Digital Health Data Quality Issues: Systematic Review.

BACKGROUND: The promise of digital health is principally dependent on the ability to electronically capture data that can be analyzed to improve decision-making. However, the ability to effectively harness data has proven elusive, largely because of the quality of the data captured. Despite the importance of data quality (DQ), an agreed-upon DQ taxonomy evades literature. When consolidated frameworks are developed, the dimensions are often fragmented, without consideration of the interrelationships among the dimensions or their resultant impact. OBJECTIVE: The aim of this study was to develop a consolidated digital health DQ dimension and outcome (DQ-DO) framework to provide insights into 3 research questions: What are the dimensions of digital health DQ? How are the dimensions of digital health DQ related? and What are the impacts of digital health DQ? METHODS: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a developmental systematic literature review was conducted of peer-reviewed literature focusing on digital health DQ in predominately hospital settings. A total of 227 relevant articles were retrieved and inductively analyzed to identify digital health DQ dimensions and outcomes. The inductive analysis was performed through open coding, constant comparison, and card sorting with subject matter experts to identify digital health DQ dimensions and digital health DQ outcomes. Subsequently, a computer-assisted analysis was performed and verified by DQ experts to identify the interrelationships among the DQ dimensions and relationships between DQ dimensions and outcomes. The analysis resulted in the development of the DQ-DO framework. RESULTS: The digital health DQ-DO framework consists of 6 dimensions of DQ, namely accessibility, accuracy, completeness, consistency, contextual validity, and currency; interrelationships among the dimensions of digital health DQ, with consistency being the most influential dimension impacting all other digital health DQ dimensions; 5 digital health DQ outcomes, namely clinical, clinician, research-related, business process, and organizational outcomes; and relationships between the digital health DQ dimensions and DQ outcomes, with the consistency and accessibility dimensions impacting all DQ outcomes. CONCLUSIONS: The DQ-DO framework developed in this study demonstrates the complexity of digital health DQ and the necessity for reducing digital health DQ issues. The framework further provides health care executives with holistic insights into DQ issues and resultant outcomes, which can help them prioritize which DQ-related problems to tackle first.

Process mining for healthcare: Characteristics and challenges.

Process mining techniques can be used to analyse business processes using the data logged during their execution. These techniques are leveraged in a wide range of domains, including healthcare, where it focuses mainly on the analysis of diagnostic, treatment, and organisational processes. Despite the huge amount of data generated in hospitals by staff and machinery involved in healthcare processes, there is no evidence of a systematic uptake of process mining beyond targeted case studies in a research context. When developing and using process mining in healthcare, distinguishing characteristics of healthcare processes such as their variability and patient-centred focus require targeted attention. Against this background, the Process-Oriented Data Science in Healthcare Alliance has been established to propagate the research and application of techniques targeting the data-driven improvement of healthcare processes. This paper, an initiative of the alliance, presents the distinguishing characteristics of the healthcare domain that need to be considered to successfully use process mining, as well as open challenges that need to be addressed by the community in the future.

Three novel bird strike likelihood modelling techniques: The case of Brisbane Airport, Australia.

The risk posed by wildlife to air transportation is of great concern worldwide. In Australia alone, 17,336 bird-strike incidents and 401 animal-strike incidents were reported to the Air Transport Safety Board (ATSB) in the period 2010-2019. Moreover, when collisions do occur, the impact can be catastrophic (loss of life, loss of aircraft) and involve significant cost to the affected airline and airport operator (estimated at globally US$1.2 billion per year). On the other side of the coin, civil aviation, and airport operations have significantly affected bird populations. There has been an increasing number of bird strikes, generally fatal to individual birds involved, reported worldwide (annual average of 12,219 reported strikes between 2008-2015 being nearly double the annual average of 6,702 strikes reported 2001-2007) (ICAO, 2018). Airport operations including construction of airport infrastructure, frequent take-offs and landings, airport noise and lights, and wildlife hazard management practices aimed at reducing risk of birdstrike, e.g., spraying to remove weeds and invertebrates, drainage, and even direct killing of individual hazard species, may result in habitat fragmentation, population decline, and rare bird extinction adjacent to airports (Kelly T, 2006; Zhao B, 2019; Steele WK, 2021). Nevertheless, there remains an imperative to continually improve wildlife hazard management methods and strategies so as to reduce the risk to aircraft and to bird populations. Current approved wildlife risk assessment techniques in Australia are limited to ranking of identified hazard species, i.e., are 'static' and, as such, do not provide a day-to-day risk/collision likelihood. The purpose of this study is to move towards a dynamic, evidence-based risk assessment model of wildlife hazards at airports. Ideally, such a model should be sufficiently sensitive and responsive to changing environmental conditions to be able to inform both short and longer term risk mitigation decisions. Challenges include the identification and quantification of contributory risk factors, and the selection and configuration of modelling technique(s) that meet the aforementioned requirements. In this article we focus on likelihood of bird strike and introduce three distinct, but complementary, assessment techniques, i.e., Algebraic, Bayesian, and Clustering (ABC) for measuring the likelihood of bird strike in the face of constantly changing environmental conditions. The ABC techniques are evaluated using environment and wildlife observations routinely collected by the Brisbane Airport Corporation (BAC) wildlife hazard management team. Results indicate that each of the techniques meet the requirements of providing dynamic, realistic collision risks in the face of changing environmental conditions.

Trauma by-pass guideline: A data-driven conformance analysis for road trauma cases in Queensland.

OBJECTIVE: Study objectives were to (i) develop and test a whole-of-system method for identifying patients who meet a major trauma by-pass guideline definition; (ii) apply this method to assess conformance to the current 2006 guideline for a road trauma cohort; and (iii) leverage relevant findings to propose improvements to the guideline. METHODS: Retrospective analysis of existing, routinely collected data relating to Queensland road trauma patients July 2015 to June 2017. Data from ambulance, aero-medical retrievals, ED, hospital and death registers were linked and used for analysis. Processes of care measured included: frequency of pre-hospital triage criteria, distribution of destination (trauma service level), compliance with guideline (recommended vs actual destination), trauma service level by threat to life (injury severity) (all modes of transport and aero-medical in particular), proportion of patients requiring only ED, transport pathway (direct vs inter-hospital transfer). RESULTS: 3847 cases were identified from data as meeting criteria for major trauma by-pass. The top five most frequently used criteria for qualifying patients as meeting the major trauma by-pass guideline were pulse rate, vehicle rollover, possible spinal cord injury, respiration rate and entrapment. The study demonstrates a 65% conformance to the clinical guideline. Overtriaged patients (transported to higher trauma service than recommended) generally reveal International Classification of Disease Injury Severity Score representing a high threat to life. CONCLUSION: Overall, the present study found good conformance, with overtriage rate as expected by clinicians. It is recommended to include data values to capture paramedics assessment of trauma level to enable more accurate assessment of conformance to guideline and future revision of the thresholds.

Privacy-Preserving Process Mining in Healthcare.

Process mining has been successfully applied in the healthcare domain and has helped touncover various insights for improving healthcare processes. While the benefits of process miningare widely acknowledged, many people rightfully have concerns about irresponsible uses of personaldata. Healthcare information systems contain highly sensitive information and healthcare regulationsoften require protection of data privacy. The need to comply with strict privacy requirements mayresult in a decreased data utility for analysis. Until recently, data privacy issues did not get muchattention in the process mining community; however, several privacy-preserving data transformationtechniques have been proposed in the data mining community. Many similarities between datamining and process mining exist, but there are key differences that make privacy-preserving datamining techniques unsuitable to anonymise process data (without adaptations). In this article, weanalyse data privacy and utility requirements for healthcare process data and assess the suitabilityof privacy-preserving data transformation methods to anonymise healthcare data. We demonstratehow some of these anonymisation methods affect various process mining results using three publiclyavailable healthcare event logs. We describe a framework for privacy-preserving process mining thatcan support healthcare process mining analyses. We also advocate the recording of privacy metadatato capture information about privacy-preserving transformations performed on an event log.

Leveraging Data Quality to Better Prepare for Process Mining: An Approach Illustrated Through Analysing Road Trauma Pre-Hospital Retrieval and Transport Processes in Queensland.

While noting the importance of data quality, existing process mining methodologies (i) do not provide details on how to assess the quality of event data (ii) do not consider how the identification of data quality issues can be exploited in the planning, data extraction and log building phases of any process mining analysis, (iii) do not highlight potential impacts of poor quality data on different types of process analyses. As our key contribution, we develop a process-centric, data quality-driven approach to preparing for a process mining analysis which can be applied to any existing process mining methodology. Our approach, adapted from elements of the well known CRISP-DM data mining methodology, includes conceptual data modeling, quality assessment at both attribute and event level, and trial discovery and conformance to develop understanding of system processes and data properties to inform data extraction. We illustrate our approach in a case study involving the Queensland Ambulance Service (QAS) and Retrieval Services Queensland (RSQ). We describe the detailed preparation for a process mining analysis of retrieval and transport processes (ground and aero-medical) for road-trauma patients in Queensland. Sample datasets obtained from QAS and RSQ are utilised to show how quality metrics, data models and exploratory process mining analyses can be used to (i) identify data quality issues, (ii) anticipate and explain certain observable features in process mining analyses, (iii) distinguish between systemic and occasional quality issues, and (iv) reason about the mechanisms by which identified quality issues may have arisen in the event log. We contend that this knowledge can be used to guide the data extraction and pre-processing stages of a process mining case study to properly align the data with the case study research questions.