10,011 research outputs found

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

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    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

    Harmful Freedom of Choice: Lessons from the Cellphone Market

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    This article focuses on the relationship between provider and customer, specifically on the complexity of available contracts in the cellphone market and the ways this complexity might be harmful to consumers. This article aims to elucidate the issues, fleshing them out both as a general phenomenon and as a specific implementation in the cellphone context. The aim is not to provide ultimate solutions, but to show the directions these solutions might take and the difficulties involved

    Strategies for optimizing psychosocial health at work

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    This contribution points out the individual and organizational strategies that can be carried out in order to not to prevent or intervene in the disease but to promote the psychosocial health of employees. Based on the Positive Experiences Model, authors describe two main types of optimizing strategies both at individual and organizational level: 1) preventive optimization strategies, as interventions or actions addressed to the entire population of the organization although nobody has expressed psychosocial distress, and 2) improvement optimization strategies, as interventions addressed to those employees who do not show any psychosocial risk or distress problems, but with some subjective well-being indicators identified as susceptible to be improved. A total of 12 optimization strategies are briefly described. Finally, authors stress the importance of combining both individual and organizational optimization strategies.Esta contribución señala las estrategias individuales y organizacionales que se pueden llevar a cabo con el fin de no de impedir, ni intervenir en la enfermedad, sino para promover la salud psicosocial de los trabajadores. En base a las experiencias positivas modelo, los autores describen dos tipos principales de optimización de las estrategias tanto a nivel individual, como de organización: 1) estrategias de optimización de prevención, como las intervenciones o acciones dirigidas a toda la población de la organización, aunque nadie haya expresado malestar psicosocial, y 2) estrategias de optimización de mejora, como las intervenciones dirigidas a los empleados que no muestran ningún riesgo psicosocial pero con algunos indicadores de bienestar subjetivo identificados como susceptibles de ser mejorados. Se describen brevemente a un total de 12 estrategias de optimización. Por último, los autores destacan la importancia de la combinación de estrategias de optimización, tanto individual como organizacional

    Minimizing Antipsychotic Medication Side Effects in Adults Diagnosed with Mental Illness through Psychoeducation: An Evidence-Based Approach

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    Adherence to antipsychotic medication has demonstrated significant impact in decreasing symptom exacerbation among patients diagnosed with mental illness. Antipsychotic medications have several benefits including the management of psychotic and mood disorders; however, they could cause unwanted medication side effects with metabolic and cardiovascular risks. This issue is one of the commonly linked side effects resulting in nonadherence among mentally ill patients. The purpose of this project was to implement a psychoeducational intervention using the SIMPLE program to address metabolic and cardiovascular risks associated with antipsychotic medications among adult patients diagnosed with mental illness. A sample size of sixteen adult patients completed this project over a four-week period. There was a significant increase in mean healthy lifestyle change score on pre-HPLP II (M = 16.675, SD = ± 2.385) compared to post-test score; HPLP II (M = 21.104, SD = ± 2.287). The findings of this project supports that psychoeducation promotes healthy lifestyle changes among patients prescribed antipsychotic medications. Keywords: psychoeducation, mental illness, antipsychotic medication, metabolic risk

    Personalized neuromusculoskeletal modeling to improve treatment of mobility impairments: a perspective from European research sites

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    Mobility impairments due to injury or disease have a significant impact on quality of life. Consequently, development of effective treatments to restore or replace lost function is an important societal challenge. In current clinical practice, a treatment plan is often selected from a standard menu of options rather than customized to the unique characteristics of the patient. Furthermore, the treatment selection process is normally based on subjective clinical experience rather than objective prediction of post-treatment function. The net result is treatment methods that are less effective than desired at restoring lost function. This paper discusses the possible use of personalized neuromusculoskeletal computer models to improve customization, objectivity, and ultimately effectiveness of treatments for mobility impairments. The discussion is based on information gathered from academic and industrial research sites throughout Europe, and both clinical and technical aspects of personalized neuromusculoskeletal modeling are explored. On the clinical front, we discuss the purpose and process of personalized neuromusculoskeletal modeling, the application of personalized models to clinical problems, and gaps in clinical application. On the technical front, we discuss current capabilities of personalized neuromusculoskeletal models along with technical gaps that limit future clinical application. We conclude by summarizing recommendations for future research efforts that would allow personalized neuromusculoskeletal models to make the greatest impact possible on treatment design for mobility impairments

    Examining College Student Athlete Attitudes Towards Concussion Testing and Reporting Concussions

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    Examining College Student Athlete Attitudes and Behaviors Toward Baseline Neurocognitive Concussion Testing FryK, Anderson, M, Anderson, M, Schatz, P, Elbin, RJ: University of Arkansas, Fayetteville, Arkansas Context: Examining athletes’ attitudes toward concussion diagnosis, management, and treatment can lead to improved multi-faceted management of a concussion injury. Although attitudes towards concussion injuries have been studied, the examination of athletes’ attitudes towards baseline computerized neurocognitive testing is understudied and is warranted. Objective: To examine the relationship between sex, concussion history, and previous exposure to baseline testing on athletes’ perceptions of effort provided during baseline testing and the utility of neurocognitive testing. Methods: College athletes (18-23 years) completing a baseline neurocognitive test (Immediate Post-Concussion Assessment and Cognitive Test: ImPACT) were asked to complete an anonymous 33-item online survey. Survey questions included demographics and inquired about athletes’ effort and utility of baseline and post-concussion neurocognitive testing. A series of chi-square analyses measured the association between sex, concussion history, and previous exposure to baseline testing on effort provided during testing and utility of the test. Level of statistical significance was p \u3c .05. Results: One hundred eighty-two (88 males, 95 females) athletes (M =19.05, SD = 1.15 years) completed the survey. Thirty-eight percent (70/183) reported prior concussion history and 27% (50/182) were first time test takers. Ninety-four percent (172/183) reported providing above average to maximal effort on the baseline test they completed prior to completing the survey. Ninety percent (158/176) and 87% (156/179) of the sample reported that the baseline and post-concussion test results were useful in mitigating premature return to play, respectively. There was no association between sex, concussion history, or previous exposure to baseline testing on reported effort or perceptions of utility for baseline neurocognitive testing (p \u3e .05). Conclusion: The majority of athletes report high effort on baseline neurocognitive testing and recognize the utility of this measure for safe return to play

    Quantitative Methods for Optimizing Patient Outcomes in Liver Transplantation

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    Liver transplantation continues to be the gold standard for treating patients with end-stage liver diseases. However, despite the huge success of liver transplantation in improving patient outcomes, long term graft survival continues to be a major problem. The current clinical practice in the management of liver transplant patients is centered around immunosuppressive multidrug regimens. Current research has been focusing on phenotypic personalized medicine as a novel approach in the optimization of immunosuppression, a regressional math modeling focusing on individual patient dose and response using specific markers like transaminases. A prospective area of study includes the development of a mechanistic computational math modeling for optimizing immunosuppression to improve patient outcomes and increase long-term graft survival by exploring the intricate immune/drug interactions to help us further our understanding and management of medical problems like transplants, autoimmunity, and cancer therapy. Thus, by increasing long-term graft survival, the need for redo transplants will decrease, which will free up organs and potentially help with the organ shortage problem promoting equity and equal opportunity for transplants, as well as decreasing the medical costs associated with additional testing and hospital admissions. Although long-term graft survival remains challenging, computational and quantitative methods have led to significant improvements. In this article, we review recent advances and remaining opportunities. We focus on the following topics: donor organ availability and allocation with a focus on equity, monitoring of patient and graft health, and optimization of immunosuppression dosing.Comment: 2 figures, including a graphical abstrac
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