We hypothesize that when using a clinician order entry system (COES), nurses and physicians encounter specific information needs that can be predicted based on the information they are reviewing. By automatically providing links to on-line resources designed to resolve those needs, we can decrease the rate at which information seeking is deferred. This should, in turn, increase the rate at which information seeking is successful, leading to better-informed ordering. We will study this problem using programs, called """"""""infobuttons"""""""" that use context-specific information to anticipate information needs and automate retrieval from appropriate resources. For example, an infobutton placed next to patient data in a COES display can use the patient data itself to facilitate information retrieval. We believe it is time to study this approach for COES, at multiple institutions. Our approach will be to extend our current research to: . Study information needs that arise when clinicians use commercial or local COES's at three institutions . Build infobuttons that address the specific needs that are identified . Integrate links from the COES's to the infobuttons . Study the ability of the infobuttons to improve access to information Our study will involve the direct observation of clinicians, using a portable usability laboratory, as they use Web-based COES's at New York Presbyterian Hospital, LDS Hospital and Regenstrief Institute during routine patient care and """"""""think aloud"""""""" about their information needs. We will analyze these activities to determine, for a given context, the information needs most likely to arise. We will then construct institution-independent infobuttons to automate the retrieval of specific information relevant to specific needs. The infobuttons will be integrated into the COES and we will study their use by clinicians to determine if they are usable and useful in the process of actual patient care.

Agency
National Institute of Health (NIH)
Institute
National Library of Medicine (NLM)
Type
Research Project (R01)
Project #
5R01LM007593-04
Application #
7009327
Study Section
Biomedical Library and Informatics Review Committee (BLR)
Program Officer
Sim, Hua-Chuan
Project Start
2002-09-01
Project End
2008-01-16
Budget Start
2006-01-17
Budget End
2007-01-16
Support Year
4
Fiscal Year
2006
Total Cost
$538,318
Indirect Cost
Name
Columbia University (N.Y.)
Department
Miscellaneous
Type
Schools of Medicine
DUNS #
621889815
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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