Delinquent Medical Records: Who Are the Stakeholders for Timely Medical Documentation?

The explosion of electronic documentation associated with Meaningful Use-certified electronic health record systems has led to a massive increase in provider workload for completion and finalization of patient encounters. Delinquency of required documentation affects multiple areas of hospital operations. We present the major stakeholders affected by delinquency of the electronic medical record and examine the differing perspectives to gain insight for successful engagement to reduce the burden of medical record delinquency.

Development of a Weighted Well-Being Assessment Mobile App for Trauma Affected Communities: A Usability Study

A well-being mobile app was built and tested by performing a usability study in a trauma affected community (TAC). Seven usability tasks were given to social workers during Phase 1. Phase 2 of the usability study was a re-test of the same tasks with the same social workers after refinements were applied. The results showed that most users preferred darker foreground colors, lighter background colors, larger fonts, and larger sized UI components. Statistically significant improvements were found after changes were implemented to the app and included time for page navigation (Z = -2.366, p = 0.018), logout (Z = -1.997, p = 0.046), and item selection in a page (Z = -2.371, p = 0.018). UI positioning and size changes proved to be a significant determinant of user satisfaction based on the positive feedback received from the computer systems usability questionnaire (CSUQ). (User1: p = .000, User 2 withdrew; User3: p = .010, User4: p = .000, User5: p = .001, User6: p = .006, User7: p = .025). HIM professionals assisted in the design, development, and administration of the usability study. This is another area in which HIM professionals are needed when assessing health and wellness in communities affected by trauma.

Health Information Management Reimagined: Assessing Current Professional Skills and Industry Demand

This paper examines the changes affecting the health information management (HIM) professional skill set and industry demand to determine differences affecting practitioners. As the industry continues to experience technological innovation, the responsibilities of the HIM professional are in flux, affecting the required skill set of the changing environment. This research used the American Health Information Management Association salary survey and current job postings to determine whether the workforce has experienced deskilling and whether a theory-practice-gap exists. It also assesses if industry competencies align with the Health Information Management Reimaged perspectives. The results indicate that the workforce has not experienced deskilling, that a theory-practice gap does exist, and that Health Information Management Reimaged is aligned with industry needs.

Information Management in the Emergency Department

Information management in the emergency department (ED) is a challenge for all providers. The volume of information required to care for each patient and to keep the ED functioning is immense. It must be managed through varying means of communication and in connection with ED information systems. Management of information in the ED is imperfect; different modes and methods of identification, interpretation, action, and communication can be beneficial or harmful to providers, patients, and departmental flow. This article reviews the state of information management in the ED and proposes recommendations to improve the management of information in the future.

What Caused the Outbreak of COVID-19 in China: From the Perspective of Crisis Management

Since the first known case of a COVID-19 infected patient in Wuhan, China on 8 December 2019, COVID-19 has spread to more than 200 countries, causing a worldwide public health crisis. The existing literature fails to examine what caused this sudden outbreak from a crisis management perspective. This article attempts to fill this research gap through analysis of big data, officially released information and other social media sources to understand the root cause of the crisis as it relates to China's current management system and public health policy. The article draws the following conclusions: firstly, strict government control over information was the main reason for the early silencing of media announcements, which directly caused most people to be unprepared and unaware of COVID-19. Secondly, a choice between addressing a virus with an unknown magnitude and nature, and mitigating known public panic during a politically and culturally sensitive time, lead to falsehood and concealment. Thirdly, the weak autonomous management power of local public health management departments is not conducive for providing a timely response to the crisis. Finally, the privatization of many state-owned hospitals led to the unavailability of public health medical resources to serve affected patients in the Wuhan and Hubei Province. This article suggests that China should adopt a Singaporean-style public health crisis information management system to ensure information disclosure and information symmetry and should use it to monitor public health crises in real time. In addition, the central government should adopt the territorial administration model of a public health crisis and increase investment in public health in China.

The impact of an integrated electronic immunization registry and logistics management information system (EIR-eLMIS) on vaccine availability in three regions in Tanzania: A pre-post and time-series analysis

BACKGROUND

Since 2016, the Government of Tanzania has been implementing TImR, an integrated Electronic Immunization registry-logistics management information system (EIR-LMIS) that includes stock notifications. The objective of this study is to estimate the impact of this intervention on vaccine availability.

METHODS

Monthly stock-out data were collected from paper registers at facilities, an Excel-based system at districts, and the new system (TImR) across all 924 health facilities in Arusha, Tanga and Kilimanjaro Regions. Six months of stockout rates pre- and post-introduction, by antigen, were compared via a two-way analysis of variance (ANOVA). A mixed-effects logistic regression model with the TImR data identified predictors of vaccine availability across antigens.

FINDINGS

Post-introduction, ANOVA models estimated that overall stock-out rates declined from a monthly average of 7.1% to 2.1% (p < 0.01). Three specific vaccines had fewer stock-outs; OPV's monthly average dropped from 12.5% to 2.1% (p < 0.01), MR from 9.4% to 1.0% (p < 0.01) and DTP-HepB-HiB from 8.1% to 1.7% (p < 0.01). In the mixed-effects logistic regression model, controlling for antigen, odds of stock-out were 4.1% (95% CI: 3.3 - 4.9) lower for each week of tenure. Compared to DTP-HepB-HiB vaccine, odds of BCG vaccine being stocked out were 4.31 as high (95% CI: 3.1 - 5.0). The odds of being stocked-out were 29.7% lower for PCV (95% CI: 8.8 - 45.8) and 26.6% (95% CI: 3.4 - 44.1) lower for rotavirus vaccines compared to DTP-HepB-HiB. The odds of stock out were 37.7% lower for MR vaccine than DTP-HepB-HiB (95% CI: 18.1 - 52.6).

CONCLUSIONS

Tanzania's integrated EIR-eLMIS may increase vaccine availability compared to its paper and Excel based system. Post-introduction of an eLMIS, the odds of a vaccine stock-out reduced over time. Further research could determine the impact of this intervention on vaccine wastage and replenishment response times.

Evidence-based Operations Management in Health Information Management: A Case Study

This is a case study of the evidence-based management practices of a centralized health information management (HIM) department in a large integrated healthcare delivery system. The case study used interviews and focus groups, as well as de-identified dashboards, to explore the impact of reporting on the organization. The dashboards and key performance indicators (KPIs) were initially developed in 2012 and have continued to evolve. The themes that resulted include the following: (1) evidence-based management is integral to the culture of the organization; (2) communicating regularly via dashboards and KPIs is key to transmitting the value of HIM to the entire organization; and (3) staff not only report the required measures for the dashboard but also take pride in it and often develop methods for tracking their individual performance. Most evidence supporting HIM operations management is related to coding and clinical documentation improvement, but even in those areas, national benchmarks are missing. It is important for the HIM profession to develop national and regional benchmarks to assist professionals in managing operations effectively and communicating their value to the healthcare industry.

Developing and Implementing Health Information Management Document Imaging Productivity Standards: A Case Study from an Acute Care Community Hospital

As health information management (HIM) shifts from paper-based medical records to electronic medical documentation, HIM professionals must appropriately manage their resources to produce higher results for their organization's operational and financial indicators. This case study highlights the experience of the HIM department in a small Florida community hospital in analyzing existing productivity standards and developing new standards with the purpose of improving the document imaging process. The research produced new productivity standards that more accurately represent the time HIM technicians spend performing their everyday tasks. The data collected during this period indicate that the average HIM technician was prepping 844 images an hour, scanning 601 images an hour, and indexing 482 images an hour. While a trend in productivity cannot be identified because different types of data were collected, the department's standards are now based on more consistently measurable output. The data collected during this study were used to manage the continuously changing workflow processes; improve the staff's knowledge, skills, and abilities; and identify potential areas of process improvement.

Communication, learning and assessment: Exploring the dimensions of the digital learning environment

Advances in technology make it possible to supplement in-person teaching activities with digital learning, use electronic records in patient care, and communicate through social media. This relatively new "digital learning environment" has changed how medical trainees learn, participate in patient care, are assessed, and provide feedback. Communication has changed with the use of digital health records, the evolution of interdisciplinary and interprofessional communication, and the emergence of social media. Learning has evolved with the proliferation of online tools such as apps, blogs, podcasts, and wikis, and the formation of virtual communities. Assessment of learners has progressed due to the increasing amounts of data being collected and analyzed. Digital technologies have also enhanced learning in resource-poor environments by making resources and expertise more accessible. While digital technology offers benefits to learners, the teachers, and health care systems, there are concerns regarding the ownership, privacy, safety, and management of patient and learner data. We highlight selected themes in the domains of digital communication, digital learning resources, and digital assessment and close by providing practical recommendations for the integration of digital technology into education, with the aim of maximizing its benefits while reducing risks.

Genetic Variations and Precision Medicine

The time and costs associated with the sequencing of a human genome have decreased significantly in recent years. Many people have chosen to have their genomes sequenced to receive genomics-based personalized healthcare services. To reach the goal of genomics-based precision medicine, health information management (HIM) professionals need to manage and analyze patients' genomic data. Two important pieces of information from the genome sequence are the risk of genetic diseases and the specific medication or pharmacogenomic results for the individual patient, both of which are linked to a patient's genetic variations. In this review article, we introduce genetic variations, including their data types, relevant databases, and some currently available analysis methods and systems. HIM professionals can choose to use these databases, methods, and systems in the management and analysis of patients' genomic data.

The Expanding Role of Clinical Documentation Improvement Programs in Research and Analytics

The future of clinical documentation improvement (CDI) will require expanding the reach of CDI programs into new areas of expertise because the traditional realms of CDI work are increasingly becoming automated. CDI-based research and analytics can serve as a means for demonstrating continued value to an institution. We present four studies as examples of these efforts. We explored the use of claims data to determine whether a clinical condition meets the criteria for a secondary diagnosis and to evaluate whether a clinical problem should be elevated to the status of a comorbid or complicating condition. We demonstrated a way in which CDI professionals can evaluate the impacts of changes in clinical definitions, and we explored how CDI can work with other institutional programs to decrease length of stay. We believe that these models may serve as a springboard within institutions and among the larger CDI community to make research and analytics a foundation of future CDI activities.

Development of a Catheterization and Percutaneous Coronary Intervention Registry with a Data Management Approach: A Systematic Review

Coronary catheterization is the gold standard for diagnosis and treatment of cardiovascular conditions. The development of a catheterization and percutaneous coronary intervention (CathPCI) registry considering key steps of data management has a pivotal role in coronary catheterization because it could help improve CathPCI approaches, develop equipment and devices, and minimize complications of the CathPCI procedure. Data management comprises data gathering, data processing, and information distribution. Data gathering involves the collection of data elements, including demographics, episode of care, history and relevant risk factors, visits to the catheterization laboratory, diagnosis of cardiac catheterization, estimation of the coronary arterial anatomy, percutaneous coronary intervention procedures, lesions, devices, outcomes, and discharge. Data processing is performed with respect to the number of procedures performed in different circumstances, the outcomes of the performed procedures, improvement in the healthcare approach, development of devices and equipment, and the quality of the performed procedures. Information distribution involves the sharing of information and making information accessible to researchers and clinicians, relevant health care managers, and manufacturers of medical devices and equipment. This study reviewed relevant English-language publications regarding cardiac catheterization registries, data collection, data processing, and information distribution, regardless of the date of publication.

Health Information Counselors: A New Profession for the Age of Big Data

Health care is increasingly data driven. Concurrently, there are concerns that health professionals lack the time and training to guide patients through the growing medical "data jungle." In the age of big data, ever wider domains of people's lives are "datafied," which renders ever more information-at least in principle-usable for health care purposes. Turning data into meaningful information for clinical practice-and deciding what data or information should not be used for this purpose-requires a significant amount of time, resources, and skill. The authors argue that academic medicine should lead the way in navigating the use of complex, highly personal data in clinical practice. To make data actionable for both clinicians and patients, the authors propose that the best way to navigate the interface between patients and providers in the era of data-rich medicine would be the creation of a new profession entirely: health information counselors (HICs). HICs would have broad knowledge of various kinds of health data and data quality evaluation techniques, as well as analytic skills in statistics and data interpretation. Trained also in interpersonal communication, health management, insurance systems, and medico-legal aspects of data privacy, HICs would know enough about clinical medicine to advise on the relevance of any kind of data for prevention, diagnosis, and treatment. The creation of this new specialty would help patients and health care professionals to make more informed choices about how increasing amounts of health data and information can or should inform health care.

Evaluation de la performance du système de gestion logistique des Intrants de Lutte contre le paludisme dans le Département du Littoral, au Bénin, en 2017

Introduction

Cette étude visait à évaluer la performance du système de gestion logistique (SGL) des intrants de lutte contre le paludisme (ILP) dans le Département du Littoral, au Bénin, en 2017.

Méthodes

Il s’agissait d’une étude transversale évaluative qui s’était déroulée en juin 2017. Elle portait sur les structures de stockage et de cession des ILP ainsi que le personnel impliqué dans leur gestion. La performance du SGL était évaluée à partir de la conformité observée pour les composantes et sous-composantes de la « Structure », du « Processus » et des « Résultats » par rapport aux normes ou standards définis par le Ministère de la Santé.

Résultats

Un total de 36 structures a été enquêté avec leurs cibles secondaires. Il résulte que 52,78% des dépôts répartiteurs réunissaient les conditions optimales de stockage des intrants alors que seulement 33,33% des agents chargés de la gestion des ILP étaient formés en gestion logistique. La performance du SGL des ILP était insuffisante (conformité de 59,13% par rapport au score attendu). La structure, ainsi que le processus avaient une conformité Insuffisante par rapport aux normes (respectivement 60,20% et 73,22% du score attendu), engendrant des résultats jugés mauvais (41,53% du score attendu). La sous-composante la plus insuffisante était le système d’information de la gestion logistique (SIGL).

Conclusion

Cette étude met en évidence la place du SIGL pour une meilleure performance de la gestion des ILP. Une attention particulière devra être accordée à ce volet.

[Fifty years of services of biomedical information in health documentation centers in Puebla, Mexico]

Librarian and information services focused on supporting research, teaching, and health care are vital for the generation of new knowledge and its application in health care, both by staff and students, helps to improve the quality of medical care. Therefore, in this article we expose an historical and social tour of 50 years of the Instituto Mexicano del Seguro Social's library services in Puebla. From 1964 to 2014 occurred many events in the development of these services in our area, from the creation of a small space in the basement, to the implementation of spaces created deliberately to provide dignified service to all users, which is why this historical sketch is here as an acknowledgement to the first librarians who contributed to the training of specialists in Mexico.

A Health Information System for Scalable and Comprehensive Assessment of Well-Being: A Multidisciplinary Team Solution

To improve the health and well-being of the medically underserved in a free clinic in Pittsburgh, Pennsylvania, a multidisciplinary team representing several health information management and information technology (IT) professionals, including faculty, students, researchers, and clinicians, created a novel IT system called imHealthy. The imHealthy system includes four critical components: a multidomain well-being questionnaire, a mobile app for data collection and tracking, a customization of an open-source electronic health record (EHR), and a data integration and well-being evaluation program leading to recommendations for personalized interventions to caregivers serving the medically underserved. This multidisciplinary team has worked closely on this project and finished critical components of the imHealthy system. Evaluations of these components will be conducted, and factors facilitating the design and adoption of the imHealthy system will be presented. The results from this research can serve as a model for free clinics with similar needs that identified by the research team in Cleveland, Indianapolis, Minnesota, Motor City, Orange County, San Diego, and St. Louis.

The Role of Health Information Management Professionals in the Use of Geographic Information Systems

In recent years the use of geographic information systems (GIS) in healthcare has expanded rapidly. Although the use of GIS has increased quickly, very little consensus has been reached on which healthcare professionals are best suited to be trained in and use GIS. A moderate amount of research has addressed the use of GIS in healthcare, but very little research has addressed selecting and training healthcare professionals in the area of GIS. As the use of GIS becomes more closely tied to electronic health records (EHRs), the thought arises that those best versed in EHRs, health information management (HIM) professionals, would be best suited to take on the GIS role. This mixed-methods study explored the current status of HIM professionals' role in GIS as well as the extent to which GIS is being taught in health information educational programs. Although the findings indicate that few HIM professionals are currently using GIS in their jobs and few HIM programs are currently teaching GIS, there is interest in GIS in the future for HIM professionals and in HIM educational programs.

Impact of Internet on Cytology Information Management

Internet technologies and services impose global information standards in the sphere of healthcare as a whole, which are then implied and applied in the domain of cytology laboratories. Web-based operations form a significant operating segment of any contemporary cytology laboratory as they enable operations by the use of technology, which is usually free of the restrictions imposed by the traditional way of business (geographic area and narrow localisation of activities). In their operations, almost all healthcare organisations currently create and use electronic data anddocuments, which can originate both inside and outside the organisation. An enormous amount of information thus used and exchanged may be processed timely and in a high-quality way only by integrated information systems, given three basic safety requirements: data confidentiality, integrity and availability. In the Republic of Croatia, integration of private and public healthcare information systems has been ongoing for several years but the private healthcare does not yet operate as an integrated system. Instead, each office operates using its own separate information system, i.e.

DATABASE

This paper elaborates the argument that the sample private cytology laboratory possesses an IT system that meets current market and stakeholder needs of the healthcare sector in Croatia, given that private doctors' offices/polyclinics use IT technologies in their operations but make only partial use of Internet capacities in the segment of communication with their business associates and patients, implying the need to continue the research on a statistically relevant sample of EU countries.

The Need for Evidence in Health Informatics

While the use of health IT applications has increased rapidly over past decades, this does not compare strongly with other business sectors. Both reluctance to invest in, and lack of demand to use IT systems may in part be due to lack of robust evidence as to proven benefits. At the same time, the health IT sector has lagged behind other health technology areas in working to, and being expected to work to, robust evidence standards showing benefit and also avoidance of harm. Exacerbating this, limited availability of evidence has perpetuated this misplaced comfort in use of aspiration and expectation rather than evidence in driving investment in health IT applications. Reference back to the core principles drawn from influential thinkers shows the essential centrality of the need for evidence of safety and effectiveness, and for its use relevantly related to context.

Strategies for Leveraging Interoperable Health Information Exchange Systems Among Healthcare Communities

The panel will share international Health Information Exchange (HIE) projects to improve quality and lower costs in healthcare communities (i.e. hospitals, clinician practices, and aged care facilities). HIE allows healthcare professionals and patients to appropriately access and securely share a patient's vital medical information electronically within and across organizations. Intended audience: Researchers, consumers, practitioners, vendors, care providers, and policy makers with interests in technology design, development, implementation, and management, particularly focused on HIE.

POLESAT an Innovative e-Geoplatform in Health Management

Health geography and geomatics have become major disciplines in the last few years and are the source of attractive concepts for medical informatics. POLESAT's e-geoplatform was built to present information and support decision-making during medical consultation. We have improved its usability with innovative and modern methodology. Results show five steps of the process. 1: we select one of three hospitals. 2: thanks to PiNoKio's anatomy, the related activity segments are displayed. 3: the activity segment "AB-Orthopedics, Rheumatology" is displayed. 4: click on "AB02-Amputations" product line and 5: go to hospital activity choropleth map.

CONCLUSION

This third e-geoplatform version is a showcase for advanced open-source geomatics via web-mapping possibilities. Health management based on geography concepts, geomatics, an amusing avatar for children, health and/or geographic open data represent the technology of tomorrow. This e-geoplatform concept presents an opportunity for the serious games industry, education and will reduce health access inequalities.