HINZ 2009 1st Oct. Submitted papers Room 1

In the first session, Sheryl Jury talks about her expereinces at her DHB with customizing Microsoft's CRM application for her public health workflow management. An interesting way to demonstrate cross industry utilization of applications. The public health professionals need to Investigate location of the case related groups and events that’s trigger a outbreak. She reports how it helped her team to manage thousands of reports (of notifiable conditions) to find data relationship and build intelligence into reporting. It also helped their tean to allocate tasks to team members, issue alerts, reminders etc. through integrated mail box application. In summary this innovation is complex but has potential to be explored further.
 
In the second session Jim Warren presented his systematic literature review that was submitted to the ministry of health on success of health information systems undertaken last year. He talks about Puff city, a IT based intervention in US suburban areas mainly targeted at Afro-American teenagers suffering from asthma.  They were given 4 consecutive computer sessions by multimedia designed to suit their preferences. The education helped them significantly improve symptom management. The second case study was on Carelink, which is an internet based insulin management system, where a doctor looked at glucose levels and advised insulin dosing which helped improve the HbA1c outcomes. The third one was on Canadian post discharge heart monitoring, where a nurse interacted through video conferencing,  periodic ECGs were transmitted and daily home monitoring data was reported. All combined together showed significant improvents in readmission rates, user satisfaction and care quality. Jim recommends to  learn from known success and apply them to new contexts, take advantage of these innovations to break out of limitations of present healthcare system. he also emphasized that exploitation will require changes in the system and create new roles for people involved.
 
 In the third sesion Rowena Cullen presenting the evidence based information seeking of young clinicians when they enter active practice.  Between 1995-2003 she studied 34 participants that could be tracked and interviewed, filled self evaluation questionnaire regarding search skills and underwent expert evaluation of their searching skills based on relevant scenarios. Doctors do remember that they got some training and some content and terms, interface, but they do not remember how to apply these terms. Finally EBM training had no impact on how doctors reviewed the literature in practice. They do pick up systemic  reviews but not very skilled at evaluating the quality of trials. The experts found that the average scoring of skills was around half of what was expected. Though they are confident of their skills, the doctors actually underutilize medline and show little correlation between EBM training and current skills. She recommends that literature search skills require ongoing training of practicing doctors and that the subject should be incorporated into mainstream  medical curriculum; also the peer pressure from professional bodies would help this essential skill to be retained and used by doctors to provide best evidence based care to their patients.