Suzanne Bakken

Access to personal health information assists efforts to improve health outcomes and creates a population of active and informed health consumers. Understanding this significance, Healthy People 2020 retained, as a Focus Area, the need for improved interactive Health Communication and HIT. Attainment of this goal includes increasing the use of Internet-based electronic personal health management tools (EPHMT). Health information management, essential for favorable health outcomes, can be problematic in low income, special needs populations with complex chronic illnesses such as HIV/AIDS. Furthermore, barriers to the adoption and acceptance of an EPHMT in such populations have not been well explored. The current study seeks to explore the usability of an EPHMT entitled MyHealthProfile and to identify perceived health information needs in a vulnerable population of people living with HIV and AIDS (PLWH) that have access to an EPHMT through their Medicaid Special Needs Plan.

Despite more than a decade of patient safety initiatives in our health care system, nurses (N = 172) identified a large number of safety issues in the ambulatory care setting, including issues in their own practice (50.7% of the encounters), feeling rushed or hurried (34.8% of encounters), and being interrupted (27.0% of encounters). Greater patient complexity was a significant predictor of identifying a diagnostic or management and treatment issue. The presence of an electronic health record was not related to reporting of a patient safety issue.

Next-generation tablets (iPads and Android tablets) may potentially improve the collection and management of clinical research data. The widespread adoption of tablets, coupled with decreased software and hardware costs, has led to increased consideration of tablets for primary research data collection. When using tablets for the Washington Heights/Inwood Infrastructure for Comparative Effectiveness Research (WICER) project, we found that the devices give rise to inherent security issues associated with the potential use of cloud-based data storage approaches. This paper identifies and describes major security considerations for primary data collection with tablets; proposes a set of architectural strategies for implementing data collection forms with tablet computers; and discusses the security, cost, and workflow of each strategy. The paper briefly reviews the strategies with respect to their implementation for three primary data collection activities for the WICER project.

Valid measures of attitudes are an important component of developing and testing educational interventions aimed at improving technology acceptance. The aim of this study was to assess the construct validity (factor analysis and discriminant validity), internal consistency reliability (Cronbach α), and responsiveness (independent-samples t test) of the Attitudes toward Handheld Decision Support Software Scale in a sample of 103 nursing students engaged in a set of curricular activities focused on enabling safe and evidence-based nursing practice through the use of information technology. Principal components factor analysis resulted in three factors (ease of use and usefulness, clinical support, and barriers to use) that explained 55.49% of the variance. Internal consistency reliability estimates ranged from .61 to .82. Factor scores did not discriminate between nursing students who owned a PDA and those who did not. There were no significant changes in factors scores over time (responsiveness). This study provides preliminary evidence for the factorial structure of the Handheld Decision Support Software Scale and internal consistency of two of the three factor scales. Further exploration of the construct validity, internal consistency, and responsiveness is warranted.

Implications for Nursing Research and Generation of Evidence: 10.4018/978-1-60960-034-1.ch009: A sound informatics infrastructure is essential to optimise the application of evidence in nursing practice. A comprehensive review of the infrastructure and

The purpose of this study was to determine if race/ethnicity, payer type, or nursing specialty affected depression screening rates in primary care settings in which nurses received a reminder to screen. The sample comprised 4,160 encounters in which nurses enrolled in advanced practice training were prompted to screen for depression using the Patient Health Questionnaire (PHQ)-2/PHQ-9 integrated into a personal digital assistant-based clinical decision support system for depression screening and management. Nurses chose to screen in response to 52.5% of reminders. Adjusted odds ratios showed that payer type and nurse specialty, but not race/ethnicity, significantly predicted proportion of patients screened.

Effective communication is essential to safe and efficient patient care. We aimed to understand the current patterns and perceptions of communication of common goals in the ICU using the distributed cognition and clinical communication space theoretical frameworks. We conducted a focus group and 5 interviews with ICU clinicians and observed 59.5 hours of interdisciplinary ICU morning rounds. Clinicians used a CIS/CPOE system and paper artifacts for documentation; yet, preferred verbal communication as a method of information exchange because they perceived that the documentation was often not updated or efficient for information retrieval. These perceptions that the CIS/CPOE is a "shift behind" may lead to a further reliance on verbal information exchange, which is a valuable clinical communication activity, yet, is subject to information loss. Electronic documentation tools that, in real time, capture information that is currently verbally communicated may increase the effectiveness of communication.