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Improving healthcare information systems: A key to evidence based medicine
University of Skövde, School of Informatics. University of Skövde, The Informatics Research Centre. (Informationssystem, Information Systems)ORCID iD: 0000-0001-8957-9853
2015 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Delivering good quality care is a complex endeavor that is highly dependent on patient information and medical knowledge. When decisions about the care of a patient are made, they must, as far as possible, be based on research-derived evidence rather than on clinical skills and experience alone. Evidence based medicine (EBM) is the conscientious and judicious use of current best evidence in conjunction with clinical expertise as well as patient values and preferences to guide healthcare decisions. Following the principles of EBM, healthcare practitioners are required to formulate questions based on patients’ current clinical status, medical history, values and preferences, search the literature for answers, evaluate the evidence for its validity and usefulness, and finally apply the information to the patient. Information systems play a crucial role in the practice of evidence based medicine, by allowing healthcare practitioners to access clinical evidence and information about the patients’ health as they formulate their patient-care strategies. However, current information systems solutions are far from this perspective for various reasons. One of these reasons is that existing information systems do not support a seamless flow of patient information along the patient process. Due to interoperability issues, healthcare practitioners cannot easily exchange patient information from one information system to another and from one healthcare practitioner to another. Consequently, vital information that is stored in separate information systems and which could present a clear and complete picture of the patient cannot be easily accessed. All too often, units have to operate without knowledge of the problems addressed by other healthcare practitioners from other units, the services provided, medications prescribed, or preferences expressed in those previous situations. The practice of EBM is further complicated by current information systems that do not support practitioners in their search and evaluation of current evidence in everyday clinical care.

Based on a qualitative approach, this work aims to find solutions for how future healthcare information systems can support the practice of EBM. By combining existing research on process orientation, knowledge management and evidence based medicine with empirical data, a number of recommendations have been initiated. These recommendations aim to support healthcare managers, IT–managers and system developers in the development of future healthcare information systems, from a process-oriented and knowledge management perspective. By following these recommendations, it is possible to develop information systems that facilitate the practice of evidence based medicine, and improve patient engagement.

Place, publisher, year, edition, pages
Skövde: University of Skövde , 2015. , 80 p.
Series
Dissertation Series, 7
Keyword [en]
Process orientation, Knowledge management, Healthcare, Evidence based medicine
National Category
Information Systems
Identifiers
URN: urn:nbn:se:his:diva-11019Libris ID: 18007581ISBN: 978-91-981474-7-6 OAI: oai:DiVA.org:his-11019DiVA: diva2:818725
Presentation
2015-06-15, G207, Högskolan i Skövde, Skövde, 12:45 (English)
Opponent
Supervisors
Available from: 2015-06-10 Created: 2015-06-09 Last updated: 2016-01-13Bibliographically approved
List of papers
1. Patients' Experiences of Communicating with Healthcare - an Information Exchange Perspective
Open this publication in new window or tab >>Patients' Experiences of Communicating with Healthcare - an Information Exchange Perspective
2011 (English)In: Proceedings of the 15th International Symposium on Health Information Management Research (ISHIMR 2011) / [ed] Bath, P. A., Mettler, T., Raptis, D. A. & Sen, B. A., University of Zurich , 2011, 241-251 p.Conference paper, Published paper (Refereed)
Abstract [en]

Aims: To explore on how patients experience the information exchange with healthcare organizations and how this relates to the six areas that constitute good quality care.Method: A qualitative approach inspired by Grounded Theory was adopted. Seven interviews with patients were carried out in the homes of patients.Conclusion: Healthcare does not always meet the requirements of Health and Medical Services Act with regard to good quality health. An effective exchange of information between health professionals and patients was found as a key issue for creating the conditions for good quality care.

Place, publisher, year, edition, pages
University of Zurich, 2011
Keyword
Good quality health, information exchange, IT in healthcare, patient process
National Category
Computer and Information Science
Research subject
Technology
Identifiers
urn:nbn:se:his:diva-5682 (URN)978-0-9559283-1-4 (ISBN)
Conference
15th International Symposium on Health Information Management Research (ISHIMR 2011)
Available from: 2012-04-04 Created: 2012-04-04 Last updated: 2015-06-10Bibliographically approved
2. Challenges and Opportunities with Information System Support for Healthcare Processes: a Healthcare Practitioner Perspective
Open this publication in new window or tab >>Challenges and Opportunities with Information System Support for Healthcare Processes: a Healthcare Practitioner Perspective
2015 (English)In: Proceedings of the 8th IADIS International Conference Information Systems 2015, IS 2015, 2015, 61-69 p.Conference paper, Published paper (Refereed)
Abstract [en]

Healthcare processes require the cooperation of different healthcare providers and medical disciplines. In such an environment, the quality and safety of care rely heavily on the ability to exchange information from one software to another, and from one person to another. However, information systems that support a seamless flow of information along healthcare processes are not broadly used in healthcare environments. Usually, healthcare organizations have their own autonomously developed information systems that do not support the cooperation of different organizational units and medical disciplines. This has led to the fragmentation of the patients’ information in proprietary heterogeneous systems across healthcare organizations. The aim of this paper is to: (1) explore how healthcare practitioners´ in Sweden experience information system support in their daily work activities, and (2) present and illustrate how key design principles of a process support system prototype can support healthcare practitioners in their work practice. An important conclusion from this research is that a process support as the one described in this paper creates new opportunities to organize and coordinate healthcare

Keyword
Healthcare Processes, Patient Process, Process Support Systems, Information Systems in Healthcare
National Category
Computer and Information Science
Research subject
Technology
Identifiers
urn:nbn:se:his:diva-10822 (URN)2-s2.0-84944097590 (Scopus ID)978-989-8533-33-3 (ISBN)
Conference
8th IADIS International Conference on Information Systems, Madeira, Portugal, 14-16 March, 2015
Projects
Vårdens framtida Informationssystem
Available from: 2015-04-08 Created: 2015-04-08 Last updated: 2016-01-13Bibliographically approved
3. Web-based Knowledge Portals in Swedish Healthcare: Overview and Challenges
Open this publication in new window or tab >>Web-based Knowledge Portals in Swedish Healthcare: Overview and Challenges
2012 (English)In: Scandinavian Conference on Health Informatics 2012 / [ed] Daniel Karlsson, Johan Gustav Bellika, Pia Britt Elberg, Mariann Fossum, Gert Galster, Gunnar Hartvigsen, Sabine Koch, Gunilla Nilsson, Linköping University Electronic Press, 2012, 9-12 p.Conference paper, Published paper (Refereed)
Abstract [en]

Healthcare organizations are increasingly becoming dependent on knowledge management activities to improve the quality of care, to maintain a high level of efficiency and innovation as well as to flexibly adapt to raid change. Utilizing knowledge management support systems - e.g. Internet based knowledge portals - to manage medical information and healthcare knowledge aimed to support the full spectrum of knowledge needs has become an important issue for all healthcare professionals. This paper reports on the main findings from analyzing the characteristics and challenges of 15 Swedish knowledge portals containing healthcare information. The analysis is based on inspection of the portals and interviews with their owners. The main challenges found concern fragmentation of knowledge, structuring of knowledge content, usability, interaction and resources for maintaining knowledge content. Future successful development and use of knowledge portals to disseminate healthcare knowledge depend on addressing these challenges, which requires portal owners to have a long-term strategy as well as a systematic way of working.

Place, publisher, year, edition, pages
Linköping University Electronic Press, 2012
Series
Linköping Electronic Conference Proceeding, ISSN 1650-3686 ; 70
Keyword
Knowledge management, knowledge portal
National Category
Computer and Information Science
Research subject
Technology
Identifiers
urn:nbn:se:his:diva-6914 (URN)978-91-7519-758-6 (ISBN)
Conference
Scandinavian Conference on Health Informatics 2012, October 2–3, Linköping, Sverige
Available from: 2012-12-14 Created: 2012-12-14 Last updated: 2015-06-10Bibliographically approved
4. Supporting Active Patient and Healthcare Collaboration - A Prototype for Future Healthcare Information Systems
Open this publication in new window or tab >>Supporting Active Patient and Healthcare Collaboration - A Prototype for Future Healthcare Information Systems
2013 (English)In: Proceedings of the 16th International Symposium on Health Information Management Research (ISHIMR 2013). Halifax, June 26-28 2013 / [ed] Sibte, Abidi and Bath, 2013, 13-23 p.Conference paper, Published paper (Refereed)
Abstract [en]

This paper presents and illustrates the main features of a proposed process oriented approach for patient information distribution in future healthcare information systems by using a prototype of a process support system. The development of the prototype was based on Visuera method which includes five various steps. The results indicate that a visualised prototype is a suitable tool for illustrating both the opportunities and constraints of future ideas and solutions in eHealth. The main challenges for developing and implementing a fully functional process support system are both on a technical and organisational/management level.

Keyword
e-health services, prototype development, process support systems, process oriented approach, patient centered care
National Category
Computer and Information Science
Research subject
Technology
Identifiers
urn:nbn:se:his:diva-8557 (URN)
Conference
16th International Symposium on Health Information Management Research (ISHIMR 2013), Halifax, Canada, June 26-28, 2013
Available from: 2013-10-21 Created: 2013-10-21 Last updated: 2015-06-10Bibliographically approved
5. Supporting evidence based medicine: A prototype for future healthcare information systems
Open this publication in new window or tab >>Supporting evidence based medicine: A prototype for future healthcare information systems
2015 (English)In: Information Systems 2015: Proceedings of the 8th IADIS International Conference, 2015, 185-195 p.Conference paper, Published paper (Refereed)
Abstract [en]

The primary and basic component of healthcare is information. Being a healthcare practitioner involves using medical knowledge and patient information to deliver the best possible care. When decisions about the care of the patient are made they must as far as possible be based on research-derived evidence rather than on clinical skills and experience alone. This decision process is complex as evidence is infrequently available in a form that can be acted upon at the time decisions must be made. The aim of this paper is to present and illustrate how a prototype visualization of a process support system can support the availability of relevant medical knowledge in a way which seamlessly integrates with healthcare practitioners work practice, and thereby enables healthcare practitioners to work in accordance with EBM. An important conclusion from this research is that a process support as the one described in this paper can reshape the practice of EBM

National Category
Information Systems
Research subject
Humanities and Social sciences
Identifiers
urn:nbn:se:his:diva-10930 (URN)2-s2.0-84944096721 (Scopus ID)978-989-8533-33-3 (ISBN)
Conference
8th IADIS International Conference on Information Systems 2015, 14–16 March, Madeira, Portugal
Projects
Medical decision support, Process Support Systems, Process Oriented Approach, Knowledge
Available from: 2015-05-12 Created: 2015-05-12 Last updated: 2016-01-13Bibliographically approved

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