Building an Open Health Data Analytics Platform: a Case Study Examining Relationships and Trends in Seniority and Performance in Healthcare Providers.

With a movement toward an open data-driven approach, governments worldwide are releasing public data in an effort to increase transparency. Despite the availability of this data, many factors make it difficult for anyone to extract knowledge from it. The relationship between seniority and performance is a controversial issue in many fields; using an open and reproducible framework, we investigate the relationship in open healthcare data. Using data from the Center for Medicare and Medicaid Services covering 895,000 practitioners and 3000 hospitals, weak but statistically significant correlations between graduation year, a proxy for seniority, and the hospital value-based performance score were found in 29 of 74 specialties (Spearman rank correlation values < 0.164, p value < 0.05). This result represents 7% of US healthcare practitioners and over 75% of medical practitioners in several specialties. With 5 years of data (2009-2014) from the New York Statewide Planning and Research Cooperative System (SPARCS), we found weak but statistically significant correlations between graduation year and cardiac surgery outcome measures (Spearman rank correlation value - 0.096, p value < 0.0005). An unsupervised clustering K-means-based algorithm for finding outliers was also applied to these datasets. It captured a unique trend in the number of nurse practitioners which was increasing rapidly since 2010. It also revealed consistencies in practitioner placement throughout hospitals. Our findings suggest that the training of healthcare professionals appears to be robust and positions them for long-lasting and consistent careers across the majority of specialties.

Health Care in the Community: Developing Academic/Practice Partnerships for Care Coordination and Managing Transitions.

The delivery of health care is quickly changing from an acute care to a community-based setting. Faculty development and mastery in the use of new technologies, such as high-definition simulation and virtual communities are crucial for effective student learning outcomes. Students' benefits include opportunities for hands-on experience in various patient care scenarios, realtime faculty feedback regarding their critical reasoning and clinical performance, interdisciplinary collaboration, and access to a nonthreatening learning environment. The results of this study provide some evidence of the benefits of developing faculty and nursing curricula that addresses the shift from an ilness-based, acute hospital model, to a community and population health-based preventive model.

A framework for describing first time breastfeeding Latina mothers' information needs, information seeking behaviors, resources & communication processes.

A literature review highlights the need to use multiple concepts to describe and understand First Time Breastfeeding (FTBF) Latina mothers information needs, information seeking behaviors, communication processes, and resources used to initiate, continue and prevent premature weaning. A framework for describing these concepts integrates 5 major theoretical perspectives.

Glucose testing and insufficient follow-up of abnormal results: a cohort study.

BACKGROUND: More than 6 million Americans have undiagnosed diabetes. Several national organizations endorse screening for diabetes by physicians, but actual practice is poorly understood. Our objectives were to measure the rate, the predictors and the results of glucose testing in primary care, including rates of follow-up for abnormal values. METHODS: We conducted a retrospective cohort study of 301 randomly selected patients with no known diabetes who received care at a large academic general internal medicine practice in New York City. Using medical records, we collected patients' baseline characteristics in 1999 and followed patients through the end of 2002 for all glucose tests ordered. We used multivariate logistic regression to measure associations between diabetes risk factors and the odds of glucose testing. RESULTS: Three-fourths of patients (78%) had at least 1 glucose test ordered. Patient age (> or = 45 vs. < 45 years), non-white ethnicity, family history of diabetes and having more primary care visits were each independently associated with having at least 1 glucose test ordered (p < 0.05), whereas hypertension and hyperlipidemia were not. Fewer than half of abnormal glucose values were followed up by the patients' physicians. CONCLUSION: Although screening for diabetes appears to be common and informed by diabetes risk factors, abnormal values are frequently not followed up. Interventions are needed to trigger identification and further evaluation of abnormal glucose tests.