Documentation of work ability data in occupational health records.

BACKGROUND: In Finland, patient health records are structured in the same way. Patient data entries are grouped using national headings and each data entry must have at least one heading. AIMS: To determine the use of national headings for the documentation of work ability data and to gather the experience of professionals on usefulness, ease of use and usability of national headings in occupational health services (OHSs). METHODS: An electronic questionnaire and a semi-structured themed interview were used to collect data. Data were analysed using SPSS Statistics 24 and interview material was analysed by deductive content analysis using ATLAS.ti. RESULTS: A total of 359 people completed the questionnaire. Most of the work ability data were documented using the headings history, plan and current status. More than half of respondents felt that using national headings improved quality and allowed greater control. Almost all respondents thought that learning to use national headings was easy. During the interviews (n = 19), all respondents felt that use of national headings improved the quality of documentation. However, more than half stated that national headings were not well suited to documentation of work ability data. CONCLUSION: These results can be used to develop national documentation standards, as well as electronic health records, to support healthcare professionals' interactions with working-age patients. Earlier studies of national headings in OHSs were not found.

Methods for Addressing Technology-induced Errors: The Current State.

OBJECTIVES: The objectives of this paper are to review and discuss the methods that are being used internationally to report on, mitigate, and eliminate technology-induced errors. METHODS: The IMIA Working Group for Health Informatics for Patient Safety worked together to review and synthesize some of the main methods and approaches associated with technology- induced error reporting, reduction, and mitigation. The work involved a review of the evidence-based literature as well as guideline publications specific to health informatics. RESULTS: The paper presents a rich overview of current approaches, issues, and methods associated with: (1) safe HIT design, (2) safe HIT implementation, (3) reporting on technology-induced errors, (4) technology-induced error analysis, and (5) health information technology (HIT) risk management. The work is based on research from around the world. CONCLUSIONS: Internationally, researchers have been developing methods that can be used to identify, report on, mitigate, and eliminate technology-induced errors. Although there remain issues and challenges associated with the methodologies, they have been shown to improve the quality and safety of HIT. Since the first publications documenting technology-induced errors in healthcare in 2005, we have seen in a short 10 years researchers develop ways of identifying and addressing these types of errors. We have also seen organizations begin to use these approaches. Knowledge has been translated into practice in a short ten years whereas the norm for other research areas is of 20 years.

Patient-Centred Coordinated Care in Times of Emerging Diseases and Epidemics. Contribution of the IMIA Working Group on Patient Safety.

OBJECTIVES: In this paper the researchers describe how existing health information technologies (HIT) can be repurposed and new technologies can be innovated to provide patient-centered care to individuals affected by new and emerging diseases. METHODS: The researchers conducted a focused review of the published literature describing how HIT can be used to support safe, patient-centred, coordinated care to patients who are affected by Ebola (an emerging disease). RESULTS: New and emerging diseases present opportunities for repurposing existing technologies and for stimulating the development of new HIT innovation. Innovative technologies may be developed such as new software used for tracking patients during new or emerging disease outbreaks or by repurposing and extending existing technologies so they can be used to support patients, families and health professionals who may have been exposed to a disease. The paper describes the development of new technologies and the repurposing and extension of existing ones (such as electronic health records) using the most recent outbreak of Ebola as an example.

Outcomes assessment of the regional health information exchange: a five-year follow-up study.

BACKGROUND: The implementation of a technology such as health information exchange (HIE) through a Regional Health Information System (RHIS) may improve the mobilization of health care information electronically across organizations. There is a need to coordinate care and bring together regional and local stakeholders. OBJECTIVES: To describe how HIE had influenced health care delivery in one hospital district area in Finland. METHOD: Trend analysis was used to evaluate the influence of a regional HIE. We conducted a retrospective, longitudinal study for the period 2004-2008 for the eleven federations of municipalities in the study area. We reviewed statistical health data from the time of implementation of an RHIS. The t-test was used to determine statistical significance. The selected outcomes were the data obtained from the regional database on total appointments, emergency department visits, laboratory tests and radiology examinations, and selected laboratory tests and radiology examinations carried out in both primary care and special health care. RESULTS: Access to HIE may have influenced health care delivery in the study area. There are indications that there is a connection between access to regional HIE and the number of laboratory tests and radiology examinations performed in both primary care and specialized health care, as observed in the decreased frequency in outcomes such as radiology examinations, number of appointments, and emergency department visits in the study environment. The decreased frequencies of the latter suggest an increased efficiency of outpatient care, but we were not able to estimate to what extent the readily available comprehensive clinical information contributed to these trends. CONCLUSION: Outcome assessment of HIE through an RHIS is essential for the success of health information technology (HIT) and as evidence to use in the decision-making process. As health care information becomes more digital, it increases the potential for a strong HIE effect on health care delivery.

Developing and testing instruments for improving cooperation and patient's participation in mental health care.

The main purpose of the project was to develop computerized instruments that could be used by nurses and patients to assess their cooperation and mutual contributions to care. This paper presents a part of the project: the reliability and validity testing phase of a process of instrument development. To test the validity and reliability of the instruments, data were collected with questionnaires from nurses (n = 146) and patients (n = 286). The validity evaluated as construct validity and the reliability evaluated as internal consistency of the instruments were quite good. Construct validity was tested by factor analysis, and internal consistency was tested by Cronbach's alpha coefficient, which varied from 0.69 to 0.79. The instruments, which consisted of a software application that can be operated in a www environment, were meant to be used as tools in the psychiatric nursing context for assessing the cooperation between the nurses and patients and the patient's participation in his/her care. Furthermore, the computer programme can be used as a tool for developing and assessing the patient orientation in nursing.

Evaluation of the outcomes of a multi-professional education programme in health informatics.

A multi-professional continuing education programme on healthcare information systems was designed on the basis of the IMIA WG 1 recommendations for teaching health informatics. This paper presents the outcomes of the education programme on the basis of the participants' (n=19) narrative assessments and a questionnaire. According to the results, the participants were very satisfied with their personal learning outcomes and they felt that the programme content was useful for their duties at work. They regarded that particularly the multi-professional group had given them many ideas and rewarding discussions. The learning arrangements were assessed very successful and the learning methods rewarding. In conclusion we suggest that it is important to include different professions--healthcare and technical--into the same continuing education programmes in health informatics, and to include real life-like team projects. The validity of the results to undergraduate education programmes should be studied.

Nursing informatics in nursing education: a challenge to nurse teachers.

The use of computers in education has become commonplace. In this study with 162 nurse teachers, we found that although most nursing colleges in Finland have the necessary hardware for teaching informatics, teachers are not familiar with the software that is available for nursing education purposes. Teachers also lack confidence in their own abilities to cope with computer-assisted education. The information systems used in practical nursing are often inaccessible to nurse teachers. The teachers themselves say they would regularly need further training in their own computer skills.

Computer literacy in nursing: developing the information technology syllabus in nursing education.

This study has two main purposes: first, to identify and describe the computer skills required in nursing; and second, to find out what should be taught about information technology in nursing education. A three-round Delphi survey was carried out with a panel of experts representing nursing practice, nursing education, nurse students and consumers. The panel showed a consensus of opinion on 71% of the items included in the questionnaire designed for the study. The experts agreed that nurses must know how to use the computer for word-processing purposes, for accessing and using the hospital information system, and for e-mailing. Nurses must also be aware of system security and show a positive attitude towards computers. It is concluded that hospital information systems and nursing informatics should be integrated into laboratory and hospital training.

Computer literacy: expected learning outcomes in nursing studies and the reality.

Information technology has been taught as part of nursing curricula for several years. With computer literacy now a basic requirement in clinical nursing practice, it is important to look more seriously at the standards and methods of teaching information technology at nursing colleges. In this study the objectives of teaching information technology and the content of information technology studies were evaluated by nurse educators (n = 162) and by an expert panel (n = 15). Nurse educators and the expert panel had more or less identical views on what those objectives should be. The quality and outcomes of information technology teaching in nurse education have never been measured in Finland before. In order to find out the consumers' point of view, student nurses were asked to assess their knowledge and skills in computer use. The student nurses (n = 373) felt that they had a reasonable command of the theoretical knowledge in information technology. However, their keyboard skills were confined to the use of word processors.