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Alsaleh MM, Watzlaf VJM, DeAlmeida DR, Saptono A. EVALUATION OF A TELEHEALTH APPLICATION (SEHHA) USED DURING THE COVID-19 PANDEMIC IN SAUDI ARABIA: PROVIDER EXPERIENCE AND SATISFACTION. Perspect Health Inf Manag 2021; 18:1b. [PMID: 34975351 PMCID: PMC8649707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION COVID-19 has drastically transformed healthcare delivery and forced many to utilize telehealth. This study aimed to comprehensively evaluate the telehealth service "Sehha" used during COVID-19 in Saudi Arabia and assess the provider experience and satisfaction with Sehha. METHODS A questionnaire was distributed by the Ministry of Health (MoH) to 362 physicians using Sehha. The questionnaire items were adapted from previous studies and then tested for content validity and reliability (α = 0.88). RESULTS The findings showed that most of the physicians improved their experience in telehealth because of COVID-19. The majority of the physicians (67.6 percent) reported being satisfied with Sehha. However, the most commonly perceived challenge by the physicians was difficulty in providing accurate medical assessments. CONCLUSION COVID-19 has remarkably uncovered numerous benefits of telehealth. Therefore, telehealth should remain a permanent model of healthcare delivery with consideration of further telehealth development initiatives.
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Joyce EL, DeAlmeida DR, Fuhrman DY, Priyanka P, Kellum JA. eResearch in acute kidney injury: a primer for electronic health record research. Nephrol Dial Transplant 2019; 34:401-407. [PMID: 29617846 DOI: 10.1093/ndt/gfy052] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 02/08/2018] [Indexed: 12/29/2022] Open
Abstract
Acute kidney injury (AKI) has a significant impact on patient morbidity and mortality as well as overall health care costs. eResearch, which integrates information technology and information management to optimize research strategies, provides a perfect platform for necessary ongoing AKI research. With the recent adoption of a widely accepted definition of AKI and near-universal use of electronic health records, eResearch is becoming an important tool in AKI research. Conducting eResearch in AKI should ideally be based on a relatively uniform methodology. This article is the first of its kind to describe a methodology for pursuing eResearch specific to AKI and includes an illustrative database example for critically ill patients. We discuss strategies for using serum creatinine and urine output in large databases to identify and stage AKI and ways to interpolate missing values and validate data. Issues specific to the pediatric population include variation in serum creatinine with growth, varied severity of illness scoring systems and medication dosage based on weight. Many of these same strategies used to optimize AKI eResearch can be applicable to real-time AKI alerts with potential integration of additional clinical variables.
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Affiliation(s)
- Emily L Joyce
- Division of Nephrology, Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
- Center for Critical Care Nephrology, UPMC and University of Pittsburgh, Pittsburgh, PA, USA
- Clinical Research, Investigation and Systems Modeling of Acute Illness (CRISMA) Laboratory, Pittsburgh, PA, USA
| | - Dilhari R DeAlmeida
- Department of Health Information Management, University of Pittsburgh, Pittsburgh, PA, USA
| | - Dana Y Fuhrman
- Division of Nephrology, Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
- Center for Critical Care Nephrology, UPMC and University of Pittsburgh, Pittsburgh, PA, USA
- Clinical Research, Investigation and Systems Modeling of Acute Illness (CRISMA) Laboratory, Pittsburgh, PA, USA
- Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Priyanka Priyanka
- Center for Critical Care Nephrology, UPMC and University of Pittsburgh, Pittsburgh, PA, USA
- Clinical Research, Investigation and Systems Modeling of Acute Illness (CRISMA) Laboratory, Pittsburgh, PA, USA
| | - John A Kellum
- Center for Critical Care Nephrology, UPMC and University of Pittsburgh, Pittsburgh, PA, USA
- Clinical Research, Investigation and Systems Modeling of Acute Illness (CRISMA) Laboratory, Pittsburgh, PA, USA
- Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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DeAlmeida DR, Houser SH, Wangia-Anderson V, Fenton SH, Hazelwood A, Barefield AC, Freeman JM, Jones LM, Bakuzonis K, Hamada DL. An Exploratory Study Demonstrating the Health Information Management Profession as a STEM Discipline. Perspect Health Inf Manag 2019; 16:1a. [PMID: 31423115 PMCID: PMC6669362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
It is time to make the case for health information management (HIM) to be included in science, technology, engineering, and math (STEM) education. A careful review of the HIM competencies approved by the American Health Information Management Association (AHIMA) illustrates the role of HIM professionals in informatics, data analytics, and data use. More precisely, the competency subdomains clearly align with content in the STEM disciplines of science, math, and technology, and the individual competencies or tasks in each subdomain solidify the assertion that HIM should be considered part of the STEM disciplines. Evaluation of AHIMA membership data showed that, at the education and work setting levels, AHIMA members are employed in many areas that are common to both HIM and STEM.
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Affiliation(s)
- Dilhari R DeAlmeida
- Department of Health Information Management at the University of Pittsburgh in Pittsburgh, PA
| | - Shannon H Houser
- the Department of Health Services Administration/Health Informatics Program at the University of Alabama at Birmingham in Birmingham, AL
| | | | - Susan H Fenton
- University of Texas Health Science Center at Houston School of Biomedical Informatics in Houston, TX
| | | | | | - Jeanne M Freeman
- Department of Health Information Management at Davenport University in Grand Rapids, MI
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Sandefer RH, DeAlmeida DR, Dougherty M, Mancilla D, Marc DT. Keeping current in the electronic era. J AHIMA 2014; 85:38-45. [PMID: 25682656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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DeAlmeida DR, Watzlaf VJ, Anania-Firouzan P, Salguero O, Rubinstein E, Abdelhak M, Parmanto B. Evaluation of inpatient clinical documentation readiness for ICD-10-CM. Perspect Health Inf Manag 2014; 11:1h. [PMID: 24808815 PMCID: PMC3995487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This research study examined the gaps in documentation that occur when coding in ICD-10-CM. More than 4,000 diagnoses from all chapters were coded from 656 electronic documents obtained from a large integrated healthcare facility at the time the study was conducted (2012). After the documents were coded, areas for documentation improvement were identified for chapters that resulted in deficiencies in documentation, and a quick reference guide was developed. The overall absent documentation percentage was 15.4 percent. The 10 chapters with the highest percentage of absent documentation were chapter 7 (Diseases of Eye and Adnexa), with 67.65 percent (p < .001); chapter 8 (Diseases of Ear and Mastoid Process), with 63.64 percent (p < .001); chapter 13 (Diseases of the Musculoskeletal System and Connective Tissue), with 46.05 percent (p < .001); chapter 14 (Diseases of the Genitourinary System), with 40.29 percent (p < .001); chapter 10 (Diseases of Respiratory System), with 35.52 percent (p < .001); chapter 1 (Infectious and Parasitic Diseases), with 32.88 percent (p < .001); chapter 12 (Diseases of the Skin and Subcutaneous Tissue), with 32.35 percent (p < .001); chapter 2 (Neoplasms), with 25.45 percent (p < .001); chapter 4 (Endocrine, Nutritional and Metabolic Diseases), with 14.58 percent (p < .001); and chapter 17 (Congenital Malformations, Deformations, and Chromosomal Abnormalities), with 12.50 percent. We addressed the deficient areas in the quick reference guide developed for clinicians and technology vendors. Having complete and accurate documentation would benefit both the clinician and the patient in providing the highest quality of care.
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Affiliation(s)
- Dilhari R DeAlmeida
- The Department of Health Information Management in the School of Health and Rehabilitation Sciences at the University of Pittsburgh in Pittsburgh, PA
| | - Valerie J Watzlaf
- The Department of Health Information Management in the School of Health and Rehabilitation Sciences at the University of Pittsburgh in Pittsburgh, PA
| | - Patti Anania-Firouzan
- The Department of Health Information Management in the School of Health and Rehabilitation Sciences at the University of Pittsburgh in Pittsburgh, PA
| | - Otto Salguero
- The Health Systems Engineering Initiative in the Industrial Engineering Department at the University of Pittsburgh in Pittsburgh, PA
| | - Elaine Rubinstein
- The Health Communications, Surveillance, and Research Support Branch of the National Institute for Occupational Safety and Health in Pittsburgh, PA
| | - Mervat Abdelhak
- The Department of Health Information Management in the School of Health and Rehabilitation Sciences at the University of Pittsburgh in Pittsburgh, PA
| | - Bambang Parmanto
- The Department of Health Information Management in the School of Health and Rehabilitation Sciences at the University of Pittsburgh in Pittsburgh, PA
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Giles BM, Bissel SJ, DeAlmeida DR, Wiley CA, Ross TM. Antibody breadth and protective efficacy are increased by vaccination with computationally optimized hemagglutinin but not with polyvalent hemagglutinin-based H5N1 virus-like particle vaccines. Clin Vaccine Immunol 2012; 19:128-39. [PMID: 22190399 PMCID: PMC3272934 DOI: 10.1128/cvi.05533-11] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2011] [Accepted: 12/06/2011] [Indexed: 12/25/2022]
Abstract
One of the challenges for developing an H5N1 influenza vaccine is the diversity of antigenically distinct isolates within this subtype. Previously, our group described a novel hemagglutinin (HA) derived from a methodology termed computationally optimized broadly reactive antigen (COBRA). This COBRA HA, when used as an immunogen, elicits a broad antibody response against H5N1 isolates from different clades. In this report, the immune responses elicited by the COBRA HA virus-like particle (VLP) vaccine were compared to responses elicited by a mixture of VLPs expressing representative HA molecules from clade 2.1, 2.2, and 2.3 primary H5N1 isolates (polyvalent). The COBRA HA VLP vaccine elicited higher-titer antibodies to a panel of H5N1 HA proteins than did the other VLPs. Both COBRA and polyvalent vaccines protected vaccinated mice and ferrets from experimental infection with highly lethal H5N1 influenza viruses, but COBRA-vaccinated animals had decreased viral replication, less inflammation in the lungs of mice, and reduced virus recovery in ferret nasal washes. Both vaccines had similar cellular responses postchallenge, indicating that higher-titer serum antibodies likely restrict the duration of viral replication. Furthermore, passively transferred immune serum from the COBRA HA VLP-vaccinated mice protected recipient animals more efficiently than immune serum from polyvalent-vaccinated mice. This is the first report comparing these two vaccine strategies. The single COBRA HA antigen elicited a broader antibody response and reduced morbidity and viral titers more effectively than a polyvalent mixture of primary H5N1 HA antigens.
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Affiliation(s)
- Brendan M. Giles
- Center for Vaccine Research
- Graduate Program in Immunology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Stephanie J. Bissel
- Division of Neuropathology, Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Clayton A. Wiley
- Division of Neuropathology, Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ted M. Ross
- Center for Vaccine Research
- Department of Microbiology and Molecular Genetics
- Graduate Program in Immunology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Schneider-Ohrum K, Giles BM, Weirback HK, Williams BL, DeAlmeida DR, Ross TM. Adjuvants that stimulate TLR3 or NLPR3 pathways enhance the efficiency of influenza virus-like particle vaccines in aged mice. Vaccine 2011; 29:9081-92. [PMID: 21963872 DOI: 10.1016/j.vaccine.2011.09.051] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Revised: 08/12/2011] [Accepted: 09/02/2011] [Indexed: 10/17/2022]
Abstract
There is intense interest in the design and use of vaccine strategies against influenza to enhance protective immune responses in the elderly. To address the need for improved influenza vaccines for the aged, two inflammatory adjuvants, Imject(®) alum (a stimulator of the Nod-like receptor, Nalp3) and poly I:C (a toll-like receptor type 3 ligand), were used during vaccination with novel influenza virus-like particles (VLP). Adult (4 month old) or aged (24 month old) mice were vaccinated with VLPs alone or in combination with adjuvant. VLP-vaccinated adult mice were protected from a lethal influenza virus challenge without the use of either adjuvant. In contrast, only aged mice that were vaccinated with VLPs plus adjuvant survived challenge, whereas ∼33% of the mice vaccinated with VLP only survived challenge. Mice vaccinated with adjuvant only did not survive challenge despite similar levels of activation of CD11b(+)/CD11c(+) dendritic cells in the lungs. The protection was not associated with HAI titers or HA specific CD8(+) T cells, since both adjuvants boosted the VLP-induced serum HAI titers and CD8(+) responses in adult mice, but not aged mice. Influenza VLPs used in combination with two different inflammatory adjuvants during vaccination allow for the immune system to overcome the deficiency in the aged immune system to influenza virus infection.
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Brown BN, Price IM, Toapanta FR, DeAlmeida DR, Wiley CA, Ross TM, Oury TD, Vodovotz Y. An agent-based model of inflammation and fibrosis following particulate exposure in the lung. Math Biosci 2011; 231:186-96. [PMID: 21385589 PMCID: PMC3088650 DOI: 10.1016/j.mbs.2011.03.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2010] [Revised: 02/26/2011] [Accepted: 03/01/2011] [Indexed: 12/11/2022]
Abstract
Inflammation and airway remodeling occur in a variety of airway diseases. Modeling aspects of the inflammatory and fibrotic processes following repeated exposure to particulate matter may provide insights into a spectrum of airway diseases, as well as prevention/treatment strategies. An agent-based model (ABM) was created to examine the response of an abstracted population of inflammatory cells (nominally macrophages, but possibly including other inflammatory cells such as lymphocytes) and cells involved in remodeling (nominally fibroblasts) to particulate exposure. The model focused on a limited number of relevant interactions, specifically those among macrophages, fibroblasts, a pro-inflammatory cytokine (TNF-α), an anti-inflammatory cytokine (TGF-β1), collagen deposition, and tissue damage. The model yielded three distinct states that were equated with (1) self-resolving inflammation and a return to baseline, (2) a pro-inflammatory process of localized tissue damage and fibrosis, and (3) elevated pro- and anti-inflammatory cytokines, persistent tissue damage, and fibrosis outcomes. Experimental results consistent with these predicted states were observed in histology sections of lung tissue from mice exposed to particulate matter. Systematic in silico studies suggested that the development of each state depended primarily upon the degree and duration of exposure. Thus, a relatively simple ABM resulted in several, biologically feasible, emergent states, suggesting that the model captures certain salient features of inflammation following exposure of the lung to particulate matter. This ABM may hold future utility in the setting of airway disease resulting from inflammation and fibrosis following particulate exposure.
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Affiliation(s)
- Bryan N. Brown
- Center for Inflammation and Regenerative Modeling, McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15219, USA
| | - Ian M. Price
- Center for Inflammation and Regenerative Modeling, McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Mathematics, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Franklin R. Toapanta
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Dilhari R. DeAlmeida
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Clayton A. Wiley
- Department of Pathology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Ted M. Ross
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA 15261, USA
- Department of Microbiology and Molecular Genetics, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Tim D. Oury
- Department of Pathology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Yoram Vodovotz
- Center for Inflammation and Regenerative Modeling, McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213
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