Spotlight: Doctors and Patients--Working Together to Make Medical Decisions

Electronic Health Records to Coordinate Decision Making for Complex Patients: What Can We Learn from Wiki?

Medical Decision Making ◽

10.1177/0272989x10385846 ◽

2010 ◽

Vol 30 (6) ◽

pp. 722-731 ◽

Cited By ~ 26

Author(s):

Aanand D. Naik ◽

Hardeep Singh

Keyword(s):

Decision Making ◽

Disease Management ◽

Communication Model ◽

Medical Decisions ◽

Disease Management Programs ◽

Complex Patients ◽

Patterns Of Communication ◽

Working Together ◽

Electronic Health ◽

Novel Model

Background . Processes of communication that guide decision making among clinicians collaboratively caring for complex patients are poorly understood and vary based on local contexts. In this paper, the authors characterize these processes and propose a wiki-style communication model to improve coordination of decision making among clinicians using an integrated electronic health record (EHR). Methods . A narrative review of current patterns of communication among clinicians sharing medical decisions focusing on the emerging and potential roles of EHRs to enhance communication among clinicians caring for complex patients. Results . The authors present the taxonomy of decision making and communication among clinicians caring for complex patients. They then adapt wiki-style communication to propose a novel model of communication among clinicians for decision making within multidisciplinary disease management programs. Future innovations using wiki-style communication among clinicians are also described and placed in the context of medical decisions by clinicians working together in disease management programs. Conclusions . EHR-based wiki-style applications may have the potential to improve communication and care coordination among clinicians caring for complex patients. This could lead to improved quality and safety within multidisciplinary disease management programs.

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Project BRAIN: Working Together to Improve Educational Outcomes for Students With Traumatic Brain Injury

Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders ◽

10.1044/nnsld22.3.106 ◽

2012 ◽

Vol 22 (3) ◽

pp. 106-118 ◽

Cited By ~ 3

Author(s):

Paula Denslow ◽

Jean Doster ◽

Kristin King ◽

Jennifer Rayman

Keyword(s):

Traumatic Brain Injury ◽

At Risk ◽

Brain Injury ◽

Educational Outcomes ◽

School Personnel ◽

Department Of Education ◽

Health Providers ◽

Accurate Identification ◽

Transition Intervention ◽

Working Together

Children and youth who sustain traumatic brain injury (TBI) are at risk for being unidentified or misidentified and, even if appropriately identified, are at risk of encountering professionals who are ill-equipped to address their unique needs. A comparison of the number of people in Tennessee ages 3–21 years incurring brain injury compared to the number of students ages 3–21 years being categorized and served as TBI by the Department of Education (DOE) motivated us to create this program. Identified needs addressed by the program include the following: (a) accurate identification of students with TBI; (b) training of school personnel; (c) development of linkages and training of hospital personnel; and (d) hospital-school transition intervention. Funded by Health Services and Resources Administration (HRSA) grants with support from the Tennessee DOE, Project BRAIN focuses on improving educational outcomes for students with TBI through the provision of specialized group training and ongoing education for educators, families, and health professionals who support students with TBI. The program seeks to link families, hospitals, and community health providers with school professionals such as speech-language pathologists (SLPs) to identify and address the needs of students with brain injury.

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