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The full impact of IT in health care has not been realized because of the failure to recognize that (1) the path from availability of applications to the anticipated benefits passes through a series of steps; and (2) progress can be stopped at any one of those steps. As a result, strategies for diffusion, adoption, and use have been incomplete and have produced disappointing results. In this paper, we present [...]

Few instruments are available to measure the performance of intensive care unit (ICU) clinical information systems. Our objectives were: 1) to develop a survey-based metric that assesses the automation and usability of an ICU's clinical information system; 2) to determine whether higher scores on this instrument correlate with improved outcomes in a multi-institution quality improvement collaborative.

Concerned about evidence-based health informatics, the authors conducted a limited pilot survey attempting to determine how many IT evaluation studies in health care are never published, and why. A survey distributed to 722 academics had a low response rate, with 136 respondents giving instructive comments on 217 evaluation studies. Of those studies, half were published in international journals, and more than one-third were never published. Reasons for not publishing (with [...]

Hyperglycemia worsens clinical outcomes in critically ill patients. Precise glycemia control using intravenous insulin improves outcomes. To determine if we could improve glycemia control over a previous paper-based, manual protocol, authors implemented, in a surgical intensive care unit (SICU), an intravenous insulin protocol integrated into a care provider order entry (CPOE) system.

Although demand for information about the effectiveness and efficiency of health care information technology grows, large-scale resource-intensive randomized controlled trials of health care information technology remain impractical. New methods are needed to translate more commonly available clinical process measures into potential impact on clinical outcomes.

To characterize PubMed usage over a typical day and compare it to previous studies of user behavior on Web search engines.

Developments in information technology offer new opportunities to design electronic patient record systems (EPR) which integrate a broad range of functions such as clinical decision support, order entry, or electronic alerts. It has been recently suggested that EPR could support new applications for disease surveillance and patient safety. We describe the integration of a voluntary incident reporting system into an EPR used in operating theatres, to allow the reporting of [...]

The UMLS constitutes the largest existing collection of medical terms. However, little has been published about the users and uses of the UMLS. This study sheds light on these issues.

There are limited data regarding implementing electronic health records (EHR) in underserved settings. We evaluated the implementation of an EHR within the Indian Health Service (IHS), a federally funded health system for Native Americans.