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Preventive care measures remain underutilized despite recommendations to increase their use. The objective of this review was to examine the characteristics, types, and effects of paper- and computer-based interventions for preventive care measures. The study provides an update to a previous systematic review. We included randomized controlled trials that implemented a physician reminder and measured the effects on the frequency of providing preventive care. Of the 1,535 articles identified, 28 [...]

As health care organizations dramatically increase investment in information technology (IT) and the scope of their IT projects, implementation failures become critical events. Implementation failures cause stress on clinical units, increase risk to patients, and result in massive costs that are often not recoverable. At an estimated 28% success rate, the current level of investment defies management logic. This paper asserts that there are "chasms" in IT implementations that represent [...]

Diverse stakeholders--clinicians, researchers, business leaders, policy makers, and the public--have good reason to believe that the effective use of electronic health care records (EHRs) is essential to meaningful advances in health care quality and patient safety. However, several reports have documented the potential of EHRs to contribute to health care system flaws and patient harm. As organizations (including small hospitals and physician practices) with limited resources for care-process transformation, human-factors [...]

The development of regional data-sharing among healthcare organizations is viewed as an important step in the development of health information technology (HIT), but little is known about this complex task. This is a case study of a regional perinatal data system that involved four hospitals, together responsible for over 10,000 births annually. Using standard qualitative methods, we chronicled project milestones, and identified 31 "critical incidents" that delayed or prevented their [...]

To investigate the agreement among clinical experts in their judgments of monitoring data with respect to artifacts, and to examine the effect of reference standards that consist of individual and joint expert judgments on the performance of artifact filters.

Patients, policymakers, providers, payers, employers, and others have increasing interest in using personal health records (PHRs) to improve healthcare costs, quality, and efficiency. While organizations now invest millions of dollars in PHRs, the best PHR architectures, value propositions, and descriptions are not universally agreed upon. Despite widespread interest and activity, little PHR research has been done to date, and targeted research investment in PHRs appears inadequate. The authors reviewed the [...]

Development of public health informatics applications often requires the integration of multiple data sources. This process can be challenging due to issues such as different file formats, schemas, naming systems, and having to scrape the content of web pages. A potential solution to these system development challenges is the use of Web 2.0 technologies. In general, Web 2.0 technologies are new internet services that encourage and value information sharing and [...]

Family health history is a complex, multifaceted tool for assessing disease risk that can offer insight into the interplay between inherited and social factors relevant to patient care. Family health history tools in electronic health records can enable the user to collect, represent, and interpret structured data that properly supports clinical decisions. If these data can be made interoperable, important health information can be shared with minimal duplication of effort [...]

The purpose of this study was to translate and integrate nursing diagnosis concepts from the Clinical Care Classification (CCC) System Version 2.0 to DiagnosticPhenomenon or nursing diagnostic statements in the International Classification for Nursing Practice (ICNP) Version 1.0. Source concepts for CCC were mapped by the project team, where possible, to pre-coordinated ICNP terms. The manual decomposition of source concepts according to the ICNP 7-Axis Model served to validate the [...]