Novel Representation of Clinical Information in the ICU

The introduction of electronic medical records (EMR) and computerized physician order entry (CPOE) into the intensive care unit (ICU) is transforming the way health care providers currently work. The challenge facing developers of EMR's is to create products which add value to systems of health care delivery. As EMR's become more prevalent, the potential impact they have on the quality and safety, both negative and positive, will be amplified. In this paper we outline the key barriers to effective use of EMR and describe the methodology, using a worked example of the output. AWARE (Ambient Warning and Response Evaluation), is a physician led, electronic-environment enhancement program in an academic, tertiary care institution's ICU. The development process is focused on reducing information overload, improving efficiency and eliminating medical error in the ICU.

[1]  K. Wood,et al.  Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock* , 2006, Critical care medicine.

[2]  Amber E Barnato,et al.  Use of intensive care at the end of life in the United States: An epidemiologic study* , 2004, Critical care medicine.

[3]  Y. Han,et al.  Han YY, Carcillo JA, Venkataraman ST, Clark RS, Watson RS, Nguyen TC, Bayir H, Orr RA. Unexpected increased mortality after implementation of a commercially sold computerized physician order entry system. Pediatrics , 2011 .

[4]  V. Herasevich,et al.  Medical informatics: an essential tool for health sciences research in acute care. , 2009, Bosnian journal of basic medical sciences.

[5]  Y. Han,et al.  Unexpected Increased Mortality After Implementation of a Commercially Sold Computerized Physician Order Entry System , 2005, Pediatrics.

[6]  Y. Donchin,et al.  A look into the nature and causes of human errors in the intensive care unit , 2022 .

[7]  P. Embí,et al.  Clinical decision support systems in the pediatric intensive care unit* , 2009, Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

[8]  Marc Berg,et al.  Viewpoint Paper: Some Unintended Consequences of Information Technology in Health Care: The Nature of Patient Care Information System-related Errors , 2003, J. Am. Medical Informatics Assoc..

[9]  Jiajie Zhang,et al.  Human-centered computing in health information systems: Part 2: Evaluation , 2005, J. Biomed. Informatics.

[10]  Emilie M. Roth,et al.  Research Paper: Impact of Clinical Reminder Redesign on Learnability, Efficiency, Usability, and Workload for Ambulatory Clinic Nurses , 2007, J. Am. Medical Informatics Assoc..

[11]  Jiajie Zhang,et al.  Human-centered computing in health information systems Part 1: Analysis and design , 2005, J. Biomed. Informatics.

[12]  Serguei V. S. Pakhomov,et al.  Electronic medical records for clinical research: application to the identification of heart failure. , 2007, The American journal of managed care.

[13]  Richard L. Horst,et al.  A systems engineering perspective on the human-centered design of health information systems , 2005, J. Biomed. Informatics.

[14]  V. Herasevich,et al.  Informatics infrastructure for syndrome surveillance, decision support, reporting, and modeling of critical illness. , 2010, Mayo Clinic proceedings.

[15]  V. Herasevich,et al.  Rule base system for identification of patients with specific critical care syndromes: The "sniffer" for acute lung injury. , 2007, AMIA ... Annual Symposium proceedings. AMIA Symposium.

[16]  Frank Drews,et al.  Research Paper: The Evaluation of a Pulmonary Display to Detect Adverse Respiratory Events Using High Resolution Human Simulator , 2006, J. Am. Medical Informatics Assoc..

[17]  Brian W Pickering,et al.  Identification of patient information corruption in the intensive care unit: Using a scoring tool to direct quality improvements in handover* , 2009, Critical care medicine.

[18]  J. Car,et al.  Interventions for promoting information and communication technologies adoption in healthcare professionals. , 2009, The Cochrane database of systematic reviews.

[19]  Dean F. Sittig,et al.  Lessons From “Unexpected Increased Mortality After Implementation of a Commercially Sold Computerized Physician Order Entry System” , 2006, Pediatrics.

[20]  Jean-Blaise Wasserfallen,et al.  Human errors in a multidisciplinary intensive care unit: a 1-year prospective study , 2001, Intensive Care Medicine.

[21]  Stephen E Lapinsky,et al.  Medical informatics in the intensive care unit: overview of technology assessment. , 2003, Journal of critical care.

[22]  J. Beyene,et al.  Quantifying the volume of documented clinical information in critical illness. , 2008, Journal of critical care.