IS-HEART presentation June 5th: Dynamic Clinical Checklist Support Systems

Also see the online agenda item for this session.

Speakers: Lonneke Vermeulen (TU/e – IS) and Ashley De Bie Dekker (Catharina Ziekenhuis Eindhoven)
Title: The first pilot study of DCCSS Tracebook, from idea to results

Abstract: Atul Gawandas’ Checklist Manifesto made the medical world realize the high potential of clinical safety checklists in reducing medical errors and improving patient safety. As the current computerized checklist support systems were too static, the Brainbridge II program (a collaboration between the Eindhoven University of Technology, Zhejiang University, Philips Research and Catharina Hospital Eindhoven) developed a system that can individualize checklists based on information from the patient’s medical record while also considering the context of the clinical workflows. By the end of last year (2014) the first pilot study of the Dynamic Clinical Checklist Support System (DCCSS) Tracebook took place in the hospital. In this presentation we will guide you from the beginning of this project to the results of the first pilot study.

After a short introduction of the Tracebook system, we will describe how we developed these dynamic checklists, which research design we followed and how the pilot study was set up. We will conclude with the promising results from the study and afterwards there is time for discussion.

Master Thesis Defense Sven Bastianen: Towards an architecture for the support of integrated Personal Health Records

Pieter Van Gorp is proud to announce the very successful completion of the master thesis project of Sven Bastianen.  Sven has worked closely with SAP NL and for the final presentation the large number of attendees confirmed that he tackled a very relevant problem.

MTP Defense Sven Bastianen (web)
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IS-HEART session by Stan Lamers

The 2nd IS-HEART session of Feb. 2015 will be scheduled in week 4 instead of week 3.

Title: Physician Order Alert Assessment Support using Data Mining Techniques.

Where: K16
When: 27/02/2015, 12:30-13:30
Also see the online agenda item.

Everybody Welome!

Abstract: During the last four decades there has been a major increase in the number of automatic reporting systems for adverse drug events (ADEs)in the healthcare setting. Computerized prescription alerts can assist in avoiding ADEs but research has indicated that one important example of an ADE is the situation where a medical specialist fails to adequately assess computerized prescription alerts. These computerized prescription alerts can be shown to a physician when for example there is a problem with the dosage of a prescribed medicine or an interaction with other medicines is found. Hospital Pharmacist Drs. P.A.G. De Klaver indicates that Maxima Medical Center’s Pharmacy has to deal with 500-800 prescription alerts on an average day, which is considered to be too high and time consuming. The alert system that is currently in use at the hospital is emphasizing the breadth of coverage instead of clinical relevance or severity of the event, which leads to low clinician acceptance of drug alerts. Many alerts can cause alert fatigue; a state in which the user becomes less responsive to alerts in general.
The aim of this research project is to find data mining techniques to create models that can support processing of prescription alerts at the Maxima Medical Center in Veldhoven. This research will not focus on all ADEs but only on drug-drug interaction effects and their alerts because those alerts are considered to be the most time consuming for pharmacy personnel.

In this presentation, an overview of recent work on improving healthcare alerts systems is given and the overall research proposal is clarified.

Master Thesis Defense by Michel Koeken on HIS/EHR Procurement

Today, Michel Koeken has defended his master thesis. The thesis relates to a project conducted in collaboration with Siemens and provides valuable insights into the HIS procurement methods of Dutch academic hospitals.

Thesis title

Identifying and ranking the selection criteria in European tenders regarding the procurement of HIS/EHR systems in Dutch academic hospitals.

Management summary (excluding tables)

The thesis focused on the procurement of Hospital Information System / Electronic Health Record (HIS/EHR) systems at Dutch academic hospitals. As Dutch academic hospitals are considered to be a public institution and the value of the procurement of a HIS/EHR system exceeds the threshold value of €200,000 they are obliged by the BAO (Besluit Aanbestedingsregels voor Overheidsopdrachten) to conduct a European tender. The BAO is the Dutch implementation of the European guideline 2004/18/EG.

Each European tender contains a Research For Proposal (RFP). The RFP provides a detailed set of requirements of what the academic hospital wants to acquire and the score model that the academic hospital will use to evaluate the proposals of the vendors. The detailed set of requirements is divided into subtopics and these subtopics are considered as the selection criteria. The score model states how much points can be scored by the vendors by fulfilling a specific selection criterion. The vendor with the highest score and therefore the most economically advantageous offer (i.e. best price-quality ratio) wins the tender. In The Netherlands are three European tenders conducted by the Dutch academic hospitals in order to acquire a HIS/EHR system. All three European tenders were won by different vendors and this is interesting when one take into account that:

  • a vendor had to be selected through a strict tendering process which is based on the three principles (equal treatment, transparency, and non-discrimination) and therefore ensures for total transparency since all decisions are open for involved parties, no possibility for negotiation, and an equally review of every vendor;
  • the Dutch academic hospitals did not differ that much;
  • and there were only five (six at the time of the first two European tenders) available vendors from which the Dutch academic hospitals could choose from.

One would expect that at least two out of the three European tenders were won by the same vendor, but this was not the case. Therefore it is interesting to analyze these European tenders to investigate how Dutch academic hospitals used the European tenders to come to their results.

To answer the raised issue the thesis started with analyzing the three score models in the RFPs in order to identify and rank the selection criteria in terms of importance. The three included RFPs were those from the European tenders conducted by Leiden University Medical Center + University Medical Center Utrecht, University Medical Center St. Radboud, and Erasmus Medical Center + University Medical Center Groningen. This analysis showed that the three European tenders could not be compared one on one as they used slightly different terminology and wording for their selection criteria. This problem was tackled by selecting one European tender as the reference tender and the selection criteria of the other two European tenders were matched with the selection criteria of the reference tender. This matching was done by two vendor experts and followed the two round Delphi method (Skulmoski, Hartman, & Krahn, 2007). Now the three European tender could be compared as they contained the same selection criteria. The comparison showed that the European tenders scored their selection criteria differently.

As academic hospitals are often an example for general hospitals this identification and ranking could be an important insight for general hospitals. It is even possible that general hospitals use this as a blueprint for determining their own selection criteria. Obviously also other academic hospitals can use this insight to their advantage and consultancy companies can use it in advising their clients.

The differences between the percentages were analyzed with the help of a vendor expert and as the tenders occurred sequentially trends were determined. It is important to state that the trends could be based on coincidence as there were only three available data sets. Nonetheless it is interesting and useful to discuss the possible trend and especially the most important ones.

The possible trends can be beneficial for every stakeholder in The Netherlands or elsewhere as they show which topics are hot or not. Vendors could use it to determine their business strategy, the consultancy companies can advise their clients about it, and the hospitals can take it into account in their procurement processes.

The full thesis text can be downloaded here. Michel also provided a Powerpoint file with an embedded audio recording of his (trial) presentation.

Master Thesis Plan: Bas van Geffen

We just had an interesting session with Bas van Geffen, a student who is also an information architect in a Dutch hospital. Bas today presented to fellow students as well as IS researchers his plan for his master thesis.