Quantifying and contextualizing the impact of bioRxiv preprints through automated social media audience segmentation.

Engagement with scientific manuscripts is frequently facilitated by Twitter and other social media platforms. As such, the demographics of a paper's social media audience provide a wealth of information about how scholarly research is transmitted, consumed, and interpreted by online communities. By paying attention to public perceptions of their publications, scientists can learn whether their research is stimulating positive scholarly and public thought. They can also become aware of potentially negative patterns of interest from groups that misinterpret their work in harmful ways, either willfully or unintentionally, and devise strategies for altering their messaging to mitigate these impacts. In this study, we collected 331,696 Twitter posts referencing 1,800 highly tweeted bioRxiv preprints and leveraged topic modeling to infer the characteristics of various communities engaging with each preprint on Twitter. We agnostically learned the characteristics of these audience sectors from keywords each user's followers provide in their Twitter biographies. We estimate that 96% of the preprints analyzed are dominated by academic audiences on Twitter, suggesting that social media attention does not always correspond to greater public exposure. We further demonstrate how our audience segmentation method can quantify the level of interest from nonspecialist audience sectors such as mental health advocates, dog lovers, video game developers, vegans, bitcoin investors, conspiracy theorists, journalists, religious groups, and political constituencies. Surprisingly, we also found that 10% of the preprints analyzed have sizable (>5%) audience sectors that are associated with right-wing white nationalist communities. Although none of these preprints appear to intentionally espouse any right-wing extremist messages, cases exist in which extremist appropriation comprises more than 50% of the tweets referencing a given preprint. These results present unique opportunities for improving and contextualizing the public discourse surrounding scientific research.

Using change management to implement barcode medicines administration technology.

Confirming the patient's identity is one of the most important elements in medicines administration, with research showing that medication errors are one of the most common sources of harm caused to patients. This article discusses the implementation of a barcode medicines administration system using two change management models. A complex project such as the implementation of barcode medicines administration technology, requires staff engagement at all levels. The adoption rates of the new workflow patterns in this project showed the benefits of using various change management models during different phases of a project. The project also demonstrated how nurse leaders must use a range of resources to effectively implement a new project.

Description of an integrated management system for invasive mosquitoes at entry-exit ports in Zhejiang, China.

BACKGROUND: As mosquitoes are one of the most harmful creatures in the world, recent high-frequency interceptions of invasive mosquito species have emphasized the need to enhance the biological security of the Zhejiang Province in China. As such, an integrated management system should be implemented to monitor the vectors of mosquito-borne diseases during data digitization and the processing of permanent E-forms and provide an online one-stop identification service. METHODS: This system is a semi-open network built on the latest Microsoft.NET Framework, Active Server Page.NET (ASP.NET) and Internet Information Services (IIS) for the Windows 2000 service as a basic infrastructure platform. This creates a physical separation between the data input as the back-page intranet and the online automated Lucid identification as the front-page internet through the digital interchange platform and security firewall. RESULTS: This system mainly comprises three core modules: automated statistical analysis of operational data, online vector identification and digital specimen storage management, in addition to accessory modules. The joint analysis of invasive and native data collected between 2011 and 2017 at 14 surveillance points in the Zhejiang Province, excluding Ningbo Port, provided insights into the geographical differences in species abundance and the dynamic nature of seasonal interception within the statistical analysis module. Most importantly, multi-access keys to mosquitoes based on Lucid software were loaded in the module for vector identification. Subscribers can utilize this procedure for the online identification of 2 subfamilies, 10 genera and 33 mosquitoes by selecting any typical morphological feature in the classification system that matches the current images at hand. CONCLUSIONS: Our report suggests that this system can enhance the ability to master the basic information on invasive mosquitoes and satisfy the increasing requirements for public health safety in the integrated management of vector-borne diseases.

Implementing Mobile Health Interventions to Capture Post-Operative Patient-Generated Health Data.

Background: The implementation of health information technology interventions is at the forefront of most hospital institutional policy agendas. Despite the availability of numerous apps and mobile platforms focusing on specific areas in healthcare the widespread integration into clinical practice can be a complex process. Here we present guidelines and methodology that we have learned in the implementation process of new technology and an overview of some of the current barriers and enablers specific to implementation of post-surgical site surveillance technology. Methods: Analysis of the experience of successful information technology (IT) implementation in different healthcare systems reveals that, despite differences among patient groups, care providers, and hospitals, there are common barriers and enablers to implementation of health IT. Results: The process of implementation in organizations and among individuals can be most successful by identifying barriers and enablers within three key stakeholder groups: (1) patients; (2) care providers/clinicians; and (3) manager/administration within healthcare systems. This can be achieved by specific engagement and co-design processes establishing clear benefits, sufficient incentives, and adequate support for clinicians as well as payer-provider relationships, marketplace competition and privacy legislation. Conclusions: The successful implementation of such programs requires appropriate strategic planning to address the needs of three specific components: patients, care provider, and policymakers/healthcare management understanding and acceptance.

Review of a medical illustration department's data processing system to confirm general data protection regulation (GDPR) compliance.

This article reviews the clinical photography and video data processing and storage arrangements of the Medical Illustration Department (MID) at the Queen Elizabeth Hospital Birmingham National Health Service (NHS) Foundation Trust (QEHB), part of the University Hospitals Birmingham (UHB) NHS Foundation Trust umbrella group. This review suggests that the department's current workflow and technical processing solution satisfies the requirements of the general data protection regulation (GDPR). At the time of writing, there were no additional financial costs or technical skills required for implementing GDPR regulations but this could change in future data processing systems. There are significant potential costs for non-compliance with GDPR. Brexit is unlikely to have any effect on complying with GDPR requirements. The GDPR gives the public the right to access information and be informed of how and why it is processed. It is recommended that improved administrative processing capability to accommodate this requirement should be included in future data processing designs. At the QEHB informed consent for use of photographs and videos is currently adequate to satisfy the common law of confidence.

'Fit-for-purpose?' - challenges and opportunities for applications of blockchain technology in the future of healthcare.

Blockchain is a shared distributed digital ledger technology that can better facilitate data management, provenance and security, and has the potential to transform healthcare. Importantly, blockchain represents a data architecture, whose application goes far beyond Bitcoin - the cryptocurrency that relies on blockchain and has popularized the technology. In the health sector, blockchain is being aggressively explored by various stakeholders to optimize business processes, lower costs, improve patient outcomes, enhance compliance, and enable better use of healthcare-related data. However, critical in assessing whether blockchain can fulfill the hype of a technology characterized as 'revolutionary' and 'disruptive', is the need to ensure that blockchain design elements consider actual healthcare needs from the diverse perspectives of consumers, patients, providers, and regulators. In addition, answering the real needs of healthcare stakeholders, blockchain approaches must also be responsive to the unique challenges faced in healthcare compared to other sectors of the economy. In this sense, ensuring that a health blockchain is 'fit-for-purpose' is pivotal. This concept forms the basis for this article, where we share views from a multidisciplinary group of practitioners at the forefront of blockchain conceptualization, development, and deployment.

Constructing the informatics and information technology foundations of a medical device evaluation system: a report from the FDA unique device identifier demonstration.

Objective: The US Food and Drug Administration (FDA) has recognized the need to improve the tracking of medical device safety and performance, with implementation of Unique Device Identifiers (UDIs) in electronic health information as a key strategy. The FDA funded a demonstration by Mercy Health wherein prototype UDIs were incorporated into its electronic information systems. This report describes the demonstration's informatics architecture. Methods: Prototype UDIs for coronary stents were created and implemented across a series of information systems, resulting in UDI-associated data flow from manufacture through point of use to long-term follow-up, with barcode scanning linking clinical data with UDI-associated device attributes. A reference database containing device attributes and the UDI Research and Surveillance Database (UDIR) containing the linked clinical and device information were created, enabling longitudinal assessment of device performance. The demonstration included many stakeholders: multiple Mercy departments, manufacturers, health system partners, the FDA, professional societies, the National Cardiovascular Data Registry, and information system vendors. Results: The resulting system of systems is described in detail, including entities, functions, linkage between the UDIR and proprietary systems using UDIs as the index key, data flow, roles and responsibilities of actors, and the UDIR data model. Conclusion: The demonstration provided proof of concept that UDIs can be incorporated into provider and enterprise electronic information systems and used as the index key to combine device and clinical data in a database useful for device evaluation. Keys to success and challenges to achieving this goal were identified. Fundamental informatics principles were central to accomplishing the system of systems model.

Assessing Documentation of Critical Imaging Result Follow-up Recommendations in Emergency Department Discharge Instructions.

To facilitate follow-up of critical test results across transitions in patient care settings, we implemented an electronic discharge module that enabled care providers to include follow-up recommendations in the discharge instructions. We assessed the impact of this module on documentation of follow-up recommendations for critical imaging findings in Emergency Department (ED) discharge instructions. We studied 240 patients with critical imaging findings discharged from the ED before (n = 80) and after (n = 160) implementation of the module. We manually reviewed hand-written forms and electronic discharge instructions to determine if follow-up recommendations were documented. Follow-up recommendations in ED discharge instructions increased from 60.0% (48/80) to 73.8% (118/160) post-module implementation (p = 0.03), a relative increase of 23%. There was no significant change in the rate of documented critical imaging findings in the discharge instructions (77.5% [62/80] before the intervention and 76.9% [123/160] after the intervention; p = 0.91). Implementation of a discharge module was associated with increased documentation of critical imaging finding follow-up recommendations in ED discharge instructions. However, one in four patients still did not receive adequate follow-up recommendations, suggesting further opportunities for performance improvement exist.

Supportive care pathway functionalities of EHR system in a Saudi Arabian hospital.

BACKGROUND: Electronic health record (EHR) is a data management system used in healthcare services. The stored medical information in EHR can be accessed and utilized by authorized users, which helps clinicians in making clinical decisions. Therefore, this study aims at comparing the embedded clinical guidelines or the supportive pathway functions as well as their compliance level in the two EMR systems, i.e. QuadraMed (QCPR) and BestCare. METHODS: A test vignette was used to evaluate the features, functions, performance, and output to assess the EHR clinical path way functionality of the QCPR and BestCare. The study was based on interview and discussion, followed by actual system testing. RESULTS: The results of the evaluation showed that the overall total score of QuadraMed and BESTCare systems supportive care pathway functions were 44.4% and 68.9%, respectively. BestCare is set to replace QCPR in all King Abdulaziz Medical City (KAMCS) hospitals. CONCLUSIONS: Embedding clinical decision support system into EMRs improved clinician performance and facilitated quality of care. However, further investigation of the BESTCare is highly recommended to utilize and fulfill the basic demands of the supportive care pathway functions in King Abdulaziz Medical City (KAMC) hospitals.

[Intelligent operating room suite : From passive medical devices to the self-thinking cognitive surgical assistant]. / Der intelligente Operationssaal : Vom passiven Gerätepark zum mitdenkenden, kognitiven Assistenten.

Modern operating room (OR) suites are mostly digitally connected but until now the primary focus was on the presentation, transfer and distribution of images. Device information and processes within the operating theaters are barely considered. Cognitive assistance systems have triggered a fundamental rethinking in the automotive industry as well as in logistics. In principle, tasks in the OR, some of which are highly repetitive, also have great potential to be supported by automated cognitive assistance via a self-thinking system. This includes the coordination of the entire workflow in the perioperative process in both the operating theater and the whole hospital. With corresponding data from hospital information systems, medical devices and appropriate models of the surgical process, intelligent systems could optimize the workflow in the operating theater in the near future and support the surgeon. Preliminary results on the use of device information and automatically controlled OR suites are already available. Such systems include, for example the guidance of laparoscopic camera systems. Nevertheless, cognitive assistance systems that make use of knowledge about patients, processes and other pieces of information to improve surgical treatment are not yet available in the clinical routine but are urgently needed in order to automatically assist the surgeon in situation-related activities and thus substantially improve patient care.

Comprehensive Child Welfare Information System. Final rule.

This final rule replaces the Statewide and Tribal Automated Child Welfare Information Systems (S/TACWIS) rule with the Comprehensive Child Welfare Information System (CCWIS) rule. The rule also makes conforming amendments in rules in related requirements. This rule will assist title IV-E agencies in developing information management systems that leverage new innovations and technology in order to better serve children and families. More specifically, this final rule supports the use of cost-effective, innovative technologies to automate the collection of high-quality case management data and to promote its analysis, distribution, and use by workers, supervisors, administrators, researchers, and policy makers.

Electronic Tool for Distribution and Allocation of Heart on Donation and Transplantation in Mexico.

In Mexico and globally, organs and/or tissues donated from deceased people are insufficient to cover the demand for transplants. In 2014, a rate of 3.6 organ donors per million in habitants was recorded; this is reflected in the transplants performed, including heart transplantation, with a rate of 0.4 per million population. According to the legal framework of Mexico, the National Transplant Center is responsible for coordinating National Subsystem of donation and transplantation, and one of its functions is to integrate and backup information regarding donation and transplantation through the National Transplant Registry System. In July 2015, 45 people were registered in the database of patients waiting for a heart transplant, of which 34.61% were female recipients and 65.39% male. Distribution and allocation processes are a key element to provide a fair distribution for those patients waiting for that organ; thus the creation of an electronic tool is proposed, one that aims to support the decision of the donation and/or transplants coordination committee by providing the necessary elements to make this process more efficient.

The use of big data in transfusion medicine.

'Big data' refers to the huge quantities of digital information now available that describe much of human activity. The science of data management and analysis is rapidly developing to enable organisations to convert data into useful information and knowledge. Electronic health records and new developments in Pathology Informatics now support the collection of 'big laboratory and clinical data', and these digital innovations are now being applied to transfusion medicine. To use big data effectively, we must address concerns about confidentiality and the need for a change in culture and practice, remove barriers to adopting common operating systems and data standards and ensure the safe and secure storage of sensitive personal information. In the UK, the aim is to formulate a single set of data and standards for communicating test results and so enable pathology data to contribute to national datasets. In transfusion, big data has been used for benchmarking, detection of transfusion-related complications, determining patterns of blood use and definition of blood order schedules for surgery. More generally, rapidly available information can monitor compliance with key performance indicators for patient blood management and inventory management leading to better patient care and reduced use of blood. The challenges of enabling reliable systems and analysis of big data and securing funding in the restrictive financial climate are formidable, but not insurmountable. The promise is that digital information will soon improve the implementation of best practice in transfusion medicine and patient blood management globally.

Ingesta de energía y nutrientes; armonización de las Bases de Datos de Composición de Alimentos / Intake of energy and nutrients: harmonization of foof composition databases

La conversión de consumo de alimentos a ingesta de nutrientes necesita una base de datos de composición de alimentos (FCDB) que recoge los valores nutricionales medios de una porción dada de alimento. Las limitaciones de las FCDBs son, en ocasiones, poco conocidas por los usuarios. Los estudios multicéntricos han planteados varios retos metodológicos que permitan estandarizar la composición de alimentos y la ingesta de nutrientes para la evaluación nutricional en diferentes poblaciones y áreas geográficas. Las diferencias entre FCDBs incluyen las atribuibles a aspectos técnicos, como la descripción de los alimentos, cálculo de energía y definición de los nutrientes, métodos analíticos y principios para el cálculo de recetas. Estas diferencias necesitan ser identificadas y eliminadas antes de comparar los datos obtenidos de diferentes estudios, especialmente cuando dichos datos dietéticos se relacionan con resultados de salud. Desde 1984 se han realizado diversas iniciativas para estandarizar los FCDBs en el mundo (INFOOD, EPIC, EUROFIR, etc.). Los datos de composición de alimentos pueden ser obtenidos de diferentes fuentes como análisis de empresas privadas, universidades, laboratorios gubernamentales e industria alimentaria. También pueden tomarse prestados de la literatura científica o incluso del etiquetado nutricional. Existen diferentes propuestas para evaluar la calidad de los datos de composición de alimentos. Para el desarrollo de una FCDB es fundamental documentar, lo más detallado posible, cada uno de los valores de los diferentes componentes y nutrientes de un alimento. El objetivo de la AECOSAN y la asociación BEDCA fue el desarrollo y mantenimiento en España de una FCDB de acuerdo con los estándares definidos para Europa. BEDCA es actualmente la única FCDB desarrollada en España con datos compilados y documentados siguiendo los estándares de EuroFIR (AU)

Food composition databases (FCDBs) provide detailed information about the nutritional composition of foods. The conversion of food consumption into nutrient intake need a Food composition database (FCDB) which lists the mean nutritional values for a given food portion. The limitations of FCDBs are sometimes little known by the users. Multicentre studies have raised several methodology challenges which allow to standardize nutritional assessments in different populations and geographical areas for food composition and nutrient intake. Differences between FCDBs include those attributed to technical matters, such as description of foods, calculation of energy and definition of nutrients, analytical methods, and principles for recipe calculation. Such differences need to be identified and eliminated before comparing data from different studies, especially when dietary data is related to a health outcome. There are ongoing efforts since 1984 to standardize FCDBs over the world (INFOODS, EPIC, EuroFIR, etc.). Food composition data can be gathered from different sources like private company analysis, universities, government laboratories and food industry. They can also be borrowed from scientific literature or even from the food labelling. There are different proposals to evaluate the quality of food composition data. For the development of a FCDB it is fundamental document in the most detailed way, each of the data values of the different components and nutrients of a food. The objective of AECOSAN (Agencia Española de Consumo Seguridad Alimentaria y Nutrición) and BEDCA (Base de Datos Española de Composición de Alimentos) association was the development and support of a reference FCDB in Spain according to the standards to be defined in Europe. BEDCA is currently the only FCDB developed in Spain with compiled and documented data following EuroFIR standards (AU)

Building a geospatial data model for humanitarian response.

OBJECTIVE: An effectual emergency response effort is contingent upon the quality and timeliness of information provided to both the decision making and coordinating functions; conditions that are hard to guarantee in the urgent climate of the response effort. The purpose of this paper is to present a validated Humanitarian Data Model (HDM) that can assist in the rapid assessment of disaster needs and subsequent decision making. Substandard, inconsistent information can lead to poorly informed decisions, and subsequently, inappropriate response activities. Here we present a novel, organized, and fluid information management workflow to be applied during the rapid assessment phase of an emergency response. A comprehensive, peer-reviewed geospatial data model not only directs the design of data collection tools but also allows for more systematic data collection and management, leading to improved analysis and response outcomes. DESIGN: This research involved the development of a comprehensive geospatial data model to guide the collection, management and analysis of geographically referenced assessment information, for implementation at the rapid response phase of a disaster using a mobile data collection app based on key outcome parameters. A systematic review of literature and best practices was used to identify and prioritize the minimum essential data variables. SUBJECTS: The data model was critiqued for variable content, structure, and usability by a group of subject matter experts in the fields of humanitarian information management and geographical information systems. CONCLUSIONS: Consensus found that the adoption of a standardized system of data collection, management, and processing, such as the data model presented here, could facilitate the collection and sharing of information between agencies with similar goals, facilitate the better coordination of efforts by unleashing the power of geographic information for humanitarian decision support.

Criteria for clinical information technology device selection: what do nurse executives need to know?

Hospital and healthcare's "most wired" organizations were surveyed to determine the evaluative criteria in the selection of bedside devices for clinical documentation. Ranked results of the characteristics are presented. Results can be used to inform nurse executives about selection criteria to consider.

Barcode medication administration work-arounds: a systematic review and implications for nurse executives.

Safe medication administration is necessary to ensure quality healthcare. Barcode medication administration systems were developed to reduce drug administration errors and the related costs and improve patient safety. Work-arounds created by nurses in the execution of the required processes can lead to unintended consequences, including errors. This article provides a systematic review of the literature associated with barcoded medication administration and work-arounds and suggests interventions that should be adopted by nurse executives to ensure medication safety.