A framework for information system usage in collaborative care

David A. Dorr, Spencer S. Jones, Adam Wilcox

Research output: Contribution to journalArticle

26 Scopus citations

Abstract

Clinical information systems (CIS) can affect the quality of patient care. In this paper, we focus on CIS use in the collaborative treatment of chronic diseases. We have developed a framework to determine which CIS functions have general usefulness for improving patient outcomes. Methods: We reviewed the use of clinical information systems within a collaborative care environment, identifying CIS functions important in chronic disease care. We grouped the functions into categories of access, best practices, and communication (ABC). Three independent raters selected the most important collaborative care related functions from the HL7 Electronic Health Record Systems functional model, and mapped the HL7 functions against the ABC categories. We then built a model of CIS use and tested it on data from a cohort of patients with chronic illnesses. Results: Of the 133 HL7 elements in the ABC model, 60 (45%) were ranked as important for collaborative care by two reviewers. Agreement was moderate for importance (κ = .20) but high for ABC categorization (κ = .67). In our data tests, for the 1105 patients, access 4.4 ± 6.5, best practices 0.8 ± 1.6, and communication 2.9 ± 4.5. CIS functions were used per episode of care. We were able to identify several key functions that may affect patient care. For example, certain CIS functions related to best practices were associated with higher clinician adherence to testing guidelines. Discussion: This framework may be useful to assess and compare CIS systems for collaborative care. Future refinements of the model are discussed.

Original languageEnglish (US)
Pages (from-to)282-287
Number of pages6
JournalJournal of Biomedical Informatics
Volume40
Issue number3
DOIs
StatePublished - Jun 1 2007

Keywords

  • Collaboration
  • Cooperative behavior [MeSH]
  • Information systems [MeSH]
  • Interdisciplinary communication [MeSH]
  • Organizational models [MeSH]

ASJC Scopus subject areas

  • Computer Science Applications
  • Health Informatics

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