Showing papers by "James J. Cimino published in 2003"

Clinical information needs in context: an observational study of clinicians while using a clinical information system.

Abstract: Introduction The development of tools to meet the information needs of clinicians requires an understanding of the clinician and the context in which clinical decisions are being made

Automated discovery of patient-specific clinician information needs using clinical information system log files.

Abstract: Knowledge about users and their information needs can contribute to better user interface design and organization of information in clinical information systems. This can lead to quicker access to desired information, which may facilitate the decision-making process. Qualitative methods such as interviews, observations and surveys have been commonly used to gain an understanding of clinician information needs. We introduce clinical information system (CIS) log analysis as a method for identifying patient-specific information needs and CIS log mining as an automated technique for discovering such needs in CIS log files. We have applied this method to WebCIS (Web-based Clinical Information System) log files to discover patterns of usage. The results can be used to guide design and development of relevant clinical information systems. This paper discusses the motivation behind the development of this method, describes CIS log analysis and mining, presents preliminary results and summarizes how the results can be applied.

Use of Online Resources While Using a Clinical Information System

Abstract: Background Clinical information system (CIS) use is likely to evoke information needs, yet information resources use during CIS use has not been studied

The classification of clinicians' information needs while using a clinical information system.

Abstract: Introduction Information needs are prevalent in clinical practice. They represent a potential source of medical errors. This study seeks to empirically determine the information needs of clinicians while using a clinical information system (CIS), and characterize those needs. In addition this paper will provide the framework necessary for the development of the solutions to these information needs.

Sharing infobuttons to resolve clinicians' information needs.

Abstract: Attempts to link clinical information systems to on-line information resources date back over a decade The World Wide Web presents new opportunities to create such links, which we refer to as "infobuttons" This capability is partly due to the ease with which a link (called a Uniform Resource Locator, or URL) in one Web-based system can take users to another Web-based system, and partly due to the proliferation of high-quality Web-based resources Typically, contextual information from the clinical system (such as patient data) is passed to a search engine that is evoked and, in turn, presents search results to the user Impediments to infobutton development include customized programming to pass context information to the information resource, lack of standards for types and values of context information, variability of search engine interfaces, and a lack of understanding of clinicians' information needs We are addressing these limitations with an Infobutton Manager (IM) that provides a standardized interface for matching user contexts to information resources

Characterizing information needs and cognitive processes during CIS use.

Abstract: Medical errors are often associated with inadequate cognitive processing that is based upon impaired access to information.1 Understanding the information needs of nurses and physicians' when using a clinical information system (CIS) is difficult largely because there are few systematic attempts made to do so. We collected 15.5 hours of data of nurses and physicians' CIS interactions in three clinical environments (cardiac ICU, a general medical/surgical nursing, and an ambulatory clinic). We accomplished this through observational, cognitive-based methods (e.g., thinking aloud during interaction) and the video capturing of events with a portable usability laboratory.2 We developed a systematic approach to identify and define in-context clinical information needs while using a CIS, and determine how to categorize and code such events. 3

Automated identification of shortcuts to patient data for a wireless handheld clinical information system.

Abstract: Inadequate access to patient information at the point of care has been identified as an impediment to the health care process. To create clinical computing tools that are useful to and used by clinicians, developers of clinical information systems must have accurate models of the users for whom their systems are intended. To create these models, the information needs of clinicians must be understood. While the wireless handheld environment offers many advantages such as the ability to provide mobile access to information, there are a number of challenges. Developing for this environment differs from the laptop and desktop environments due to features such as processing power, screen size, input mechanism, and bandwidth. PalmCIS (Palm-based Clinical Information System) is a clinical application being developed at New York Presbyterian Hospital (NYPH) that provides clinicians with access to patient data via a wireless handheld device. We are using an automated technique to uncover patient-specific information needs of clinicians while using a patient record system. With the results, we can enhance PalmCIS.

Development of infobuttons in a wireless environment.

Abstract: At Columbia-Presbyterian Medical Center, a clinical information system (CIS) called WebCIS is used by health care providers. We have developed a palm-based extension to WebCIS, called PalmCIS, which provides physicians access to clinical data through a wireless connection. As part of PalmCIS, we have added links to two on-line information resources: PubMed and Micromedex.