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1.

Objective

Despite of emerging evidence that electronic health records (EHRs) can improve the clinical quality, enhances patient safety and efficiency. Most physicians in primary health care clinics in the Taiwan do not currently adopt EHR at their clinic practices. We aim to measure the relationship between usage intention and adoption behavior.

Study design and methods

We used structured questionnaires distributed both EHRs adopter and non-adopter group to the primary health care physicians which participated in the DOH project to establish the information exchange environment across Taiwan. The response rate of adopter and non-adopter is 54.7% and 55.0% respectively.

Measurements

EHRs adoption behavior.

Results

The EHRs adopter group has higher intention than non-adopter (p = 0.003). From the result of logistic regression analyses, we found the key factors affecting physicians’ adoption pattern were intention to use (OR: 2.85; 95% CI: 2.30–3.54). In addition, higher perceived usefulness (OR: 1.29; 95% CI: 1.06–1.56) and perceived ease to use (OR: 1.48; 95% CI: 1.22–1.79) increase adoption of EHR found.

Conclusion

The intention to use EHR, perceived usefulness and ease to use of primary care physicians were found as key factors influencing EHRs adoption. Thus, we suggest that government should promote the potential benefits of EHR and enhance physicians’ willingness to adopt the EHRs at their clinic practices.  相似文献   

2.
This study explores the relationship between primary care physicians' interactions with health information technology and primary care workflow. Clinical encounters were recorded with high-resolution video cameras to capture physicians' workflow and interaction with two objects of interest, the electronic health record (EHR) system, and their patient. To analyze the data, a coding scheme was developed based on a validated list of primary care tasks to define the presence or absence of a task, the time spent on each task, and the sequence of tasks. Results revealed divergent workflows and significant differences between physicians' EHR use surrounding common workflow tasks: gathering information, documenting information, and recommend/discuss treatment options. These differences suggest impacts of EHR use on primary care workflow, and capture types of workflows that can be used to inform future studies with larger sample sizes for more effective designs of EHR systems in primary care clinics. Future research on this topic and design strategies for effective health information technology in primary care are discussed.Relevance to industryThis paper presents the effect of EHR use on workflow of a primary care visit. Understanding physicians' interaction styles can inform design of specific features of future health IT systems for more effective and efficient workflow in outpatient setting.  相似文献   

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4.
《Information & Management》2016,53(5):570-580
This study uses institutional theory to explain adoption of electronic health records (EHRs) in ambulatory medical practices in the U.S. Health care is a highly institutionalized industry, subject to multiple regulatory forces, high levels of professionalism, and growing network externalities that can influence adoption decisions. We found that mimetic forces were more critical predictors when there was greater uncertainty, coercive forces were significant predictors after the U.S. government established incentives, and normative forces have continually influenced adoption. This study demonstrates the impact of the institutional effect of government policies and industry norms on adoption of critical technologies.  相似文献   

5.
Distributed computing infrastructures are commonly used through scientific gateways, but operating these gateways requires important human intervention to handle operational incidents. This paper presents a self-healing process that quantifies incident degrees of workflow activities from metrics measuring long-tail effect, application efficiency, data transfer issues, and site-specific problems. These metrics are simple enough to be computed online and they make little assumptions on the application or resource characteristics. From their degree, incidents are classified in levels and associated to sets of healing actions that are selected based on association rules modeling correlations between incident levels. We specifically study the long-tail effect issue, and propose a new algorithm to control task replication. The healing process is parametrized on real application traces acquired in production on the European Grid Infrastructure. Experimental results obtained in the Virtual Imaging Platform show that the proposed method speeds up execution up to a factor of 4, consumes up to 26% less resource time than a control execution and properly detects unrecoverable errors.  相似文献   

6.
We investigate the impact of cohesion versus structural holes in two different types of knowledge networks—help‐seeking networks and voluntary contribution networks—on adaptation to health IT‐enabled patient‐care practices. In a multimethod study conducted within a large hospital system, qualitative and quantitative data were collected from 806 clinicians working with electronic medical record systems in 27 inpatient patient‐care units. Multilevel analysis of the data revealed that overall network cohesiveness versus location in structural hole positions related to adaptation differently, depending on the type of network. In help‐seeking networks, location in structural hole positions was negatively related to adaptation, while network cohesion had a bell‐shaped curvilinear relationship with adaptation; in voluntary contribution networks, the overall cohesiveness of the network was negatively related to adaptation, but location in structural hole positions was irrelevant to adaptation. Our findings suggest a more nuanced way of monitoring and utilising different sets of informal social interactions at work to maximise employees' adaptation to IT‐enabled work.  相似文献   

7.
The impact of electronic markets: the case of the Dutch Flower Auctions   总被引:1,自引:0,他引:1  
The concept of electronic markets has been widely researched. There is, however, less experience with its operation and even less with the organisational impact that electronic markets can have on specific companies and sectors. This case study discusses a very specific market which is gradually moving into the electronic age: the Dutch Flower Auction. This auction is the world marketplace for flowers and pot plants. This case is unusual both in terms of industry (agriculture) and the specific nature of the goods dealt with (highly perishable and fragile, where quality is based on perception). This study, therefore, has been particularly revealing for the use of electronic markets as a strategic response in a changing marketplace.  相似文献   

8.
The paper is concerned with investigating relationships between labor productivity and information and communication technology (ICT) components such as the use of enterprise resource planning (ERP), e-commerce and customer relationship management (CRM) software, and the number of ICT specialists at the country level. The proposed approach uses a neoclassical framework of growth accounting and a translog production function to examine the impact of ICT components on labor productivity in the transition and developed economies of the European Union (EU). Our findings show the positive and significant influence of selected ICT components on labor productivity in EU countries. Moreover, the results indicate that the impact of ERP, e-commerce and CRM software on labor productivity is greater in transition economies than in developed economies of the EU.  相似文献   

9.
并行自动测试系统中,并行测试程序的运行管理是系统设计中的关键问题。由于该类系统的强异构性特征和特殊的运行监管要求,常规的基于多计算机系统的任务管理机制不适于并行自动测试系统。以事务工作流描述并行测试任务运行管理模型,在此基础上,提出了基于事务工作流的并行测试任务运行管理机制,最后,给出了运行管理调度的算法实现思路。  相似文献   

10.
熊双武  周振刚  陶斓 《软件》2013,34(5):81-82
针对企业内部管理协作高效需求的日益凸显,介绍了普元工作流平台的参考模型。基于普元BPS工作流平台,构建了企业协同办公系统功能框架,并以企业核心业务发文处理流程为例,探讨了基于BPS工作流系统的流程设计过程,对构建信息共享和业务协同的高效企业具有重要意义。  相似文献   

11.
针对现有中心化信任背景下电子健康记录存储存在的安全风险,提出一种基于区块链的电子健康记录安全存储模型。模型首先设计了新的电子健康记录区块链存储结构,解决了现有存储模型实用性不强的问题;然后优化了区块链中区块入链的工作流程,减少了点对点(P2P)网络中的信息传播量;最后设计了基于随机数选举的共识机制,提高区块入链的时间效率。将提出的模型在Hyperledger中进行模拟实验,并将所提出的共识机制与现有共识机制进行性能对比。实验结果表明,提出的存储模型具有较高的安全性和更好的运行时间效率。该模型适用于区块链在医疗卫生领域的应用,为电子健康记录的安全共享提供了支撑。  相似文献   

12.
Collaborative development environments allow a group of users to view and edit a shared item from geographically dispersed sites. Consistency maintenance in the face of concurrent accesses to shared entities is one of the core issues in the design of these systems. The paper introduces a lock based solution and three different algorithms that enable controlled, concurrent access to workflows for multiple application developers. Collaborative development of workflow applications promises better outcome in shorter time. The described method ensures that collaborators cannot break the consistency criteria of workflows by adding cycles or invalid edges to the graphs. A formal analysis of the three graph locking algorithms is also provided, focusing on the number of users who are allowed to edit a single workflow simultaneously. Based on the findings, a more powerful fourth graph locking algorithm is defined.  相似文献   

13.
The advent of Grid environments made feasible the solution of computational intensive problems in a reliable and cost-effective way. As workflow systems carry out more complex and mission-critical applications, Quality of Service (QoS) analysis serves to ensure that each application meets user requirements. In that frame, we present a novel algorithm which allows the mapping of workflow processes to Grid provided services assuring at the same time end-to-end provision of QoS based on user-defined parameters and preferences. We also demonstrate the operation of the implemented algorithm and evaluate its effectiveness using a Grid scenario, based on a 3D image rendering application.  相似文献   

14.
A workflow management system (WFMS) is a system that completely defines, manages and executes workflow through the use of software whose order of execution is driven by a computer representation of the workflow logic. The correct sequence of tasks in the database can be automatically discovered by applying data mining technology to the data of the audit trail written by WFMS. During the data mining process, an attempt is made to find all of the objects of interest. In this paper, a model is presented which can be used to forecast the ultimate size of a complete collection. The model can also be used to estimate the expected time necessary to complete the collection, and the probability of finding more items in a fixed interval of time. The data necessary to compute these forecasts is the number of items which have already been found, and the time it took to collect them. A case study from the field of post card collecting is presented.  相似文献   

15.
随着计算机技术和internet技术的飞速发展,信息技术已经越来越广泛地被应用到行政机关、企事业单位和金融机构的办公中来,从而实现了办公的自动、便捷。办公自动化以工作流技术为核心,通过网络实现信息共享。文章简单介绍了当前成熟的基于Lotus Domino/Notes上的工作流技术,并以购买电脑工作流的实现为例,分步予以介绍如何应用Lotus Domino/Notes实现办公自动化。  相似文献   

16.
This study synthesizes the extant literature to derive an integrative developmental framework for IT business cases that can be applied to diagnose the feasibility of technological investments. We then construct a theoretical model that postulates the impact of IT business case elements on the initial cost estimates of technological investments. Subsequently, our theoretical model is subjected to empirical validation through content analysis of IT business cases developed for municipal e-government projects. Findings indicate that the richness of the richness of business cases translates to more initial costs being identified in technological investments, thereby conserving resources for the organization through informed investment decisions.  相似文献   

17.
Larry   《Annual Reviews in Control》2006,30(2):243-253
Human-centred systems has a long theoretical tradition within the automation and control community stretching back at least into the 1970s and particularly in manufacturing systems. As automation and control systems are increasingly important outside the factory many researchers are revisiting core concepts within this tradition in order to address concerns in these other contexts. One particularly important sector is health care which, in recent years, has implemented a range of AMAT-type solutions not least of which are enterprise systems. This paper reviews the application of enterprise integration systems to health-care and, in doing so, unpacks several theoretical tensions. The paper proposes a re-assessment of human-centred systems (HCS) thinking as a way to address these tensions in automatic healthcare systems.  相似文献   

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19.
US hospitals now fully embrace electronic documentation systems as a way to reduce medical errors and improve patient safety outcomes. Whether spending time on electronic documentation detracts from the time available for direct patient care, however, is still unresolved. There is no knowledge on the permanent effects of documenting electronically and whether it takes away significant time from patient care when the healthcare information system is mature. To understand the time spent on documentation, direct patient care tasks, and other clinical tasks in a mature information system, we conducted an observational and interview study in a midwestern academic hospital. The hospital implemented an electronic medical record system 11 years ago. We observed 22 health care workers across intensive care units, inpatient floors, and an outpatient clinic in the hospital. Results show that healthcare workers spend more time on documentation activities compared to patient care activities. Clinical roles have no influence on the time spent on documentation. This paper describes results on the time spent between documentation and patient care tasks, and discusses implications for future practice.Relevance to industryThe study applies to healthcare industry that faces immense challenges in balancing documentation activities and patient care activities.  相似文献   

20.
The Standard Shiftwork Index (SSI) provides shiftwork researchers with a standardised battery for assessing the impact of shiftwork on psychological and physiological well-being. We review the published SSI literature and evaluate the extent to which the results of these publications support the model underpinning the SSI. A total of 70 SSI publications were identified, of which 41 were selected. The 41 studies were published between 1993 and 2006 and had a combined total of 21,420 respondents. The analysis indicated support for parts of the SSI model, particularly in relation to the impact of shift systems design on individual well-being, as well as the role of individual factors (e.g., personality, coping style). However, evidential support for the model as a whole is incomplete. The findings of the reviewed studies are summarised and methodological limitations are discussed.  相似文献   

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