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To coordinate themselves, home care (HC) professionals use artifacts to keep a mutual understanding on their common activity: lightly structured charts written in natural language. Instead of trying to define a record to capture them, we want to focus on efficient indexing of this information. The use of a Domain Ontology was proposed. This paper explains how we built and implemented it. Three complementary aspects of the HC charts were analyzed (i) functional aspects performed with precise analyses of actual charts; (ii) interoperability aspects with the use of some HL7-RIM standardized descriptions; and (iii) cooperative aspects, with the integration of a cooperation model. We proposed a Domain Ontology to represent the concepts and the relations used in the charts. The implementation was done with Protégé; the ontology was built in OWL-DL. The IAnnotate application helps us to index the HC chart with the domain ontology. The next step of the work will use the ontology to reason about the different items of information contained in the charts so that contextual use of them should be envisaged. [ABSTRACT FROM AUTHOR]

Background: Clinical practice guidelines are useful for physicians, and guidelines are available on the Internet from various websites such as Vidal Recos. However, these guidelines are long and difficult to read, especially during consultation. Similar difficulties have been encountered with drug summaries of product characteristics. In a previous work, we have proposed an iconic language (called VCM, for Visualization of Concepts in Medicine) for representing patient conditions, treatments and laboratory tests, and we have used these icons to design a user interface that graphically indexes summaries of product characteristics. In the current study, our objective was to design and evaluate an iconic user interface for the consultation of clinical practice guidelines by physicians., Methods: Focus groups of physicians were set up to identify the difficulties encountered when reading guidelines. Icons were integrated into Vidal Recos, taking human factors into account. The resulting interface includes a graphical summary and an iconic indexation of the guideline. The new interface was evaluated. We compared the response times and the number of errors recorded when physicians answered questions about two clinical scenarios using the interactive iconic interface or a textual interface. Users' perceived usability was evaluated with the System Usability Scale., Results: The main difficulties encountered by physicians when reading guidelines were obtaining an overview and finding recommendations for patients corresponding to "particular cases". We designed a graphical interface for guideline consultation, using icons to identify particular cases and providing a graphical summary of the icons organized by anatomy and etiology. The evaluation showed that physicians gave clinical responses more rapidly with the iconic interface than the textual interface (25.2 seconds versus 45.6, p < 0.05). The physicians appreciated the new interface, and the System Usability Scale score value was 75 (between good and excellent)., Conclusion: An interactive iconic interface can provide physicians with an overview of clinical practice guidelines, and can decrease the time required to access the content of such guidelines.

Background: Health care professionals' collaboration is highly important for the medical practice. Efficient exchange of information improves good cooperation, but remains complex, due to the diversity of the medical activities. Currently, the health record is mainly used to manage structured medical information. On the one hand, such structure supports treatment that requires the documented information. On the other hand, however, the structure also imposes constraints on narrative and conversational practices of health care professionals. They use other collaboration means through phone, mail, annotations and free texts for informal strategies of communication. We focussed on informal written documents. Two different studies provided us some materials: home care charts in the context of home care and annotations in the context of the hospital health records., Purposes: We wanted to design a model of the Communication Notes to computerize the written notes so as to improve the communication and the coordination of the practitioners., Methods: We compared the results of the two studies about the various writing strategies used by the health care professionals to keep traces of their exchanges and of their acts. The first study deals with the information mentioned by the nurses in a chart during home care situations. We analysed the distribution of cooperation activities in action and in planning. The second study deals with the annotations which are written by all the practitioners to complete the documents of the health record in a paediatric ward. We analysed how annotations take part in their collaborations., Results: We found some invariable items in these two situations and we proposed a model for these Communication Notes which can be used to describe and to index them according to different points of view. Some indications on the way such descriptions are used in current computerized systems are also reported. The originality of this model comes from the way it takes into account a collaborative perspective which is not often used in the electronic medical settings., Conclusions: With our model of Communication Notes, we now dispose of a promising setting for managing all the informal and unforeseeable information produced by the health care professionals during care.

To coordinate themselves, home care (HC) professionals use artifacts to keep a mutual understanding on their common activity: lightly structured charts written in natural language. Instead of trying to define a record to capture them, we want to focus on efficient indexing of this information. The use of a Domain Ontology was proposed. This paper explains how we built and implemented it. Three complementary aspects of the HC charts were analyzed (i) functional aspects performed with precise analyses of actual charts; (ii) interoperability aspects with the use of some HL7-RIM standardized descriptions; and (iii) cooperative aspects, with the integration of a cooperation model. We proposed a Domain Ontology to represent the concepts and the relations used in the charts. The implementation was done with Protégé; the ontology was built in OWL-DL. The IAnnotate application helps us to index the HC chart with the domain ontology. The next step of the work will use the ontology to reason about the different items of information contained in the charts so that contextual use of them should be envisaged.

Introduction: To build relevant tools for Health Care Professionals, we must study and understand their practices. This paper discusses the way they leave traces in the Patient Record to help asynchronous collaboration, elaborating new documents or adding annotations., Methods: We compared the results of two studies about the various writing strategies used by the Health Care Professionals to capture knowledge in the Patient Records. The first study deals with the information written by the nurses in a textbook during homecare situations. The second one deals with the annotations left by all the practitioners to complete the documents of the patient record in a hospital ward., Results: We have found some invariants in these two situations. An interpretation model based on four levels: Communication Context, Communication Object, Value of Communication and Value of Cooperation, is proposed in order to describe and to index the characteristics of the Communication Notes.