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1.
Rev. bioét. derecho ; (50): 385-406, nov. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-191364

RESUMO

La Ley Orgánica de Protección de Datos (LOPD) es necesaria para garantizar el derecho a la intimidad reconocido en la Constitución Española. La gestión de los datos personales debe ser especialmente sensible en el ámbito sanitario por las características de los protegidos. Este trabajo revisa las resoluciones dictadas desde el 28 de octubre de 2005 hasta el 29 de octubre de 2018 por la Agencia Española de Protección de Datos (AEPD), agrupando las infracciones por frecuencia de infracción y describiendo las peculiaridades de algunas resoluciones. En la medida de la información aportada por la denuncia, se trata de valorar la intención de la misma


The Organic Law on Data Protection (LOPD) is necessary to guarantee the right to privacy recognized in the Spanish Constitution. The management of personal data must be especially sensitive in the health field due to the characteristics of the protected persons. This paper reviews the resolutions issued from October 28 2005 to October 29 2018 by the Spanish Agency for Data Protection (AEPD), grouping the infractions by frequency of infringement and describing the peculiarities of some resolutions. To the extent of the information provided by the complaint, the aim is to assess its intention


La Llei Orgànica de Protecció de Dades (LOPD) és necessària per a garantir el dret a la intimitat reconegut en la Constitució Espanyola. La gestió de les dades personals ha de ser especialment sensible en l'àmbit sanitari per les característiques dels protegits. Aquest treball revisa les resolucions dictades des del 28 d'octubre de 2005 fins al 29 d'octubre de 2018 per l'Agència Espanyola de Protecció de Dades (AEPD), agrupant les infraccions per freqüència d'infracció I descrivint les peculiaritats d'algunes resolucions. En la mesura de la informació aportada per la denúncia, es tracta de valorar la intenció d'aquesta


Assuntos
Humanos , Segurança Computacional/legislação & jurisprudência , Informática Médica/legislação & jurisprudência , Informática Médica/normas
2.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 5610-5614, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019249

RESUMO

Sepsis, a dysregulated immune response to infection, has been the leading cause of morbidity and mortality in critically ill patients. Multiple studies have demonstrated improved survival outcomes when early treatment is initiated for septic patients. In our previous work, we developed a real-time machine learning algorithm capable of predicting onset of sepsis four to six hours prior to clinical recognition. In this work, we develop AIDEx, an open-source platform that consumes data as FHIR resources. It is capable of consuming live patient data, securely transporting it into a cloud environment, and monitoring patients in real-time. We build AIDEx as an EHR vendor-agnostic open-source platform that can be easily deployed in clinical environments. Finally, the computation of the sepsis risk scores uses a common design pattern that is seen in streaming clinical informatics and predictive analytics applications. AIDEx provides a comprehensive case study in the design and development of a production-ready ML platform that integrates with Healthcare IT systems.


Assuntos
Informática Médica , Sepse , Algoritmos , Estado Terminal , Humanos , Aprendizado de Máquina , Sepse/diagnóstico
3.
Rev Med Suisse ; 16(704): 1574-1578, 2020 Sep 02.
Artigo em Francês | MEDLINE | ID: mdl-32880115

RESUMO

Precision medicine aims to tailor prevention and treatment to individual data. Although different markers can be used (e.g. transcriptome or proteome), its rise is closely linked to that of genomics, owing to the henceforth reasonable cost of DNA sequencing. The enormous datasets thus generated can be exploited due to remarkable advances in bioinformatics and information sciences. However, beyond the technological endeavor, humanities and social sciences also play a central role to redefine health and illness. The precision medicine unit at CHUV gathers stakeholders from these various domains in order to demonstrate the utility of precision medicine and catalyze its integration into healthcare, to the benefit of the patient.


Assuntos
Genômica , Ciências Humanas , Informática Médica , Biologia Molecular , Medicina de Precisão/tendências , Humanos
4.
Popul Health Manag ; 23(5): 350-360, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32897820

RESUMO

Given the severe and rapid impact of COVID-19, the pace of information sharing has been accelerated. However, traditional methods of disseminating and digesting medical information can be time-consuming and cumbersome. In a pilot study, the authors used social listening to quickly extract information from social media channels to explore what people with COVID-19 are talking about regarding symptoms and disease progression. The goal was to determine whether, by amplifying patient voices, new information could be identified that might have been missed through other sources. Two data sets from social media groups of people with or presumed to have COVID-19 were analyzed: a Facebook group poll, and conversation data from a Reddit group including detailed disease natural history-like posts. Content analysis and a customized analytics engine that incorporates machine learning and natural language processing were used to quickly identify symptoms mentioned. Key findings include more than 20 symptoms in the data sets that were not listed in online lists of symptoms from 4 respected medical information sources. The disease natural history-like posts revealed that people can experience symptoms for many weeks and that some symptoms change over time. This study demonstrates that social media can offer novel insights into patient experiences as a source of real-world data. This inductive research approach can quickly generate descriptive information that can be used to develop hypotheses and new research questions. Also, the method allows rapid assessments of large numbers of social media conversations that could be applied to monitor public health for emerging and rapidly spreading diseases such as COVID-19.


Assuntos
Infecções por Coronavirus/fisiopatologia , Progressão da Doença , Disseminação de Informação/métodos , Informática Médica/estatística & dados numéricos , Pandemias/estatística & dados numéricos , Pneumonia Viral/fisiopatologia , Mídias Sociais/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Análise de Dados , Feminino , Humanos , Masculino , Projetos Piloto , Pneumonia Viral/epidemiologia , Saúde Pública , Índice de Gravidade de Doença , Estados Unidos
6.
West J Emerg Med ; 21(5): 1114-1117, 2020 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-32970563

RESUMO

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has seriously impacted clinical research operations in academic medical centers due to social distancing measures and stay-at-home orders. The purpose of this paper is to describe the implementation of a program to continue clinical research based out of an emergency department (ED) using remote research associates (RA). METHODS: Remote RAs were trained and granted remote access to the electronic health record (EHR) by the health system's core information technology team. Upon gaining access, remote RAs used a dual-authentication process to gain access to a host-based, firewall-protected virtual network where the EHR could be accessed to continue screening and enrollment for ongoing studies. Study training for screening and enrollment was also provided to ensure study continuity. RESULTS: With constant support and guidance available to establish this EHR access pathway, the remote RAs were able to gain access relatively independently and without major technical troubleshooting. Each remote RA was granted access and trained on studies within one week and self-reported a high degree of program satisfaction, EHR access ease, and study protocol comfort through informal evaluation surveys. CONCLUSIONS: In response to the COVID-19 pandemic, we virtualized a clinical research program to continue important ED-based studies.


Assuntos
Betacoronavirus , Pesquisa Biomédica/organização & administração , Infecções por Coronavirus/prevenção & controle , Registros Eletrônicos de Saúde , Serviço Hospitalar de Emergência/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pesquisadores/organização & administração , Centros Médicos Acadêmicos/organização & administração , California , Humanos , Informática Médica , Desenvolvimento de Programas
7.
Ann Surg ; 272(4): 669-675, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32932324

RESUMO

OBJECTIVE: We present a holistic perioperative optimization approach led by a CI team with the goal to optimize the workflow within our EHR, improve operative room metrics and user satisfaction. SUMMARY OF BACKGROUND DATA: The EHR has become integral to perioperative care. Many approaches are utilized to improve performance including systems-based approaches, process redesign, lean methodology, checklists, root cause analysis, and parallel processing. Although most reports describe strategies improving day or surgery productivity, few include perioperative interventions to improve efficiencies. METHODS: An interdisciplinary CI team consisting of clinicians, informatics specialists, and analysts spent 6 weeks assessing users and optimizing all perioperative areas (scheduling, day of surgery, postop discharge/admission). Elbow-to-elbow retraining and simultaneous content development was performed utilizing an Agile workflow process optimization with the Scrum framework. This iterative approach averaged 1 week from build to change implementation. Pre/post optimization surveys were sent. RESULTS: Two hundred forty-two perioperative enhancements were completed. While most impacted documentation, all areas were enhanced including billing, reporting, registration, device integration, scheduling, central supply, and so on. FCOTS improved from <70% to >85% and total delay was halved. These parameters were consistently sustained for over 1 year after the 6-week optimization. While only 5% of pre-optimization users agreed to proficiency in the EHR system, this improved to 70% post-optimization. Furthermore, EHR confidence and acceptance improved from 40% to 90%. CONCLUSIONS: To improve workflow efficiency, all who contribute to the perioperative process must be assessed. This IT driven initiative resulted in improved FCOTS, perioperative workflows, and user satisfaction.


Assuntos
Registros Eletrônicos de Saúde , Informática Médica , Equipe de Assistência ao Paciente , Assistência Perioperatória/métodos , Assistência Perioperatória/normas , Melhoria de Qualidade , Humanos
8.
Proc Natl Acad Sci U S A ; 117(38): 23636-23642, 2020 09 22.
Artigo em Inglês | MEDLINE | ID: mdl-32900923

RESUMO

Some directly transmitted human pathogens, such as influenza and measles, generate sustained exponential growth in incidence and have a high peak incidence consistent with the rapid depletion of susceptible individuals. Many do not. While a prolonged exponential phase typically arises in traditional disease-dynamic models, current quantitative descriptions of nonstandard epidemic profiles are either abstract, phenomenological, or rely on highly skewed offspring distributions in network models. Here, we create large socio-spatial networks to represent contact behavior using human population-density data, a previously developed fitting algorithm, and gravity-like mobility kernels. We define a basic reproductive number [Formula: see text] for this system, analogous to that used for compartmental models. Controlling for [Formula: see text], we then explore networks with a household-workplace structure in which between-household contacts can be formed with varying degrees of spatial correlation, determined by a single parameter from the gravity-like kernel. By varying this single parameter and simulating epidemic spread, we are able to identify how more frequent local movement can lead to strong spatial correlation and, thus, induce subexponential outbreak dynamics with lower, later epidemic peaks. Also, the ratio of peak height to final size was much smaller when movement was highly spatially correlated. We investigate the topological properties of our networks via a generalized clustering coefficient that extends beyond immediate neighborhoods, identifying very strong correlations between fourth-order clustering and nonstandard epidemic dynamics. Our results motivate the observation of both incidence and socio-spatial human behavior during epidemics that exhibit nonstandard incidence patterns.


Assuntos
Epidemias/estatística & dados numéricos , Modelos Biológicos , Rede Social , Algoritmos , Análise por Conglomerados , Simulação por Computador , Características da Família , Humanos , Incidência , Informática Médica , Densidade Demográfica
9.
Medicine (Baltimore) ; 99(30): e21348, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791735

RESUMO

Medical information websites are usually targeted toward patients, physicians, and medical students. Most of the latest studies researched the usability of such websites. However, reports on user numbers and behavior are rare.The goal of our study is to analyze the utility of a website of a large tertiary referral center in ophthalmology in terms of various target audiences (patients, applicants, medical students, referring ophthalmologists).The web access data from our institutional website was assessed with Google Analytics. Data collection started in 2016.From 2016 to 2018, we counted a total of 763,942 page views. The overall number of users dropped from 81,572 to 67,740. This drop's onset correlates with a change in the website structure. All target audience pages received constant traffic from 2016 to 2019, with the patients' and doctors' sites attracting the most traffic. The pages for medical students and job applicants, although not viewed often, revealed a long session duration.Our website is used by all our target audiences. The behavior and the user numbers of each target group differ. Changes to a website's structure can influence the number of users and their behavior. It is not possible to make a direct comparison to other institutions' websites as there are so few similar reports available. By adding more parameters to the analytics profile in a prospective setting, more detailed analyses of user behavior may be possible in the future.


Assuntos
Internet , Informática Médica/estatística & dados numéricos , Oftalmologia , Centros de Atenção Terciária
10.
PLoS One ; 15(8): e0236939, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32823270

RESUMO

We present a dataset of behavioral data recorded from 61 children diagnosed with Autism Spectrum Disorder (ASD). The data was collected during a large-scale evaluation of Robot Enhanced Therapy (RET). The dataset covers over 3000 therapy sessions and more than 300 hours of therapy. Half of the children interacted with the social robot NAO supervised by a therapist. The other half, constituting a control group, interacted directly with a therapist. Both groups followed the Applied Behavior Analysis (ABA) protocol. Each session was recorded with three RGB cameras and two RGBD (Kinect) cameras, providing detailed information of children's behavior during therapy. This public release of the dataset comprises body motion, head position and orientation, and eye gaze variables, all specified as 3D data in a joint frame of reference. In addition, metadata including participant age, gender, and autism diagnosis (ADOS) variables are included. We release this data with the hope of supporting further data-driven studies towards improved therapy methods as well as a better understanding of ASD in general.


Assuntos
Transtorno do Espectro Autista/terapia , Bases de Dados Factuais , Informática Médica , Robótica , Comportamento , Criança , Medicina Baseada em Evidências , Feminino , Humanos , Masculino
11.
Stud Health Technol Inform ; 272: 43-46, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32604596

RESUMO

One of the major regulatory factors for health informatics is data privacy protection. In the European Union, a shared set of laws has been implemented - the General Data Protection Regulation. While this set of rules aims at harmonizing the European data privacy protection standards, it fails in properly detailing the handling of anonymized data. This is a problem, as, for example many current research initiatives aim at reusing patient data collected within primary care, but lack a patient consent, hence, might rely on anonymized data as being the only alternative. Within this work, we detail different aspects why the concept of anonymity is wrongly handled within the GDPR and give suggestions how the laws could be adapted.


Assuntos
Pesquisa Biomédica , Segurança Computacional , Informática Médica , União Europeia , Humanos , Privacidade
12.
Stud Health Technol Inform ; 272: 163-166, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32604626

RESUMO

Within the HiGHmeducation consortium various online learning modules shall be developed by members of the consortium to address the increasing need for skilled professionals in a networked and digitalized healthcare system. Transferability of these modules to other locations is one main objective for the design of online learning modules. Thus, a didactical framework for online learning modules was developed. To ensure feasibility of the framework, the participating universities were analyzed concerning availability of e-learning support structures and infrastructures including learning management systems (LMS). The analysis especially focuses on the various LMS learning tools and their suitability for the framework. The framework is the basis for 12 HiGHmeducation online learning modules of which a part has firstly been conducted in winter 2019/20 and leads to a comparable structure of the modules.


Assuntos
Educação a Distância , Informática Médica , Aprendizagem , Universidades
13.
Stud Health Technol Inform ; 272: 487-488, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32604709

RESUMO

The COVID-19 pandemic became a challenge to all the health care systems across the world causing at places collapse of the healthcare systems and endangering the healthcare professionals and consequently the public health. One powerful tool for the healthcare systems and the policy makers is Health Informatics. This brief article presents the challenges faced by Health Informatics in supporting healthcare professionals and public health authorities in the world.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Informática Médica , Pandemias , Pneumonia Viral , Humanos , Saúde Pública
14.
Recenti Prog Med ; 111(7): 393-397, 2020.
Artigo em Italiano | MEDLINE | ID: mdl-32658876

RESUMO

The CoViD-19 pandemic has provided the opportunity for the health care's digital revolution with the unprecedented accelerated expansion of telehealth, telemedicine and other digital health tools. Several tools have been developed and launched at national and international level to face the emergency, including tools to perform online triage, symptoms checking, video visits and remote monitoring, and to conduct local and national epidemiological surveillance studies. Artificial intelligence-based tools have also been developed to diagnose cases of CoViD-19 or to identify patients at risk. Most of these technologies have been endorsed by medical societies such as the American Medical Association and the American Academy of Family Physicians which launched specific guidelines about their use. The growth in telemedicine services and in digital health technologies could not have occurred without important telehealth regulatory changes that have occurred in some countries aimed at promoting their use to face the CoViD-19 emergency, such as the deregulation of the use of video conferencing and video chat systems to carry out video visits, and the payment parity between telehealth and in clinic care. In order to decide whether to continue using these tools even after the pandemic is over, it could be useful to perform validation and efficacy studies of these tools to study their implications on the doctor-patient relationship, to understand if the new features can be integrated with the other technological tools already in use, and if they can improve clinical practice and quality of care.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Informática Médica , Pandemias , Pneumonia Viral , Inteligência Artificial , Informática Aplicada à Saúde dos Consumidores , Prescrição Eletrônica , Necessidades e Demandas de Serviços de Saúde , Humanos , Itália , Monitorização Fisiológica/métodos , Relações Médico-Paciente , Vigilância da População/métodos , Guias de Prática Clínica como Assunto , Telemedicina , Telemetria , Triagem/métodos , Comunicação por Videoconferência
15.
Health Res Policy Syst ; 18(1): 80, 2020 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-32664985

RESUMO

BACKGROUND: The COVID-19 pandemic is a complex global public health crisis presenting clinical, organisational and system-wide challenges. Different research perspectives on health are needed in order to manage and monitor this crisis. Performance intelligence is an approach that emphasises the need for different research perspectives in supporting health systems' decision-makers to determine policies based on well-informed choices. In this paper, we present the viewpoint of the Innovative Training Network for Healthcare Performance Intelligence Professionals (HealthPros) on how performance intelligence can be used during and after the COVID-19 pandemic. DISCUSSION: A lack of standardised information, paired with limited discussion and alignment between countries contribute to uncertainty in decision-making in all countries. Consequently, a plethora of different non-data-driven and uncoordinated approaches to address the outbreak are noted worldwide. Comparative health system research is needed to help countries shape their response models in social care, public health, primary care, hospital care and long-term care through the different phases of the pandemic. There is a need in each phase to compare context-specific bundles of measures where the impact on health outcomes can be modelled using targeted data and advanced statistical methods. Performance intelligence can be pursued to compare data, construct indicators and identify optimal strategies. Embracing a system perspective will allow countries to take coordinated strategic decisions while mitigating the risk of system collapse.A framework for the development and implementation of performance intelligence has been outlined by the HealthPros Network and is of pertinence. Health systems need better and more timely data to govern through a pandemic-induced transition period where tensions between care needs, demand and capacity are exceptionally high worldwide. Health systems are challenged to ensure essential levels of healthcare towards all patients, including those who need routine assistance. CONCLUSION: Performance intelligence plays an essential role as part of a broader public health strategy in guiding the decisions of health system actors on the implementation of contextualised measures to tackle COVID-19 or any future epidemic as well as their effect on the health system at large. This should be based on commonly agreed-upon standardised data and fit-for-purpose indicators, making optimal use of existing health information infrastructures. The HealthPros Network can make a meaningful contribution.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Assistência à Saúde/organização & administração , Planejamento em Saúde/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Saúde Global , Programas Governamentais , Política de Saúde , Pesquisa sobre Serviços de Saúde/organização & administração , Humanos , Cooperação Internacional , Informática Médica
16.
Stud Health Technol Inform ; 272: 474-477, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32604705

RESUMO

Qatar's digital health initiatives are growing through the development of research capacity, innovative technologies, and academic programs to serve the national health needs of the country. The digital health community of Qatar lacks the adequate representation of a professional body to serve the needs of the community. The purpose of this paper is to develop a strategic framework for the Health Informatics Association of Qatar (HIAQ) and present the preliminary findings of this effort. We utilized a multi-stage mixed methods approach in the development of HIAQ's strategic framework. We first reviewed the relevant literature, interviewed key stakeholders within the region, validated our findings with local stakeholders, and adapted the strategic directions to conform with Qatari laws. We present the purpose, organizational structure, vision, mission, and aims of HIAQ. Future work will engage the digital health community to further refine and adapt HIAQ's strategic direction to serve the local needs of Qatar.


Assuntos
Ecossistema , Informática Médica , Catar
17.
Stud Health Technol Inform ; 272: 482-483, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32604707

RESUMO

In this research, almost 2000 universities and colleges were checked in order to find related educational programs at all academic levels. More than 1000 academic leading degree programs in those domains have already been identified. The detailed records of the related educational programs will help to understand the current educational needs and priorities. Although, the growth of the related educational programs is not the same in each country. The data are available via a special website.


Assuntos
Informática Médica , Currículo , Relatório de Pesquisa , Universidades
18.
Stud Health Technol Inform ; 272: 484-486, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32604708

RESUMO

The Accreditation and Certification Committee (AC2) of the European Federation for Medical Informatics (EFMI) has initiated, firstly, a collection of data on the existing academic programs in Europe in Biomedical and Health Informatics in Europe, and, secondly, the implementation of the accreditation process for programs. This paper presents the background and the procedures to be applied for the implementation.


Assuntos
Acreditação , Informática Médica , Certificação , Europa (Continente) , Organizações
19.
PLoS One ; 15(7): e0236019, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32667953

RESUMO

BACKGROUND: Delivery of preventive care and chronic disease management are key components of a high functioning primary care practice. Health Centers (HCs) funded by the Health Resources and Services Administration (HRSA) have been delivering affordable and accessible primary health care to patients in underserved communities for over fifty years. This study examines the association between health center organization's health information technology (IT) optimization and clinical quality performance. METHODS AND FINDINGS: Using 2016 Uniform Data System (UDS) data, we performed bivariate and multivariate analyses to study the association of Meaningful Use (MU) attestation as a proxy for health IT optimization, patient centered medical home (PCMH) recognition status, and practice size on performance of twelve electronically specified clinical quality measures (eCQMs). Bivariate analysis demonstrated performance of eleven out of the twelve preventive and chronic care eCQMs was higher among HCs attesting to MU Stage 2 or above. Multivariate analysis demonstrated that Stage 2 MU or above, PCMH status, and larger practice size were positively associated with performance on cancer screening, smoking cessation counseling and pediatric weight assessment and counseling eCQMs. CONCLUSIONS: Organizational advancement in MU stages has led to improved quality of care that augments HCs patient care capacity for disease prevention, health promotion, and chronic care management. However, rapid technological advancement in health care acts as a potential source of disparity, as considerable resources needed to optimize the electronic health record (EHR) and to undertake PCMH transformation are found more commonly among larger HCs practices. Smaller practices may lack the financial, human and educational assets to implement and to maintain EHR technology. Accordingly, targeted approaches to support small HCs practices in leveraging economies of scale for health IT optimization, clinical decision support, and clinical workflow enhancements are critical for practices to thrive in the dynamic value-based payment environment.


Assuntos
Promoção da Saúde/normas , Informática Médica/normas , Assistência Centrada no Paciente/normas , Atenção Primária à Saúde/normas , Melhoria de Qualidade , Qualidade da Assistência à Saúde/normas , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Adulto Jovem
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