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Descalzo JM, Frutos EL, Castro J, Lombardo VR, Gimenez C, Otero P, Luna D, Otero C. Improving Waiting Time for Chemotherapy with Ahead-of-Time Drug Preparation. Stud Health Technol Inform 2024; 310:144-148. [PMID: 38269782 DOI: 10.3233/shti230944] [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
Waiting time for chemotherapy infusion is a fundamental factor to measure quality of care. It has been shown that a prolonged waiting time is related to a higher incidence of anticipatory nausea and poor patient adherence to scheduled appointments and recommended oncology treatment programs. Some chemotherapy regimens can be prepared hours ahead-of-time, due to long stability. We aimed to study the effect of an informatic-led workflow redesign intervention, facilitating workflow changes in the Oncology Pharmacy, on patient waiting time. This intervention included changes on EHR processes and the chemotherapy CPOE. Their main effect was allowing ahead-of-time preparation of selected chemotherapy regimes. We conducted a cross sectional study, comparing waiting times pre and post intervention periods. A total of 4600 programmed chemotherapy episodes were included. We found a 26.5 % decrease in the mean wait time in the post intervention period (p > 0.02). We were able to show a decrease in waiting time and a measurable impact of the intervention. This evaluation produced valuable and actionable data for Oncology units and adds a valuable, Latin American experience to the literature.
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Affiliation(s)
- Juan Marcos Descalzo
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires, Argentina
| | | | - Javier Castro
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires, Argentina
| | | | - Cintia Gimenez
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires, Argentina
| | - Paula Otero
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires, Argentina
| | - Daniel Luna
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires, Argentina
- Instituto de Medicina Traslacional e Ingeniería Biomédica (IMTIB), UE de triple dependencia CONICET - Instituto Universitario del Hospital Italiano (IUHI) - Hospital Italiano de Buenos Aires, Argentina
| | - Carlos Otero
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires, Argentina
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Frutos E, Kakazu M, Tajerian M, Gaiera A, Rubin L, Otero C, Luna D. Clinical Decision Support System for PIM in Elderly Patients: Implementation and Initial Evaluation in Ambulatory Care. Stud Health Technol Inform 2022; 294:475-479. [PMID: 35612125 DOI: 10.3233/shti220504] [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: 06/15/2023]
Abstract
The high prevalence of PIMs in elderly is a major healthcare concern and indicates the need for medication monitoring systems. Most PIM CDSS have shown positive effects respecting PIM prescription but these results were more consistently in hospital settings compared with ambulatory care. We describe the post-implementation evaluation of a PIM CDSS for general practitioners (GP) in the ambulatory setting and explore GP interactions with the PIM alerts. The CDSS generated 3218 unique alerts and involved 2863 elderly patients. Benzodiazepines was the drug with the most alerts triggered. Only 129 (4 %) were opened by GP during patient appointments. We need to develop an understanding of how alerts should be designed and display information to support the workflow of general practitioners. Pos-implementation evaluations are the key of CDSS improvements.
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Affiliation(s)
- Eliana Frutos
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Martin Kakazu
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Matias Tajerian
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Alejandro Gaiera
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Luciana Rubin
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Carlos Otero
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Daniel Luna
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
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Assefi A, van Dommelen P, Arnaud L, Otero C, Fernandez-Luque L, Koledova E, Calliari LE. Adherence to Growth Hormone Treatment Using a Connected Device in Latin America: Real-World Exploratory Descriptive Analysis Study. JMIR Mhealth Uhealth 2022; 10:e32626. [PMID: 35049518 PMCID: PMC8814928 DOI: 10.2196/32626] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/21/2021] [Accepted: 11/27/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Recombinant human growth hormone (rhGH) therapy is an effective treatment for children with growth disorders. However, poor outcomes are often associated with suboptimal adherence to treatment. OBJECTIVE The easypod connected injection device records and transmits injection settings and dose data from patients receiving rhGH. In this study, we evaluated adherence to rhGH treatment, and associated growth outcomes, in Latin American patients. METHODS Adherence and growth data from patients aged 2-18 years from 12 Latin American countries were analyzed. Adherence data were available for 6207 patients with 2,449,879 injections, and growth data were available for 497 patients with 2232 measurements. Adherence was categorized, based on milligrams of rhGH injected versus milligrams of rhGH prescribed, as high (≥85%), intermediate (>56%-<85%), or low (≤56%). Transmission frequency was categorized as high (≥1 per 3 months) or low (<1 per 3 months). Chi-square tests were applied to study the effect of pubertal status at treatment start and sex on high adherence, and to test differences in frequency transmission between the three adherence levels. Multilevel linear regression techniques were applied to study the effect of adherence on observed change in height standard deviation score (∆HSDS). RESULTS Overall, 68% (4213/6207), 25% (n=1574), and 7% (n=420) of patients had high, intermediate, and low adherence, respectively. Pubertal status at treatment start and sex did not have a significant effect on high adherence. Significant differences were found in the proportion of patients with high transmission frequency between high (2018/3404, 59%), intermediate (608/1331, 46%), and low (123/351, 35%) adherence groups (P<.001). Adherence level had a significant effect on ∆HSDS (P=.006). Mean catch-up growth between 0-24 months was +0.65 SD overall (+0.52 SD in patients with low/intermediate monthly adherence and +0.69 SD in patients with high monthly adherence). This difference translated into 1.1 cm greater catch-up growth with high adherence. CONCLUSIONS The data extracted from the easypod Connect ecosystem showed high adherence to rhGH treatment in Latin American patients, with positive growth outcomes, indicating the importance of connected device solutions for rhGH treatment in patients with growth disorders.
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Affiliation(s)
- Aria Assefi
- Fertility and Endocrinology, Merck SA (an affiliate of Merck KGaA, Darmstadt, Germany), Buenos Aires, Argentina
| | - Paula van Dommelen
- Department of Child Health, The Netherlands Organization for Applied Scientific Research TNO, Leiden, Netherlands
| | - Lilian Arnaud
- Global Healthcare Operations, Connected Health & Devices, Ares Trading SA (an affiliate of Merck KGaA, Darmstadt, Germany), Eysins, Switzerland
| | - Carlos Otero
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Ekaterina Koledova
- Global Medical Affairs Cardiometabolic & Endocrinology, the healthcare business of Merck KGaA, Darmstadt, Germany
| | - Luis Eduardo Calliari
- Pediatric Endocrinology Unit, Pediatric Department, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil
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Lado L, Piñeiro C, Luna V, Sánchez M, Otero C, Mosquera J, Lobato R, Pombar M. Positioning accuracy and reproducibility of the PTW TruFix system. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00153-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Rodenas E, Otero C. Base-Catalysed Dehydrohalogenation — NS of Dicofol in CTAB Micelles. TENSIDE SURFACT DET 2021. [DOI: 10.1515/tsd-1990-270612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Otero C, Arredondo C, Echeverría-Vega A, Gordillo-Fuenzalida F. Penicillium spp. mycotoxins found in food and feed and their health effects. WORLD MYCOTOXIN J 2020. [DOI: 10.3920/wmj2019.2556] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Mycotoxins are toxic secondary metabolites produced by fungi. These compounds have different structures and target different organs, acting at different steps of biological processes inside the cell. Around 32 mycotoxins have been identified in fungal Penicillium spp. isolated from food and feed. Some of these species are important pathogens which contaminate food, such as maize, cereals, soybeans, sorghum, peanuts, among others. These microorganisms can be present in different steps of the food production process, such as plant growth, harvest, drying, elaboration, transport, and packaging. Although some Penicillium spp. are pathogens, some of them are used in elaboration of processed foods, such as cheese and sausages. This review summarises the Penicillium spp. mycotoxin toxicity, focusing mainly on the subgenus Penicillium, frequently found in food and feed. Toxicity is reviewed both in animal models and cultured cells. Finally, some aspects of their regulations are discussed.
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Affiliation(s)
- C. Otero
- Escuela de Química y Farmacia, Facultad de Medicina, Universidad Andrés Bello, República 252, Santiago, Chile
| | - C. Arredondo
- Laboratorio de Neuroepigenética, Instituto de Ciencias Biomédicas (ICB), Facultad de Medicina y Facultad de Ciencias de la Vida, Universidad Andrés Bello, República 330, Santiago, Chile
| | - A. Echeverría-Vega
- Centro de Investigación en Estudios Avanzados del Maule (CIEAM), Vicerrectoría de Investigación y Postgrado, Universidad Católica del Maule, Talca, Chile
| | - F. Gordillo-Fuenzalida
- Centro de Biotecnología de los Recursos Naturales (CENBIO), Laboratorio de Microbiología Aplicada, Facultad de Ciencias Agrarias y Forestales, Universidad Católica del Maule, Avda. San Miguel 3605, Talca, Chile
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Cassarino M, Correa E, Minoletti S, Jauregui I, Grande Ratti MF, Otero C, Luna D. A Path to Inclusion: Design and Prototype of Transgender Identity in an Electronic Health Record. Stud Health Technol Inform 2020; 270:1181-1182. [PMID: 32570569 DOI: 10.3233/shti200352] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
With the purpose of reducing discrimination on gender, the Department of Health Informatics of the Hospital Italiano de Buenos Aires (HIBA) developed changes in its Patient Master Index to register chosen name and self-perceived gender identity. To improve the visualization of information related to the identity of each person to provide comprehensive quality care, it was decided to modify the impact of this information on the EHR. For this, prototypes were developed with changes in the patient identification module and then user-tests were carried out.
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Affiliation(s)
- Melanie Cassarino
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Argentina
| | - Eunice Correa
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Argentina
| | - Sebastián Minoletti
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Argentina
| | - Ignacio Jauregui
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Argentina
| | | | - Carlos Otero
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Argentina
| | - Daniel Luna
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Argentina
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Peute LW, Lichtner V, Baysari MT, Hägglund M, Homco J, Jansen-Kosterink S, Jauregui I, Kaipio J, Kuziemsky CE, Lehnbom EC, Leite F, Lesselroth B, Luna D, Otero C, Pedersen R, Pelayo S, Santos R, Silva NA, Tyllinen M, Van Velsen L, Zheng WY, Jaspers M, Marcilly R. Challenges and Best Practices in Ethical Review of Human and Organizational Factors Studies in Health Technology: a Synthesis of Testimonies. Yearb Med Inform 2020; 29:58-70. [PMID: 32303100 PMCID: PMC7442520 DOI: 10.1055/s-0040-1701979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE Human and Organizational Factors (HOF) studies in health technology involve human beings and thus require Institutional Review Board (IRB) approval. Yet HOF studies have specific constraints and methods that may not fit standard regulations and IRB practices. Gaining IRB approval may pose difficulties for HOF researchers. This paper aims to provide a first overview of HOF study challenges to get IRB review by exploring differences and best practices across different countries. METHODS HOF researchers were contacted by email to provide a testimony about their experience with IRB review and approval. Testimonies were thematically analyzed and synthesized to identify and discuss shared themes. RESULTS Researchers from seven European countries, Argentina, Canada, Australia, and the United States answered the call. Four themes emerged that indicate shared challenges in legislation, IRB inefficiencies and inconsistencies, general regulation and costs, and lack of HOF study knowledge by IRB members. We propose a model for IRB review of HOF studies based on best practices. CONCLUSION International criteria are needed that define low and high-risk HOF studies, to allow identification of studies that can undergo an expedited (or exempted) process from those that need full IRB review. Enhancing IRB processes in such a way would be beneficial to the conduct of HOF studies. Greater knowledge and promotion of HOF methods and evidence-based HOF study designs may support the evolving discipline. Based on these insights, training and guidance to IRB members may be developed to support them in ensuring that appropriate ethical issues for HOF studies are considered.
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Affiliation(s)
- Linda W Peute
- Centre for Human Factor Engineering of Health Information technology - Amsterdam UMC, University of Amsterdam, department of Medical Informatics, Amsterdam, The Netherlands
| | - Valentina Lichtner
- Centre for Medication Safety and Service Quality, UCL School of Pharmacy, UK
| | - Melissa T Baysari
- The University of Sydney, Faculty of Medicine and Health, Sydney, Australia
| | - Maria Hägglund
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Juell Homco
- Department of Medical Informatics, University of Oklahoma - Tulsa School of Community Medicine, USA
| | | | - Ignacio Jauregui
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Johanna Kaipio
- Department of Computer Science, Aalto University, Finland
| | | | - Elin Christina Lehnbom
- Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Norway; Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Sweden
| | | | - Blake Lesselroth
- Department of Medical Informatics, University of Oklahoma - Tulsa School of Community Medicine, USA
| | - Daniel Luna
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Carlos Otero
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Rune Pedersen
- Norwegian Centre for E-health Research, University Hospital of North Norway HF, Norway; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Norway
| | - Sylvia Pelayo
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, INSERM-CIC-IT 1403/Evalab, Lille, France
| | | | | | - Mari Tyllinen
- Department of Computer Science, Aalto University, Finland
| | - Lex Van Velsen
- Roessingh Research and Development, eHealth group, Enschede, The Netherlands
| | - Wu Yi Zheng
- The University of Sydney, Faculty of Medicine and Health, Sydney, Australia
| | - Monique Jaspers
- Centre for Human Factor Engineering of Health Information technology - Amsterdam UMC, University of Amsterdam, department of Medical Informatics, Amsterdam, The Netherlands
| | - Romaric Marcilly
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, INSERM-CIC-IT 1403/Evalab, Lille, France
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9
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Mallo SC, Patten SB, Ismail Z, Pereiro AX, Facal D, Otero C, Juncos-Rabadán O. Does the neuropsychiatric inventory predict progression from mild cognitive impairment to dementia? A systematic review and meta-analysis. Ageing Res Rev 2020; 58:101004. [PMID: 31881368 DOI: 10.1016/j.arr.2019.101004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 10/22/2019] [Accepted: 12/23/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Neuropsychiatric Symptoms (NPS) are common in Mild Cognitive Impairment (MCI). The Neuropsychiatric Inventory (NPI) and its shorter version, the Neuropsychiatric Inventory Questionnaire (NPI-Q), are the most common measures to assess NPS. Our objective was to determine if NPI/NPI-Q ratings predict conversion from MCI to dementia. METHODS Empirical longitudinal studies published in English or Spanish, concerned with the role of NPS as a risk factor for conversion from MCI to dementia, with a diagnosis of MCI following clinical criteria, that reported NPI/NPI-Q total score in converters versus non-converters, were included. Random effects models were used, and heterogeneity was explored with stratification and a random-effects meta-regression. The overall conversion rate and the standardized mean difference (SMD) for evolution, as a function of NPI/NPI-Q scores, were calculated. RESULTS The overall conversion rate was 35 %. Mean NPI/NPI-Q ratings were higher in converters versus in non-converters, with the overall SMD approaching significance. Heterogeneity was observed in studies of more than two years of follow-up and in a study with a mean age of more than 80 years. This heterogeneity concerned the size, not the direction of the difference. CONCLUSIONS Our results suggest that NPI/NPI-Q ratings are associated with conversion from MCI to dementia.
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Galván CS, Daus M, Jauregui OI, Álvarez MA, Otero C, Luna D. CDSS for Documenting Blood Glycemia Critical Values at the POC. Stud Health Technol Inform 2019; 264:1775-1776. [PMID: 31438338 DOI: 10.3233/shti190642] [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
When a critical blood glucose value is detected, then it is necessary to inform, advice, communicate, act and document it in the patient's medical record. We sought to describe the development of an alert system for glycemia values at the point of care integrated with an EHR, both in desktop and mobile devices.
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Affiliation(s)
| | - Mariana Daus
- Department of Health Informatics, Hospital Italiano de Buenos Aires
| | | | | | - Carlos Otero
- Department of Health Informatics, Hospital Italiano de Buenos Aires
| | - Daniel Luna
- Department of Health Informatics, Hospital Italiano de Buenos Aires
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11
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Correa E, Jauregui OI, Frangella J, Peuchot V, Otero C, Luna D. Adverse Drug Event Reporting Rates After the Implementation of an EHR Integrated Reporting System. Stud Health Technol Inform 2019; 264:1652-1653. [PMID: 31438276 DOI: 10.3233/shti190580] [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
Under-reporting of adverse drug events (ADEs) is a common issue across healthcare systems, and lack of integration with clinical workflow and systems are among the leading causes of this problem. We sought to describe the development of an ADEs reporting system within an EHR that represents user needs and captures relevant data. We compared periods before and after the implementation, and describe the corresponding reporting rates.
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Affiliation(s)
- Eunice Correa
- Department of Health Informatics, Hospital Italiano of Buenos Aires, Buenos Aires, Argentina
| | - Oscar Ignacio Jauregui
- Department of Health Informatics, Hospital Italiano of Buenos Aires, Buenos Aires, Argentina
| | - Julia Frangella
- Department of Health Informatics, Hospital Italiano of Buenos Aires, Buenos Aires, Argentina
| | - Verónica Peuchot
- Department of Health Informatics, Hospital Italiano of Buenos Aires, Buenos Aires, Argentina
| | - Carlos Otero
- Department of Health Informatics, Hospital Italiano of Buenos Aires, Buenos Aires, Argentina
| | - Daniel Luna
- Department of Health Informatics, Hospital Italiano of Buenos Aires, Buenos Aires, Argentina
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12
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Park H, Castaño J, Ávila P, Pérez D, Berinsky H, Gambarte L, Luna D, Otero C. An Information Retrieval Approach to ICD-10 Classification. Stud Health Technol Inform 2019; 264:1564-1565. [PMID: 31438233 DOI: 10.3233/shti190536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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
ICD-10 (International Classification of Diseases 10th revision) is a classification code for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases. This paper describes an automatic information retrieval approach to map free-text disease descriptions to ICD-10 codes. We use the Hospital Italiano de Buenos Aires (HIBA) terminology data mapped to ICD-10 codes as indexed data to find an appropriate ICD-10 code using search engine similarity metrics.
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Affiliation(s)
- Hee Park
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires, Argentina
| | - José Castaño
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires, Argentina
| | - Pilar Ávila
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires, Argentina
| | - David Pérez
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires, Argentina
| | - Hernán Berinsky
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires, Argentina
| | - Laura Gambarte
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires, Argentina
| | - Daniel Luna
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires, Argentina
| | - Carlos Otero
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires, Argentina
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Giussi Bordoni MV, Baum A, García G, Moriñigo P, Luna D, Otero P, Otero C, de Quirós FBG. Change Management in Healthcare Organizations: Soft Skills Training Strategies Through Blended Learning Environments. Stud Health Technol Inform 2019; 264:1999-2000. [PMID: 31438448 DOI: 10.3233/shti190754] [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
Teaching soft skills for change management in healthcare organizations is becoming increasingly necessary, even more, when implementing health information systems (HIS). There is little evidence that these skills can be learned through online teaching environments. This paper describes the experience of having taught soft skills to health informatics master's degree students, through blended learning environments.
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Affiliation(s)
- M V Giussi Bordoni
- Department of HealthInformatics, Hospital Italiano de Buenos Aires, Argentina
| | - A Baum
- Department of HealthInformatics, Hospital Italiano de Buenos Aires, Argentina
| | - G García
- Department of HealthInformatics, Hospital Italiano de Buenos Aires, Argentina
| | - P Moriñigo
- Department of HealthInformatics, Hospital Italiano de Buenos Aires, Argentina
| | - D Luna
- Department of HealthInformatics, Hospital Italiano de Buenos Aires, Argentina
| | - P Otero
- Department of HealthInformatics, Hospital Italiano de Buenos Aires, Argentina
| | - C Otero
- Department of HealthInformatics, Hospital Italiano de Buenos Aires, Argentina
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Frid S, Zapico V, Mansilla A, Álvarez M, López G, Otero C, Luna D. Design and Implementation of a Tool for Pharmacists to Register Potential Errors in Prescribed Medication. Stud Health Technol Inform 2019; 264:581-585. [PMID: 31437990 DOI: 10.3233/shti190289] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Adverse drug events are frequent and may be mitigated with the implementation of functionalities within Health Information Systems. We developed a tool that allows Pharmacists to register and communicate to providers potential errors in prescribed drugs in terms of medication omission, unjustified stop of medication or other reasons. We included all interventions performed by Pharmacists for admitted patients between July, 31st 2018 and October, 23rd 2018. During the study period, 193 interventions were carried out by Pharmacists. 117 (60%) were intended for registering medication omission, 7 (4%) for unjustified stop of medication and 69 (36%) for other reasons. 112 interventions lead to the provider performing the suggested action (58%), 77 (40%) were rejected and 4 (2%) required no action. Although there were errors in the use of the tool, a great amount of interventions were accepted, thus representing a better quality of care for patients.
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Affiliation(s)
- Santiago Frid
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | - Valeria Zapico
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | - Adriana Mansilla
- Department of Pharmacy, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | - Matías Álvarez
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | - Gastón López
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | - Carlos Otero
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | - Daniel Luna
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
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Castaño J, Park H, Ávila P, Pérez D, Berinsky H, Gambarte L, Otero C, Luna D. Evaluating the Performance of a Terminology Search Engine Using Historical Data. Stud Health Technol Inform 2019; 264:1439-1440. [PMID: 31438170 DOI: 10.3233/shti190473] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Clinical terms are noisy descriptions typed by healthcare professionals in Spanish language in the electronic health record system (EHR). Thus, an evaluation of terminology search engine that extends SNOMED CT and an approach that uses historical data of clinical terms is described. We show how to measure precision and recall using historical search data, and we show how the performance of the search engine can be improved significantly using the technology available in the search engine.
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Affiliation(s)
- José Castaño
- Departamento de Informática en Salud, Hospital Italiano, Buenos Aires, Argentina
| | - Hee Park
- Departamento de Informática en Salud, Hospital Italiano, Buenos Aires, Argentina
| | - Pilar Ávila
- Departamento de Informática en Salud, Hospital Italiano, Buenos Aires, Argentina
| | - David Pérez
- Departamento de Informática en Salud, Hospital Italiano, Buenos Aires, Argentina
| | - Hernán Berinsky
- Departamento de Informática en Salud, Hospital Italiano, Buenos Aires, Argentina
| | - Laura Gambarte
- Departamento de Informática en Salud, Hospital Italiano, Buenos Aires, Argentina
| | - Carlos Otero
- Departamento de Informática en Salud, Hospital Italiano, Buenos Aires, Argentina
| | - Daniel Luna
- Departamento de Informática en Salud, Hospital Italiano, Buenos Aires, Argentina
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Frangella J, Cassarino M, Plazzotta F, Gassino F, Otero C, Luna D. Designed Strategies and Adaptation of a Master Patient Index for Transgender Patients in a Tertiary Care Hospital. Stud Health Technol Inform 2019; 264:1698-1699. [PMID: 31438299 DOI: 10.3233/shti190603] [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
Transgender people experience their gender identity as different from the sex assigned to them at birth and/or those listed on their legal identification. A Master Patient Index (MPI) is a centralized index of all patients in a health care system. The objective of this work was to describe the designed strategies and adapting of a MPI that contemplates transgender patient registration needs as regards as health and legal context.
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Affiliation(s)
- Julia Frangella
- Department of Health Informatics, Hospital Italiano de Buenos Aires, city of Buenos Aires, Argentina
| | - Melanie Cassarino
- Department of Health Informatics, Hospital Italiano de Buenos Aires, city of Buenos Aires, Argentina
| | - Fernando Plazzotta
- Department of Health Informatics, Hospital Italiano de Buenos Aires, city of Buenos Aires, Argentina
| | - Fernando Gassino
- Department of Health Informatics, Hospital Italiano de Buenos Aires, city of Buenos Aires, Argentina
| | - Carlos Otero
- Department of Health Informatics, Hospital Italiano de Buenos Aires, city of Buenos Aires, Argentina
| | - Daniel Luna
- Department of Health Informatics, Hospital Italiano de Buenos Aires, city of Buenos Aires, Argentina
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17
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Zapico V, Rubin L, Díaz S, Gambarte L, Rebrij R, Otero C, Luna D. Decision Support Tools for Drugs Prescription Process in a Hospital in Argentina. Stud Health Technol Inform 2019; 264:903-907. [PMID: 31438055 DOI: 10.3233/shti190354] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
While medications can improve the health of patients, the prescription process is complex and prone to errors. The structured medical order entry systems (CPOE) with clinical decision support (CDS) are increasingly implemented to improve patient safety, however the organizations that decide to implement them will have several challenges: understanding which classes of CDS can admit their systems, ensure that clinical knowledge is adequate and design tools for proper monitoring. We share our experience of over ten years of development and implementation of clinical decision support tools during drugs prescription process and tools that have allowed us to monitor them correctly.
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Affiliation(s)
- Valeria Zapico
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | - Luciana Rubin
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | - Soledad Díaz
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | - Laura Gambarte
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | - Romina Rebrij
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | - Carlos Otero
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
| | - Daniel Luna
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
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18
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Renato A, Berinsky H, Daus M, Dachery MF, Jauregui O, Storani F, Gambarte ML, Otero C, Luna D. Design and Evaluation of an Automatic Speech Recognition Model for Clinical Notes in Spanish in a Mobile Online Environment. Stud Health Technol Inform 2019; 264:1761-1762. [PMID: 31438331 DOI: 10.3233/shti190635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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
Clinical documentation in healthcare institutions is one of the daily tasks that consumes most of the time for those involved. The adoption of mobile devices in medical practice increases efficiency among healthcare professionals. We describe the design and evaluation of an automatic speech recognition system that enables the transcription of audio to text of clinical notes in a mobile environment. Our system achieved 94.1% word accuracy when evaluated on pediatrics, internal medicine and surgery services.
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Affiliation(s)
- Alejandro Renato
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Hernan Berinsky
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Mariana Daus
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Miguel Fantin Dachery
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Oscar Jauregui
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Fernando Storani
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - María Laura Gambarte
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Carlos Otero
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Daniel Luna
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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19
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Abstract
Healthcare Information Systems should capture clinical data in a structured and preferably coded format. This is crucial for data exchange between health information systems, epidemiological analysis, quality and research, clinical decision support systems, administrative functions, among others. Structured data entry is an obstacle for the usability of electronic health record (EHR) applications and their acceptance by physicians who prefer to document patient EHRs using “free text”. Natural language allows for rich expressiveness but at the same time is ambiguous; it has great dependence on context and uses jargon and acronyms. Although much progress has been made in knowledge and natural language processing techniques, the result is not yet satisfactory enough for the use of free text in all dimensions of clinical documentation. In order to address the trade-off between capturing data with free text and at the same time coding data for computer processing, numerous terminological systems for the systematic recording of clinical data have been developed. The purpose of terminology services consists of representing facts that happen in the real world through database management in order to allow for semantic interoperability and computerized applications. These systems interrelate concepts of a particular domain and provide references to related terms with standards codes. In this way, standard terminologies allow the creation of a controlled medical vocabulary, making terminology services a fundamental component for health data management in the healthcare environment. The Hospital Italiano de Buenos Aires has been working in the development of its own terminology server. This work describes its experience in the field.
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Affiliation(s)
| | - Carlos Otero
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Daniel Luna
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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20
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Almerares A, Luna D, Marcelo A, Househ M, Mandirola H, Otero C. Health Informatics in Developing Countries: A Review of Unintended Consequences of IT Implementations, as They Affect Patient Safety and Recommendations on How to Address Them. Yearb Med Inform 2018. [DOI: 10.1055/s-0038-1641611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
SummaryBackground: Patient safety concerns every healthcare organization. Adoption of Health information technology (HIT) appears to have the potential to address this issue, however unanticipated and undesirable consequences from implementing HIT could lead to new and more complex hazards. This could be particularly problematic in developing countries, where regulations, policies and implementations are few, less standandarized and in some cases almost non-existing.Methods: Based on the available information and our own experience, we conducted a review of unintended consequences of HIT implementations, as they affect patient safety in developing countries.Results: We found that user dependency on the system, alert fatigue, less communications among healthcare actors and workarounds topics should be prioritize. Institution should consider existing knowledge, learn from other experiences and model their implementations to avoid known consequences. We also recommend that they monitor and communicate their own efforts to expand knowledge in the region.
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21
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Ávila P, Castaño J, Berinsky H, Gambarte L, Park H, Pérez D, Otero C, Albornoz M, Luna D. Selection of Semantic Relevant Healthcare Services Subsets. Stud Health Technol Inform 2018; 247:915-919. [PMID: 29678094] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We describe an approach to select semantically coherent specialty subsets based on the historical use of terminology by different service areas. Our approach uses rule-based and machine learning techniques to obtain a reduced set of 29 specialties.
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Affiliation(s)
- Pilar Ávila
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires
| | - José Castaño
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires
| | - Hernán Berinsky
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires
| | - Laura Gambarte
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires
| | - Hee Park
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires
| | - David Pérez
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires
| | - Carlos Otero
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires
| | - Mario Albornoz
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires
| | - Daniel Luna
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires
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22
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Frangella J, Otero C, Luna D. Strategies for Effectively Documenting Sexual Orientation and Gender Identity in Electronic Health Record. Stud Health Technol Inform 2018; 247:66-70. [PMID: 29677924] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In this communication we identify strategies for effectively documenting Sexual Orientation and Gender Identity in Electronic Health Records. For this review a multidisciplinary group composed by three physicians, a nurse, an engineer and a lawyer analyzed the evidence in bibliography related to the topic and summarized the results. After analyzing the information, we summarized and classified them into three major topics: To request, to store and to display and access to the information. How to standardize those data and where data specifically will be populated in EHRs have not been answered yet. The target of all of these efforts should be: to be sensitive with the needs of the patient and to ensure high quality of care.
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Affiliation(s)
- Julia Frangella
- Health Informatics Department, Hospital Italiano de Buenos Aires. C.A.B.A. Argentina
| | - Carlos Otero
- Health Informatics Department, Hospital Italiano de Buenos Aires. C.A.B.A. Argentina
| | - Daniel Luna
- Health Informatics Department, Hospital Italiano de Buenos Aires. C.A.B.A. Argentina
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23
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Guiu-Souto J, Otero C, Pérez-Fentes DA, Fernández-Baltar C, Francisco Sánchez-Garcia J, García-Freire C, Pombar-Cameán M, Pardo-Montero J. Characterising endourologist learning curve during percutaneous nephrolithotomy: implications on occupational dose and patients. J Radiol Prot 2017; 37:N49-N54. [PMID: 29140797 DOI: 10.1088/1361-6498/aa8e51] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In this study we have characterised the learning curve for percutaneous nephrolithotomy procedures over 301 cases for six years. Different surrogate parameters of clinical expertise have been used, such as dose area product, total procedure time, fluoroscopy time and personal equivalent doses. In addition, two different endourologists have been monitored; one of whom had specific Radiation Protection training (ICRP 85). Eye lens dose was estimated from thermoluminescent dosimeters. Significant differences were observed between both endourologists, especially in the fluoroscopy time. Finally, both entrance skin dose and effective doses of patients have been determined.
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Affiliation(s)
- Jacobo Guiu-Souto
- Department of Medical Physics and Radiological Protection, University Hospital of Santiago de Compostela, Spain
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25
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Mandirola Brieux HF, Benitez S, Otero C, Luna D, Masud JHB, Marcelo A, Househ M, Hullin C, Villalba C, Indarte S, Guillen S, Otero P, Campos F, Baum A, Gonzalez Bernaldo de Quirós F. Cultural Problems Associated with the Implementation of eHealth. Stud Health Technol Inform 2017; 245:1213. [PMID: 29295300] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A major hurdle in eHealth implementation is that it is difficult to put into practice. In this study, the primary aim was to identify the main barrier associated with implementing eHealth. This study surveyed IMIA members from May to November 2015. From the results, it is clear that medical professionals were recording most of their data by hand. This paper culture is a paradigm that is difficult to break. Cultural factors are the primary barrier in eHealth implementation.
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Affiliation(s)
| | - S Benitez
- Hospital Italiano (HIBA), Buenos Aires, Argentina
| | - C Otero
- Hospital Italiano (HIBA), Buenos Aires, Argentina
| | - D Luna
- Hospital Italiano (HIBA), Buenos Aires, Argentina
| | - J H B Masud
- Public Health Informatics Foundation (PHIF), Bangladesh
| | - A Marcelo
- University of the Philippines, Manila, Philippines
| | - M Househ
- King Saud Bin Abdulaziz University for Health Sciences, College of Public Health and Health Informatics, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - C Hullin
- UC Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
| | - C Villalba
- Facultad Politécnica, Universidad Nacional de Asunción, Paraguay
| | | | | | - P Otero
- Hospital Italiano (HIBA), Buenos Aires, Argentina
| | - F Campos
- Hospital Italiano (HIBA), Buenos Aires, Argentina
| | - A Baum
- Hospital Italiano (HIBA), Buenos Aires, Argentina
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26
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Márquez Fosser S, Gaiera A, Otero C, Benitez S, Luna D, Quiroz F. Automatic Loading of Problems Using a Comorbidities Subset: One Step to Organize and Maintain the Patient's Problem List. Stud Health Technol Inform 2017; 245:1358. [PMID: 29295437] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
An accurate and updated problems' list is critical in a problem-oriented Electronic Health Record (EHR). The lack of organization and maintenance of the problems limits its value. Certain problems have a larger effect on the clinical evolution of the patient, these are known as Comorbidities. The aim of this paper is to evaluate the impact of the automatic loading of comorbidities in the organization and maintenance of inpatient problems' list using a comorbidities subset.
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Affiliation(s)
| | - Alejandro Gaiera
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires
| | - Carlos Otero
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires
| | - Sonia Benitez
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires
| | - Daniel Luna
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires
| | - Fernán Quiroz
- Departamento de Informática en Salud, Hospital Italiano de Buenos Aires
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27
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Guiu-Souto J, Sánchez-García M, Vázquez-Vázquez R, Otero C, Luna V, Mosquera J, Busto RL, Aguiar P, Ruibal Á, Pardo-Montero J, Pombar-Cameán M. Evaluation and optimization of occupational eye lens dosimetry during positron emission tomography (PET) procedures. J Radiol Prot 2016; 36:299-308. [PMID: 27182832 DOI: 10.1088/0952-4746/36/2/299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The last recommendations of the International Commission on Radiological Protection for eye lens dose suggest an important reduction on the radiation limits associated with early and late tissue reactions. The aim of this work is to quantify and optimize the eye lens dose associated to nurse staff during positron emission tomography (PET) procedures. PET is one of the most important diagnostic methods of oncological and neurological cancer disease involving an important number of workers exposed to the high energy isotope F-18. We characterize the relevant stages as preparation and administration of monodose syringes in terms of occupational dose. A direct reading silicon dosimeter was used to measure the lens dose to staff. The highest dose of radiation was observed during preparation of the fluorodesoxyglucose (FDG) syringes. By optimizing a suitable vials' distribution of FDG we find an important reduction in occupational doses. Extrapolation of our data to other clinical scenarios indicates that, depending on the work load and/or syringes activity, safety limits of the dose might be exceeded.
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Affiliation(s)
- Jacobo Guiu-Souto
- Department of Medical Physics and Radiological Protection, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
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28
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Carreño A, Gacitúa M, Fuentes JA, Páez-Hernández D, Peñaloza JP, Otero C, Preite M, Molins E, Swords WB, Meyer GJ, Manríquez JM, Polanco R, Chávez I, Arratia-Pérez R. Fluorescence probes for prokaryotic and eukaryotic cells using Re(CO)3+complexes with an electron withdrawing ancillary ligand. NEW J CHEM 2016. [DOI: 10.1039/c6nj00905k] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Re(CO)3+complexes with an ancillary ligand present an electron withdrawing effect suitable for cell imaging.
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29
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Luna D, Otero C, Risk M, Stanziola E, González Bernaldo de Quirós F. Impact of Participatory Design for Drug-Drug Interaction Alerts. A Comparison Study Between Two Interfaces. Stud Health Technol Inform 2016; 228:68-72. [PMID: 27577343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Decision support systems for alert drug-drug interactions have been shown as valid strategy to reduce medical error. Even so the use of these systems has not been as expected, probably due to the lack of a suitable design. This study compares two interfaces, one of them developed using participatory design techniques (based on user centered design processes). This work showed that the use of these techniques improves satisfaction, effectiveness and efficiency in an alert system for drug-drug interactions, a fact that was evident in specific situations such as the decrease of errors to meet the specified task, the time, the workload optimization and users overall satisfaction with the system.
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Affiliation(s)
- Daniel Luna
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Carlos Otero
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Marcelo Risk
- Instituto Tecnológico de Buenos Aires (ITBA), Argentina
| | - Enrique Stanziola
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
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30
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Otero C, Díaz D, Uriarte I, Bezrodnik L, Finiasz MR, Fink S. Peripheral blood monocyte and T cell subsets in children with specific polysaccharide antibody deficiency (SPAD). Hum Immunol 2015; 77:12-19. [PMID: 26577026 DOI: 10.1016/j.humimm.2015.09.053] [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: 02/10/2014] [Revised: 11/05/2014] [Accepted: 09/28/2015] [Indexed: 11/16/2022]
Abstract
Specific polysaccharide antibody deficiency (SPAD) is a well reported immunodeficiency characterized by a failure to produce antibodies against polyvalent polysaccharide antigens, expressed by encapsulated microorganisms. The clinical presentation of these patients involves recurrent bacterial infections, being the most frequent agent Streptococcus (S.) pneumoniae. In SPAD patients few reports refer to cells other than B cells. Since the immune response to S. pneumoniae and other encapsulated bacteria was historically considered restricted to B cells, the antibody deficiency seemed enough to justify the repetitive infections in SPAD patients. Our purpose is to determine if the B cell defects reported in SPAD patients are accompanied by defects in other leukocyte subpopulations necessary for the development of a proper adaptive immune response against S. pneumoniae. We here report that age related changes observed in healthy children involving increased percentages of classical monocytes (CD14++ CD16- cells) and decreased intermediate monocytes (CD14++ CD16+ cells), are absent in SPAD patients. Alterations can also be observed in T cells, supporting that the immune deficiency in SPAD patients is more complex than what has been described up to now.
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Affiliation(s)
- C Otero
- Immunology Department, IMEX-CONICET-Academia Nacional de Medicina, Buenos Aires, Argentina
| | - D Díaz
- Immunology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina
| | - I Uriarte
- Immunology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina
| | - L Bezrodnik
- Immunology, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina
| | - M R Finiasz
- Immunology Department, IMEX-CONICET-Academia Nacional de Medicina, Buenos Aires, Argentina
| | - S Fink
- Immunology Department, IMEX-CONICET-Academia Nacional de Medicina, Buenos Aires, Argentina.
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31
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Affiliation(s)
- Carlos G Musso
- Nephrology Service, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina,
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32
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Kumar D, Ramanathan S, Haider E, Khanna M, Otero C. Education and Imaging. Gastroenterology: Revisiting the forgotten sign: Five layered gut signature and Y configuration in enteric duplication cysts on high resolution ultrasound. J Gastroenterol Hepatol 2015; 30:1111. [PMID: 26094659 DOI: 10.1111/jgh.12903] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- D Kumar
- Department of Radiology, Hamad Medical Corporation, Doha, Qatar
| | - S Ramanathan
- Department of Radiology, Hamad Medical Corporation, Doha, Qatar
| | - E Haider
- Saint Joes Hospital, McMaster University, Hamilton, ON, Canada
| | - M Khanna
- Department of Radiology, Hamad Medical Corporation, Doha, Qatar
| | - C Otero
- McMaster Children Hospital, McMaster University, Hamilton, ON, Canada
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33
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Otero C, Luna D, Marcelo A, Househ M, Mandirola H, Curioso W, Pazos P, Villalba C. Why Patient Centered Care Coordination Is Important in Developing Countries? Contribution of the IMIA Health Informatics for Development Working Group. Yearb Med Inform 2015; 10:30-3. [PMID: 26123907 DOI: 10.15265/iy-2015-013] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
UNLABELLED Patient Centered Care Coordination (PCCC) focuses on the patient health care needs. PCCC involves the organization, the patients and their families, that must coordinate resources in order to accomplish the goals of PCCC. In developing countries, where disparities are frequent, PCCC could improve clinical outcomes, costs and patients satisfaction. OBJECTIVE the IMIA working group Health Informatics for Development analyzes the benefits, identifies the barriers and proposes strategies to reach PCCC. METHODS Discussions about PCCC emerged from a brief guide that posed questions about what is PCCC, why consider PCCC important, barriers to grow in this direction and ask about resources considered relevant in the topic. RESULTS PCCC encompasses a broad definition, includes physical, mental, socio-environmental and self care. Even benefits are proved, in developing countries the lack of a comprehensive and integrated healthcare network is one of the main barriers to reach this objective. Working hard to reach strong health policies, focus on patients, and optimizing the use of resources could improve the performance in the devolvement of PCCC programs. International collaboration could bring benefits. We believe information IT, and education in this field will play an important role in PCCC. CONCLUSION PCCC in developing countries has the potential to improve quality of care. Education, IT, policies and cultural issues must be addressed in an international collaborative context in order to reach this goal.
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Affiliation(s)
- C Otero
- Dr. Carlos Martín Otero, Departamento de Informática en Salud, Hospital Italiano de Buenos Aires, E-mail:
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34
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Audisio P, Alonso Zarazaga MA, Slipinski A, Nilsson A, Jelínek J, Taglianti AV, Turco F, Otero C, Canepari C, Kral D, Liberti G, Sama G, Nardi G, Löbl I, Horak J, Kolibac J, Háva J, Sapiejewski M, Jäch M, Bologna MA, Biondi M, Nikitsky NB, Mazzoldi P, Zahradnik P, Wegrzynowicz P, Constantin R, Gerstmeier R, Zhantiev R, Fattorini S, Tomaszewska W, Rücker WH, Vazquez-Albalate X, Cassola F, Angelini F, Johnson C, Schawaller W, Regalin R, Baviera C, Rocchi S, Cianferoni F, Beenen R, Schmitt M, Sassi D, Kippenberg H, Zampetti MF, Trizzino M, Chiari S, Carpaneto GM, Sabatelli S, de Jong Y. Fauna Europaea: Coleoptera 2 (excl. series Elateriformia, Scarabaeiformia, Staphyliniformia and superfamily Curculionoidea). Biodivers Data J 2015; 3:e4750. [PMID: 25892924 PMCID: PMC4399155 DOI: 10.3897/bdj.3.e4750] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 02/18/2015] [Accepted: 03/31/2015] [Indexed: 11/16/2022] Open
Abstract
Fauna Europaea provides a public web-service with an index of scientific names (including synonyms) of all living European land and freshwater animals, their geographical distribution at country level (up to the Urals, excluding the Caucasus region), and some additional information. The Fauna Europaea project covers about 230,000 taxonomic names, including 130,000 accepted species and 14,000 accepted subspecies, which is much more than the originally projected number of 100,000 species. This represents a huge effort by more than 400 contributing specialists throughout Europe and is a unique (standard) reference suitable for many users in science, government, industry, nature conservation and education. Coleoptera represent a huge assemblage of holometabolous insects, including as a whole more than 200 recognized families and some 400,000 described species worldwide. Basic information is summarized on their biology, ecology, economic relevance, and estimated number of undescribed species worldwide. Little less than 30,000 species are listed from Europe. The Coleoptera 2 section of the Fauna Europaea database (Archostemata, Myxophaga, Adephaga and Polyphaga excl. the series Elateriformia, Scarabaeiformia, Staphyliniformia and the superfamily Curculionoidea) encompasses 80 families (according to the previously accepted family-level systematic framework) and approximately 13,000 species. Tabulations included a complete list of the families dealt with, the number of species in each, the names of all involved specialists, and, when possible, an estimate of the gaps in terms of total number of species at an European level. A list of some recent useful references is appended. Most families included in the Coleoptera 2 Section have been updated in the most recent release of the Fauna Europaea index, or are ready to be updated as soon as the FaEu data management environment completes its migration from Zoological Museum Amsterdam to Berlin Museum für Naturkunde.
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Affiliation(s)
- Paolo Audisio
- Sapienza Rome University, Department of Biology and Biotechnologies 'C. Darwin', Rome, Italy
| | | | | | | | | | - Augusto Vigna Taglianti
- Sapienza Rome University, Department of Biology and Biotechnologies 'C. Darwin', Rome, Italy
| | | | - Carlos Otero
- Departamento de Biología Animal, Santiago de Compostela, Spain
| | | | - David Kral
- Charles University, Prague, Czech Republic
| | | | | | - Gianluca Nardi
- MiPAAF, Corpo Forestale dello Stato, Centro Nazionale per lo Studio e la Conservazione della Biodiversità Forestale “Bosco Fontana” di Verona, Sede di Bosco Fontana, Strada Mantova 29, I-46045, Marmirolo (MN), Italy
| | - Ivan Löbl
- Museum d'Histoire naturelle Geneve, Geneve, Switzerland
| | - Jan Horak
- K Hádku 1567, Dubeček, CZ-107 00 Praha 10, Prague, Czech Republic
| | | | - Jirí Háva
- Dermestidae World, Prague, Czech Republic
| | | | | | | | - Maurizio Biondi
- University of L`Aquila, Department of Health, Life and Environmental Sciences, L`Aquila - Coppito, Italy
| | | | | | - Petr Zahradnik
- Forestry and Game Management Research Institute, Praha, Czech Republic
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Cosimo Baviera
- University of Messina, Department of Biological and Environmental Sciences, Messina, Italy
| | - Saverio Rocchi
- University of Florence, Natural History Museum, Zoological Section 'La Specola', Florence, Italy
| | - Fabio Cianferoni
- University of Florence, Natural History Museum, Zoological Section 'La Specola', Florence, Italy
- Institute of Agroenvironmental and Forest Biology, CNR - National Research Council of Italy, Monterotondo Scalo (Rome), Italy
| | - Ron Beenen
- Naturalis Biodiversity Center, Leiden, Netherlands
| | | | - David Sassi
- c/o Museo Civico di Storia Naturale, Milano, Italy
| | | | | | - Marco Trizzino
- Department of Genetics, University of Pennsylvania, Philadelphia, United States of America
| | - Stefano Chiari
- Sapienza Rome University, Department of Biology and Biotechnologies 'C. Darwin', Rome, Italy
| | | | - Simone Sabatelli
- Sapienza Rome University, Department of Biology and Biotechnologies 'C. Darwin', Rome, Italy
| | - Yde de Jong
- University of Eastern Finland, Joensuu, Finland
- University of Amsterdam - Faculty of Science, Amsterdam, Netherlands
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Stanziola E, Uznayo MQ, Ortiz JM, Simón M, Otero C, Campos F, Luna D. User-Centered Design of Health Care Software Development: Towards a Cultural Change. Stud Health Technol Inform 2015; 216:368-371. [PMID: 26262073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Health care software gets better user efficiency, efficacy and satisfaction when the software is designed with their users' needs taken into account. However, it is not trivial to change the practice of software development to adopt user-centered design. In order to produce this change in the Health Informatics Department of the Hospital Italiano de Buenos Aires, a plan was devised and implemented. The article presents the steps of the plan, shows how the steps were carried on, and reflects on the lessons learned through the process.
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Affiliation(s)
- Enrique Stanziola
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | | | - Juan Marcos Ortiz
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Mariana Simón
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Carlos Otero
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Fernando Campos
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Daniel Luna
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
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Mandirola Brieux HF, Bhuiyan Masud JH, Kumar Meher S, Kumar V, Portilla F, Indarte S, Luna D, Otero C, Otero P, Bernaldo de Quirós FG. Challenges and Hurdles of eHealth Implementation in Developing Countries. Stud Health Technol Inform 2015; 216:434-437. [PMID: 26262087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
UNLABELLED Health informatics has the potential to improve the security and quality of patient care, but its impact has varied between developed and developing countries. Related to this, the objective of this study is to identify the challenges and hurdles to improve eHealth in developing countries. We surveyed experts to discover their opinions about five general questions: economic support by Government for eHealth, Government education or training projects in the field, issues related to cultural or educational problems for the implementation of eHealth, policies in terminology or messaging standards and eHealth status policies for long periods. The respondents answered affirmatively in these proportions: 1. Economic support policies 58%, 2. Training policies 25%, 3. Cultural and educational problems 95%, 4. Standards policies, 38%, 5. Policies for long periods, 50% CONCLUSION Our survey has shown that the important problems that need to be addressed in order to implement e-Health in developing countries are firstly, cultural and educational, secondly, economic resources and thirdly policies for long periods.
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Affiliation(s)
| | | | - S Kumar Meher
- All India Institute of Medical Sciences, Delhi, India
| | - V Kumar
- All India Institute of Medical Sciences, Delhi, India
| | | | | | - D Luna
- Hospital Italiano, Buenos Aires, Argentina
| | - C Otero
- Hospital Italiano, Buenos Aires, Argentina
| | - P Otero
- Hospital Italiano, Buenos Aires, Argentina
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Luna D, Otero C, Almerares A, Stanziola E, Risk M, González Bernaldo de Quirós F. Participatory design for drug-drug interaction alerts. Stud Health Technol Inform 2015; 210:45-49. [PMID: 25991099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The utilization of decision support systems, in the point of care, to alert drug-drug interactions has been shown to improve quality of care. Still, the use of these systems has not been as expected, it is believed, because of the difficulties in their knowledge databases; errors in the generation of the alerts and the lack of a suitable design. This study expands on the development of alerts using participatory design techniques based on user centered design process. This work was undertaken in three stages (inquiry, participatory design and usability testing) it showed that the use of these techniques improves satisfaction, effectiveness and efficiency in an alert system for drug-drug interactions, a fact that was evident in specific situations such as the decrease of errors to meet the specified task, the time, the workload optimization and users overall satisfaction in the system.
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Affiliation(s)
- Daniel Luna
- Programa de Maestría en Ingenieria de Sistemas de Información, Escuela de Posgrado, Facultad Regional Buenos Aires, UTN, Argentina
| | - Carlos Otero
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Alfredo Almerares
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Enrique Stanziola
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Marcelo Risk
- Instituto Tecnológico de Buenos Aires (ITBA), Argentina
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Franco M, Giussi Bordoni MV, Otero C, Landoni MC, Benitez S, Borbolla D, Luna D. Problem Oriented Medical Record: Characterizing the Use of the Problem List at Hospital Italiano de Buenos Aires. Stud Health Technol Inform 2015; 216:877. [PMID: 26262179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Problem oriented medical record (POMR) was born in late sixties. Expecting an ordered, complete and updated medical record were some of the goals of its founder. Several healthcare institutions have included problem list into their clinical records but some concerns have been reported. These concerns are in reference to their voluminosity, incompleteness and outdatedness. This study attempts to understand how healthcare professionals are using the problem list at Hospital Italiano de Buenos Aires (HIBA). We believe it is essential to understand the local reality applied to our own applications and cultural instances of documentation. This report is the basis from which several improvements could be made in order to meet the goals of Weed's proposal.
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Affiliation(s)
- Mariano Franco
- Health Informatics Department, Hospital Italiano de Buenos Aires
| | | | - Carlos Otero
- Health Informatics Department, Hospital Italiano de Buenos Aires
| | | | - Sonia Benitez
- Health Informatics Department, Hospital Italiano de Buenos Aires
| | - Damian Borbolla
- Health Informatics Department, Hospital Italiano de Buenos Aires
| | - Daniel Luna
- Health Informatics Department, Hospital Italiano de Buenos Aires
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Luna D, Quispe M, Gonzalez Z, Alemrares A, Risk M, Garcia Aurelio M, Otero C. User-centered design to develop clinical applications. Literature review. Stud Health Technol Inform 2015; 216:967. [PMID: 26262269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
User-centered design is mentioned by Norman as "the need for a design that uses the natural properties of the individuals, exploiting the relationships and constraints and focusing on the needs and interests of the user, in order to make the final products usable and understandable". This is also important in health developments. The objective of this paper is to search and analyze articles in the healthcare field where user-centered design principles have been applied. We describe findings in this topic from articles published between January 1995 and September 2014.
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Affiliation(s)
- Daniel Luna
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Argentina
| | - María Quispe
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Argentina
| | - Zulma Gonzalez
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Argentina
| | - Alfredo Alemrares
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Argentina
| | - Marcelo Risk
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Argentina
| | | | - Carlos Otero
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Argentina
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Luna D, Almerares A, Mayan JC, González Bernaldo de Quirós F, Otero C. Health Informatics in Developing Countries: Going beyond Pilot Practices to Sustainable Implementations: A Review of the Current Challenges. Healthc Inform Res 2014; 20:3-10. [PMID: 24627813 PMCID: PMC3950262 DOI: 10.4258/hir.2014.20.1.3] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [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: 11/06/2013] [Revised: 01/15/2014] [Accepted: 01/15/2014] [Indexed: 12/03/2022] Open
Abstract
Objectives Information technology is an essential tool to improve patient safety and the quality of care, and to reduce healthcare costs. There is a scarcity of large sustainable implementations in developing countries. The objective of this paper is to review the challenges faced by developing countries to achieve sustainable implementations in health informatics and possible ways to address them. Methods In this non-systematic review of the literature, articles were searched using the keywords medical informatics, developing countries, implementation, and challenges in PubMed, LILACS, CINAHL, Scopus, and EMBASE. The authors, after reading the literature, reached a consensus to classify the challenges into six broad categories. Results The authors describe the problems faced by developing countries arising from the lack of adequate infrastructure and the ways these can be bypassed; the fundamental need to develop nationwide e-Health agendas to achieve sustainable implementations; ways to overcome public uncertainty with respect to privacy and security; the difficulties shared with developed countries in achieving interoperability; the need for a trained workforce in health informatics and existing initiatives for its development; and strategies to achieve regional integration. Conclusions Central to the success of any implementation in health informatics is knowledge of the challenges to be faced. This is even more important in developing countries, where uncertainty and instability are common. The authors hope this article will assist policy makers, healthcare managers, and project leaders to successfully plan their implementations and make them sustainable, avoiding unexpected barriers and making better use of their resources.
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Affiliation(s)
- Daniel Luna
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Alfredo Almerares
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - John Charles Mayan
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Carlos Otero
- Department of Health Informatics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Borbolla D, Del Fiol G, Taliercio V, Otero C, Campos F, Martinez M, Luna D, Quiros F. Integrating personalized health information from MedlinePlus in a patient portal. Stud Health Technol Inform 2014; 205:348-352. [PMID: 25160204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The objective of this paper is to describe the implementation and use of context aware information in Spanish from MedlinePlus embedded in a Patient Portal. Personalized information can help patients solve problems, make treatment decisions, gain confidence in their ability to care for themselves and communicate with providers. To integrate MedlinePlus information in our institutional PHR we used the HL7 Context-Aware Knowledge Retrieval Standard, also known as the Infobutton Standard. After analysing one year of use, patients accessed MedlinePlus information in Spanish in a similar rate to other personalized information generated locally. Infobuttons associated to laboratory test results were used in approximately 10% of patients portal sessions when reviewing lab results.
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Affiliation(s)
- Damian Borbolla
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | | | - Vanina Taliercio
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Carlos Otero
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Fernando Campos
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Marcela Martinez
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Daniel Luna
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
| | - Fernan Quiros
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
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Otero C, Paz RD, Galassi N, Bezrodnik L, Finiasz MR, Fink S. Immune response to Streptococcus pneumoniae in asthma patients: comparison between stable situation and exacerbation. Clin Exp Immunol 2013; 173:92-101. [PMID: 23607482 DOI: 10.1111/cei.12082] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2013] [Indexed: 01/01/2023] Open
Abstract
In Argentina, more than 3 million people suffer from asthma, with numbers rising. When asthma patients acquire viral infections which, in turn, trigger the asthmatic response, they may develop subsequent bacterial infections, mainly by Streptococcus (S.) pneumoniae. This encapsulated Gram(+) bacterium has been considered historically a T cell-independent antigen. Nevertheless, several papers describe the role of T cells in the immune response to S. pneumoniae. We evaluated the response to S. pneumoniae and compared it to the response to Mycobacterium (M.) tuberculosis, a different type of bacterium that requires a T helper type 1 (Th1) response, in cells from atopic asthmatic children, to compare parameters for the same individual under exacerbation and in a stable situation whenever possible. We studied asthma patients and a control group of age-matched children, evaluating cell populations, activation markers and cytokine production by flow cytometry, and cytokine concentration in serum and cell culture supernatants by enzyme-linked immunosorbent assay (ELISA). No differences were observed in γδ T cells for the same patient in either situation, and a tendency to lower percentages of CD4(+) CD25(hi) T cells was observed under stability. A significantly lower production of tumour necrosis factor (TNF)-α and a significantly higher production of interleukin (IL)-5 was observed in asthma patients compared to healthy individuals, but no differences could be observed for IL-4, IL-13 or IL-10. A greater early activation response against M. tuberculosis, compared to S. pneumoniae, was observed in the asthmatic patients' cells. This may contribute to explaining why these patients frequently acquire infections caused by the latter bacterium and not the former.
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Affiliation(s)
- C Otero
- Immune Response to Human Infections Laboratory, IMEX-CONICET-Academia Nacional de Medicina, Argentina
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Otero C, Marcelo A, Luna D. Health Informatics in Developing Countries: Systematic Review of Reviews Contribution of the IMIA Working Group Health Informatics for Development. Yearb Med Inform 2013. [DOI: 10.1055/s-0038-1638829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Summary
Objectives: An evidence-base is important for medicine and health informatics. Despite numerous publications showing the benefits of health informatics, the emergence of health information systems in developing countries has been slower than expected. The aim of this paper is to identify systematic reviews on the domain of health informatics in developing countries, and classify the different types of applications covered.
Methods: A systematic review of reviews was conducted. The literature search spanned the time period between 2000 and 2012 and included PubMed, EMBASE, CINAHL, Scopus, Cochrane Systematic Reviews, LILACS, and Google Scholar. The search term was ‘systematic reviews of health informatics in developing countries’, and transparent and systematic procedures were applied to limit bias at all stages.
Results: Of the 982 identified articles, only 10 met the inclusion criteria and one more article was added in a second manual search, resulting in a total of 11 systematic reviews for the analysis.
Conclusions: Although it was difficult to find high quality resources on the selected domain, the best evidence available allowed us to generate this report and create an incipient review of the state of the art in health informatics in the developing countries. More studies will be needed to optimize the results.
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García HS, Baeza-Jiménez R, Miranda K, Otero C. Lipase-catalyzed glycerolysis of fish oil to obtain diacylglycerols. Grasas y Aceites 2013. [DOI: 10.3989/gya.084412] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Borbolla D, Gorman P, Del Fiol G, Mohan V, Hersh W, Otero C, Luna D, Gonzalez Bernaldo De Quiros F. Physicians perceptions of an educational support system integrated into an electronic health record. Stud Health Technol Inform 2013; 186:125-129. [PMID: 23542982 PMCID: PMC3745779] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The purpose of this study is to determine the perceptions by physicians of an educational system integrated into an electronic health record (EHR). Traditional approaches to continuous medical education (CME) have not shown improvement in patient health care outcomes. Hospital Italiano de Buenos Aires (HIBA) has implemented a system that embeds information pearls into the EHR, providing learning opportunities that are integrated into the patient care process. This study explores the acceptability and general perceptions of the system by physicians when they are in the consulting room. We interviewed 12 physicians after one or two weeks of using this CME system and we performed a thematic analysis of these interviews. The themes that emerged were use and ease of use of the system; value physicians gave to the system; educational impact on physicians; respect for the individual learning styles; content available in the system; and barriers that were present or absent for using the CME system. We found that the integrated CME system developed at HIBA was well accepted and perceived as useful and easy to use. Future work will involve modifications to the system interface, expansion of the content offered and further evaluation.
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Affiliation(s)
- Damian Borbolla
- Hospital Italiano de Buenos Aires, Buenos Aires City, Argentina.
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Luna D, Otero C, Marcelo A. Health Informatics in Developing Countries: Systematic Review of Reviews. Contribution of the IMIA Working Group Health Informatics for Development. Yearb Med Inform 2013; 8:28-33. [PMID: 23974545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
OBJECTIVES An evidence-base is important for medicine and health informatics. Despite numerous publications showing the benefits of health informatics, the emergence of health information systems in developing countries has been slower than expected. The aim of this paper is to identify systematic reviews on the domain of health informatics in developing countries, and classify the different types of applications covered. METHODS A systematic review of reviews was conducted. The literature search spanned the time period between 2000 and 2012 and included PubMed, EMBASE, CINAHL, Scopus, Cochrane Systematic Reviews, LILACS, and Google Scholar. The search term was 'systematic reviews of health informatics in developing countries', and transparent and systematic procedures were applied to limit bias at all stages. RESULTS Of the 982 identified articles, only 10 met the inclusion criteria and one more article was added in a second manual search, resulting in a total of 11 systematic reviews for the analysis. CONCLUSIONS Although it was difficult to find high quality resources on the selected domain, the best evidence available allowed us to generate this report and create an incipient review of the state of the art in health informatics in the developing countries. More studies will be needed to optimize the results.
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Affiliation(s)
- D Luna
- Health Informatics Department, Hospital Italiano de Buenos Aires, Gascon 450, CABA, Buenos Aires, Argentina (C1181ACH). E-mail:
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Plazzotta F, Otero C, Luna D, de Quiros FGB. Natural language processing and inference rules as strategies for updating problem list in an electronic health record. Stud Health Technol Inform 2013; 192:1163. [PMID: 23920937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
UNLABELLED Physicians do not always keep the problem list accurate, complete and updated. OBJECTIVE To analyze natural language processing (NLP) techniques and inference rules as strategies to maintain completeness and accuracy of the problem list in EHRs. METHODS Non systematic literature review in PubMed, in the last 10 years. Strategies to maintain the EHRs problem list were analyzed in two ways: inputting and removing problems from the problem list. RESULTS NLP and inference rules have acceptable performance for inputting problems into the problem list. No studies using these techniques for removing problems were published Conclusion: Both tools, NLP and inference rules have had acceptable results as tools for maintain the completeness and accuracy of the problem list.
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Affiliation(s)
- Fernando Plazzotta
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
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Luna D, Franco M, Plaza C, Otero C, Wassermann S, Gambarte ML, Giunta D, González Bernaldo de Quirós F. Accuracy of an electronic problem list from primary care providers and specialists. Stud Health Technol Inform 2013; 192:417-421. [PMID: 23920588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Accurate patient problem lists in Electronic Health Records (EHRs) are valuable tools for improving the quality of care, communication among professionals, facilitating research, quality measurement and the implementation of clinical decision support systems. However, problem lists are frequently inaccurate and out-of-date, and use varies widely across providers. These deficiencies limit problem list benefits. We decided to check if accuracy of problem lists-assessed at a granular level of detail-registered in EHRs depended on the specialty of the physician (primary care providers vs. specialists), and in the event that such differences did occur, whether or not accuracy had also been affected by the work environment. By using registered problems and taking the generated clinical document, we designed a cross-sectional survey following the guidelines of the Clinical Document Architecture standard. Problems registered by primary care providers have a higher level of accuracy than those registered by specialists in all settings considered (emergency unit, inpatient and outpatient). The work environment also significantly affects the accuracy level of problems registered.
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Affiliation(s)
- Daniel Luna
- Health Informatics Department, Hospital Italiano de Buenos Aires, Argentina
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Affiliation(s)
- Carlos Musso
- Nephrology Division, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
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García HS, Baeza-Jiménez R, González-Rodríguez J, Kim IH, Otero C. Use of immobilized phospholipase A1-catalyzed acidolysis for the production of structured phosphatidylcholine with an elevated conjugated linoleic acid content. Grasas y Aceites 2012. [DOI: 10.3989/gya.045211] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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