located in the 6 New England states offering a minimum of a baccalaureate degree in nursing. Quantitative and qualitative data analysis revealed that many of the same issues, previously reported as deterrents to the use of computers, also play a significant role in preventing the use of online resources. The two open-ended questions provided clarification of facilitators and detractors to use of online resources and were used to understand better the quantitative results. Based on the findings of this study, recommendations for administrators, educators, staff developers, and technical support personnel are discussed.

Attitude to Computers↗
PubMed2001

Attitudes of academic-based and community-based physicians regarding EMR use during outpatient encounters.

Physician satisfaction with EMR implementations has been reported in a number of recent studies. Most of these have reported on implementation of an EMR in a uniform practice setting rather than comparing satisfaction with implementation between settings. Our objectives in this study were to: 1) compare and contrast the attitudes of academic-based and community-based primary care physicians toward EMR use 6 months after implementation, and 2) investigate some of the factors influencing their attitudes toward the EMR implementation. Although physicians in both settings regularly use computers, the academic-based physicians use computers for a wider range of activities. Both groups endorse improvements in quality and communication as well as concern over rapport with the patient and privacy. There is considerable discrepancy between the two settings in ratings of the impact on workflow, with the community-based physicians being much more positive about the EMR. Factors that may account for this discrepancy may include overall expectations of computer systems as well as different rates of adaptation to use of the system.

Academic Medical Centers↗
PubMed2002

Evaluation of web-based dental CE courses.

Various organizations offer online continuing dental education (CDE) courses. While previous investigations focused on objective measures to determine the quality of the courses, this exploratory study evaluates the participants' experience with them. We surveyed 436 past course participants from nine online CDE courses (courses provided by six organizations) regarding their experience with the courses taken. Our analysis of the 169 responses (38.8 percent response rate) focuses on how the participants of online CDE courses can be characterized; whether the participants' expectations were met by the courses; how the participants evaluated the content of the courses; why they enrolled; and the participants' experience of the online environment. The results suggest that online CDE courses partially meet the needs and expectations of dental professionals. The lack of communication with peers and instructors as well as the fact that courses appeared outdated were main reasons for dissatisfaction. Most of the participants accomplished their goals of gaining new knowledge and deepening their understanding of the subject. Based on this evaluation, future courses can be tailored to meet more closely the expectations and needs of dental professionals.

Adult↗
PubMedDate not supplied

Developing an outcomes management program in a public health department.

A local public health department planned and implemented a comprehensive outcomes management program over a 5-year period. Critical components included commitment of leadership and staff, collaborative decision-making related to clinical record software selection, extensive staff training and support in documentation and automation, and ongoing evaluation. This successful program now provides reliable and valid quantitative outcomes data for the department.

Computer Literacy↗
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↗
PubMed2002

In search of evidence: family practitioners' use of the Internet for clinical information.

PURPOSE: The aim of the study was to determine the extent of use of the Internet for clinical information among family practitioners in New Zealand, their skills in accessing and evaluating this information, and the ways they dealt with patient use of information from the Internet. METHOD: A random sample of members of the Royal New Zealand College of General Practitioners was surveyed to determine their use of the Internet as an information source and their access to MEDLINE. They were asked how they evaluated and applied the retrieved information and what they knew about their patients' use of the Internet. Structured interviews with twelve participants focused in more depth on issues such as the physicians' skills in using MEDLINE and in evaluating retrieved material, their searches for evidence-based information, their understanding of critical appraisal, their patients' use of the Internet, and the ways they handle this use. RESULTS: More than 80% (294/363) of members in the sample completed and returned the questionnaire. Of these, 48.6% reported that they used the Internet to look for clinical information. Gender and age were more significant in determining use than practice type or location. Information was primarily sought on rare diseases, updates on common diseases, diagnosis, and information for patients. MEDLINE was the most frequently accessed source. Search skills were basic, and abstracts were commonly used if the full text of an item was not readily available. Most reported that up to 10% of patients bring information from the Internet to consultations. Both Internet users and non-Internet users encouraged patients to search the Web. Internet users were more likely to recommend specific sites. CONCLUSIONS: Practitioners urgently need training in searching and evaluating information on the Internet and in identifying and applying evidence-based information. Portals to provide access to high-quality, evidence-based clinical and patient information are needed along with access to the full text of relevant items.

Adult↗