Clinical Computing in a Teaching Hospital

Bleich, Howard L.; Beckley, Robert F.; Horowitz, Gary L.; Jackson, Jerome D.; Moody, Edna S.; Franklin, Caryn; Goodman, Sandra; McKay, Michael W.; Pope, Richard A.; Walden, Timothy; Bloom, Saul M.; Slack, Warner V.

doi:10.1056/nejm198503213121205

Cited by 124 publications

(19 citation statements)

References 20 publications

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“…Early calls for software tools in order to improve accessibility and management of medical information [46] were followed by the development of systems to facilitate not only collecting data but also synthesizing and analyzing outcomes. With the increasing use of PRO data the need for adequate software packages became more urgent.…”

Section: Discussionmentioning

confidence: 99%

The Computer-based Health Evaluation Software (CHES): a software for electronic patient-reported outcome monitoring

Holzner

Giesinger

Pinggera

et al. 2012

BMC Med Inform Decis Mak

152

124

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BackgroundPatient-reported Outcomes (PROs) capturing e.g., quality of life, fatigue, depression, medication side-effects or disease symptoms, have become important outcome parameters in medical research and daily clinical practice. Electronic PRO data capture (ePRO) with software packages to administer questionnaires, storing data, and presenting results has facilitated PRO assessment in hospital settings. Compared to conventional paper-pencil versions of PRO instruments, ePRO is more economical with regard to staff resources and time, and allows immediate presentation of results to the medical staff.The objective of our project was to develop software (CHES – Computer-based Health Evaluation System) for ePRO in hospital settings and at home with a special focus on the presentation of individual patient’s results.MethodsFollowing the Extreme Programming development approach architecture was not fixed up-front, but was done in close, continuous collaboration with software end users (medical staff, researchers and patients) to meet their specific demands. Developed features include sophisticated, longitudinal charts linking patients’ PRO data to clinical characteristics and to PRO scores from reference populations, a web-interface for questionnaire administration, and a tool for convenient creating and editing of questionnaires.ResultsBy 2012 CHES has been implemented at various institutions in Austria, Germany, Switzerland, and the UK and about 5000 patients participated in ePRO (with around 15000 assessments in total). Data entry is done by the patients themselves via tablet PCs with a study nurse or an intern approaching patients and supervising questionnaire completion.DiscussionDuring the last decade several software packages for ePRO have emerged for different purposes. Whereas commercial products are available primarily for ePRO in clinical trials, academic projects have focused on data collection and presentation in daily clinical practice and on extending cancer registries with PRO data. CHES includes several features facilitating the use of PRO data for individualized medical decision making. With its web-interface it allows ePRO also when patients are home. Thus, it provides complete monitoring of patients‘physical and psychosocial symptom burden.

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Section: Discussionmentioning

confidence: 99%

The Computer-based Health Evaluation Software (CHES): a software for electronic patient-reported outcome monitoring

Holzner

Giesinger

Pinggera

et al. 2012

BMC Med Inform Decis Mak

152

124

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“…Our Division of Clinical Informatics at Beth Israel Deaconess Medical Center and Department of Medicine, Harvard Medical School will turn 40 years old in 2010 and has been developing and evolving patient-centered clinical computing systems over that entire timeframe [1] . We have had tightly integrated hospital information systems for 30 years, full EHRs for 20 years and Personal Health Records for 10 years.…”

Section: Safran Division Of Clinical Informatics Beth Israel Deacmentioning

confidence: 99%

Informatics Training for Clinicians Is More Important than Hardware and Software

Safran

2009

Yearb Med Inform

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Objective: The importance of training physicians and nurses in the art, skill and science of clinical informatics has never been greater. What level of training is necessary and sufficient to equip the 21st century healthcare workforce for the transformative opportunity enabled by widespread deployment of EHRs? Methods: Building on the success of its 10x10 program, AMIA with support from the Robert Wood Johnson foundation took its next step to create the necessary documents to have clinical informatics recognized as a sub-specialty by the American Board of Medical Specialties (ABMS). Results: We defined the core content that had to be mastered and describing how physicians interested in the sub-specialty clinical informatics would be trained. The results of this work have been approved by the board of AMIA and have been published in its journal JAMIA. Conclusion: The health challenges of the 21 century require that we rapidly train the clinical workforce in clinical informatics. In addition to buying hardware and software, our health systems need to sponsor this training. Two percent of every Health IT budget should be targeted for clinician education.

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“…Renamed the Beth Israel Deaconess Medical Center following a 1996 merger, the hospital is served by a clinical computing system that stores a variety of administrative and clinical data on inpatient admissions since 1984. 14,15…”

Section: Study Sitementioning

confidence: 99%