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Huyghe E, Ducrot Q, Costa N. Vasectomy: an increasingly common procedure in France. Fr J Urol 2024:102640. [PMID: 38697266 DOI: 10.1016/j.fjurol.2024.102640] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 04/26/2024] [Indexed: 05/04/2024]
Abstract
OBJECTIVES To analyze the evolutionary trends concerning vasectomy over the last 8 years in order to better understand the situation and identify measures to be implemented to develop this activity. METHODS The number of vasectomy procedures performed between 2015 and 2022 was extracted from the Open CCAM file compiled from the national database of the Programme de médicalisation du système d'informations français (PMSI). RESULTS Over the period 2015-2022, the number of vasectomy procedures increased from 3743 in 2015 to 29890 in 2022. This increase was observed in all French metropolitan and overseas regions. The number of minimally invasive vasectomies (notably without scalpel) rose sharply, from 313 to 7760. Almost all vasectomies were performed during outpatient hospitalization (0 nights), with fewer than 300 acts reported /year in outpatient care. CONCLUSION In France, vasectomy is becoming an increasingly frequent contraceptive method. This analysis is in line with recent surveys carried out in France, and tends to prove that more and more couples of childbearing age are in favour of sharing the contraceptive burden.
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Affiliation(s)
- Eric Huyghe
- Department of Reproductive Medicine Paule de Viguier Hospital Toulouse University Hospital, France; Department of Urology, Andrology and Renal Transplantation Rangueil Hospital Toulouse University Hospital, France; UMR DEFE INSERM 1203 University of Toulouse 3, France
| | - Quentin Ducrot
- Department of Reproductive Medicine Paule de Viguier Hospital Toulouse University Hospital, France
| | - Nadège Costa
- Medico-Economic Evaluation Unit Hôtel-Dieu Toulouse University Hospital, France
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Cho J, Yoo S, Lee EE, Lee HY. Impact of a Nationwide Medication History Sharing Program on the Care Process and End-User Experience in a Tertiary Teaching Hospital: Cohort Study and Cross-Sectional Study. JMIR Med Inform 2024; 12:e53079. [PMID: 38533775 PMCID: PMC11004625 DOI: 10.2196/53079] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/16/2024] [Accepted: 02/04/2024] [Indexed: 03/28/2024] Open
Abstract
Background Timely and comprehensive collection of a patient's medication history in the emergency department (ED) is crucial for optimizing health care delivery. The implementation of a medication history sharing program, titled "Patient's In-home Medications at a Glance," in a tertiary teaching hospital aimed to efficiently collect and display nationwide medication histories for patients' initial hospital visits. Objective As an evaluation was necessary to provide a balanced picture of the program, we aimed to evaluate both care process outcomes and humanistic outcomes encompassing end-user experience of physicians and pharmacists. Methods We conducted a cohort study and a cross-sectional study to evaluate both outcomes. To evaluate the care process, we measured the time from the first ED assessment to urgent percutaneous coronary intervention (PCI) initiation from electronic health records. To assess end-user experience, we developed a 22-item questionnaire using a 5-point Likert scale, including 5 domains: information quality, system quality, service quality, user satisfaction, and intention to reuse. This questionnaire was validated and distributed to physicians and pharmacists. The Mann-Whiteny U test was used to analyze the PCI initiation time, and structural equation modeling was used to assess factors affecting end-user experience. Results The time from the first ED assessment to urgent PCI initiation at the ED was significantly decreased using the patient medication history program (mean rank 42.14 min vs 28.72 min; Mann-Whitney U=346; P=.03). A total of 112 physicians and pharmacists participated in the survey. Among the 5 domains, "intention to reuse" received the highest score (mean 4.77, SD 0.37), followed by "user satisfaction" (mean 4.56, SD 0.49), while "service quality" received the lowest score (mean 3.87, SD 0.79). "User satisfaction" was significantly associated with "information quality" and "intention to reuse." Conclusions Timely and complete retrieval using a medication history-sharing program led to an improved care process by expediting critical decision-making in the ED, thereby contributing to value-based health care delivery in a real-world setting. The experiences of end users, including physicians and pharmacists, indicated satisfaction with the program regarding information quality and their intention to reuse.
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Affiliation(s)
- Jungwon Cho
- College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea
- Department of Pharmacy, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Sooyoung Yoo
- Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Eunkyung Euni Lee
- College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea
- Department of Pharmacy, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Ho-Young Lee
- Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
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Guinez-Molinos S, Espinoza S, Andrade J, Medina A. Design and Development of Learning Management System Huemul for Teaching Fast Healthcare Interoperability Resource: Algorithm Development and Validation Study. JMIR Med Educ 2024; 10:e45413. [PMID: 38285492 PMCID: PMC10862243 DOI: 10.2196/45413] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/27/2023] [Accepted: 11/16/2023] [Indexed: 01/30/2024]
Abstract
BACKGROUND Interoperability between health information systems is a fundamental requirement to guarantee the continuity of health care for the population. The Fast Healthcare Interoperability Resource (FHIR) is the standard that enables the design and development of interoperable systems with broad adoption worldwide. However, FHIR training curriculums need an easily administered web-based self-learning platform with modules to create scenarios and questions that the learner answers. This paper proposes a system for teaching FHIR that automatically evaluates the answers, providing the learner with continuous feedback and progress. OBJECTIVE We are designing and developing a learning management system for creating, applying, deploying, and automatically assessing FHIR web-based courses. METHODS The system requirements for teaching FHIR were collected through interviews with experts involved in academic and professional FHIR activities (universities and health institutions). The interviews were semistructured, recording and documenting each meeting. In addition, we used an ad hoc instrument to register and analyze all the needs to elicit the requirements. Finally, the information obtained was triangulated with the available evidence. This analysis was carried out with Atlas-ti software. For design purposes, the requirements were divided into functional and nonfunctional. The functional requirements were (1) a test and question manager, (2) an application programming interface (API) to orchestrate components, (3) a test evaluator that automatically evaluates the responses, and (4) a client application for students. Security and usability are essential nonfunctional requirements to design functional and secure interfaces. The software development methodology was based on the traditional spiral model. The end users of the proposed system are (1) the system administrator for all technical aspects of the server, (2) the teacher designing the courses, and (3) the students interested in learning FHIR. RESULTS The main result described in this work is Huemul, a learning management system for training on FHIR, which includes the following components: (1) Huemul Admin: a web application to create users, tests, and questions and define scores; (2) Huemul API: module for communication between different software components (FHIR server, client, and engine); (3) Huemul Engine: component for answers evaluation to identify differences and validate the content; and (4) Huemul Client: the web application for users to show the test and questions. Huemul was successfully implemented with 416 students associated with the 10 active courses on the platform. In addition, the teachers have created 60 tests and 695 questions. Overall, the 416 students who completed their courses rated Huemul highly. CONCLUSIONS Huemul is the first platform that allows the creation of courses, tests, and questions that enable the automatic evaluation and feedback of FHIR operations. Huemul has been implemented in multiple FHIR teaching scenarios for health care professionals. Professionals trained on FHIR with Huemul are leading successful national and international initiatives.
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Affiliation(s)
| | - Sonia Espinoza
- Interoperability Area, National Center for Health Information System, Santiago, Chile
| | - Jose Andrade
- Interoperability Area, National Center for Health Information System, Santiago, Chile
| | - Alejandro Medina
- Interoperability Area, National Center for Health Information System, Santiago, Chile
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Seth M, Jalo H, Lee E, Bakidou A, Medin O, Björner U, Sjöqvist BA, Candefjord S. Reviewing Challenges in Specifying Interoperability Requirement in Procurement of Health Information Systems. Stud Health Technol Inform 2024; 310:8-12. [PMID: 38269755 DOI: 10.3233/shti230917] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Procurement of health information systems (HIS) is a complex and critical task that requires early identification of interoperability requirements. However, specifying adequate requirements is often associated with several challenges. We examined relevant peer-reviewed literature and public documents (policy documents, annual reports, and newspapers) to summarize existing challenges in specifying interoperability requirement during procurement of HISs. In this study, 32 public documents and 2343 peer-reviewed articles were found using Google search engine, Springer, PubMed and ScienceDirect. Collected data were analyzed using a thematic coding schema. Our result shows that challenges related to describing the needs properly, conflicting needs and knowledge gaps are shared between most articles. Further research in the direction of developing a model that can bridge knowledge gaps, facilitate interdisciplinary collaboration, and help to avoid fuzzy requirements is needed.
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Affiliation(s)
- Mattias Seth
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Hoor Jalo
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Eunji Lee
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Anna Bakidou
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | | | - Ulrica Björner
- Äldre Samt Vård och Omsorgsförvaltningen, Gothenburg, Sweden
| | - Bengt Arne Sjöqvist
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Stefan Candefjord
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
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Marques R, de Lopes MVO, Neves‐Amado JD, Ramos PAS, de Sá LO, da Oliveira IMS, da Amado JMC, de Vasconcelos MJM, Salgado PMF, Alves PJP. Integrating factors associated with complex wound healing into a mobile application: Findings from a cohort study. Int Wound J 2024; 21:e14339. [PMID: 37667542 PMCID: PMC10781894 DOI: 10.1111/iwj.14339] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 09/06/2023] Open
Abstract
Complex, chronic or hard-to-heal wounds are a prevalent health problem worldwide, with significant physical, psychological and social consequences. This study aims to identify factors associated with the healing process of these wounds and develop a mobile application for wound care that incorporates these factors. A prospective multicentre cohort study was conducted in nine health units in Portugal, involving data collection through a mobile application by nurses from April to October 2022. The study followed 46 patients with 57 wounds for up to 5 weeks, conducting six evaluations. Healing time was the main outcome measure, analysed using the Mann-Whitney test and three Cox regression models to calculate risk ratios. The study sample comprised various wound types, with pressure ulcers being the most common (61.4%), followed by venous leg ulcers (17.5%) and diabetic foot ulcers (8.8%). Factors that were found to impair the wound healing process included chronic kidney disease (U = 13.50; p = 0.046), obesity (U = 18.0; p = 0.021), non-adherence to treatment (U = 1.0; p = 0.029) and interference of the wound with daily routines (U = 11.0; p = 0.028). Risk factors for delayed healing over time were identified as bone involvement (RR 3.91; p < 0.001), presence of odour (RR 3.36; p = 0.007), presence of neuropathy (RR 2.49; p = 0.002), use of anti-inflammatory drugs (RR 2.45; p = 0.011), stalled wound (RR 2.26; p = 0.022), greater width (RR 2.03; p = 0.002), greater depth (RR 1.72; p = 0.036) and a high score on the healing scale (RR 1.21; p = 0.001). Integrating the identified risk factors for delayed healing into the assessment of patients and incorporating them into a mobile application can enhance decision-making in wound care.
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Affiliation(s)
- Raquel Marques
- Centre for Interdisciplinary Research in HealthUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
| | | | - João Daniel Neves‐Amado
- Centre for Interdisciplinary Research in HealthUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
- School of Nursing DepartmentUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
| | - Paulo Alexandre Silva Ramos
- Centre for Interdisciplinary Research in HealthUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
- Unidade de Saúde Familiar Corino de AndradePortoPortugal
| | - Luís Octávio de Sá
- Centre for Interdisciplinary Research in HealthUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
- School of Nursing DepartmentUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
| | - Irene Maria Silva da Oliveira
- Centre for Interdisciplinary Research in HealthUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
- School of Nursing DepartmentUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
| | - João Manuel Costa da Amado
- Centre for Interdisciplinary Research in HealthUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
- School of Nursing DepartmentUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
| | | | | | - Paulo Jorge Pereira Alves
- Centre for Interdisciplinary Research in HealthUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
- School of Nursing DepartmentUniversidade Católica Portuguesa, Institute of Health SciencesPortoPortugal
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Jackson-Morris A, Sembajwe R, Mustapha FI, Chandran A, Niyonsenga SP, Gishoma C, Onyango E, Muriuki Z, Dharamraj K, Ellermeier N, Nugent R, Kazlauskaite R. Identifying the necessary capacities for the adaptation of a diabetes phenotyping algorithm in countries of differing economic development status. Glob Health Action 2023; 16:2157542. [PMID: 36692486 PMCID: PMC9879185 DOI: 10.1080/16549716.2022.2157542] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND In 2019, the World Health Organization recognised diabetes as a clinically and pathophysiologically heterogeneous set of related diseases. Little is currently known about the diabetes phenotypes in the population of low- and middle-income countries (LMICs), yet identifying their different risks and aetiology has great potential to guide the development of more effective, tailored prevention and treatment. OBJECTIVES This study reviewed the scope of diabetes datasets, health information ecosystems, and human resource capacity in four countries to assess whether a diabetes phenotyping algorithm (developed under a companion study) could be successfully applied. METHODS The capacity assessment was undertaken with four countries: Trinidad, Malaysia, Kenya, and Rwanda. Diabetes programme staff completed a checklist of available diabetes data variables and then participated in semi-structured interviews about Health Information System (HIS) ecosystem conditions, diabetes programme context, and human resource needs. Descriptive analysis was undertaken. RESULTS Only Malaysia collected the full set of the required diabetes data for the diabetes algorithm, although all countries did collect the required diabetes complication data. An HIS ecosystem existed in all settings, with variations in data hosting and sharing. All countries had access to HIS or ICT support, and epidemiologists or biostatisticians to support dataset preparation and algorithm application. CONCLUSIONS Malaysia was found to be most ready to apply the phenotyping algorithm. A fundamental impediment in the other settings was the absence of several core diabetes data variables. Additionally, if countries digitise diabetes data collection and centralise diabetes data hosting, this will simplify dataset preparation for algorithm application. These issues reflect common LMIC health systems' weaknesses in relation to diabetes care, and specifically highlight the importance of investment in improving diabetes data, which can guide population-tailored prevention and management approaches.
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Affiliation(s)
- Angela Jackson-Morris
- Center for Global Noncommunicable Diseases (AJM, RN, NE), RS Social, Statistical, and Environmental Sciences, RTI International, Seattle, WA, USA,CONTACT Angela Jackson-Morris Center for Global Noncommunicable Diseases, RTI International, 3040 Cornwallis Road, Durham, NC27709, USA
| | - Rita Sembajwe
- Center for Global Noncommunicable Diseases (AJM, RN, NE), RS Social, Statistical, and Environmental Sciences, RTI International, Seattle, WA, USA
| | - Feisul Idzwan Mustapha
- NCD section, Disease Control Division, Malaysia Ministry of Health, Kuala Lumpur, Malaysia
| | - Arunah Chandran
- NCD section, Disease Control Division, Malaysia Ministry of Health, Kuala Lumpur, Malaysia
| | | | | | - Elizabeth Onyango
- Division of Non-Communicable Disease Prevention and Control, Kenya Ministry of Health, Nairobi, Kenya
| | - Zachariah Muriuki
- Division of Non-Communicable Disease Prevention and Control, Kenya Ministry of Health, Nairobi, Kenya
| | - Kavita Dharamraj
- South Western Regional Health Authority, Princes Town, Trinidad and Tobago
| | - Nathan Ellermeier
- Center for Global Noncommunicable Diseases, Consultant, Durham, NC, USA
| | - Rachel Nugent
- Center for Global Noncommunicable Diseases (AJM, RN, NE), RS Social, Statistical, and Environmental Sciences, RTI International, Seattle, WA, USA
| | - Rasa Kazlauskaite
- Department of Internal Medicine, RUSH University Medical Center, Chicago, IL, USA
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Epizitone A, Moyane SP, Agbehadji IE. A Data-Driven Paradigm for a Resilient and Sustainable Integrated Health Information Systems for Health Care Applications. J Multidiscip Healthc 2023; 16:4015-4025. [PMID: 38107085 PMCID: PMC10725635 DOI: 10.2147/jmdh.s433299] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/02/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Many transformations and uncertainties, such as the fourth industrial revolution and pandemics, have propelled healthcare acceptance and deployment of health information systems (HIS). External and internal determinants aligning with the global course influence their deployments. At the epic is digitalization, which generates endless data that has permeated healthcare. The continuous proliferation of complex and dynamic healthcare data is the digitalization frontier in healthcare that necessitates attention. Objective This study explores the existing body of information on HIS for healthcare through the data lens to present a data-driven paradigm for healthcare augmentation paramount to attaining a sustainable and resilient HIS. Method Preferred Reporting Items for Systematic Reviews and Meta-Analyses: PRISMA-compliant in-depth literature review was conducted systematically to synthesize and analyze the literature content to ascertain the value disposition of HIS data in healthcare delivery. Results This study details the aspects of a data-driven paradigm for robust and sustainable HIS for health care applications. Data source, data action and decisions, data sciences techniques, serialization of data sciences techniques in the HIS, and data insight implementation and application are data-driven features expounded. These are essential data-driven paradigm building blocks that need iteration to succeed. Discussions Existing literature considers insurgent data in healthcare challenging, disruptive, and potentially revolutionary. This view echoes the current healthcare quandary of good and bad data availability. Thus, data-driven insights are essential for building a resilient and sustainable HIS. People, technology, and tasks dominated prior HIS frameworks, with few data-centric facets. Improving healthcare and the HIS requires identifying and integrating crucial data elements. Conclusion The paper presented a data-driven paradigm for a resilient and sustainable HIS. The findings show that data-driven track and components are essential to improve healthcare using data analytics insights. It provides an integrated footing for data analytics to support and effectively assist health care delivery.
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Affiliation(s)
- Ayogeboh Epizitone
- ICT and Society Research Group, Department of Information and Corporate Management, Durban University of Technology, Durban, South Africa
| | - Smangele Pretty Moyane
- Department of Information and Corporate Management, Durban University of Technology, Durban, South Africa
| | - Israel Edem Agbehadji
- Centre for Transformative Agricultural and Food Systems, School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa
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de Souza CRA, Vanderlei LCDM, de Frias PG. Measles epidemiological surveillance system before and during the COVID-19 pandemic in Pernambuco, Brazil, 2018-2022: a descriptive evaluation. Epidemiol Serv Saude 2023; 32:e2023545. [PMID: 38018649 PMCID: PMC10684126 DOI: 10.1590/s2237-96222023000300008.en] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 09/11/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVE To evaluate the measles epidemiological surveillance system, before and during the COVID-19 pandemic in Pernambuco, Brazil. METHODS This was a descriptive evaluation of the quality (duplicity; completeness; consistency), timeliness and usefulness attributed, classified as excellent ≥ 90.0%, regular ≥ 70.0% and < 90.0%, and poor (< 70.0%). Data from the Notifiable Health Conditions Information System and Laboratory Environment Management System were used, before (03/11/2018-03/10/2020) and during (03/11/2020-03/10/2022) the pandemic. RESULTS 1,548 suspected measles cases were registered (1,469 before and 79 during the pandemic). In the two periods studied, there were 11 and 1 duplicate records, average completeness in filling out the variables was 99.2% and 95.7%, while average consistency was 96.7% and 97.5%, respectively. Timeliness (receipt of samples, 16.2% and 33.0%. Release of results, 1.3% and 1.3%) and usefulness (43.5% and 24.4%) were poor. CONCLUSION Quality was classified as excellent in the periods studied, timeliness and usefulness were classified as poor, signaling non-compliance with the purpose of the system. MAIN RESULTS The quality of data from the measles epidemiological surveillance system in Pernambuco was excellent, while its timeliness and usefulness were poor during both periods. IMPLICATIONS FOR SERVICES The limited timeliness and, therefore, the low usefulness of the measles epidemiological surveillance system must be discussed in the three government spheres of health service management, with the aim of training the professionals involved, as well as monitoring and evaluating the system. PERSPECTIVES Systematic monitoring and evaluation generates evidence that supports health service managers and workers in the timely identification of gaps that compromise the full fulfillment of the objectives proposed.
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Affiliation(s)
| | | | - Paulo Germano de Frias
- Instituto de Medicina Integral Prof. Fernando Figueira, Programa de Pós-Graduação em Avaliação em Saúde, Recife, PE, Brazil
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Barbieri C, Neri L, Stuard S, Mari F, Martín-Guerrero JD. From electronic health records to clinical management systems: how the digital transformation can support healthcare services. Clin Kidney J 2023; 16:1878-1884. [PMID: 37915897 PMCID: PMC10616428 DOI: 10.1093/ckj/sfad168] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Indexed: 11/03/2023] Open
Abstract
Healthcare systems worldwide are currently undergoing significant transformations in response to increasing costs, a shortage of healthcare professionals and the growing complexity of medical needs among the population. Value-based healthcare reimbursement systems are emerging as an attempt to incentivize patient-centricity and cost containment. From a technological perspective, the transition to digitalized services is intended to support these transformations. A Health Information System (HIS) is a technological solution designed to govern the data flow generated and consumed by healthcare professionals and administrative staff during the delivery of healthcare services. However, the exponential growth of digital capabilities and applied advanced analytics has expanded their traditional functionalities and brought the promise of automating administrative procedures and simple repetitive tasks, while enhancing the efficiency and outcomes of healthcare services by incorporating decision support tools for clinical management. The future of HIS is headed towards modular architectures that can facilitate implementation and adaptation to different environments and systems, as well as the integration of various tools, such as artificial intelligence (AI) models, in a seamless way. As an example, we present the experience and future developments of the European Clinical Database (EuCliD®). EuCliD is a multilingual HIS used by 20 000 nurses and physicians on a daily basis to manage 105 000 patients treated in 1100 clinics in 43 different countries. EuCliD encompasses patients' follow-up, automatic reporting and mobile applications while enabling efficient management of clinical processes. It is also designed to incorporate multiagent systems to automate repetitive tasks, AI modules and advanced dynamic dashboards.
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Affiliation(s)
- Carlo Barbieri
- Global Digital Transformation and Innovation, Clinical Digital Center of Excellence, Fresenius Medical Care, Crema Italy
| | - Luca Neri
- Global Medical Office, Clinical Advanced Analytics, Fresenius Medical Care, Crema Italy
| | - Stefano Stuard
- Global Medical Office, Clinical and Therapeutic Governance, Fresenius Medical Care, Naples, Italy
| | - Flavio Mari
- Global Digital Transformation and Innovation, Clinical Digital Center of Excellence, Fresenius Medical Care, Crema Italy
| | - José D Martín-Guerrero
- Intelligent Data Analysis Laboratory, Department of Electronic Engineering, ETSE -UV, Universitat de València, Valencia, Spain
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Kaihlanen AM, Elovainio M, Virtanen L, Kinnunen UM, Vehko T, Saranto K, Heponiemi T. Nursing informatics competence profiles and perceptions of health information system usefulness among registered nurses: A latent profile analysis. J Adv Nurs 2023; 79:4022-4033. [PMID: 37243421 DOI: 10.1111/jan.15718] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 02/27/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023]
Abstract
AIMS To identify different nursing informatics competence (NIC) profiles in nurses, examine the factors associated with profile memberships and examine the associations of the derived profiles with the nurses' perception of the usefulness of a health information system (HIS). DESIGN A cross-sectional study. METHODS A sample of 3610 registered nurses responded to a nationwide survey in March 2020. A latent profile analysis was performed to identify NIC profiles based on three competence areas: nursing documentation, working in digital environment, and ethics and data protection. A multinomial logistic regression was carried out to examine the associations of demographic and background variables with the profile membership. Linear regression analyses were carried out to examine the association between the profile membership and perceived HIS usefulness. RESULTS Three NIC profiles were identified and labelled as low, moderate and high competence groups. A younger age, recent graduation year, sufficient orientation and high-rated proficiency as an HIS user were associated with nurses belonging to a high or moderate competence group relative to a low competence group. Competence group membership was associated with perceived HIS usefulness. The high competence group consistently expressed the highest usefulness of the HIS and the low competence group the lowest. CONCLUSION Tailored training and support should be provided for nurses with different levels of informatics competence, thereby facilitating their ability to respond to increasingly digitalized work. This could contribute to higher usefulness of the HIS in terms of supporting the nurses' work tasks and promoting the quality of care. IMPACT This was the first study exploring latent profiles of informatics competence in nurses. Insights from this study are useful for nursing management to identify different competence profiles of their employees, provide support and training to meet their needs, and promote the successful use of an HIS.
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Affiliation(s)
| | - Marko Elovainio
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Lotta Virtanen
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Ulla-Mari Kinnunen
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Tuulikki Vehko
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Kaija Saranto
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
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Barbalho IMP, Fonseca ALA, Fernandes F, Henriques J, Gil P, Nagem D, Lindquist R, Lima T, dos Santos JPQ, Paiva J, Morais AHF, Dourado Júnior MET, Valentim RAM. Digital health solution for monitoring and surveillance of Amyotrophic Lateral Sclerosis in Brazil. Front Public Health 2023; 11:1209633. [PMID: 37693725 PMCID: PMC10485256 DOI: 10.3389/fpubh.2023.1209633] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/10/2023] [Indexed: 09/12/2023] Open
Abstract
Amyotrophic Lateral Sclerosis (ALS) is a complex and rare neurodegenerative disease given its heterogeneity. Despite being known for many years, few countries have accurate information about the characteristics of people diagnosed with ALS, such as data regarding diagnosis and clinical features of the disease. In Brazil, the lack of information about ALS limits data for the research progress and public policy development that benefits people affected by this health condition. In this context, this article aims to show a digital health solution development and application for research, intervention, and strengthening of the response to ALS in the Brazilian Health System. The proposed solution is composed of two platforms: the Brazilian National ALS Registry, responsible for the data collection in a structured way from ALS patients all over Brazil; and the Brazilian National ALS Observatory, responsible for processing the data collected in the National Registry and for providing a monitoring room with indicators on people diagnosed with ALS in Brazil. The development of this solution was supported by the Brazilian Ministry of Health (MoH) and was carried out by a multidisciplinary team with expertise in ALS. This solution represents a tool with great potential for strengthening public policies and stands out for being the only public database on the disease, besides containing innovations that allow data collection by health professionals and/or patients. By using both platforms, it is believed that it will be possible to understand the demographic and epidemiological data of ALS in Brazil, since the data will be able to be analyzed by care teams and also by public health managers, both in the individual and collective monitoring of people living with ALS in Brazil.
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Affiliation(s)
- Ingridy M. P. Barbalho
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | - Aleika L. A. Fonseca
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | - Felipe Fernandes
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | - Jorge Henriques
- Department of Informatics Engineering, Center for Informatics and Systems of the University of Coimbra, Universidade de Coimbra, Coimbra, Portugal
| | - Paulo Gil
- Department of Informatics Engineering, Center for Informatics and Systems of the University of Coimbra, Universidade de Coimbra, Coimbra, Portugal
| | - Danilo Nagem
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | - Raquel Lindquist
- Department of Physical Therapy, Rio Grande do Norte Federal University, Natal, Brazil
| | - Thaisa Lima
- Brazilian Ministry of Health, Brasília, Brazil
| | - João Paulo Queiroz dos Santos
- Advanced Nucleus of Technological Innovation (NAVI), Federal Institute of Education Science and Technology, Natal, Brazil
| | - Jailton Paiva
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | - Antonio H. F. Morais
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | | | - Ricardo A. M. Valentim
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
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Sari PK, Handayani PW, Hidayanto AN. Demographic Comparison of Information Security Behavior Toward Health Information System Protection: Survey Study. JMIR Form Res 2023; 7:e49439. [PMID: 37616025 PMCID: PMC10485712 DOI: 10.2196/49439] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/11/2023] [Accepted: 07/24/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND The health information system (HIS) functions are getting wider with more diverse users. Information security in the health industry is crucial because it involves comprehensive and strategic information that might harm human life. The human factor is one of the biggest security threats to HIS. OBJECTIVE This study aims to investigate the information security behavior (ISB) of HIS users using a comprehensive assessment scale suited to the information security concerns in health care. Patients are increasingly being asked to submit their own data into HIS systems. As a result, this study examines the security behavior of health workers and patients, as well as their demographic variables. METHODS We used a quantitative approach using surveys of health workers and patients. We created a research instrument from 4 existing measurement scales to measure prosecurity and antisecurity behavior. We analyzed statistical differences to test the hypotheses, that is, the Kruskal-Wallis test and the Mann-Whitney test. The descriptive analysis was used to determine whether the group exhibited exemplary behavior when processing the survey results. A correlational test using the Spearman correlation coefficient was performed to establish the significance of the relationship between ISB and age as well as level of education. RESULTS We analyzed 421 responses from the survey. According to demographic factors, the hypotheses tested for full and partial security behavior reveal substantial differences. Education levels most significantly affect security behavior differences, followed by user type, gender, and age. The health workers' ISB is higher than that of the patients. Women are more likely than men to engage in prosecurity actions while avoiding antisecurity behaviors. The older the HIS user, the more likely it is that they will participate in prosecurity behavior and the less probable it is that they will engage in antisecurity behavior. According to this study, differences in prosecurity behavior are mostly impacted by education level. Higher education, on the other hand, does not guarantee improved ISB for HIS users. All demographic characteristics, particularly concerning user type, show discrepancies that are caused mainly by antisecurity behavior rather than prosecurity behavior. CONCLUSIONS Since patients engage in antisecurity behavior more frequently than health workers and may pose security risks, health care facilities should start to consider information security education for patients. More comprehensive research on ISB in health care facilities is required to better understand the patient's perspective, which is currently understudied.
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Affiliation(s)
- Puspita Kencana Sari
- Faculty of Computer Science, Universitas Indonesia, Depok, Indonesia
- Faculty of Economics & Business, Telkom University, Bandung, Indonesia
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Anfinogenova ND, Novikova OM, Trubacheva IA, Efimova EV, Chesalov NP, Ussov WY, Maksimova AS, Shelkovnikova TA, Ryumshina NI, Stepanov VA, Popov SV, Repin AN. Prescribed Versus Taken Polypharmacy and Drug-Drug Interactions in Older Cardiovascular Patients during the COVID-19 Pandemic: Observational Cross-Sectional Analytical Study. J Clin Med 2023; 12:5061. [PMID: 37568464 PMCID: PMC10420276 DOI: 10.3390/jcm12155061] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/19/2023] [Accepted: 07/30/2023] [Indexed: 08/13/2023] Open
Abstract
The study aimed to assess clinical pharmacology patterns of prescribed and taken medications in older cardiovascular patients using electronic health records (EHRs) (n = 704) (2019-2022). Medscape Drug Interaction Checker was used to identify pairwise drug-drug interactions (DDIs). Prevalence rates of DDIs were 73.5% and 68.5% among taken and prescribed drugs, respectively. However, the total number of DDIs was significantly higher among the prescribed medications (p < 0.05). Serious DDIs comprised 16% and 7% of all DDIs among the prescribed and taken medications, respectively (p < 0.05). Median numbers of DDIs between the prescribed vs. taken medications were Me = 2, IQR 0-7 vs. Me = 3, IQR 0-7 per record, respectively. Prevalence of polypharmacy was significantly higher among the prescribed medications compared with that among the taken drugs (p < 0.05). Women were taking significantly more drugs and had higher prevalence of polypharmacy and DDIs (p < 0.05). No sex-related differences were observed in the list of prescribed medications. ICD code U07.1 (COVID-19, virus identified) was associated with the highest median DDI number per record. Further research is warranted to improve EHR structure, implement patient engagement in reporting adverse drug reactions, and provide genetic profiling of patients to avoid potentially serious DDIs.
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Affiliation(s)
- Nina D. Anfinogenova
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia; (O.M.N.); (I.A.T.); (E.V.E.); (N.P.C.); (W.Y.U.); (A.S.M.); (T.A.S.); (N.I.R.); (S.V.P.); (A.N.R.)
| | - Oksana M. Novikova
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia; (O.M.N.); (I.A.T.); (E.V.E.); (N.P.C.); (W.Y.U.); (A.S.M.); (T.A.S.); (N.I.R.); (S.V.P.); (A.N.R.)
| | - Irina A. Trubacheva
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia; (O.M.N.); (I.A.T.); (E.V.E.); (N.P.C.); (W.Y.U.); (A.S.M.); (T.A.S.); (N.I.R.); (S.V.P.); (A.N.R.)
| | - Elena V. Efimova
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia; (O.M.N.); (I.A.T.); (E.V.E.); (N.P.C.); (W.Y.U.); (A.S.M.); (T.A.S.); (N.I.R.); (S.V.P.); (A.N.R.)
| | - Nazary P. Chesalov
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia; (O.M.N.); (I.A.T.); (E.V.E.); (N.P.C.); (W.Y.U.); (A.S.M.); (T.A.S.); (N.I.R.); (S.V.P.); (A.N.R.)
| | - Wladimir Y. Ussov
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia; (O.M.N.); (I.A.T.); (E.V.E.); (N.P.C.); (W.Y.U.); (A.S.M.); (T.A.S.); (N.I.R.); (S.V.P.); (A.N.R.)
- Meshalkin National Medical Research Center, Novosibirsk 630055, Russia
| | - Aleksandra S. Maksimova
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia; (O.M.N.); (I.A.T.); (E.V.E.); (N.P.C.); (W.Y.U.); (A.S.M.); (T.A.S.); (N.I.R.); (S.V.P.); (A.N.R.)
| | - Tatiana A. Shelkovnikova
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia; (O.M.N.); (I.A.T.); (E.V.E.); (N.P.C.); (W.Y.U.); (A.S.M.); (T.A.S.); (N.I.R.); (S.V.P.); (A.N.R.)
| | - Nadezhda I. Ryumshina
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia; (O.M.N.); (I.A.T.); (E.V.E.); (N.P.C.); (W.Y.U.); (A.S.M.); (T.A.S.); (N.I.R.); (S.V.P.); (A.N.R.)
| | - Vadim A. Stepanov
- Research Institute of Medical Genetics, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634050, Russia;
| | - Sergey V. Popov
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia; (O.M.N.); (I.A.T.); (E.V.E.); (N.P.C.); (W.Y.U.); (A.S.M.); (T.A.S.); (N.I.R.); (S.V.P.); (A.N.R.)
| | - Alexey N. Repin
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia; (O.M.N.); (I.A.T.); (E.V.E.); (N.P.C.); (W.Y.U.); (A.S.M.); (T.A.S.); (N.I.R.); (S.V.P.); (A.N.R.)
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Naz O, Ibrahim M, Mohiuddin AF, Khan AA, Samad Z. Public health data quality and evidence use in developing countries: a call to action. Front Public Health 2023; 11:1194499. [PMID: 37483937 PMCID: PMC10357505 DOI: 10.3389/fpubh.2023.1194499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/26/2023] [Indexed: 07/25/2023] Open
Affiliation(s)
- Olan Naz
- Research and Development Solutions, Islamabad, Pakistan
| | | | | | - Adnan Ahmad Khan
- Research and Development Solutions, Islamabad, Pakistan
- Data, Evaluations and Evidence for Policy (DEEP) Unit, Ministry of National Health Services, Regulations and Coordination, Islamabad, Pakistan
| | - Zainab Samad
- CITRIC Health Data Science Center, Aga Khan University, Karachi, Pakistan
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Idaiani S, Hendarwan H, Herawati MH. Disparities of Health Program Information Systems in Indonesia: A Cross-Sectional Indonesian Health Facility Research 2019. Int J Environ Res Public Health 2023; 20:4384. [PMID: 36901393 PMCID: PMC10001594 DOI: 10.3390/ijerph20054384] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/09/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
Although a recording and reporting format for health centers already exists for Indonesia's standard information system, numerous health applications still need to meet the needs of each program. Therefore, this study aimed to demonstrate the potential disparities in information systems in the application and data collection of health programs among Indonesian community health centers (CHCs) based on provinces and regions. This cross-sectional research used data from 9831 CHCs from the Health Facilities Research 2019 (RIFASKES). Significance was assessed using a chi-square test and analysis of variance (ANOVA). The number of applications was depicted on a map using the spmap command with STATA version 14. It showed that region 2, which represented Java and Bali, was the best, followed by regions 1, which comprised Sumatra Island and its surroundings, and 3, Nusa Tenggara. The highest mean, equaling that of Java, was discovered in three provinces of region 1, namely, Jambi, Lampung, and Bangka Belitung. Furthermore, Papua and West Papua had less than 60% for all types of data-storage programs. Hence, there is a disparity in the health information system in Indonesia by province and region. The results of this analysis recommend future improvement of the CHCs' information systems.
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Affiliation(s)
- Sri Idaiani
- Research Centre for Preclinical and Clinical Medicine, National Research and Innovation Agency, Cibinong Science Center, Jalan Raya Jakarta-Bogor Km. 46, Kec. Cibinong, Kabupaten Bogor 16915, West Java, Indonesia
| | - Harimat Hendarwan
- Research Centre for Preclinical and Clinical Medicine, National Research and Innovation Agency, Cibinong Science Center, Jalan Raya Jakarta-Bogor Km. 46, Kec. Cibinong, Kabupaten Bogor 16915, West Java, Indonesia
| | - Maria Holly Herawati
- Research Centre for Public Health and Nutrition, National Research and Innovation Agency, Cibinong Science Center, Jalan Raya Jakarta-Bogor Km. 46, Kec. Cibinong, Kabupaten Bogor 16915, West Java, Indonesia
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Gallego E, Arias-Merino G, Sánchez-Díaz G, Villaverde-Hueso A, Posada de la Paz M, Alonso-Ferreira V. Familial Mediterranean Fever in Spain: Time Trend and Spatial Distribution of the Hospitalizations. Int J Environ Res Public Health 2023; 20:4374. [PMID: 36901385 PMCID: PMC10002354 DOI: 10.3390/ijerph20054374] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/23/2023] [Accepted: 02/26/2023] [Indexed: 06/18/2023]
Abstract
Familial Mediterranean Fever (FMF) is a rare, hereditary, auto-inflammatory disease. The aims of this study were to explore the time trend and geographical distribution of hospitalizations in Spain from 2008 to 2015. We identified hospitalizations of FMF from the Spanish Minimum Basic Data Set at hospital discharge, using ICD-9-CM code 277.31. Age-specific and age-adjusted hospitalization rates were calculated. The time trend and the average percentage change were analyzed using Joinpoint regression. Standardized morbidity ratios were calculated and mapped by province. A total of 960 FMF-related hospitalizations (52% men) were identified across the period 2008-2015, with an increase in hospitalizations of 4.9% per year being detected (p < 0.05). The risk of hospitalization was higher than expected for the national total (SMR > 1) in 13 provinces (5 in the Mediterranean area), and lower (SMR < 1) in 14 provinces (3 in the Mediterranean area). There was an increase in hospitalizations of patients with FMF in Spain throughout the study period, with a risk of hospitalization that was higher, though not exclusively so, in provinces along the Mediterranean coast. These findings contribute to the visibility of FMF and provide useful information for health planning. Further research should take into account new population-based information, in order to continue monitoring this disease.
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Affiliation(s)
- Elisa Gallego
- Instituto de Investigación de Enfermedades Raras (IIER), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Escuela Internacional de Doctorado, Universidad Nacional de Educación a Distancia (UNED), Calle Bravo Murillo, 38, 28015 Madrid, Spain
| | - Greta Arias-Merino
- Instituto de Investigación de Enfermedades Raras (IIER), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Germán Sánchez-Díaz
- Instituto de Investigación de Enfermedades Raras (IIER), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), 28029 Madrid, Spain
| | - Ana Villaverde-Hueso
- Instituto de Investigación de Enfermedades Raras (IIER), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), 28029 Madrid, Spain
| | - Manuel Posada de la Paz
- Instituto de Investigación de Enfermedades Raras (IIER), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Verónica Alonso-Ferreira
- Instituto de Investigación de Enfermedades Raras (IIER), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), 28029 Madrid, Spain
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Moll C, Arndt F, Arvanitis TN, Gonzàlez N, Groene O, Ortega-Gil A, Verdoy D, Bloemeke J. "It depends on the people!" - A qualitative analysis of contextual factors, prior to the implementation of digital health innovations for chronic condition management, in a German integrated care network. Digit Health 2023; 9:20552076231222100. [PMID: 38162835 PMCID: PMC10756073 DOI: 10.1177/20552076231222100] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 12/05/2023] [Indexed: 01/03/2024] Open
Abstract
Objective Integrated care and digital health technology interventions are promising approaches to coordinate services for people living with chronic conditions, across different care settings and providers. The EU-funded ADLIFE project intends to provide digitally integrated personalized care to improve and maintain patients' health with advanced chronic conditions. This study conducted a qualitative assessment of contextual factors prior to the implementation of the ADLIFE digital health platforms at the German pilot site. The results of the assessment are then used to derive recommendations for action for the subsequent implementation, and for evaluation of the other pilot sites. Methods Qualitative interviews with healthcare professionals and IT experts were conducted at the German pilot site. The interviews followed a semi-structured interview guideline, based on the HOT-fit framework, focusing on organizational, technological, and human factors. All interviews were audio recorded, transcribed, and subsequently analysed following qualitative content analysis. Results The results of the 18 interviews show the interviewees' high openness and motivation to use new innovative digital solutions, as well as an apparent willingness of cooperation between different healthcare professionals. Challenges include limited technical infrastructure and large variability of software to record health data, lacking standards and interfaces. Conclusions Considering contextual factors on different levels is critical for the success of implementing innovations in healthcare and the transfer into other settings. In our study, the HOT-fit framework proved suitable for assessing contextual factors, when implementing IT innovations in healthcare. In a next step, the methodological approach will be transferred to the six other European pilot sites, participating in the project, for a cross-national assessment of contextual factors.
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Affiliation(s)
- Clemens Moll
- Research and Innovation, OptiMedis AG, Hamburg, Germany
| | - Fritz Arndt
- Gesunder Werra-Meißner Kreis GmbH, Eschwege, Germany
| | - Theodoros N. Arvanitis
- Institute of Digital Healthcare, University of Warwick, Coventry, UK
- School of Engineering, University of Birmingham, Birmingham, UK
| | - Nerea Gonzàlez
- Kronikgune Institute for Health Service Research, Basque Country, Spain
| | - Oliver Groene
- Research and Innovation, OptiMedis AG, Hamburg, Germany
- Faculty of Management and Economics, University of Witten/Herdecke, Witten, Germany
| | - Ana Ortega-Gil
- Kronikgune Institute for Health Service Research, Basque Country, Spain
| | - Dolores Verdoy
- Kronikgune Institute for Health Service Research, Basque Country, Spain
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Sari PK, Handayani PW, Hidayanto AN, Yazid S, Aji RF. Information Security Behavior in Health Information Systems: A Review of Research Trends and Antecedent Factors. Healthcare (Basel) 2022; 10. [PMID: 36554055 DOI: 10.3390/healthcare10122531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
This study aims to review the literature on antecedent factors of information security related to the protection of health information systems (HISs) in the healthcare organization. We classify those factors into organizational and individual aspects. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. Academic articles were sourced from five online databases (Scopus, PubMed, IEEE, ScienceDirect, and SAGE) using keywords related to information security, behavior, and healthcare facilities. The search yielded 35 studies, in which the three most frequent individual factors were self-efficacy, perceived severity, and attitudes, while the three most frequent organizational factors were management support, cues to action, and organizational culture. Individual factors for patients and medical students are still understudied, as are the organizational factors of academic healthcare facilities. More individual factors have been found to significantly influence security behavior. Previous studies have been dominated by the security compliance behavior of clinical and non-clinical hospital staff. These research gaps highlight the theoretical implications of this study. This study provides insight for managers of healthcare facilities and governments to consider individual factors in establishing information security policies and programs for improving security behavior.
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Brůha P, Mouček R, Salamon J, Vacek V. Workflow for health-related and brain data lifecycle. Front Digit Health 2022; 4:1025086. [PMID: 36532611 PMCID: PMC9748096 DOI: 10.3389/fdgth.2022.1025086] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/01/2022] [Indexed: 09/19/2023] Open
Abstract
Poor lifestyle leads potentially to chronic diseases and low-grade physical and mental fitness. However, ahead of time, we can measure and analyze multiple aspects of physical and mental health, such as body parameters, health risk factors, degrees of motivation, and the overall willingness to change the current lifestyle. In conjunction with data representing human brain activity, we can obtain and identify human health problems resulting from a long-term lifestyle more precisely and, where appropriate, improve the quality and length of human life. Currently, brain and physical health-related data are not commonly collected and evaluated together. However, doing that is supposed to be an interesting and viable concept, especially when followed by a more detailed definition and description of their whole processing lifecycle. Moreover, when best practices are used to store, annotate, analyze, and evaluate such data collections, the necessary infrastructure development and more intense cooperation among scientific teams and laboratories are facilitated. This approach also improves the reproducibility of experimental work. As a result, large collections of physical and brain health-related data could provide a robust basis for better interpretation of a person's overall health. This work aims to overview and reflect some best practices used within global communities to ensure the reproducibility of experiments, collected datasets and related workflows. These best practices concern, e.g., data lifecycle models, FAIR principles, and definitions and implementations of terminologies and ontologies. Then, an example of how an automated workflow system could be created to support the collection, annotation, storage, analysis, and publication of findings is shown. The Body in Numbers pilot system, also utilizing software engineering best practices, was developed to implement the concept of such an automated workflow system. It is unique just due to the combination of the processing and evaluation of physical and brain (electrophysiological) data. Its implementation is explored in greater detail, and opportunities to use the gained findings and results throughout various application domains are discussed.
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Affiliation(s)
- Petr Brůha
- Department of Computer Science and Engineering, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czech Republic
| | - Roman Mouček
- Department of Computer Science and Engineering, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czech Republic
- New Technologies for the Information Society, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czech Republic
| | - Jaromír Salamon
- Department of Computer Science and Engineering, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czech Republic
| | - Vítězslav Vacek
- Department of Computer Science and Engineering, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czech Republic
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Epizitone A, Moyane SP, Agbehadji IE. Health Information System and Health Care Applications Performance in the Healthcare Arena: A Bibliometric Analysis. Healthcare (Basel) 2022; 10:2273. [PMID: 36421597 PMCID: PMC9690197 DOI: 10.3390/healthcare10112273] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 10/26/2023] Open
Abstract
There have been several studies centred on health information systems with many insights provided to enhance health care applications globally. These studies have provided theoretical schemes for fortifying the enactment and utilisation of the Health Information System (HIS). In addition, these research studies contribute greatly to the development of HIS in alignment with major stakeholders such as health practitioners and recipients of health care. Conversely, there has been trepidation about HIS' sustainability and resilience for healthcare applications in the era of digitalization and globalization. Hence, this paper investigates research on HIS with a primary focus on health care applications to ascertain its sustainability and resilience amidst the transformation of the global healthcare space. Therefore, using a bibliometric approach, this paper measures the performance of health information systems and healthcare for health care applications using bibliometric data from the web of science database. The findings reveal solid evidence of the constructive transformation of health information systems and health care applications in the healthcare arena, providing ample evidence of the adaptation of HIS and health care applications within the healthcare arena to the fourth industrial revolution and, additionally, revealing the resilient alignment of health care applications and health information systems.
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Affiliation(s)
- Ayogeboh Epizitone
- ICT and Society Research Group, Durban University of Technology, Durban 4001, South Africa
| | - Smangele Pretty Moyane
- Department of Information and Corporate Management, Durban University of Technology, Durban 4001, South Africa
| | - Israel Edem Agbehadji
- Honorary Research Associate, Faculty of Accounting and Informatics, Durban University of Technology, Durban 4001, South Africa
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Mulenga-Cilundika P, Ekofo J, Kabanga C, Criel B, Van Damme W, Chenge F. Indirect Effects of Ebola Virus Disease Epidemics on Health Systems in the Democratic Republic of the Congo, Guinea, Sierra Leone and Liberia: A Scoping Review Supplemented with Expert Interviews. Int J Environ Res Public Health 2022; 19:13113. [PMID: 36293703 PMCID: PMC9602680 DOI: 10.3390/ijerph192013113] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/30/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
Ebola Virus Disease (EVD) epidemics have been extensively documented and have received large scientific and public attention since 1976. Until July 2022, 16 countries worldwide had reported at least one case of EVD, resulting in 43 epidemics. Most of the epidemics occurred in the Democratic Republic of Congo (DRC) but the largest epidemic occurred from 2014-2016 in Guinea, Sierra Leone and Liberia in West Africa. The indirect effects of EVD epidemics on these countries' health systems, i.e., the consequences beyond infected patients and deaths immediately related to EVD, can be significant. The objective of this review was to map and measure the indirect effects of the EVD epidemics on the health systems of DRC, Guinea, Sierra Leone and Liberia and, from thereon, draw lessons for strengthening their resilience vis-à-vis future EVD outbreaks and other similar health emergencies. A scoping review of published articles from the PubMed database and gray literature was conducted. It was supplemented by interviews with experts. Eighty-six articles were included in this review. The results were structured based on WHO's six building blocks of a health system. During the EVD outbreaks, several healthcare services and activities were disrupted. A significant decline in indicators of curative care utilization, immunization levels and disease control activities was noticeable. Shortages of health personnel, poor health data management, insufficient funding and shortages of essential drugs characterized the epidemics that occurred in the above-mentioned countries. The public health authorities had virtually lost their leadership in the management of an EVD response. Governance was characterized by the development of a range of new initiatives to ensure adequate response. The results of this review highlight the need for countries to invest in and strengthen their health systems, through the continuous reinforcement of the building blocks, even if there is no imminent risk of an epidemic.
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Affiliation(s)
- Philippe Mulenga-Cilundika
- Centre de Connaissances en Santé en République Démocratique du Congo, Kinshasa 3088, Democratic Republic of the Congo
- School of Public Health, Faculty of Medicine, University of Lubumbashi, Lubumbashi 1825, Democratic Republic of the Congo
| | - Joel Ekofo
- Centre de Connaissances en Santé en République Démocratique du Congo, Kinshasa 3088, Democratic Republic of the Congo
| | - Chrispin Kabanga
- Centre de Connaissances en Santé en République Démocratique du Congo, Kinshasa 3088, Democratic Republic of the Congo
| | - Bart Criel
- Centre de Connaissances en Santé en République Démocratique du Congo, Kinshasa 3088, Democratic Republic of the Congo
- Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Wim Van Damme
- Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Faustin Chenge
- Centre de Connaissances en Santé en République Démocratique du Congo, Kinshasa 3088, Democratic Republic of the Congo
- School of Public Health, Faculty of Medicine, University of Lubumbashi, Lubumbashi 1825, Democratic Republic of the Congo
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22
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Colais P, Pinnarelli L, Mataloni F, Giordani B, Duranti G, D’Errigo P, Rosato S, Seccareccia F, Baglio G, Davoli M. The National Outcomes Evaluation Programme in Italy: The Impact of Publication of Health Indicators. Int J Environ Res Public Health 2022; 19:ijerph191811685. [PMID: 36141957 PMCID: PMC9517347 DOI: 10.3390/ijerph191811685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/14/2022] [Accepted: 09/14/2022] [Indexed: 06/12/2023]
Abstract
In Italy the National Outcomes Evaluation Programme, (P.N.E.) is the most comprehensive comparative evaluation of healthcare outcomes at the national level. The aim of this report is to describe the P.N.E. and some of the most relevant results achieved. The P.N.E. analysed 184 indicators on quality of care in 2015-2020 period. The data sources are the Italian Health Information Systems. The indicators reported were: proportion of surgery within 2 days after hip fracture in the elderly (HF), 30-day mortality after hospital admission for acute myocardial infarction (AMI), proportion of reoperations within 90 days of breast-conserving surgery and proportion of primary caesarean deliveries. Risk adjustment methods were used to take into account patients' characteristics. From 2010 to 2020 the proportion of interventions within 2 days after HF increased from 31.3% to 64.6%, the AMI 30-day mortality decreased from 10.4% to 8.3%, the proportion of reinterventions within 90 days of breast-conserving surgery decreased from 12.0% to 5.9% and the proportion of primary caesarean deliveries decreased from 28.4% to 22.7%. Results by area of residence showed heterogeneity of healthcare quality. We observed a general improvement in different clinical areas not always associated with a reduction of heterogeneity among areas of residence.
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Affiliation(s)
- Paola Colais
- Department of Epidemiology, Lazio Regional Health Service, 00147 Rome, Italy
| | - Luigi Pinnarelli
- Department of Epidemiology, Lazio Regional Health Service, 00147 Rome, Italy
| | - Francesca Mataloni
- Department of Epidemiology, Lazio Regional Health Service, 00147 Rome, Italy
| | - Barbara Giordani
- Research and International Relations Unit, Italian National Agency for Regional Healthcare Services (AGENAS), 00187 Rome, Italy
| | - Giorgia Duranti
- Research and International Relations Unit, Italian National Agency for Regional Healthcare Services (AGENAS), 00187 Rome, Italy
| | - Paola D’Errigo
- National Centre for Global Health, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Stefano Rosato
- National Centre for Global Health, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Fulvia Seccareccia
- National Centre for Global Health, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - Giovanni Baglio
- Research and International Relations Unit, Italian National Agency for Regional Healthcare Services (AGENAS), 00187 Rome, Italy
| | - Marina Davoli
- Department of Epidemiology, Lazio Regional Health Service, 00147 Rome, Italy
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Lee YJ, Lee S, Kim S, Choi W, Jeong Y, Rhim NJJ, Seo I, Kim SY. An mHealth-Based Health Management Information System Among Health Workers in Volta and Eastern Regions of Ghana: Pre-Post Comparison Analysis. JMIR Med Inform 2022; 10:e29431. [PMID: 36044256 PMCID: PMC9475412 DOI: 10.2196/29431] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 11/27/2021] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite the increasing attention to electronic health management information systems (HMISs) in global health, most African countries still depend on inefficient paper-based systems. Good Neighbors International and Evaluate 4 Health have recently supported the Ghana Health Service on the rollout of a mobile health-based HMIS called the e-Tracker system in 2 regions in Ghana. The e-Tracker is an Android-based tracker capture app that electronically manages maternal and child health (MCH) data. The Ghana Health Service has implemented this new system in Community Health Planning and Services in the 2 regions (Volta and Eastern). OBJECTIVE This study aims to evaluate changes in health workers' capacity and behavior after using the e-Tracker to deliver MCH services. Specifically, the study assesses the changes in knowledge, attitude, and practice (KAP) of the health workers toward the e-Tracker system by comparing the pre- and postsurvey results. METHODS The KAP of frontline health workers was measured through self-administered surveys before and after using the e-Tracker system to assess their capacity and behavioral change toward the system. A total of 1124 health workers from the Volta and Eastern regions responded to the pre-post surveys. This study conducted the McNemar chi-square test and Wilcoxon signed-rank test for a pre-post comparison analysis. In addition, random-effects ordered logistic regression analysis and random-effects panel analysis were conducted to identify factors associated with KAP level. RESULTS The pre-post comparison analysis showed significant improvement in health workers' capacity, with higher knowledge and practice levels after using the e-Tracker system. As for knowledge, there was a 9.9%-point increase (from 559/1109, 50.41% to 669/1109, 60.32%) in the proportion of the respondents who were able to generate basic statistics on the number of children born in a random month within 30 minutes. In the practice section, the percentage of respondents who had scheduled clientencounters increased from 91.41% (968/1059) to 97.83% (1036/1059). By contrast, responses to the attitude (acceptability) became less favorable after experiencing the actual system. For instance, 48.53% (544/1121) initially expressed their preferences for an electronic system; however, the proportion decreased to 33.45% (375/1121) after the intervention. Random-effects ordered logistic regression showed that days of overwork were significantly associated with health workers' attitudes toward the e-Tracker system. CONCLUSIONS This study provides empirical evidence that the e-Tracker system is conducive to enhancing capacity in MCH data management for providing necessary MCH services. However, the change in attitude implies that the users appear to feel less comfortable using the new system. As Ghana plans to scale up the electronic HMIS system using the e-Tracker to the national level, strategies to enhance health workers' attitudes are necessary to sustain this new system.
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Affiliation(s)
- Young-Ji Lee
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Gwanak Campus, Seoul, Republic of Korea
| | - Seohyun Lee
- Department of Global Public Administration, Yonsei University Mirae Campus, Wonju, Republic of Korea
| | - SeYeon Kim
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Gwanak Campus, Seoul, Republic of Korea
| | - Wonil Choi
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Gwanak Campus, Seoul, Republic of Korea
| | - Yoojin Jeong
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Gwanak Campus, Seoul, Republic of Korea
| | | | | | - Sun-Young Kim
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Gwanak Campus, Seoul, Republic of Korea.,Institute of Health and Environment, Seoul National University, Gwanak Campus, Seoul, Republic of Korea
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Vargas-Herrera J, Meneses G, Cortez-Escalante J. Physicians' Perceptions as Predictors of the Future Use of the National Death Information System in Peru: Cross-sectional Study. J Med Internet Res 2022; 24:e34858. [PMID: 35969435 PMCID: PMC9425167 DOI: 10.2196/34858] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 04/27/2022] [Accepted: 05/30/2022] [Indexed: 11/21/2022] Open
Abstract
Background A computer application called the National Death Information System (SINADEF) was implemented in Peru so that physicians can prepare death certificates in electronic format and the information is available online. In 2018, only half of the estimated deaths in Peru were certified using SINADEF. When a death is certified in paper format, the probability being entered in the mortality database decreases. It is important to know, from the user’s perspective, the factors that can influence the successful implementation of SINADEF. SINADEF can only be successfully implemented if it is known whether physicians believe that it is useful and easy to operate. Objective The aim of this study was to identify the perceptions of physicians and other factors as predictors of their behavioral intention to use SINADEF to certify a death. Methods This study had an observational, cross-sectional design. A survey was provided to physicians working in Peru, who used SINADEF to certify a death for a period of 12 months, starting in November 2019. A questionnaire was adapted based on the Technology Acceptance Model. The questions measured the dimensions of subjective norm, image, job relevance, output quality, demonstrability of results, perceived usefulness, perceived ease of use, and behavioral intention to use. Chi-square and logistic regression tests were used in the analysis, and a confidence level of 95% was chosen to support a significant association. Results In this study, 272 physicians responded to the survey; 184 (67.6%) were men and the average age was 45.3 (SD 10.1) years. The age range was 24 to 73 years. In the bivariate analysis, the intention to use SINADEF was found to be associated with (1) perceived usefulness, expressed as “using SINADEF avoids falsifying a death certificate” (P<.001), “using SINADEF reduces the risk of errors” (P<.001), and “using SINADEF allows for filling out a certificate in less time” (P<.001); and (2) perceived ease of use, expressed as “I think SINADEF is easy to use” (P<.001). In the logistic regression, perceived usefulness (odds ratio [OR] 8.5, 95% CI 2.2-32.3; P=.002), perceived ease of use (OR 10.1, 95% CI 2.4-41.8; P=.001), and training in filling out death certificates (OR 8.3, 95% CI 1.6-42.8; P=.01) were found to be predictors of the behavioral intention to use SINADEF. Conclusions The behavioral intention to use SINADEF was related to the perception that it is an easy-to-use system, the belief that it improves the performance of physicians in carrying out the task at hand, and with training in filling out death certificates.
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Affiliation(s)
- Javier Vargas-Herrera
- Department of Preventive Medicine and Public Health, National University of San Marcos, Lima, Peru
| | - Giovanni Meneses
- Department of Preventive Medicine and Public Health, National University of San Marcos, Lima, Peru
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Prasad GVR, Sahay M, Kit-Chung Ng J. The Role of Registries in Kidney Transplantation Across International Boundaries. Semin Nephrol 2022; 42:151267. [PMID: 36577647 DOI: 10.1016/j.semnephrol.2022.07.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Transplant professionals strive to improve domestic kidney transplantation rates safely, cost efficiently, and ethically, but to increase rates further may wish to allow their recipients and donors to traverse international boundaries. Travel for transplantation presents significant challenges to the practice of transplantation medicine and donor medicine, but can be enhanced if sustainable international registries develop to include low- and low-middle income countries. Robust data collection and sharing across registries, linking pretransplant information to post-transplant information, linking donor to recipient information, increasing living donor transplant activity through paired exchange, and ongoing reporting of results to permit flexibility and adaptability to changing clinical environments, will all serve to enhance kidney transplantation across international boundaries.
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Affiliation(s)
- G V Ramesh Prasad
- Kidney Transplant Program, St. Michael Hospital, University of Toronto, Toronto, Ontario, Canada.
| | - Manisha Sahay
- Department of Nephrology, Osmania General Hospital, Osmania Medical College, Hyderabad, Telangana, India
| | - Jack Kit-Chung Ng
- Carol and Richard Yu Peritoneal Dialysis Research Center, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
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Bouraghi H, Rezayi S, Amirazodi S, Nabovati E, Saeedi S. Evaluating the usability of a national health information system with heuristic method. J Educ Health Promot 2022; 11:182. [PMID: 36003253 PMCID: PMC9393958 DOI: 10.4103/jehp.jehp_349_21] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 09/12/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND Hospital Statistics and Information System is one of the most important health information systems in Iran used in all hospitals in this country. Usability problems can reduce the speed and precision of users when interacting with this system. This study aimed to identify the usability problems of a national health system called "AVAB". MATERIALS AND METHODS This descriptive cross-sectional study was conducted in 2020, and three experts evaluated the usability of this system independently by the heuristic evaluation method. Nielsen's usability principles were used to identify usability problems and to classify their severity. RESULTS A total of 86 unique problems were identified. The highest number of problems were related to the two principles of "help and documentation" and "match between system and the real world" with 23 and 11 usability problems, respectively. The lowest number of problems were related to the two principles of "visibility of system status" and "help users recognize, diagnose, and recover from errors," each with three problems. 58.1% of the identified problems were in the group of major and catastrophic problems. CONCLUSIONS With the help of heuristic evaluation method, a significant number of usability problems of Hospital Statistics and Information System were identified. Most of the identified problems were major and catastrophic, and it is necessary to solve these problems by the designers and developers of this system.
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Affiliation(s)
- Hamid Bouraghi
- Department of Health Information Technology, School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sorayya Rezayi
- Health Information Management Department, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahrzad Amirazodi
- Department of Management and Health Information Technology, School of Management and Medical Information, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ehsan Nabovati
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Soheila Saeedi
- Health Information Management Department, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
- Clinical Research Development Unit of Farshchian Heart Center, Hamadan University of Medical Sciences, Hamadan, Iran
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Silva DAD, Veiga DABG, Cruz OG, Bastos LS, Gomes MFDC. Severe Acute Respiratory Infection Surveillance in Brazil: the Role of Public, Private, and Philanthropic Health Care Units. Health Policy Plan 2022; 37:1075-1085. [PMID: 35766892 PMCID: PMC9384390 DOI: 10.1093/heapol/czac050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/21/2022] [Accepted: 06/28/2022] [Indexed: 12/03/2022] Open
Abstract
Epidemiological surveillance and notification of respiratory infections are important for management and control of epidemics and pandemics. Fact-based decisions, like social distancing policies and preparation of hospital beds, are taken based on several factors, including case numbers; hence, health authorities need quick access to reliable and well-analysed data. We aimed to analyse the role of the Brazilian public health system in the notification and hospitalization of patients with severe acute respiratory infection (SARI). Data of SARI cases in Brazil (2013–20) were obtained from SIVEP-Gripe platform, and legal status of each healthcare unit (HCU) responsible for case notification and hospitalization was obtained from the National Registry of Health Facilities (CNES) database. HCUs that are part of the hospital network were classified as ‘Public Administration’, ‘Business Entities’, ‘Philanthropic Entities’ or ‘Individuals’. SARI notification data from Brazilian macro-regions (North, Northeast, Midwest, Southeast and South) were analysed and compared between administrative spheres. This study reveals that hospitalizations due to SARI increased significantly in Brazil during the coronavirus disease 2019 (COVID-19) pandemic, especially in HCUs of Public Administration. In the Southeast and South, where incidence of SARI is high, philanthropic HCUs also contribute to hospitalization of SARI cases and attend up to 7.4% of the cases notified by the Public Administration. The number of cases is usually lower in other regions, but in 2020 the Northeast showed more hospitalizations than the South. In the South, SARI season occurs later; however, in 2020, an early peak was observed because of COVID-19. Notably, the contribution of each administrative sphere that manages hospital networks in Brazil in the control and management of SARI varies between regions. Our approach will allow managers to assess the use of public resources, given that there are different profiles of healthcare in each region of Brazil and that the public health system has a major role in notifying and attending SARI cases.
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Affiliation(s)
- da Amauri Duarte Silva
- Programa de Pós-Graduação em Tecnologias da Informação e Gestão em Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA). Rua Sarmento Leite, 245 - Porto Alegre, RS - 90050-170, Brazil
| | - da Ana Beatriz Gorini Veiga
- Programa de Pós-Graduação em Tecnologias da Informação e Gestão em Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA). Rua Sarmento Leite, 245. Porto Alegre, RS - 90050-170, Brazil
| | - Oswaldo Gonçalves Cruz
- Fiocruz, Programa de Computação Científica, Grupo de Métodos Analíticos em Vigilância Epidemiológica (MAVE). Av Brasil, 4365. Rio de Janeiro, RJ - 21040-900, Brazil
| | - Leonardo Soares Bastos
- Fiocruz, Programa de Computação Científica, Grupo de Métodos Analíticos em Vigilância Epidemiológica (MAVE). Av Brasil, 4365. Rio de Janeiro, RJ - 21040-900, Brazil
| | - Marcelo Ferreira da Costa Gomes
- Fiocruz, Programa de Computação Científica, Grupo de Métodos Analíticos em Vigilância Epidemiológica (MAVE). Av Brasil, 4365. Rio de Janeiro, RJ - 21040-900, Brazil
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Lee K, Seo L, Yoon D, Yang K, Yi JE, Kim Y, Lee JH. Digital Health Profile of South Korea: A Cross Sectional Study. Int J Environ Res Public Health 2022; 19:6329. [PMID: 35627866 PMCID: PMC9140860 DOI: 10.3390/ijerph19106329] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/17/2022] [Accepted: 05/20/2022] [Indexed: 11/16/2022]
Abstract
(1) Backgroud: For future national digital healthcare policy development, it is vital to collect baseline data on the infrastructure and services of medical institutions' information and communication technology (ICT). To assess the state of medical ICT across the nation, we devised and administered a comprehensive digital healthcare survey to medical institutions across the nation. (2) Methods: From 16 November through 11 December 2020, this study targeted 42 tertiary hospitals, 311 general hospitals, and 1431 hospital locations countrywide. (3) Results: Since 2015, most hospitals have implemented electronic medical record (EMR) systems (90.5 percent of hospitals, which is the smallest unit, and 100 percent of tertiary hospitals). The rate of implementation of personal health records (PHRs) varied significantly between 61.9 percent and 2.4 percent, depending on the size of the hospital. Hospitals have implemented around three to seven government-sponsored information/data transmission and receiving systems for statistical or investigative objectives. For secondary usage of medical data, more than half of tertiary hospitals have implemented a clinical data warehouse or shared data model. However, new service establishments utilizing modern medical technologies such as artificial intelligence or lifelogging were scarce and in the planning stages. (4) Conclusion: This study shows that the level of digitalization in Korean medical institutions is significant, despite the fact that the development and spending in ICT infrastructure and services provided by individual institutions imposes a significant cost. This illustrates that, in the face of a pandemic, strong government backing and policymaking are essential to activate ICT-based medical services and efficiently use medical data.
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Affiliation(s)
- Kyehwa Lee
- Department of Information Medicine, Asan Medical Center, Seoul 05505, Korea; (K.L.); (L.S.)
| | - Libga Seo
- Department of Information Medicine, Asan Medical Center, Seoul 05505, Korea; (K.L.); (L.S.)
| | - Dukyong Yoon
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Yongin-si 16995, Korea;
| | - Kwangmo Yang
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
| | - Jae-Eun Yi
- Korea Health Information Service, Seoul 04515, Korea; (J.-E.Y.); (Y.K.)
| | - Yoomi Kim
- Korea Health Information Service, Seoul 04515, Korea; (J.-E.Y.); (Y.K.)
| | - Jae-Ho Lee
- Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
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Zuske M, Auer C, Oliver S, Eyers J, Bosch‐Capblanch X. Framework synthesis to inform the ideation and design of a paper-based health information system (PHISICC). Int J Health Plann Manage 2022; 37:1953-1972. [PMID: 35460301 PMCID: PMC9544999 DOI: 10.1002/hpm.3487] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 04/04/2022] [Accepted: 04/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background Health information systems (HIS) are meant to support decision‐making at all levels of the system, including frontline health workers. In field studies in Côte d’Ivoire, Mozambique and Nigeria, we observed health workers' interactions with the HIS and identified twelve decision‐making components of HIS. The objective of this framework synthesis is to portray these components in HIS research, in order to inform the ideation of a paper‐based HIS intervention (PHISICC). Methods We searched studies in the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, Epistemonikos, Medline, in‐Process on the Ovid platform, OpenGrey, PDQ Evidence (“pretty darnd quick” Evidence), the World Health Organization (WHO) Global Health Library and included studies focussing on HIS interventions, data quality, information support tools and data use for decision‐making in the context of the governmental health care sector. We assessed the methodological quality of studies using the Critical Appraisal Skills Programme tool. We synthesised the findings based on the decision‐making components of HIS and thematic areas. Results The search identified 6784 studies; 50 were included. Most of the 50 studies had quality concerns. All studies included at least one of the decision‐making components: the most prominent were the technical aspects of ‘recording’ and ‘reporting’. Data use for decision‐making was much less represented. Conclusion HIS research focuses on the more technical aspects of HIS. Further research on HIS, given the strong push towards HIS digitalisation, should consider putting at the centre the human experience of decision‐making and data use, in order to make HIS relevant for quality of care. Across the health system, Health Information Systems (HIS) are meant to support data management and use, which are key activities of health care delivery. Informed by existing frameworks and by fieldwork in three African countries, we identified twelve decision‐making components of HIS. In this framework synthesis, we found that the most common decision‐making components in the HIS literature were those related to the technical aspects of data ‘recording’ and ‘reporting’; data use for decision‐making was much less represented. For HIS instruments to facilitate improved health care delivery, clinical and public health decision‐making components of HIS should be put at the centre for HIS research, ideation and implementation.
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Affiliation(s)
- Meike‐Kathrin Zuske
- Swiss Tropical and Public Health InstituteAllschwilSwitzerland
- University of BaselBaselSwitzerland
| | - Christian Auer
- Swiss Tropical and Public Health InstituteAllschwilSwitzerland
- University of BaselBaselSwitzerland
| | - Sandy Oliver
- University College LondonEPPI‐CentreSocial Research InstituteLondonUK
- University of JohannesburgAfrica Centre for EvidenceFaculty of HumanitiesJohannesburgSouth Africa
| | - John Eyers
- Independent Consultant & Senior Research Fellow, 3ie, c/o LIDCLondonUK
| | - Xavier Bosch‐Capblanch
- Swiss Tropical and Public Health InstituteAllschwilSwitzerland
- University of BaselBaselSwitzerland
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Chanyalew MA, Yitayal M, Atnafu A, Mengiste SA, Tilahun B. The Effectiveness of the Capacity Building and Mentorship Program in Improving Evidence-Based Decision-making in the Amhara Region, Northwest Ethiopia: Difference-in-Differences Study. JMIR Med Inform 2022; 10:e30518. [PMID: 35451990 PMCID: PMC9077516 DOI: 10.2196/30518] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 02/13/2022] [Accepted: 02/25/2022] [Indexed: 11/15/2022] Open
Abstract
Background Weak health information systems (HISs) hobble countries’ abilities to effectively manage and distribute their resources to match the burden of disease. The Capacity Building and Mentorship Program (CBMP) was implemented in select districts of the Amhara region of Ethiopia to improve HIS performance; however, evidence about the effectiveness of the intervention was meager. Objective This study aimed to determine the effectiveness of routine health information use for evidence-based decision-making among health facility and department heads in the Amhara region, Northwest Ethiopia. Methods The study was conducted in 10 districts of the Amhara region: five were in the intervention group and five were in the comparison group. We employed a quasi-experimental study design in the form of a pretest-posttest comparison group. Data were collected from June to July 2020 from the heads of departments and facilities in 36 intervention and 43 comparison facilities. The sample size was calculated using the double population formula, and we recruited 172 participants from each group. We applied a difference-in-differences analysis approach to determine the effectiveness of the intervention. Heterogeneity of program effect among subgroups was assessed using a triple differences method (ie, difference-in-difference-in-differences [DIDID] method). Thus, the β coefficients, 95% CIs, and P values were calculated for each parameter, and we determined that the program was effective if the interaction term was significant at P<.05. Results Data were collected using the endpoint survey from 155 out of 172 (90.1%) participants in the intervention group and 166 out of 172 (96.5%) participants in the comparison group. The average level of information use for the comparison group was 37.3% (95% CI 31.1%-43.6%) at baseline and 43.7% (95% CI 37.9%-49.5%) at study endpoint. The average level of information use for the intervention group was 52.2% (95% CI 46.2%-58.3%) at baseline and 75.8% (95% CI 71.6%-80.0%) at study endpoint. The study indicated that the net program change over time was 17% (95% CI 5%-28%; P=.003). The subgroup analysis also indicated that location showed significant program effect heterogeneity, with a DIDID estimate equal to 0.16 (95% CI 0.026-0.29; P=.02). However, sex, age, educational level, salary, and experience did not show significant heterogeneity in program effect, with DIDID estimates of 0.046 (95% CI –0.089 to 0.182), –0.002 (95% CI –0.015 to 0.009), –0.055 (95% CI –0.190 to 0.079), –1.63 (95% CI –5.22 to 1.95), and –0.006 (95% CI –0.017 to 0.005), respectively. Conclusions The CBMP was effective at enhancing the capacity of study participants in using the routine HIS for decision-making. We noted that urban facilities had benefited more than their counterparts. The intervention has been shown to produce positive outcomes and should be scaled up to be used in other districts. Moreover, the mentorship modalities for rural facilities should be redesigned to maximize the benefits. Trial Registration Pan African Clinical Trials Registry PACTR202001559723931; https://tinyurl.com/3j7e5ka5
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Affiliation(s)
- Moges Asressie Chanyalew
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mezgebu Yitayal
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Asmamaw Atnafu
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Shegaw Anagaw Mengiste
- Management Information Systems, School of Business, University of South-Eastern Norway, Notodden, Norway
| | - Binyam Tilahun
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Tilahun B, Endehabtu BF, Gashu KD, Mekonnen ZA, Animut N, Belay H, Denboba W, Alemu H, Mohammed M, Abate B. Current and Future Needs for Human Resources for Ethiopia's National Health Information System: Survey and Forecasting Study. JMIR Med Educ 2022; 8:e28965. [PMID: 35412469 PMCID: PMC9044145 DOI: 10.2196/28965] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 08/17/2021] [Accepted: 01/16/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Strengthening the national health information system is one of Ethiopia's priority transformation agendas. A well-trained and competent workforce is the essential ingredient to a strong health information system. However, this workforce has neither been quantified nor characterized well, and there is no roadmap of required human resources to enhance the national health information system. OBJECTIVE We aimed to determine the current state of the health information system workforce and to forecast the human resources needed for the health information system by 2030. METHODS We conducted a survey to estimate the current number of individuals employed in the health information system unit and the turnover rate. Document review and key-informant interviews were used to collect current human resources and available health information system position data from 110 institutions, including the Ministry of Health, federal agencies, regional health bureaus, zonal health departments, district health offices, and health facilities. The Delphi technique was used to forecast human resources required for the health information system in the next ten years: 3 rounds of workshops with experts from the Ministry of Health, universities, agencies, and regional health bureaus were held. In the first expert meeting, we set criteria, which was followed by expert suggestions and feedback. RESULTS As of April 2020, there were 10,344 health information system professionals working in the governmental health system. Nearly 95% (20/21) of district health offices and 86.7% (26/30) of health centers reported that the current number of health information system positions was inadequate. In the period from June 2015 to June 2019, health information technicians had high turnover (48/244, 19.7%) at all levels of the health system. In the next ten years, we estimate that 50,656 health information system professionals will be needed to effectively implement the Ethiopia's national health information system. CONCLUSIONS Current health information system-related staffing levels were found to be inadequate. To meet the estimated need of 50,656 multidisciplinary health information system professionals by 2030, the Ministry of Health and regional health bureaus, in collaboration with partners and academic institutions, need to work on retaining existing and training additional health information system professionals.
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Affiliation(s)
- Binyam Tilahun
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Berhanu F Endehabtu
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassahun D Gashu
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zeleke A Mekonnen
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Health Systems Directorate, Ministry of Health, Addis Ababa, Ethiopia
| | - Netsanet Animut
- Data Use Partnership Project, John Snow, Inc (JSI), Addis Ababa, Ethiopia
| | - Hiwot Belay
- Data Use Partnership Project, John Snow, Inc (JSI), Addis Ababa, Ethiopia
| | - Wubshet Denboba
- Data Use Partnership Project, John Snow, Inc (JSI), Addis Ababa, Ethiopia
| | - Hibret Alemu
- Data Use Partnership Project, John Snow, Inc (JSI), Addis Ababa, Ethiopia
| | - Mesoud Mohammed
- Policy, Planning, Monitoring and Evaluation Directorate, Ministry of Health, Addis Ababa, Ethiopia
| | - Biruk Abate
- Policy, Planning, Monitoring and Evaluation Directorate, Ministry of Health, Addis Ababa, Ethiopia
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Gäbler G, Lycett D, Gall W. Integrating a New Dietetic Care Process in a Health Information System: A System and Process Analysis and Assessment. Int J Environ Res Public Health 2022; 19:2491. [PMID: 35270184 DOI: 10.3390/ijerph19052491] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 12/04/2022]
Abstract
Managing routinely collected data in health care and public health is important for evaluation of interventions and answering research questions using “real life” and ”big data”. In addition to the technical requirements of information systems, both standardized terminology and standardized processes are needed. The aim of this project was to analyse and assess the integration of standardized terminology and document templates for a dietetic care process (DCP) into the health information system (HIS) in a hospital in Austria. Using an action research approach, the DCP was analysed through four expert interviews and the integration into the HIS through two expert interviews with observations. Key strengths and weaknesses for the main criteria (“integration of the ICF catalogue”, “adaption of the document templates”, “adaption of the DCP”, and the “adaption of the user authorizations”) were presented and proposals for improvement given. The system and process integration of the DCP is possible, and the document templates can be adapted with the software currently in use. Although an increase in resources and finances required is to be expected initially, the integration of a standardized dietetic terminology in combination with a standardized process is likely to improve the quality of care and support outcomes management and research.
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Baird A, Cheng Y, Xia Y. Telehealth Adoption and Discontinuation by US Hospitals: Results From 2 Quasi-Natural Experiments. JMIR Form Res 2022; 6:e28979. [PMID: 35179503 PMCID: PMC8900896 DOI: 10.2196/28979] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 08/10/2021] [Accepted: 01/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background Prior US hospital telehealth (video visit) studies have focused on describing factors that influence telehealth adoption or performance effects for specific patient segments, hospital systems, or geographic regions. To our knowledge, a larger-scale, national-level (US) study has yet to be conducted on the causal impacts of hospital telehealth adoption as well as discontinuation. Objective The aim of this study is to understand the causal impact of US hospital telehealth adoption or discontinuation on hospital performance from 2016 to 2018. Methods We analyzed impacts of telehealth adoption or discontinuation by US hospitals on emergency department visits, total ambulatory visits (minus emergency department visits), outpatient services revenue, total facility expenses, and total hospital revenue for the 2016-2018 period. We specifically focused on performance effects for hospitals that switched from not having telehealth to adopting telehealth, or vice versa, during the 2016-2018 period, thus exploiting 2 quasi-natural experiments. We applied a difference-in-differences research design to each of the 2 main analyses. We compared hospitals that have made a telehealth change to groups of hospitals with similar characteristics that did not make a telehealth change, which established a counterfactual. To appropriately match hospitals between treatment and control groups, we applied propensity score matching. Our primary data were from the American Hospital Association Annual Survey and the Healthcare Cost Report Information System data. Several control variables were obtained from additional sources, including the Area Health Resource File and the Federal Communications Commission. Results We found that telehealth adoption by US hospitals during the 2016-2018 period resulted in, on average, an increased number of total ambulatory visits (P=.008), increased total facility expenses (P<.001), and increased hospital revenue (P=.004) compared with the control group. We found that telehealth discontinuation during the same period resulted in, on average, decreased outpatient services revenue (P=.02) compared with the control group. Conclusions Our findings suggest that telehealth adoption increases use but has mixed impacts on performance, given that cost and revenue increase. However, once telehealth is offered, removing it can have a negative impact on performance, implying that returning to prior performance levels, if telehealth is removed, may be challenging.
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Affiliation(s)
- Aaron Baird
- Institute of Health Administration, Georgia State University, Atlanta, GA, United States.,Department of Computer Information Systems, Robinson College of Business, Georgia State University, Atlanta, GA, United States
| | - Yichen Cheng
- Institute for Insight, Robinson College of Business, Georgia State University, Atlanta, GA, United States
| | - Yusen Xia
- Institute for Insight, Robinson College of Business, Georgia State University, Atlanta, GA, United States
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Teixeira RA, Vasconcelos AMN, Torens A, França EB, Ishitani L, Bierrenbach AL, de Abreu DMX, Marinho F. Excess Mortality due to natural causes among whites and blacks during the COVID-19 pandemic in Brazil. Rev Soc Bras Med Trop 2022; 55:e0283. [PMID: 35107533 PMCID: PMC9009425 DOI: 10.1590/0037-8682-0283-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/09/2021] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Excess Mortality by all causes considers deaths directly related to COVID-19 and those attributed to conditions caused by the pandemic. When stratified by social dimensions, such as race/color, it allows for the evaluation of more vulnerable populations. The study estimated the excess mortality by natural causes, separating the white and black populations in 2020. METHODS Public civil registration data on deaths observed in 2020, corrected for under registration, were used. The expected number of deaths was estimated based on the mortality rates observed in 2019, applied to the estimated population in 2020. The difference between the values expected and observed and the proportion of excess was considered the excess mortality. RESULTS The present study found an excess of 270,321 deaths (22.2% above the expected) in 2020. Every state of Brazil reported deaths above the corresponding expected figure. The excess was higher for men (25.2%) than for women (19.0%). Blacks showed an excess of 27.8%, as compared to whites at 17.6%. In both sexes and all age groups, excess was higher in the black population, especially in the South, Southeast, and Midwest regions. São Paulo, the largest in population number, had twice as much excess death in the black population (25.1%) than in the white population (11.5%). CONCLUSIONS The present study showed racial disparities in excess mortality during the COVID-19 pandemic in Brazil. The higher excess found for the black suggests an intrinsic relationship with the socioeconomic situation, further exposing the Brazilian reality, in which social and structural inequality is evident.
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Affiliation(s)
- Renato Azeredo Teixeira
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Saúde Pública, Belo Horizonte, MG, Brasil
- Vital Strategies, New York, United States of America
| | | | - Ana Torens
- Vital Strategies, New York, United States of America
| | - Elisabeth Barboza França
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Saúde Pública, Belo Horizonte, MG, Brasil
| | - Lenice Ishitani
- Universidade Federal de Minas Gerais, Grupo de Pesquisas em Epidemiologia e Avaliação em Saúde, Belo Horizonte, MG, Brasil
| | | | - Daisy Maria Xavier de Abreu
- Universidade Federal de Minas Gerais, Grupo de Pesquisas em Epidemiologia e Avaliação em Saúde, Belo Horizonte, MG, Brasil
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Kshenin A, Kovalchuk S. Data-Driven Modeling of Complex Business Process in Heterogeneous Environment of Healthcare Organization with Health Information Systems. Stud Health Technol Inform 2021; 285:118-23. [PMID: 34734861 DOI: 10.3233/SHTI210583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
Abstract
Business process modeling aims to construct digital representations of processes being executed in the company. However, models derived from the event logs of their execution tend to overcomplicate the desired representation, making them difficult to apply. The most accurate recovery of the business process model requires a comprehensive study of the various artifacts stored in the company's information system. This paper, however, aims to explore the possibility to automatically obtain the most accurate model of business process, using mutual optimization of models recovered from a set of event logs. Further, the obtained models are executed in multi-agent simulation model of company, and the resulting event logs are examined to determine patterns that are specific to distinct employees and those that generally characterize business process.
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Negro-Calduch E, Azzopardi-Muscat N, Nitzan D, Pebody R, Jorgensen P, Novillo-Ortiz D. Health Information Systems in the COVID-19 Pandemic: A Short Survey of Experiences and Lessons Learned From the European Region. Front Public Health 2021; 9:676838. [PMID: 34650946 PMCID: PMC8505771 DOI: 10.3389/fpubh.2021.676838] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 09/02/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The COVID-19 crisis provides an opportunity to reflect on what worked during the pandemic, what could have been done differently, and what innovations should become part of an enhanced health information system in the future. Methods: An online qualitative survey was designed and administered online in November 2020 to all the 37 Member States that are part of the WHO European Health Information Initiative and the WHO Central Asian Republics Information Network. Results: Nineteen countries responded to the survey (Austria, Belgium, Croatia, Czech Republic, Finland, Greece, Iceland, Ireland, Israel, Italy, Kazakhstan, Latvia, Lithuania, Romania, Russian Federation, Sweden, Turkey, United Kingdom, and Uzbekistan). The COVID-19 pandemic required health information systems (HIS) to rapidly adapt to identify, collect, store, manage, and transmit accurate and timely COVID-19 related data. HIS stakeholders have been put to the test, and valuable experience has been gained. Despite critical gaps such as under-resourced public health services, obsolete health information technologies, and lack of interoperability, most countries believed that their information systems had worked reasonably well in addressing the needs arising during the COVID-19 pandemic. Conclusion: Strong enabling environments and advanced and digitized health information systems are vital to controlling epidemics. Sustainable finance and government support are required for the continued implementation and enhancement of HIS. It is important to promote digital solutions beyond the COVID-19 pandemic. Now is the time to discuss potential solutions to obtain timely, accurate, and reliable health information and steer policy-making while protecting privacy rights and meeting the highest ethical standards.
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Affiliation(s)
- Elsa Negro-Calduch
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | | | - Dorit Nitzan
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Richard Pebody
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Pernille Jorgensen
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
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Llop-Gironés A, Santillan-Garcia A, Cash-Gibson L, Benach J, Zabalegui A. COVID-19 and the global need for knowledge on nurses' health. Int Nurs Rev 2021; 69:196-200. [PMID: 34614229 PMCID: PMC8652808 DOI: 10.1111/inr.12722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 09/07/2021] [Indexed: 11/29/2022]
Abstract
Aim To emphasize that nurses need to be fully protected to carry out their vital role, particularly during pandemics, yet the lack of a standardized and systematic collection of high‐quality disaggregated data on nurses health inhibits our ability to assess this within and across countries. Background Nurses are the largest workforce group in the health sector, yet only 59 countries worldwide report on nurse COVID‐19 infections and related deaths, and the standardized, systematic collection of disaggregated health data is not yet in place. Sources of evidence Medline, International Council of Nurses, World Health Organization, Centers of Disease Control and Prevention and the experiences of the authors. Discussion Inconsistent recording and definitions of nurses, precarious and informal employment conditions, limited transparent and reliable data, lack of mass testing and long‐standing structural issues and biases have affected nursing for too long. Conclusions These issues are reflected in the limited capacity of many national public health information systems to collect, monitor and report on the health of the largest group of health workers. Political will, accountability and public data transparency at different levels are essential to adequately protect nurses at work. Implications for nursing practice, and nursing and health policy Building on current momentum in the nursing field, immediate political action is required to strengthen existing nursing and midwifery policies, standards and regulatory capacity, as well as existing public health services and information and surveillance systems. The generation of up‐to‐date, context‐specific knowledge is needed to inform and monitor political decisions related to the protection of nurses, and the improvement of their employment conditions, as well as to strengthen accountability for these areas at various levels.
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Affiliation(s)
- Alba Llop-Gironés
- Research Group on Health Inequalities, Environment, and Employment Conditions (GREDS-EMCONET), Department of Political and Social Sciences, Universitat Pompeu Fabra, Barcelona, Spain.,The Johns Hopkins-UPF Public Policy Center (JHU-UPF PPC, Barcelona, Spain
| | | | - Lucinda Cash-Gibson
- Research Group on Health Inequalities, Environment, and Employment Conditions (GREDS-EMCONET), Department of Political and Social Sciences, Universitat Pompeu Fabra, Barcelona, Spain.,The Johns Hopkins-UPF Public Policy Center (JHU-UPF PPC), Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Joan Benach
- Research Group on Health Inequalities, Environment and Employment Conditions, Political Science Department, Pompeu Fabra University, Barcelona, Spain.,Johns Hopkins University-Pompeu Fabra University Public Policy Center, Barcelona, Spain.,Transdisciplinary Research Group on Socioecological Transitions (GinTrans2), Universidad Autónoma de Madrid, Spain
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Kremer L, Lipprandt M, Röhrig R, Breil B. Examining the Mental Workload Associated With Digital Health Technologies in Health Care: Protocol for a Systematic Review Focusing on Assessment Methods. JMIR Res Protoc 2021; 10:e29126. [PMID: 34342590 PMCID: PMC8371485 DOI: 10.2196/29126] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/23/2021] [Accepted: 06/14/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The workload in health care is high; physicians and nurses report high stress levels due to a demanding environment where they often have to perform multiple tasks simultaneously. As a result, mental health issues among health care professionals (HCPs) are on the rise and the prevalence of errors in their daily tasks could increase. Processes of demographic change are partly responsible for even higher stress levels among HCPs. The digitization of patient care is intended to counteract these processes. However, it remains unclear whether these health information systems (HIS) and digital health technologies (DHT) support the HCPs and relieve stress, or if they represent a further burden. The mental construct that describes this burden of technologies is mental workload (MWL). Work in the clinic can be viewed as working in safety-critical environments. Particularly in this sensitive setting, the measurement methods of MWL are relevant, mainly due to their strongly differing levels of intrusiveness and sensitivity. The method of eye tracking could be a useful way to measure MWL directly in the field. OBJECTIVE The systematic review aims to address the following questions: (1) In which manner do DHT contribute to the overall MWL of HCPs? (2) Can we observe a direct or indirect effect of DHT on MWL? (3) Which aspects or factors of DHT contribute to an increase in MWL? (4) Which methods/assessments are applied to measure MWL related to HIS/DHT? (5) What role does eye tracking/pupillometry play in the context of measuring MWL? (6) Which outcomes are being assessed via eye tracking? METHODS Following the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) statement, we will conduct a systematic review. Based on the research questions, we define keywords that we then combine in search terms. The review follows the following steps: literature search, article selection, data extraction, risk of bias assessment, data analysis, and data synthesis. RESULTS We expect results as well as a finalization of the review in the summer of 2021. CONCLUSIONS This review will evaluate the impact of DHT on the MWL of HCPs. In addition, assessment methods of MWL in the context of digital technologies will be systematically analyzed. TRIAL REGISTRATION PROSPERO (International Prospective Register of Systematic Reviews) CRD42021233271; https://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42021233271. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/29126.
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Affiliation(s)
- Lisanne Kremer
- Faculty of Health Care, Niederrhein University of Applied Sciences, Krefeld, Germany
| | - Myriam Lipprandt
- Institute of Medical Informatics, RWTH Aachen University, Aachen, Germany
| | - Rainer Röhrig
- Institute of Medical Informatics, RWTH Aachen University, Aachen, Germany
| | - Bernhard Breil
- Faculty of Health Care, Niederrhein University of Applied Sciences, Krefeld, Germany
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Pesec M, Spigel L, Granados JMM, Bitton A, Hirschhorn LR, Brizuela JAJ, Pignone M, Sáenz MDR, Schwarz D, Villegas Del Carpio O, Wilson IB, Zamora Méndez E, Ratcliffe HL. Strengthening data collection and use for quality improvement in primary care: the case of Costa Rica. Health Policy Plan 2021; 36:740-753. [PMID: 33848340 PMCID: PMC8173660 DOI: 10.1093/heapol/czab043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 01/23/2021] [Accepted: 03/22/2021] [Indexed: 12/24/2022] Open
Abstract
Costa Rica is a bright spot of primary healthcare (PHC) performance, providing first-contact accessibility and continuous, comprehensive, coordinated, and patient-centered care to its citizens. Previous research hypothesized that strong data collection and use for quality improvement are central to Costa Rica's success. Using qualitative data from 40 interviews with stakeholders across the Costa Rican healthcare system, this paper maps the various data streams at the PHC level and delineates how these data are used to make decisions around insuring and improving the quality of PHC delivery. We describe four main types of PHC data: individual patient data, population health data, national healthcare delivery data, and local supplementary healthcare delivery data. In particular, we find that the Healthcare Delivery Performance Index-a ranking of the nation's 106 Health Areas using 15 quality indicators-is utilized by Health Area Directors to create quality improvement initiatives, ranging from education and coaching to optimization of care delivery and coordination. By ranking Health Areas, the Index harnesses providers' intrinsic motivation to stimulate improvement without financial incentives. We detail how a strong culture of valuing data as a tool for improving population health and robust training for personnel have enabled effective data collection and use. However, we also find that the country's complex data systems create unnecessary duplication and can inhibit efficient data use. Costa Rica's experience with data collection, analysis, and use for quality improvement hold important lessons for PHC in other public sector systems.
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Affiliation(s)
- Madeline Pesec
- Ariadne Labs, Brigham and Women's Hospital & Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, MA 02215, USA.,Division of General Medicine, Department of Internal Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
| | - Lauren Spigel
- Ariadne Labs, Brigham and Women's Hospital & Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, MA 02215, USA
| | - José María Molina Granados
- Department of Quality Assurance, Costa Rican Social Security Administration, Second Avenue between 5th and 7th Street, San José, 10105, Costa Rica
| | - Asaf Bitton
- Ariadne Labs, Brigham and Women's Hospital & Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, MA 02215, USA.,Division of General Medicine, Department of Internal Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.,Center for Primary Care, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Lisa R Hirschhorn
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 420 E Superior Street, Chicago, IL 60611, USA
| | | | - Michael Pignone
- Department of Internal Medicine, Dell Medical School University of Texas, 1501 Red River Street, Austin, TX 78712, USA
| | - María Del Rocío Sáenz
- School of Public Health, University of Costa Rica, Calle la Cruz 26, San José, Mercedes, Costa Rica
| | - Dan Schwarz
- Ariadne Labs, Brigham and Women's Hospital & Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, MA 02215, USA.,Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.,Department of Medicine, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Oscar Villegas Del Carpio
- Health Service Delivery Strengthening Department, Costa Rican Social Security Administration, Second Avenue between 5th and 7th Street, San José, 10105, Costa Rica
| | - Ira B Wilson
- Department of Health Services, Policy & Practice, Brown University School of Public Health, 121 South Main Street, Providence, RI 02903, USA
| | - Eduardo Zamora Méndez
- Costa Rican Social Security Administration, Second Avenue between 5th and 7th Street, San José, 10105, Costa Rica
| | - Hannah L Ratcliffe
- Ariadne Labs, Brigham and Women's Hospital & Harvard T.H. Chan School of Public Health, 401 Park Drive, Boston, MA 02215, USA
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Jones J, Gottlieb D, Mandel JC, Ignatov V, Ellis A, Kubick W, Mandl KD. A landscape survey of planned SMART/HL7 bulk FHIR data access API implementations and tools. J Am Med Inform Assoc 2021; 28:1284-1287. [PMID: 33675659 DOI: 10.1093/jamia/ocab028] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 02/03/2021] [Indexed: 11/13/2022] Open
Abstract
The Office of National Coordinator for Health Information Technology final rule implementing the interoperability and information blocking provisions of the 21st Century Cures Act requires support for two SMART (Substitutable Medical Applications, Reusable Technologies) application programming interfaces (APIs) and instantiates Health Level Seven International (HL7) Fast Healthcare Interoperability Resources (FHIR) as a lingua franca for health data. We sought to assess the current state and near-term plans for the SMART/HL7 Bulk FHIR Access API implementation across organizations including electronic health record vendors, cloud vendors, public health contractors, research institutions, payors, FHIR tooling developers, and other purveyors of health information technology platforms. We learned that many organizations not required through regulation to use standardized bulk data are rapidly implementing the API for a wide array of use cases. This may portend an unprecedented level of standardized population-level health data exchange that will support an apps and analytics ecosystem. Feedback from early adopters on the API's limitations and unsolved problems in the space of population health are highlighted.
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Affiliation(s)
- James Jones
- Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Daniel Gottlieb
- Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Joshua C Mandel
- Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA
| | - Vladimir Ignatov
- Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Alyssa Ellis
- Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Wayne Kubick
- Health Level Seven International, Ann Arbor, Michigan, USA
| | - Kenneth D Mandl
- Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.,Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA
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41
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Scheplitz T. Pathway-Supporting Health Information Systems: A Review. Stud Health Technol Inform 2021; 279:87-94. [PMID: 33965923 DOI: 10.3233/shti210093] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Care pathways and supporting health information systems (HIS) have been permeate the discipline of Health Information Systems Research (HISR) over years. Traditional objectives of workflow assistance are increasingly extended by interdisciplinary goals from technology, medicine, management and public health research. A systematic literature review is dedicated to this integrating character. It examines the interdisciplinary mesh of objectives associated with care pathways and pathway-supporting HIS in the HISR literature. From 47 identified articles, 6 thematic themes were derived. Their consolidation supports in particular design and development processes as it describes the solution space of future pathway-supporting HIS addressing requirements stated by multiple stakeholders.
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Wu CL, Kuo CT, Shih SJ, Chen JC, Lo YC, Yu HH, Huang MD, Sheu WHH, Liu SA. Implementation of an Electronic National Early Warning System to Decrease Clinical Deterioration in Hospitalized Patients at a Tertiary Medical Center. Int J Environ Res Public Health 2021; 18:ijerph18094550. [PMID: 33922991 PMCID: PMC8123282 DOI: 10.3390/ijerph18094550] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 12/23/2022]
Abstract
The National Early Warning Score (NEWS) is an early warning system that predicts clinical deterioration. The impact of the NEWS on the outcome of healthcare remains controversial. This study was conducted to evaluate the effectiveness of implementing an electronic version of the NEWS (E-NEWS), to reduce unexpected clinical deterioration. We developed the E-NEWS as a part of the Health Information System (HIS) and Nurse Information System (NIS). All adult patients admitted to general wards were enrolled into the current study. The “adverse event” (AE) group consisted of patients who received cardiopulmonary resuscitation (CPR), were transferred to an intensive care unit (ICU) due to unexpected deterioration, or died. Patients without AE were allocated to the control group. The development of the E-NEWS was separated into a baseline (October 2018 to February 2019), implementation (March to August 2019), and intensive period (September. to December 2019). A total of 39,161 patients with 73,674 hospitalization courses were collected. The percentage of overall AEs was 6.06%. Implementation of E-NEWS was associated with a significant decrease in the percentage of AEs from 6.06% to 5.51% (p = 0.001). CPRs at wards were significantly reduced (0.52% to 0.34%, p = 0.012). The number of patients transferred to the ICU also decreased significantly (3.63% to 3.49%, p = 0.035). Using multivariate analysis, the intensive period was associated with reducing AEs (p = 0.019). In conclusion, we constructed an E-NEWS system, updating the NEWS every hour automatically. Implementing the E-NEWS was associated with a reduction in AEs, especially CPRs at wards and transfers to ICU from ordinary wards.
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Affiliation(s)
- Chieh-Liang Wu
- Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
- Department of Automatic Control Engineering, Feng Chia University, Taichung 40724, Taiwan
- Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung 40705, Taiwan
| | - Chen-Tsung Kuo
- Computer & Communication Center, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
- Department of Biomedical Engineering, Hang-Kung University, Taichung 43302, Taiwan
| | - Sou-Jen Shih
- Department of Nursing, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (S.-J.S.); (H.-H.Y.)
| | - Jung-Chen Chen
- Center of Quality Management, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (J.-C.C.); (Y.-C.L.); (M.-D.H.)
| | - Ying-Chih Lo
- Center of Quality Management, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (J.-C.C.); (Y.-C.L.); (M.-D.H.)
| | - Hsiu-Hui Yu
- Department of Nursing, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (S.-J.S.); (H.-H.Y.)
| | - Ming-De Huang
- Center of Quality Management, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (J.-C.C.); (Y.-C.L.); (M.-D.H.)
| | - Wayne Huey-Herng Sheu
- Department of Top Hospital Administration, Taipei Veterans General Hospital, Taichung 11221, Taiwan;
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
- Institute of Medical Technology, College of Life Science, National Chung-Hsing University, Taichung 402204, Taiwan
- School of Medicine, National Defense Medical Center, Taipei 114, Taiwan
| | - Shih-An Liu
- Center of Quality Management, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (J.-C.C.); (Y.-C.L.); (M.-D.H.)
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
- Correspondence: ; Tel.: +886-4-2359-2525; Fax: +886-4-2359-4980
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Sayeed R, Jones J, Gottlieb D, Mandel JC, Mandl KD. A proposal for shoring up Federal Trade Commission protections for electronic health record-connected consumer apps under 21st Century Cures. J Am Med Inform Assoc 2021; 28:640-645. [PMID: 33306804 PMCID: PMC7936404 DOI: 10.1093/jamia/ocaa227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 08/28/2020] [Accepted: 09/09/2020] [Indexed: 12/03/2022] Open
Abstract
Under the 21st Century Cures Act and the Office of the National Coordinator for Health Information Technology (ONC) rule implementing its interoperability provisions, a patient’s rights to easily request and obtain digital access to portions of their medical records are now supported by both technology and policy. Data, once directed by a patient to leave a Health Insurance Portability and Accountability Act–covered health entity and enter a consumer app, will usually fall under Federal Trade Commission oversight. Because the statutory authority of the ONC does not extend to health data protection, there is not yet regulation to specifically address privacy protections for consumer apps. A technologically feasible workflow that could be widely adopted and permissible under ONC’s rule, involves using the SMART on FHIR OAuth authorization routine to present standardized information about app behavior. This approach would not bias the patient in a way that triggers penalties under information blocking provisions of the rule.
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Affiliation(s)
- Raheel Sayeed
- Computational Health Informatics Program, Boston Children's Hospital, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - James Jones
- Computational Health Informatics Program, Boston Children's Hospital, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Daniel Gottlieb
- Computational Health Informatics Program, Boston Children's Hospital, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.,Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA
| | - Joshua C Mandel
- Computational Health Informatics Program, Boston Children's Hospital, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.,Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA
| | - Kenneth D Mandl
- Computational Health Informatics Program, Boston Children's Hospital, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.,Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA
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Ye J. Health Information System's Responses to COVID-19 Pandemic in China: A National Cross-sectional Study. Appl Clin Inform 2021; 12:399-406. [PMID: 34010976 PMCID: PMC8133837 DOI: 10.1055/s-0041-1728770] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 03/08/2021] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE After the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, Chinese hospitals and health information technology (HIT) vendors collaborated to provide comprehensive information technology support for pandemic prevention and control. This study aims to describe the responses from the health information systems (HIS) to the COVID-19 pandemic and provide empirical evidence in the application of emerging health technologies in China. METHODS This observational descriptive study utilized a nationally representative, cross-sectional survey of hospitals in China (N = 1,014) from 30 provincial administrative regions across the country. Participants include hospital managers, hospital information workers, and health care providers. RESULTS Among all the responses, the most popular interventions and applications include expert question-and-answer sessions and science popularization (61.74%) in online medical consultation, online appointment registration (58.97%) in online medical service, and remote consultation (75.15%) in telehealth service. A total of 63.71% of the participating hospitals expanded their fever clinics during the pandemic, 15.38% hospitals used new or upgraded mobile ward rounds systems, and 44.68% hospitals applied online self-service systems. Challenges and barriers include protecting network information security (57.00%) since some hospitals experienced cybersecurity incidents. 71.79% participants hope to shorten wait time and optimize the treatment process. Health care workers experienced increased amount of work during the pandemic, while hospital information departments did not experience significant changes in their workload. CONCLUSION In the process of fighting against the COVID-19, hospitals have widely used traditional and emerging novel HITs. These technologies have strengthened the capacity of prevention and control of the pandemic and provided comprehensive information technology support while also improving accessibility and efficiency of health care delivery.
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Affiliation(s)
- Jiancheng Ye
- Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
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Jeyakumar T, McClure S, Lowe M, Hodges B, Fur K, Javier-Brozo M, Tassone M, Anderson M, Tripp T, Wiljer D. An Education Framework for Effective Implementation of a Health Information System: Scoping Review. J Med Internet Res 2021; 23:e24691. [PMID: 33625370 PMCID: PMC7946593 DOI: 10.2196/24691] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/05/2021] [Accepted: 01/16/2021] [Indexed: 11/28/2022] Open
Abstract
Background To optimize their use of a new Health Information System (HIS), supporting health care providers require effective HIS education. Failure to provide this education can significantly hinder an organization’s HIS implementation and sustainability efforts. Objective The aim of this review is to understand the most effective educational strategies and approaches to enable health care providers to optimally use an HIS. Methods Ovid MEDLINE, Ovid Embase, EBSCO Cumulative Index to Nursing and Allied Health Literature, and EBSCO Education Resources Information Center were searched to identify relevant papers. Relevant studies were systematically reviewed and analyzed using a qualitative thematic analysis approach. Results Of the 3539 studies screened, 17 were included for data extraction. The literature on the most effective approaches to enable health care providers to optimally use an HIS emphasized the importance of investing in engaging and understanding learners in the clinical context, maximizing the transfer of learning to care, and designing continuous and agile evaluation to meet the emerging demands of the clinical environment. Conclusions This review supports the advancement of a new HIS learning framework that organizational leaders and educators can use to guide HIS education design and development. Future research should examine how this framework can be translated into practice.
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Affiliation(s)
- Tharshini Jeyakumar
- University Health Network, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | | | - Mandy Lowe
- University Health Network, Toronto, ON, Canada.,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Brian Hodges
- University Health Network, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Wilson Centre, Toronto, ON, Canada
| | | | | | - Maria Tassone
- University Health Network, Toronto, ON, Canada.,Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Tim Tripp
- University Health Network, Toronto, ON, Canada
| | - David Wiljer
- University Health Network, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Office of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
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Cho J, Park YS, Park DJ, Kim S, Lee H, Kim M, Lee E, Lee HY, Lee E. Bridging Policy and Service Performance of Hospital-Based Nutrition Support by Healthcare Information Technology. Nutrients 2021; 13:595. [PMID: 33670196 DOI: 10.3390/nu13020595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/02/2021] [Accepted: 02/08/2021] [Indexed: 01/07/2023] Open
Abstract
Although the healthcare policy was implemented to incentivize the multidisciplinary services of hospital-based nutrition support team (NST) in South Korea, timely completion of the services has been challenging in the hospitals. We enhanced NST healthcare information technology (NST-HIT) to bridge the gap between policy implementation and seamless execution of the policy in the hospital system. A 48 month pre-test-post-test study was performed, including a 12 month pre-intervention period, a six month intervention period, and a 30 month post-intervention period. The enhanced NST-HIT provided sufficient patient data and streamlined communication processes among end-users. A Student's t-test showed that the timely completion rate of NST consultations, the reimbursement rate of NST consultations, average response times of NST physicians and nurses, and length of hospital stay significantly improved during the post-intervention period. A segmented regression analysis of interrupted time series showed that the average response times of NST physicians had sustained after the interventions. We believe that well-structured, multi-pronged initiatives with leadership support from the hospital improved service performance of hospital NST in response to national-level healthcare policy changes.
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47
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Lee AR, Kim IK, Lee E. Developing a Transnational Health Record Framework with Level-Specific Interoperability Guidelines Based on a Related Literature Review. Healthcare (Basel) 2021; 9:healthcare9010067. [PMID: 33450811 PMCID: PMC7828296 DOI: 10.3390/healthcare9010067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/08/2021] [Accepted: 01/08/2021] [Indexed: 01/08/2023] Open
Abstract
With the advent of digital healthcare without borders, enormous amounts of health information are captured and computerized. As healthcare quality largely depends on the reliability of given health information, personal health records should be accessible according to patients’ mobility, even as they travel or migrate to other countries. However, since all the health information is scattered in multiple places, it is an onerous task to carry it whenever people move to other countries. To effectively and efficiently utilize health information, interoperability, which is the ability of various healthcare information technologies to exchange, to interpret, and to use data, is needed. Hence, building a robust transnational health information infrastructure with clear interoperability guidelines considering heterogeneous aspects is necessary. For this purpose, this study proposes a Transnational Health Record framework, which enables access to personal health records anywhere. We review related literature and define level-specific interoperability guidelines, business processes, and requirements for the Transnational Health Record system framework.
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Affiliation(s)
- Ah Ra Lee
- School of Computer Science & Engineering, College of IT Engineering, Kyungpook National University, Daegu 41566, Korea;
| | - Il Kon Kim
- School of Computer Science & Engineering, College of IT Engineering, Kyungpook National University, Daegu 41566, Korea;
- Correspondence: ; Tel.: +82-53-4228182
| | - Eunjoo Lee
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu 41566, Korea;
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Regeru RN, Chikaphupha K, Bruce Kumar M, Otiso L, Taegtmeyer M. 'Do you trust those data?'-a mixed-methods study assessing the quality of data reported by community health workers in Kenya and Malawi. Health Policy Plan 2020; 35:334-345. [PMID: 31977014 PMCID: PMC7152729 DOI: 10.1093/heapol/czz163] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2019] [Indexed: 11/13/2022] Open
Abstract
High-quality data are essential to monitor and evaluate community health worker (CHW) programmes in low- and middle-income countries striving towards universal health coverage. This mixed-methods study was conducted in two purposively selected districts in Kenya (where volunteers collect data) and two in Malawi (where health surveillance assistants are a paid cadre). We calculated data verification ratios to quantify reporting consistency for selected health indicators over 3 months across 339 registers and 72 summary reports. These indicators are related to antenatal care, skilled delivery, immunization, growth monitoring and nutrition in Kenya; new cases, danger signs, drug stock-outs and under-five mortality in Malawi. We used qualitative methods to explore perceptions of data quality with 52 CHWs in Kenya, 83 CHWs in Malawi and 36 key informants. We analysed these data using a framework approach assisted by NVivo11. We found that only 15% of data were reported consistently between CHWs and their supervisors in both contexts. We found remarkable similarities in our qualitative data in Kenya and Malawi. Barriers to data quality mirrored those previously reported elsewhere including unavailability of data collection and reporting tools; inadequate training and supervision; lack of quality control mechanisms; and inadequate register completion. In addition, we found that CHWs experienced tensions at the interface between the formal health system and the communities they served, mediated by the social and cultural expectations of their role. These issues affected data quality in both contexts with reports of difficulties in negotiating gender norms leading to skipping sensitive questions when completing registers; fabrication of data; lack of trust in the data; and limited use of data for decision-making. While routine systems need strengthening, these more nuanced issues also need addressing. This is backed up by our finding of the high value placed on supportive supervision as an enabler of data quality.
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Affiliation(s)
| | | | - Meghan Bruce Kumar
- Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
| | - Lilian Otiso
- Research Division, LVCT Health, PO Box 19835-00202, Nairobi, Kenya
| | - Miriam Taegtmeyer
- Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
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Llanes-Álvarez C, llano JMAD, Álvarez-Navares AI, Roncero C, Pastor-Hidalgo MT, Garmendia-Leiza JR, Andrés-Alberola I, Franco-Martín MA. Hospitalization and Socio-Health Care for Dementia in Spain. J Clin Med 2020; 9:jcm9123875. [PMID: 33260542 PMCID: PMC7760198 DOI: 10.3390/jcm9123875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/20/2020] [Accepted: 11/25/2020] [Indexed: 11/24/2022] Open
Abstract
Dementias are brain diseases that affect long-term cognitive and behavioral functions and cause a decrease in the ability to think and remember that is severe enough to disturb daily functioning. In Spain, the number of people suffering from dementia is rising due to population ageing. Reducing admissions, many of them avoidable, would be advantageous for patients and care-providers. Understanding the correlation of admission of people with dementia and its trends in hospitalization would help us to understand the factors leading to admission. We conducted a cross-sectional study of the hospital discharge database of Castilla y León from 2005 to 2015, selecting hospitalizations for dementia. Trends in hospitalizations by year and age quartiles were studied by joinpoint regression analysis. 2807 out of 2,717,192 total hospitalizations (0.10%) were due to dementias; the main groups were degenerative dementia (1907) followed by vascular dementia (607). Dementias are not a major cause of hospitalization, but the average stay and cost are high, and many of them seem avoidable. Decreasing trends were detected in hospitalization rates for all dementias except for the group of mild cognitive impairment, which grew. An increasing–decreasing joinpoint detected in 2007 for vascular dementia and the general downward hospitalization trends for most dementias suggest that socio-health measures established since 2007 in Spain might play a key role in reducing hospitalizations.
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Affiliation(s)
- Carlos Llanes-Álvarez
- Department of Psychiatry, Complejo Asistencial de Zamora, 49022 Zamora, Spain;
- Correspondence: ; Tel.: +34-980-548-820 (ext. 48200)
| | - Jesús M. Andrés-de llano
- Department of Pediatrics, Complejo Asistencial Universitario de Palencia, 34005 Palencia, Spain;
| | - Ana I. Álvarez-Navares
- Department of Psychiatry, University of Salamanca Health Care Complex, 37007 Salamanca, Spain; (A.I.Á.-N.); (C.R.)
| | - Carlos Roncero
- Department of Psychiatry, University of Salamanca Health Care Complex, 37007 Salamanca, Spain; (A.I.Á.-N.); (C.R.)
| | | | - José R. Garmendia-Leiza
- General Direction of Information Systems, Quality and Pharmaceutical Provision at Castilla y León Health Authority, Regional Health Management, 47007 Valladolid, Spain;
| | - Irene Andrés-Alberola
- Castilla y León Health Authority, Complejo Asistencial Universitario de Palencia, 34005 Palencia, Spain;
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Miyazaki K, Nozaki I, Tojo B, Moji K. Assessing the feasibility of introducing an electronic health information system into Tuberculosis clinics and laboratories in Myanmar. Glob Health Med 2020; 2:247-254. [PMID: 33330815 PMCID: PMC7731357 DOI: 10.35772/ghm.2020.01020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 08/06/2020] [Accepted: 08/21/2020] [Indexed: 06/12/2023]
Abstract
Myanmar has launched an advanced tuberculosis examination policy, which involves specimen exchanges among clinics and referral laboratories. However, with the current paper-based operation, it is difficult to trace information accurately. Therefore, since April 2017, we introduced a pilot operation consisting of an electronic health information system (HIS) that uses QR codes for data sharing in the tuberculosis laboratory at seven facilities. This study aimed to assess the feasibility of introducing the electronic HIS into tuberculosis clinics and laboratories based on staff perception, workload and workflow, and data accuracy, and to clarify its advantages and disadvantages. The analysis was descriptive, and it involved a semi-structured interview for the staff, workflow observations to evaluate the workload and describe the change in workflow, and evaluation of the data accuracy by comparing the numbers yielded by the paper-based and HIS-based reports. The HIS was positively accepted as it improved work efficiency, while the operation still depended on paper-based reports. Parallel data registration using both paper-based and HIS-based reports increased the workload. Data discrepancies were found when comparing the paper-based and HIS-based reports, and these discrepancies were not directly attributed to the HIS introduction but individual factors. Crucial facilitating factors of the HIS were its operability and user-friendliness, because it does not require specific training. The additional workload translates into the need for additional human resources, and the parallel data registration remains a challenge. However, we consider that these challenges could be overcome as coverage of the HIS expands.
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Affiliation(s)
- Kazuki Miyazaki
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Ikuma Nozaki
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Bumpei Tojo
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Kazuhiko Moji
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
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