Outreach marketing may be a successful strategy for NHS libraries.

This dissertation study investigates the ways that NHS libraries are currently marketing their services within their organisation and was submitted as part of the MA Library and Information Management at the University of Sheffield in 2019. This paper presents the findings from twelve semi-structured interviews carried out with NHS library managers in the East of England to identify the most and least successful methods, and in comparison with that which is currently in the general marketing literature. The study found that outreach marketing was the most effective and that librarians are currently conducting marketing to the best of their ability, but they lack time and funding to be able to make the most of their promotional campaigns. F.J.

Demands for multidimensional information on the work environment: A methodological framework for regular studies.

BACKGROUND: Development of methodologies for making economic decisions on designing work environment studies is a theoretical challenge for researchers in occupational health sciences. There are well-defined tools available in the relevant literature for analysis of cost-efficiency associated with the assessment of an occupational exposure of interest. However, these analytical tools are not appropriate for holistic studies of the work environment as a multidimensional reality. OBJECTIVE: This article introduces an appropriate methodology for designing cross-sectional comprehensive studies of the work environment, in order to optimize the production of information on the psychosocial, ergonomic, and physical dimensions of the work environment in regular studies. METHODS: The employment of a translog cost-utility function is suggested as a suitable way to provide cost-minimized designs for regular studies which are aimed at providing or developing multidimensional information systems of the work environment. RESULTS: The translog cost-utility function is not subject to predetermined restrictions, but has a flexibility property allowing it to be transformed to any specification that is adaptable to the specific work environmental characteristics and research requirements. CONCLUSION: The translog cost-utility function is an appropriate econometric model for optimizing the production of multidimensional information on occupational exposures in regular cross-sectional workplace studies.

Legibilidad, relevancia y calidad de la información en español en la Web para pacientes con artritis reumatoide / Readability, relevance and quality of the information in Spanish on the Web for patients with rheumatoid arthritis

La educación es un determinante mayor de salud y uno de los predictores independientes de desenlace en artritis reumatoide (AR). El uso del Internet por pacientes ha crecido en forma exponencial en la última década. Objetivos. Evaluar las características, legibilidad y calidad de la información disponible en Internet en idioma español en relación con la AR. Material y métodos. Se buscó la frase AR en Google. Se evaluaron las primeras 30 páginas de resultados de acuerdo con un formato diseñado ex profeso (relevancia, autoría, tipo de publicación, enfermedad discutida e interés financiero); además se evaluaron la calidad y la legibilidad de las páginas, con las herramientas DISCERN e INFLESZ, respectivamente. La extracción de datos se realizó por médicos pasantes y la evaluación fue por consenso. Resultados. Se obtuvieron 323 resultados, pero solo el 63% de ellos fueron relevantes; el 80% de estos fueron sitios de información (71% discutían exclusivamente AR, 44% terapia convencional y 12% terapias alternativas). Un 12,5% tenía interés financiero. El 60% de los sitios fueron creados por organizaciones no lucrativas y 15% por asociaciones médicas. Las asociaciones médicas de Estados Unidos de América se posicionan mejor en español (Arthritis Foundation en la posición 4 y el American College of Rheumatology en la 10) que los sitios web de países de habla hispana. Conclusiones. Existe riesgo de desinformación para los pacientes con AR que utilizan la Web. Se identifica además áreas de oportunidad para instituciones médicas de países de habla hispana para tener un mayor involucramiento social en la educación de sus pacientes (AU)

Background. Education is a major health determinant and one of the main independent outcome predictors in rheumatoid arthritis (RA). The use of the Internet by patients has grown exponentially in the last decade. Objective. To assess the characteristics, legibility and quality of the information available in Spanish in the Internet regarding to rheumatoid arthritis. Material and methods. The search was performed in Google using the phrase rheumatoid arthritis. Information from the first 30 pages was evaluated according to a pre-established format (relevance, scope, authorship, type of publication and financial objective). The quality and legibility of the pages were assessed using two validated tools, DISCERN and INFLESZ respectively. Data extraction was performed by senior medical students and evaluation was achieved by consensus. Results. The Google search returned 323 hits but only 63% were considered relevant; 80% of them were information sites (71% discussed exclusively RA, 44% conventional treatment and 12% alternative therapies) and 12.5% had a primary financial interest. 60% of the sites were created by nonprofit organizations and 15% by medical associations. Web sites posted by medical institutions from the United States of America were better positioned in Spanish (Arthritis Foundation 4th position and American College of Rheumatology 10th position) than web sites posted by Spanish speaking countries. Conclusions. There is a risk of disinformation for patients with RA that use the Internet. We identified a window of opportunity for rheumatology medical institutions from Spanish-speaking countries to have a more prominent societal involvement in the education of their patients with RA (AU)

Development of an Excel-based laboratory information management system for improving workflow efficiencies in early ADME screening.

BACKGROUND: There is a clear requirement for enhancing laboratory information management during early absorption, distribution, metabolism and excretion (ADME) screening. The application of a commercial laboratory information management system (LIMS) is limited by complexity, insufficient flexibility, high costs and extended timelines. RESULTS: An improved custom in-house LIMS for ADME screening was developed using Excel. All Excel templates were generated through macros and formulae, and information flow was streamlined as much as possible. This system has been successfully applied in task generation, process control and data management, with a reduction in both labor time and human error rates. CONCLUSION: An Excel-based LIMS can provide a simple, flexible and cost/time-saving solution for improving workflow efficiencies in early ADME screening.

Modelo de sistema de organización del conocimiento basado en ontologías / Model of a knowledge organization system based on ontologies

El presente trabajo tiene como objetivo proponer un modelo para el diseño y construcción de un sistema de organización del conocimiento basado en ontologías. Se propone, a través del uso de métodos descriptivos y criterios de otros autores, un modelo a partir del cual se puede obtener un sistema de información basado en ontologías. Se muestra y se explica la relación entre cada una de las partes del modelo, y se demuestran sus propiedades holísticas. Se plantean los resultados obtenidos de la evaluación del modelo para su validación a través del criterio de expertos. Todos los pasos establecidos a través del modelo resultaron importantes. La mayoría de los encuestados estuvieron a favor y en ningún caso se consideró que los pasos eran poco importantes o no importantes. Con la aplicación del modelo se espera estructurar las bases de un dominio del conocimiento en específico, tras una progresiva sustitución de los modelos convencionales del proceso de recuperación de la información por un modelo cognitivo(AU)

The study is aimed at proposing a model for the design and construction of a knowledge organization system based on ontologies. Descriptive methods and criteria provided by other authors were used to devise and propose a model to obtain an information system based on ontologies. It is expected that the bases of a specific knowledge domain may be structured with the application of this method, following gradual replacement of conventional information retrieval models by a cognitive model. A discussion is also provided about the relationship between the various parts of the model, showing its holistic properties. The results obtained from evaluation of the model are presented for consideration by experts. All the steps established by the model were important. Most respondents were in favor and none considered that the steps were not very important or not important at all(AU)

Modelo de sistema de organización del conocimiento basado en ontologías / Model of a knowledge organization system based on ontologies

El presente trabajo tiene como objetivo proponer un modelo para el diseño y construcción de un sistema de organización del conocimiento basado en ontologías. Se propone, a través del uso de métodos descriptivos y criterios de otros autores, un modelo a partir del cual se puede obtener un sistema de información basado en ontologías. Se muestra y se explica la relación entre cada una de las partes del modelo, y se demuestran sus propiedades holísticas. Se plantean los resultados obtenidos de la evaluación del modelo para su validación a través del criterio de expertos. Todos los pasos establecidos a través del modelo resultaron importantes. La mayoría de los encuestados estuvieron a favor y en ningún caso se consideró que los pasos eran poco importantes o no importantes. Con la aplicación del modelo se espera estructurar las bases de un dominio del conocimiento en específico, tras una progresiva sustitución de los modelos convencionales del proceso de recuperación de la información por un modelo cognitivo...

The study is aimed at proposing a model for the design and construction of a knowledge organization system based on ontologies. Descriptive methods and criteria provided by other authors were used to devise and propose a model to obtain an information system based on ontologies. It is expected that the bases of a specific knowledge domain may be structured with the application of this method, following gradual replacement of conventional information retrieval models by a cognitive model. A discussion is also provided about the relationship between the various parts of the model, showing its holistic properties. The results obtained from evaluation of the model are presented for consideration by experts. All the steps established by the model were important. Most respondents were in favor and none considered that the steps were not very important or not important at all...

The ultimate physical limits of privacy.

Among those who make a living from the science of secrecy, worry and paranoia are just signs of professionalism. Can we protect our secrets against those who wield superior technological powers? Can we trust those who provide us with tools for protection? Can we even trust ourselves, our own freedom of choice? Recent developments in quantum cryptography show that some of these questions can be addressed and discussed in precise and operational terms, suggesting that privacy is indeed possible under surprisingly weak assumptions.

Web 2.0 in healthcare: state-of-the-art in the German health insurance landscape.

The Internet is increasingly used as a source for information and knowledge. Even in the field of healthcare, information is widely available. Patients and their relatives increasingly use the Internet in order to search for healthcare information and applications. "Health 2.0" - the increasing use of Web 2.0 technologies and tools in Electronic Healthcare - promises new ways of interaction, communication, and participation for healthcare. In order to explore how Web 2.0 applications are in general adopted and implemented by health information providers, we analysed the websites of all German health insurances companies regarding their provision of Web 2.0 applications. As health insurances play a highly relevant role in the German healthcare system, we conduct an exploratory survey in order to provide answers about the adoption and implementation of Web 2.0 technologies. Hence, all 198 private and public health insurances were analysed according to their websites. The results show a wide spread diffusion of Web 2.0 applications but also huge differences between the implementation by the respective insurances. Therefore, our findings provide a foundation for further research on aspects that drive the adoption.

Paper trails. Document management is no silver bullet, but it can patch holes as hospitals transition to paperless.

Hospitals are leveraging content management to ease the transition from a paper-based to electronic environment. Document management is used to scan, index and archive medical records and financial documents. Even fully integrated health systems receive outside documents such as lab results and referrals that must be incorporated into the patient record. The data in scanned documents cannot be used for trending purposes without manual work. The market for natural language processing, a tool used to extract data elements from scanned documents, could ramp up significantly in the near future.

Integrated specialty service readiness in health reform: connections in haemophilia comprehensive care.

The World Health Organization (WHO) has identified primary healthcare reform as a global priority whereby innovative practice changes are directed at improving health. This transformation to health reform in haemophilia service requires clarification of comprehensive care to reflect the WHO definition of health and key elements of primary healthcare reform. While comprehensive care supports effective healthcare delivery, comprehensive care must also be regarded beyond immediate patient management to reflect the broader system purpose in the care continuum with institutions, community agencies and government. Furthermore, health reform may be facilitated through integrated service delivery (ISD). ISD in specialty haemophilia care has the potential to reduce repetition of assessments, enhance care plan communication between providers and families, provide 24-h access to care, improve information availability regarding care quality and outcomes, consolidate access for multiple healthcare encounters and facilitate family self-efficacy and autonomy [1]. Three core aspects of ISD have been distinguished: clinical integration, information management and technology and vertical integration in local communities [2]. Selected examples taken from Canadian haemophilia comprehensive care illustrate how practice innovations are bridged with a broader system level approach and may support initiatives in other contexts. These innovations are thought to indicate readiness regarding ISD. Reflecting on the existing capacity of haemophilia comprehensive care teams will assist providers to connect and direct their existing strengths towards ISD and health reform.

[Thinking on TCM literature evaluation methods and techniques based on mass information].

The necessity and feasibility of TCM literature evaluation based on mass information of TCM literature was discussed in this paper. Beginning with the description on current situation of mass TCM literature information research, the authors offered a tentative plan for evaluating scientific and technologic TCM literature, its method and technique, and systematically analyzed the key issues, such as the subjects selection, documents screening and sorting, literature analysis, and development of software analysis platform, then, the methodology and the technology for constituting the mass TCM literature information based evaluation system was systemically clarified.

Technology solutions for better outcomes: integrated information management in key to productivity increases in medicine.

The challenges to healthcare systems around the world are primarily impacted by two topics: demographic factors and progress in medicine. An ageing population inherently needs more medical services which add financial burdens, in particular, to public healthcare. Since the level of medical education is growing at the same time, we are observing an increased demand for sophisticated (in general expensive) medicine. Drastic changes in financing seem unavoidable. Multiple diagnoses, repeated examinations, trial-and-error, overcapacities and other signs of missing economical considerations are reinforced by reimbursement systems. In a world where, in principle, all information is available everywhere, more than a patient's history should be accessible. Other industries have knowledge management systems in place that make state-of-the-art expertise available everywhere. Intelligent patient databases could consist of learning cycles that (i) enable the individual to benefit from structured knowledge, in addition to personal experience of the physician, and (ii) use the knowledge generated from the individual to extend the database. The novel area of molecular medicine fits perfectly well into these scenarios. Only attached to an IT backbone can the flood of information be managed in a beneficial way. Efficiency improvements in healthcare address the needs of all parties in the system: patients, providers, and payers. The opportunities, however, can only materialize if everyone is prepared to change. IT will set the standards for the biggest challenge in healthcare: The paradigm shift in medicine.

DICOM structured reporting: Part 1. Overview and characteristics.

Supplement 23 to Digital Imaging and Communications in Medicine (DICOM) is an introduction to the structured reporting (SR) classes, which are used for transmission and storage of clinical documents. The SR classes fully support both conventional free-text reports and structured information, thus enhancing the precision, clarity, and value of clinical documentation. In addition, the SR standard provides the capability to link text and other data to particular images or waveforms and to store the coordinates of findings. In other words, SR documents not only describe the specific features contained in images or waveforms but can also refer to any number of images or waveforms. Accordingly, SR bridges the traditional gap between imaging systems and information systems. Furthermore, SR plays an essential role in Integrating the Healthcare Enterprise by providing healthcare practitioners with an effective tool that encompasses a variety of clinical contexts. Harmonization of DICOM SR and the Health Level Seven clinical document architecture standard is under way.

DICOM structured reporting: Part 2. Problems and challenges in implementation for PACS workstations.

Structured reporting (SR) was recently added to the Digital Imaging and Communications in Medicine (DICOM) standard to provide an efficient mechanism for the generation, distribution, and management of clinical reports. The main advantage of SR is the ability to link clinical documents with the referenced images for simultaneous retrieval and display. A generic SR toolkit that covers the different clinical reports used in today's healthcare enterprises was developed for picture archiving and communication system (PACS) workstations. The modules of the SR toolkit collaborate to automatically construct the DICOM SR files from the free-text input presented in hypertext markup language (HTML) by using the associated SR trees. The DICOM toolkit is reused for SR encoding and DICOM services. A setup module was required for creating both the standard and private SR templates used in different healthcare specialties. The SR manager transparently converts between the different SR document presentations, that is, DICOM SR files and HTML documents, to provide the end users with an easy-to-use toolkit. To evaluate and demonstrate the effectiveness of the SR toolkit in a pragmatic setting, the toolkit was integrated into PACS workstations.

Towards a continuous evolution and adaptation of information systems in healthcare.

OBJECTIVES: To address the problem of alignment of health information systems to healthcare processes, which is a major challenge in healthcare organizations; to present a layered approach for system evolution and adaptation based on an application framework and rapid application development; to accomplish a demand-driven system evolution by embedding the software engineering process in business process optimization projects and by closely involving end users to improve their own work practices. METHODS: We have used a holistic health information system as a core application framework. System functionality is incrementally improved using an integrated "generator tool" for rapid application development. We have developed an iterative and participatory software engineering process, adapted to the conditions of the generator tool. The documentation techniques provided by the Unified Modeling Language (UML) were modified to achieve a straight forward documentation covering the whole development cycle from the business process model to generator-based computer applications. RESULTS AND CONCLUSION: The layered approach for system evolution did provide an environment in which a flexible and participatory software development process could be established. Today, generator-based applications are used in all clinical departments of our 1200-bed University Hospital. We expect that tools for rapid application development will be further improved and will play an increasingly important role to establish responsive IT-infrastructures where the application developer can concentrate on business process alignment instead of coding and debugging.

From SARS to systems: developing advanced knowledge management for public health.

Historically, public health has been at the forefront of data processing applications but it is lagging behind other areas of health care in the application of advanced interconnected and mobile information technologies. Ready to use technologies are lacking not only for the management of emerging infections or bio-terrorism but also for the coordination of prevention and chronic care initiatives. Advanced information and knowledge management for community health should expedite the transfer of research evidence to practice and provide essential logistical support for action. We need to find ways to integrate new scientific knowledge into our environment in order to expedite the translation of research to practice.

Assessing the information management requirements for behavioral health providers.

Behavioral health agencies will soon implement automated information-management systems to support their administrative, financial, and clinical care functions. Assessing current information-management capabilities and delineating future needs are prerequisite to recommending a specific information technology solution. Quantifying the discrepancy between current information-management capabilities and future requirements highlights the areas of greatest unmet need for information management. Selecting an information system that addresses the most critical areas of unmet need is a prudent purchase decision. This article describes the results of a process to assess the information-management requirements for agencies that were considering implementation of an integrated behavioral health information-management system. The assessment revealed that these agencies already employed automated systems to manage most financial functions and many administrative functions. Few agencies, however, utilized automated systems to manage clinical care functions. Selection of a behavioral health electronic medical record (EMR) effectively addressed clinical care information-management needs without duplicating existing financial and administrative management functions. Also, the EMR included features that addressed some administrative functions for which a discrepancy between current capabilities and future needs was found. Selecting an EMR instead of an integrated behavioral health information system was associated with a significant reduction in information system acquisition costs.

About FACE: the applications of a structured approach to mental health information.

This article describes the Functional Analysis of Care Environments (FACE), and demonstrates some of its' applications in mental health services. FACE is a recording and measurement technology designed to integrate clinical and management information. Its major features are a multi-axial framework and measurement tools for assessment and outcome recording. Structured information about mental and physical well being, social circumstances and environmental functioning was recorded for 520 clients receiving either 'assertive' or 'community' forms of mental health care. The information generated formed the basis for comparison between clients, identified significant differences between the two client groups, and highlighted treatment effectiveness.

[Integrated health information system based on Resident Assessment Instruments]. / Geïntegreerd gezondheidsinformatiesysteem op basis van Resident Assessment Instrumenten.

The paper explores the meaning of Resident Assessment Instruments. It gives a summary of existing RAI instruments and derived applications. It argues how all of these form the basis for an integrated health information system for "chain care" (home care, home for the elderly care, nursing home care, mental health care and acute care). The primary application of RAI systems is the assessment of client care needs, followed by an analysis of the required and administered care with the objective to make an optimal individual care plan. On the basis of RAI, however, applications have been derived for reimbursement systems, quality improvement programs, accreditation, benchmarking, best practice comparison and care eligibility systems. These applications have become possible by the development on the basis of the Minimum Data Set of RAI of outcome measures (item scores, scales and indices), case-mix classifications and quality indicators. To illustrate the possibilities of outcome measures of RAI we present a table and a figure with data of six Dutch nursing homes which shows how social engagement is related to ADL and cognition. We argue that RAI/MDS assessment instruments comprise an integrated health information system because they have consistent terminology, common core items, and a common conceptual basis in a clinical approach that emphasizes the identification of functional problems.

Orchestrating a unified approach to information management.

Articles in both business and healthcare literature make frequent reference to the need for integration in healthcare organizations. In healthcare, the term horizontal integration can refer to the purchase of one hospital by another in the same geographical area, particularly where the hospitals' services overlap. Services might be consolidated in this example or one hospital may totally shut down the acquired one. Vertical integration refers to a hospital exercising control of its inputs or outputs. In one sense, patients referred to a hospital can be considered inputs. A hospital that purchases physician practices or integrated delivery systems is an example. Purchasing a nursing facility by an integrated delivery system (IDS) is another. This article focuses on organizational or holographic integration, where an organization is understood and embedded--like a hologram--in each of its smaller components, and each operating unit has knowledge about the whole system in which it is embedded. Conceptually, a hospital can achieve organizational integration relatively easily. One way is to assign administrative responsibility for two departments, radiology and pathology, for example, to one person who will handle billing, budgeting and human resources issues. Organizational integration breaks down turf barriers between distinct functional areas (often known as stovepipes or the silo mentality) because the result is less energy expended to solve problems. Organizational integration must include the merging of information technology (IT) into a single computer system that can report results across several departments, for example, in order entry, result reporting, resource scheduling or billing. At the University of Michigan Health System, technical and organizational integration are taking place across the information systems of the radiology and pathology departments. Deployment of an intranet-based architecture for ancillary information systems will provide the means to achieve high level integration across previously heterogeneous and non-integrated department-based clinical information systems.