RESUMEN
INTRODUCTION: Kazakhstan has made significant strides in digital health implementation since 2013, transitioning from paper-based systems to wide implementation of digital solutions. However, challenges persist, notably the misalignment between existing data collection requirements and ongoing digital transformations. To address this obstacle, the development of a new digital-friendly requirements for health data collection at provider levels was initiated. MATERIAL AND METHODS: A comparative analysis of all existing requirements on health and care data collection set a foundation for further actions. A dedicated technical working group, established by the Ministry of Healthcare, oversaw this process, while several specialized expert groups participated in detailed discussions to ensure alignment with healthcare needs. We took as a basis the legislative act enforcing use of data forms inherited from pre-digital era. Data elements from most used forms were cataloged, checked for consistency, and standardized. ISO 13940 standard guided transformation of rigid paper-based forms into flexible digital-friendly data sets. RESULTS: Analysis of the healthcare legislation reveals significant optimization opportunities. We categorized 157 forms into four groups by their content and role and focusing on clinical and administrative records for transformation. Data elements' analysis led to developing 209 standardized classifications with data values. 83 data sets, encompassing clinical and administrative domains, were developed to substitute 63 (out of 157) forms. Therefore, the foundation for better data and structure interoperability was set. DISCUSSION: The top-down approach to digital health standardization, combined with open market policies, results in inconsistent data collection practices. Developed data sets align with the goal of developing the national Electronic Health Records system as enabler for interoperability and adds a bottom-up perspective to digital health standardization. This effort addresses the lack of guidance for digital data model development, however additional efforts required to change the current practice and finalize the national legislation transformation into digital-friendly mode.
RESUMEN
BACKGROUND: This study assessed the association between lead poisoning prevention activities and blood lead levels (BLLs) among children living in lead-contaminated camps for internally displaced persons in the United Nations-Administered Province of Kosovo. METHODS: We conducted a population-based study to examine the relationship among geometric mean BLLs in children (i) born before any lead poisoning prevention activities were instituted, (ii) born when specific interim interventions were instituted and (iii) born after relocation and medical therapy were available. The study population consisted of 145 of the 186 children born in the camps between December 1999 and July 2007. RESULTS: Lower mean BLLs were found in children born following implementation of the interventions as compared with the children born before the interventions. However, this decrease in mean BLLs was attenuated in children born into families suspected of informal lead smelting. CONCLUSION: Despite lower BLLs following interventions, children living in these camps have BLLs that remain unacceptably high. Further efforts are urgently needed to control or eliminate lead exposure in this population. Continued blood lead monitoring of the population is also warranted.