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Building a Common Ground on the Clinical Case : Design, Implementation and Evaluation of an Information Model for a Handover EHR

  • Handovers need a common ground on the clinical cases between the members of the successive shifts to establish continuity of care. Conventional electronic patient record systems (EHR) proved to be only insufficiently suitable for supporting the grounding process. Against this background we proposed a basic concept for a handover EHR that extends general EHRs in particular openEHR based systems. The resulting handover information model was implemented in a database and evaluated based on 120 clinical cases. The information items of these cases could be mapped successfully to the model, however, the new class “anticipatory guidance” needed to be introduced. The evaluation also demonstrated the importance of highly aggregated information on the clinical case, opinions and meta-information such as the relevance of an item during handovers. Based on these findings, in particular the handover database, handover EHR applications are currently developed to support the grounding process.

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Metadaten
Author:Daniel Flemming, Mareike Paul, Ursula Hertha HübnerORCiD
Title (English):Building a Common Ground on the Clinical Case : Design, Implementation and Evaluation of an Information Model for a Handover EHR
URN:urn:nbn:de:bsz:959-opus-20920
DOI:https://doi.org/10.3233/978-1-61499-415-2-167
ISBN:978-1-61499-414-5
ISBN:978-1-61499-415-2
Parent Title (English):Nursing Informatics 2014
Publisher:IOS Press
Place of publication:Amsterdam, Berlin, Washington (DC)
Document Type:Conference Proceeding
Language:English
Year of Completion:2014
Release Date:2021/05/27
First Page:167
Last Page:174
Note:
12th International Congress on Nursing Informatics, 21.06. - 25.06.2014, Taipei (Taiwan)
Faculties:Fakultät WiSo
DDC classes:600 Technik, Medizin, angewandte Wissenschaften / 610 Medizin, Gesundheit
Review Status:Veröffentlichte Fassung/Verlagsversion
Licence (German):License LogoCreative Commons - CC BY-NC - Namensnennung - Nicht kommerziell 4.0 International