The iterative harmonization process enabled a more homogeneous identification of events across differently structured databases using different coding based algorithms. This workflow can facilitate transparent and reproducible event extractions and understanding of differences between databases.

The objective of this study is to examine health care professionals' opinions of the critical events (opportunities and barriers) surrounding EMR implementation in a French teaching psychiatric hospital. This qualitative study was based on semi-structured interviews with 115 health care professionals: 16 psychiatrists, 84 nurses, six psychologists or social assistants and nine secretaries or administrative professionals. Interviews were thematically analysed. Most responders (96%) used EMR. Among these EMR users, 70% perceived EMR positively. Concerning the opportunities from implementing an EMR, the most represented theme was "the improved access to medical record information" (75%), followed by "the strategy to guarantee the adhesion of professionals and the use of EMR" (69%), and "the technological performances of EMR" (49%). Concerning the barriers to implementation, four themes emerged, as follows: "the workflow and efficiency decrease" (73%), "the triangulation of the patient-professional relationship" (47%), "the information sharing and confidentiality" (32%), and "the ambiguity of EMR" (26%), which answers both to the production of care and to an economic issue. In conclusion, EMR implementation involved several critical components, and the strategy of implementation is particularly important. Implementing an EMR should be considered a continuous process, and the principle and theory of continuous quality improvement appears pertinent for addressing this problem.

This work presents a method to find previously established relationships between drugs and adverse events in the literature. Using MEDLINE, following a MeSH approach to filter the signals, is a valid option. Our contribution is available as a web service that will be integrated in the final European EU-ADR project (Exploring and Understanding Adverse Drug Reactions by integrative mining of clinical records and biomedical knowledge) automated system.

BackgroundWe are currently witnessing a significant increase in use of Open Source tools in the field of health. Our study aims to research the potential of these software packages for developing countries. Our experiment was conducted at the Centre Hospitalier Mere Enfant in Mali.MethodsAfter reviewing several Open Source tools in the field of hospital information systems, Mediboard software was chosen for our study. To ensure the completeness of Mediboard in relation to the functionality required for a hospital information system, its features were compared to those of a well-defined comprehensive record management tool set up at the University Hospital "La Timone" of Marseilles in France. It was then installed on two Linux servers: a first server for testing and validation of different modules, and a second one for the deployed full implementation. After several months of use, we have evaluated the usability aspects of the system including feedback from end-users through a questionnaire.ResultsInitial results showed the potential of Open Source in the field of health IT for developing countries like Mali.Five main modules have been fully implemented: patient administrative and medical records management of hospital activities, tracking of practitioners' activities, infrastructure management and the billing system. This last component of the system has been fully developed by the local Mali team.The evaluation showed that the system is broadly accepted by all the users who participated in the study. 77% of the participants found the system useful; 85% found it easy; 100% of them believe the system increases the reliability of data. The same proportion encourages the continuation of the experiment and its expansion throughout the hospital.ConclusionsIn light of the results, we can conclude that the objective of our study was reached. However, it is important to take into account the recommendations and the challenges discussed here to avoid several potential pitfalls specific to the context of Africa.Our future work will target the full integration of the billing module in Mediboard and an expanded implementation throughout the hospital.

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