Multidisciplinary user experience of a newly implemented electronic patient record in Ireland: An exploratory qualitative study.

BACKGROUND: Implementation of an Electronic Patient Record (EPR) in a key milestone in the digital strategy of modern healthcare organisations. The implementation of EPR systems can be viewed as challenging and complex. OBJECTIVE: The aim of the study was to investigate user perspectives and experiences of the implementation of an Electronic Medical Record in a major academic teaching hospital, with simultaneous 'go-live' across the whole hospital taking place. METHODS: Focus groups and individual in-depth interviews were conducted with stakeholders and users (n = 105), approximately nine months post-EPR implementation. The study explored EPR users' perceptions using an extended theoretical framework of the DeLone and McLean Information Systems Success Model (2003), which measured information systems, system quality, information quality, service quality, use/perceived usefulness & user satisfaction and net benefits. RESULTS: Staff engagement and satisfaction was high and the EPR is accepted as the new standard way of completing care. There was agreement that the EPR affords transparency, and greater accountability. There was some concern expressed regarding impact of the EPR on interprofessional and patient/provider interactions and communication. Physicians reported the inputting of social history through free text as an issue of concern and time consuming. The Big Bang approach with mandatory conversion was key to the successful adoption of EPR. There was consensus across professional and administrative respondents that there was no appetite to return to paper-based records. CONCLUSION: The successful roll out of the EPR reflects the digital readiness of healthcare providers and organisations. The potential for unintended consequences on work process requires continual monitoring. A key future benefit of the EPR will be the capacity to reach a broader understanding and analysis of variation in processes and outcomes within healthcare organisations. It is clear that skills in data analytics will be needed to mine data successfully.

The NOtizer--a device for the convenient preparation of diazen-1-ium-1,2-diolates.

N-bound diazen-1-ium-1,2-diolates, also known as NONOates or "solid nitric oxide" (NO), have become popular tools in biomedical research since the discovery of NO as a very important multifunctional endogenous messenger. In contrast to other well-known NO donors, NONOates are capable of releasing NO spontaneously in aqueous media. The rate of NO liberation is determined by the molecular structure of the diazeniumdiolate and the pH value and temperature of the medium in which it is dissolved. In this chapter, we introduce a novel device (the NOtizer) for simple and convenient preparation of diazeniumdiolates. It not only enables the user to provide all the necessary conditions for reliable synthesis such as anaerobic conditions and high pressure of NO gas in the translucent reaction chamber but also includes software that records the course of pressure and temperature online and calculates the consumption of NO by the reaction. The plot of the pressure decay shows the user completion of the reaction and allows the user to study kinetic characteristics from synthesis of different NONOates. A brief guide for the synthesis of PYRRO/NO, DEA/NO, PAPA/NO, SPER/NO, and DETA/NO, which are the most widely applied diazeniumdiolates, is presented in this chapter. Finally, characteristics of NONOates that need to be considered concerning analytics and storage are mentioned.