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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

The ISABEL user survey

Dr Jim BriggsDr Tineke Fitch

Healthcare Computing GroupUniversity of Portsmouthhttp://www.disco.port.ac.uk/hcc

contents
Contents
  • What is ISABEL?
  • Our study
  • Results
  • Observations
what is isabel
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)
what does isabel provide
Primarily:

Differential diagnosis tool

Based on standard textbooks

Autonomy software

Supported by:

Text

Annotated images

Practice guidelines

Experience

What does ISABEL provide?
background to the study
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
objectives of our study
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
1 log data analysis
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
2 user survey
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
data analysis results
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
survey results 1
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
survey results 2
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
survey results 3
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
survey results 4
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
key observations
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
issues for dh
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
finally
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