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David M Gaba - One of the best experts on this subject based on the ideXlab platform.
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the effect of Electronic Record keeping and transesophageal echocardiography on task distribution workload and vigilance during cardiac anesthesia
Anesthesiology, 1997Co-Authors: Matthew B Weinger, Oliver W Herndon, David M GabaAbstract:Background: Electronic anesthesia Record keeping (EARK) systems increasingly are used in the operating room, but studies have only recently begun to investigate their effect on anesthesia task performance. Task analysis, workload assessment, and vigilance assessment techniques were used to study senior residents providing anesthesia for coronary artery bypass graft (CABG) procedures. The impact on anesthesia residents' workload of the routine use of transesophageal echocardiography (TEE) also was examined. Methods: Before each case, the Record keeping system was randomly selected as either Electronic (Diatek ARKIVE; EARK) or traditional manual Recording (MAN). Twenty CABG procedures (10 EARK and 10 MAN) were examined, with observation commencing with anesthetic induction and terminating on initiation of cardiopulmonary bypass. The activities of each resident, divided into 32 task categories (e.g., laryngoscopy, observe monitors, etc.), were Recorded by a trained observer using a computer. The response latency to a randomly activated alarm light was used as a measure of vigilance (vigilance latency). Workload was rated by subject and observer at random 10- to 15-min intervals throughout the case. Data analysis included calculation of workload density (number of tasks/min multiplied by task-specific workload values) and task-links (relationship between sequential tasks). Results: The two groups had a similar distribution of tasks before intubation. In only 4 of the 20 cases studied did any manual Record keeping occur before intubation. After intubation, the EARK group spent less time Record keeping and using the TEE but more time observing the monitors and conversing with the attending physician than the MAN group did. All subjects reported significantly higher workload scores before intubation compared with after intubation. Similarly, vigilance latency was greater before intubation compared with after intubation (57 vs. 31 s; P < 0.001). There were no significant differences between the two Record keeping groups in subjective workload scores, workload density, or vigilance latency. During TEE use, vigilance latency was significantly longer, and workload density was greater than during other monitoring or Recording tasks. Conclusions: This study provides an objective description of the task distribution and workload during the administration of anesthesia for cardiac surgery. Under the conditions of this study, EARK use modestly decreased the time spent Record keeping during the postintubation prebypass period. However, there was no effect of EARK either on vigilance or several measures of workload. TEE use was associated with increased workload and possibly decreased vigilance.
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the effect of Electronic Record keeping and transesophageal echocardiography on task distribution workload and vigilance during cardiac anesthesia
Anesthesiology, 1997Co-Authors: Matthew B Weinger, Oliver W Herndon, David M GabaAbstract:BACKGROUND: Electronic anesthesia Record keeping (EARK) systems increasingly are used in the operating room, but studies have only recently begun to investigate their effect on anesthesia task performance. Teak analysis, workload assessment, and vigilance assessment techniques were used to study senior residents providing anesthesia for coronary artery bypass graft (CABG) procedures. The impact on anesthesia residents' workload of the routine use of transesophageal echocardiography (TEE) also was examined. METHODS: Before each case, the Record keeping system was randomly selected as either Electronic (Distek ARKIVE; EARK) or traditional manual Recording (MAN). Twenty CABG procedures (10 EARK and 10 MAN) were examined, with observation commencing with anesthetic induction and terminating on initiation of cardiopulmonary bypass. The activities of each resident, divided into 32 task categories (e.g., "laryngoscopy," "observe monitors," etc.), were Recorded by a trained observer using a computer. The response latency to a randomly activated alarm light was used as a measure of vigilance ("vigilance latency"). Workload was rated by subject and observer at random 10- to 15-min intervals throughout the case. Data analysis included calculation of workload density (number of tasks/min multiplied by task-specific workload values) and task-links (relationship between sequential tasks). RESULTS: The two groups had a similar distribution of tasks before intubation. In only 4 of the 20 cases studied did any manual Record keeping occur before intubation. After intubation, the EARK group spent less time Record keeping and using the TEE but more time observing the monitors and conversing with the attending physician than the MAN group did. All subjects reported significantly higher workload scores before intubation compared with after intubation. Similarly, vigilance latency was greater before intubation compared with after intubation (57 vs. 31 s; P < 0.001). There were no significant differences between the two Record keeping groups in subjective workload scores, workload density, or vigilance latency. During TEE use, vigilance latency was significantly longer, and workload density was greater than during other monitoring or Recording tasks. CONCLUSIONS: This study provides an objective description of the task distribution and workload during the administration of anesthesia for cardiac surgery. Under the conditions of this study. EARK use modestly decreased the time spent Record keeping during the postintubation prebypass period. However, there was no effect of EARK either on vigilance or several measures of workload. TEE use was associated with increased workload and possibly decreased vigilance.
Matthew B Weinger - One of the best experts on this subject based on the ideXlab platform.
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the effect of Electronic Record keeping and transesophageal echocardiography on task distribution workload and vigilance during cardiac anesthesia
Anesthesiology, 1997Co-Authors: Matthew B Weinger, Oliver W Herndon, David M GabaAbstract:Background: Electronic anesthesia Record keeping (EARK) systems increasingly are used in the operating room, but studies have only recently begun to investigate their effect on anesthesia task performance. Task analysis, workload assessment, and vigilance assessment techniques were used to study senior residents providing anesthesia for coronary artery bypass graft (CABG) procedures. The impact on anesthesia residents' workload of the routine use of transesophageal echocardiography (TEE) also was examined. Methods: Before each case, the Record keeping system was randomly selected as either Electronic (Diatek ARKIVE; EARK) or traditional manual Recording (MAN). Twenty CABG procedures (10 EARK and 10 MAN) were examined, with observation commencing with anesthetic induction and terminating on initiation of cardiopulmonary bypass. The activities of each resident, divided into 32 task categories (e.g., laryngoscopy, observe monitors, etc.), were Recorded by a trained observer using a computer. The response latency to a randomly activated alarm light was used as a measure of vigilance (vigilance latency). Workload was rated by subject and observer at random 10- to 15-min intervals throughout the case. Data analysis included calculation of workload density (number of tasks/min multiplied by task-specific workload values) and task-links (relationship between sequential tasks). Results: The two groups had a similar distribution of tasks before intubation. In only 4 of the 20 cases studied did any manual Record keeping occur before intubation. After intubation, the EARK group spent less time Record keeping and using the TEE but more time observing the monitors and conversing with the attending physician than the MAN group did. All subjects reported significantly higher workload scores before intubation compared with after intubation. Similarly, vigilance latency was greater before intubation compared with after intubation (57 vs. 31 s; P < 0.001). There were no significant differences between the two Record keeping groups in subjective workload scores, workload density, or vigilance latency. During TEE use, vigilance latency was significantly longer, and workload density was greater than during other monitoring or Recording tasks. Conclusions: This study provides an objective description of the task distribution and workload during the administration of anesthesia for cardiac surgery. Under the conditions of this study, EARK use modestly decreased the time spent Record keeping during the postintubation prebypass period. However, there was no effect of EARK either on vigilance or several measures of workload. TEE use was associated with increased workload and possibly decreased vigilance.
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the effect of Electronic Record keeping and transesophageal echocardiography on task distribution workload and vigilance during cardiac anesthesia
Anesthesiology, 1997Co-Authors: Matthew B Weinger, Oliver W Herndon, David M GabaAbstract:BACKGROUND: Electronic anesthesia Record keeping (EARK) systems increasingly are used in the operating room, but studies have only recently begun to investigate their effect on anesthesia task performance. Teak analysis, workload assessment, and vigilance assessment techniques were used to study senior residents providing anesthesia for coronary artery bypass graft (CABG) procedures. The impact on anesthesia residents' workload of the routine use of transesophageal echocardiography (TEE) also was examined. METHODS: Before each case, the Record keeping system was randomly selected as either Electronic (Distek ARKIVE; EARK) or traditional manual Recording (MAN). Twenty CABG procedures (10 EARK and 10 MAN) were examined, with observation commencing with anesthetic induction and terminating on initiation of cardiopulmonary bypass. The activities of each resident, divided into 32 task categories (e.g., "laryngoscopy," "observe monitors," etc.), were Recorded by a trained observer using a computer. The response latency to a randomly activated alarm light was used as a measure of vigilance ("vigilance latency"). Workload was rated by subject and observer at random 10- to 15-min intervals throughout the case. Data analysis included calculation of workload density (number of tasks/min multiplied by task-specific workload values) and task-links (relationship between sequential tasks). RESULTS: The two groups had a similar distribution of tasks before intubation. In only 4 of the 20 cases studied did any manual Record keeping occur before intubation. After intubation, the EARK group spent less time Record keeping and using the TEE but more time observing the monitors and conversing with the attending physician than the MAN group did. All subjects reported significantly higher workload scores before intubation compared with after intubation. Similarly, vigilance latency was greater before intubation compared with after intubation (57 vs. 31 s; P < 0.001). There were no significant differences between the two Record keeping groups in subjective workload scores, workload density, or vigilance latency. During TEE use, vigilance latency was significantly longer, and workload density was greater than during other monitoring or Recording tasks. CONCLUSIONS: This study provides an objective description of the task distribution and workload during the administration of anesthesia for cardiac surgery. Under the conditions of this study. EARK use modestly decreased the time spent Record keeping during the postintubation prebypass period. However, there was no effect of EARK either on vigilance or several measures of workload. TEE use was associated with increased workload and possibly decreased vigilance.
Oliver W Herndon - One of the best experts on this subject based on the ideXlab platform.
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the effect of Electronic Record keeping and transesophageal echocardiography on task distribution workload and vigilance during cardiac anesthesia
Anesthesiology, 1997Co-Authors: Matthew B Weinger, Oliver W Herndon, David M GabaAbstract:Background: Electronic anesthesia Record keeping (EARK) systems increasingly are used in the operating room, but studies have only recently begun to investigate their effect on anesthesia task performance. Task analysis, workload assessment, and vigilance assessment techniques were used to study senior residents providing anesthesia for coronary artery bypass graft (CABG) procedures. The impact on anesthesia residents' workload of the routine use of transesophageal echocardiography (TEE) also was examined. Methods: Before each case, the Record keeping system was randomly selected as either Electronic (Diatek ARKIVE; EARK) or traditional manual Recording (MAN). Twenty CABG procedures (10 EARK and 10 MAN) were examined, with observation commencing with anesthetic induction and terminating on initiation of cardiopulmonary bypass. The activities of each resident, divided into 32 task categories (e.g., laryngoscopy, observe monitors, etc.), were Recorded by a trained observer using a computer. The response latency to a randomly activated alarm light was used as a measure of vigilance (vigilance latency). Workload was rated by subject and observer at random 10- to 15-min intervals throughout the case. Data analysis included calculation of workload density (number of tasks/min multiplied by task-specific workload values) and task-links (relationship between sequential tasks). Results: The two groups had a similar distribution of tasks before intubation. In only 4 of the 20 cases studied did any manual Record keeping occur before intubation. After intubation, the EARK group spent less time Record keeping and using the TEE but more time observing the monitors and conversing with the attending physician than the MAN group did. All subjects reported significantly higher workload scores before intubation compared with after intubation. Similarly, vigilance latency was greater before intubation compared with after intubation (57 vs. 31 s; P < 0.001). There were no significant differences between the two Record keeping groups in subjective workload scores, workload density, or vigilance latency. During TEE use, vigilance latency was significantly longer, and workload density was greater than during other monitoring or Recording tasks. Conclusions: This study provides an objective description of the task distribution and workload during the administration of anesthesia for cardiac surgery. Under the conditions of this study, EARK use modestly decreased the time spent Record keeping during the postintubation prebypass period. However, there was no effect of EARK either on vigilance or several measures of workload. TEE use was associated with increased workload and possibly decreased vigilance.
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the effect of Electronic Record keeping and transesophageal echocardiography on task distribution workload and vigilance during cardiac anesthesia
Anesthesiology, 1997Co-Authors: Matthew B Weinger, Oliver W Herndon, David M GabaAbstract:BACKGROUND: Electronic anesthesia Record keeping (EARK) systems increasingly are used in the operating room, but studies have only recently begun to investigate their effect on anesthesia task performance. Teak analysis, workload assessment, and vigilance assessment techniques were used to study senior residents providing anesthesia for coronary artery bypass graft (CABG) procedures. The impact on anesthesia residents' workload of the routine use of transesophageal echocardiography (TEE) also was examined. METHODS: Before each case, the Record keeping system was randomly selected as either Electronic (Distek ARKIVE; EARK) or traditional manual Recording (MAN). Twenty CABG procedures (10 EARK and 10 MAN) were examined, with observation commencing with anesthetic induction and terminating on initiation of cardiopulmonary bypass. The activities of each resident, divided into 32 task categories (e.g., "laryngoscopy," "observe monitors," etc.), were Recorded by a trained observer using a computer. The response latency to a randomly activated alarm light was used as a measure of vigilance ("vigilance latency"). Workload was rated by subject and observer at random 10- to 15-min intervals throughout the case. Data analysis included calculation of workload density (number of tasks/min multiplied by task-specific workload values) and task-links (relationship between sequential tasks). RESULTS: The two groups had a similar distribution of tasks before intubation. In only 4 of the 20 cases studied did any manual Record keeping occur before intubation. After intubation, the EARK group spent less time Record keeping and using the TEE but more time observing the monitors and conversing with the attending physician than the MAN group did. All subjects reported significantly higher workload scores before intubation compared with after intubation. Similarly, vigilance latency was greater before intubation compared with after intubation (57 vs. 31 s; P < 0.001). There were no significant differences between the two Record keeping groups in subjective workload scores, workload density, or vigilance latency. During TEE use, vigilance latency was significantly longer, and workload density was greater than during other monitoring or Recording tasks. CONCLUSIONS: This study provides an objective description of the task distribution and workload during the administration of anesthesia for cardiac surgery. Under the conditions of this study. EARK use modestly decreased the time spent Record keeping during the postintubation prebypass period. However, there was no effect of EARK either on vigilance or several measures of workload. TEE use was associated with increased workload and possibly decreased vigilance.
Fangming Hsu - One of the best experts on this subject based on the ideXlab platform.
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agency satisfaction with Electronic Record management systems a large scale survey
Journal of the Association for Information Science and Technology, 2010Co-Authors: Fangming Hsu, Hsunchun ChenAbstract:We investigated agency satisfaction with an Electronic Record management system (ERMS) that supports the Electronic creation, archival, processing, transmittal, and sharing of Records (documents) among autonomous government agencies. A factor model, explaining agency satisfaction with ERMS functionalities, offers hypotheses, which we tested empirically with a large-scale survey that involved more than 1,600 government agencies in Taiwan. The data showed a good fit to our model and supported all the hypotheses. Overall, agency satisfaction with ERMS functionalities appears jointly determined by regulatory compliance, job relevance, and satisfaction with support services. Among the determinants we studied, agency satisfaction with support services seems the strongest predictor of agency satisfaction with ERMS functionalities. Regulatory compliance also has important influences on agency satisfaction with ERMS, through its influence on job relevance and satisfaction with support services. Further analyses showed that satisfaction with support services partially mediated the impact of regulatory compliance on satisfaction with ERMS functionalities, and job relevance partially mediated the influence of regulatory compliance on satisfaction with ERMS functionalities. Our findings have important implications for research and practice, which we also discuss. © 2010 Wiley Periodicals, Inc.
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WEB - Examining Agencies’ Satisfaction with Electronic Record Management Systems in e-Government: A Large-Scale Survey Study
Designing E-Business Systems. Markets Services and Networks, 2009Co-Authors: Fangming Hsu, Hsinchun ChenAbstract:While e-government is propelling and maturing steadily, advanced technological capabilities alone cannot guarantee agencies’ realizing the full benefits of the enabling computer-based systems. This study analyzes information systems in e-government settings by examining agencies’ satisfaction with an Electronic Record management system (ERMS). Specifically, we investigate key satisfaction determinants that include regulatory compliance, job relevance, and satisfaction with support services for using the ERMS. We test our model and the hypotheses in it, using a large-scale survey that involves a total of 1,652 government agencies in Taiwan. Our results show significant effects of regulatory compliance on job relevance and satisfaction with support services, which in turn determine government agencies’ satisfaction with an ERMS. Our data exhibit a reasonably good fit to our model, which can explain a significant portion of the variance in agencies’ satisfaction with an ERMS. Our findings have several important implications to research and practice, which are also discussed.
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examining the business technology alignment in government agencies a study of Electronic Record management systems in taiwan
Pacific Asia Conference on Information Systems, 2006Co-Authors: Fangming Hsu, Hsinchun ChenAbstract:For e-government to succeed, government agencies must manage their Records and archives of which the sheer volume and diversity necessitate the use of Electronic Record management systems (ERMS). Using an established business–technology alignment model, we analyze an agency’s strategic alignment choice and examine the outcomes and agency performance associated with that alignment. The specific research questions addressed in the study are as follows: (1) Do strategic alignment choices vary among agencies that differ in purpose or position within the overall government hierarchy? (2) Do agencies’ alignment choices lead to different outcomes? and (3) Does performance in implementing, operating, and using ERMS vary among agencies that follow different alignment choices? We conducted a large-scale survey study of 3,319 government agencies in Taiwan. Our data support the propositions tested. Based on the findings, we discuss their implications for digital government research and practice.
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PACIS - Examining the Business-Technology Alignment in Government Agencies: A Study of Electronic Record Management Systems in Taiwan
2006Co-Authors: Fangming Hsu, Hsinchun ChenAbstract:For e-government to succeed, government agencies must manage their Records and archives of which the sheer volume and diversity necessitate the use of Electronic Record management systems (ERMS). Using an established business–technology alignment model, we analyze an agency’s strategic alignment choice and examine the outcomes and agency performance associated with that alignment. The specific research questions addressed in the study are as follows: (1) Do strategic alignment choices vary among agencies that differ in purpose or position within the overall government hierarchy? (2) Do agencies’ alignment choices lead to different outcomes? and (3) Does performance in implementing, operating, and using ERMS vary among agencies that follow different alignment choices? We conducted a large-scale survey study of 3,319 government agencies in Taiwan. Our data support the propositions tested. Based on the findings, we discuss their implications for digital government research and practice.
Omar Bouhaddou - One of the best experts on this subject based on the ideXlab platform.
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the department of veterans affairs va implementation of the virtual lifetime Electronic Record vler findings and lessons learned from health information exchange at 12 sites
International Journal of Medical Informatics, 2014Co-Authors: Colene Byrne, Nathan E. Botts, Lois M. Olinger, Lauren M Mercincavage, Omar Bouhaddou, Jamie R Bennett, Eric C Pan, Elaine Hunolt, Karl H Banty, Tim CromwellAbstract:Abstract Purpose We describe the Department of Veterans Affairs' (VA) Virtual Lifetime Health Electronic Record (VLER) pilot phase in 12 communities to exchange health information with private sector health care organizations and the Department of Defense (DoD), key findings, lessons, and implications for advancing Health Information Exchanges (HIE), nationally. Methods A mixed methods approach was used to monitor and evaluate the status of VLER Health Exchange pilot phase implementation from December 2009 through October 2012. Selected accomplishments, contributions, challenges, and early lessons that are relevant to the growth of nationwide HIE are discussed. Results Veteran patient and provider acceptance, trust, and perceived value of VLER Health Exchange are found to be high, and usage by providers is steadily growing. Challenges and opportunities to improve provider use are identified, such as better data quality and integration with workflow. Key findings and lessons for advancing HIE are identified. Conclusions VLER Health Exchange has made great strides in advancing HIE nationally by addressing important technical and policy issues that have impeded scalability, and by increasing trust and confidence in the value and accuracy of HIE among users. VLER Health Exchange has advanced HIE interoperability standards and patient consent policies nationally. Policy, programmatic, technology, and health Information Technology (IT) standards implications to advance HIE for improved delivery and coordination of health care are discussed. The pilot phase success led to VA-wide deployment of this data sharing capability in 2013.
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toward a virtual lifetime Electronic Record the department of veterans affairs experience with the nationwide health information network
American Medical Informatics Association Annual Symposium, 2012Co-Authors: Omar Bouhaddou, Jamie R Bennett, Jennifer Teal, Margaret Pugh, Melissa Sands, Frank Fontaine, Marie Swall, Sanjay Dhar, Tony Mallia, Brian MorganAbstract:Health information exchange is expected of all Electronic health Records (EHRs) in order to ensure safe, quality care coordination. The U.S. Department of Veterans Affairs (VA) has a long history of information exchange across VA facilities and with the U.S. Department of Defense (DoD). However, since a majority of VA and DoD patients receive a portion of their health care from the private sector, it is essential that both agencies enable health information exchange with private sector providers. This has been made possible by the use of the specifications and trust agreement developed by the Nationwide Health Information Network (NwHIN) initiative. Currently, VA has 12 medical centers exchanging information with the private sector and is evaluating the value of the exchange. The authors report on the success of these pilots as well as on the challenges, which include stricter technical specifications and a more efficient approach to patient identification (ID) matching and consent management.
