Linkman (2019) A Best Evidence Medical Education (BEME) systematic review of: What works best for health professions students using mobile (hand-held) devices for educational support on clinical placements?
Patient information is one aspect of meeting the needs of health service users; it is meant to empower patients and their carers in making informed decisions and managing their health needs. Mary Dixon-Woods described two types of discourse in patient education: the first is more concerned with making patients comply with their doctors orders and the second is about empowering patients and rejecting direction. This article looks at the aims of the two and shows that neither is capable of supporting highly successful best practice within medicine. Instead, a hybrid set of strategic aims are proposed for patient education created by merging the two discourses in the same way that John Dewey merged the child-centred and child-led schools of thought in education. These hybrid strategic aims for patient education are then used to develop requirements for an information system to support patient education, using a mixture of system centric and user centric approaches.
As modern healthcare shifts towards a patient-centric model, there is an increasing emphasis on teamwork. Legacy healthcare information systems are ill equipped to meet new requirements arising from this change. Many projects have been undertaken to address various aspects of the challenge of supporting patient-centric work. In the UK, development and adoption of a unified electronic patient record (EPR) that serves practitioners across the country is a high priority. This article considers what additional support healthcare teams will require beyond the cross-discipline unified EPR. A system that considers practitioners as part of a patient's care team and which tracks teams and professional roles is proposed and evaluated as a means to provide each practitioner with a view of the EPR appropriate to his/her professional role and to provide improved support for collaboration among team members.
This paper describes the design, implementation and testing of a functional prototype interface which enables primary healthcare teams to access the information system supporting clinical oncology specialists in South Wales, UK. A lack of information sharing has been recognized for some time as a barrier to improving the primary care of cancer patients. This extension to the existing ISCO information system will allow sharing of information about patient management at all levels of cancer patient support (general practitioners, hospital-based clinicians and palliative care teams). The application was designed to allow general practitioners to gain access to the existing system. This will give all healthcare professionals interested in a cancer patient's care the advantage of accessing detailed multiple providers' electronic casenotes in almost real time, thus improving communication of information within a care team. However, no attempt was made to include the much bigger issue of patients and their families or carers in the scope of the project at this stage, as this is an area requiring separate investigation. The pilot also enables general practitioners to determine the information they require and the information they need to be able to communicate with the cancer specialists.
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