Abstract
Clinicians often need access to electronic information resources that answer questions that occur in daily clinical practice. This information generally comes from publicly available resources. However, clinicians also need knowledge on institution-specific information (e.g., institution-specific guidelines, choice of drug, choice of laboratory test, information on adverse events, and advice from professional colleagues). This information needs to be available in real time. This study characterizes these needs in order to build a prototype hospital information system (HIS) that can help clinicians get timely answers to questions. We previously designed medical knowledge units called Medical Cells (MCs). We developed a portal server of MCs that can create and store medical information such as institution-specific information. We then developed a prototype HIS that embeds MCs as links (MCLink); these links are based on specific terms (e.g., drug, laboratory test, and disease). This prototype HIS presents clinicians with institution-specific information. The HIS clients (e.g., clinicians, nurses, pharmacists, and laboratory technicians) can also create an MCLink in the HIS using the portal server in the hospital. The prototype HIS allowed efficient sharing and use of institution-specific information to clinicians at the point of care. This study included institution-specific information resources and advice from professional colleagues, both of which might have an important role in supporting good clinical decision making.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Wyatt, J., Use and sources of medical knowledge. Lancet 338(8779):1368–1373, 1991.
Ely, J. W., Osheroff, J. A., Chambliss, M. L., Ebell, M. H., and Rosenbaum, M. E., Answering physicians’ clinical questions: obstacles and potential solutions. J. Am. Med. Inform. Assoc 12(2):217–224, 2005.
Westbrook, J. I., Coiera, E. W., and Gosling, A. S., Do online information retrieval systems help experienced clinicians answer clinical questions? J. Am. Med. Inform. Assoc. 12(3):315–321, 2005.
Ely, J. W., Osheroff, J. A., Maviglia, S. M., and Rosenbaum, M. E., Patient-care questions that physicians are unable to answer. J. Am. Med. Inform. Assoc. 14(4):407–414, 2007. doi:10.1197/jamia.M2398.
Dawes, M., and Sampson, U., Knowledge management in clinical practice: a systematic review of information seeking behavior in physicians. Int. J. Med. Inform. 71(1):9–15, 2003.
Hersh, W. R., and Hickam, D. H., How well do physicians use electronic information retrieval systems? A framework for investigation and systematic review. JAMA 280(15):1347–1352, 1998.
Magrabi, F., Coiera, E. W., Westbrook, J. I., Gosling, A. S., and Vickland, V., General practitioners’ use of online evidence during consultations. Int. J. Med. Inform. 74(1):1–12, 2005. doi:10.1016/j.ijmedinf.2004.10.003.
Collins, S. A., Currie, L. M., Bakken, S., and Cimino, J. J., Information needs, infobutton manager use, and satisfaction by clinician type: a case study. J. Am. Med. Inform. Assoc. 16(1):140–142, 2009. doi:10.1197/jamia.M2746.
Williamson, J. W., German, P. S., Weiss, R., Skinner, E. A., and Bowes, F., 3rd, Health science information management and continuing education of physicians. A survey of U.S. primary care practitioners and their opinion leaders. Ann. Intern. Med. 110(2):151–160, 1989.
Cimino, J. J., Use, usability, usefulness, and impact of an infobutton manager. AMIA Annu. Symp. Proc. 151–155, 2006.
Cimino, J. J., Li, J., Allen, M., Currie, L. M., Graham, M., Janetzki, V., Lee, N. J., Bakken, S., and Patel, V. L., Practical considerations for exploiting the World Wide Web to create infobuttons. Stud. Health Technol. Inform 107(Pt 1):277–281, 2004.
Maviglia, S. M., Yoon, C. S., Bates, D. W., and Kuperman, G., KnowledgeLink: impact of context-sensitive information retrieval on clinicians’ information needs. J. Am. Med. Inform. Assoc 13(1):67–73, 2006.
Cimino, J. J., Li, J., Graham, M., Currie, L. M., Allen, M., Bakken, S., Patel, V. L., Use of online resources while using a clinical information system. AMIA Annu. Symp. Proc. 175–179, 2003.
Del Fiol, G., Haug, P. J., Cimino, J. J., Narus, S. P., Norlin, C., and Mitchell, J. A., Effectiveness of topic-specific infobuttons: a randomized controlled trial. J. Am. Med. Inform. Assoc 15(6):752–759, 2008. doi:10.1197/jamia.M2725.
Smith, R., What clinical information do doctors need? BMJ 313(7064):1062–1068, 1996.
Yamashita, Y., Komiya, M., and Abe, S., Information needs and behavior of university hospital Internet connection [in Japanese]. Igaku Toshokan 52(1):59–65, 2005.
Takahiro, S., Takashi, K., Shinsuke, H., and Katsuhiko, T., The existing university hospital Internet connection [in Japanese]. JAMI Proc 28:696–697, 2008.
Shimura, H., and Kanemori, K., Usefulness and safety of hospital systems [in Japanese]. New Med. Jpn 39(1):112–116, 2012.
Shibuya, A., Inoue, R., Ohsaga, A., Nakayama, M., Endo, A., and Kondo, Y., A new approach to medical and clinical knowledge management by using the Medical Cells strategy. AMIA Annu. Symp. Proc. 1113, 2007
Shibuya, A., Nakayama, M., Inoue, R., Endo, A., Imai, Y., and Kondo, Y., The medical cells: for the spread of clinical knowledge management. AMIA Annu. Symp. Proc. 1130, 2008
Davies, K., and Harrison, J., The information-seeking behaviour of doctors: a review of the evidence. Health. Inf. Libr. J 24(2):78–94, 2007. doi:10.1111/j.1471-1842.2007.00713.x.
Pluye, P., Grad, R. M., Dunikowski, L. G., and Stephenson, R., Impact of clinical information-retrieval technology on physicians: a literature review of quantitative, qualitative and mixed methods studies. Int. J. Med. Inform 74(9):745–768, 2005. doi:10.1016/j.ijmedinf.2005.05.004.
Robertson, J., Moxey, A. J., Newby, D. A., Gillies, M. B., Williamson, M., and Pearson, S. A., Electronic information and clinical decision support for prescribing: state of play in Australian general practice. Fam. Pract. 28(1):93–101, 2011. doi:10.1093/fampra/cmq031.
Shariff, S. Z., Bejaimal, S. A., Sontrop, J. M., Iansavichus, A. V., Weir, M. A., Haynes, R. B., Speechley, M. R., Thind, A., and Garg, A. X., Searching for medical information online: a survey of Canadian nephrologists. J. Nephrol 24(6):723–732, 2011. doi:10.5301/jn.2011.6373.
McKibbon, K. A., and Fridsma, D. B., Effectiveness of clinician-selected electronic information resources for answering primary care physicians’ information needs. J. Am. Med. Inform. Assoc 13(6):653–659, 2006. doi:10.1197/jamia.M2087.
Coiera, E., and Tombs, V., Communication behaviours in a hospital setting: an observational study. BMJ 316(7132):673–676, 1998.
Acknowledgments
The authors are grateful to the staff members of Medical Informatics Center, Tohoku University Hospital, Japan for their valuable support of the study, and to Mr. Toyohiko Hoshikawa and Mr. Toshihiro Shirakawa for their cooperation in conducting the study.
Conflict of interest
This study was supported by FUJITSU LIMITED, Tokyo, Japan as a joint research grant (http://jp.fujitsu.com). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Shibuya, A., Inoue, R., Nakayama, M. et al. An Approach to Medical Knowledge Sharing in a Hospital Information System Using MCLink. J Med Syst 37, 9956 (2013). https://doi.org/10.1007/s10916-013-9956-1
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s10916-013-9956-1