Jeeyae Choi

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Improving the human readability of Arden Syntax medical logic modules using a concept-oriented terminology and object-oriented programming expressions.

Medical logic modules are a procedural representation for sharing task-specific knowledge for decision support systems. Based on the premise that clinicians may perceive object-oriented expressions as easier to read than procedural rules in Arden Syntax-based medical logic modules, we developed a method for improving the readability of medical logic modules. Two approaches were applied: exploiting the concept-oriented features of the Medical Entities Dictionary and building an executable Java program to replace Arden Syntax procedural expressions. The usability evaluation showed that 66% of participants successfully mapped all Arden Syntax rules to Java methods. These findings suggest that these approaches can play an essential role in the creation of human readable medical logic modules and can potentially increase the number of clinical experts who are able to participate in the creation of medical logic modules. Although our approaches are broadly applicable, we specifically discuss the relevance to concept-oriented nursing terminologies and automated processing of task-specific nursing knowledge.

Explorative Analyses of Nursing Research Data

As a first step of pursuing the vision of “Big Data science in nursing,” we described the characteristics of nursing research data reported in 194 published nursing studies. We also explored how completely the Version 1 metadata specification of biomedical and healthCAre Data Discovery Index Ecosystem (bioCADDIE) represents these metadata. The metadata items of the nursing studies were all related to one or more of the bioCADDIE metadata entities. However, values of many metadata items of the nursing studies were not sufficiently represented through the bioCADDIE metadata. This was partly due to the differences in the scope of the content that the bioCADDIE metadata are designed to represent. The 194 nursing studies reported a total of 1,181 unique data items, the majority of which take non-numeric values. This indicates the importance of data standardization to enable the integrative analyses of these data to support Big Data science in nursing.

Developing a Web-Based Nursing Practice and Research Information Management System: A Pilot Study.

Many hospital information systems have been developed and implemented to collect clinical data from the bedside and have used the information to improve patient care. Because of a growing awareness that the use of clinical information improves quality of care and patient outcomes, measuring tools (electronic and paper based) have been developed, but most of them require multiple steps of data collection and analysis. This necessitated the development of a Web-based Nursing Practice and Research Information Management System that processes clinical nursing data to measure nurses’ delivery of care and its impact on patient outcomes and provides useful information to clinicians, administrators, researchers, and policy makers at the point of care. This pilot study developed a computer algorithm based on a falls prevention protocol and programmed the prototype Web-based Nursing Practice and Research Information Management System. It successfully measured performance of nursing care delivered and its impact on patient outcomes successfully using clinical nursing data from the study site. Although Nursing Practice and Research Information Management System was tested with small data sets, results of study revealed that it has the potential to measure nurses’ delivery of care and its impact on patient outcomes, while pinpointing components of nursing process in need of improvement.

A workflow-oriented framework-driven implementation and local adaptation of clinical information systems: a case study of nursing documentation system implementation at a tertiary rehabilitation hospital.

Health information systems are often designed and developed without integrating users’ specific needs and preferences. This decreases the users’ productivity, satisfaction, and acceptance of the system and increases the necessity for a local adaptation process to reduce the unwanted outcomes after implementation. A workflow-oriented framework developed in a previous study indicates that users’ needs and preferences could be incorporated into the system when implementation follows the steps of the framework, eventually increasing satisfaction with and usefulness of the system. The overall goal of this study was to demonstrate application of the workflow-oriented framework to the implementation of a nursing documentation system at Spaulding Rehabilitation Hospital. In this case study, we present specific steps of implementing and adapting a health information system at a local site and raise critical questions that need to be answered in each step based on the workflow-oriented framework.