Ageism in healthcare technology: the older patients' aspirations for improved online accessibility.

Objective: To identify concerns, barriers and facilitators impacting the use of patient portals by older patients as well as desired features in future updates. Materials and Methods: This is a cross-sectional study consisting of 2 focus group discussions culminating in an anonymous survey administered to women who were 65 years and older receiving urogynecologic care in Northwest Ohio. Results: Of the 205 women surveyed (91% response rate), providers and healthcare systems play the primary 2 roles (73% and 69%, respectively) in facilitating patients' use of patient portal systems and telehealth applications. Barriers to use revolved around technical difficulties (50%), privacy concerns (45%), and cost of technology (24%). The most important features desired were the ability to modify the text size within the application (47%) and an intuitive, simple interface (46%). Additional assistance for navigating technical challenges was suggested, specifically set-up of accounts (36%), saving and sharing information with caregivers (35%), and sign-in and navigation of portals (32%). Conclusion: The paucity of age-aligned medical access software and products may lead to worsening of digital exclusion and disparities in healthcare. Portal application developers and healthcare systems must advance efforts that consider the needs of those who may be older when designing patient portals.

An Exploratory Study Demonstrating the Health Information Management Profession as a STEM Discipline.

It is time to make the case for health information management (HIM) to be included in science, technology, engineering, and math (STEM) education. A careful review of the HIM competencies approved by the American Health Information Management Association (AHIMA) illustrates the role of HIM professionals in informatics, data analytics, and data use. More precisely, the competency subdomains clearly align with content in the STEM disciplines of science, math, and technology, and the individual competencies or tasks in each subdomain solidify the assertion that HIM should be considered part of the STEM disciplines. Evaluation of AHIMA membership data showed that, at the education and work setting levels, AHIMA members are employed in many areas that are common to both HIM and STEM.

Chronic Rhinitis Is a High-Risk Comorbidity for 30-Day Hospital Readmission of Patients with Asthma and Chronic Obstructive Pulmonary Disease.

BACKGROUND: Early hospital readmissions for asthma and chronic obstructive pulmonary disease (COPD), measured as hospital readmission within 30 days from the last discharge, is a major economic burden to our health care system. The association of this measure with comorbid chronic rhinitis (CR) has not been investigated before despite significant clinical association between CR and asthma or COPD. OBJECTIVE: To investigate the association of CR with the risk of asthma or COPD-related early hospital readmission rates. METHODS: This retrospective cohort study was performed using the asthma- and COPD-related hospital encounter and patient comorbidity data between June 15, 2012, and July 19, 2017, from a large hospital care system in Cincinnati, Ohio. Patients (any sex, race or socioeconomic status, and of all ages) with a primary discharge diagnosis of asthma (n = 4754 patients, 10,111 encounters) and COPD (n = 2176 patients, 4748 encounters) based on International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes were included. Relevant comorbidities, including comorbid allergic rhinitis (AR) or nonallergic rhinitis (NAR), in such patients were identified using ICD-10-CM codes. The association between 30-day asthma or COPD-related hospital readmission (1670 such encounters for asthma and 736 for COPD) and comorbid CR in the affected patients were determined using Cox proportional hazards models. Multivariate-adjusted hazard ratios (HRs), adjusted for relevant patient comorbidities, compared 30-day asthma- and COPD-related readmissions of patients with CR with those patients without a CR diagnosis. RESULTS: Analysis was performed on 4754 patients with asthma and 2176 patients with COPD. The median follow-up period (+interquartile range) for asthma was 980 (+760) days and for COPD was 553 (+827) days. The HRs for 30-day asthma- or COPD-related readmission rates were significantly higher in patients with AR (HR = 4.4 [3.9, 5.0] and 2.4 [1.7, 3.2], respectively) or NAR (HR = 3.7 [2.9, 4.9] and 2.6 [1.8, 3.7], respectively) compared with patients without rhinitis. For asthma, both AR and NAR had higher HRs compared with all other comorbidities analyzed. For COPD, both AR and NAR had HRs to the magnitude as obesity and hypertension. CONCLUSIONS: Comorbid CR is significantly associated with 30-day asthma- and COPD-related readmissions. These findings are useful for guiding health care professionals to focus on outpatient management of both the upper and lower respiratory tracts to reduce early readmission of patients with asthma and COPD.

An overview of two open interactive computing environments useful for data science education.

OBJECTIVE: To discuss and illustrate the utility of two open collaborative data science platforms, and how they would benefit data science and informatics education. METHODS AND MATERIALS: The features of two online data science platforms are outlined. Both are useful for new data projects and both are integrated with common programming languages used for data analysis. One platform focuses more on data exploration and the other focuses on containerizing, visualization, and sharing code repositories. RESULTS: Both data science platforms are open, free, and allow for collaboration. Both are capable of visual, descriptive, and predictive analytics. DISCUSSION: Data science education benefits by having affordable open and collaborative platforms to conduct a variety of data analyses. CONCLUSION: Open collaborative data science platforms are particularly useful for teaching data science skills to clinical and nonclinical informatics students. Commercial data science platforms exist but are cost-prohibitive and generally limited to specific programming languages.