Point-of-care clinical documentation: assessment of a bladder cancer informatics tool (eCancerCareBladder): a randomized controlled study of efficacy,efficiency and user friendliness compared with standard electronic medical records |
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Authors: | Peter J Bostrom Paul J Toren Hao Xi Raymond Chow Tran Truong Justin Liu Kelly Lane Laura Legere Anjum Chagpar Alexandre R Zlotta Antonio Finelli Neil E Fleshner Ethan D Grober Michael A S Jewett |
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Affiliation: | 1.Division of Urology, Department of Surgical Oncology, Princess Margaret Hospital, Toronto, Ontario, Canada;2.Healthcare Human Factors, University Health Network, Toronto, Ontario, Canada;3.Health Informatics Research, University Health Network, Toronto, Ontario, Canada;4.Division of Urology, Mount Sinai & Women''s College Hospital, University Health Network, Toronto, Ontario, Canada |
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Abstract: | ObjectiveTo compare the use of structured reporting software and the standard electronic medical records (EMR) in the management of patients with bladder cancer. The use of a human factors laboratory to study management of disease using simulated clinical scenarios was also assessed.DesigneCancerCareBladder and the EMR were used to retrieve data and produce clinical reports. Twelve participants (four attending staff, four fellows, and four residents) used either eCancerCareBladder or the EMR in two clinical scenarios simulating cystoscopy surveillance visits for bladder cancer follow-up.MeasurementsTime to retrieve and quality of review of the patient history; time to produce and completeness of a cystoscopy report. Finally, participants provided a global assessment of their computer literacy, familiarity with the two systems, and system preference.ResultseCancerCareBladder was faster for data retrieval (scenario 1: 146 s vs 245 s, p=0.019; scenario 2: 306 vs 415 s, NS), but non-significantly slower to generate a clinical report. The quality of the report was better in the eCancerCareBladder system (scenario 1: p<0.001; scenario 2: p=0.11). User satisfaction was higher with the eCancerCareBladder system, and 11/12 participants preferred to use this system.LimitationsThe small sample size affected the power of our study to detect differences.ConclusionsUse of a specific data management tool does not appear to significantly reduce user time, but the results suggest improvement in the level of care and documentation and preference by users. Also, the use of simulated scenarios in a laboratory setting appears to be a valid method for comparing the usability of clinical software. |
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Keywords: | Bladder cancer informatics electronic medical records point of care documentation synoptic reporting cancer machine learning predictive modeling statistical learning privacy technology decision modeling education public health informatics |
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