Information Technology Reference
In-Depth Information
Context Identification
Once we have the contexts, it is necessary to have an automatic method to identify
when a medical doctor accesses an EHR in a given context. By means of differ-
ent interviews with the medical staff we have identified some characteristics of the
accesses they perform, that are important in this process:
Specialty of the medical staff like cardiology, ophthalmology, internal medicine,
emergency, administration, nursing, and so on.
Position of the medical staff. There are different positions for each type of
medical personnel like. Some examples are: resident (from first to fifth year),
facultative, section manager or head of service for the medical doctors; the cat-
egories of management technician, administrative technician, section manager
or head of service for the administrative personnel; or the nursing position or
nursing supervisor in that department.
Type of the medical workstation. The data about the type of terminal used to
perform the access, gives a lot of information about the type of assistance act in
which the medical staff is involved. This attribute has several parts:
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The type of the terminal. This value gives information about the hardware
used (PC, PDA, patient's room terminal, computer associated to a concrete
equipment like the X-ray machines or ultrasound scan, etc).
-
The medical unit associated. Each terminal is associated to an unit (gyne-
cology, pediatrics, etc.) for management reasons; but this information helps
to identify the context. As an example if a cardiologist is acceding an EHR
from a computer associated to the emergency unit, the context could be a
cardiology emergency.
-
Physical Location. It helps to concrete even more the type of context in
which the medical staff is involved. In the previous example, if the terminal
acceded is located in the observation room in emergencies, the context is
different from the case when the access is performed from the surgery room.
The kind of the present patient's appointment. For each appointment with a
doctor, the information about its type is stored. There are around 50 usual types
of appointments like first visit, checkup, scheduled visit, urgent visit, extern
emergency, admission, several types for the different complementary tests and
explorations, inter-consultation, movement between services, and so on. There
are also some other types less usual or even rare but also considered in the sys-
tem, like radiologic surgery.
Last visit of the patient. This information in some cases helps to predict the
cause of the next appointment. As an example, always after a surgical interven-
tion there is a post-surgical checkup.
23.4.2
Pertinence
Once the set of considered contexts is defined it is necessary to identify the relevant
information for each one. The relevance of a concrete data group for a given context
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