|
Sign In to gain access to subscriptions and/or personal tools.
|
Clinical Informatics in Critical Care
G. Daniel Martich, MD
Department of Critical Care Medicine, University of Pittsburgh School of Medicine
Carl S. Waldmann, MA, MB, BChir, FRCA, EDIC
Intensive Care Unit, Royal Berkshire Hospital, Reading, UK
Michael Imhoff, MD, PhD
Surgical Intensive Care Unit, Klinikum Dortmund gGmbH, Dortmund, Germany
Health care information systems have the potential to enable better care of patients in much the same manner as the widespread use of the automobile and telephone did in the early 20th century. The car and phone were rapidly accepted and embraced throughout the world when these breakthroughs occurred. However, the automation of health care with use of computerized information systems has not been as widely accepted and implemented as computer technology use in all other sectors of the global economy. In this article, the authors examine the need, risks, and rewards of clinical informatics in health care as well as its specific relationship to critical care medicine.
Key Words: electronic medical record electronic health record clinical information systems clinical decision support computerized physician order entry health care informatics critical care information systems leapfrog Institute of Medicine medical errors clinical decision support return on investment
References
- 1. Karlsson G, Johannesson M. Cost-effectiveness analysis and capital costs. Soc Sci Med. 1998;46:1183-1191.[Medline]
[Order article via Infotrieve]
- 2. Leape LL. Error in medicine. JAMA. 1994;272:1851-1857.[Abstract/Free Full Text]
- 3. Imhoff M. Health informatics. In: Sibbald W, Bion J, eds. Evaluating Critical Care: Using Health Services Research to Improve Quality. Update in Intensive Care and Emergency Medicine 35. Heidelberg, Germany: Springer; 2000:255-269.
- 4. Bates DW, Spell N, Cullen DJ, et al. The costs of adverse drug events in hospitalized patients. Adverse Drug Events Prevention Study Group. JAMA. 1997;277:307-311.[Abstract/Free Full Text]
- 5. Classen DC, Pestotnik SL, Evans RS, et al. Adverse drug events in hospitalized patients. Excess length of stay, extra costs, and attributable mortality. JAMA. 1997;277:301-306.[Abstract/Free Full Text]
- 6. Raschke RA, Gollihare B, Wunderlich TA, et al. A computer alert system to prevent injury from adverse drug eventsdevelopment and evaluation in a community teaching hospital. JAMA. 1998;280:1317-1320.[Abstract/Free Full Text]
- 7. Morris A. Algorithm-based decision-making. In: Tobin JA, ed. Principles and Practice of Intensive Care Monitoring. New York, NY: McGraw-Hill; 1998:1355-1381.
- 8. Miller G. The magical number seven, plus or minus two: some limits to our capacity for processing information. Psychol Rev. 1956;63:81-97.[CrossRef][Medline]
[Order article via Infotrieve]
- 9. Jennings D, Amabile T, Ross L. Informal covariation assessments: data-based versus theory-based judgements. In: Kahnemann D, ed. Judgement Under Uncertainty: Heuristics and Biases. Cambridge, UK: Cambridge University Press; 1982:211-230.
- 10. Guyatt G, Drummond M, Feeny D, et al. Guidelines for the clinical and economic evaluation of health care technologies. Soc Sci Med. 1986;22:393-408.[CrossRef][Medline]
[Order article via Infotrieve]
- 11. Andrews LB, Stocking C, Krizek T, et al. An alternative strategy for studying adverse events in medical care. Lancet. 1997;349:309-319.[CrossRef][Medline]
[Order article via Infotrieve]
- 12. Bosman RJ, Rood E, Oudemans-Van Straaten HM, et al. Intensive care information system reduces documentation time of the nurses after cardiothoracic surgery. Intensive Care Med. 2003;29:83-90.[Medline]
[Order article via Infotrieve]
- 13. Imhoff M. A clinical information system on the intensive care unit: dream or nightmare? In: Rubi JAG, ed. Medicina Intensiva 1995, XXX. Murcia, Spain: Congreso SEMIUC, Murcia Pictographia; 1995:17-22.
- 14. Imhoff M. Three years clinical use of the Siemens EMTEK System 2000: efforts and benefits. Clin Intensive Care. 1996;7(suppl):43-47.
- 15. Imhoff M, Lehner JH, Lohlein D. Two year clinical experience with a clinical information system on a surgical ICU. In: Monduzzi, ed. 7th European Congress on Intensive Care Medicine. Bologna, Italy: European Congress; 1994:163-166.
- 16. Haux R. Aims and tasks of medical informatics. Int J Med Inf. 1997;44:9-20.[CrossRef][Medline]
[Order article via Infotrieve]
- 17. Chalmers TC, Laus J. Meta-analytic stimulus for changes in clinical trial. Stat Methods Med Res. 1993;2:161-172.[Medline]
[Order article via Infotrieve]
- 18. JCAHO. Six core ICU measures. Available at: http://www.jcaho.org/pms/core+measures/candidate+core+measure+sets.htm.
- 19. Celi LA, Hassan E, Marquardt C, et al. The eICU: its not just telemedicine. Crit Care Med. 2001;29:N183-N189.[CrossRef][Medline]
[Order article via Infotrieve]
- 20. Balas EA, Weingarten S, Garb CT, et al. Improving preventive care by prompting physicians. Arch Intern Med. 2000;160:301-308.[Abstract/Free Full Text]
- 21. Imhoff M, Gather U, Morik K. Development of decision support algorithms for intensive care medicine: a new approach combining time series analysis and a knowledge base system with learning and revision capabilities. In: Brugard W, ed. KI-99: Advances in Artificial Intelligence. Bonn, Germany: Springer; 1999:219-230.
- 22. Gardner RM. Computer technology and its application to cardiovascular nursing. J Cardiovasc Nurs. 1987;1:69-71.[Medline]
[Order article via Infotrieve]
- 23. Leyerle BJ, LoBue M, Shabot M. Integrated computerized databases for medical data management beyond the bed-side. Int J Clin Monit Comput. 1990;7:83-89.[CrossRef][Medline]
[Order article via Infotrieve]
- 24. Shabot MM, LoBue M, Leyerle BJ, et al. Decision support alerts for clinical laboratory and blood gas data. J Clin Monit Comput. 1990;7:27-31.[Medline]
[Order article via Infotrieve]
- 25. Fraenkel DJ, Cowie M, Daley P. Quality benefits of an intensive care clinical information system. Crit Care Clin. 2003;31:120-125.
- 26. Committee on Quality of Health Care in America, Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press; 2001.
- 27. Blum MS, Cole C, Leviss J, Shabot MM, Weisenthal A. Advanced EMR implementations: practical experience from those who have been there. Presented at: AMAIA Symposium 2003; November 8-12, 2003; Washington, DC.
- 28. Classen D, Evans R, Pestotnik S, et al. The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. N Engl J Med. 1992;326:281-286.[Abstract]
- 29. Pestotnik SL, Classen DC, Evans RS, et al. Implementing antibiotic practice guidelines through computer-assisted decision support: clinical and financial outcomes. Ann Intern Med. 1996;124:884-890.[Abstract/Free Full Text]
- 30. Morris AH. Computerized protocols and beside decision support. Crit Care Clin. 1999;15:523-545.[CrossRef][Medline]
[Order article via Infotrieve]
- 31. Walton M. The Deming Management Method. New York, NY: Putnam; 1986.
- 32. Massaro TA. Introducing physician order entry at a major academic medical-center: 1. Impact on organizational culture and behavior. Acad Med. 1993;68:20-25.[Medline]
[Order article via Infotrieve]
- 33. Massaro TA. Introducing physician order entry at a major academic medical-center: 2. Impact on medical-education. Acad Med. 1993;68:25-30.[Medline]
[Order article via Infotrieve]
- 34. Maviglia SM, Zielstorff RD, Paterno M, Teich JM, Bates DW, Kuperman GJ. Automating complex guidelines for chronic disease: lessons learned. J Am Med Inform Assoc. 2003;10(2):154-165.[Abstract/Free Full Text]
- 35. Ornstein C. Hospital heeds doctors: suspends use of software. Los Angeles Times. January 22, 2003:B1.
- 36. Bates DW, Kuperman GJ, Wang S, et al. Ten commandments for effective clinical decision support: making the practice of evidence-based medicine a reality. J Am Med Inform Assoc. 2003;10(6):523-530.[Abstract/Free Full Text]
- 37. Tierney WM, Miller ME, Overhage JM, McDonald CJ. Physician inpatient order writing on microcomputer workstationseffects on resource utilization. JAMA. 1993;269:379-383.[Abstract/Free Full Text]
- 38. Lee F, Teich JM, Spurr CD, Bates DW. Implementation of physician order entry: user satisfaction and self-reported usage patterns. J Am Med Inform Assoc. 1996;3(1):42-55.[Abstract/Free Full Text]
- 39. Shojania KG, Yokoe D, Platt R, et al. Reducing vancomycin use utilizing a computer guideline: results of a randomized controlled trial. J Am Med Inform Assoc. 1998;5:554-562.[Abstract/Free Full Text]
- 40. Overhage JM, Tierney WM, Zhou XH, et al. A randomized trial of "corollary orders" to prevent errors of omission. J Am Med Inform Assoc. 1997;4:364-375.[Abstract/Free Full Text]
- 41. Teich JM, Glaser JP, Beckley RF, et al. Toward cost-effective, quality care: the Brigham Integrated Computing System. In: Proceedings of the 2nd Nicholas E. Davies CPR Recognition Symposium. Washington, DC: Computerized Patient Record Institute; 1996: 3-34.
- 42. Teich JM, Glaser JP, Beckley RF, et al. The Brigham integrated computing system (BICS): advanced clinical systems in an academic hospital environment. Int J Med Inform. 1999;54:197-208.[CrossRef][Medline]
[Order article via Infotrieve]
- 43. Cocks RA, Glucksman E. What does London need from its Ambulance Service? BMJ. 1993;306:1428-1429.[Free Full Text]
- 44. Work Group on Computerization of Patient Records. Toward a National Health Information Infrastructure: Report of the Work Group on Computerization of Patient Records. Washington, DC: US Department of Health and Human Services; 2000.
- 45. McDonald CJ, Wilson FJ Jr. Physician response to computer reminders. JAMA. 1980;244:1579-1581.[Abstract/Free Full Text]
- 46. McDonald CJ. Protocol-based computer reminders, the quality of care and the non-perfectability of man. N Engl J Med. 1976;295(24):1351-1355.[Abstract]
- 47. Organisation for Economic Co-operation and Development. A Comparative Analysis of 29 Countries. OECD Health Data. Paris, France: Organisation for Economic Cooperation and Development; 1999.
- 48. Thomsen GE, Pope D, East T, et al. Clinical performance of a rule-based decision support system for mechanical ventilation of ARDS patients. Proc Annu Symp Comput Appl Med Care. 1993:339-343.
- 49. Sharpe V, Faden A. Medical Harm. Cambridge, UK: Cambridge University Press; 1998.
- 50. Leape LL, Bates DW, Cullen DJ, et al. Systems analysis of adverse drug events. JAMA. 1995;274:35-43.[Abstract/Free Full Text]
- 51. Eckhart JG. Costing out nursing services: Examining the research. Nurs Econ. 1993;11:91-98.[Medline]
[Order article via Infotrieve]
- 52. Bauer JC. Return on investment: going beyond traditional analysis. J Health Inf Manag. 2003;17(4):4-5.
Journal of Intensive Care Medicine, Vol. 19, No. 3,
154-163 (2004)
DOI: 10.1177/0885066604264016

CiteULike Complore Connotea Del.icio.us Digg Reddit Technorati Twitter What's this?
This article has been cited by other articles:

|
 |

|
 |
 
D. M. Hilty, S. Benjamin, G. Briscoe, D. J. Hales, R. J. Boland, J. S. Luo, C. H. Chan, R. S. Kennedy, H. Karlinsky, D. B. Gordon, et al.
APA Summit on Medical Student Education Task Force on Informatics and Technology: Steps to Enhance the Use of Technology in Education Through Faculty Development, Funding and Change Management
Acad Psychiatry,
December 1, 2006;
30(6):
444 - 450.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R. Tackley
Integrating anaesthesia and intensive care into the National Care Record
Br. J. Anaesth.,
July 1, 2006;
97(1):
69 - 76.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. M. Hilty, D. J. Hales, G. Briscoe, S. Benjamin, R. J. Boland, J. S. Luo, C. H. Chan, R. S. Kennedy, H. Karlinsky, D. B. Gordon, et al.
APA Summit on Medical Student Education Task Force on Informatics and Technology: Learning About Computers and Applying Computer Technology to Education and Practice
Acad Psychiatry,
February 1, 2006;
30(1):
29 - 35.
[Abstract]
[Full Text]
[PDF]
|
 |
|
|
|