ABSTRACT
Conversational virtual human (VH) agents are increasingly used to support role-play experiential learning. This project examined whether a Virtual Interactive Training Agent (ViTA) system would improve job interviewing skills in individuals with autism and developmental disabilities (N = 32). A linear mixed model was employed to evaluate adjusted least square mean differences of means scores on the Marino Interview Assessment Scale (MIAS) across different time points. The mean score of MIAS over all questions increased between the first ViTA session and the final face-to-face interview. Participants developed the ability to identify strengths, self-promote, self-advocate, answer situational questions, and respond to behavioral/social questions as measured by multiple evaluations using the MIAS.
Subject(s)
Autistic Disorder/psychology , Autistic Disorder/therapy , Developmental Disabilities/psychology , Developmental Disabilities/therapy , Problem-Based Learning/methods , Virtual Reality Exposure Therapy/methods , Adult , Autistic Disorder/diagnosis , Developmental Disabilities/diagnosis , Employment/psychology , Female , Humans , MaleABSTRACT
OBJECTIVES: Unnecessary duplicate laboratory testing is common and costly. Systems-based means to avert unnecessary testing should be investigated and employed. METHODS: We compared the effectiveness and cost savings associated with two clinical decision support tools to stop duplicate testing. The Hard Stop required telephone contact with the laboratory and justification to have the duplicate test performed, whereas the Smart Alert allowed the provider to bypass the alert at the point of order entry without justification. RESULTS: The Hard Stop alert was significantly more effective than the Smart Alert (92.3% vs 42.6%, respectively; P < .0001). The cost savings realized per alert activation was $16.08/alert for the Hard Stop alert vs $3.52/alert for the Smart Alert. CONCLUSIONS: Structural and process changes that require laboratory contact and justification for duplicate testing are more effective than interventions that allow providers to bypass alerts without justification at point of computerized physician order entry.
Subject(s)
Clinical Laboratory Services/statistics & numerical data , Decision Support Systems, Clinical/economics , Meaningful Use/statistics & numerical data , Medical Records Systems, Computerized/economics , Unnecessary Procedures/statistics & numerical data , Clinical Laboratory Services/economics , Cost Savings , Humans , Meaningful Use/economics , Reminder Systems/economics , Unnecessary Procedures/economicsABSTRACT
Electronic health records (EHRs) offer a number of advantages over the old paper record. They have the potential to improve the quality of patient care, reduce the cost of health care, and expedite the transfer of information. Yet fewer than 20% of hospitals and physician practices now use them. We discuss the advantages of EHRs, reasons for adopting this system, current barriers to the adoption of EHRs, and issues to consider when choosing a system.
