Pitfalls of Artificial Intelligence in Medicine.

Artificial Intelligence (AI) offers great promise for healthcare, but integrating it comes with challenges. Over-reliance on AI systems can lead to automation bias, necessitating human oversight. Ethical considerations, transparency, and collaboration between healthcare providers and AI developers are crucial. Pursuing ethical frameworks, bias mitigation techniques, and transparency measures is key to advancing AI's role in healthcare while upholding patient safety and quality care.

Information Technology and Value-Based Healthcare Systems: A Strategy and Framework.

Value-based healthcare offers a pathway for enhancing patient satisfaction and population health and reducing healthcare costs. In addition, it provides a means to enhance physicians' perception and experience in healthcare delivery. The foundation of the said system is the notion that community wellness can only be benefited when the health effects of many people are also addressed. The provision of healthcare services incurs costs. However, a value-based model addresses this issue by establishing teams that cater to individuals with similar needs. This approach fosters expertise and efficiency, ultimately leading to cost savings without rationing. Furthermore, entrusting decision-making authority regarding healthcare delivery to the clinical team enhances doctors' professionalism and the integrity of clinician-patient interactions, resulting in more effective and relevant treatments. Currently, various information technology (IT)-based solutions are the main focus for accomplishing the desired value-based healthcare system. The establishment of a coordinated framework that can help organizations create value-based healthcare systems is covered in the current article. Additionally listed are many IT-based solutions used to create a value-based healthcare system.

Strengths and Obstacles of Health Informatics and Health Information Management Education and Professions in Hail City, Kingdom of Saudi Arabia: A Qualitative Study.

Health and higher education ministries in Saudi Arabia recognize the need for a highly qualified workforce specializing in health informatics and information management (HIIM). Therefore, KSA colleges and universities offer HIIM programs, health information systems, and health information technology. It is critical to investigate the HIIM professions and education in Hail City due to differences in these educational programs. This study examined HIIM professions and education in Hail City, Saudi Arabia, and provided strategies and recommendations. Based on a qualitative research approach, we interviewed 39 academicians, health informaticians, and other stakeholders in Hail City. The strengths, weaknesses, opportunities, threats (SWOT) framework was used to explore HIIM status and make recommendations. According to participants, HIIM Saudi professionals in Hail City have been growing and motivated, as have the university's undergraduate and postgraduate programs. Informants indicated several weaknesses, but many opportunities were found, including Saudi Vision 2030 and a new HIIM faculty at the University of Hail. According to our findings, relevant specialties control HIIM leadership while unspecialized academicians provide instruction. The extraordinary transmission of digital health in Saudi Arabia promises to enhance HIIM professions and education strengths and opportunities and reduce their weaknesses and threats.

An Evaluation of Drug-Drug Interaction Alerts Produced by Clinical Decision Support Systems in a Tertiary Hospital.

Introduction Drug-drug interactions (DDIs) have the potential to harm patients. Hence, DDI alerts are meant to prevent harm; as a result, their usefulness is reduced when most alerts displayed to providers are ignored. This study aims to explore the rates and reasons for overriding alerts of DDI. Methods This is a retrospective study of DDI alert overrides that occurred between January 2020 and December 2020 within the inpatient medical records at a tertiary hospital, Medina City, Kingdom of Saudi Arabia. Results A total of 7,098 DDI alerts were generated from inpatient settings, of which 6,551(92.2%) were overridden by the physicians at the point of prescribing. "Will Monitor as Recommended" (33%) was the most common reason for the override, followed by 'Will Adjust the Dose as Recommended (27.1%)," "The Patient Has Already Tolerated the Combination" (25.7%), and "No Overridden Reason Selected" (13.0%). Discussion The DDI alert overriding is still high and is comparable to other studies. However, this study reveals that physicians are ready to deal with the consequences of around 58% of DDI alerts. Additionally, 13% of physicians were not willing to report the reason for overriding. This indicates an urgent need to review and restructure the DDI alert system. Conclusion The DDI alert override rates are high, and this is undesirable. It is recommended to revise the DDI alert system. Future studies should dig deep for real reasons for overriding and seek inputs from all stakeholders, including developing actionable metrics to track and monitor DDI alerting system.

Personal Health Record (PHR) Experience and Recommendations for a Transformation in Saudi Arabia.

A Personal Health Record (PHR) is a patient-managed platform for health data. Most hospitals provide a PHR as an extension of the Electronic Medical Record (EMR). However, there are unresolved issues around the adoption rate, functionalities, barriers and, more importantly, the impact of the PHR on patients' health. A cross-sectional, survey-based descriptive study was conducted in which patients from four main tertiary hospitals in Saudi Arabia were targeted from September 2022 to February 2023. The survey was tested and validated to address the objectives of the study. The survey covered components related to intention to use the PHR, required functions, obstacles and expected outcomes. This study involved 396 participants from the top four hospitals. It was discovered that the majority of them had intentions to use the PHR (93%) and believed it to be useful (94%) and easy to use (94%). It was widely agreed that accessing medical records (77%), scheduling appointments (88%), renewing medication (90%), tracking patient data (70%) and receiving personalized education (78%) were essential aspects of the PHR. Furthermore, the survey revealed that 54% of respondents saw a positive effect on their health status. A significant number of participants, around 54%, expressed concerns about the privacy of their PHR, and 46% reported concerns about the accuracy of their information. The study found that demographic factors and the type of hospital did not have a statistically significant association with the intention to use the PHR. Our findings showed that there were no significant barriers to adopting the PHR. Additionally, we found that less than half of the participants believed that their current PHR helped them to improve their health. This highlights the need for healthcare organizations to focus on improving the PHR's functionality and overall purpose. Instead of simply providing basic features, the PHR should allow patients to manage their health information comprehensively, including compiling information from hospitals and patient-generated data. Having a PHR is crucial in improving an individual's overall health. As technology advances, more data are being generated that should be included in the PHR to ensure an accurate and comprehensive view of the patient's health. Expanding the scope of the PHR to include capabilities beyond merely hospital data is important. Achieving this requires an open and honest discussion about the role of the PHR, potential obstacles and how to coordinate efforts among different stakeholders.

Machine Learning for Early Prediction of Sepsis in Intensive Care Unit (ICU) Patients.

Background and Objectives: Early detection of sepsis is crucial and can save lives. However, identifying sepsis early and accurately remains a difficult task in the medical field. This study aims to investigate a new machine-learning approach. By analyzing the clinical laboratory results and vital signs of adult patients in the ICU, this approach can predict and detect the initial signs of sepsis. Materials and Methods: To examine survival rates and predict outcomes, the study utilized several models, including the proportional hazards model and data mining algorithms. We analyzed data from the BESTCare database at KAMC, with a focus on patients aged 14 and older who were admitted to the ICU between April and October 2018. We conducted a thorough analysis of the medical records of a total of 1182 patients who were diagnosed with sepsis. Results: We studied two approaches to predict sepsis in ICU patients. The regression model utilizing survival analysis showed moderate predictive ability, emphasizing the importance of only three factors-time (from sepsis to an outcome; discharge or death), lactic acid, and temperature-had a significant p-value (p = 0.000568, p = 0.01, p = 0.02, respectively). Other data mining algorithms may have limitations due to their assumptions of variable independence and linear classification nature. Conclusions: To achieve progress and accuracy in the field of sepsis prediction, it is important to continuously strive for improvement. By meticulously cleaning and selecting data attributes, we can create a strong foundation for future advancements in this area.

The Progress of Speech Recognition in Health Care: Surgery as an Example.

Artificial Intelligence (AI) is a computer system that simulates intelligent human behavior. The use of AI is rapidly shifting Healthcare. Speech recognition (SR) is a type of AI physicians use to operate Electronic Health records (EHR). This paper aims to demonstrate the technological advancements made thus far concerning speech recognition in health care and explore multiple scholarly studies to generate a wide-ranging and detailed assessment of its current progress. The effectiveness of speech recognition is the heart of this analysis. This review investigates published papers on the progress and effectiveness of speech recognition in Healthcare. Eight research papers exploring the progress and effectiveness of speech recognition in Healthcare were thoroughly reviewed. Articles were identified from Google Scholar, PubMed, and the World Wide Web. The five relevant papers generally discussed the progress and current effectiveness of SR in Healthcare, implementing SR in the EHR, adapting healthcare workers to SR and the problems they face, developing an intelligent healthcare system based on SR and using SR systems in other languages. Conclusion: This report demonstrates the technological improvements realized concerning SR in Healthcare. It proved that SR could be a tremendous help to providers if every medical and health institution continued to progress in using this technology.

A Model for Clinical Coder Satisfaction in Saudi Arabia Based on a Holistic Approach: Clinical, Professional and Organizational Dimensions.

The quality of clinical coding influences not only hospital revenue but also the quality and efficiency of healthcare services. Assessing the coders' satisfaction is essential to optimizing the quality of clinical coding. This mixed-method study used a qualitative approach to propose the study model while testing the model through a quantitative approach. The relevant variables of the satisfaction model were assessed through a survey targeting clinical coders across the country on a timely basis. Fourteen experts participated in establishing the model with three dimensions: professional, organizational, and clinical. Each dimension has its relevant variables. One hundred eighty-four clinical coders participated in phase two. 34.5% were male, 61% held a diploma, 38% had a bachelor's and above, and 49.7% worked in hospitals having fully electronic health records. We found that organizational and clinical dimensions strongly correlate with coders' satisfaction. Noticeably, the most influencing variables were the availability of coding policies and the computer-assisted coding (CAC) system. The results show that the model explains the satisfaction of the clinical coders, and organizational and clinical-related variables are crucial. Although gender-based differences exist, training (regardless of the training mode), coding policies, and the CAC system substantially influence coders' satisfaction. A significant stream of the literature supports these findings. However, attempting a holistic approach to assess coders' satisfaction and affecting coding quality is the added value of this study. Optimizing clinical coding practice requires organization-wide initiatives and policies to regulate coding practices and standards to promote the quality and timeliness of clinical documentation. Training is indispensable not only for clinical coders, but physicians also need to understand the rationale and value of clinical coding. Better utilization of the outcomes of the coding process and adopting the CAC system are significant drivers to enhance coders' satisfaction.

Physicians' Perspectives on a Multi-Dimensional Model for the Roles of Electronic Health Records in Approaching a Proper Differential Diagnosis.

Many healthcare organizations have adopted Electronic Health Records (EHRs) to improve the quality of care and help physicians make proper clinical decisions. The vital roles of EHRs can support the accuracy of diagnosis, suggest, and rationalize the provided care to patients. This study aims to understand the roles of EHRs in approaching proper differential diagnosis and optimizing patient safety. This study utilized a cross-sectional survey-based descriptive research design to assess physicians' perceptions of the roles of EHRs on diagnosis quality and safety. Physicians working in tertiary hospitals in Saudi Arabia were surveyed. Three hundred and fifty-one participants were included in the study, of which 61% were male. The main participants were family/general practice (22%), medicine, general (14%), and OB/GYN (12%). Overall, 66% of the participants ranked themselves as IT competent, most of the participants underwent IT self-guided learning, and 65% of the participants always used the system. The results generally reveal positive physicians' perceptions toward the roles of the EHR system on diagnosis quality and safety. There was a statistically significant relationship between user characteristics and the roles of the EHR by enhancing access to care, patient-physician encounter, clinical reasoning, diagnostic testing and consultation, follow-up, and diagnostic safety functionality. The study participants demonstrate positive perceptions of physicians toward the roles of the EHR system in approaching differential diagnosis. Yet, areas of improvement in the design and using EHRs are emphasized.

A Framework and System Design for Medicines Resources Allocation: A Multi-Stakeholder Assessment of Processes and Electronic Platform Needs.

Utilizing resources effectively is becoming more critical, especially with the ever-increasing healthcare cost. Little is known about the current practices used by healthcare organizations for the procurement, allocation, and utilization of medical resources. Moreover, the available literature needed to be enriched to bridge the link between resource utilization and allocation processes' performance and outcomes. This study investigated the processes that major healthcare facilities in Saudi Arabia apply to procure, allocate and utilize medicines resources. The work explored the role of electronic systems and provided a system design and conceptual framework to enhance the availability and utilization of resources. A three-part multi-method, multi-field (healthcare and operational), and multi-level exploratory and descriptive qualitative research design were used to collect the data that was analyzed and interrupted to feed the "future state" model. The findings demonstrated the current state procedure and discussed the challenges and the experts' opinions on developing the framework. The framework includes various elements and perspectives and is designed based on the results of the first part and was further validated by experts who were optimistic about the inclusiveness of this framework. Some major technical, operational, and human factors were perceived as obstacles by the subjects. Decision-makers can adopt the conceptual framework to gain insights into interrelated objects, entities, and processes. The findings of this study can imply future directions for research and practices.

Informational Needs for Dental-Oriented Electronic Health Records from Dentists' Perspectives.

INTRODUCTION: Information technology is vital to support dental care services and is yet to be thoroughly investigated. This study aims to assess the dentists' needs and requirements for health records from dental care providers' perspectives. METHODS: In-depth interviews were conducted with dentists during clinic practices. This qualitative research method involves exploring the information and functions dentists use to obtain information from EHR. The target population is the dental staff interacting with the patients and accessing the electronic health records in the government and private sectors. RESULTS: Thirty-five dentists were interviewed directly after the treatment session and asked four pre-defined questions, the dentists' needs were collected, and the met and unmet needs were presented. The interview results revealed 42 needs (15 were met and 27 were unmet), with an average of 1.17 needs per session. The information needs were categorized into foreground and background information needs and reported in nine main themes. DISCUSSION: The interviews were analyzed, and as a result, nine themes were generated: chief complaints and symptoms, medical and health history, medications, visual representations of the problem, treatment procedures, X-ray services, needs related to advanced features, needs related to insurance coverage, and finally, information needs related to the treatment environment. The required information and functions mentioned by dentists in the study emphasize the need for integrated modules for oral and medical care services. Generally, it is evident that dentists have substantial unmet needs, and the desired EHR should have functions that cover all dentists' needs. CONCLUSION: The study's findings demonstrate gaps between current and desired EHR to serve dentists' needs. Dentists need better access to patient history and medical information, progress notes, and X-rays to provide visualization tools for problems and patient charts. Moreover, essential needs were related to messaging capability, educational tools, availability of tutorial videos, and accessing external resources. Information needs were described and should be considered when designing EHR to meet all dentists' needs.

Establishing a Graduate Certificate in Health Informatics: Need Assessment and Competency-Based Framework.

Background: Health Informatics is an indispensable science in light of the massive reform healthcare has undertaken recently. Objective: Health Informatics is an indispensable science in light of the massive reform healthcare has undertaken recently. Methods: This descriptive multiphase study used a questionnaire to assess the need and applied a competency-based postgraduate curriculum to collect the required competencies as well as their proficiency levels. Results: Eighty percent of the respondents agreed that the current training should be advanced. 73.7% of the respondents agreed that this certificate would improve the level of knowledge, and it would impact on the delivery of healthcare positively (78.9%). For the required competencies, 10 competencies scored 1.75 and above, 22 scored between 1.5 and 1.75 and 22 scored below 1.50. The expert panel came to an agreement that the competencies with 1.5 and above should be included. Discussion: The findings emphasize the need to establish PG diploma in comply with previous studies that unveiled the need to provide education and training in Health Informatics. Only the required competencies were included as the program is one-year long. The selected competencies were validated and presented by the panel. Conclusion: A PG diploma in Health Informatics is a key element in the evolution of healthcare services, therefore, a competency-based framework was provided and validated by experts.

The Impact of Virtual Reality in Enhancing the Quality of Life of Pediatric Oncology Patients.

Pediatric oncology interventions involve many challenges, such as multiple hospitalizations, invasive procedures, and adverse physical and psychological treatment side effects. Treatment burden, including administration of general anesthesia, contributes to high levels of psychological distress among pediatric patients and their families. Virtual reality (VR) is a distraction method, which offers an extremely realistic and interactive virtual environment and helps reduce pain and distress by means of a head-mounted display and headphones. VR is based on two crucial dimensions: immersion and presence, which results in the complete suspension of disbelief that the experience is artificial and allows a greater degree of presence and reaction to the stimulations. The VR technology has become a common practice in scientific and clinical research due to its affordability and ease of use. In pediatric settings, the most widely researched clinical application of VR has focused on the effectiveness of VR distraction therapy in the attenuation of acute pain, anxiety, and distress during invasive medical procedures. It has also been hypothesized to be a nonpharmacological form of analgesia that positively influences the body's intricate pain modulation system during painful medical procedures. In this review, we showed the potential benefits of VR technology during radiotherapy and intrathecal procedures on pediatric oncology patients and its involvement in enhancing their quality of life during and after the treatment. Therefore, a collaboration between researchers, clinicians, and programmers is crucial for the inclusion of VR technology in more clinical procedures, which would consequently enhance the patient's quality of life.

Pitfalls of Social Media in the Era of COVID-19 Pandemics.

In December 2019, Wuhan, China, reported an outbreak of nSARS-CoV2 that caused viral pneumonia, COVID-19. Li Wenliang, a Chinese ophthalmologist, first communicated on Chinese social media about the existence and spread of the unknown viral pneumonia in Wuhan, China. By the end of March 2020, the virus had spread worldwide. However, non-scientific information related to the viral outbreak, disease, and mortality spread even faster on social media. This study performed literature searches among different databases, i.e., PubMed, PubMed Central, and Web of Science, to understand the pitfall of social media during the COVID-19 pandemic and the impact of non-scientific information on public health. Social media not only shared information regarding the outbreak of nSARS-CoV2 and COVID-19 disease but also misinformation regarding epidemiology, government policies, prevention, cure, and vaccination. Thus, strict regulation is required to control the spread of misleading information.

Improving Antimicrobial Prescriptions with Computerized Decision Support Systems: Where Are We?

Antimicrobial computerized decision support systems (CDSS) have been developed to improve decision-making at the point of prescribing. Uptake of CDSS for antibiotic prescribing remains low, and evidence to suggest that CDSS provides a clear benefit for antimicrobial outcomes is scarce. We reviewed existing evidence on the impact of CDSS on antimicrobial prescribing. Based on the results of our literature search, we discuss the use of CDSS for antimicrobial management in hospitals and antibiotic prescribing practices in ambulatory primary care settings. We identify some of the issues surrounding selecting and defining appropriate outcome measures for assessing the impact of CDSS on antimicrobial prescribing in the hospital setting. In the primary care setting, we observed that CDSS has a modest impact in changing antibiotic prescribing practice, which could be related to the underutilization of antimicrobial CDSS.

Utilizing Big Data in Healthcare, How to Maximize Its Value.

Big data has been applied in a variety of ways in healthcare. It can be considered as a tool for data collection. And hence, there are certain criteria needed in this tool to be of value. Optimists have exaggerated the benefits of big data, while pessimists reported negative aspects. Big data remains a reality that healthcare must face and maximize its value. The authors identified few guiding principles for scientific utilization of big data in healthcare. These include: generate evidence by scientific methods, assure validity and significance, use multi-step analysis, and lastly consider sensitivity, and specificity.

The Effect of Electronic Medication Administration Records on the Culture of Patient Safety: A Literature Review.

Medication errorsare a leading cause of deathacross many parts of the world. Several factors increase medication errors. These can be individual-related factors, such as the burden ofa heavy workload, often experiencedby nurses, or organizational-related factors, such as inadequate space for documenting and poor labeling of medication. This paper shares the results of a preliminary literaturereview on the impacts of electronic medication administration records (eMAR) on patient safety. UsingPubMed and Google Scholar, we searchedthe following terms: "eMAR", "medication errors", and "workflow". Our preliminary findings revealthat eMAR can have impacton nursing workflow, and reducemedication errors, thus improving patient safety. Although the results are preliminary, they provide some insight into the impacts of eMAR on nursing workflow and patient safety. Our plans for future researchare to conduct a systematic review study to further examine the impacts of eMAR on patient safety.

Documentation integrity: Authorship functionalities of EHR in a Saudi Arabian hospital.

This paper aims to evaluate the authorship, privacy capabilities and functions of QuadraMed and BestCare systems, implemented at the Ministry of National Guard Health Affairs (MNGHA) in Riyadh, Saudi Arabia. A survey was conducted by interviewing back-end users of the EMR system in the KAMC hospital to check the aforementioned systems' authorship capabilities. Both the systems scored the same, with the overall result being 146/165 including the compliance level, which represents 88% availability of all authorship functions. The Quadra system's non-complying item was identified for only one entity, which is related to the lack of diagnosis documentation. It does not aid physicians in enhancing their ability to document diagnosis, which depends on coding and has not been implemented within the system so far. However, BestCare system provides documenting diagnosis depending on the coding part rather than free text, suggesting it is a promising system with enhanced functionalities.

Causes of EHR projects stalling or failing: A study of EHR projects in Saudi Arabia.

BACKGROUND: Electronic Medical Records (EMRs) are designed to automatically collect, store, and retrieve patients' information from healthcare providers within an organization. They assist clinicians in deciding the future course of treatment. The primary objective of this study is to investigate the practices of Electronic Health Record (EHR) project managers regarding the causes of EHR projects getting stalled or failing in Saudi Arabia. METHODS: Three focus groups were identified across three main cities of Saudi Arabia, namely Riyadh, Jeddah, and Dammam during the years 2013 and 2014. Each group consisted of 10-15 experienced EHR project managers. Qualitative analysis consisted of immersion and crystallization to develop a coding scheme that included both preconceived and emergent themes. RESULTS AND CONCLUSION: The findings of this study highlight the difficulties, which ensue between EHR and project management practice as well as the issues that can arise from the common use of these terms. It highlights how the aims of an EHR project and its management are transformed, and how the reputation of the project management is to achieve the exact and short-term objectives associated with the comprehensive aims of an EHR project.

Health ATMs in Saudi Arabia: A Perspective.

BACKGROUND: Health ATMs are terminals which are connected to a centrally located database storing patients' electronic healthcare records (EHR). These machines are capable of collecting information in a far superior fashion than humans and are also able to rectify obsolete data in a manner that humans are generally not inclined to. OBJECTIVES: The main goal of this study is to assess the importance of adopting health ATMs in the Kingdom of Saudi Arabia (KSA), which can improve the confidence of patients, reward health self-management, and achieve positive health outcomes through their easy-to-use applications that are secure and accessible through various devices. METHODS: Strength, Weakness, Opportunity, and Threat (SWOT) analysis was used to assess the efficiency of adopting health ATMs in KSA and reveal the said characteristics. Three focus groups assembled in the cities of Riyadh, Jeddah and Dammam during the period 2013-2014. The groups consisted of individuals experienced in the function of health ATMs. RESULTS: It was found that the sector possessed a number of strengths that would help it in reaching the goals outlined therein, thereby achieving successful outcomes. CONCLUSIONS: Health ATMs could be a promising new advancement in the field of health if the project were to be planned and implemented correctly. Their benefits would consequently reach organizational and national levels. It is, therefore, crucial to educate the project managers about the benefits of learning from others as well as educating them about the needs and the requirements of the concerned organization.