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The ISABEL user survey

The ISABEL user survey. Dr Jim Briggs Dr Tineke Fitch Healthcare Computing Group University of Portsmouth http://www.disco.port.ac.uk/hcc. Contents. What is ISABEL? Our study Results Observations. What is ISABEL?. www.isabel.org.uk Web-based paediatric clinical decision-support system

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The ISABEL user survey

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  1. The ISABEL user survey Dr Jim BriggsDr Tineke Fitch Healthcare Computing GroupUniversity of Portsmouthhttp://www.disco.port.ac.uk/hcc

  2. Contents • What is ISABEL? • Our study • Results • Observations

  3. What is ISABEL? • www.isabel.org.uk • Web-based paediatric clinicaldecision-support system • (Adult version since January 2005) • History • The ISABEL medical charity • (Now also a UK & US-based company)

  4. Primarily: Differential diagnosis tool Based on standard textbooks Autonomy software Supported by: Text Annotated images Practice guidelines Experience What does ISABEL provide?

  5. Background to the study • Brought to the attention of the UK Department of Health • DH were considering: • wider adoption in the NHS • possibility of an adult version • DH commissioned two studies: • Clinical review • User survey

  6. Objectives of our study • Determine the extent of use of ISABEL • Find out users' attitudes to it • Identify barriers to further deployment or development • Study performed in 2 parts • log data analysis • user survey

  7. 1. Log data analysis • Based on log data provided by the web hosting company • Conventional web server logs • showed number of hits, pages accessed, etc. • Login and user registration records • User identity and timestamp • Covered the period from July 2001 to December 2002

  8. 24-item questionnaire sent by email to all UK-based registered users (4436) + covering letter from ISABEL team encouraging completion Returns by post, email and fax Survey addressed: Profession / grade / speciality Work setting and available IT equipment Familiarity with computers Frequency of use of ISABEL Evaluation of ISABEL Comments 2. User survey

  9. Data analysis results • 7179 registered users • 46% only used it once • 72% no more than twice • 90% no more than 5 times • Core of 50 users • average >= 1 visit per week • Usage highest during "office hours" • Most usage (where identifiable) from UK • Detail often hidden by NHS firewalls

  10. Survey results 1 • 518 usable responses (12%) • included high proportion of most frequent users • 58% from paediatric specialists • of whom about half were of consultant grade • rest were junior doctors or nurses • 42% from other healthcare professionals • of whom 45% were General Practitioners

  11. Survey results 2 • Paediatric specialists used ISABEL slightly more frequently than non-specialists • 28% vs 15% use it weekly or more • 76% would use it more but for: • time constraints (25% paed cons; 33% GP) • lack of access to IT (16% paed; 9% others) • 24% would not use it more: • already use it as much as required

  12. Survey results 3 • 37% of paediatric consultants and 21% of GPs said it was unsatisfactory and needed improvements • Only 2% used it routinely; 61% used it in "some" cases; 35% used it in "difficult" cases • 88% found it easy to use • 70% were of the opinion that ISABEL assists in clinical management

  13. Survey results 4 • 96% of users had computer access in their workplace • 82% connected to Internet • Paed cons had twice the access vs junior paeds (2.6 person/computer vs 5.8) • Only 3% of paeds had computer next to patient compared with 37% of others • 18% of paeds and 57% of others have access in same room as patient

  14. Key observations • Small number of devoted users • Not just a tool for hospital doctors • Website was not sufficiently useful or not sufficiently convenient for the vast majority of users • Evidence that Internet access was ad hoc rather than established in workplace • particularly in secondary care sector • Not everyone wanted to use it more

  15. Issues for DH • To encourage use of ISABEL: • improve professionals' access to IT (evidence of queuing) • improve proximity of computers to patient • make it part of clinical protocols • note its usefulness as an educational tool • adult version would be valuable

  16. Finally • Acknowledge help of ISABEL team • Financial support from Department of Health - Directorate of Research, Analysis and Information • ISABEL: • http://www.isabel.org.uk • Our report: • http://www.disco.port.ac.uk/hcc/projects/ISABEL • Email: • jim.briggs@port.ac.uk

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