A generally applicable lightweight method for calculating a value structure for tools and services in bioinformatics infrastructure projects.

Sustainable noncommercial bioinformatics infrastructures are a prerequisite to use and take advantage of the potential of big data analysis for research and economy. Consequently, funders, universities and institutes as well as users ask for a transparent value model for the tools and services offered. In this article, a generally applicable lightweight method is described by which bioinformatics infrastructure projects can estimate the value of tools and services offered without determining exactly the total costs of ownership. Five representative scenarios for value estimation from a rough estimation to a detailed breakdown of costs are presented. To account for the diversity in bioinformatics applications and services, the notion of service-specific 'service provision units' is introduced together with the factors influencing them and the main underlying assumptions for these 'value influencing factors'. Special attention is given on how to handle personnel costs and indirect costs such as electricity. Four examples are presented for the calculation of the value of tools and services provided by the German Network for Bioinformatics Infrastructure (de.NBI): one for tool usage, one for (Web-based) database analyses, one for consulting services and one for bioinformatics training events. Finally, from the discussed values, the costs of direct funding and the costs of payment of services by funded projects are calculated and compared.

Priorities in research on foodborne parasites indicated by short-term scientific missions as part of COST Action a European Network for Foodborne Parasites (Euro-FBP).

The European Cooperation in Science and Technology (COST) is a funding organization for the creation of research networks. These networks support collaboration and networking among scientists across Europe and thereby give impetus to research advancements and innovation. One of the most important mechanisms of COST actions are the short-term scientific missions (STSM), which are a funding mechanism that enables scientists, particularly those earlier in their careers, to visit an institution or laboratory in another COST Member state in order to learn techniques that will enhance their skills and improve the scientific knowledge of their institution. The European Network for Foodborne Parasites (Euro-FBP; FA1408) was a COST Action that ended in early 2019, which brought together different experts with knowledge and interest on a broad spectrum of different foodborne parasites of relevance in Europe. In the course of the Euro-FBP COST Action, 32 such STSM occurred. This article provides a short overview of the short-term scientific missions that were approved during this action, as well as the relation of these actions to several relevant socio-economic parameters. The subjects of these STSM, the majority of which were concerned with detection techniques, probably reflect the priorities for research skills on foodborne parasites in Europe.

The Feasibility of the Nationwide Health Information Network.

The Nationwide Health Information Network (NHIN) use in health care facilities was examined for utilization and efficacy; although the advantages are abundant, health care facilities have been reluctant to adopt it because of associated costs. The purpose of this study was to analyze the feasibility of a US NHIN by exploring and determining the benefits of an NHIN and assessing the barriers to its implementation. The research methodology applied in examining the implementation of NHIN in the United States was a qualitative literature review, which followed the basic guidelines of a systematic literature review, partnered with a semistructured interview of a chief information officer of a private, nonprofit, 193-bed hospital located in Westminster, Maryland. A total of 33 sources were referenced. The results of this study suggest that implementation and utilization of NHIN by health care industry stakeholders lead to an increased quality of patient care, increased patient-provider communication, and cost-savings opportunities. Increased quality of care is achieved by reducing adverse drug events and medical errors. Cost-savings opportunities are generated by a reduction in spending and prices that is attributable to electronic health record systems' increased efficiency and effectiveness. Nevertheless, barriers to NHIN implementation and utilization still remain throughout the health care industry, the main one being concerns about interoperability.

The cost of quality: Implementing generalization and suppression for anonymizing biomedical data with minimal information loss.

OBJECTIVE: With the ARX data anonymization tool structured biomedical data can be de-identified using syntactic privacy models, such as k-anonymity. Data is transformed with two methods: (a) generalization of attribute values, followed by (b) suppression of data records. The former method results in data that is well suited for analyses by epidemiologists, while the latter method significantly reduces loss of information. Our tool uses an optimal anonymization algorithm that maximizes output utility according to a given measure. To achieve scalability, existing optimal anonymization algorithms exclude parts of the search space by predicting the outcome of data transformations regarding privacy and utility without explicitly applying them to the input dataset. These optimizations cannot be used if data is transformed with generalization and suppression. As optimal data utility and scalability are important for anonymizing biomedical data, we had to develop a novel method. METHODS: In this article, we first confirm experimentally that combining generalization with suppression significantly increases data utility. Next, we proof that, within this coding model, the outcome of data transformations regarding privacy and utility cannot be predicted. As a consequence, existing algorithms fail to deliver optimal data utility. We confirm this finding experimentally. The limitation of previous work can be overcome at the cost of increased computational complexity. However, scalability is important for anonymizing data with user feedback. Consequently, we identify properties of datasets that may be predicted in our context and propose a novel and efficient algorithm. Finally, we evaluate our solution with multiple datasets and privacy models. RESULTS: This work presents the first thorough investigation of which properties of datasets can be predicted when data is anonymized with generalization and suppression. Our novel approach adopts existing optimization strategies to our context and combines different search methods. The experiments show that our method is able to efficiently solve a broad spectrum of anonymization problems. CONCLUSION: Our work shows that implementing syntactic privacy models is challenging and that existing algorithms are not well suited for anonymizing data with transformation models which are more complex than generalization alone. As such models have been recommended for use in the biomedical domain, our results are of general relevance for de-identifying structured biomedical data.

Monitoring the web to support vaccine coverage: results of two years of the portal VaccinarSì.

OBJECTIVES: The increasingly widespread use of the Internet by the population to collect information regarding health and medical treatments and the circulation of many non-scientific documents on the effectiveness and safety of vaccines has led the Italian Society of Hygiene (SItI), in 2013, to promote a portal to provide scientific information that is verified and easily understood to counteract the rampant misinformation on health treatments and combat the phenomenon of vaccine hesitancy. METHODS: The project was launched in May 2013 and provides a portal with six main sections (vaccine preventable diseases, registered vaccines, benefits and risks of vaccination, against misinformation, pros & cons and travel immunizations) and other headings that relate to scientific events, comics and news coverage concerning vaccines. The contents are validated and evaluated by a scientific committee of high profile scientists and experts in computer-mediated communication. RESULTS: In the first two years of activity, the portal has published more than 250 web pages on all aspects related to vaccinations. The number of individual users was 860,411, with a constant increase over time. Of these, about 21.7% returned to the website at least once. The total visits in 24 months were 1,099,670, with a total page count of 2,530,416. The frequency of contact was almost exclusively Italian (95.6%), with a higher proportion of males (54.1%) and younger age groups (25-34 years, 33.5%, and18-24 years, 27.5%). The data also show a significant position of the website in the major web search engines. The website has been certified by the Health On the Net Foundation. It is connected with the main social networks and it has recently opened its first regional section (Veneto). CONCLUSIONS: The strong, progressive increase in web contacts, the involvement of several institutional bodies, and the appreciation of various stakeholders give an absolutely positive assessment of the first two years of the VaccinarSì project. The success of the website suggests future developments, with updates, sections devoted to regional problems, in-depth news analysis, and international expansion. The authors conclude that initiatives like this are to be implemented and constitute an effective way to counteract vaccine hesitancy.

International trends in health science librarianship Part 10: The Greater China area.

This is the 10th in a series of articles exploring international trends in health science librarianship. This issue describes developments in health science librarianship in the first decade of the 21st century in China, Hong Kong and Taiwan. The next issue will report on Japan and South Korea. JM.

Status, sale and patenting of human genetic material: an international survey.

Following a decade of debate, the European Directive on the Legal Protection of Biotechnological Inventions was adopted by the European Parliament and the Council of the European Union on July 6, 1998. The Directive constitutes a legal and social policy landmark in biotechnology, taking an explicit position on the contentious issue of the patentability of higher life forms. It fails, however, to provide definitive statements on the legal status of human genetic material or the possibility of personal financial gain in relation to such material. An overview of the international, regional and national positions (as found in laws and official policy statements) on the status, commodification and patentability of human genetic material indicates that, although the Directive represents a consolidation of opinions, many issues remain unresolved.

[Health information systems in the Mesoamerican Region]. / Sistemas de información en salud en la Región Mesoamericana.

OBJECTIVE: To evaluate and analyze health information systems (his) in the Mesoamerican Region. MATERIAL AND METHODS: The conceptual framework and tools of the Health Metrics Network (nhm) was used. It measures six components of the his assessment: resources, indicators, data sources, information management, products and use. RESULTS: In this study we found that the average score of the HIS in the Mesoamerican region was 57%, being the maximum value for Mexico (75%) and the minimum for El Salvador (41%). The item that had lowest scores was that referring to the Management and Administration, where the average assessment was 37%, placing it as present but not adequate. The component with the highest score was Information Products with more than 69%, adequate. In any case, no items were very adequate. CONCLUSION: The performance of his is heterogeneous between countries. It is necessary to strengthen and standardize the criteria of the his in the region, so that these are integrated and used in the decision making process based on real information.

HIE sustainability secrets. NeHC report shares HIE success stories of alternate revenue streams and payer buy-in.

Getting effective stakeholder engagement, including that of payers, and creating innovative value-added services that provide alternate revenue streams beyond basic subscription services, are just a couple of the common traits of the flourishing health information exchanges profiled in the sustainability report released in August by the National eHealth Collaborative.

Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol.

This paper reviews the evidence for the effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol, in the areas of education and information, the health sector, community action, driving while under the influence of alcohol (drink-driving), availability, marketing, pricing, harm reduction, and illegally and informally produced alcohol. Systematic reviews and meta-analyses show that policies regulating the environment in which alcohol is marketed (particularly its price and availability) are effective in reducing alcohol-related harm. Enforced legislative measures to reduce drink-driving and individually directed interventions to already at-risk drinkers are also effective. However, school-based education does not reduce alcohol-related harm, although public information and education-type programmes have a role in providing information and in increasing attention and acceptance of alcohol on political and public agendas. Making alcohol more expensive and less available, and banning alcohol advertising, are highly cost-effective strategies to reduce harm. In settings with high amounts of unrecorded production and consumption, increasing the proportion of alcohol that is taxed could be a more effective pricing policy than a simple increase in tax.

Analysis of the question-answer service of the Emma Children's Hospital information centre.

The information centre of the Emma Children's Hospital AMC (EKZ AMC) is a specialised information centre where paediatric patients and persons involved with the patient can ask questions about all aspects of disease and its social implications. The aim of the study was to evaluate the question-answer service of this information centre in order to determine the role of a specialised information centre in an academic children's hospital, identify the appropriate resources for the service and potential positive effects. For this purpose, a case management system was developed in MS ACCESS. The characteristics of the requester and the question, the time it took to answer questions, the information sources used and the extent to which we were able to answer the questions were registered. The costs of the service were determined. We analysed all questions that were asked in the year 2007. Fourteen hundred thirty-four questions were asked. Most questions were asked by parents (23.3%), healthcare workers (other than nurses; 16.5%) and nurses (15.3%). The scope of the most frequently asked questions include disease (20.2%) and treatment (13.0%). Information on paper was the main information source used. Most questions could be solved within 15 min. Twelve percent to 28% of total working hours are used for the question-answer service. Total costs including staff salary are rather large. In conclusions, taking over the task of providing additional medical information and by providing readily available, good quality information that healthcare professionals can use to inform their patients will lead to less time investment of these more expensive staff members. A specialised information service can anticipate on the information need of parents and persons involved with the paediatric patient. It improves information by providing with relatively simple resources that has the potential to improve patient and parent satisfaction, coping and medical results. A specialised information centre is therefore a valuable and affordable asset to an academic children's hospital.

K-core robustness in ecological and financial networks.

In many real-world networks, the ability to withstand targeted or global attacks; extinctions; or shocks is vital to the survival of the network itself, and of dependent structures such as economies (for financial networks) or even the planet (for ecosystems). Previous attempts to characterise robustness include nestedness of mutualistic networks or exploration of degree distribution. In this work we present a new approach for characterising the stability and robustness of networks with all-positive interactions by studying the distribution of the k-shell of the underlying network. We find that high occupancy of nodes in the inner and outer k-shells and low occupancy in the middle shells of financial and ecological networks (yielding a "U-shape" in a histogram of k-shell occupancy) provide resilience against both local targeted and global attacks. Investigation of this highly-populated core gives insights into the nature of a network (such as sharp transitions in the core composition of the stock market from a mix of industries to domination by one or two in the mid-1990s) and allow predictions of future network stability, e.g., by monitoring populations of "core" species in an ecosystem or noting when stocks in the core-dominant sector begin to move in lock-step, presaging a dramatic move in the market. Moreover, this "U-shape" recalls core-periphery structure, seen in a wide range of networks including opinion and internet networks, suggesting that the "U-shaped" occupancy histogram and its implications for network health may indeed be universal.

An economic analysis of email-based telemedicine: a cost minimisation study of two service models.

BACKGROUND: Email-based telemedicine has been reported to be an efficient method of delivering online health services to patients at a distance and is often described as a low-cost form of telemedicine. The service may be low-cost if the healthcare organisation utilise their existing email infrastructure to provide their telemedicine service. Many healthcare organisations use commercial-off-the-shelf (COTS) email applications. COTS email applications are designed for peer-to-peer communication; hence, in situations where multiple clinicians need to be involved, COTS applications may be deficient in delivering telemedicine. Larger services often rely on different staff disciplines to run their service and telemedicine tools for supervisors, clinicians and administrative staff are not available in COTS applications. Hence, some organisations may choose to develop a purpose-written email application to support telemedicine. We have conducted a cost-minimisation analysis of two different service models for establishing and operating an email service. The first service model used a COTS email application and the second used a purpose-written telemedicine application. METHODS: The actual costs used in the analysis were from two organisations that originally ran their counselling service with a COTS email application and later implemented a purpose-written application. The purpose-written application automated a number of the tasks associated with running an email-based service. We calculated a threshold at which the higher initial costs for software development were offset by efficiency gains from automation. We also performed a sensitivity analysis to determine the effect of individual costs on the threshold. RESULTS: The cost of providing an email service at 1000 consultations per annum was $19,930 using a COTS email application and $31,925 using a purpose-written application. At 10,000 consultations per annum the cost of providing the service using COTS email software was $293,341 compared to $272,749 for the purpose-written application. The threshold was calculated at a workload of 5216 consultations per annum. When more than 5216 email consultations per annum are undertaken, the purpose-written application was cheaper than the COTS service model. The sensitivity analysis showed the threshold was most sensitive to changes in administrative staff salaries. CONCLUSION: In the context of telemedicine, we have compared two different service models for email-based communication - purpose-written and COTS applications. Under the circumstances described in the paper, when workload exceeded 5216 email consultations per annum, there were savings made when a purpose-written email application was used. This analysis provides a useful economic model for organisations contemplating the use of an email-based telemedicine system.

[Adapting the service portfolio of a public health organisation to shrinking resources]. / Adaptación de los servicios de una organización de salud pública a la disminución de los recursos.

This paper describes the review process of the Agency of Public Health of Barcelona's service portfolio in response to the budget cuts introduced since 2010 in the public administrations in Spain. A working group reviewed the different business activities, taking into account their costs and generated revenue and their justification, assessing factors such as the existence of legal constraints, tied funding, explicit demands from the founding administrations and other actors that may be capable of undertaking particular activities. The changes and their consequences are described. The new service portfolio has been consolidated and is considered ratified by the Agency board, which was renewed after political changes. We conclude that this is because it was based on professional consensus and management criteria, which are key for the smooth operation of a public autonomous executive organisation.

The costs of a national health information network.

BACKGROUND: The use of information technology may result in a safer and more efficient health care system. However, consensus does not exist about the structure or costs of a national health information network (NHIN). OBJECTIVES: To describe the potential structure and estimate the costs of an NHIN. DESIGN: Cost estimates of an NHIN model developed by an expert panel. SETTING: U.S. health care system. MEASUREMENTS: An expert panel estimated the existing and the expected prevalence in 5 years of critical information technology functionalities. They then developed a model of an achievable NHIN by defining key providers, functionalities, and interoperability functions. By using these data and published cost estimates, the authors determined the cost of achieving this model NHIN in 5 years given the current state of information technology infrastructure. RESULTS: To achieve an NHIN would cost 156 billion dollars in capital investment over 5 years and 48 billion dollars in annual operating costs. Approximately two thirds of the capital costs would be required for acquiring functionalities and one third for interoperability. Ongoing costs would be more evenly divided between functionality and interoperability. If the current trajectory continues, the health care system will spend 24 billion dollars on functionalities over the next 5 years or about one quarter of the cost for functionalities of a model NHIN. LIMITATIONS: Because of a lack of primary data, the authors relied on expert estimates. CONCLUSIONS: While an NHIN will be expensive, 156 billion dollars is equivalent to 2% of annual health care spending for 5 years. Assessments such as this one may assist policymakers in determining the level of investment that the United States should make in an NHIN.

[Deficient information in developing countries: Internet alone is no solution]. / Gebrekkige informatie in ontwikkelingslanden: internet alleen is geen oplossing.

Health-care personnel in developing countries have poor access to information, partly because the books are out of date and journals and Internet access are lacking, and partly because the information that is available is not appropriate for the local situation. There is too little research aimed at the problems of the Third World. This is due to a lack of interest in Western countries and because local scientists have done too little research. Internet solves the problem of access to information for health-care personnel in large hospitals and institutes, but there is still a shortage of relevant information for them as well. The editorial boards of professional journals could make a contribution by facilitating the publication of relevant research. Health-care personnel in rural areas will remain dependent upon basic books. This basic component of the provision of information should continue to receive attention. For the time being, Internet will remain inaccessible for rural health-care personnel. One of the initiatives being undertaken in order to improve the provision of information to health-care personnel in developing countries is the distribution of the 'blue trunk library' of the WHO with a selection of more than 100 basic books in every trunk. A number of journals have also taken action: the BMJ Publishing Group offers access to its journals free of charge to the 118 poorest countries and the Canadian Medical Association Journal provides free copies to libraries in developing countries. Moreover, a number ofwebsites have been started with a view to enlarging the information for health-care personnel in the Third World.

Health Information Economy: Literature Review.

INTRODUCTION: Health Information Economy (HIE) is one of the broader, more complex, and challenging and yet important topics in the field of health science that requires the identification of its dimensions for planning and policy making. The aim of this study was to determine HIE concept dimensions. METHODS: This paper presents a systematic methodology for analyzing the trends of HIE. For this purpose, the main keywords of this area were identified and searched in the databases and from among 4775 retrieved sources, 12 sources were studied in the field of HIE. RESULTS: Information Economy (IE) in the world has passed behind four paradigms that involve the information evaluation perspective, the information technology perspective, the asymmetric information perspective and information value perspective. In this research, the fourth perspective in the HIE was analyzed. The main findings of this research were categorized in three major groups, including the flow of information process in the field of health (production. collection, processing and dissemination), and information applications in the same field (education, research, health industry, policy, legislation, and decision-making) and the underlying fields. CONCLUSION: According to the findings, HIE has already developed a theoretical and conceptual gap that due to its importance in the next decade would be one of the research approaches to health science.