BackgroundThe health care sector is an area of social and economic interest in several countries; therefore, there have been lots of efforts in the use of electronic health records. Nevertheless, there is evidence suggesting that these systems have not been adopted as it was expected, and although there are some proposals to support their adoption, the proposed support is not by means of information and communication technology which can provide automatic tools of support. The aim of this study is to identify the critical adoption factors for electronic health records by physicians and to use them as a guide to support their adoption process automatically.MethodsThis paper presents, based on the PRISMA statement, a systematic literature review in electronic databases with adoption studies of electronic health records published in English. Software applications that manage and process the data in the electronic health record have been considered, i.e.: computerized physician prescription, electronic medical records, and electronic capture of clinical data. Our review was conducted with the purpose of obtaining a taxonomy of the physicians main barriers for adopting electronic health records, that can be addressed by means of information and communication technology; in particular with the information technology roles of the knowledge management processes. Which take us to the question that we want to address in this work: "What are the critical adoption factors of electronic health records that can be supported by information and communication technology?". Reports from eight databases covering electronic health records adoption studies in the medical domain, in particular those focused on physicians, were analyzed.ResultsThe review identifies two main issues: 1) a knowledge-based classification of critical factors for adopting electronic health records by physicians; and 2) the definition of a base for the design of a conceptual framework for supporting the design of knowledge-based systems, to assist the adoption process of electronic health records in an automatic fashion. From our review, six critical adoption factors have been identified: user attitude towards information systems, workflow impact, interoperability, technical support, communication among users, and expert support. The main limitation of the taxonomy is the different impact of the adoption factors of electronic health records reported by some studies depending on the type of practice, setting, or attention level; however, these features are a determinant aspect with regard to the adoption rate for the latter rather than the presence of a specific critical adoption factor.ConclusionsThe critical adoption factors established here provide a sound theoretical basis for research to understand, support, and facilitate the adoption of electronic health records to physicians in benefit of patients.
Handheld computers are increasingly being used by hospital workers. With the integration of wireless networks into hospital information systems, handheld computers can provide the basis for a pervasive computing hospital environment; to develop this designers need empirical information to understand how hospital workers interact with information while moving around. To characterise the medical phenomena we report the results of a workplace study conducted in a hospital. We found that individuals spend about half of their time at their base location, where most of their interactions occur. On average, our informants spent 23% of their time performing information management tasks, followed by coordination (17.08%), clinical case assessment (15.35%) and direct patient care (12.6%). We discuss how our results offer insights for the design of pervasive computing technology, and directions for further research and development in this field such as transferring information between heterogeneous devices and integration of the physical and digital domains.
Objective: This study aims to analyse the number and characteristics of calls made to the Málaga Prehospital Emergency Service (PES) for suicidal behavior based on sociodemographic, temporal, and health care variables.Method: This is a retrospective, descriptive study that records all calls made to the PES due to suicidal behavior (suicide attempts and completed suicides) in 2014. Sociodemographic variables (age, sex, and health district), variables related to the calls (time-slot, degree of sunlight, type of day, month, season of the year, prioritization, and number of resources mobilized) were extracted from these calls. The number of cases and percentages were presented for the qualitative variables. The rates per 100,000 were calculated by sex and health district and presented with the corresponding 95% confidence interval (CI).Results: Of the total valid calls to PES (n = 181,824), 1,728 calls were made due to suicidal behavior (0.9%). The mean age was 43.21 (±18) years, 57.4% were women, and the rate was 112.1 per 100,000 inhabitants. The calls due to suicidal behavior were in the younger-middle age segment, in the time-slot between 16 and 23 h and during daylight hours, on bank holidays, in spring and summer in comparison with winter, and with a peak of calls in August. The majority of these calls were classified as undelayable emergencies and mobilized one health resource.Conclusions: Prehospital emergency services are the first contact to the sanitary services of persons or families with suicide attempts. This information should be a priority to offer a complete overview of the suicide behavior.
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