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May 2020 DOI 10.14302/issn.2692-5257.ijgp-20-3368
Mango LucioCorresponding author
Head for Higher Education in Healthcare, University of International Studies (UNINT) – Rome, Italy
General practitioners are the first contact between the person, the family and the community with the health system. The philosopher and epistemologist K. Popper (1902-1994) recommended the need to register errors, in order to know them, catalog them and therefore prevent them. J.Reason in 1963 introduced the systemic approach to the study of errors with the theory of latent errors. The knowledge of the causal factors, or which in any case contribute, of possible errors, as well as of the latent gaps in the system, is a fundamental prerequisite for the construction of paths aimed at improving the quality of assistance, structures and organizational aspects.
Jan 2024 DOI 10.14302/issn.2641-5526.jmid-24-4893
J. Johnson RalphCorresponding author
This evidence-based brief commentary discusses the potential of EPIC ® medicalrecords software to help or hinder in advancing High Reliability in healthcare—namely, the intent to attain repeatable, increasingly high levels of quality and safety over time. Four of EPIC’s key aspects relevant to High Reliability are examined: Standardized (High Quality) Information / Data Collection, Technological Somnambulism, Enhanced Patient Safety, and Reminders / “Hardstops.” A conclusion is drawn that EPIC, if used correctly, has vast potential to advance High Reliability high-quality and safety, specifically in medical treatment and regarding healthcare organization practice in general. However, it has hidden costs that are more than money; if unfettered, those costs can hinder its usefulness and even render it counterproductive. EPIC only works well in terms of Maximum High Reliability in healthcare as long as users and leaders remain mindful, prudent, and balanced in its use.
Feb 2021 DOI 10.14302/issn.2641-5526.jmid-21-3739
Ralph J. JohnsonCorresponding author
Background As healthcare markets have become more dynamic and turbulent, healthcare organizations have evolved by becoming increasingly “Smart-Agile” in their business practices. Smart-Agility definition-ally ensures success due to its inherent ability to rapidly detect and react appropriately to varied and evolving unclear, complex, and seemingly tumultuous situations and produce high-quality, low-cost goods and services with high customer satisfaction. Thus, there is a vital need for Smart-Agile healthcare IT systems for collection, analyses, and reporting of substantial quantities of healthcare data to inform patient treatment and organizational decisions. EPIC® and its meaningful-use components appear increasingly popular, capturing a majority portion of the healthcare Electronic Healthcare Records (EHR) IT market (>~30%).Yet, there are few, if any, studies reporting on EPIC in terms of Smart-Agility. Aim The intent of this article is to report a systematic review of scientific literature regarding EPIC’s healthcare IT systems meaningful-use features cross-compared with Smart-Agility aspects to produce a positive vs. negative report card—and whether its features are critical vs. non-critical in terms of Smart-Agility. Method Findings reported herein derive from a grounded, iterative review of open-source, peer-reviewed scientific literature following PRISMA. Findings Report card results were mixed. EPIC clearly succeeds and excels (better than average) on Smart-Agile healthcare IT system core aspects that are the most central, critical and valuable in terms of informing healthcare organizations’ decisions and their patients’ care (6 out of 7; B+, -A), specifically: Standardized Data Collection / Connectivity, Real-Time Data Warehousing/Outcome Measures, Enhanced Patient Safety, Patient Tracking and Follow-up (Continuity of Care), Patient Involvement, and Potential Use in Medical Education. The only critical core criterion it failed on was End-User Satisfaction, and some of that appears to dissipate with new users’ software familiarity. Conclusion EPIC provides a solid and relatively inexpensive foundation with great potential for enabling Smart Agility in healthcare organizations with its high-quality collection and management of vast amounts of inter-connected raw data, auto-analysis, and fast report generation. But it does so with hidden costs and inefficiencies. Avenues of further inquiry are suggested.
Nov 2016
Wan Kim YoungCorresponding author
Division of Colorectal Surgery, Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
This practical overview lists prerequisites for emergent laparoscopic colorectal cancer surgery, including team readiness, equipment, and perioperative protocols to optimize patient safety.