Laurence Leneveut

Université René Descartes - Paris 5, Lutetia Parisorum, Île-de-France, France

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Publications (8)3.83 Total impact

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    ABSTRACT: Purpose: The evaluation of end-user satisfaction is an essential part of any clinical information system (CIS) project. The purpose of this study is to evaluate the determinants of CIS continuance intention in a late post-adoption phase at the Georges Pompidou University Hospital (HEGP) in Paris. Methods: We designed an electronic survey instrument based on an IT post-adoption model (ITPAM) developed from three previous models, i.e., the Delone and McLean Information Success Model, the Davis TAM model and the Bhattacherjee information system continuance intention model. Results: 419 questionnaires were collected from CIS users directly involved in patient care. The perceived CIS quality, usefulness and user satisfaction are significantly lower for medical professions than other professional groups. Continuance intention is very high within all professional subgroups. In a multiple regression analysis, the global satisfaction (R(2) = .780) was positively and significantly correlated with CIS quality, confirmation of expectations and perceived CIS usefulness. The continuance intention (R(2) = .392) was positively and significantly correlated with perceived CIS usefulness, confirmation of expectations and global satisfaction. Conclusion: In a late post-adoption CIS deployment phase, continuance intention does not significantly depend on individual end user characteristics but is significantly associated with the perceived CIS usefulness, confirmation of expectations and global satisfaction.
    Full-text · Article · Aug 2014 · Studies in health technology and informatics
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    ABSTRACT: Introduction-L'évaluation de la satisfaction des utilisateurs doit être effectuée régulièrement lors des différentes phases de déploiement d'un système d'information clinique (SIC). Cet article compare, en période de post-adoption tardive, la satisfaction des utilisateurs dans les trois hôpitaux du groupe hospitalier (GH) universitaire Paris-Ouest (HUPO), HEGP, Corentin-Celton (CCL) et Vaugirard (VGR). Méthodes-Deux enquêtes standardisées de satisfaction du SIC ont été réalisées en 2011 et 2013 dans les 3 sites du groupe. Le modèle utilisé, IT-PAM (Information Technology Post-Adoption Model), est bâti autour de 7 dimensions : caractéristiques des utilisateurs, qualité du SIC, utilité perçue, qualité du support utilisateurs, confirmation des attentes, satisfaction et intention de continuer. Résultats-L'analyse des résultats combinés des enquêtes 2011 et 2013 obtenus chez 519 utilisateurs montre une satisfaction plus grande à l'HEGP que dans les hôpitaux CCL et VGR (p<0,01) associée à un plus grand déploiement et une plus grande utilisation du dossier patient électronique (p<0,001). La confirmation des attentes est significativement plus faible chez les médecins et les personnels de sexe masculin que dans les autres catégories d'utilisateurs (p<0,001). 74,7% des utilisateurs sont en faveur d'une homogénéisation complète du SIC sur les trois sites du GH. Dans les modèles de régression multiple, la qualité du SIC, l'utilité perçue et la confirmation des attentes sont les paramètres les plus liés à la satisfaction. Conclusion-La réalisation d'enquêtes périodique de satisfaction est indispensable pour améliorer l'utilisation hospitalière des SIC et leur amélioration par les fournisseurs de solutions informatiques. Abstract Introduction: Evaluation of user satisfaction should be regularly monitored during the various phases of deployment of a clinical information system (CIS). Objective: This paper compares in a Articles longs des 15 es Journées francophones d'informatique médicale, JFIM 2014, pages 115–126 Fès, Maroc, 12–13 juin 2014 late post-adoption phase CIS satisfaction in the three hospitals of the Paris-West University Hospital group (HUPO): HEGP, Corentin-Celton (CCL), and Vaugirard (VGR). Methods: Two standardized satisfaction surveys were conducted in 2011 and 2013. The IT–PAM model used (Information Technology Post-Adoption Model) is built around 7 dimensions: user characteristics, CIS quality, user support, confirmation of expectations, satisfaction, and continuance intention. Results: The analysis of the combined surveys 2011-2013 obtained from 519 users shows greater user satisfaction at the HEGP compared to CCL-VGR (p<0.01), associated with a greater deployment and use of the CIS functions (p<0.001). Confirmation of expectations is lower among physicians and male users than among other categories (p<0.001). 74.7% of users are in favor of a complete unification of the CIS in the three HUPO hospitals. In multi-regression models, satisfaction is positively and significantly correlated with CIS quality, perceived usefulness and confirmation of expectations. Conclusion: Repetition of satisfaction surveys is a necessary condition to improve CIS use within hospitals and their continuous improvement by solution providers. Mots-clés : Acceptabilité des systèmes d'information cliniques – Modèle d'évaluation en post-adoption – Confirmation des attentes – Satisfaction – Intention de continuer.
    Full-text · Conference Paper · Jun 2014
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    ABSTRACT: The evaluation of a clinical information system (CIS) at different stages of deployment and routine use is a key factor to improve acceptability and use by health professionals. This paper examines on an expectation-confirmation model (ITPAM) the relationships between the determinants of success of a CIS in a cross-sectional survey performed at the Georges Pompidou University Hospital (HEGP). Results for the groups of physicians and nurses that replied to the survey (n=312) suggest that health professional satisfaction (overall R(2)=0.60) is determined by the quality of user support (r=.21, p=<0001), ease of use (r=.19, p=<0001), confirmation of expectations (r=.15, p=.0037), usefulness (r=.12, p=.0068), and compatibility (r=.10, p=.0206). The best predictor of physician satisfaction (R(2)=0.71) was compatibility (r=.21, p=.0072) whereas for nurses (R(2)=0.52) it was user support (r=.22, p=<0001) and ease of use (r=.22, p=.0001). Confirmation of expectations had an impact on post-adoption expectation and user's satisfaction, and confirms its importance for CIS evaluation studies.
    Full-text · Article · Jan 2010 · AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium
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    ABSTRACT: Despite initiatives to standardize methods for the development of clinical guidelines, several barriers hinder their integration in daily clinical practice: failure to fulfil quality criteria, poor effectiveness of their dissemination. Computerization of guidelines can favor their dissemination. The initial step of computerization is the knowledge specification from the text of the guideline. We describe the method of knowledge specification, which is used in EsPeR (Personalized Estimate of Risks), a web-based decision support system in preventive medicine, which allows, for a given person, to estimate risks and access recommendations, based on clinical profile. This method is based on a structured and systematic analysis of text allowing detailed specification of a decision tree. We use decision tables to validate the decision algorithm and decision trees to specify this algorithm, along with elementary messages of recommendation. Editing tools are used to facilitate the process of validation and the workflow between expert physicians and computer scientists. Applied to eleven different guidelines, the method allows a quick and valid computerization and integration in the EsPeR system. The method used for computerization could help to define a framework usable at the initial step of guideline development in order to produce guidelines ready for electronic implementation.
    No preview · Article · Sep 2005 · International Journal of Medical Informatics
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    ABSTRACT: Background: Many preventable diseases such as ischemic heart diseases and breast cancer prevail at a large scale in the general population. Computerized decision support systems are one of the solutions for improving the quality of prevention strategies.
    No preview · Article · Jul 2004
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    ABSTRACT: The initial step for the computerization of guidelines is the knowledge specification from the prose text of guidelines. We describe a method of knowledge specification based on a structured and systematic analysis of text allowing detailed specification of a decision tree. We use decision tables to validate the decision algorithm and decision trees to specify and represent this algorithm, along with elementary messages of recommendation. Edition tools are also necessary to facilitate the process of validation and workflow between expert physicians who will validate the specified knowledge and computer scientist who will encode the specified knowledge in a guide-line model. Applied to eleven different guidelines issued by an official agency, the method allows a quick and valid computerization and integration in a larger decision support system called EsPeR (Personalized Estimate of Risks). The quality of the text guidelines is however still to be developed further. The method used for computerization could help to define a framework usable at the initial step of guideline development in order to produce guidelines ready for electronic implementation.
    Full-text · Article · Feb 2004 · Studies in health technology and informatics
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    ABSTRACT: Many preventable diseases such as ischemic heart diseases and breast cancer prevail at a large scale in the general population. Computerized decision support systems are one of the solutions for improving the quality of prevention strategies. The system called EsPeR (Personalized Estimate of Risks) combines calculation of several risks with computerisation of guidelines (cardiovascular prevention, screening for breast cancer, colorectal cancer, uterine cervix cancer, and prostate cancer, diagnosis of depression and suicide risk). We present a qualitative evaluation of its ergonomics, as well as it's understanding and acceptance by a group of general practitioners. We organised four focus groups each including 6-11 general practitioners. Physicians worked on several structured clinical scenarios with the help of EsPeR, and three senior investigators leaded structured discussion sessions. The initial sessions identified several ergonomic flaws of the system that were easily corrected. Both clinical scenarios and discussion sessions identified several problems related to the insufficient comprehension (expression of risks, definition of familial history of disease), and difficulty for the physicians to accept some of the recommendations. Educational, socio-professional and organisational components (i.e. time constraints for training and use of the EsPeR system during consultation) as well as acceptance of evidence-based decision-making should be taken into account before launching computerised decision support systems, or their application in randomised trials.
    Full-text · Article · Dec 2003 · BMC Medical Informatics and Decision Making
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    ABSTRACT: Many preventable diseases such as ischemic heart diseases or breast cancer are still not adequately managed in the population. Computerized decision support systems are one of the solutions for improving the quality of prevention strategies. We designed a system called EsPeR (Personalised Estimate of Risks) combining calculation of several risks and computerisation of guidelines (cardio-vascular prevention, screening for breast cancer, colorectal cancer, uterine cervix cancer, and prostate cancer, diagnosis of depression and suicide risk). We present a qualitative evaluation of its ergonomics, its understanding and acceptance by a group of general practitioners. We organised 4 focus groups comprising 6-11 general practitioners. Physicians worked on several structured clinical scenario with help of EsPeR, and 3 senior investigators leaded structured discussion sessions. Initial sessions identified several ergonomics flaws that were easily corrected. Both clinical scenari and discussion sessions identified several problems of insufficient comprehension (expression of risks, definition of familial history of disease), lack of knowledge, and acceptance of recommendation by both the physician. Educational and organisational components (i.e. time constraints) as well as acceptance of evidence-based decision-making should be taken into account before launching computerised decision support system, or testing them in randomised trials.
    No preview · Article · Feb 2003 · Studies in health technology and informatics