“Evaluation of HSJ-ICU system use by medical doctors”

Professor Orientador: Ricardo Correia

Turma 20

ObjectiveObjective

To evaluate the use of HSJ-ICU system To evaluate the use of HSJ-ICU system by medical doctors working at HSJby medical doctors working at HSJ

MethodsMethods

Type of study: observational and transversal study

Target population: 1116 medical doctors currently working at HSJ (workers for the Department of Human Resources).

Sampling method: simple random sampling

Sample: 68 medical doctors

Application of the Application of the definitive questionnairedefinitive questionnaire

Collection of Collection of data:data:

Elaboration of the questionnaire (Elaboration of the questionnaire (personal and personal and structured interviewstructured interview))

Application of the 4 pilots (Application of the 4 pilots (reformulation of the reformulation of the questionnaire after the application of each pilotquestionnaire after the application of each pilot))

Frequency of utilization of ICU and others electronic medical records of HSJ

Frequency of utilization of ICU in urgency, consultation and internment

Mean of access to the ICU

Degree of importance of several characteristics of ICU

Departments from which more reports are visualized

Reasons to not use ICU

Impact of the implementation of ICU in the professional life and in HSJ

Changes to ICU

Questionnaire:

Elaboration of the table of data and introduction Elaboration of the table of data and introduction of the data in the SPSSof the data in the SPSS

Statistical analysis of the data in SPSS:

We elaborated frequency tables:

• to count how many medical doctors answered to the questionnaire;and how many did not and the reasons for it;

• to analyze the sex and the age of the medical doctors;

• to analyse the mean of access to the ICU system.

We elaborated several graphs:

• showing the frequency of utilization of ICU, SAM, CLINIDATA and Sistema Informático de Radiologia, in order to compare them;• to compare the frequency of utilization of ICU in urgency, consultation and internment;• to compare the means of the degree of importance of various characteristics of ICU system;• to compare the degree of visualization of reports provided by the departments that send reports to the ICU system.

We also analyzed all the questions about the impact of the ICU and about the changes suggested to this system.

Results, tables and graphsResults, tables and graphs

• Number of medical doctors we searched for in HSJ: 68

• Percent of women: 48,5% (33 medical doctors)

• Percent of men: 51,5% (35 medical doctors)

• Medical doctors that answered to the questionnaire: 52,9% (36 medical doctors)

• Medical doctors that don’t work anymore in HSJ: 17,6% (12 medical doctors)

• Medical doctors were not found: 10,3% (7 medical doctors)

• Medical doctors that refused to answer the questionnaire: 5,9% (4 medical doctors)

• Medical doctors were absent on holidays: 4,4% (3 medical doctors)

• Medical doctors were absent due to labour license: 1,5% (1 medical doctor)

• Medical doctors were absent due to sick note: 2,9% (2 medical doctors)

• Not medical doctors: 4,4% (3 people)

Never used From 1 to 3 times per month

From 1 to 4 times per week

From 1 to 4 times per day

From 5 to 10 times per day

Frequency of utilization of ICU system

0

5

10

15

20

25

30

35

40

45

50

Per

cen

t

Frequency of utilization of ICU system

Graph 1

Never used From 1 to 3 times per

month

From 1 to 4 times per

week

From 1 to 4 times per day

From 5 to 10 times per day

> than 10 times per day

Frequency of utilization of SAM system

0

5

10

15

20

25

30

35

40

45

50

Per

cen

t

Frequency of utilization of SAM system

Graph 2

Never used < than 1 time per month

From 1 to 3 times per

month

From 1 to 4 times per

week

From 1 to 4 times per

day

From 5 to 10 times per day

> than 10 times per

day

Frequency of utilization of CLINIDATA system

0

5

10

15

20

25

30

35

40

45

50

Per

cen

t

Frequency of utilization of CLINIDATA system

Graph 3

Never used From 1 to 3 times per

month

From 1 to 4 times per

week

From 1 to 4 times per day

From 5 to 10 times per day

> than 10 times per day

Frequency of utilization of Sistema Informático de Radiologia

0

5

10

15

20

25

30

35

40

45

50

Per

cen

t

Frequency of utilization of Sistema Informático de Radiologia

Graph 4

Statistics

36 36 36 36

32 32 32 32

29,72 67,50 47,842 109,89

50,213 108,705 69,3357 185,206

Valid

Missing

N

Mean

Std. Deviation

1.1 Frequencyof utilization of

the ICU(InformaçãoClínica doUtente) (intimes permonth)

1.2 Frequencyof utilization of

the SAM(Sistema de

Apoio aoMédico) (intimes permonth)

1.3 Frequencyof utilization of

theCLINIDATA (in

times permonth)

1.4 Frequencyof utilization of

the SistemaInformático deRadiologia (in

times permonth)

Table 1

Frequency of utilization of ICU system in the internment, consultation and urgency

0% 20% 40% 60% 80% 100%

Frequency of utilization of ICU in theurgency

Frequency of utilization of ICU in theconsultation

Frequency of utilization of ICU in theinternment

I usually use

I rarelly use

I never use

Graph 5

Within the 36 medical doctors that answered to the questionnaire, 21 used the ICU system.

• Access to ICU only trough a link on the desktop (HSJ.ICU): 38,1% (8 medical doctors)

• Access to ICU only through SAM: 33,3% (7 medical doctors)

• Access through the link HSJ.ICU, through SAM and through the intranet of the hospital: 14,3% (3 medical doctors)

• Access only through the Intranet of the Hospital: 4,8% (1 medical doctor)

• Access through the link HSJ.ICU, through SAM and through obs.gyn.care (electronic medical record of gynaecology e obstetricses): 4,8% (1 medical doctor)

• Access through the link HSJ.ICU and through SAM: 4,8% (1 medical doctor) Within the 36 medical doctors that answered to the questionnaire, 41,7% (15 medical doctors) have never used the ICU system, all of tem stated they didn’t know this system.

Access to reports of several

departments

Access to reports integrated in one single process of

the patient

Access to actualized

information of a patient

Find important reports that I didn´t know

Chronological visualization of

the clinical history of the patient

Fast access to reports that only existed in paper

Decrease of the time needed to

access to clinical and laboratorial

reports

0

1

2

3

4

5

6

7

8

9

10

Mea

n o

f th

e d

egr

ee o

f im

port

anc

e o

f th

e ch

ara

cter

istic

s of

ICU

cl

assi

fica

ted

from

0 (

very

less

impo

rtan

t) t

o 1

0 (v

ery

muc

h im

port

ant)

Importance of the characteristics of the ICU system

Graph 6

Anatomo-Pathology

Clinical Pathology

Imm

unohemotherapy

Intensive Care

Obstetricses

Pneumology

Gastrenterology

Imm

unoalergology

Gynaecological endoscopy

0

2

4

6

8

Mea

n of

the

degr

ee o

f vi

sual

izat

ion

of r

epor

ts p

rovi

ded

by th

e de

part

men

ts th

at s

end

repo

rts

to I

CU

Degree of visualization of reports provided by the departments that send reports to ICU

Graph 7

Impact caused by the ICU system

AnswersNumber of doctors

that agree

Decrease of the time of access to laboratorial and clinical information 12

It is easier to access to the clinical information of the patient 8

Better communication between health professionals 2

Better integration of the clinical information 1

Access to the clinical information from several places 1

ICU do the same function of SAM 1

ICU is a low system 1

Little impact on my professional life 1

ICU had an important impact 1

Didn’t answer 2

Table 2

Changes suggested to the ICU

AnswersNumber of doctors

that agree

Increase the number of departments from which it is possible to visualize reports 4

Decrease the technical problems that sometimes don’t allow the parcial or total use of ICU 3

Decrease the up-date time of the reports displayed on ICU 2

Possibility of making requests of clinical and laboratorial analysis through ICU 1

Decrease the problems of access of reports from Pathological Anatomy 1

Make the access to ICU easier 1

No suggestion 11

Table 3

Discusion of the resultsDiscusion of the results• ICU is less used than SAM, CLINIDATA and SISTEMA INFORMÁTICO DE RADIOLOGIA because is the most recent system and so it is the last spread;

• Although SAM has a lesser number of users than CLINIDATA, these users use SAM more times per month than the users of CLINIDATA;

• ICU is more used in the internment, following consultation and finally urgency because of the characteristic of each work place;

• The most important characteristics of ICU are “It allows the access to reports (analysis...) from several departments” and “It decreases the time needed to access clinical and laboratorial reports” because they are probably those which make more easy the clinical practice;

• The three departments from which more reports are visualized are Pathological Anatomy, Clinical Pathology and immunohemotherapy. This situation probably occurs because these three departments provide reports which subject is more general.

Flowchart Gantt chart Questionnaire

Website plan Full articleTable of data

of SPSS

Syntax

References

1. Aula sobre Registos Clínicos Electrónicos do Curso de Informática Médica que se encontra em http://im.med.up.pt.

2. Stanley J. Reiser, The Clinical Record in Medicine Part 1: Learning from cases, American College of Physicians, 1991.

3. Richard S. Dick, Elaine B. Steen, and Don E. Detmer, The Computer-based patient record: An Essential Technology for Health Care, National Academy Press, 1997.

4. R. Cruz-Correia, P. Vieira-Marques, P. Costa, A. Ferreira, E. Oliveira-Palhares, F. Araújo and A. Costa-Pereira, Integration oh hospital data using agent Technologies- A case study (2005).

5. Torchio M, Molino F, Sestero D, Seidemari C, Molino G. Na electronic madical diary for computer assisted patient management. Minerva Med.2003 Jun; 94 (3): 167-79.

6.Coiera E. Guide to medical informatics, the internet and telemedicine. Arnold Publishers, London, 1997.

7.Uckert F. et al. Functions of an electronic health record. INT J Comput Dent. 2002 Apr-Jul; 5 (2-3): 125-32.

8.Lenz R and Kuhn KA. Integration of heterogeneous and autonomous systems in hospital. Business Briefing: Data management & Storage Technology, 2002.

9.Manual do utilizador do ICU

10.Panfleto de divulgação do ICU.