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Health care information technology can be a means to improve quality and efficiency in the primary care setting. However, merely applying technology without addressing how it fits into provider workflow and existing systems is unlikely to achieve improvement goals. Improving quality of primary care, such as cancer screening rates, requires addressing barriers at system, provider, and patient levels. The authors report the development, implementation, and preliminary use of a new [...]

The authors implemented what is possibly the first secure messaging system in a VA Medical Center. Since reimbursement for secure messaging is not of great concern and clinical data systems are fully computerized, several evaluation strategies were used to assess clinical adoption. To address known concerns of clinicians, the authors analyzed secure messaging use and performed a content analysis. Message volumes were low and content analysis demonstrated that messages were [...]

This study sought to investigate user interactions with an electronic health records (EHR) system by uncovering hidden navigational patterns in the EHR usage data automatically recorded as clinicians navigated through the system's software user interface (UI) to perform different clinical tasks.

In public health and health services research, the inclusion of geographic information in data sets is critical. Because of concerns over the re-identification of patients, data from small geographic areas are either suppressed or the geographic areas are aggregated into larger ones. Our objective is to estimate the population size cut-off at which a geographic area is sufficiently large so that no data suppression or further aggregation is necessary.

The purpose of this study was to evaluate the adequacy of the International Classification of Nursing Practice (1) (ICPN) Version 1.0 as a representational model for nursing assessment documentation.

The Core Content for Clinical Informatics defines the boundaries of the discipline and informs the Program Requirements for Fellowship Education in Clinical Informatics. The Core Content includes four major categories: fundamentals, clinical decision making and care process improvement, health information systems, and leadership and management of change. The AMIA Board of Directors approved the Core Content for Clinical Informatics in November 2008.

This paper proposes, in words and pictures, a "fundamental theorem" to help clarify what informatics is and what it is not. In words, the theorem stipulates that a person working in partnership with an information resource is "better" than that same person unassisted. The theorem is applicable to health care, research, education, and administrative activities. Three corollaries to the theorem illustrate that informatics is more about people than technology; that [...]

The active engagement of consumers is an important factor in achieving widespread success of health information systems. The disability community represents a major segment of the healthcare arena, with more than 50 million Americans experiencing some form of disability. In keeping with the "consumer-driven" approach to e-health systems, this paper considers the distinctive aspects of electronic and personal health record use by this segment of society. Drawing upon the information [...]

This study sought to develop and evaluate an approach for auditing the semantic completeness of the SNOMED CT contents using a formal concept analysis (FCA)-based model.