Defining and Testing EMR Usability: Principles and Proposed Methods of EMR Usability Evaluation and Rating

For more information about the Information Experience Laboratory, visit http://ielab.missouri.edu/Electronic medical record (EMR) adoption rates have been slower than expected in the United States, especially in comparison to other industry sectors and other developed countries. A key reason, aside from initial costs and lost productivity during EMR implementation, is lack of efficiency and usability of EMRs currently available. Achieving the healthcare reform goals of broad EMR adoption and “meaningful use” will require that efficiency and usability be effectively addressed at a fundamental level. We conducted a literature review of usability principles, especially those applicable to EMRs. The key principles identified were simplicity, naturalness, consistency, minimizing cognitive load, efficient interactions, forgiveness and feedback, effective use of language, effective information presentation, and preservation of context. Usability is often mistakenly equated with user satisfaction, which is an oversimplification. We describe methods of usability evaluation, offering several alternative methods for measuring efficiency and effectiveness, including patient safety. We provide samples of objective, repeatable and cost‐efficient test scenarios applicable to evaluating EMR usability as an adjunct to certification, and we discuss rating schema for scoring the results. (42 pages

New Perspectives on Electric Vehicles

Modern transportation systems have adverse effects on the climate, emitting greenhouse gases and polluting the air. As such, new modes of non-polluting transportation, including electric vehicles and plug-in hybrids, are a major focus of current research and development. This book explores the future of transportation. It is divided into four sections: “Electric Vehicles Infrastructures,” “Architectures of the Electric Vehicles,” “Technologies of the Electric Vehicles,” and “Propulsion Systems.” The chapter authors share their research experience regarding the main barriers in electric vehicle implementation, their thoughts on electric vehicle modelling and control, and network communication challenges

ECO-CHIP: Estimation of Carbon Footprint of Chiplet-based Architectures for Sustainable VLSI

Decades of progress in energy-efficient and low-power design have successfully reduced the operational carbon footprint in the semiconductor industry. However, this has led to an increase in embodied emissions, encompassing carbon emissions arising from design, manufacturing, packaging, and other infrastructural activities. While existing research has developed tools to analyze embodied carbon at the computer architecture level for traditional monolithic systems, these tools do not apply to near-mainstream heterogeneous integration (HI) technologies. HI systems offer significant potential for sustainable computing by minimizing carbon emissions through two key strategies: ``reducing" computation by reusing pre-designed chiplet IP blocks and adopting hierarchical approaches to system design. The reuse of chiplets across multiple designs, even spanning multiple generations of integrated circuits (ICs), can substantially reduce embodied carbon emissions throughout the operational lifespan. This paper introduces a carbon analysis tool specifically designed to assess the potential of HI systems in facilitating greener VLSI system design and manufacturing approaches. The tool takes into account scaling, chiplet and packaging yields, design complexity, and even carbon overheads associated with advanced packaging techniques employed in heterogeneous systems. Experimental results demonstrate that HI can achieve a reduction of embodied carbon emissions up to 70\% compared to traditional large monolithic systems. These findings suggest that HI can pave the way for sustainable computing practices, contributing to a more environmentally conscious semiconductor industry.Comment: Under review at HPCA2

Design and Development of Simulation-based Instruction on Meaningful Use and Interprofessionalism Core Competencies in a Healthcare Team-based Learning Environment

Policymakers and electronic health records (EHR) experts agree that healthcare professionals lack proficiency in meaningful use of EHRs. This competency gap can result in increased medical errors. It is essential for health professions graduates to acquire skill sets that are adaptable to any electronic health information technologies including the EHRs to facilitate work process and information access. Simulation as an instructional method to create transformative learning experiences has shown promise in the medical profession. In simulations, learners are able to engage in real-life scenarios and practice their cognitive, affective, and psychomotor skills in a safe environment. The goal was to design and develop a simulation-based instructional module on meaningful use of EHR and interprofessional collaborative practice core competencies and evaluate students’ performance and satisfaction under an inter professional teambased setting. Using a design and development research approach, a simulation-based instructional module on meaningful use of EHR and interprofessional core competencies was designed. An internal validation of the module was conducted with an expert panel of medical professionals and instructional designers. Following validation, the instructional module was developed and pilot tested with a group of 21 second- and third year health professions students in medicine, pharmacy, and nursing in an interprofessional team-based learning environment. Students’ performance on meaningful use and interprofessionalism core competencies and their satisfaction during the simulation-based training were evaluated. The results confirmed that the students properly implemented the core competencies based on their performances during the immersive virtual patient encounter in the 3D virtual world. The analysis also showed how the students’ satisfaction was met as a reaction to the guided experiential learning’s (GEL) simulation-based instructional intervention, and in some instances were not sufficiently met. The analysis of the students’ testimonials further confirmed their overall satisfaction with the immersive simulation experience.The findings, based on the feedback from the students and faculty in this pilot implementation, highlighted simulation-based interactive gaming instruction and the hands-on experience in a 3D virtual world guided by GEL as an effective and engaging way to train healthcare professionals in the preparation to deliver care in a safe and effective manner under interprofessional team-based settings for better patient safety and outcome

Space benefits: The secondary application of aerospace technology in other sectors of the economy

Over 580 examples of the beneficial use of NASA aerospace technology by public and private organizations are described to demonstrate the effects of mission-oriented programs on technological progress in the United States. General observations regarding technology transfer activity are presented. Benefit cases are listed in 20 categories along with pertinent information such as communication link with NASA; the DRI transfer example file number and individual case numbers associated with the technology and examples used; and the date of the latest contract with user organizations. Subject, organization, geographic, and field center indexes are included

Effect of Root Cause Analysis on Pre-Licensure, Senior-Level Nursing Students’ Safe Medication Administration Practices

Aim: The aim of this study was to examine if student nurse participation in root cause analysis has the potential to reduce harm to patients from medication errors by increasing student nurse sensitivity to signal and responder bias. Background: Schools of nursing have traditionally relied on strategies that focus on individual characteristics and responsibility to prevent harm to patients. The modern patient safety movement encourages utilization of systems theory strategies like Root Cause Analysis (RCA). The Patient Risk Detection Theory (Despins, Scott-Cawiezell, & Rouder, 2010) supports the use of nurse training to reduce harm to patients. Method. Descriptive and inferential analyses of the demographic and major study variables were conducted. Validity and reliability assessments for the instruments were performed. The Safe Administration of Medications-Revised Scale (Bravo, 2014) was used to measure sensitivity to signal. The Safety Attitudes Questionnaire (SAQ; Sexton et al., 2006) was used to assess responder bias; this was the first use of this instrument with nursing students. Results: The sample consisted of 125 senior-level nursing students from three universities in the southeastern United States. The SAQ was found to be a valid and reliable test of safety attitudes in nursing students. Further support for the validity and reliability of the SAM-R was provided. A significant difference in safety climate between schools was observed. There were no differences detected between the variables. Conclusion: The results of this study provide support for the use of the SAQ and the SAM-R to further test the PRDT, and to explore methods to improve nursing student ability to administer medications safely