Human, social, and organizational aspects of health information systems

"This book offers an evidence-based management approach to issues associated with the human and social aspects of designing, developing, implementing, and maintaining health information systems across a healthcare organization--specific to an individual, team, organizational, system, and intern...

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650 4 |a Information storage and retrieval systems / Health services administration 
650 4 |a Health services administration / Data processing 
650 4 |a Management information systems / Human factors 
650 4 |a Management information systems / Social aspects 
650 4 |a Management information systems / Management 
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adam_text Table of Contents Foreword xvi Preface xviii Section I Usability and Human-Computer Interaction in Healthcare Chapter I Emerging Approaches to Evaluating the Usability of Health Information Systems 1 Andre W. Kushniruk, University of Victoria, Canada Elizabeth M. Borycki, University of Victoria, Canada Shige Kuwata, University of Victoria, Canada Francis Ho, Tottori University Hospital, Japan Chapter II A Bio-Psycho-Social Review of Usability Methods and their Applications in Healthcare 23 Morgan Price, University of Victoria, Canada and University of British Columbia, Canada Section II Supporting Healthcare Work Practices Chapter HI Enhancing Fit of Health Information Systems Design Through Practice Support 50 Craig E. Kuziemsky, University of Ottawa, Canada Chapter IV Towards Computer Supported Clinical Activity: A Roadmap Based on Empirical Knowledge and some Theoretical Reflections 67 Christian Nohr, Aalborg University, Denmark Niels Boye, Aalborg University, Denmark Chapter V Pervasive Healthcare: Problems and Potentials 84 Niels Boye, University ofAalborg, Denmark Section III Organizational Aspects: Change Management, Best Practices, and Evaluation Chapter VI The Human Aspects of Change in IT Projects 103 Karen Day, University of Auckland, New Zealand Tony Norris, Massey University, New Zealand Chapter VD Best Practices for Implementing Electronic Health Records and Information Systems 120 Beste Kucukyazici, McGill University, Canada Karim Keshavjee, InfoClin Inc., Canada John Bosomworth, University of Victoria, Canada JohnCopen, University of Victoria, Canada James Lai, University of British Columbia, Canada Chapter VIII Health Informatics and Healthcare Redesign Using ICT to Move from an Evolutionary to a Revolutionary Stage 139 Vivian Vimarlund, Linkoping University, Sweden Chapter IX Where do Technology Induced Errors Come From? Towards a Model for Conceptualizing and Diagnosing Errors Caused by Technology 148 Elizabeth M. Borycki, University of Victoria, Canada Andre WKushniruk, University of Victoria, Canada Chapter X Regional Patient Safety Initiatives: The Missing Element of Organizational Change 167 James G. Anderson, Purdue University, USA Chapter XI Evaluation Methods to Monitor Success and Failure Factors in Health Information System s Development 180 Jytte Brender, University ofAalborg and Virtual Center for Health Informatics, Denmark Section IV Strategic Approaches to Improving the Healthcare System Chapter XII A Comparison of How Canada, England and Denmark are Managing their Electronic Health Record Journeys 203 Denis Protti, University of Victoria, Canada Chapter XIII Operationalizing the Science: Integrating Clinical Informatics into the Daily Operations of the Medical Center 219 Joseph Kannry, Mt. Sinai Medical Center, USA Chapter XIV Health Information Technology Economic Evaluation 240 Eric L. Eisenstein, Duke Clinical Research Institute, USA Maqui Ortiz, Duke Clinical Research Institute, USA Kevin J. Anstrom, Duke Clinical Research Institute, USA David F. Lobach, Duke Clinical Research Institute, USA Section V Legal, Ethical, and Professional Issues Chapter XV Legal Issues in Health Information and Electronic Health Records 260 Nola Ries, University of Alberta, Canada and University of Victoria, Canada Chapter XVI Accountability, Beneficence, and Self Determination: Can Health Information Systems Make Organizations Nicer ? 274 Tina Saryeddine, University of Toronto, Canada Chapter XVII Electronic Health Records: Why Does Ethics Count? 287 Eike-Henner W. Kluge, University of Victoria, Canada Section VI Knowledge Translation in Healthcare Chapter XVIII Technology Enabled Knowledge Translation: Using Information and Communications Technologies to Accelerate Evidence Based Health Practices 301 Kendall Ho, University of British Columbia, Canada Chapter XIX Knowledge Translation in Nursing Through Decision Support at the Point of Care 314 Diane Dorcm, University of Toronto, Canada Tammie Di Pietro, University of Toronto, Canada Chapter XX Improving Internet-Based Health Knowledge Through Attention to Literacy 331 Jose F. Arocha, University of Waterloo, Canada Laurie Hqffman-Goetz, University of Waterloo, Canada Compilation of References 347 About the Contributors 385 Index 392 Detailed Table of Contents Foreword xvi Preface xviii Section I Usability and Human-Computer Interaction in Healthcare Chapter I Emerging Approaches to Evaluating the Usability of Health Information Systems 1 Andre W. Kushniruk, University of Victoria, Canada Elizabeth M. Borycki, University of Victoria, Canada Shige Kuwata, University of Victoria, Canada Francis Ho, Tottori University Hospital, Japan It is essential that health information systems are easy to use, meet user information needs, and are shown to be safe. However, there is currently a wide range of issues and problems with health information sys¬ tems related to human-computer interaction. Indeed, lack of ease of use of health information systems has been a major impediment to the adoption of such systems. To address these issues, the authors have applied methods emerging from the field of usability engineering in order to improve the adoption of a wide range of health information systems in collaboration with hospitals and other healthcare orga¬ nizations throughout the world. In this chapter, we describe our work in conducting usability analyses that can be used to rapidly evaluate the usability and safety of healthcare information systems, both in artificial laboratory and real clinical settings. We then discuss how this work has evolved towards the development of software systems ( virtual usability laboratories ) capable of remotely collecting, integrating and supporting analysis of a range of usability data. Chapter II A Bio-Psycho-Social Review of Usability Methods and their Applications in Healthcare 23 Morgan Price, University of Victoria, Canada and University of British Columbia, Canada The purpose of this chapter is to provide the reader with an overview of several models and theories from the general HCI literature, highlighting models at three levels of focus: biomechanical interac¬ tions, individual-cognitive interactions, and social interactions. This chapter will also explore how these models have been or could be applied to the design and evaluation of clinical information systems, such as electronic medical records and hospital information systems. Finally, it will conclude with how an understanding at each level compliments the other two in order to create a more complete understanding of the interactions of information systems in healthcare. Section II Supporting Healthcare Work Practices Chapter in Enhancing Fit of Health Information Systems Design Through Practice Support 50 Craig E. Kuziemsky, University of Ottawa, Canada The design and implementation of healthcare information systems (HIS) is problematic as many HIS projects do not achieve the desired outcomes. There exist a number of theories to enhance our ability to successfully develop HIS. Examples of such theories include fit and the sociotechnical approach. However, there are few empirical studies that illustrate how to understand and operationalize such theo¬ ries at the empirical level needed for HIS design. This chapter introduces a practice support framework that bridges the gap between the theoretical and empirical aspects of HIS design by identifying specific process and information practice supports that need to be considered to actively produce fit of an HIS within a healthcare setting. The chapter also provides an empirical case study of how practice support was used to develop a computer based tool in the domain area of palliative care severe pain management. Chapter IV Towards Computer Supported Clinical Activity: A Roadmap Based on Empirical Knowledge and some Theoretical Reflections 67 Christian Nohr, Aalborg University, Denmark Niels Boye, Aalborg University, Denmark The introduction of electronic health records (EHR) to the clinical setting has led healthcare professionals, policy makers, and administrators to believe that health information systems will improve the function¬ ing of the health care system. In general such expectations of health information system functionality, impact, and ability to disseminate have not been met. In this chapter, we present the findings of three empirical studies: (1) the structured monitoring of EHR implementation processes in Denmark from 1999-2006 by the Danish EHR observatory, (2) a usability study based on human factors engineering concepts with clinicians in artificial but realistic circumstances—a state of the art (2005) for Danish CPOE (computerized physician order entry system) and (3) user reactions to a conceptual high level model of healthcare activities—the Danish G-EPJ model in order to better understand the reasons for health information system failures and to suggest methods of improving adoption. The authors suggest that knowledge handling as a science seems immature and is not in line with the nature of clinical work. The prerequisites for mature knowledge handling are discussed in the second part of this chapter. More specifically, the authors describe one way of improving knowledge handling: the development of a more true digital representation of the object of interest or the virtual patient/citizen that interacts with computer based health care services on behalf of and for the benefit of the citizen s health. Chapter V Pervasive Healthcare: Problems and Potentials 84 Niels Boye, University ofAalborg, Denmark Pervasive healthcare is a vision for the future of health care stating that some healthcare provisions can be delivered in high quality at low cost and with higher patient-experienced quality and satisfaction as a service on top of a pervasive computing infrastructure, which can be built by integrating communicating computer-power into industrial products and fixed structures in urban and rural spaces. For pervasive healthcare integration with on body networks sensors, and actuators may also be needed. The chapter discusses the prerequisites of this vision from a point of a healthcare professional. A number of paral¬ lel advances in concepts have to take place before pervasive healthcare (PH) is matured into a general method for delivering health care provisions. The contemporary most widespread model of healthcare provisions as industrial products with consumer-goods characteristics has to mature into the concepts of welfare economics and new market models have to be developed for PH to pervade society and add value to the health aspects of an individual s life. Ethical and legal aspects must also be further matured. Maturation of technology is also needed. This includes all the components of the pervasive loop from sensors to the central intelligence back to the actuators. The virtual patient/healthy human as an op¬ erational digital representation of the object/subject of care also has to be developed. Section III Organizational Aspects: Change Management, Best Practices, and Evaluation Chapter VI The Human Aspects of Change in IT Projects 103 Karen Day, University of Auckland, New Zealand Tony Norris, Massey University, New Zealand In this chapter, we describe the transition phase (capability crisis) of the change process linked to health IT projects, indicate how it can be identified and outline the ways in which we can use change manage¬ ment to intervene and assist people in their journey of change. Despite IT projects being considered a failure more often than not, we continue to implement IT innovations encapsulated in health informa¬ tion systems in healthcare services. These projects bring about considerable organizational change. Good project management includes the use of critical success factors such as change management in our attempts at ensuring success. The purpose of this chapter is to examine the ways in which we can identify (diagnose) the capability crisis and intervene (with change management) by means of learning, leadership, communication and workload management. Chapter VII Best Practices for Implementing Electronic Health Records and Information Systems 120 Beste Kucukyazici, McGill University, Canada Karim Keshavjee, InfoClin Inc., Canada John Bosomworth, University of Victoria, Canada John Copen, University of Victoria, Canada James Lai, University of British Columbia, Canada This chapter introduces a multi-level, multi-dimensional meta-framework for successful implementations of EHR in health care organizations. Existing implementation frameworks do not explain many features experienced and reported by implemented and have not helped to make health information technology implementation any more successful. To close this gap, we developed an EHR implementation frame¬ work that integrates multiple conceptual frameworks in an overarching, yet pragmatic meta-framework to explain factors which lead to successful EHR implementation, in order to provide more quantitative insight into EHR implementations. Our meta-framework captures the dynamic nature of an EHR imple¬ mentation through their function, interactivity with other factors and phases, and iterative nature. Chapter VIII Health Informatics and Healthcare Redesign Using ICT to Move from an Evolutionary to a Revolutionary Stage 139 Vivian Vimarlwtd, Linkoping University, Sweden This chapter introduces a framework to analyze the pre-requisites to move from an evolutionary stage to a revolutionary one when using ICT in healthcare. It argues that the degree of transformation should be determined by the role ICT has in the organization when initiating the redesigning process, but also by the aims technology is supposed to achieve. The suggested framework can be used to identify precondi¬ tions and areas affected from the implementation and use of ICT providing a structure to evaluate how changes will affect key actors and the organization. The classification suggested to identify different steps of transformation should indicate stakeholders, healthcare personnel and managers how to refocus their priorities to be able to built organizations that can be adapted to the revolutionary stage to obtain the same benefits that the industry has previously identified from the implementation of use of ICT. Chapter IX Where do Technology Induced Errors Come From? Towards a Model for Conceptualizing and Diagnosing Errors Caused by Technology 148 Elizabeth M. Borycki, University of Victoria, Canada Andre W Kushniruk, University of Victoria, Canada Health information technology has the potential to greatly improve health care delivery. Indeed in re¬ cent years many have argued that introduction of information technology will be essential in order to decrease medical error and increase health care safety. In this chapter we review some of the evidence that has accumulated indicating the positive benefits of health information technology for improving safety in health care. However, a number of recent studies have indicated that if systems are not designed and implemented properly health information technology may actual inadvertently result in new types of medical errors—technology-induced errors. In this chapter, we discuss where such error may arise and propose a model for conceptualizing and diagnosing technology-induced error so that the benefits of technology can be achieved while the likelihood of the occurrence of technology-induced medical error is reduced. Chapter X Regional Patient Safety Initiatives: The Missing Element of Organizational Change 167 James G. Anderson, Purdue University, USA Data-sharing systems—where healthcare providers jointly implement a common reporting system to promote voluntary reporting, information sharing, and learning—are emerging as an important regional, state-level, and national strategy for improving patient safety. The objective of this chapter is to review the evidence regarding the effectiveness of these data-sharing systems and to report on the results of an analysis of data from the Pittsburgh Regional Healthcare Initiative (PRHI). PRHI consists of 42 hos¬ pitals, purchasers and insurers in southwestern Pennsylvania that implemented Medmarx, an on-line medication error reporting systems. Analysis of data from the PRHI hospitals indicated that the number of errors and corrective actions reported initially varied widely with organizational characteristics such as hospital size, JCAHO accreditation score and teaching status. But the subsequent trends in reporting errors and reporting actions were different. Whereas the number of reported errors increased significantly, and at similar rates, across the participating hospitals, the number of corrective actions reported per error remained mostly unchanged over the 12-month period. A computer simulation model was developed to explore organizational changes designed to improve patient safety. Four interventions were simulated involving the implementation of computerized physician order entry, decision support systems and a clinical pharmacist on hospital rounds. The results of this study carry implications for the design and assessment of data-sharing systems. Improvements in patient safety require more than voluntary report¬ ing and clinical initiatives. Organizational changes are essential in order to significantly reduce medical errors and adverse events. Chapter XI Evaluation Methods to Monitor Success and Failure Factors in Health Information System s Development 180 Jytte Brender, University ofAalborg and Virtual Center for Health Informatics, Denmark Section IV Strategic Approaches to Improving the Healthcare System This chapter discusses the extent to which factors known to influence the success and failure of health information systems may be evaluated. More specifically, this is concerned with evaluation of such factors—for screening, diagnostic or preventive purposes—by means of existing evaluation methods designed for users. The author identifies that it is feasible to identify evaluation methods for most success factor and failure criteria. However, there is a need for situational methods engineering as the methods are not dedicated to answering the precise information needs of the project management. Therefore, de¬ mands are being placed on the evaluators methodical and methodological skills, when evaluating health information systems. The author concludes the paper by pointing at research needs and opportunities. Chapter XII A Comparison of How Canada, England and Denmark are Managing their Electronic Health Record Journeys 203 Denis Protti, University of Victoria, Canada Healthcare is one of the world s most information intensive industries. Every day volumes of data are produced which, properly used, can improve clinical practice and outcomes, guide planning and resource allocation, and enhance accountability. Electronic health information is fundamental to better health care. There will be no significant increase forward in health care quality and efficiency without high quality, user-friendly health information compiled and delivered electronically. The growing use of information and communication technology (ICT) in the healthcare sector has introduced numerous opportunities and benefits to patients, providers and governments alike. Patients are being provided with tools to help them manage and monitor their health care, providers are able to seamlessly access up-to-date patient information and governments are showing transparency to the public by reporting health data and infor¬ mation on their Web sites. There is mounting evidence that national, regional and organizational e-health strategies are being developed and implemented worldwide. This chapter provides an overview of three different national e-health strategies, and identifies the lessons learned from the e-health strategies of Canada, England, and Denmark. Chapter XI11 Operational izing the Science: Integrating Clinical Informatics into the Daily Operations of the Medical Center 219 Joseph Kanrtry, Mt. Sinai Medical Center, USA Healthcare IT (HIT) has failed to live up to its promise in the United States. HIT solutions and decisions need to be evidence based and standardized. Interventional Informatics is ideally positioned to provide evidence based and standardized solutions in the enterprise (aka, the medical center) which includes all or some combination of hospital(s), hospital based-practices, enterprise owned offsite medical practices, faculty practice and a medical school. For purposes of this chapter, interventional informatics is defined as applied medical or clinical informatics with an emphasis on an active interventional role in the enter¬ prise. A department of interventional informatics, which integrates the science of Informatics into daily operations, should become a standard part of any 21st century medical center in the United States. Chapter XIV Health Information Technology Economic Evaluation 240 EricL. Eisenstein, Duke Clinical Research Institute, USA Maqui Ortiz, Duke Clinical Research Institute, USA Kevin J. Anstrom, Duke Clinical Research Institute, USA David F. Lobach, Duke Clinical Research Institute, USA This chapter describes a framework for conducting economic analyses of health information technologies (HIT). It explains the basic principles of healthcare economic analyses and the relationships between the costs and effectiveness of a health intervention, and then uses these principles to explain the types of data that need to be gathered in order to conduct a health information technology economic evalua¬ tion study. A current health information technology study is then used to illustrate the incorporation of the framework s economic analysis methods into an ongoing research project. Economic research in the field of health information technology is not yet well developed. This chapter is meant to educate researchers about the need for HIT economic analyses as well as provide a structured framework to as¬ sist them in conducting these analyses. Section V Legal, Ethical, and Professional Issues Chapter XV Legal Issues in Health Information and Electronic Health Records 260 Nola Ries, University of Alberta, Canada and University of Victoria, Canada This chapter discusses key legal issues raised by the contemporary trend to managing and sharing pa¬ tient information via electronic health records (EHR). Concepts of privacy, confidentiality, consent and security are defined and considered in the context of EHR initiatives in Canada, the United Kingdom and Australia. This chapter explores whether patients have the right to withhold consent to the collection and sharing of their personal information via EHRs. It discusses opt-in and opt-out models for participation in EHRs and concludes that presumed consent for EHR participation will ensure more rapid and complete implementation, but at the cost of some personal choice for patients. The reduction in patient control over personal information ought to be augmented with strong security protections to minimize risks of unauthorized access to EHRs and fulfill legal and ethical obligations to safeguard patient information. Chapter XVI Accountability, Beneficence, and Self Determination: Can Health Information Systems Make Organizations Nicer ? 274 Tina Saryeddine, University of Toronto, Canada Existing literature often addresses the ethical problems posed by health informatics. Instead of this problem-based approach, this chapter explores the ethical benefits of health information systems in an attempt to answer the question can health information systems make organizations more accountable, beneficent, and more responsive to a patient s right to self determination? It does so by unpacking the accountability for reasonableness framework in ethical decision making and the concepts of beneficence and self-determination. The framework and the concepts are discussed in light of four commonly used health information systems, namely: Web-based publicly accessible inventories of services; Web-based patient education; telemedicine; and the electronic medical record. The objective of this chapter is to discuss the ethical principles that health information systems actually help to achieve, with a view to enabling researchers, clinicians, and managers make the case for the development and maintenance of these systems in a client-centered fashion. Chapter XVII Electronic Health Records: Why Does Ethics Count? 287 Eike-Henner W. Kluge, University of Victoria, Canada The development of electronic health records marked a fundamental change in the ethical and legal status of health records and in the relationship between the subjects of the records, the records themselves and health information and health care professionals—changes that are not fully captured by traditional pri¬ vacy- and confidentiality considerations. The chapter begins with a sketch of the nature of this evolution and places it into the epistemic framework of health care decision-making. It then outlines why EHRs are special, what the implications of this special status are both ethically and juridically, and what this means for professionals and institutions. An attempt is made to link these considerations to the develop¬ ment of secure e-health, which requires not only the interoperability of technical standards but also the harmonization of professional education, institutional protocols and of laws and regulations. Section VI Knowledge Translation in Healthcare Chapter XVIII Technology Enabled Knowledge Translation: Using Information and Communications Technologies to Accelerate Evidence Based Health Practices 301 Kendall Ho, University of British Columbia, Canada Because of the rapid growth of health evidence and knowledge generated through research, and as the health system is becoming increasingly complex, clinical care gaps increasingly widen where best practices based on latest evidence are not routinely integrated into everyday health service delivery. Therefore, there is a strong need to inculcate knowledge translation strategies into our health system so as to promote seamless incorporation of new knowledge into routine service delivery and education to promote positive change in individuals and the health system towards eliminating the clinical care gaps. E-health, the use of information and communication technologies (ICT) in health which encompasses telehealth, health informatics, and e-learning, can play a prominently supportive role. This chapter ex¬ amines the opportunities and challenges of technology enabled knowledge translation (TEKT) —using ICT to accelerate knowledge translation—in today s health system with two case studies for illustration. Future TEKT research and evaluation directions are also articulated. Chapter XIX Knowledge Translation in Nursing Through Decision Support at the Point of Care 314 Diane Dor an, University of Toronto, Canada Tammie Di Pietro, University of Toronto, Canada With advances in electronic health record systems and mobile computing technologies it is possible to re-conceptualize how health professionals access information and design appropriate decision-support systems to support quality patient care. This chapter uses the context of nursing sensitive patient outcomes data collection to explore how technology can be used to increase nurses and other health profession¬ als access to patient outcomes information in real time to continually improve patient care. The chapter draws upon literature related to: (1) case-based reasoning, (2) feedback, (3) and evidence-based nursing practice to provide the theoretical foundation for an electronic knowledge translation intervention that was developed and tested for usability. Directions for future research include the need to understand how nurses experience uncertainty in their practice, how this influences information seeking behavior, and how information resources can be designed to support real-time clinical decision making. Chapter XX Improving Internet-Based Health Knowledge Through Attention to Literacy 331 Jose F. Arocha, University of Waterloo, Canada Laurie Hoffman-Goetz, University of Waterloo, Canada Laurie Hoffman-Goetz, University of Waterloo, Canada This chapter presents a discussion and findings of health literacy and its relevance to health informat¬ ics. We argue that the Internet represents an increasingly important vehicle for knowledge translation to consumers of health information. However, much of the Internet-based information available to consumers is difficult to understand by those who need it the most. A critical factor to improve the comprehensibility, and therefore the quality, of health information is literacy. We summarize studies of various aspects of health literacy, such as readability and comprehensibility of risk information. We also point out ways in which the study of health literacy, including prose and numeric literacy, should inform researchers, health practitioners, and Web designers of specific ways in which consumer health information can be improved. Compilation of References 347 About the Contributors 385 Index 392
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Integrating knowledge from multiple levels, will benefit scholars and practitioners from the medical information, health service management, information technology arenas"--Provided by publisher</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Information storage and retrieval systems / Health services administration</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Health services administration / Data processing</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Management information systems / Human factors</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Management information systems / Social aspects</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Management information systems / Management</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Medical Informatics Applications</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Health Services Administration</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Datenverarbeitung</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Gesellschaft</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Health Services Administration</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Health services administration</subfield><subfield code="x">Data processing</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Information storage and retrieval systems</subfield><subfield code="x">Health services administration</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Management information systems</subfield><subfield code="x">Human factors</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Management information systems</subfield><subfield code="x">Management</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Management information systems</subfield><subfield code="x">Social aspects</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Medical Informatics Applications</subfield></datafield><datafield tag="650" ind1="0" ind2="7"><subfield code="a">Gesundheitsinformationssystem</subfield><subfield code="0">(DE-588)4113742-5</subfield><subfield code="2">gnd</subfield><subfield code="9">rswk-swf</subfield></datafield><datafield tag="655" ind1=" " ind2="7"><subfield code="0">(DE-588)4143413-4</subfield><subfield code="a">Aufsatzsammlung</subfield><subfield code="2">gnd-content</subfield></datafield><datafield tag="689" ind1="0" ind2="0"><subfield code="a">Gesundheitsinformationssystem</subfield><subfield code="0">(DE-588)4113742-5</subfield><subfield code="D">s</subfield></datafield><datafield tag="689" ind1="0" ind2=" "><subfield code="C">b</subfield><subfield code="5">DE-604</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Kushniruk, Andre W.</subfield><subfield code="e">Sonstige</subfield><subfield code="4">oth</subfield></datafield><datafield tag="856" ind1="4" ind2="2"><subfield code="m">HBZ Datenaustausch</subfield><subfield code="q">application/pdf</subfield><subfield code="u">http://bvbr.bib-bvb.de:8991/F?func=service&amp;doc_library=BVB01&amp;local_base=BVB01&amp;doc_number=016481046&amp;sequence=000002&amp;line_number=0001&amp;func_code=DB_RECORDS&amp;service_type=MEDIA</subfield><subfield code="3">Inhaltsverzeichnis</subfield></datafield><datafield tag="943" ind1="1" ind2=" "><subfield code="a">oai:aleph.bib-bvb.de:BVB01-016481046</subfield></datafield></record></collection>
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id DE-604.BV023296519
illustrated Illustrated
indexdate 2024-12-23T21:00:22Z
institution BVB
isbn 9781599047928
1599047926
language English
oai_aleph_id oai:aleph.bib-bvb.de:BVB01-016481046
oclc_num 180907748
open_access_boolean
owner DE-12
owner_facet DE-12
physical XXIV, 395 S. Ill., graph. Darst. 29 cm
publishDate 2008
publishDateSearch 2008
publishDateSort 2008
publisher Medical Information Science Reference
record_format marc
spellingShingle Human, social, and organizational aspects of health information systems
Information storage and retrieval systems / Health services administration
Health services administration / Data processing
Management information systems / Human factors
Management information systems / Social aspects
Management information systems / Management
Medical Informatics Applications
Health Services Administration
Datenverarbeitung
Gesellschaft
Health services administration Data processing
Information storage and retrieval systems Health services administration
Management information systems Human factors
Management information systems Management
Management information systems Social aspects
Gesundheitsinformationssystem (DE-588)4113742-5 gnd
subject_GND (DE-588)4113742-5
(DE-588)4143413-4
title Human, social, and organizational aspects of health information systems
title_auth Human, social, and organizational aspects of health information systems
title_exact_search Human, social, and organizational aspects of health information systems
title_full Human, social, and organizational aspects of health information systems Andre W. Kushniruk, Elizabeth M. Borycki [eds.]
title_fullStr Human, social, and organizational aspects of health information systems Andre W. Kushniruk, Elizabeth M. Borycki [eds.]
title_full_unstemmed Human, social, and organizational aspects of health information systems Andre W. Kushniruk, Elizabeth M. Borycki [eds.]
title_short Human, social, and organizational aspects of health information systems
title_sort human social and organizational aspects of health information systems
topic Information storage and retrieval systems / Health services administration
Health services administration / Data processing
Management information systems / Human factors
Management information systems / Social aspects
Management information systems / Management
Medical Informatics Applications
Health Services Administration
Datenverarbeitung
Gesellschaft
Health services administration Data processing
Information storage and retrieval systems Health services administration
Management information systems Human factors
Management information systems Management
Management information systems Social aspects
Gesundheitsinformationssystem (DE-588)4113742-5 gnd
topic_facet Information storage and retrieval systems / Health services administration
Health services administration / Data processing
Management information systems / Human factors
Management information systems / Social aspects
Management information systems / Management
Medical Informatics Applications
Health Services Administration
Datenverarbeitung
Gesellschaft
Health services administration Data processing
Information storage and retrieval systems Health services administration
Management information systems Human factors
Management information systems Management
Management information systems Social aspects
Gesundheitsinformationssystem
Aufsatzsammlung
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