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“Evaluation of HSJ-ICU system use by medical doctors”
Professor Orientador: Ricardo Correia
Turma 20
ObjectiveObjective
To evaluate the use of HSJ-ICU system To evaluate the use of HSJ-ICU system by medical doctors working at HSJby medical doctors working at HSJ
MethodsMethods
Type of study: observational and transversal study
Target population: 1116 medical doctors currently working at HSJ (workers for the Department of Human Resources).
Sampling method: simple random sampling
Sample: 68 medical doctors
Application of the Application of the definitive questionnairedefinitive questionnaire
Collection of Collection of data:data:
Elaboration of the questionnaire (Elaboration of the questionnaire (personal and personal and structured interviewstructured interview))
Application of the 4 pilots (Application of the 4 pilots (reformulation of the reformulation of the questionnaire after the application of each pilotquestionnaire after the application of each pilot))
Frequency of utilization of ICU and others electronic medical records of HSJ
Frequency of utilization of ICU in urgency, consultation and internment
Mean of access to the ICU
Degree of importance of several characteristics of ICU
Departments from which more reports are visualized
Reasons to not use ICU
Impact of the implementation of ICU in the professional life and in HSJ
Changes to ICU
Questionnaire:
Elaboration of the table of data and introduction Elaboration of the table of data and introduction of the data in the SPSSof the data in the SPSS
Statistical analysis of the data in SPSS:
We elaborated frequency tables:
• to count how many medical doctors answered to the questionnaire;and how many did not and the reasons for it;
• to analyze the sex and the age of the medical doctors;
• to analyse the mean of access to the ICU system.
We elaborated several graphs:
• showing the frequency of utilization of ICU, SAM, CLINIDATA and Sistema Informático de Radiologia, in order to compare them;• to compare the frequency of utilization of ICU in urgency, consultation and internment;• to compare the means of the degree of importance of various characteristics of ICU system;• to compare the degree of visualization of reports provided by the departments that send reports to the ICU system.
We also analyzed all the questions about the impact of the ICU and about the changes suggested to this system.
Results, tables and graphsResults, tables and graphs
• Number of medical doctors we searched for in HSJ: 68
• Percent of women: 48,5% (33 medical doctors)
• Percent of men: 51,5% (35 medical doctors)
• Medical doctors that answered to the questionnaire: 52,9% (36 medical doctors)
• Medical doctors that don’t work anymore in HSJ: 17,6% (12 medical doctors)
• Medical doctors were not found: 10,3% (7 medical doctors)
• Medical doctors that refused to answer the questionnaire: 5,9% (4 medical doctors)
• Medical doctors were absent on holidays: 4,4% (3 medical doctors)
• Medical doctors were absent due to labour license: 1,5% (1 medical doctor)
• Medical doctors were absent due to sick note: 2,9% (2 medical doctors)
• Not medical doctors: 4,4% (3 people)
Never used From 1 to 3 times per month
From 1 to 4 times per week
From 1 to 4 times per day
From 5 to 10 times per day
Frequency of utilization of ICU system
0
5
10
15
20
25
30
35
40
45
50
Per
cen
t
Frequency of utilization of ICU system
Graph 1
Never used From 1 to 3 times per
month
From 1 to 4 times per
week
From 1 to 4 times per day
From 5 to 10 times per day
> than 10 times per day
Frequency of utilization of SAM system
0
5
10
15
20
25
30
35
40
45
50
Per
cen
t
Frequency of utilization of SAM system
Graph 2
Never used < than 1 time per month
From 1 to 3 times per
month
From 1 to 4 times per
week
From 1 to 4 times per
day
From 5 to 10 times per day
> than 10 times per
day
Frequency of utilization of CLINIDATA system
0
5
10
15
20
25
30
35
40
45
50
Per
cen
t
Frequency of utilization of CLINIDATA system
Graph 3
Never used From 1 to 3 times per
month
From 1 to 4 times per
week
From 1 to 4 times per day
From 5 to 10 times per day
> than 10 times per day
Frequency of utilization of Sistema Informático de Radiologia
0
5
10
15
20
25
30
35
40
45
50
Per
cen
t
Frequency of utilization of Sistema Informático de Radiologia
Graph 4
Statistics
36 36 36 36
32 32 32 32
29,72 67,50 47,842 109,89
50,213 108,705 69,3357 185,206
Valid
Missing
N
Mean
Std. Deviation
1.1 Frequencyof utilization of
the ICU(InformaçãoClínica doUtente) (intimes permonth)
1.2 Frequencyof utilization of
the SAM(Sistema de
Apoio aoMédico) (intimes permonth)
1.3 Frequencyof utilization of
theCLINIDATA (in
times permonth)
1.4 Frequencyof utilization of
the SistemaInformático deRadiologia (in
times permonth)
Table 1
Frequency of utilization of ICU system in the internment, consultation and urgency
0% 20% 40% 60% 80% 100%
Frequency of utilization of ICU in theurgency
Frequency of utilization of ICU in theconsultation
Frequency of utilization of ICU in theinternment
I usually use
I rarelly use
I never use
Graph 5
Within the 36 medical doctors that answered to the questionnaire, 21 used the ICU system.
• Access to ICU only trough a link on the desktop (HSJ.ICU): 38,1% (8 medical doctors)
• Access to ICU only through SAM: 33,3% (7 medical doctors)
• Access through the link HSJ.ICU, through SAM and through the intranet of the hospital: 14,3% (3 medical doctors)
• Access only through the Intranet of the Hospital: 4,8% (1 medical doctor)
• Access through the link HSJ.ICU, through SAM and through obs.gyn.care (electronic medical record of gynaecology e obstetricses): 4,8% (1 medical doctor)
• Access through the link HSJ.ICU and through SAM: 4,8% (1 medical doctor) Within the 36 medical doctors that answered to the questionnaire, 41,7% (15 medical doctors) have never used the ICU system, all of tem stated they didn’t know this system.
Access to reports of several
departments
Access to reports integrated in one single process of
the patient
Access to actualized
information of a patient
Find important reports that I didn´t know
Chronological visualization of
the clinical history of the patient
Fast access to reports that only existed in paper
Decrease of the time needed to
access to clinical and laboratorial
reports
0
1
2
3
4
5
6
7
8
9
10
Mea
n o
f th
e d
egr
ee o
f im
port
anc
e o
f th
e ch
ara
cter
istic
s of
ICU
cl
assi
fica
ted
from
0 (
very
less
impo
rtan
t) t
o 1
0 (v
ery
muc
h im
port
ant)
Importance of the characteristics of the ICU system
Graph 6
Anatomo-Pathology
Clinical Pathology
Imm
unohemotherapy
Intensive Care
Obstetricses
Pneumology
Gastrenterology
Imm
unoalergology
Gynaecological endoscopy
0
2
4
6
8
Mea
n of
the
degr
ee o
f vi
sual
izat
ion
of r
epor
ts p
rovi
ded
by th
e de
part
men
ts th
at s
end
repo
rts
to I
CU
Degree of visualization of reports provided by the departments that send reports to ICU
Graph 7
Impact caused by the ICU system
AnswersNumber of doctors
that agree
Decrease of the time of access to laboratorial and clinical information 12
It is easier to access to the clinical information of the patient 8
Better communication between health professionals 2
Better integration of the clinical information 1
Access to the clinical information from several places 1
ICU do the same function of SAM 1
ICU is a low system 1
Little impact on my professional life 1
ICU had an important impact 1
Didn’t answer 2
Table 2
Changes suggested to the ICU
AnswersNumber of doctors
that agree
Increase the number of departments from which it is possible to visualize reports 4
Decrease the technical problems that sometimes don’t allow the parcial or total use of ICU 3
Decrease the up-date time of the reports displayed on ICU 2
Possibility of making requests of clinical and laboratorial analysis through ICU 1
Decrease the problems of access of reports from Pathological Anatomy 1
Make the access to ICU easier 1
No suggestion 11
Table 3
Discusion of the resultsDiscusion of the results• ICU is less used than SAM, CLINIDATA and SISTEMA INFORMÁTICO DE RADIOLOGIA because is the most recent system and so it is the last spread;
• Although SAM has a lesser number of users than CLINIDATA, these users use SAM more times per month than the users of CLINIDATA;
• ICU is more used in the internment, following consultation and finally urgency because of the characteristic of each work place;
• The most important characteristics of ICU are “It allows the access to reports (analysis...) from several departments” and “It decreases the time needed to access clinical and laboratorial reports” because they are probably those which make more easy the clinical practice;
• The three departments from which more reports are visualized are Pathological Anatomy, Clinical Pathology and immunohemotherapy. This situation probably occurs because these three departments provide reports which subject is more general.
References
1. Aula sobre Registos Clínicos Electrónicos do Curso de Informática Médica que se encontra em http://im.med.up.pt.
2. Stanley J. Reiser, The Clinical Record in Medicine Part 1: Learning from cases, American College of Physicians, 1991.
3. Richard S. Dick, Elaine B. Steen, and Don E. Detmer, The Computer-based patient record: An Essential Technology for Health Care, National Academy Press, 1997.
4. R. Cruz-Correia, P. Vieira-Marques, P. Costa, A. Ferreira, E. Oliveira-Palhares, F. Araújo and A. Costa-Pereira, Integration oh hospital data using agent Technologies- A case study (2005).
5. Torchio M, Molino F, Sestero D, Seidemari C, Molino G. Na electronic madical diary for computer assisted patient management. Minerva Med.2003 Jun; 94 (3): 167-79.
6.Coiera E. Guide to medical informatics, the internet and telemedicine. Arnold Publishers, London, 1997.
7.Uckert F. et al. Functions of an electronic health record. INT J Comput Dent. 2002 Apr-Jul; 5 (2-3): 125-32.
8.Lenz R and Kuhn KA. Integration of heterogeneous and autonomous systems in hospital. Business Briefing: Data management & Storage Technology, 2002.
9.Manual do utilizador do ICU
10.Panfleto de divulgação do ICU.