Supporting Work Activities in Healthcare by Mobile Electronic Patient Records

Abstract. Supporting work activities in healthcare is highly complex and chal-lenging. This paper outlines the findings from a usability study of a commercial PC based electronic patient record (EPR) system at a large Danish hospital and presents our experiences with the design of a mobile counterpart. First, a num-ber of challenges in relation to the use of traditional desktop-based EPR sys-tems in healthcare were identified. Secondly, a mobile context-aware prototype was designed and implemented, which automatically keeps track of contextual factors such as the physical location of patients and staff, upcoming appoint-ments etc. The usability of the mobile EPR prototype was evaluated in a labora-tory as well as in relation to carrying out real work activities at the hospital. Our results indicate that mobile EPR systems can support work activities in healthcare, but that interaction design of such systems must be carefully thought out and evaluated. Specifically, our findings challenge the view of con-text-awareness being a universally useful paradigm for mobile HCI.

GeoHealth:a location-based service for home healthcare workers

We describe a map-based location-based service ‘GeoHealth ’ for home healthcare workers who attend patients at home within a large geographical area. Informed by field studies of work activities and interviews with care providers, we have designed a mobile location-based service prototype supporting collaboration through information sharing and distributed electronic patient records. The GeoHealth prototype gives the users live contextual information about patients, coworkers, current and scheduled work activities and alarms adapted to their geographical location. The application is web-based and uses Google Maps, Global Positioning System (GPS) and Web 2.0 technology to provide a lightweight, dynamic and interactive representation of the work domain supporting distributed collaboration, communication and peripheral awareness among nomadic workers. Through a user-based evaluation, we found that the healthcare workers were positive towards the use of location-based services in their work, and that the dynamic and interactive geospatial representation of the work domain provided by GeoHealth supported distributed collaboration, communication and peripheral awareness. We also identified areas for improvements

Electronic Health Records: Cure-all or Chronic Condition?

Computer-based information systems feature in almost every aspect of our lives, and yet most of us receive handwritten prescriptions when we visit our doctors and rely on paper-based medical records in our healthcare. Although electronic health record (EHR) systems have long been promoted as a cost-effective and efficient alternative to this situation, clear-cut evidence of their success has not been forthcoming. An examination of some of the underlying problems that prevent EHR systems from delivering the benefits that their proponents tout identifies four broad objectives - reducing cost, reducing errors, improving coordination and improving adherence to standards - and shows that they are not always met. The three possible causes for this failure to deliver involve problems with the codification of knowledge, group and tacit knowledge, and coordination and communication. There is, however, reason to be optimistic that EHR systems can fulfil a healthy part, if not all, of their potential

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Public Health and Epidemiology Informatics: Recent Research and Trends in the United States

Objectives To survey advances in public health and epidemiology informatics over the past three years. Methods We conducted a review of English-language research works conducted in the domain of public health informatics (PHI), and published in MEDLINE between January 2012 and December 2014, where information and communication technology (ICT) was a primary subject, or a main component of the study methodology. Selected articles were synthesized using a thematic analysis using the Essential Services of Public Health as a typology. Results Based on themes that emerged, we organized the advances into a model where applications that support the Essential Services are, in turn, supported by a socio-technical infrastructure that relies on government policies and ethical principles. That infrastructure, in turn, depends upon education and training of the public health workforce, development that creates novel or adapts existing infrastructure, and research that evaluates the success of the infrastructure. Finally, the persistence and growth of infrastructure depends on financial sustainability. Conclusions Public health informatics is a field that is growing in breadth, depth, and complexity. Several Essential Services have benefited from informatics, notably, “Monitor Health,” “Diagnose & Investigate,” and “Evaluate.” Yet many Essential Services still have not yet benefited from advances such as maturing electronic health record systems, interoperability amongst health information systems, analytics for population health management, use of social media among consumers, and educational certification in clinical informatics. There is much work to be done to further advance the science of PHI as well as its impact on public health practice