Bibliographie

Précisions des auteurs : un nombre relativement important de nos références bibliographiques est désormais disponible dans les archives ouvertes, les pages de chercheurs dans les sites de leurs universités ou leurs sites personnels. Cependant, nous ne transcrivons pas l’adresse (URL) de ces publications en libre accès pour éviter d’allonger une bibliographie déjà bien fournie et nous invitons les lecteurs à les retrouver avec leur moteur de recherche favori, de préférence spécialisé dans les ..

THE IMPACT OF HEALTH INFORMATION TECHNOLOGY ON FAMILY PHYSICIAN’S PRACTICE PATTERNS: A CROSS-SECTIONAL STUDY USING DATA FROM THE 2007 NATIONAL PHYSICIAN SURVEY

Objective: To evaluate the impact of health information technology on primary care physicians in Canada by the number of medical services and clinical procedures they offer, total direct patient care hours provided, and visit duration. Methods: We used nationally representative data from the 2007 National Physician Survey to examine the extent of Health Information Technology (HIT count and HIT type) on the scope of practice, total direct patient care hours, and length of office visits among family physicians/general practitioners. HIT count is defined as the number of HIT the physician uses and HIT type is categorical variable based on its features. Negative binomial regression models were used to assess the number of medical services and clinical procedures offered. Linear regression models were used to assess the total direct patient care hours and visit duration. Results: Multivariate analyses show a significant increase in the expected mean number of medical services offered, clinical procedures offered, direct patient care hours, and visit duration with each additional HIT the physician uses in his/her practice. The greatest positive impact was found among physicians who uses EMR-Plus HIT for medical services (8.8 percent, p\u3c0.01) and clinical procedures (8.7 percent, p\u3c0.01) when compared to non-HIT users. Physicians were found to increase their time spent per patient visit who use EMR HIT by 7.8 percent (p\u3c0.05) and EMR-Plus HIT by 6.8 percent (p\u3c0.01) when compared to non-HIT users. No significant association was found between the different HIT types physician uses and total direct patient care hours. Conclusion: The use of health information technology is found to be associated with an increase of medical services and clinical procedures offered, and duration of visit. Limited impact of HIT was found to be associated with total direct patient care hours. Further investigation of what components in HIT affects the workflow of family physicians is needed. Overall, careful consideration needs to be taken when investing and implementing HIT in Canada because there may be unintended consequences

A qualitative study of workflow and information systems within Emergency Departments in the UK

Background: Health Information Technology (HIT) has the potential to improve the quality and efficiency of healthcare delivery and reduce costs. However, the integration of HIT into healthcare workflows has experienced a range of issues during its implementation. It can adversely impact healthcare workflows, therefore reducing efficiency and safety in healthcare delivery. As healthcare settings are characterised by its own workflow, an in-depth understanding of the workflows of where the HIT to be implemented is crucial in order to avoid complexities that can arise. As there is a lack of research investigating an overall ED workflow, both clinical and non-clinical processes and practices, this research aims to gain an in-depth understanding of emergency care workflow which includes the work processes and practices of its clinicians and non-clinicians and its information artefacts. Methodology: This research employed a fieldwork case study approach analysing the work processes and practices of clinicians and non-clinicians in the delivery of emergency care. The approach was used in order to capture the situated nature of the ED workflow. The study was conducted in two emergency care settings located in the UK. Data were collected using semi-structured interviews, non-participant observations and documents. A multiple triangulation technique: data triangulation and within-methods triangulation were employed in order to gain an in-depth understanding of the topic. The data were analysed using thematic analysis. Findings: The emergency care workflow consisted of multidisciplinary ED team members’ work processes. These work processes were comprised of collaborative clinical and non-clinical tasks and activities in delivering care treatment governed and defined by time-related activities, organisational rules, exceptions and variability. The workflow was supported by both computerised systems and non-computerised information artefacts, such as non-electronic whiteboards and paper-based records and forms, which needed to be used in conjunction with each other. Additionally, the hybrid implementation had also been utilised to support collaborative work of the clinicians and non-clinicians, hence giving the implication that HIT systems should not be designed as purely technical system focusing on single users, but also as a collaborative work system. Conclusion: An ED workflow consists of interrelated care processes, clinical and non-clinical processes. These processes are executed semi-autonomously by clinicians and non-clinicians and governed by time-related organisational constraints, variable and exception-filled, relying on hybrid information architecture. The architecture presented workflow with a number of integration issues. However, its implementation does not only support the functionalities for the delivery of emergency care processes but also the collaborative practices of the clinicians and non-clinicians

Qu'est-ce que rechercher de l'information ?

Rechercher de l'information dans les bases de données, dans le Web ou même à l'intérieur d'un document, est devenu une activité extrêmement commune dans la « société de l'information ». Autrefois mise en œuvre par des spécialistes, par des professionnels ayant suivi une formation (les documentalistes, les bibliothécaires), elle est aujourd'hui à la portée de tous : de la jeune élève, de l'adolescent, de l'étudiante, de l'adulte ou de la personne âgée, que ce soit dans le cadre académique, professionnel, culturel ou de loisir. comment font-ils ? Quelles sont leurs démarches, leurs difficultés ? Pourquoi procèdent- ils de la sorte ? L'objectif de cet ouvrage est de répondre à ces questions en offrant pour la première fois en langue française un panorama de la recherche internationale sur ces thèmes. Le livre est destiné aux étudiants et aux chercheurs, particulièrement celles et ceux en sciences de l'information et de la communication et en psychologie, qui y trouveront l'ensemble des thématiques, des plus traditionnelles aux plus récentes, les concepts clés, les principales modélisations et la gamme des outils méthodologiques utilisés dans le domaine

A qualitative study of workflow and information systems within Emergency Departments in the UK

Background: Health Information Technology (HIT) has the potential to improve the quality and efficiency of healthcare delivery and reduce costs. However, the integration of HIT into healthcare workflows has experienced a range of issues during its implementation. It can adversely impact healthcare workflows, therefore reducing efficiency and safety in healthcare delivery. As healthcare settings are characterised by its own workflow, an in-depth understanding of the workflows of where the HIT to be implemented is crucial in order to avoid complexities that can arise. As there is a lack of research investigating an overall ED workflow, both clinical and non-clinical processes and practices, this research aims to gain an in-depth understanding of emergency care workflow which includes the work processes and practices of its clinicians and non-clinicians and its information artefacts. Methodology: This research employed a fieldwork case study approach analysing the work processes and practices of clinicians and non-clinicians in the delivery of emergency care. The approach was used in order to capture the situated nature of the ED workflow. The study was conducted in two emergency care settings located in the UK. Data were collected using semi-structured interviews, non-participant observations and documents. A multiple triangulation technique: data triangulation and within-methods triangulation were employed in order to gain an in-depth understanding of the topic. The data were analysed using thematic analysis. Findings: The emergency care workflow consisted of multidisciplinary ED team members’ work processes. These work processes were comprised of collaborative clinical and non-clinical tasks and activities in delivering care treatment governed and defined by time-related activities, organisational rules, exceptions and variability. The workflow was supported by both computerised systems and non-computerised information artefacts, such as non-electronic whiteboards and paper-based records and forms, which needed to be used in conjunction with each other. Additionally, the hybrid implementation had also been utilised to support collaborative work of the clinicians and non-clinicians, hence giving the implication that HIT systems should not be designed as purely technical system focusing on single users, but also as a collaborative work system. Conclusion: An ED workflow consists of interrelated care processes, clinical and non-clinical processes. These processes are executed semi-autonomously by clinicians and non-clinicians and governed by time-related organisational constraints, variable and exception-filled, relying on hybrid information architecture. The architecture presented workflow with a number of integration issues. However, its implementation does not only support the functionalities for the delivery of emergency care processes but also the collaborative practices of the clinicians and non-clinicians