Catherine K. Craven

Evaluating information prescriptions in two clinical environments

OBJECTIVE The research sought to evaluate whether providing personalized information services by libraries can improve satisfaction with information services for specific types of patients. METHODS Adult breast cancer (BrCa) clinic patients and mothers of inpatient neonatal intensive care unit (NICU) patients were randomized to receive routine information services (control) or an IRx intervention. RESULTS The BrCa trial randomized 211 patients and the NICU trial, 88 mothers. The BrCa trial showed no statistically significant differences in satisfaction ratings between the treatment and control groups. The IRx group in the NICU trial reported higher satisfaction than the control group regarding information received about diagnosis, treatments, respiratory tradeoffs, and medication tradeoffs. BrCa patients posed questions to librarians more frequently than did NICU mothers, and a higher percentage reported using the website. Questions asked of the librarians by BrCa patients were predominantly clinical and focused on the areas of treatment and side effects. CONCLUSIONS Study results provide some evidence to support further efforts to both implement information prescription projects in selected settings and to conduct additional research on the costs and benefits of services.

CAH to CAH: EHR Implementation Advice to Critical Access Hospitals from Peer Experts and Other Key Informants

UNLABELLED The US government allocated

The need for a multidisciplinary team approach to life science workflows

30 billion to implement electronic health records (EHRs) in hospitals and provider practices through policy addressing Meaningful Use (MU). Most small, rural hospitals, particularly those designated as Critical Access Hospitals (CAHs), comprising nearly a quarter of US hospitals, had not implemented EHRs before. Little is known about implementation in this setting. Socio-technical factors differ between larger hospitals and CAHs, which continue to lag behind other hospitals in EHR adoption. OBJECTIVE The main objective is to provide EHR implementation advice for CAHs from a spectrum of experts with an emphasis on recommendations from their peers at CAHs that have undertaken the process. The secondary objective is to begin to identify implementation process differences at CAHs v. larger hospitals. METHODS We interviewed 41 experts, including 16 CAH staff members from EHR teams at 10 CAHs that recently implemented EHRs. We qualitatively analyzed the interviews to ascertain themes and implementation recommendations. RESULTS Nineteen themes emerged. Under each theme, comments by experts provide in-depth advice on all implementation stages including ongoing optimization and use. We present comments for three top themes as ranked by number of CAH peer experts commenting - EHR System Selection, EHR Team, and Preparatory Work - and for two others, Outside Partners/Resources and Clinical Decision Support (CDS)/Knowledge Management (KM). Comments for remaining themes are included in tables. DISCUSSION CAH experts rank the themes differently from all experts, a likely indication of the differences between hospitals. Comments for each theme indicate the specific difficulties CAHs encountered. CAH staffs have little or no EHR experience before implementation. A factor across themes is insufficient system and process knowledge, compounded by compressed implementation schedules. Increased, proactive self-education, via available outside partners and information resources, will mitigate difficulties and aid CAHs in meeting increased CDS requirements in MU Stages 2 and 3.

Academic library monographic acquisitions : Selection of choice's outstanding academic books

Information retrieval for life science research (a broad rubric encompassing many traditional disciplines such as biochemistry, botany, cell biology, and molecular biology [1]) often involves the use of combinations of multiple information resources. Such combinations have been called “workflows” [2, 3] and may include factual databases such as Genbank [4], literature databases such as Entrez-PubMed [5], and analysis tools such as the Basic Local Alignment Search Tool (BLAST) [6]. Information resources can be combined in different ways toward the same goal; varying combinations may produce different results for the same research question. Combinations that produce different results may appear equivalent to a scientifically sophisticated user who lacks knowledge of metadata about the resources that may indicate the possibility of varying results. In addition, a user who pursues only a single combination of resources may not even realize that another combination might produce different results. This studys objective was to compare the results of three intuitively plausible and seemingly similar workflows for retrieving gene function information, with the goal of illustrating the importance of library science in bioinformatics and the need for a multidisciplinary team approach to authoring, vetting, and using life science workflows.

Evidence-based Health Informatics Frameworks for Applied Use.

There are strong indications that academic libraries are acquiring fewer unique titles, prompting the concern that the nation’s library resources are effectively shrinking. This study examines one portion of that concern—the acquisition of particular titles by academic libraries of various sizes. The source for the titles is “Outstanding Academic Books,” as selected by Choice for several years. Holdings are taken from the OCLC/AMIGOS Collection Analysis CD-ROM products. Findings demonstrate that across all subject and for broad subject areas, there have been significant declines in holdings over time and for all groupings of libraries. The changes in holdings over time are not always significant when specific subject areas are measured, however. In general, the concern that has been expressed regarding shrinking library resources is corroborated in this study.

How to teach health IT evaluation: recommendations for health IT evaluation courses

Health Informatics frameworks have been created surrounding the implementation, optimization, adoption, use and evaluation of health information technology including electronic health record systems and medical devices. In this contribution, established health informatics frameworks are presented. Important considerations for each framework are its purpose, component parts, rigor of development, the level of testing and validation its undergone, and its limitations. In order to understand how to use a framework effectively, its often necessary to seek additional explanation via literature, documentation, and discussions with the developers.

Recommendations for health IT evaluation training as a key prerequisite to obtaining evidence

Systematic health IT evaluation studies are needed to ensure system quality and safety and to provide the basis for evidence-based health informatics. Well-trained health informatics specialists are required to guarantee that health IT evaluation studies are conducted in accordance with robust standards. Also, policy makers and managers need to appreciate how good evidence is obtained by scientific process and used as an essential justification for policy decisions. In a consensus-based approach with over 80 experts in health IT evaluation, recommendations for the structure, scope and content of health IT evaluation courses on the master or postgraduate level have been developed, supported by a structured analysis of available courses and of available literature. The recommendations comprise 15 mandatory topics and 15 optional topics for a health IT evaluation course.

Representing clinical communication knowledge through database management system integration

Health—exploring complexity: an interdisciplinary systems approach HEC2016 28 August–2 September 2016, Munich, Germany Eva Grill • Martin Müller • Ulrich Mansmann Springer Science+Business Media Dordrecht 2016 Health is a complex process with potentially interacting components from the molecular to the societal and environmental level. Adequate research designs and data analysis methods are needed to improve our understanding of this complexity, to ultimately derive high quality evidence to inform patients, health professionals, and health policy decision makers. Also, effective patient-centred health care has to address the complexity of health, functioning, and disability, not only by implementing interventions, but also by using information technology that represents the complexity of health care to inform all actors. Given this background, we developed the concept of our conference HEC2016 as an interdisciplinary European event in beautiful Bavaria, in the city of München. Quite ironically this is the place, where William of Ockham, whose ideas of parsimony are the very opposite of complexity, accused of heresy, spent 17 years under the protection of the Bavarian King Ludwig IV. Furthermore, our local public health hero Max von Pettenkofer (1818–1901) contributed a lot to the basic systemic understanding of health, especially the relevance of a healthy environment. Under the joint theme of health as a complex system we joined the activities of five scientific disciplines: Medical Informatics, Medical Biometry, Bioinformatics, Epidemiology and Health Data Management. The mission behind this interdisciplinary effort was to serve as an important scientific forum for the exchange of new ideas and applications to strengthen health sciences on a national and international level. The analysis of health as a complex system opens needed perspectives on a challenging reality: filtering current hypotheses, resolving controversies, and tailoring interventions to the need of the individual within a health system environment. The conference encouraged the dialogue of the disciplines in order to advance our understanding of health and to decrease burden of disease. HEC2016 brought together the annual conferences of the German Association for Medical Informatics, Biometry and Epidemiology (GMDS), the German Society for Epidemiology (DGEpi), the International Epidemiological AssociationEuropean Region (IEA-EEF) and the European Federation for Medical Informatics Association (EFMI, MIE 2016). HEC2016 took place in München, Germany, in the main building of the Ludwig-Maximilians-Universität (LMU) from 28 August to 2 September 2016 under the auspices of the Institute for Medical Information Processing, Biometry and Epidemiology of LMU. The conference received 832 contributions for oral and poster presentation (Table 1). Fourteen percent of them were from outside Europe with the largest group of 10 % from Asia (Table 2). Scientific program committees and reviewers selected 408 submissions as oral contributions and 303 for poster presentations. The program was surrounded by twelve tutorials held by international renowned scientists and covered a broad spectrum from innovative biostatistical and epidemiological methods to tutorials in application of innovative software, scientific writing and data protection issues. Over 50 panel discussions and workshops allowed in-depth exchange of ideas on specific topics and underscored the interactive nature of HEC2016. A special focus of HEC2016 was on the promotion of young scientists from all disciplines whose participation was supported by numerous travel grants. We would like to express our deepest gratitude to all the colleagues who supported us as speakers, committee members and reviewers, lent us a hand before, during and after the conference, gave critical but friendly comments at all stages of the preparations, supported us by providing coffee, audience or Butterbrezen, and specifically to those who submitted contributions to the conference and attended the conference and its many tutorials, lectures and sessions. We extend our gratitude to the Deutsche Forschungsgemeinschaft for generous financial support (grant no. GR 3608/4-1). Last not least we would like to thank our families who allowed us to spend most of our weekends with organizing this conference, to William of Ockham for lending us his razor (from time to time) and to Max von Pettenkofer for guidance. Eva Grill Martin Müller Ulrich Mansmann for the local organizing committee (Tables 1, 2) 123 Eur J Epidemiol (2016) 31:S1–S239 DOI 10.1007/s10654-016-0183-1Original citation: Lim Choi Keung, Sarah Niukyun, Murphy, Paddie, Khan, Mohammed Omar, Perkins, Gavin D., Smith, Christopher and Arvanitis, Theodoros N. (2016) Perspectives of UK community first responders on a national public access defibrillator database. In: HEC 2016 (Health Exploring Complexity: An Interdisciplinary Systems Approach) Conference, Munich, Germany, 28 Aug 2 Sep 2016. Published in: European Journal of Epidemiology, 31 (Supplement 1). S117 (796).

Factors to weigh when considering electronic data collection.

Clinical communication failures are considered the leading cause of medical errors [1]. The complexity of the clinical culture and the significant variance in training and education levels form a challenge to enhancing communication within the clinical team. In order to improve communication, a comprehensive understanding of the overall communication process in health care is required. In an attempt to further understand clinical communication, we conducted a thorough methodology literature review to identify strengths and limitations of previous approaches [2]. Our research proposes a new data collection method to study the clinical communication activities among Intensive Care Unit (ICU) clinical teams with a primary focus on the attending physician. In this paper, we present the first ICU communication instrument, and, we introduce the use of database management system to aid in discovering patterns and associations within our ICU communications data repository.