Clinical governance, education and learning to manage health information

Purpose – This paper aims to suggest that the concept of clinical governance goes beyond a bureaucratic accountability structure and can be viewed as a negotiated balance between imperfectly aligned and sometimes conflicting goals within a complex adaptive system. On this view, the information system cannot be separated conceptually from the system of governance it supports or the people whose work it facilitates or hinders. Design/methodology/approach – The study, located within the English National Health Service (NHS) between 1999 and 2005, is case study based using a multi method approach to data collection within two primary care organisations (PCOs). The research strategy is conducted within a social constructionist ontological perspective. Findings – The findings reflect the following broad-based themes: mutual adjustment of a plurality of stakeholder perceptions, preferences and priorities; the development of information and communication systems, empowered by informatics; an emphasis on education and training to build capacity and capability. Research limitations/implications – Limitations of case study methodology include a tendency to provide selected accounts. These are potentially biased and risk trivialising findings. Rooted in specific context, their generalisability to other contexts is limited by the extent to which contexts are similar. Reasonable attempts were made to minimise any bias. The diversity of data collection methods used in the study was an attempt to counterbalance the limitations highlighted in one method by strength from alternative techniques. Practical implications – The paper makes recommendations in two key governance areas: education and learning to manage health information. In practice, the lessons learned provide opportunities to inform future approaches to health informatics educational programmes. Originality/value – With regard to topicality, it is suggested that many of the developmental issues highlighted during the establishment of quality improvement programmes within primary care organisations (PCGs/PCTs) are relevant in the light of current NHS reforms and move towards commissioning consortia

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Prescription for nursing informatics in pre-registration nurse education.

Nurses need to be able to use information and communications technology not only to support their own practice, but also to help their patients make best use of it. This article argues that nurses are not currently adequately prepared to work with information and technology through their pre-registration education. Reflecting the lack of nursing informatics expertise, it is recommended that all pre-registration nursing programmes should have access to a nursing informatics specialist. A prescription to meet the informatics needs of the newly qualified nurse is proposed. This places the areas that need to be included in pre-registration education into broad groups that both articulate the competencies that nurses need to develop, and indicate why they are needed, rather than providing context-free checklists of skills. This is presented as a binary scatter chart with two axes, skill to knowledge and technology to information

Sensor, Signal, and Imaging Informatics in 2017.

Objective To summarize significant contributions to sensor, signal, and imaging informatics literature published in 2017.Methods PubMed® and Web of Science® were searched to identify the scientific publications published in 2017 that addressed sensors, signals, and imaging in medical informatics. Fifteen papers were selected by consensus as candidate best papers. Each candidate article was reviewed by section editors and at least two other external reviewers. The final selection of the four best papers was conducted by the editorial board of the International Medical Informatics Association (IMIA) Yearbook.Results The selected papers of 2017 demonstrate the important scientific advances in management and analysis of sensor, signal, and imaging information.ConclusionThe growth of signal and imaging data and the increasing power of machine learning techniques have engendered new opportunities for research in medical informatics. This synopsis highlights cutting-edge contributions to the science of Sensor, Signal, and Imaging Informatics

Investing in People

Foundations have long created programs to provide grants to individuals—most often in the form of fellowships, scholarships, and prizes. Several of these programs have become so prominent that they are now institutions in and of themselves. Consider just a few examples: the Pulitzer Prize, Fulbright Program, and MacArthur "genius" awards. Governments, as well as foundations large and small, fund individual support programs.The Robert Wood Johnson Foundation has generously allowed the authors of this report to examine its portfolio of individual support programs to explore what the authors believe are some of the strategic fundamentals underlying this type of programming that could be applied to future individual support grantmaking. The purpose of this study is to inform those interested in individual support programs about not only some of the strategy considerations underlying this type of grantmaking but what these programs can be expected to achieve—and under what circumstances.

The Electronic Health Record Scorecard: A Measure of Utilization and Communication Skills

As the adoption rate of electronic health records (EHRs) in the United States continues to grow, both providers and patients will need to adapt to the reality of a third actor being present during the visit encounter. The purpose of this project is to provide insight on “best” practice patterns for effective communication and efficient use of the EHR in the clinical practice setting. Through the development of a comprehensive scorecard, this project assessed current status of EHR use and communication skills among health care providers in various clinical practice settings. Anticipated benefits of this project are increased comfortability in interfacing with the EHR and increased satisfaction on the part of the provider as well as the patient. Serving as a benchmark, this assessment has the potential to help guide future health information technology development, training, and education for both students and health care providers

Librarians as Members of Integrated Institutional Information Programs: Management and Organizational Issues

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Addendum to Informatics for Health 2017: Advancing both science and practice

This article presents presentation and poster abstracts that were mistakenly omitted from the original publication

Opening the Black Box: Explaining the Process of Basing a Health Recommender System on the I-Change Behavioral Change Model

Recommender systems are gaining traction in healthcare because they can tailor recommendations based on users' feedback concerning their appreciation of previous health-related messages. However, recommender systems are often not grounded in behavioral change theories, which may further increase the effectiveness of their recommendations. This paper's objective is to describe principles for designing and developing a health recommender system grounded in the I-Change behavioral change model that shall be implemented through a mobile app for a smoking cessation support clinical trial. We built upon an existing smoking cessation health recommender system that delivered motivational messages through a mobile app. A group of experts assessed how the system may be improved to address the behavioral change determinants of the I-Change behavioral change model. The resulting system features a hybrid recommender algorithm for computer tailoring smoking cessation messages. A total of 331 different motivational messages were designed using 10 health communication methods. The algorithm was designed to match 58 message characteristics to each user pro le by following the principles of the I-Change model and maintaining the bene ts of the recommender system algorithms. The mobile app resulted in a streamlined version that aimed to improve the user experience, and this system's design bridges the gap between health recommender systems and the use of behavioral change theories. This article presents a novel approach integrating recommender system technology, health behavior technology, and computer-tailored technology. Future researchers will be able to build upon the principles applied in this case study.European Union's Horizon 2020 Research and Innovation Programme under Grant 68112

The chaotic nature of healthcare information systems: The need for transdisciplinary collaboration

Copyright @ 2013 EMCIS.This paper demonstrates one of the challenges of the healthcare information systems development, namely the chaotic nature of healthcare systems. Although the reliable evidence demonstrating the positive effects of health information systems on safety and quality remains inconclusive (a growing body of research revealing the unintended consequences and potentially error producing effects of health information systems’ implementation. Different arguments from the literature concerning the chaotic nature of healthcare, including but not limited to the nature of patients and disease have been presented. The requirements of new ways of systems design and the need for transdisciplinary dynamic teams within the requirements engineering phase as a start has been discussed. These arguments have been investigated in the context of an exploratory case addressing one of the advanced oncology centres in the US. This paper concludes that there is an important need to rethink healthcare information systems development method, which has to be in a dynamic ongoing manner for some major issues