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7. Using research to prepare for outbreaks of severe acute respiratory infection

Author

Mich, Vann, Pho, Yaty, Bory, Sotharith, Vann, Mich, Teav, Bunlor, Som, Leakhann, Jarrvisalo, Mikko J, Pulkkinen, Anni, Kuitunen, Anne, Ala-kokko, Tero, Melto, Sari, Daix, Thomas, Philippart, Francois, Antoine, Marchalot, Tiercelet, Kelly, Bruel, Cedric, Nicholas, Sedillot, Siami, Shidasp, Fabienne, Taimon, Bruyere, Raomi, Forceville, Xavier, Erickson, Simon, Campbell, Lewis, Sonawane, Ravikiran, Santamaria, John, Kol, Mark, Awasthi, Shally, Powis, Jeff, Hall, Richard, McCarthy, Anne E, Jouvet, Philippe, Opaysky, Mary Anne, Gilfoyle, Elaine, Farshait, Nataly, Martin, Dori-Ann, Griesdale, Donald, Katz, Kevin, Ruberto, Aaron J, Carrier, Francois Martin, Lamontagne, Francois, Muscedere, John, Rishu, Asgar, Sin, Wai Ching, Ngai, Wallace Chun Wai, Young, Paul, Forrest, Annette, Kazemi, Alex, Henderson, Seton, Browne, Troy, Ganeshalingham, Anusha, McConnochie, Rachael, Cho, Jae Hwa, Park, Tai Sun, Sim, Yun Su, Chang, Youjin, Lee, Heung Bum, Park, Seung Yong, Chan, Wai Ming, Lee, Won-Yeon, Wallace, David J, Angus, Derek C, Charles, Anthony G, van Doom, H Rogier, Kinh, Nguyen Van, Trung, Nguyen Vu, Prin, Meghan, Twagirumugabe, Theogene, Umuhire, Olivier Felix, Sylvain, Habarurema, Al Qasim, Eman, Heraud, Jean-Michel, Raberahona, Mihaja, Rabarison, Joelinotahiana Hasina, Patrigeon, Santiago Perez, Ramirez-Venegas, Alejandra, Melendez, Javier Araujo, Guerrero, M Lourdes, Mambule, Ivan, Ochieng, Otieno George, Nadjm, Behzad, Li, Iris Wai Sum, Choi, Won-Il, Florence, Komurian-Pradel, Arabi, Yaseen M, West, T Eoin, Riviello, Elisabeth D, Parke, Rachael, Djillali, Annane E, Fowler, Robert, Murthy, Srinivas, Nichol, Alistair, Cheng, Allen C, Semple, Calum, George, Maya, Valkonen, Miia, McArthur, Colin, Carson, Gail, O'Neill, Genevieve, Cobb, J Perren, Dunning, Jake, Chiche, Jean-Daniel, Huh, Jin-Won, Marshall, John, Rello, Jordi, Guillebaud, Julia, Razanazatovo, Norosoa, Otieno, Juilett Wambura, Green, Karen, Rowan, Kathy, Baillie, John Kenneth, Merson, Laura, Hsu, Li Yang, Christian, Michael D, Egi, Moritoki, Shindo, Nahoko, Horby, Peter, Pardinaz-Solis, Raul, Ubiergo, Sebastian Ugarte, Webb, Steve AR, Uyeki, Timothy M, Gordon, Anthony C, Paterson, David L, Everett, Dean, Giamarellos-Bourboulis, Evangelos J, Longuere, Kajsa-Stina, Maslove, David, Ohuma, Eric, Growl, Gloria, PedutemHumber, Theresa, EllazarHumber, Edward, Bahinskaya, Ilona, Osbourne-Townsend, Joan, Bentley, Andrew, Goodson, Jennifer, Welters, Ingeborg, Malik, Nadia, Browne, TS, Mahesh, Vinaya, Investigators, SPRINT-SARI, HUS Perioperative, Intensive Care and Pain Medicine, University of Helsinki, Anestesiologian yksikkö, University College Dublin [Dublin] (UCD), Monash University [Melbourne], We acknowledge support from the National Health and Medical Research Council in Australia, the Australia New Zealand Intensive Care Society Clinical Trials Group and the Seventh Framework Program in Europe, which have facilitated the progress that has been made for central project infrastructure. Data collection was funded locally by local research coordinators and investigators, including the International Respiratory and Severe Illness Center, University of Washington., Collaborators Vann Mich, Khmer Soviet Friend Hospital. Yaty Pho, Khmer Soviet Friend Hospital. Sotharith Bory, Calmette Hospital and University of Health Sciences. Mich Vann, Khmer-Soviet Friendship Hospital and University of Health Sciences. Bunlor Teav, Takeo Provincial Hospital. Leakhann Som, National Pediatric Hospital. Mikko J Jarrvisalo, Turku university hospital, ICU. Anni Pulkkinen, Central Hospital of Central Finland. Anne Kuitunen, Tampere University Hospital. Tero Ala-kokko, Oulu University Hospital, Research Group of Anesthesiology, Surgery and Intensive Care Medicine. Sari. Melto, South Karelia Central Hospital. Thomas DAIX, Reanimation polyvalente, CHU Dupuytren, Limoges, France and Inserm CIC 1435, CHU Dupuytren, Limoges, France. Francois Philippart, Intensive Care Unit. Marchalot Antoine, Dieppe General Hospital. Kelly Tiercelet, Groupe hospitalier Paris Saint Joseph. Cedric Bruel, Groupe hospitalier Paris Saint Joseph. BRUYERE Remi, Centre Hospitalier Fleyriat. Sedillot Nicholas, Centre Hospitalier Fleyriat. Shidasp SIAMI, General Intensive Care Medicine, Sud Essonne Hospital Etampes. Marchalot Antoine, Centre Hospitalier Dieppe. Taimon Fabienne, Service de Medecine Intensive et Reanimation, Rouen University Hospital (G.B.), and Normandie University, Universite de Rouen, U1096, Rouen University Hospital. Philippart, Groupe hospitalier Paris Saint joseph. Raomi Bruyere, Service de reanimation. Centre Hospitalier Fleyriat. Xavier Forceville, Grand Hopital de l'Est Francilien. Simon Erickson, Perth Children's Hospital. Lewis Campbell, Royal Darwin Hospital. Ravikiran Sonawane, Rockingham General Hospital. John Santamaria, St Vincent's Hospital (Melbourne). Mark Kol, Concord Hospital. Shally Awasthi, King George's Medical University. Jeff Powis, Michael Garron Hospital. Richard Hall, Dalhousie University. Anne E McCarthy, University of Ottawa and the Ottawa Hospital. Philippe Jouvet, Ste-Justine Hospital and Research Center. Mary Anne Opavsky, Joseph Brant Hospital. Elaine Gilfoyle, University of Calgary. Nataly Farshait, Humber River Hospital. Dori-Ann Martin, University of Calgary. Donald Griesdale, Department of Anesthesiology, Pharmacology & Therapeutics Department of Medicine, Divisions of Critical Care Medicine & Neurology University of British Columbia. Kevin Katz, North York General Hospital. Aaron J. Ruberto, Queen's University & Kingston Health Sciences Centre. Francois Martin Carrier, Centre Hospitalier de l'Universite de Montreal. Francois Lamontagne, Universite de Sherbrooke. John Muscedere, Queens University. Asgar Rishu, Sunnybrook Health Sciences Centre. Wai Ching Sin, Department of Adult Intensive Care Unit, Queen Mary Hospital. Wallace Chun Wai Ngai, Department of Adult Intensive Care Unit, Queen Mary Hospital. Paul Young, Medical Research Institute of New Zealand. Dr Annette Forrest, Waikato Hospital. Alex Kazemi, Middlemore Hospital. Seton Henderson, Christchurch Hospital. Troy Browne, Tauranga Hospital. Anusha Ganeshalingham, Starship Hospital. Rachael McConnochie, Department of Critical Care Medicine, Auckland City Hospital. Jae Hwa Cho, Yonsei University. Tai Sun Park, Hanyang University Guri Hospital. Yun Su Sim, Hallym University Kangnam Sacred Hospital. Youjin Chang, Inje University, College of Medicine, Sanggye Paik Hospital. Heung Bum Lee, Chonbuk National University Hospital. Seung Yong Park, Chonbuk National University Hospital. Wai Ming Chan, Department of Adult Intensive Care Unit, Queen Mary Hospital, Hong Kong. Won-Yeon Lee, Yonsei University Wonju College of Medicine. David J. Wallace, University of Pittsburgh School of Medicine. Derek C. Angus, University of Pittsburgh School of Medicine. Anthony G Charles, University of North Carolina at Chapel Hill. H Rogier van Doorn, Oxford University Clinical Research Unit. Nguyen Van Kinh, National Hospital for Tropical Diseases. Nguyen Vu Trung, National Hospital for Tropical Diseases. Meghan Prin, Columbia University College of Physicians & Surgeons. Theogene Twagirumugabe, University of Rwanda /College of Medicine and Health Sciences. Olivier Felix Umuhire, Department of Anesthesia, Emergency Medicine and Critical Care. University of Rwanda. Habarurema Sylvain, Centre hospitalier Universitaire de Butare(CHUB). Eman Al Qasim, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center. Jean-Michel Heraud, Institut Pasteur de Madagascar. Mihaja Raberahona, University Hospital Joseph Raseta Befelatanana. Joelinotahiana Hasina Rabarison, Insttut Pasteur de Madagascar. Santiago Perez Patrigeon, Instituto Nacional de Ciencias Medicas y Nutrición Salvador Subirán. Alejandra Ramirez-Venegas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas. Javier Araujo Meléndez, Hospital Central 'Dr. Ignacio Morones Prieto'. M. Lourdes Guerrero, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiren. Ivan Mambule, Clinical Infection, Microbiology and Immunology, Institute of Infection and Global Health University of Liverpool and Malawi-Liverpool-Wellcome Trust, Clinical Research Programme. Otieno George Ochieng, Kijabe Mission Hospital. Behzad Nadjm, Imperial College Healthcare NHS Trust, GBR. Iris Wai Sum Li, Queen Mary Hospital, School of Public Health, the University of Hong Kong. Won-Il Choi, Department of Medicine, Keimyung University, Dongsan Hospital. Komurian-Pradel Florence, Fondation Merieux. Yaseen M Arabi, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Intensive Care Department, King Abdulaziz Medical City. T. Eoin West, University of Washington. Elisabeth D Riviello, Harvard Medical School and Beth Israel Deaconess Medical Center. Rachael Parke, Cardiothoracic and Vascular ICU, Auckland City Hospital. AnnaneE Djillali, Raymond Poincare Hospital (APHP) Unievrsity of Versailles SQY/University Paris Saclay. Robert Fowler, Interdepartmental Division of Critical Care Medicine, University of Toronto. Srinivas Murthy, Department of Pediatrics. Alistair Nichol, University College Dublin / Monash University. Allen C Cheng, School of Public Health and Preventive Medicine, Monash University. Calum Semple, University of Liverpool. Maya George, Australian and New Zealand Intensive Care Research Centre, Monash University. Miia Valkonen, University of Helsinki and Helsinki University Hospital. Colin McArthur, Auckland City Hospital (DCCM 82). Gail Carson, University of Oxford. Genevieve O'Neill, Australian and New Zealand Intensive Care Research Centre, Monash University. J. Perren Cobb, University of Southern California. Jake Dunning, University of Oxford, Imperial College London. Jean-Daniel Chiche, Hopitaux Universitaire Paris Centre, site Cochin. Jin-Won Huh, ASAN Medical Center. John Marshall, St. Michael's Hospital. Jordi Rello, Ciberes & Vall d'Hebron University Hospital, Barcelona, Spain. Julia Guillebaud, Institut Pasteur de Madagascar. Norosoa Razanazatovo, Institut Pasteur de Madagascar. Juilett Wambura Otieno, KEMRI-Wellcome Trust Research Programme. Karen Green, Toronto Invasive Bacterial Diseases Network. Kathy Rowan, Intensive Care National Audit and Research Centre. John Kenneth Baillie, Roslin Institute, University of Edinburgh. Laura Merson, Infectious Diseases Data Observatory, Oxford, UK, Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, Oxford University, Oxford UK. Li Yang Hsu, National University of Singapore. Michael D. Christian, Essex & Herts Air Ambulance Trust. Miia Valkonen, Helsinki University Central Hospital. Moritoki Egi, Kobe University Hospital. Nahoko Shindo, World Health Organization. Peter Horby, University of Oxford. Raul Pardinaz-Solis, Nuffield Department of Medicine, University of Oxford. Sebastián Ugarte Ubiergo, Universidad Andrés Bello. Steve AR Webb, Monash University. Timothy M. Uyeki, Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia USA. Anthony C Gordon, Imperial College London. David L Paterson, University of Queensland Centre. Dean Everett, University of Edinburgh, The Queens Medical Research Institute and Malawi-Liverpool-Wellcome Trust, Clinical Research Programme. Evangelos J. Giamarellos-Bourboulis, National and Kapodistrian University of Athens, Medical School. Kajsa-Stina Longuere, University of Oxford. David Maslove, Queens University. Eric Ohuma, Oxford University. Gloria Crowl, Michael Garron Hospital. Theresa PedutemHumber, River Hospital. Edward EllazarHumber, River Hospital. Ilona Bahinskaya, University Health Network TGH MOT. Joan Osbourne-Townsend, Humber River Hospital. Andrew Bentley, University of Manchester. Ingeborg Welters, University of Liverpool. Nadia Malik, MountSinai Hospital/ William Osler Health Centre. Dr T S Browne, Tauranga Hospital. Jennifer Goodson, Tauranga Hospital. Vinaya Mahesh, North York General Hospital., and Carson, G

Subjects
medicine.medical_specialty, INTENSIVE-CARE-UNIT, global health, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Intensive care, Case fatality rate, Epidemiology, Global health, medicine, pneumonia, 030212 general & internal medicine, Public, Environmental & Occupational Health, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Practice, OUTCOMES, Science & Technology, business.industry, Health Policy, Public Health, Environmental and Occupational Health, Outbreak, 030208 emergency & critical care medicine, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, 3126 Surgery, anesthesiology, intensive care, radiology, Intensive care unit, 3. Good health, critical care, REAL-TIME SURVEILLANCE, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Observational study, SOFA score, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, SPRINT-SARI investigators, business, influenza, Life Sciences & Biomedicine, Demography, outbreak preparedness
Abstract

International audience; Severe acute respiratory infections (SARI) remain one of the leading causes of mortality around the world in all age groups. There is large global variation in epidemiology, clinical management and outcomes, including mortality. We performed a short period observational data collection in critical care units distributed globally during regional peak SARI seasons from 1 January 2016 until 31 August 2017, using standardised data collection tools. Data were collected for 1 week on all admitted patients who met the inclusion criteria for SARI, with follow-up to hospital discharge. Proportions of patients across regions were compared for microbiology, management strategies and outcomes. Regions were divided geographically and economically according to World Bank definitions. Data were collected for 682 patients from 95 hospitals and 23 countries. The overall mortality was 9.5%. Of the patients, 21.7% were children, with case fatality proportions of 1% for those less than 5 years. The highest mortality was in those above 60 years, at 18.6%. Case fatality varied by region: East Asia and Pacific 10.2% (21 of 206), Sub-Saharan Africa 4.3% (8 of 188), South Asia 0% (0 of 35), North America 13.6% (25 of 184), and Europe and Central Asia 14.3% (9 of 63). Mortality in low-income and low-middle-income countries combined was 4% as compared with 14% in high-income countries. Organ dysfunction scores calculated on presentation in 560 patients where full data were available revealed Sequential Organ Failure Assessment (SOFA) scores on presentation were significantly associated with mortality and hospital length of stay. Patients in East Asia and Pacific (48%) and North America (24%) had the highest SOFA scores of >12. Multivariable analysis demonstrated that initial SOFA score and age were independent predictors of hospital survival. There was variability across regions and income groupings for the critical care management and outcomes of SARI. Intensive care unit-specific factors, geography and management features were less reliable than baseline severity for predicting ultimate outcome. These findings may help in planning future outbreak severity assessments, but more globally representative data are required.

Published
2019
Full Text
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8. Using research to prepare for outbreaks of severe acute respiratory infection

Author

Mich, Vann Pho, Yaty Bory, Sotharith Vann, Mich Teav, Bunlor Som, Leakhann Jarrvisalo, Mikko J. Pulkkinen, Anni and Kuitunen, Anne Ala-kokko, Tero Melto, Sari Daix, Thomas and Philippart, Francois Antoine, Marchalot Tiercelet, Kelly and Bruel, Cedric Nicholas, Sedillot Siami, Shidasp Fabienne, Taimon Bruyere, Raomi Forceville, Xavier Erickson, Simon and Campbell, Lewis Sonawane, Ravikiran Santamaria, John Kol, Mark Awasthi, Shally Powis, Jeff Hall, Richard McCarthy, Anne E. Jouvet, Philippe Opaysky, Mary Anne Gilfoyle, Elaine and Farshait, Nataly Martin, Dori-Ann Griesdale, Donald and Katz, Kevin Ruberto, Aaron J. Carrier, Francois Martin and Lamontagne, Francois Muscedere, John Rishu, Asgar Sin, Wai Ching Ngai, Wallace Chun Wai Young, Paul Forrest, Annette and Kazemi, Alex Henderson, Seton Browne, Troy and Ganeshalingham, Anusha McConnochie, Rachael Cho, Jae Hwa and Park, Tai Sun Sim, Yun Su Chang, Youjin Lee, Heung Bum and Park, Seung Yong Chan, Wai Ming Lee, Won-Yeon Wallace, David J. Angus, Derek C. Charles, Anthony G. van Doom, H. Rogier and Nguyen Van Kinh Nguyen Vu Trung Prin, Meghan and Twagirumugabe, Theogene Umuhire, Olivier Felix Sylvain, Habarurema Al Qasim, Eman Heraud, Jean-Michel Raberahona, Mihaja Rabarison, Joelinotahiana Hasina Patrigeon, Santiago Perez Ramirez-Venegas, Alejandra Melendez, Javier Araujo and Guerrero, M. Lourdes Mambule, Ivan Ochieng, Otieno George and Nadjm, Behzad Li, Iris Wai Sum Choi, Won-Il Florence, Komurian-Pradel Arabi, Yaseen M. West, T. Eoin Riviello, Elisabeth D. Parke, Rachael Djillali, Annane E. Fowler, Robert Murthy, Srinivas Nichol, Alistair Cheng, Allen C. and Semple, Calum George, Maya Valkonen, Miia McArthur, Colin and Carson, Gail O'Neill, Genevieve Cobb, J. Perren Dunning, Jake Chiche, Jean-Daniel Huh, Jin-Won Marshall, John and Rello, Jordi Guillebaud, Julia Razanazatovo, Norosoa Otieno, Juilett Wambura Green, Karen Rowan, Kathy Baillie, John Kenneth Merson, Laura Hsu, Li Yang Christian, Michael D. and Egi, Moritoki Shindo, Nahoko Horby, Peter Pardinaz-Solis, Raul Ubiergo, Sebastian Ugarte Webb, Steve A. R. Uyeki, Timothy M. Gordon, Anthony C. Paterson, David L. Everett, Dean Giamarellos-Bourboulis, Evangelos J. Longuere, Kajsa-Stina and Maslove, David Ohuma, Eric Growl, Gloria PedutemHumber, Theresa EllazarHumber, Edward Bahinskaya, Ilona and Osbourne-Townsend, Joan Bentley, Andrew Goodson, Jennifer and Welters, Ingeborg Malik, Nadia Browne, T. S. Mahesh, Vinaya and SPRINT-SARI Investigators

Abstract

Severe acute respiratory infections (SARI) remain one of the leading causes of mortality around the world in all age groups. There is large global variation in epidemiology, clinical management and outcomes, including mortality. We performed a short period observational data collection in critical care units distributed globally during regional peak SARI seasons from 1 January 2016 until 31 August 2017, using standardised data collection tools. Data were collected for 1 week on all admitted patients who met the inclusion criteria for SARI, with follow-up to hospital discharge. Proportions of patients across regions were compared for microbiology, management strategies and outcomes. Regions were divided geographically and economically according to World Bank definitions. Data were collected for 682 patients from 95 hospitals and 23 countries. The overall mortality was 9.5%. Of the patients, 21.7% were children, with case fatality proportions of 1% for those less than 5 years. The highest mortality was in those above 60 years, at 18.6%. Case fatality varied by region: East Asia and Pacific 10.2% (21 of 206), Sub-Saharan Africa 4.3% (8 of 188), South Asia 0% (0 of 35), North America 13.6% (25 of 184), and Europe and Central Asia 14.3% (9 of 63). Mortality in low-income and low-middle-income countries combined was 4% as compared with 14% in high-income countries. Organ dysfunction scores calculated on presentation in 560 patients where full data were available revealed Sequential Organ Failure Assessment (SOFA) scores on presentation were significantly associated with mortality and hospital length of stay. Patients in East Asia and Pacific (48%) and North America (24%) had the highest SOFA scores of >12. Multivariable analysis demonstrated that initial SOFA score and age were independent predictors of hospital survival. There was variability across regions and income groupings for the critical care management and outcomes of SARI. Intensive care unit-specific factors, geography and management features were less reliable than baseline severity for predicting ultimate outcome. These findings may help in planning future outbreak severity assessments, but more globally representative data are required.

Published
2019

12. Assessment of Integrated Disease Surveillance Data Uptake in Community Health Systems within Nairobi County, Kenya.

Author

Omondi AJ, Ochieng OG, Eliud K, Yoos A, and Kavilo MR

Abstract

Background: Kenya has since independence struggled to restructure its health system to provide services to its entire population especially in outbreak responses. The last decade has seen the country witness disease outbreaks across the country i.e. Rift Valley fever in June 2018, and Chikungunya and Dengue fever in Mombasa in February 2018. This exposed the country's lack of preparedness in handling outbreaks at grass root level. Outbreak incidences tend to prevail at community level before a public health action is established, with the situation becoming dire in the lower tier health facilities., Objective: The purpose of the study was to assess the uptake of Integrated Disease Surveillance Response (IDSR) health data and utilisation at community level health systems in the six sub counties within Nairobi County of Kenya., Methodology: The study used cross-sectional descriptive research design on a target population of 1840 community health workers. The study used Yamane formula to calculate the sample size of 371 respondents, selected using stratified sampling and simple random sampling methods. The logistic regression model was used to assess the benefits of Integrated Data Surveillance and Response data in health facilities across Nairobi County. Data was collected using questionnaires, analysis done using Statistical Packages for Social Sciences, and findings presented in form of tables and bar graphs., Results: The study had 315 questionnaires were duly filled and returned, representing 85% response rate. The findings showed that 268(85%) Healthcare Workers lacked training on using disease surveillance data; 236(75%) cited lack of tools for disease surveillance in facilities, while 173(55%)cited lack of timely IDSR data as hindrance to IDSR data uptake. The regression findings showed that training of healthcare workers on IDSR, installation of disease surveillance system tools, and timely collection and dissemination of surveillance data increases the likelihood of IDSR data uptake in community health facilities., Conclusion: The study concluded that IDSR system tools should be installed in community health facilities across the six sub counties in Nairobi County. Training should be emphasised to ensure all health care workers have the required skills to use the IDSR data. There is need to ensure IDSR data is collected and disseminated on time to make it available for interpretation and use by health care workers in their respective facilities., Competing Interests: Competing Interests: None declared., (© The East African Health Research Commission 2020.)

Published
2020
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13. Factors influencing diffusion of electronic medical records: a case study in three healthcare institutions in Japan.

Author

Ochieng OG and Hosoi R

Subjects
Computer User Training, Cross-Sectional Studies, Humans, Inservice Training, Japan, Medical Records Systems, Computerized statistics & numerical data, Needs Assessment, Organizational Case Studies, Organizational Innovation, Personnel, Hospital education, Regression Analysis, Surveys and Questionnaires, Attitude of Health Personnel, Attitude to Computers, Diffusion of Innovation, Hospital Administration, Medical Records Systems, Computerized organization & administration
Abstract

This study examines the effect of three factors: information technology (IT) skills of healthcare workers, present status of computerisation in their organisations, and workers' attitudes on the diffusion of electronic medical records (EMRs) in the healthcare environment. Data were obtained from a self-questionnaire distributed to 390 healthcare workers. The study finds that respondents need an expanded EMR capability to include decision support systems and reminder systems, and that diffusion of EMR is heavily influenced by attitudes of healthcare workers. However, targeted training of healthcare workers is needed to foster positive attitudes about EMR, and build confidence in the benefits of these systems.

Published
2006
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