American Academy of
Pediatrics: Task Force on Medical Informatics.
Special requirements for electronic medical record systems in
pediatrics. Pediatrics. 2001 Aug;108(2):513-5. This
reading should familiarize you with how a pediatric electronic
health record differs from other types of electronic health records. This paper shows that an Electronic
Health Record must fit the specific details of the practice. A
generic design may do more harm than good. Click here for a
summary of the paper or see below a set of silent slides
summarizing the major points of the paper:
Alemi F.
Specifying System Requirements. This reading provides a
detailed description of how system requirements are organized.
While in this course you are not required to specify system
requirements, the reading should familiarize you with the process of
specifying system requirements.
We have proposed an approach
to specifying functional requirements of a system based on the following
steps:
Start with business
objective of the information system
Decides on a set of use cases
Examine within each use case
how the system changes the work process
Focus on clinical
decisions
Check information needed in
these decisions
Check software functionality
needed
Aggregate across use cases the
information and functionality needed
This approach can be demonstrated by
a recent design of an Electronic Health Record for a staff model HMO in
Northeastern United States. In this HMO, the central business
justification for the Electronic Health Record was to reduce visits while
maintaining quality of services. This was an unusual situation in the
sense that both patients and providers had access to email and Internet.
The idea was to take advantage of the availability of the improved communication
channels and design work processes that reduced unnecessary visits, saved the
patient's time and the HMO's resources. The assumption was that informed
consumers would be willing to take care of their own health if their clinicians
were readily available to them and willing to work with them remotely. The
electronic health record was expected to support these revised work processes.
The design of the Electronic Health Record had to assume process changes that
were planned and information requirements when these new process changes were
put in place. The specification of the EHR requirements was derived from
the planned improved work processes. The following shows how we designed
the EHR system:
Keep in mind that
successful EHR systems require a great deal of design that anticipates future
needs.
Adult learners understand the
topic in far more depth when they have to teach others. By now you
and other colleagues in the class must have completed the assignment on
information needs assessment. At this point, please obtain the
URL of the report by one of your colleagues either directly from the
colleague or from the instructor. Here are some example work done
by some students:
Proceed with evaluating their
work given the following rubric:
Comment on your colleague's presentation (please make a
comment in all five areas):
Start with what worked well.
Were the slides requested present? If there were
more or less than the expected slides were the slides
presented all necessary?
Was the narration clear? Was the sound quality
reasonable?
Were the graphics self-contained and informative.
Would one have understood the graphs and the bulleted
points, if the narration was not present?
Was the use of color and animation judicious and able to
highlight major points?
Comment on the content (you are required to make one comment
in all eight areas):
Start with what worked well? Go ahead with your praise
but give details so that one can understand why you were so
impressed.
Did the project select an outside expert and focus on a
decision maker? Does it appear that the project was
realistic or an exercise for the sake of class only.
Was the project focused on future decisions? Was
there a specific attempt to list future decisions?
Did the project ask the expert and the decision maker to
rate the usefulness of the information on a scale? In
particular, was there a numerical rating of usefulness of
information item in a decision?
Did the project assign 0 rating to items that were
relevant in one but not another decision? Decision
makers and experts do not mention irrelevant pieces of
information. Since different items are listed, some of
these are likely to be irrelevant in some decisions.
Many students forget to assign 0 to the piece of information
that is completely irrelevant to the decision.
Did the project correctly analyze the mean and variance
(range) of the ratings? Many students make a mistake
of taking the mean across information items; the
correct approach is take the mean across decisions.
The goal is to find if the information item is needed
across many decisions. When the mean is high and the
range is small, then the information item has been rated as
high for all decisions.
Did the project identify what is needed across decisions
and what is needed in some but not other decisions?
Did the project provide introspections about the method
of needs assessment? Note that students are expected
to discuss the method of needs assessment and not the
particular results in this project.
Comment on what you have learned about your own project from
contrasting your work with the project you have reviewed.
Once you have written the feedback, please post it to the same
area where your colleague's report is posted. Send a copy to
your instructor or email the instructor the URL of where the work is
posted.
Advanced learners like you, often need different ways of
understanding a topic. Reading is just one way of understanding. Another
way is through writing about what you have read. The enclosed assessment is designed to get you to think more about the
concepts taught in this session.
A use case shows how information systems are used by different
actors within an organization. Give an example of two use
cases from the reading on designing an information system for
primary care providers of an HMO. In each case, describe the
decisions that are being made by the primary care provider and the
information needed for these decisions.
Describe how design of an information system and process change
are planned together. Give an example from the reading where
this was done and list the steps that were followed.
Ask your question and we will post your
question and our answer to it here. It may take 24 hours to answer your
question. Alternatively read
answers to questions asked by others.
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