Inadequate access to timely information at the moment of decision-making is a well-documented proximal cause of medical errors. We hypothesize that when using a clinical information system (CIS), nurses and physicians encounter specific information needs that can be predicted, based on the information they are reviewing. We hypothesize that providing links to on-line resources designed to resolve those needs, can decrease the rate at which information seeking is deferred and increase the rate at which information seeking is successful. We will study this problem using """"""""infobuttons""""""""; programs that use context-specific information to anticipate information needs and automate retrieval from appropriate resources. We have built, tested and deployed infobuttons with positive anecdotal results. We believe it is now time to study them formally by: a) Studying information needs that arise when clinicians look at data in a CIS; b) Building infobuttons that address those specific needs; c) Develop a mechanism to support institution independent integration of infobuttons into a CIS and; d) Studying the ability of such infobuttons, once integrated into a working CIS, to improve access to information. We will directly observe clinicians, with an unobtrusive """"""""portable usability laboratory"""""""", as they use a Web-based CIS in the routine course of patient care. We will ask them to """"""""think aloud"""""""" about their information needs, capturing what they say and do on videotape. We will analyze the interactions to determine, for a given context, the information needs most likely to arise. We will then construct infobuttons to automate the retrieval of specific information relevant to specific needs. The infobuttons will be integrated into the CIS, using an """"""""Infobutton Manager"""""""" that will be automated and data-driven while preserving the institution-independent nature of the infobuttons. We will then study clinicians' use of infobuttons to answer the following questions: 1) What information needs arise when clinicians use a CIS? 2) Can institution-independent infobuttons be built that address context-specific needs? 3) Do infobuttons improve access to information during clinical practice?

Agency
National Institute of Health (NIH)
Institute
National Library of Medicine (NLM)
Type
Research Project (R01)
Project #
1R01LM007593-01
Application #
6521990
Study Section
Biomedical Library and Informatics Review Committee (BLR)
Program Officer
Florance, Valerie
Project Start
2002-09-01
Project End
2004-08-31
Budget Start
2002-09-01
Budget End
2003-08-31
Support Year
1
Fiscal Year
2002
Total Cost
$382,017
Indirect Cost
Name
Columbia University (N.Y.)
Department
Miscellaneous
Type
Schools of Medicine
DUNS #
167204994
City
New York
State
NY
Country
United States
Zip Code
10032
Cimino, James J (2015) Normalization of Phenotypic Data from a Clinical Data Warehouse: Case Study of Heterogeneous Blood Type Data with Surprising Results. Stud Health Technol Inform 216:559-63
Schnall, Rebecca; Cimino, James J; Currie, Leanne M et al. (2011) Information needs of case managers caring for persons living with HIV. J Am Med Inform Assoc 18:305-8
Del Fiol, Guilherme; Cimino, James J; Maviglia, Saverio M et al. (2010) A large-scale knowledge management method based on the analysis of the use of online knowledge resources. AMIA Annu Symp Proc 2010:142-6
Collins, Sarah A; Currie, Leanne M; Bakken, Suzanne et al. (2009) Information needs, Infobutton Manager use, and satisfaction by clinician type: a case study. J Am Med Inform Assoc 16:140-2
Del Fiol, Guilherme; Haug, Peter J (2009) Classification models for the prediction of clinicians' information needs. J Biomed Inform 42:82-9
Cimino, James J (2009) The contribution of observational studies and clinical context information for guiding the integration of infobuttons into clinical information systems. AMIA Annu Symp Proc 2009:109-13
Hyun, Sookyung; Johnson, Stephen B; Bakken, Suzanne (2009) Exploring the ability of natural language processing to extract data from nursing narratives. Comput Inform Nurs 27:215-23; quiz 224-5
Cimino, James J; Borovtsov, Dmitriy V (2008) Leading a horse to water: using automated reminders to increase use of online decision support. AMIA Annu Symp Proc :116-20
Del Fiol, Guilherme; Haug, Peter J (2008) Infobuttons and classification models: a method for the automatic selection of on-line information resources to fulfill clinicians'information needs. J Biomed Inform 41:655-66
Del Fiol, Guilherme; Haug, Peter J; Cimino, James J et al. (2008) Effectiveness of topic-specific infobuttons: a randomized controlled trial. J Am Med Inform Assoc 15:752-9

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