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Menon SP, Shukla PK, Sethi P, Alasiry A, Marzougui M, Alouane MTH, Khan AA. An Intelligent Diabetic Patient Tracking System Based on Machine Learning for E-Health Applications. Sensors (Basel) 2023; 23:3004. [PMID: 36991714 PMCID: PMC10052330 DOI: 10.3390/s23063004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/19/2023] [Accepted: 03/07/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Continuous surveillance helps people with diabetes live better lives. A wide range of technologies, including the Internet of Things (IoT), modern communications, and artificial intelligence (AI), can assist in lowering the expense of health services. Due to numerous communication systems, it is now possible to provide customized and distant healthcare. MAIN PROBLEM Healthcare data grows daily, making storage and processing challenging. We provide intelligent healthcare structures for smart e-health apps to solve the aforesaid problem. The 5G network must offer advanced healthcare services to meet important requirements like large bandwidth and excellent energy efficacy. METHODOLOGY This research suggested an intelligent system for diabetic patient tracking based on machine learning (ML). The architectural components comprised smartphones, sensors, and smart devices, to gather body dimensions. Then, the preprocessed data is normalized using the normalization procedure. To extract features, we use linear discriminant analysis (LDA). To establish a diagnosis, the intelligent system conducted data classification utilizing the suggested advanced-spatial-vector-based Random Forest (ASV-RF) in conjunction with particle swarm optimization (PSO). RESULTS Compared to other techniques, the simulation's outcomes demonstrate that the suggested approach offers greater accuracy.
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Affiliation(s)
- Sindhu P. Menon
- School of Computing and Information Technology, Reva University, Bangalore 560064, Karnataka, India
| | - Prashant Kumar Shukla
- Department of Computer Science and Engineering, Koneru Lakshmaiah Education Foundation, Vaddeswaram, Guntur 522302, Andhra Pradesh, India
| | - Priyanka Sethi
- Department of Physiotherapy, Faculty of Allied Health Sciences, Manav Rachna International Institute of Research & Studies, Faridabad 121004, Haryana, India
| | - Areej Alasiry
- College of Computer Science, King Khalid University, Abha 61413, Saudi Arabia
| | - Mehrez Marzougui
- College of Computer Science, King Khalid University, Abha 61413, Saudi Arabia
| | | | - Arfat Ahmad Khan
- Department of Computer Science, College of Computing, Khon Kaen University, Khon Kaen 40002, Thailand
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Ebrahimzadeh F, Nabovati E, Hasibian MR, Eslami S. Evaluation of the Effects of Radio-Frequency Identification Technology on Patient Tracking in Hospitals: A Systematic Review. J Patient Saf 2021; 17:e1157-e1165. [PMID: 29252967 DOI: 10.1097/pts.0000000000000446] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this study was to systematically review all studies that evaluated the effects of using radio-frequency identification (RFID) for tracking patients in hospitals. METHODS The PubMed and Embase databases were searched (to August 2015) for relevant English language studies, and those that evaluated the effects of a real-time locating systems with RFID for patient tracking in hospitals were identified and extracted. RESULTS Of the 652 studies found, the 17 relevant studies were extracted for inclusion. Five of the extracted studies used RFID systems in operating theaters, two in emergency departments, one in a magnetic resonance imaging department, one in a radiology room, and the remaining eight studies were in other wards. In these studies, features such as the feasibility, accuracy, precision, reliability, security, level of satisfaction, cost of care, and time efficiency of the RFID systems were reported. Of all the extracted studies, seven evaluated the accuracy of the systems in crowded and unattended areas, and five of these were satisfied with their accuracy. Six evaluated the reliability of the systems, and all of these found the systems to be reliable. Six evaluated time-savings, and all of them reported the systems to be time effective. Two focused on the cost of care, and both of these reported the systems to be cost effective. CONCLUSIONS Although most studies reported a positive impact on the accuracy and precision of patient identification, there is insufficient good evidence to show that RFID systems can accurately localize patients in crowded settings.
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Affiliation(s)
- Fahimeh Ebrahimzadeh
- From the Student Research Committee, Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad
| | - Ehsan Nabovati
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan
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Bellini G, Cipriano M, Comai S, De Angeli N, Gargano JP, Gianella M, Goi G, Ingrao G, Masciadri A, Rossi G, Salice F. Understanding Social Behaviour in a Health-Care Facility from Localization Data: A Case Study. Sensors (Basel) 2021; 21:2147. [PMID: 33803913 PMCID: PMC8003276 DOI: 10.3390/s21062147] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/04/2021] [Accepted: 03/07/2021] [Indexed: 11/30/2022]
Abstract
The most frequent form of dementia is Alzheimer's Disease (AD), a severe progressive neurological pathology in which the main cognitive functions of an individual are compromised. Recent studies have found that loneliness and living in isolation are likely to cause an acceleration in the cognitive decline associated with AD. Therefore, understanding social behaviours of AD patients is crucial to promote sociability, thus delaying cognitive decline, preserving independence, and providing a good quality of life. In this work, we analyze the localization data of AD patients living in assisted care homes to gather insights about the social dynamics among them. We use localization data collected by a system based on iBeacon technology comprising two components: a network of antennas scattered throughout the facility and a Bluetooth bracelet worn by the patients. We redefine the Relational Index to capture wandering and casual encounters, these being common phenomena among AD patients, and use the notions of Relational and Popularity Indexes to model, visualize and understand the social behaviour of AD patients. We leverage the data analyses to build predictive tools and applications to enhance social activities scheduling and sociability monitoring and promotion, with the ultimate aim of providing patients with a better quality of life. Predictions and visualizations act as a support for caregivers in activity planning to maximize treatment effects and, hence, slow down the progression of Alzheimer's disease. We present the Community Behaviour Prediction Table (CBPT), a tool to visualize the estimated values of sociability among patients and popularity of places within a facility. Finally, we show the potential of the system by analyzing the Coronavirus Disease 2019 (COVID-19) lockdown time-frame between February and June 2020 in a specific facility. Through the use of the indexes, we evaluate the effects of the pandemic on the behaviour of the residents, observing no particular impact on sociability even though social distancing was put in place.
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Affiliation(s)
- Gloria Bellini
- Alta Scuola Politecnica (Politecnico di Milano and Politecnico di Torino), 20133 Milano, Italy; (G.B.); (M.C.); (N.D.A.); (J.P.G.); (M.G.); (G.G.); (G.R.)
| | - Marco Cipriano
- Alta Scuola Politecnica (Politecnico di Milano and Politecnico di Torino), 20133 Milano, Italy; (G.B.); (M.C.); (N.D.A.); (J.P.G.); (M.G.); (G.G.); (G.R.)
| | - Sara Comai
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milano, Italy; (A.M.); (F.S.)
| | - Nicola De Angeli
- Alta Scuola Politecnica (Politecnico di Milano and Politecnico di Torino), 20133 Milano, Italy; (G.B.); (M.C.); (N.D.A.); (J.P.G.); (M.G.); (G.G.); (G.R.)
| | - Jacopo Pio Gargano
- Alta Scuola Politecnica (Politecnico di Milano and Politecnico di Torino), 20133 Milano, Italy; (G.B.); (M.C.); (N.D.A.); (J.P.G.); (M.G.); (G.G.); (G.R.)
| | - Matteo Gianella
- Alta Scuola Politecnica (Politecnico di Milano and Politecnico di Torino), 20133 Milano, Italy; (G.B.); (M.C.); (N.D.A.); (J.P.G.); (M.G.); (G.G.); (G.R.)
| | - Gianluca Goi
- Alta Scuola Politecnica (Politecnico di Milano and Politecnico di Torino), 20133 Milano, Italy; (G.B.); (M.C.); (N.D.A.); (J.P.G.); (M.G.); (G.G.); (G.R.)
| | | | - Andrea Masciadri
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milano, Italy; (A.M.); (F.S.)
| | - Gabriele Rossi
- Alta Scuola Politecnica (Politecnico di Milano and Politecnico di Torino), 20133 Milano, Italy; (G.B.); (M.C.); (N.D.A.); (J.P.G.); (M.G.); (G.G.); (G.R.)
| | - Fabio Salice
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milano, Italy; (A.M.); (F.S.)
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D'Acunto JI, Khoury M, Parodi G, Estrada G. [Inpatient identification wristbands failures detection]. Medicina (B Aires) 2021; 81:597-601. [PMID: 34453802] [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: 06/13/2023] Open
Abstract
Medical attention is not free from committing mistakes that can increase mortality and costs. The International Goals for Patient Safety include correct patient identification. The use of wristbands reduces the number of adverse events. The rate of nonidentified patients at the moment of phlebotomy was investigated retrospectively during 2019. The annual rate of non-identified patients was 9.8% and higher rates were observed from April to September. Monday was the day with the highest rate of non-identified. There was statistically significant relationship between the month rate of non-identified patients and the number of discharges from operative unit per month (r=0.6465; p=0.0237) and the bed turnover rate (r=0.7776; p=0.0029). Other wristband identification errors are unknown. The investigation detected failures in patient identification that allowed to make recommendations. In order to reduce the number of missing wristbands it will be necessary to monitor the indicator, especially during the months with the highest number of discharges and bed turnover rate, to evaluate the adherence of the personnel to the current protocol and to carry out training programs.
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Affiliation(s)
- Javier I D'Acunto
- Departamento de Clínica Médica, Instituto de Investigaciones Médicas Alfredo Lanari, Buenos Aires, Argentina. E-mail:
| | - Marina Khoury
- Departamento de Docencia e Investigación, Instituto de Investigaciones Médicas Alfredo Lanari, Buenos Aires, Argentina
| | - Graciela Parodi
- Departamento de Gestión de Pacientes y Estadística, Instituto de Investigaciones Médicas Alfredo Lanari, Buenos Aires, Argentina
| | - Gabriela Estrada
- Departamento de Bioquímica Clínica, Instituto de Investigaciones Médicas Alfredo Lanari, Buenos Aires, Argentina
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Juarez JM, Shaffer AD, Chi DH. Follow-up after failed newborn hearing screening: Parental and primary care provider awareness. Am J Otolaryngol 2020; 41:102614. [PMID: 32622290 DOI: 10.1016/j.amjoto.2020.102614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE The current loss to follow-up rate after failed newborn hearing screening (NBHS) is 34.4%. Previous studies have found that lack of parental and primary care provider (PCP) awareness of NBHS results are significant contributors to loss to follow-up. The objective of this study was to identify factors associated with parental and PCP awareness of NBHS results. MATERIALS AND METHODS Retrospective cohort study. A survey asking about demographics and knowledge of NBHS testing and results was offered to parents in the waiting room of an urban pediatric primary care office. Included were biological parents ≥18 years of age of children ≤10 years of age born in Pennsylvania. Each child's chart was reviewed for PCP documentation of NBHS results. The odds of knowing NBHS results were evaluated using logistic regression. RESULTS The survey was completed by 304 parents. 74.0% were aware of their child's NBHS results. Child age ≥1 year old (OR: 0.49, 95%CI[0.29, 0.82], P = 0.007) and Hispanic ethnicity (OR: 0.38, 95%CI[0.16, 0.89], P = 0.03) were associated with decreased odds of a parent knowing NBHS results. In addition, fewer fathers knew the results of their child's NBHS compared with mothers (OR: 0.33, 95%CI[0.18, 0.62], P < 0.001). However, parental awareness was not associated with birthing facility or insurance type. 222 charts were reviewed for NBHS documentation, revealing PCP awareness in 95.5% of cases and no associations with any of the factors examined. CONCLUSIONS Factors associated with parents not knowing NBHS results included being the parent of an older child, Hispanic, or the father.
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Affiliation(s)
- Jose M Juarez
- University of Pittsburgh School of Medicine, 3550 Terrace Street, Pittsburgh, PA 15261, USA
| | - Amber D Shaffer
- UPMC Children's Hospital of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA 15224, USA
| | - David H Chi
- UPMC Children's Hospital of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA 15224, USA.
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Vaccaroli R, Markus F, Danhardt S, Zimmermann H, Wisniewski F, Lucas P, Barge H. Grand Duchy of Luxembourg: a case study of a national master patient index in production since five years. BMC Med Inform Decis Mak 2020; 20:163. [PMID: 32680499 PMCID: PMC7368768 DOI: 10.1186/s12911-020-01178-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 07/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Unequivocal identification of patients is a precondition for a safe medical journey through different information systems (ISs) and software applications that are communicating and exchanging interoperable data. A master patient index (MPI) can facilitate this task. Being a repository of patient identity traits, a MPI allows an accurate surveillance of the patients' "medical identities". Up to 2014, the Grand Duchy of Luxembourg did not possess a MPI. Here, we describe our experience in the establishment of a national MPI for the Grand Duchy of Luxembourg. METHODS The different steps that were used to establish the MPI system are described. Firstly, through the identification of the suitable application and, secondly, through the implementation of the MPI to the eHealth national platform and its connection to the national health care system. In parallel to the first two phases, the identity management policies were defined and implemented. RESULTS Since 2014, when the MPI was integrated to the eHealth platform, we observed a continuous increase of identity profiles. At the latest update (31 December 2018), 2.418.336 identity profiles have been counted, including almost the totality of Luxembourgish residents (95.2%) as well as all the cross-border workers that are affiliated to the Luxembourgish social security system. An analysis of the identification domains connected to the platform highlighted a yearly increase in the usage rate of the identities by external applications (currently representing 70%). The evaluation of the quality of information contained in each identity profile showed low rejection rates (0.2%), indicating a high quality and a good level of completeness in regards to the required identity traits. CONCLUSIONS This paper presents the current state of patient identity management in Luxembourg and discusses how this synergistically supports the functioning of the national electronic health record (EHR) known as DSP (from the French Dossier de Soins Partagé) and the Luxemburgish health care system. The here described national MPI has refined the identification of patients, leading to an improvement of their safety during their medical journey. Nevertheless, the application regularly undergoes updates to better meet the current requirements of the Luxembourgish health system.
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Affiliation(s)
- Raffaella Vaccaroli
- Agence eSanté G.I.E., Agence Nationale des informations partagées dans le domaine de la santé, 125, route d'Esch, L-1471, Luxembourg, Luxembourg.
| | - Frédéric Markus
- Agence eSanté G.I.E., Agence Nationale des informations partagées dans le domaine de la santé, 125, route d'Esch, L-1471, Luxembourg, Luxembourg
| | - Samuel Danhardt
- Agence eSanté G.I.E., Agence Nationale des informations partagées dans le domaine de la santé, 125, route d'Esch, L-1471, Luxembourg, Luxembourg
| | - Heiko Zimmermann
- Agence eSanté G.I.E., Agence Nationale des informations partagées dans le domaine de la santé, 125, route d'Esch, L-1471, Luxembourg, Luxembourg
| | - Francois Wisniewski
- Agence eSanté G.I.E., Agence Nationale des informations partagées dans le domaine de la santé, 125, route d'Esch, L-1471, Luxembourg, Luxembourg
| | - Pascale Lucas
- Agence eSanté G.I.E., Agence Nationale des informations partagées dans le domaine de la santé, 125, route d'Esch, L-1471, Luxembourg, Luxembourg
| | - Hervé Barge
- Agence eSanté G.I.E., Agence Nationale des informations partagées dans le domaine de la santé, 125, route d'Esch, L-1471, Luxembourg, Luxembourg
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Mandirola Brieux HF, Lopez Osornio A, Diaz Maffini M, Amorese M, Rizzato Lede DA. Master Patient Index Standardization Patient Search Identification Service (PSIS) of the National Directorate of Health Information Systems (DNSIS) Argentina. Stud Health Technol Inform 2020; 270:1337-1338. [PMID: 32570647 DOI: 10.3233/shti200430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Correct patient identification is the cornerstone for the proper implementation of electronic health records. Up to 20% of the registered patients are duplicated in most systems. Strong identification policies and robust systems can minimize such errors. In this poster we share the Ministry of Health recommendations for the Master Patient Index improvement using search algorithms.
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Affiliation(s)
- Ensheng Dong
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Hongru Du
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Lauren Gardner
- Department of Civil and Systems Engineering, Johns Hopkins University, Baltimore, MD 21218, USA.
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Greenhalgh T, Koh GCH, Car J. [Not Available]. Recenti Prog Med 2020; 111:231-237. [PMID: 32319445 DOI: 10.1701/3347.33186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Gerald Choon Huat Koh
- Saw Swee Hock School of Public Health, Yong Loo Lin School of Medicine, National University of Singapore
| | - Josip Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore - Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
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Ly MYN, Kim KK, Stewart SL. Assessing the performance of the Asian/Pacific islander identification algorithm to infer Hmong ethnicity from electronic health records in California. BMJ Open 2019; 9:e031646. [PMID: 31831538 PMCID: PMC6924723 DOI: 10.1136/bmjopen-2019-031646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE This study assesses the performance of the North American Association of Central Cancer Registries Asian/Pacific Islander Identification Algorithm (NAPIIA) to infer Hmong ethnicity. DESIGN AND SETTING Analyses of electronic health records (EHRs) from 1 January 2011 to 1 October 2015. The NAPIIA was applied to the EHR data, and self-reported Hmong ethnicity from a questionnaire was used as the gold standard. Sensitivity, specificity, positive (PPV) and negative predictive values (NPVs) were calculated comparing the source data ethnicity inferred by the algorithm with the self-reported ethnicity from the questionnaire. PARTICIPANTS EHRs indicating Hmong, Chinese, Vietnamese and Korean ethnicity who met the original study inclusion criteria were analysed. RESULTS The NAPIIA had a sensitivity of 78%, a specificity of 99.9%, a PPV of 96% and an NPV of 99%. The prevalence of Hmong population in the sample was 3.9%. CONCLUSION The high sensitivity of the NAPIIA indicates its effectiveness in detecting Hmong ethnicity. The applicability of the NAPIIA to a multitude of Asian subgroups can advance Asian health disparity research by enabling researchers to disaggregate Asian data and unmask health challenges of different Asian subgroups.
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Affiliation(s)
- May Ying N Ly
- Metropolitan Studies, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Katherine K Kim
- Betty Irene Moore School of Nursing, University of California Davis, Davis, California, USA
| | - Susan L Stewart
- Department of Public Health Sciences, Division of Biostatistics, University of California Davis, Sacramento, California, USA
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Diallo AO, Kiemtoré T, Bicaba BW, Medah I, Tarbangdo TF, Sanou S, Soeters HM, Novak RT, Aké HF. Development and Implementation of a Cloud-Based Meningitis Surveillance and Specimen Tracking System in Burkina Faso, 2018. J Infect Dis 2019; 220:S198-S205. [PMID: 31671443 PMCID: PMC6822968 DOI: 10.1093/infdis/jiz376] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Nationwide case-based meningitis surveillance was established in Burkina Faso following the introduction of meningococcal serogroup A conjugate vaccine in 2010. However, timely tracking and arrival of cerebrospinal fluid specimens for confirmation at national reference laboratories remained suboptimal. To better understand this gap and identify bottlenecks, the Burkina Faso Ministry of Health, along with key partners, developed and implemented a cloud-based System for Tracking Epidemiological Data and Laboratory Specimens (STELAB), allowing for timely nationwide data reporting and specimen tracking using barcodes. STELAB was adapted to Burkina Faso's infrastructure to ensure suitability, functionality, flexibility, and sustainability. We describe the design, development, and implementation of STELAB. In addition, we discuss strategies used to promote sustainability, lessons learned during the first year of implementation, and future directions. STELAB's novel design and country-driven approach has the potential to achieve sustainable real-time data reporting and specimen tracking for the first time in sub-Saharan Africa.
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Affiliation(s)
- Alpha Oumar Diallo
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Isaïe Medah
- Ministère de la Santé, Ouagadougou, Burkina Faso
| | | | - Simon Sanou
- Ministère de la Santé, Ouagadougou, Burkina Faso
| | - Heidi M Soeters
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ryan T Novak
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Küng K, Aeschbacher K, Rütsche A, Goette J. [Closed-loop medication management: Results of a user survey]. Z Evid Fortbild Qual Gesundhwes 2019; 146:43-52. [PMID: 31526661 DOI: 10.1016/j.zefq.2019.08.005] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 07/09/2019] [Accepted: 08/15/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND New technologies, such as bar-code scanning systems, have played a significant role in enhancing medication processes over recent years. Despite the documented benefits, integration, acceptance, and user opinion continue to play an important role in the successful implementation of such systems. To date no studies have been carried out in Switzerland to assess the attitude or acceptance of nurses towards electronically supported medication systems after implementation. This study was conducted in order to close this gap. METHODS Following a four-month test phase of a closed-loop medication system on two mixed medical-surgical units in a tertiary teaching hospital, a cross-sectional online survey was conducted among the participating registered nurses (response rate: 62.5%). RESULTS The new system was evaluated positively by the majority (70%) of users. Accordingly, the barcode-assisted medication process was proven to be especially beneficial to users during the 24-hour medication preparation process and during the preparation of infusions. However, user compliance decreased significantly during the administration of bedside medication and the preparation of additional single doses. This was mainly due to a lack of time and inadequate system performance. CONCLUSION In the study, 75% of participants reported that they were open to or even enthusiastic about using the new technologies and were supportive of their introduction into the medication process. Overall, the majority rated the new system as beneficial to daily clinical practice, provided the technical performance was high.
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Affiliation(s)
- Kaspar Küng
- Institut für Spitalpharmazie, Inselspital, Universitätsspital Bern, Bern, Schweiz; Berner Fachhochschule, Departement Gesundheit, Bern, Schweiz.
| | - Katrin Aeschbacher
- Institut für Spitalpharmazie, Inselspital, Universitätsspital Bern, Bern, Schweiz
| | - Adrian Rütsche
- Direktion Technologie und Innovation, Inselspital, Universitätsspital Bern, Bern, Schweiz
| | - Jeannette Goette
- Institut für Spitalpharmazie, Inselspital, Universitätsspital Bern, Bern, Schweiz
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Abstract
A technology for automatically obtaining patient photographs along with portable radiographs was implemented clinically at a large academic hospital. This article highlights several cases in which image-related clinical context, provided by the patient photographs, provided quality control information regarding patient identification, laterality, or position and assisted the radiologist with the interpretation. The information in the photographs can easily minimize unnecessary calls to the patient’s nursing staff for clarifications and can lead to new methods of physically assessing patients.
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Affiliation(s)
- Srini Tridandapani
- From the Department of Radiology, University of Alabama School of Medicine, 619 19th Street South, JT N455E, Birmingham, AL 35249-6830 (S.T.); Department of Radiology and Imaging Science, Emory University School of Medicine, Atlanta, Ga (S.T., E.A.K., N.M.S.); School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Ga (S.T., P.B.); Camerad Technologies, LLC, Decatur, Ga (S.T., P.B., C.A.W.); Department of Radiology, University of Michigan, Ann Arbor, Mich (R.K.J.B.); and Department of Diagnostic Radiology, University of Maryland, Baltimore, Md (E.S.)
| | - Pamela Bhatti
- From the Department of Radiology, University of Alabama School of Medicine, 619 19th Street South, JT N455E, Birmingham, AL 35249-6830 (S.T.); Department of Radiology and Imaging Science, Emory University School of Medicine, Atlanta, Ga (S.T., E.A.K., N.M.S.); School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Ga (S.T., P.B.); Camerad Technologies, LLC, Decatur, Ga (S.T., P.B., C.A.W.); Department of Radiology, University of Michigan, Ann Arbor, Mich (R.K.J.B.); and Department of Diagnostic Radiology, University of Maryland, Baltimore, Md (E.S.)
| | - Richard K J Brown
- From the Department of Radiology, University of Alabama School of Medicine, 619 19th Street South, JT N455E, Birmingham, AL 35249-6830 (S.T.); Department of Radiology and Imaging Science, Emory University School of Medicine, Atlanta, Ga (S.T., E.A.K., N.M.S.); School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Ga (S.T., P.B.); Camerad Technologies, LLC, Decatur, Ga (S.T., P.B., C.A.W.); Department of Radiology, University of Michigan, Ann Arbor, Mich (R.K.J.B.); and Department of Diagnostic Radiology, University of Maryland, Baltimore, Md (E.S.)
| | - Elizabeth A Krupinski
- From the Department of Radiology, University of Alabama School of Medicine, 619 19th Street South, JT N455E, Birmingham, AL 35249-6830 (S.T.); Department of Radiology and Imaging Science, Emory University School of Medicine, Atlanta, Ga (S.T., E.A.K., N.M.S.); School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Ga (S.T., P.B.); Camerad Technologies, LLC, Decatur, Ga (S.T., P.B., C.A.W.); Department of Radiology, University of Michigan, Ann Arbor, Mich (R.K.J.B.); and Department of Diagnostic Radiology, University of Maryland, Baltimore, Md (E.S.)
| | - Nabile M Safdar
- From the Department of Radiology, University of Alabama School of Medicine, 619 19th Street South, JT N455E, Birmingham, AL 35249-6830 (S.T.); Department of Radiology and Imaging Science, Emory University School of Medicine, Atlanta, Ga (S.T., E.A.K., N.M.S.); School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Ga (S.T., P.B.); Camerad Technologies, LLC, Decatur, Ga (S.T., P.B., C.A.W.); Department of Radiology, University of Michigan, Ann Arbor, Mich (R.K.J.B.); and Department of Diagnostic Radiology, University of Maryland, Baltimore, Md (E.S.)
| | - Eliot L Siegel
- From the Department of Radiology, University of Alabama School of Medicine, 619 19th Street South, JT N455E, Birmingham, AL 35249-6830 (S.T.); Department of Radiology and Imaging Science, Emory University School of Medicine, Atlanta, Ga (S.T., E.A.K., N.M.S.); School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Ga (S.T., P.B.); Camerad Technologies, LLC, Decatur, Ga (S.T., P.B., C.A.W.); Department of Radiology, University of Michigan, Ann Arbor, Mich (R.K.J.B.); and Department of Diagnostic Radiology, University of Maryland, Baltimore, Md (E.S.)
| | - Carson A Wick
- From the Department of Radiology, University of Alabama School of Medicine, 619 19th Street South, JT N455E, Birmingham, AL 35249-6830 (S.T.); Department of Radiology and Imaging Science, Emory University School of Medicine, Atlanta, Ga (S.T., E.A.K., N.M.S.); School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Ga (S.T., P.B.); Camerad Technologies, LLC, Decatur, Ga (S.T., P.B., C.A.W.); Department of Radiology, University of Michigan, Ann Arbor, Mich (R.K.J.B.); and Department of Diagnostic Radiology, University of Maryland, Baltimore, Md (E.S.)
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Al-Zubaidie M, Zhang Z, Zhang J. PAX: Using Pseudonymization and Anonymization to Protect Patients' Identities and Data in the Healthcare System. Int J Environ Res Public Health 2019; 16:ijerph16091490. [PMID: 31035551 PMCID: PMC6540163 DOI: 10.3390/ijerph16091490] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/23/2019] [Accepted: 04/23/2019] [Indexed: 11/22/2022]
Abstract
Electronic health record (EHR) systems are extremely useful for managing patients’ data and are widely disseminated in the health sector. The main problem with these systems is how to maintain the privacy of sensitive patient information. Due to not fully protecting the records from unauthorised users, EHR systems fail to provide privacy for protected health information. Weak security measures also allow authorised users to exceed their specific privileges to access medical records. Thus, some of the systems are not a trustworthy source and are undesirable for patients and healthcare providers. Therefore, an authorisation system that provides privacy when accessing patients’ data is required to address these security issues. Specifically, security and privacy precautions should be raised for specific categories of users, doctor advisors, physician researchers, emergency doctors, and patients’ relatives. Presently, these users can break into the electronic systems and even violate patients’ privacy because of the privileges granted to them or the inadequate security and privacy mechanisms of these systems. To address the security and privacy problems associated with specific users, we develop the Pseudonymization and Anonymization with the XACML (PAX) modular system, which depends on client and server applications. It provides a security solution to the privacy issues and the problem of safe-access decisions for patients’ data in the EHR. The results of theoretical and experimental security analysis prove that PAX provides security features in preserving the privacy of healthcare users and is safe against known attacks.
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Affiliation(s)
- Mishall Al-Zubaidie
- Thi-Qar University, Nasiriyah 64001, Iraq.
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, QLD 4350, Australia.
| | - Zhongwei Zhang
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, QLD 4350, Australia.
| | - Ji Zhang
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Toowoomba, QLD 4350, Australia.
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Affiliation(s)
- Amy Luckowski
- Amy Luckowski is an assistant professor at Neumann University in Aston, Pa., and a clinical nurse in the PACU at Penn Medicine at Chester County Hospital in West Chester, Pa
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Pelzang R, Hutchinson AM. Patient safety issues and concerns in Bhutan's healthcare system: a qualitative exploratory descriptive study. BMJ Open 2018; 8:e022788. [PMID: 30061447 PMCID: PMC6067340 DOI: 10.1136/bmjopen-2018-022788] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 06/06/2018] [Accepted: 06/18/2018] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To investigate what healthcare professionals perceived and experienced as key patient safety concerns in Bhutan's healthcare system. DESIGN Qualitative exploratory descriptive inquiry. SETTINGS Three different levels of hospitals, a training institute and the Ministry of Health, Bhutan. PARTICIPANTS In total, 140 healthcare professionals and managers. METHODS Narrative data were collected via conversational in-depth interviews and Nominal Group Meetings. All data were subsequently analysed using thematic analysis strategies. RESULTS The data revealed that medication errors, healthcare-associated infections, diagnostic errors, surgical errors and postoperative complications, laboratory/blood testing errors, falls, patient identification and communication errors were perceived as common patient safety concerns. Human and system factors were identified as contributing to these concerns. Instituting clinical governance, developing and improving the physical infrastructure of hospitals, providing necessary human resources, ensuring staff receive patient safety education and promoting 'good' communication and information systems were, in turn, all identified as processes and strategies critical to improving patient safety in the Bhutanese healthcare system. CONCLUSION Patient safety concerns described by participants in this study were commensurate with those identified in other low and middle-income countries. In order to redress these concerns, the findings of this study suggest that in the Bhutanese context patient safety needs to be conceptualised and prioritised.
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Affiliation(s)
- Rinchen Pelzang
- Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Alison M Hutchinson
- Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
- Deakin Centre for Quality and Patient Safety Research, Monash Health, Melbourne, Victoria, Australia
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Musabyimana A, Ruton H, Gaju E, Berhe A, Grépin KA, Ngenzi J, Nzabonimana E, Hategeka C, Law MR. Assessing the perspectives of users and beneficiaries of a community health worker mHealth tracking system for mothers and children in Rwanda. PLoS One 2018; 13:e0198725. [PMID: 29879186 PMCID: PMC5991741 DOI: 10.1371/journal.pone.0198725] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 05/22/2018] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Mobile Health (mHealth) programs have increasingly been used to tackle maternal and child health problems in low and middle income countries. However, few studies have evaluated how these programs have been perceived by intended users and beneficiaries. Therefore, we explored perceptions of healthcare officials and beneficiaries regarding RapidSMS Rwanda, an mHealth system used by Community Health Workers (CHWs) that was scaled up nationwide in 2013. METHODS We conducted key informant interviews and focus group discussions with key stakeholders, providers, and beneficiaries of maternal and child health services at both the national and community levels. Semi-structured interviews were used to assess perceptions about the impact of and challenges facing the RapidSMS system. Interviews and focus group discussions were recorded (with the exception of one), transcribed verbatim, and analyzed. RESULTS We conducted a total of 28 in-depth interviews and 10 focus group discussions (93 total participants). A majority of respondents believed that RapidSMS contributed to reducing maternal and child mortality rates. RapidSMS was generally accepted by both CHWs and parents. Participants identified insufficient training, a lack of equipment, and low CHW motivation as the main challenges facing RapidSMS. CONCLUSION Our findings suggest that an mHealth program can be well accepted by both policymakers, health providers, and the community. We also found significant technical challenges that have likely reduced its impact. Addressing these challenges will serve to strengthen future mHealth programs.
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Affiliation(s)
- Angele Musabyimana
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Hinda Ruton
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- The Centre for Health Services and Policy Research, School of Population and Public Health, The University of British Columbia, Vancouver, Canada
| | | | | | - Karen A. Grépin
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Joseph Ngenzi
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Emmanuel Nzabonimana
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- School of Dentistry, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Celestin Hategeka
- The Centre for Health Services and Policy Research, School of Population and Public Health, The University of British Columbia, Vancouver, Canada
- Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, UBC, Vancouver, BC, Canada
| | - Michael R. Law
- The Centre for Health Services and Policy Research, School of Population and Public Health, The University of British Columbia, Vancouver, Canada
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States of America
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Abstract
Policy Points: Historically, in addition to economic and technical hurdles, state and federal health information privacy laws have been cited as a significant obstacle to expanding electronic health information exchange (HIE) in the United States. Our review finds that over the past decade, several helpful developments have ameliorated the legal barriers to HIE, although variation in states' patient consent requirements remains a challenge. Today, health care providers' complaints about legal obstacles to HIE may be better understood as reflecting concerns about the economic and competitive risks of information sharing. CONTEXT Although the clinical benefits of exchanging patients' health information electronically across providers have long been recognized, participation in health information exchange (HIE) has lagged behind adoption of electronic health records. Barriers erected by federal and state health information privacy law have been cited as a leading reason for the slow progress. A comprehensive assessment of these issues has not been undertaken for nearly a decade, despite a number of salient legal developments. METHODS Analysis of federal and state health information privacy statutes and regulations and secondary materials. FINDINGS Although some legal barriers to HIE persist, many have been ameliorated-in some cases, simply through improved understanding of what the law actually requires. It is now clear that the Health Insurance Portability and Accountability Act presents no obstacles to electronically sharing protected health information for treatment purposes and does not hold providers who properly disclose information liable for privacy breaches by recipients. The failure of federal efforts to establish a unique patient identifier number does slow HIE by inhibiting optimal matching of patient records, but other action to facilitate matching will be taken under the 21st Century Cures Act. The Cures Act also creates the legal architecture to begin to combat "information blocking." Varying patient consent requirements under federal and state law are the most important remaining legal barrier to HIE progress. However, federal rules relating to disclosure of substance-abuse treatment information were recently liberalized, and development of a technical standard, Data Segmentation for Privacy, or DS4P, now permits sensitive data requiring special handling to be segmented within a patient's record. Even with these developments, state-law requirements for patient consent remain daunting to navigate. CONCLUSIONS Although patient consent requirements make HIE challenging, providers' expressed worries about legal barriers to participating in HIE likely primarily reflect concerns that are economically motivated. Lowering the cost of HIE or increasing financial incentives may boost provider participation more than further reducing legal barriers.
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Prasser F, Kohlmayer F, Kuhn KA. The Importance of Context: Risk-based De-identification of Biomedical Data. Methods Inf Med 2018; 55:347-55. [PMID: 27322502 DOI: 10.3414/me16-01-0012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 04/12/2016] [Indexed: 11/09/2022]
Abstract
Summary
Background: Data sharing is a central aspect of modern biomedical research. It is accompanied by significant privacy concerns and often data needs to be protected from re-identification. With methods of de-identification datasets can be transformed in such a way that it becomes extremely difficult to link their records to identified individuals. The most important challenge in this process is to find an adequate balance between an increase in privacy and a decrease in data quality.
Objectives: Accurately measuring the risk of re-identification in a specific data sharing scenario is an important aspect of data de-identification. Overestimation of risks will significantly deteriorate data quality, while underestimation will leave data prone to attacks on privacy. Several models have been proposed for measuring risks, but there is a lack of generic methods for risk-based data de-identification. The aim of the work described in this article was to bridge this gap and to show how the quality of de-identified datasets can be improved by using risk models to tailor the process of de-identification to a concrete context.
Methods: We implemented a generic de-identification process and several models for measuring re-identification risks into the ARX de-identification tool for biomedical data. By integrating the methods into an existing framework, we were able to automatically transform datasets in such a way that information loss is minimized while it is ensured that re-identification risks meet a user-defined threshold. We performed an extensive experimental evaluation to analyze the impact of using different risk models and assumptions about the goals and the background knowledge of an attacker on the quality of de-identified data.
Results: The results of our experiments show that data quality can be improved significantly by using risk models for data de-identification. On a scale where 100 % represents the original input dataset and 0 % represents a dataset from which all information has been removed, the loss of information content could be reduced by up to 10 % when protecting datasets against strong adversaries and by up to 24 % when protecting datasets against weaker adversaries.
Conclusions: The methods studied in this article are well suited for protecting sensitive biomedical data and our implementation is available as open-source software. Our results can be used by data custodians to increase the information content of de-identified data by tailoring the process to a specific data sharing scenario. Improving data quality is important for fostering the adoption of de-identification methods in biomedical research.
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Affiliation(s)
- Fabian Prasser
- Dr. Fabian Prasser, Institute of Medical Statistics and Epidemiology, University Hospital rechts der Isar, Technical University of Munich, Grillparzerstr. 18, 81675 Munich, Germany, E-mail:
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Balch WH. You're Not Doing What You Think: The Myth of Instrument-To-Patient Tracking. Biomed Instrum Technol 2018; 52:395-396. [PMID: 30260661 DOI: 10.2345/0899-8205-52.5.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Policy on Child Identification Programs. Pediatr Dent 2017; 39:36-7. [PMID: 29179311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Adelman JS, Berger MA, Rai A, Galanter WL, Lambert BL, Schiff GD, Vawdrey DK, Green RA, Salmasian H, Koppel R, Schechter CB, Applebaum JR, Southern WN. A national survey assessing the number of records allowed open in electronic health records at hospitals and ambulatory sites. J Am Med Inform Assoc 2017; 24:992-995. [PMID: 28419267 PMCID: PMC7651980 DOI: 10.1093/jamia/ocx034] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 01/17/2017] [Accepted: 03/15/2017] [Indexed: 11/13/2022] Open
Abstract
To reduce the risk of wrong-patient errors, safety experts recommend limiting the number of patient records providers can open at once in electronic health records (EHRs). However, it is unknown whether health care organizations follow this recommendation or what rationales drive their decisions. To address this gap, we conducted an electronic survey via 2 national listservs. Among 167 inpatient and outpatient study facilities using EHR systems designed to open multiple records at once, 44.3% were configured to allow ≥3 records open at once (unrestricted), 38.3% allowed only 1 record open (restricted), and 17.4% allowed 2 records open (hedged). Decision-making centered on efforts to balance safety and efficiency, but there was disagreement among organizations about how to achieve that balance. Results demonstrate no consensus on the number of records to be allowed open at once in EHRs. Rigorous studies are needed to determine the optimal number of records that balances safety and efficiency.
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Affiliation(s)
- Jason S Adelman
- Department of Medicine, Columbia University Medical Center, New York, NY, USA
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
- Division of Quality and Patient Safety, NewYork-Presbyterian Hospital, New York, NY, USA
| | - Matthew A Berger
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Amisha Rai
- Division of Quality and Patient Safety, NewYork-Presbyterian Hospital, New York, NY, USA
| | - William L Galanter
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Bruce L Lambert
- Department of Communication Studies, Northwestern University, Chicago, IL, USA
| | - Gordon D Schiff
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - David K Vawdrey
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
- Division of Quality and Patient Safety, NewYork-Presbyterian Hospital, New York, NY, USA
| | - Robert A Green
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
- Division of Quality and Patient Safety, NewYork-Presbyterian Hospital, New York, NY, USA
| | - Hojjat Salmasian
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
- Division of Quality and Patient Safety, NewYork-Presbyterian Hospital, New York, NY, USA
| | - Ross Koppel
- Department of Sociology, University of Pennsylvania, Philadelphia, PA, USA
| | - Clyde B Schechter
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jo R Applebaum
- Division of Quality and Patient Safety, NewYork-Presbyterian Hospital, New York, NY, USA
| | - William N Southern
- Department of Medicine, Division of Hospital Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
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Top 10 Patient Safety Concerns for 2017. OR Manager 2017; 33:22-5. [PMID: 30001024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Culbertson A, Goel S, Madden MB, Safaeinili N, Jackson KL, Carton T, Waitman R, Liu M, Krishnamurthy A, Hall L, Cappella N, Visweswaran S, Becich MJ, Applegate R, Bernstam E, Rothman R, Matheny M, Lipori G, Bian J, Hogan W, Bell D, Martin A, Grannis S, Klann J, Sutphen R, O'Hara AB, Kho A. The Building Blocks of Interoperability. A Multisite Analysis of Patient Demographic Attributes Available for Matching. Appl Clin Inform 2017; 8:322-336. [PMID: 28378025 PMCID: PMC6241737 DOI: 10.4338/aci-2016-11-ra-0196] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 01/21/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patient matching is a key barrier to achieving interoperability. Patient demographic elements must be consistently collected over time and region to be valuable elements for patient matching. OBJECTIVES We sought to determine what patient demographic attributes are collected at multiple institutions in the United States and see how their availability changes over time and across clinical sites. METHODS We compiled a list of 36 demographic elements that stakeholders previously identified as essential patient demographic attributes that should be collected for the purpose of linking patient records. We studied a convenience sample of 9 health care systems from geographically distinct sites around the country. We identified changes in the availability of individual patient demographic attributes over time and across clinical sites. RESULTS Several attributes were consistently available over the study period (2005-2014) including last name (99.96%), first name (99.95%), date of birth (98.82%), gender/sex (99.73%), postal code (94.71%), and full street address (94.65%). Other attributes changed significantly from 2005-2014: Social security number (SSN) availability declined from 83.3% to 50.44% (p<0.0001). Email address availability increased from 8.94% up to 54% availability (p<0.0001). Work phone number increased from 20.61% to 52.33% (p<0.0001). CONCLUSIONS Overall, first name, last name, date of birth, gender/sex and address were widely collected across institutional sites and over time. Availability of emerging attributes such as email and phone numbers are increasing while SSN use is declining. Understanding the relative availability of patient attributes can inform strategies for optimal matching in healthcare.
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Affiliation(s)
- Adam Culbertson
- Adam Culbertson, 4300 Wilson Blvd., Suite 250, Arlington, VA 22203,
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Clark LN, Benda NC, Hegde S, McGeorge NM, Guarrera-Schick TK, Hettinger AZ, LaVergne DT, Perry SJ, Wears RL, Fairbanks RJ, Bisantz AM. Usability evaluation of an emergency department information system prototype designed using cognitive systems engineering techniques. Appl Ergon 2017; 60:356-365. [PMID: 28166896 PMCID: PMC5377444 DOI: 10.1016/j.apergo.2016.12.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 12/19/2016] [Accepted: 12/23/2016] [Indexed: 06/06/2023]
Abstract
This article presents an evaluation of novel display concepts for an emergency department information system (EDIS) designed using cognitive systems engineering methods. EDISs assist emergency medicine staff with tracking patient care and ED resource allocation. Participants performed patient planning and orientation tasks using the EDIS displays and rated the display's ability to support various cognitive performance objectives along with the usability, usefulness, and predicted frequency of use for 18 system components. Mean ratings were positive for cognitive performance support objectives, usability, usefulness, and frequency of use, demonstrating the successful application of design methods to create useful and usable EDIS concepts that provide cognitive support for emergency medicine staff. Nurse and provider roles had significantly different perceptions of the usability and usefulness of certain EDIS components, suggesting that they have different information needs while working.
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Affiliation(s)
- Lindsey N Clark
- National Center for Human Factors in Healthcare, MedStar Institute for Innovation, MedStar Health, Washington D.C., USA
| | - Natalie C Benda
- National Center for Human Factors in Healthcare, MedStar Institute for Innovation, MedStar Health, Washington D.C., USA; Department of Industrial and Systems Engineering, University at Buffalo, Buffalo, NY, USA
| | - Sudeep Hegde
- Department of Industrial and Systems Engineering, University at Buffalo, Buffalo, NY, USA
| | - Nicolette M McGeorge
- Department of Industrial and Systems Engineering, University at Buffalo, Buffalo, NY, USA
| | | | - A Zachary Hettinger
- National Center for Human Factors in Healthcare, MedStar Institute for Innovation, MedStar Health, Washington D.C., USA; Department of Emergency Medicine, Georgetown University School of Medicine, Washington D.C., USA
| | - David T LaVergne
- Department of Industrial and Systems Engineering, University at Buffalo, Buffalo, NY, USA
| | - Shawna J Perry
- Department of Emergency Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Robert L Wears
- Department of Emergency Medicine, University of Florida, Gainesville, FL, USA; Clinical Safety Research Unit, Imperial College London, London, UK
| | - Rollin J Fairbanks
- National Center for Human Factors in Healthcare, MedStar Institute for Innovation, MedStar Health, Washington D.C., USA; Department of Industrial and Systems Engineering, University at Buffalo, Buffalo, NY, USA; Department of Emergency Medicine, Georgetown University School of Medicine, Washington D.C., USA
| | - Ann M Bisantz
- Department of Industrial and Systems Engineering, University at Buffalo, Buffalo, NY, USA.
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Pickup L, Atkinson S, Hollnagel E, Bowie P, Gray S, Rawlinson S, Forrester K. Blood sampling - Two sides to the story. Appl Ergon 2017; 59:234-242. [PMID: 27890133 DOI: 10.1016/j.apergo.2016.08.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 08/25/2016] [Accepted: 08/26/2016] [Indexed: 06/06/2023]
Abstract
This study aimed to investigate why there is variability in taking blood. A multi method Pilot study was completed in four National Health Service Scotland hospitals. Human Factors/Ergonomics principles were applied to analyse data from 50 observations, 15 interviews and 12-months of incident data from all Scottish hospitals. The Functional Resonance Analysis Method (FRAM) was used to understand why variability may influence blood sampling functions. The analysis of the 61 pre blood transfusion sampling incidents highlighted limitations in the data collected to understand factors influencing performance. FRAM highlighted how variability in the sequence of blood sampling functions and the number of practitioners involved in a single blood sampling activity was influenced by the working environment, equipment, clinical context, work demands and staff resources. This pilot study proposes a realistic view of why blood sampling activities vary and proposes the need to consider the system's resilience in future safety management strategies.
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Affiliation(s)
- Laura Pickup
- Human Factors Department, The University of Nottingham, ITRC Building, Nottingham, NG7 2RD, United Kingdom.
| | - Sarah Atkinson
- Human Factors Department, The University of Nottingham, ITRC Building, Nottingham, NG7 2RD, United Kingdom.
| | - Erik Hollnagel
- Center for Quality Improvement, Southern Region, Denmark.
| | - Paul Bowie
- Safety and Improvement Research Group, Medicine Directorate, NHS Education for Scotland, Glasgow, United Kingdom; Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.
| | - Sandra Gray
- Scottish National Blood Transfusion Service, 17 Ellen's Glen Road, Edinburgh, EH17 7QT, United Kingdom.
| | - Sam Rawlinson
- East of Scotland Blood Transfusion Centre, Dundee, United Kingdom
| | - Kate Forrester
- Scottish National Blood Transfusion Service, 21 Ellen's Glen Road, Edinburgh, EH17 7QT, United Kingdom.
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Kasiiti N, Wawira J, Purkayastha S, Were MC. Comparative Performance Analysis of Different Fingerprint Biometric Scanners for Patient Matching. Stud Health Technol Inform 2017; 245:1053-1057. [PMID: 29295262] [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
Unique patient identification within health services is an operational challenge in healthcare settings. Use of key identifiers, such as patient names, hospital identification numbers, national ID, and birth date are often inadequate for ensuring unique patient identification. In addition approximate string comparator algorithms, such as distance-based algorithms, have proven suboptimal for improving patient matching, especially in low-resource settings. Biometric approaches may improve unique patient identification. However, before implementing the technology in a given setting, such as health care, the right scanners should be rigorously tested to identify an optimal package for the implementation. This study aimed to investigate the effects of factors such as resolution, template size, and scan capture area on the matching performance of different fingerprint scanners for use within health care settings. Performance analysis of eight different scanners was tested using the demo application distributed as part of the Neurotech Verifinger SDK 6.0.
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Affiliation(s)
- Noah Kasiiti
- Institute of Biomedical Informatics, Moi University, Eldoret, Kenya
| | - Judy Wawira
- Department of Radiology, Indiana University, Indianapolis, IN, USA
| | - Saptarshi Purkayastha
- School of Informatics, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Martin C Were
- Institute of Biomedical Informatics, Moi University, Eldoret, Kenya
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Kühne G, Rigby MJ, Majeed A, Blair ME. Towards Safe and Efficient Child Primary Care - Gaps in the Use of Unique Identifiers in Europe. Stud Health Technol Inform 2017; 235:53-57. [PMID: 28423754] [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
In order to provide for best possible child health care, timely access to all relevant medical data is of vital importance. The aim of this study is to investigate the use of unique identifiers, a key instrument in this regard, in the countries of Europe. A survey was carried out in all 28 European Member States plus 2 European Economic Area countries in 2015, and refreshed in 2016. In 23 countries unique identifiers are used to link children's health records. Five countries indicated they currently do not link child health records, and two have no such plans. There is variety as regards the type of number and the issuing process.
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Affiliation(s)
- Grit Kühne
- Department of Primary Care and Public Health, Imperial College of Science, Technology, and Medicine, UK
| | - Michael J Rigby
- Section of Paediatrics Faculty of Medicine, Imperial College of Science, Technology, and Medicine, UK
| | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College of Science, Technology, and Medicine, UK
| | - Mitch E Blair
- Section of Paediatrics Faculty of Medicine, Imperial College of Science, Technology, and Medicine, UK
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Cheng PL, Su YC, Hou CH, Chang PL. Management of In-Field Patient Tracking and Triage by Using Near-Field Communication in Mass Casualty Incidents. Stud Health Technol Inform 2017; 245:1214. [PMID: 29295301] [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
Near field communications (NFC) is an emerging technology that may potentialy assist with disaster management. A smartphone-based app was designed to help track patient flow in real time. A table-drill was held as a brief evaluation and it showed significant imporvement in both efficacy and accuracy of patient management. It is feasible to use NFC-embedded smartphones to clarify the ambiguous and chaotic patient flow in a mass casualty incident.
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Affiliation(s)
- Po-Liang Cheng
- Emergency Department, Dalin Tzu Chi Hospital, Chiayi County, Taiwan, China
| | - Yung-Cheng Su
- Emergency Department, Dalin Tzu Chi Hospital, Chiayi County, Taiwan, China
| | - Chung-Hung Hou
- Emergency Department, Dalin Tzu Chi Hospital, Chiayi County, Taiwan, China
| | - Po-Lun Chang
- Biomedical Institute, National Yang-Ming University, Taipei City, Taiwan, China
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31
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Tye GA. The Certainty of Change. Radiol Manage 2017; 39:44. [PMID: 30725549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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32
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Gaines-Buchler E. ID, Please Stay safe-and stylish-with medical ID jewelry. Diabetes Forecast 2016; 69:24-25. [PMID: 29693911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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33
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Best Practices for Patient Matching at Patient Registration. J AHIMA 2016; 87:74-81. [PMID: 29431938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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34
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Policy on Child Identification Programs. Pediatr Dent 2016; 38:32-3. [PMID: 27931411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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35
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Landsbach GD. Study Analyzes Causes and Consequences of Patient Overlay Errors. J AHIMA 2016; 87:40-43. [PMID: 29400427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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36
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Mariappan MR, Zehnder J, Arber DA, Lay M, Fadare O, Schrijver I. Identification of Mislabeled Specimen by Molecular Methods: Case Report and Review. Int J Surg Pathol 2016; 13:253-8. [PMID: 16086080 DOI: 10.1177/106689690501300304] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Specimen misidentification is a common cause of errors in surgical pathology. We report a case where bone-marrow biopsies from patients of different genders were mislabeled and molecular methods were applied to resolve the identity. A short tandem repeat (STR)-polymerase chain reaction-based assay, commonly used in paternity testing, was employed in an attempt to assign the correct identity to the specimens. However, the specimens had been processed by decalcification and the DNA yield was poor. One of the markers in the assay is the non-STR amelogenin locus that distinguishes the X and Y chromosomes. This amelogenin marker results in a product of low molecular weight, enabling unequivocal resolution of identity despite a poor DNA yield. The prevalence of errors in pathology due to specimen misidentifications is reviewed.
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Affiliation(s)
- M Rajan Mariappan
- Department of Pathology, Stanford University Medical Center, Stanford, CA 94305, USA
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Abstract
The 1999 Institute of Medicine report To Err Is Human put a spotlight on death from preventable medical errors. Surgically related errors are second only to medication errors as the most frequent cause of error-related death. Although many hospitals have ongoing programs to improve medication safety, most hospitals are not focused in a meaningful way on operating room (OR) safety despite the import of the OR to the hospital's finances and despite clearly efficacious available technologies. The perioperative environment is a high-risk area with high velocity, high complexity, and high stakes. OR errors lead to disproportionately more harm than errors elsewhere in the hospital. Actual adverse events are relatively rare in any given OR suite, but near misses are rather common. It is possible to learn much from evaluating near misses (along with adverse events) with root-cause analyses and then instituting changes in processes and systems to assist humans from making their inevitable errors. This article outlines approaches that when combined can markedly improve safety in the OR.
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Abstract
Radio frequency identification (RFID) is a technology that will have a profound impact on medicine and the operating room of the future. The purpose of this article is to provide an introduction to this exciting technology and a description of the problems in the perioperative environment that RFID might address to improve safety and increase productivity. Although RFID is still a nascent technology, applications are likely to become much more visible in patient care and treatment areas and will raise questions for practitioners. We also address both the current limitations and what appear to be reasonable near-future possibilities.
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Affiliation(s)
- Paul Nagy
- University of Maryland School of Medicine, Baltimore, MD 21201, USA.
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39
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Just BH, Marc D, Munns M, Sandefer R. Why Patient Matching Is a Challenge: Research on Master Patient Index (MPI) Data Discrepancies in Key Identifying Fields. Perspect Health Inf Manag 2016; 13:1e. [PMID: 27134610 PMCID: PMC4832129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Patient identification matching problems are a major contributor to data integrity issues within electronic health records. These issues impede the improvement of healthcare quality through health information exchange and care coordination, and contribute to deaths resulting from medical errors. Despite best practices in the area of patient access and medical record management to avoid duplicating patient records, duplicate records continue to be a significant problem in healthcare. This study examined the underlying causes of duplicate records using a multisite data set of 398,939 patient records with confirmed duplicates and analyzed multiple reasons for data discrepancies between those record matches. The field that had the greatest proportion of mismatches (nondefault values) was the middle name, accounting for 58.30 percent of mismatches. The Social Security number was the second most frequent mismatch, occurring in 53.54 percent of the duplicate pairs. The majority of the mismatches in the name fields were the result of misspellings (53.14 percent in first name and 33.62 percent in last name) or swapped last name/first name, first name/middle name, or last name/middle name pairs. The use of more sophisticated technologies is critical to improving patient matching. However, no amount of advanced technology or increased data capture will completely eliminate human errors. Thus, the establishment of policies and procedures (such as standard naming conventions or search routines) for front-end and back-end staff to follow is foundational for the overall data integrity process. Training staff on standard policies and procedures will result in fewer duplicates created on the front end and more accurate duplicate record matching and merging on the back end. Furthermore, monitoring, analyzing trends, and identifying errors that occur are proactive ways to identify data integrity issues.
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Affiliation(s)
| | - David Marc
- College of St. Scholastica in Duluth, MN
| | | | - Ryan Sandefer
- Department of Health Informatics and Information Management at the College of St. Scholastica in Duluth, MN
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Ludwig CA, Callaway NF, Park JH, Leng T. Mobile Health in the Retinal Clinic Population: Access to and Interest in Self-Tracking. Ophthalmic Surg Lasers Imaging Retina 2016; 47:252-7. [PMID: 26985799 DOI: 10.3928/23258160-20160229-08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 01/07/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Implementation of mobile health-tracking programs for retinal pathology requires both access to mobile devices and patient motivation to participate in self-tracking. The authors' study aimed to evaluate the prevalence of smartphone and tablet ownership and patient interest in self-tracking among a retinal clinic population. PATIENTS AND METHODS This is an institutional, prospective, cross-sectional survey of 103 retinal clinic outpatients. Consenting patients underwent a one-on-one interview conducted in the examination room during their waiting period by one researcher. RESULTS Overall, 75 of 103 participants (72.2%) reported either owning a smartphone and/or tablet or having access at their household to a device that could be used to track eye health. The majority of participants (69 of 103 participants; 67%) reported interest in using a mobile application (smartphone or tablet) to track their eye health. CONCLUSION These data suggest strong patient interest in the use of mobile devices to track eye health.
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41
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Wiant DB, Verchick Q, Gates P, Vanderstraeten CL, Maurer JM, Hayes TL, Liu H, Sintay BJ. A novel method for radiotherapy patient identification using surface imaging. J Appl Clin Med Phys 2016; 17:271-278. [PMID: 27074490 PMCID: PMC5875556 DOI: 10.1120/jacmp.v17i2.6066] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 11/23/2015] [Accepted: 11/23/2015] [Indexed: 11/23/2022] Open
Abstract
Performing a procedure on the wrong patient or site is one of the greatest errors that can occur in medicine. The addition of automation has been shown to reduce errors in many processes. In this work we explore the use of an automated patient identification process using optical surface imaging for radiotherapy treatments. Surface imaging uses visible light to align the patient to a reference surface in the treatment room. It is possible to evaluate the similarity between a daily set-up surface image and the reference image using distance to agreement between the points on the two surfaces. The higher the percentage overlapping points within a defined distance, the more similar the surfaces. This similarity metric was used to intercompare 16 left-sided breast patients. The reference surface for each patient was compared to 10 daily treatment surfaces for the same patient, and 10 surfaces from each of the other 15 patients (for a total of 160 comparisons per patient), looking at the percent of points overlapping. For each patient, the minimum same-patient similarity score was higher than the maximum different-patient score. For the group as a whole a threshold was able to classify correct and incorrect patients with high levels of accuracy. A 10-fold cross-validation using linear discriminant analysis gave cross-validation loss of 0.0074. An automated process using surface imaging is a feasible option to provide nonharmful daily patient identification verification using currently available technology.
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42
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Butler M. Finding John Doe. PATIENT MATCHING AND THE NEED FOR A NATIONAL PATIENT SAFETY IDENTIFIER. J AHIMA 2016; 87:14-19. [PMID: 27039620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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43
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Ludvigsson JF, Almqvist C, Bonamy AKE, Ljung R, Michaëlsson K, Neovius M, Stephansson O, Ye W. Registers of the Swedish total population and their use in medical research. Eur J Epidemiol 2016; 31:125-36. [PMID: 26769609 DOI: 10.1007/s10654-016-0117-y] [Citation(s) in RCA: 939] [Impact Index Per Article: 117.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 01/08/2016] [Indexed: 12/22/2022]
Abstract
The primary aim of the Swedish national population registration system is to obtain data that (1) reflect the composition, relationship and identities of the Swedish population and (2) can be used as the basis for correct decisions and measures by government and other regulatory authorities. For this purpose, Sweden has established two population registers: (1) The Population Register, maintained by the Swedish National Tax Agency ("Folkbokföringsregistret"); and (2) The Total Population Register (TPR) maintained by the government agency Statistics Sweden ("Registret över totalbefolkningen"). The registers contain data on life events including birth, death, name change, marital status, family relationships and migration within Sweden as well as to and from other countries. Updates are transmitted daily from the Tax Agency to the TPR. In this paper we describe the two population registers and analyse their strengths and weaknesses. Virtually 100 % of births and deaths, 95 % of immigrations and 91 % of emigrations are reported to the Population Registers within 30 days and with a higher proportion over time. The over-coverage of the TPR, which is primarily due to underreported emigration data, has been estimated at up to 0.5 % of the Swedish population. Through the personal identity number, assigned to all residents staying at least 1 year in Sweden, data from the TPR can be used for medical research purposes, including family design studies since each individual can be linked to his or her parents, siblings and offspring. The TPR also allows for identification of general population controls, participants in cohort studies, as well as calculation of follow-up time.
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Affiliation(s)
- Jonas F Ludvigsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 17177, Stockholm, Sweden.
- Department of Paediatrics, Örebro University Hospital, Örebro, Sweden.
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK.
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 17177, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Anna-Karin Edstedt Bonamy
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Women's and Children's Health, Karolinska Institutet and Hospital, Stockholm, Sweden
| | - Rickard Ljung
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Karl Michaëlsson
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Martin Neovius
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Olof Stephansson
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Women's and Children's Health, Karolinska Institutet and Hospital, Stockholm, Sweden
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 17177, Stockholm, Sweden
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44
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Sundermann K. [Radiofrequency identification technology (RFID). To play it safe]. Pflege Z 2016; 69:42-45. [PMID: 27164815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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45
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Banerjee D, Thompson C, Bingham A, Kell C, Duhon J, Grossman H. An Electronic Medical Record Report Improves Identification of Hospitalized Patients With Heart Failure. J Card Fail 2015; 22:402-5. [PMID: 26687987 DOI: 10.1016/j.cardfail.2015.12.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 10/01/2015] [Accepted: 12/02/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Early identification of inpatients with heart failure (HF) may help to reduce readmissions. We found that many patients identified by our coding team as having a primary diagnosis of HF were not identified by our clinical team. We hypothesized that an electronic medical record (EMR)-based report would improve identification of hospitalized patients eventually diagnosed with HF. METHODS AND RESULTS We constructed an automated EMR-based tool to allow our team to identify patients with HF more quickly and accurately. We selected criteria that could potentially identify the cohort as patients with an exacerbation of HF. We performed monthly reconciliations, comparing the list of patients identified by our coding team as having a primary diagnosis of HF versus the patients identified by our team as having HF. We reduced a baseline 17% discrepancy of patients coded as HF but not identified by our team to 9.5% in the year after implementation of our screening tool (P = .006), and to 5.4% in the next year (P = .03); 56% of patients that were identified as having HF by our CNS team were coded as having HF, versus 49% in the 2 years after implementation (P = .15). Thirty-day readmission rates to our hospital decreased from 16% to 11% (P = .029). CONCLUSIONS An EMR-based approach significantly improved identification of patients discharged with a primary diagnosis of HF. Future investigations should determine whether early identification of inpatients with HF can independently lower readmissions, and whether this strategy can successfully identify outpatients with HF.
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Sjögren P, Bäckman N, Sjöström O, Zimmerman M. Patient safety in domiciliary dental care for elderly nursing home residents in Sweden. Community Dent Health 2015; 32:216-220. [PMID: 26738218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To analyse patient safety in domiciliary dental care, with data from a quality registry. DESIGN Retrospective analysis. CLINICAL SETTING Domiciliary dental care, private caregiver, Sweden, 2012-2014. METHODS All reported events in the quality registry at a provider of domiciliary dental care, (2012-05-01 to 2014-06-30) were categorized into 14 domains, and for severity as 'minor', 'moderate', or 'serious' events. The reported events were also independently assessed by an experienced reviewer for national requirements of reporting patient safety related events. RESULTS The quality registry covered 724 (0.03%) reported events during 218,586 consecutive treatment sessions in domiciliary dental care, including 628,070 registered dental procedures. Fifty (6.9%) of the reported events were patient safety related, of which 11 (1.5%) events were reportedly of minor severity, 20 (2.8%) as moderate, and 19 (2.6%) as serious. For all degrees of severity, the most frequently reported events were related to problems with patient identity control (3.3%). None of the events required reporting to national authorities. CONCLUSIONS Domiciliary dental care has a low frequency of patient safety related events (0.03% of all treatments). Identity controls need to be emphasised in nursing homes or where individuals are dependent on the care of others.
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Cuadrado-Cenzual MA, García Briñón M, de Gracia Hills Y, González Estecha M, Collado Yurrita L, de Pedro Moro JA, Fernández Pérez C, Arroyo Fernández M. [Patient identification errors and biological samples in the analytical process: Is it possible to improve patient safety?]. ACTA ACUST UNITED AC 2015; 30:310-8. [PMID: 26542791 DOI: 10.1016/j.cali.2015.07.006] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 07/20/2015] [Accepted: 07/22/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Patient identification errors and biological samples are one of the problems with the highest risk factor in causing an adverse event in the patient. OBJECTIVE To detect and analyse the causes of patient identification errors in analytical requests (PIEAR) from emergency departments, and to develop improvement strategies. MATERIAL AND METHODS A process and protocol was designed, to be followed by all professionals involved in the requesting and performing of laboratory tests. Evaluation and monitoring indicators of PIEAR were determined, before and after the implementation of these improvement measures (years 2010-2014). RESULTS A total of 316 PIEAR were detected in a total of 483,254 emergency service requests during the study period, representing a mean of 6.80/10,000 requests. Patient identification failure was the most frequent in all the 6-monthly periods assessed, with a significant difference (P<.0001). CONCLUSIONS The improvement strategies applied showed to be effective in detecting PIEAR, as well as the prevention of such errors. However, we must continue working with this strategy, promoting a culture of safety for all the professionals involved, and trying to achieve the goal that 100% of the analytical and samples are properly identified.
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Affiliation(s)
- M A Cuadrado-Cenzual
- Unidad de Gestión Clínica, Análisis Clínicos, Hospital Clínico San Carlos, Madrid, España.
| | - M García Briñón
- Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, España
| | - Y de Gracia Hills
- Unidad de Gestión Clínica, Análisis Clínicos, Hospital Clínico San Carlos, Madrid, España
| | - M González Estecha
- Unidad de Gestión Clínica, Análisis Clínicos, Hospital Clínico San Carlos, Madrid, España
| | - L Collado Yurrita
- Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
| | | | - C Fernández Pérez
- Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Madrid, España
| | - M Arroyo Fernández
- Unidad de Gestión Clínica, Análisis Clínicos, Hospital Clínico San Carlos, Madrid, España
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48
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Garzón Sánchez JC, Santana González VJ, López Correa T, Sastre Rincón JA. [Allergy to latex: The danger is in the warning]. Rev Esp Anestesiol Reanim 2015; 62:547. [PMID: 25597014 DOI: 10.1016/j.redar.2014.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 11/28/2014] [Accepted: 12/02/2014] [Indexed: 06/04/2023]
Affiliation(s)
- J C Garzón Sánchez
- Servicio de Anestesiología y Reanimación, Complejo Asistencial Universitario de Salamanca e IBSAL, Salamanca, España.
| | - V J Santana González
- Servicio de Anestesiología y Reanimación, Complejo Asistencial Universitario de Salamanca e IBSAL, Salamanca, España
| | - T López Correa
- Servicio de Anestesiología y Reanimación, Complejo Asistencial de Ávila, Ávila, España
| | - J A Sastre Rincón
- Servicio de Anestesiología y Reanimación, Complejo Asistencial Universitario de Salamanca e IBSAL, Salamanca, España
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Abstract
Between medication administration, care tasks and communication with colleagues and patients' families, documentation often gets put on the back-burner. However, it is a critical aspect of nursing care that provides a precise account of your actions that is vital for your legal protection and that of your employer. Below are a few suggestions to ensure your documentation is accurate and timely.
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50
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[Laurentides/Lanaudière: The Blue Bracelet]. Perspect Infirm 2015; 12:17. [PMID: 26543999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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