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There are constraints embedded in medical record structure that limit use by patients in self-directed disease management. Through systematic review of the literature from a critical perspective, four characteristics that either enhance or mitigate the influence of medical record structure on patient utilization of an electronic patient record (EPR) system have been identified: environmental pressures, physician centeredness, collaborative organizational culture, and patient centeredness. An evaluation framework is proposed for use [...]

Qualitative studies can help us understand the "successes" and "failures" of telemedicine to normalize within clinical service provision. This report presents the development of a robust conceptual model of normalization processes in the implementation and development of telemedicine services.

Limited information is available on personal digital assistant (PDA) use patterns in medical settings. Recognizing that use patterns may be important considerations for development of handheld-based information systems, the authors characterized PDA use at their institution. A survey was mailed to all internal medicine physicians at the Mayo Clinic, Rochester, Minnesota, in May 2002. PDA use prevalence, user demographics, hardware preferences, and work setting and application use frequencies were assessed [...]

Few previous studies evaluating the benefits of diagnostic decision support systems have simultaneously measured changes in diagnostic quality and clinical management prompted by use of the system. This report describes a reliable and valid scoring technique to measure the quality of clinical decision plans in an acute medical setting, where diagnostic decision support tools might prove most useful.

The 2002 Olympic Winter Games were held in Utah from February 8 to March 16, 2002. Following the terrorist attacks on September 11, 2001, and the anthrax release in October 2001, the need for bioterrorism surveillance during the Games was paramount. A team of informaticists and public health specialists from Utah and Pittsburgh implemented the Real-time Outbreak and Disease Surveillance (RODS) system in Utah for the Games in just seven [...]

(1) To evaluate preliminary effects of a computerized support system on congruence between patients' reported symptoms and preferences and those addressed in the patient consultation and (2) to investigate the system's ease of use, time requirements, and patient satisfaction.

The EAV/CR framework, designed for database support of rapidly evolving scientific domains, utilizes metadata to facilitate schema maintenance and automatic generation of Web-enabled browsing interfaces to the data. EAV/CR is used in SenseLab, a neuroscience database that is part of the national Human Brain Project. This report describes various enhancements to the framework. These include (1) the ability to create "portals" that present different subsets of the schema to users [...]

The aim of this study was to determine whether physician offices located in high-minority and low-income neighborhoods have different levels of access to information technology than offices located in lower-minority and higher-income areas.