Improving Antibiotic Resistant Infection Transmission Situational Awareness in Enclosed Facilities with a Novel Interface Design for Tactical Biosurveillance

The implementation of the Electronic Health Record to substantially improve the practice of medicine has not fully reached its projected potential partly due to many barriers to its adoption. There is growing evidence that one of the reasons for the delay in the adoption of EHR has been due to the negative impact of current EHRs on the clinician-patient interaction, clinician workflow and communications. This research studies the usability of the Electronic Health Record for clinicians involved in cardiac care by evaluating various clinician-patient interaction workflows. The aim of the study is to identify inefficiencies by examining the similarities and differences among various clinician-patient interaction workflows. This research is presented as “work in progress”

Examining the Success of a Youth Care Management Information System through the Lenses of Novices

The goal of the research is to evaluate the success of novice end user interactions with a newly developed youth care management information system (YCMIS) that was designed to replace a paper based system managing mentally challenged clients. Delone and McLean’s (1992) framework of information system (IS) success was utilized in the evaluation which predicts the success of the end user interaction by measuring six independent variables; end user’s satisfaction, usage, system quality, information quality, individual impact, and organizational impact. In this study researchers used a semi-structured group interview to collect the data. The interview questions were designed to address the six independent variables measured in the Delone and McLean (1992) success model which are to determine the dependent variable, IS success. In conclusion, the YCMIS system was found to be a success and the interviews also identified unintended organizational value and efficiencies

Best Practices for Implementing Agile Methods: A Guide for Department of Defense Software Developers

Traditional plan-driven software development has been widely used in the government because it\u27s considered to be less risky, more consistent, and structured. But there has been a shift from this approach to Agile methods which are more flexible, resulting in fast releases by working in an incremental fashion to adapt to the reality of the changing or unclear requirements. This report describes the Agile software development philosophy, methods, and best practices in launching software design projects using the Agile approach. It is targeted to Defense Department software developers because they face broad challenges in creating enterprise-wide information systems, where Agile methods could be used most effectively. Though not a panacea, agile methods offer a solution to an important class of problems faced by organizations today. Technology and E-Government

Recognizing patient safety importance through instrument validation on physicians’ assessment of an EHR

Patient safety and high quality patient care are critical concerns for healthcare providers. The Institute of Medicine report suggests medical errors account for up to 98,000 patient deaths each year. Therefore, the US healthcare system is looking to information technology applications as one means of making patient care safer. This paper compares the psychometric properties of the Electronic Health Record Nurse Satisfaction instrument (based on the Health Information Technology Research-based Evaluation Framework) to our study that employed the same instrument but measured clinical physicians\u27 opinions of an EHR to determine if the instrument could be used across domains of users. Our results found the factor analysis and the clustering of the sub-scale items were different. We propose a two-factorial instrument that identifies the following dimensions: System Features/Performance and Data Quality/Accuracy. Another important contribution of this study is that patient safety was identified as a more salient indicator for physicians

An Evaluation of the Usability of a Computerized Decision Support System for Nursing Homes

Background: Computerized decision support systems (CDSSs) have the potential to significantly improve the quality of nursing care of older people by enhancing the decision making of nursing personnel. Despite this potential, health care organizations have been slow to incorporate CDSSs into nursing home practices. Objective: This study describes facilitators and barriers that impact the ability of nursing personnel to effectively use a clinical CDSS for planning and treating pressure ulcers (PUs) and malnutrition and for following the suggested risk assessment guidelines for the care of nursing home residents. Methods: We employed a qualitative descriptive design using varied methods, including structured group interviews, cognitive walkthrough observations and a graphical user interface (GUI) usability evaluation. Group interviews were conducted with 25 nursing personnel from four nursing homes in southern Norway. Five nursing personnel participated in cognitive walkthrough observations and the GUI usability evaluation. Text transcripts were analyzed using qualitative content analysis. Results: Group interview participants reported that ease of use, usefulness and a supportive work environment were key facilitators of CDSS use. The barriers identified were lack of training, resistance to using computers and limited integration of the CDSS with the facility’s electronic health record (EHR) system. Key findings from the usability evaluation also identified the difficulty of using the CDSS within the EHR and the poorly designed GUI integration as barriers. Conclusion: Overall, we found disconnect between two types of nursing personnel. Those who were comfortable with computer technology reported positive feedback about the CDSS, while others expressed resistance to using the CDSS for various reasons. This study revealed that organizations must invest more resources in educating nursing personnel on the seriousness of PUs and poor nutrition in the elderly, providing specialized CDSS training and ensuring that nursing personnel have time in the workday to use the CDSS

Toward Visualization-Specific Heuristic Evaluation

This position paper describes heuristic evaluation as it relates to visualization and visual analytics. We review heuristic evaluation in general, then comment on previous process-based, performance-based, and framework-based efforts to adapt the method to visualization-specific needs. We postulate that the framework-based approach holds the most promise for future progress in development of visualization-specific heuristics, and propose a specific framework as a starting point. We then recommend a method for community involvement and input into the further development of the heuristic framework and more detailed design and evaluation guidelines

Customer relationship management: digital transformation and sustainable business model innovation

[EN] The point of departure for this study is the understanding of customer relationship management (CRM) as a set of technological solutions key for efficient business management, the benefits of which, highlighted by previous works, are presented and defined here as crucial for entrepreneurial success. Of particular interest for this purpose are the existing studies on sustainability, which provide a viable research model to assess and validate the potential effect of each CRM component (sales, marketing, and services) on the three dimensions of sustainability (economic, environmental, and social). Upon confirmation of our hypotheses, the subsequent validation of such model should bring a better understanding of the way in which CRM-related benefits may increase the positive impact of its components on each dimension of sustainability. CRM can hence be considered a sort of Green IT, oriented toward digital transformation and sustainable business model innovation. 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Assessing aetiological overlap between child and adult attention-deficit hyperactivity disorder symptoms in an extended family design

Background Several longitudinal studies have cast doubt on the aetiological overlap between child and adult attention-deficit hyperactivity disorder (ADHD). However, a lack of genetically sensitive data following children across adulthood precludes direct evaluation of aetiological overlap between child and adult ADHD. Aims We circumvent the existing gap in longitudinal data by exploring genetic overlap between maternal (adult) and offspring (child) ADHD and comorbid symptoms in an extended family cohort. Method Data were drawn from the Norwegian Mother, Father and Child Cohort Study, a Norwegian birth registry cohort of 114 500 children and their parents. Medical Birth Registry of Norway data were used to link extended families. Mothers self-reported their own ADHD symptoms when children were aged 3 years; reported children's ADHD symptoms at age 5 years; and children's ADHD, oppositional defiant disorder (ODD), conduct disorder, anxiety and depression symptoms at age 8 years. Genetic correlations were derived from Multiple-Children-of-Twins-and-Siblings and extended bivariate twin models. Results Phenotypic correlations between adult ADHD symptoms and child ADHD, ODD, conduct disorder, anxiety and depression symptoms at age 8 years were underpinned by medium-to-large genetic correlations (child ADHD: rG = 0.55, 95% CI 0.43−0.93; ODD: rG = 0.80, 95% CI 0.46−1; conduct disorder: rG = 0.44, 95% CI 0.28−1; anxiety: rG = 0.72, 95% CI 0.48−1; depression: rG = 1, 95% CI 0.66−1). These cross-generational adult–child genetic correlations were of a comparable magnitude to equivalent child–child genetic correlations with ADHD symptoms at age 5 years. Conclusions Our findings provide genetically sensitive evidence that ADHD symptoms in adulthood share a common genetic architecture with symptoms of ADHD and four comorbid disorders at age 8 years. These findings suggest that in the majority of cases, ADHD symptoms in adulthood are not aetiologically distinct from in childhood

Anxiety sensitivity in adolescence and young adulthood: the role of stressful life events, 5HTTLPR and their interaction.

Background: Cognitive biases have long been hypothesized to influence the development and maintenance of symptoms of internalizing problems. Anxiety sensitivity represents one such bias and refers to sensitivity to the physical and emotional symptoms of anxiety and the belief that these are harmful. Twin studies indicate a role for both environmental and genetic influences on anxiety sensitivity. However, little work has been done specifying environments or genes involved in this phenotype. In light of this, we looked at the association between stressful life events, the serotonin transporter gene polymorphism (5HTTLPR), and anxiety sensitivity in a longitudinal sample of adolescents. Methods: Stressful life events and anxiety sensitivity were measured in over 1,500 individuals at three time points (mean ages 15, 17, and 20 years). 5HTTLPR was genotyped in 1,109 participants. Results: There was consistent evidence for an association between stressful life events and both anxiety sensitivity and change in anxiety sensitivity over time. Although the effect of independent stressful life events was relatively short lived, dependent stressful life events were associated with anxiety sensitivity over time. There was no evidence for a main effect of 5HTTLPR on anxiety sensitivity. 5HTTLPR genotype did not moderate the effect of stressful life events on anxiety sensitivity. Conclusions: The current study extends previous work by showing that stressful life events, independent of the individual, explained change in cognitions associated with anxiety and depression. This effect does not, however, appear to be moderated by genotype