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The Effects of Integrated IT Support on the Prehospital Stroke Process: Results from a Realistic Experiment
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. (Prehospen)ORCID iD: 0000-0002-6888-9323
Chalmers.
University of Borås, Faculty of Librarianship, Information, Education and IT. (PreHospen)
2019 (English)In: Journal of Healthcare Informatics Research, ISSN 2509-4971Article in journal (Refereed) Epub ahead of print
Abstract [en]

Stroke is a serious condition and the stroke chain of care is a complex. The present study aims to explore the impact of a computerised decision support system (CDSS) for the prehospital stroke process, with focus on work processes and performance. The study used an exploratory approach with a randomised controlled crossover design in a realistic contextualised simulation experiment. The study compared clinical performance among 11 emergency medical services (EMS) teams of 22 EMS clinicians using (1) a computerised decision support system (CDSS) and (2) their usual paper-based process support. Data collection consisted of video recordings, postquestionnaires and post-interviews, and data were analysed using a combination of qualitative and quantitative approaches. In this experiment, using a CDSS improved patient assessment, decision making and compliance to process recommendations. Minimal impact of the CDSS was found on EMS clinicians’ self-efficacy, suggesting that even though the system was found to be cumbersome to use it did not have any negative effects on self-efficacy. Negative effects of the CDSS include increased on-scene time and a cognitive burden of using the system, affecting patient interaction and collaboration with team members. The CDSS’s overall process advantage to the prehospital stroke process is assumed to lead to a prehospital care that is both safer and of higher quality. The key to user acceptance of a system such as this CDSS is the relative advantages of improved documentation process and the resulting patient journal. This could improve the overall prehospital stroke process.

Place, publisher, year, edition, pages
2019.
Keywords [en]
Stroke, Decision support, EMS team, Prehospital process
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hb:diva-21183DOI: 10.1007/s41666-019-00053-4OAI: oai:DiVA.org:hb-21183DiVA, id: diva2:1322897
Projects
PrehospIT
Funder
VinnovaAvailable from: 2019-06-11 Created: 2019-06-11 Last updated: 2019-06-17Bibliographically approved

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Andersson Hagiwara, MagnusMaurin Söderholm, Hanna

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