“Evaluation of HSJ-ICU system use by medical doctors” Professor Orientador: Ricardo Correia Turma 20

Objective To evaluate the use of HSJ-ICU system by medical doctors working at HSJ To evaluate the use of HSJ-ICU system by medical doctors working at HSJ

Methods Type of study: observational and transversal study Target population: 1116 medical doctors currently working at HSJ (workers for the Department of Human Resources). Sampling method: simple random sampling Sample: 68 medical doctors

 Application of the definitive questionnaire Collection of data: Collection of data:  Elaboration of the questionnaire (personal and structured interview)  Application of the 4 pilots (reformulation of the questionnaire after the application of each pilot)

Frequency of utilization of ICU and others electronic medical records of HSJ Frequency of utilization of ICU in urgency, consultation and internment Mean of access to the ICU Degree of importance of several characteristics of ICU Departments from which more reports are visualized Reasons to not use ICU Impact of the implementation of ICU in the professional life and in HSJ Changes to ICU Questionnaire:

Elaboration of the table of data and introduction of the data in the SPSS Elaboration of the table of data and introduction of the data in the SPSS  Statistical analysis of the data in SPSS: We elaborated frequency tables: to count how many medical doctors answered to the questionnaire;and how many did not and the reasons for it; to analyze the sex and the age of the medical doctors; to analyse the mean of access to the ICU system.

We elaborated several graphs: showing the frequency of utilization of ICU, SAM, CLINIDATA and Sistema Informático de Radiologia, in order to compare them; to compare the frequency of utilization of ICU in urgency, consultation and internment; to compare the means of the degree of importance of various characteristics of ICU system; to compare the degree of visualization of reports provided by the departments that send reports to the ICU system. We also analyzed all the questions about the impact of the ICU and about the changes suggested to this system.

Results, tables and graphs Number of medical doctors we searched for in HSJ: 68 Percent of women: 48,5% (33 medical doctors) Percent of men: 51,5% (35 medical doctors) Medical doctors that answered to the questionnaire: 52,9% (36 medical doctors) Medical doctors that don’t work anymore in HSJ: 17,6% (12 medical doctors) Medical doctors were not found: 10,3% (7 medical doctors) Medical doctors that refused to answer the questionnaire: 5,9% (4 medical doctors) Medical doctors were absent on holidays: 4,4% (3 medical doctors) Medical doctors were absent due to labour license: 1,5% (1 medical doctor) Medical doctors were absent due to sick note: 2,9% (2 medical doctors) Not medical doctors: 4,4% (3 people)

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Table 1

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 Within the 36 medical doctors that answered to the questionnaire, 21 used the ICU system. Access to ICU only trough a link on the desktop (HSJ.ICU): 38,1% (8 medical doctors) Access to ICU only through SAM: 33,3% (7 medical doctors) Access through the link HSJ.ICU, through SAM and through the intranet of the hospital: 14,3% (3 medical doctors) Access only through the Intranet of the Hospital: 4,8% (1 medical doctor) Access through the link HSJ.ICU, through SAM and through obs.gyn.care (electronic medical record of gynaecology e obstetricses): 4,8% (1 medical doctor) Access through the link HSJ.ICU and through SAM: 4,8% (1 medical doctor)  Within the 36 medical doctors that answered to the questionnaire, 41,7% (15 medical doctors) have never used the ICU system, all of tem stated they didn’t know this system.

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Impact caused by the ICU system Answers Number of doctors that agree Decrease of the time of access to laboratorial and clinical information 12 It is easier to access to the clinical information of the patient 8 Better communication between health professionals 2 Better integration of the clinical information 1 Access to the clinical information from several places 1 ICU do the same function of SAM 1 ICU is a low system 1 Little impact on my professional life 1 ICU had an important impact 1 Didn’t answer 2 Table 2

Changes suggested to the ICU Answers Number of doctors that agree Increase the number of departments from which it is possible to visualize reports4 Decrease the technical problems that sometimes don’t allow the parcial or total use of ICU3 Decrease the up-date time of the reports displayed on ICU2 Possibility of making requests of clinical and laboratorial analysis through ICU1 Decrease the problems of access of reports from Pathological Anatomy1 Make the access to ICU easier1 No suggestion11 Table 3

Discusion of the results ICU is less used than SAM, CLINIDATA and SISTEMA INFORMÁTICO DE RADIOLOGIA because is the most recent system and so it is the last spread; Although SAM has a lesser number of users than CLINIDATA, these users use SAM more times per month than the users of CLINIDATA; ICU is more used in the internment, following consultation and finally urgency because of the characteristic of each work place; The most important characteristics of ICU are “It allows the access to reports (analysis...) from several departments” and “It decreases the time needed to access clinical and laboratorial reports” because they are probably those which make more easy the clinical practice; The three departments from which more reports are visualized are Pathological Anatomy, Clinical Pathology and immunohemotherapy. This situation probably occurs because these three departments provide reports which subject is more general.

FlowchartGantt chartQuestionnaire Website planFull article Table of data of SPSS Syntax

References 1.Aula sobre Registos Clínicos Electrónicos do Curso de Informática Médica que se encontra em Stanley J. Reiser, The Clinical Record in Medicine Part 1: Learning from cases, American College of Physicians, Richard S. Dick, Elaine B. Steen, and Don E. Detmer, The Computer-based patient record: An Essential Technology for Health Care, National Academy Press, R. Cruz-Correia, P. Vieira-Marques, P. Costa, A. Ferreira, E. Oliveira-Palhares, F. Araújo and A. Costa-Pereira, Integration oh hospital data using agent Technologies- A case study (2005). 5.Torchio M, Molino F, Sestero D, Seidemari C, Molino G. Na electronic madical diary for computer assisted patient management. Minerva Med.2003 Jun; 94 (3):

6.Coiera E. Guide to medical informatics, the internet and telemedicine. Arnold Publishers, London, Uckert F. et al. Functions of an electronic health record. INT J Comput Dent Apr- Jul; 5 (2-3): Lenz R and Kuhn KA. Integration of heterogeneous and autonomous systems in hospital. Business Briefing: Data management & Storage Technology, Manual do utilizador do ICU 10.Panfleto de divulgação do ICU.