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1.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi ; 36(5): 818-826, 2019 Oct 25.
Artigo em Chinês | MEDLINE | ID: mdl-31631631

RESUMO

The analysis of big data in medical field cannot be isolated from the high quality clinical database, and the construction of first aid database in our country is still in the early stage of exploration. This paper introduces the idea and key technology of the construction of multi-parameter first aid database. By combining emergency business flow with information flow, an emergency data integration model was designed with reference to the architecture of the Medical Information Mart for Intensive Care III (MIMIC-III), created by Computational Physiology Laboratory of Massachusetts Institute of Technology (MIT), and a high-quality first-aid database was built. The database currently covers 22 941 medical records for 19 814 different patients from May 2015 to October 2017, including relatively complete information on physiology, biochemistry, treatment, examination, nursing, etc. And based on the database, the first First-Aid Big Data Datathon event, which 13 teams from all over the country participated in, was launched. The First-Aid database provides a reference for the construction and application of clinical database in China. And it could provide powerful data support for scientific research, clinical decision making and the improvement of medical quality, which will further promote secondary analysis of clinical data in our country.


Assuntos
Big Data , Cuidados Críticos , Bases de Dados Factuais , Informática Médica , Humanos
2.
J Nurs Adm ; 49(11): 549-555, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31651615

RESUMO

OBJECTIVE: This study aims to investigate the role of nurse managers in supporting point-of-care nurses' health information technology (IT) use and identify strategies employed by nurse managers to improve adoption, while also gathering point-of-care nurses' perceptions of these strategies. BACKGROUND: Nurse managers are essential in facilitating point-of-care nurses' use of health IT; however, the underlying phenomenon for this facilitation remains unreported. METHODS: A qualitative descriptive study was conducted with 10 nurse managers and 14 point-of-care nurses recruited from a mental health hospital environment in Ontario, Canada. Inductive and deductive content analyses were used to analyze the semistructured interviews. RESULTS: Nurse managers adopt the role of advocate, educator, and connector, using the following strategies: communicating system updates, demonstrating use of health IT, linking staff to resources, facilitating education, and providing IT oversight. CONCLUSIONS: Nurse managers use a variety of strategies to support nurses' use of health IT. Future research should focus on the effectiveness of these strategies.


Assuntos
Atitude do Pessoal de Saúde , Liderança , Informática Médica/organização & administração , Enfermeiras Administradoras/psicologia , Papel do Profissional de Enfermagem/psicologia , Recursos Humanos de Enfermagem no Hospital/psicologia , Papel Profissional , Feminino , Humanos , Ontário , Pesquisa Qualitativa
3.
Bratisl Lek Listy ; 120(7): 536-540, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31602991

RESUMO

AIM: The aim of this paper is to provide an overview of artificial neural network (ANN) in biomedical domain and compare it with the logistic regression model. METHODS: Artificial neural network models and logistic regression models were created and compared using a sample of a modified dataset adapted to the dataset from Framingham Heart Study. R statistical software package is used to create and compare the models. RESULTS: The results indicated that the ANN model is more accurate in classifying the dependent variable than the logistic regression model (84.4 % vs 82.9 %). CONCLUSION: This paper has shown the effect of artificial neural network models in classifying the survival status (event or non-event) (Tab. 2, Fig. 4, Ref. 29).


Assuntos
Informática Médica , Redes Neurais (Computação) , Humanos , Modelos Logísticos
4.
Stud Health Technol Inform ; 267: 52-58, 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31483254

RESUMO

Fast Healthcare Interoperability Resources (FHIR), an international standard for exchanging digital health data, is increasingly used in health information technology. FHIR promises to facilitate the use of electronic health records (EHRs), enable mobile technologies and make health data accessible to large-scale analytics. Until now, there is no comprehensive review of scientific articles about FHIR and its use in digital health. Here, we aim to address this gap and provide an overview of the main topics associated with FHIR in the scientific literature. For this, we screened all articles about FHIR on Web of Science and PubMed and identified the main topics discussed in these articles. We also explored the temporal trend and geography of publications and performed some basic text mining on article abstracts. We found that the topics most commonly discussed in the articles were related to data models, mobile and web applications as well as medical devices. Since its introduction, the number of publications about FHIR have steadily increased until 2017, indicating an increasing popularity of FHIR in healthcare (in 2018, publication numbers remained stable). In sum, our study provides an overview of the scientific literature about FHIR and its current use in digital health.


Assuntos
Registros Eletrônicos de Saúde , Informática Médica , Mineração de Dados , PubMed
5.
Stud Health Technol Inform ; 267: 118-125, 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31483263

RESUMO

Computerized guidelines have been utilized for several decades by now. Systems based on computerized-guidelines often intertwine (1) medical knowledge representation, (2) guideline procedures and (3) hospital workflows. This induces several drawbacks. Most prominent problems include non-shareability of the computerized guideline between hospitals, limited accessibility of the computerized guideline for humans, and an unclear, often confusing combination of hospital-specific workflow and guideline-induced control flows. This article proposes a 3-layer modelling approach strictly distinguishing the aforementioned three aspects to overcome the respective problems. We applied the 3-layer approach to the implementation of a guideline-interpreting software module in the context of the Medical Informatics Initiative Germany (here: SMITH Project) and comment on the resulting implications for the software design of that module.


Assuntos
Informática Médica , Alemanha , Guias de Prática Clínica como Assunto , Software , Desenho de Programas de Computador , Fluxo de Trabalho
6.
Stud Health Technol Inform ; 267: 164-172, 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31483269

RESUMO

Phenotyping means the determination of clinical relevant phenotypes, e.g. by classification or calculation based on EHR data. Within the German Medical Informatics Initiative, the SMITH consortium is working on the implementation of a phenotyping pipeline. to extract, structure and normalize information from the EHR data of the hospital information systems of the participating sites; to automatically apply complex algorithms and models and to enrich the data within the research data warehouses of the distributed data integration centers with the computed results. Here we present the overall picture and essential building blocks and workflows of this concept.


Assuntos
Registros Eletrônicos de Saúde , Informática Médica , Algoritmos , Fenótipo
7.
Stud Health Technol Inform ; 266: 44-50, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31397300

RESUMO

There has been no empirical evidence about the health informatics workforce in Australia produced in the last ten years. This study reports the findings from an analysis of a subset of the 2018 Australian Health Informatics Workforce Census data. Analysing 420 responses that were identified as the occupational group Health Informatics, the results indicate that whilst most of the workforce is classified as aged (>45 years), many respondents are still relatively early in their health informatics careers. Furthermore, most do not possess any formal education in health informatics and almost a quarter undertake their health informatics role alongside another health-related role. The broad range of position titles and functions demonstrates the breadth within this workforce. Ongoing monitoring of this occupational group is required to inform workforce reform and renewal.


Assuntos
Censos , Informática Médica , Austrália , Mão de Obra em Saúde , Recursos Humanos
8.
Stud Health Technol Inform ; 264: 138-142, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31437901

RESUMO

Computer-based decision support systems are often used for dedicated tasks such as the detection of sepsis. However, positive predictive values for sepsis detection are reported to achieve only around 46%. In this paper we describe a novel approach to use temporal data of electronic patient records based on similarity measures. We apply the concept of case-based reasoning, which is well-established in many fields of medical informatics. Temporal patient data are organized in a time-graph structure. For the quantification of similarity between cases, we exploit graph theory based approaches. For development and evaluation of our time-graph similarity frame we use the open MIMIC III dataset. In a later phase, we envision to transfer our concept from sepsis to other diseases.


Assuntos
Informática Médica , Registros Eletrônicos de Saúde , Sistemas Especialistas , Humanos , Software
9.
Stud Health Technol Inform ; 264: 298-302, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31437933

RESUMO

Research data generated in large projects raise challenges about not only data analytics but also data quality assessments and data governance. The provenance of a data set - that is the history of data sets - holds information relevant to technicians and non-technicians and is able to answer questions regarding data quality, transparency, and more. We propose an implementation roadmap to extract, store, and utilize provenance records in order to make provenance available to data analysts, research subjects, privacy officers, and machines (machine readability). Each aspect is tackled separately, resulting in the implementation of a provenance toolbox. We aim to do so within the context of HiGHmed, a research consortium established within the medical informatics initiative in Germany. In this testbed of federated IT-infrastructures, the toolbox shall assist each stakeholder in answering domain-specific and domain-agnostic questions regarding the provenance of data sets. This way, we will improve data re-use, transparency, and reproducibility.


Assuntos
Pesquisa Biomédica , Informática Médica , Alemanha , Reprodutibilidade dos Testes
10.
Stud Health Technol Inform ; 264: 591-595, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31437992

RESUMO

Diagnostic informatics encompasses the role of information technology in key areas of the diagnostic testing (pathology and medical imaging) process, including the selection of appropriate tests and interpretation and follow-up of test results. We present three case studies employing diagnostic informatics methodologies to demonstrate their potential use and value in health services research: (1) Data analytics applied to diagnostic data linked with patient outcome data as a means of enhanancing the monitoring of the quality and appropriateness of diagnostic test choices; (2) Business process modelling which can help to highlight healthcare processes in the diagnostic pathway as a means of improving safety and performance, and (3) Consumer involvement in the diagnostic research process to assist in the establishment of person-centred test result management systems. The case studies provide evidence of the role that diagnostic informatics can have in improving the quality and safety of patient care.


Assuntos
Informática Médica , Segurança do Paciente , Participação da Comunidade , Humanos
11.
Stud Health Technol Inform ; 264: 883-887, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438051

RESUMO

Patient safety events (PSEs), or medical errors, are major impediments to healthcare system safety. Health information technology (HIT) is expected to promote quality of care. Nonetheless, HIT also creates unintended consequences that concern patient safety consolidating a high-quality database of HIT events is essential to understanding their nature. Previous studies demonstrated the potential to use FDA Manufacturer and User Facility Device Experience (MAUDE) database to extract HIT events. In this study, we utilized classic and CNN models to extract HIT events from MAUDE. Both individual and combined models were evaluated on the test set, where the best model identified HIT events with ~90% accuracy and achieved a ~.87 f1 score. This model was capable of identifying HIT events in an HIT-exclusive database and serving as a quality and error check tool during event reporting. Moreover, the strategy of HIT event identification may scale in developing other PSE subtype-specific databases.


Assuntos
Informática Médica , Bases de Dados Factuais , Humanos , Segurança do Paciente , Relatório de Pesquisa , Estados Unidos , United States Food and Drug Administration
12.
Stud Health Technol Inform ; 264: 1999-2000, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438448

RESUMO

Teaching soft skills for change management in healthcare organizations is becoming increasingly necessary, even more, when implementing health information systems (HIS). There is little evidence that these skills can be learned through online teaching environments. This paper describes the experience of having taught soft skills to health informatics master's degree students, through blended learning environments.


Assuntos
Gestão de Mudança , Informática Médica , Humanos , Aprendizagem , Estudantes
13.
Stud Health Technol Inform ; 264: 1654-1655, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438277

RESUMO

Personal health records designed for shared decision making have the potential to engage patients in self-management decision making. This pre-implementation evaluation was underpinned by Normalization Process Theory and utilized mixed methods to describe the cognitive and behavioral work of implementation, and its potential to integrate into practice. Participants invest in sense-making, commitment and appraisal processes with strong agreement for positive impact on engagement. Future implementation success will depend on a systemic investment of collective action.


Assuntos
Tomada de Decisões , Informática Médica , Autogestão , Registros de Saúde Pessoal , Humanos , Participação do Paciente
14.
Stud Health Technol Inform ; 264: 1666-1667, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438283

RESUMO

Integrating evidence from systematic research in daily clinical practice is one of the pillars of evidence-based medicine. Electronic data capture tools simplify data collection from different centers and supports the management of multicenter clinical trials. The Ligurian HIV Network (LHN) is one such tool, originating from a regional effort to integrate clinical trial capabilities for HIV and other chronic infectious diseases. In order to manually collect a complete report of all clinical tests on patients enrolled in a trial, a strenuous human effort and the allocation of great resources would be necessary. Moreover, the risk of error in a manual system is very high. The proposed system automatically extracts clinical data from the EHR of three hospitals of the LHN in a standardized way, and enhance their re-use in clinical trials. Through dedicated questionnaires, physicians reported a strongly positive feedback about the efficacy of the platform in supporting clinical research.


Assuntos
Registros Eletrônicos de Saúde , HIV , Informática Médica , Medicina Baseada em Evidências , Humanos , Pesquisa
15.
Stud Health Technol Inform ; 264: 1678-1679, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438289

RESUMO

Given a care delivery organization, its health information system can be defined as the part of the organization that processes and stores data, information, and knowledge. There is an enormous number of frameworks, textbooks and articles that describe the scope of health information system management from the perspective of medical informatics. Transforming this knowledge to Linked Open Data results in a structured data representation that is accessible for both humans and machines, the Semantic Network of Information Management in Hospitals (SNIK). We present interfaces that are useful for researchers, practitioners and students, depending on their objectives and their Semantic Web skills.


Assuntos
Sistemas de Informação em Saúde , Informática Médica , Web Semântica , Humanos , Gestão da Informação , Gestão do Conhecimento
16.
Stud Health Technol Inform ; 263: 1-8, 2019 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-31411148

RESUMO

This chapter introduces the idea of theories in health informatics, defines what we mean by theory and distinguishes theories from models, frameworks and predictive principles. After explaining why theories and predictive principles are needed to help us professionalize our discipline, the chapter offers five criteria for a successful predictive principle, discusses how to evaluate predictive principles and theories and links this with the emerging field of evidence-based health informatics. The chapter concludes with three actions needed to move the discipline of theory-based health informatics forward.


Assuntos
Informática Médica , Modelos Teóricos
17.
Stud Health Technol Inform ; 263: 64-71, 2019 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-31411153

RESUMO

Both the Technology Acceptance Model (TAM) and the Unified Theory of Acceptance and Use of Technology (UTAUT) aim at understanding better why users accept or reject a given technology, and how user acceptance can be improved through technology design. Two case studies are presented where TAM and UTAUT were successfully used in a health care setting to predict technology adoption. Both models have found popularity in health care. However, recent reviews show that TAM and UTAUT failed to provide stable predictive capabilities for acceptance and use of technologies in health care. Reasons for this may be the specific context of health care, where not only the technology, but also socio-organizational and cultural factors influence technology acceptance.


Assuntos
Atitude Frente aos Computadores , Informática Médica , Tecnologia
18.
Stud Health Technol Inform ; 263: 75-86, 2019 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-31411154

RESUMO

Distributed cognition theory posits that our cognitive tasks are so tightly coupled to the environment that cognition extends into the environment, beyond the skin and the skull. It uses cognitive concepts to describe information processing across external representations, social networks and across different periods of time. Distributed cognition lends itself to exploring how people interact with technology in the workplace, issues to do with communication and coordination, how people's thinking extends into the environment and sociotechnical system architecture and performance more broadly. We provide an overview of early work that established distributed cognition theory, describe more recent work that facilitates its application, and outline how this theory has been used in health informatics. We present two use cases to show how distributed cognition can be used at the formative and summative stages of a project life cycle. In both cases, key determinants that influence performance of the sociotechnical system and/or the technology are identified. We argue that distributed cognition theory can have descriptive, rhetorical, inferential and application power. For evidence-based health informatics it can lead to design changes and hypotheses that can be tested.


Assuntos
Cognição , Informática Médica , Comunicação , Tecnologia
19.
Stud Health Technol Inform ; 263: 87-97, 2019 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-31411155

RESUMO

This chapter introduces Actor-Network Theory, a sociotechnical approach to studying health information technology implementation. The chapter is intended as a pragmatic introduction to the field, acknowledging that there are many contested features of an Actor-Network Theory informed methodology. Nevertheless, the approach can be usefully drawn on to help to focus data collection and sampling. A case study describing the application of Actor-Network Theory to study the "failed" implementation of national electronic health records in England as part of a national "top-down" implementation program illustrates the main tenets of the approach and provides concrete examples of how Actor-Network Theory may be applied. In doing so, this chapter offers a reflexive account of how Actor-Network Theory has provided a nuanced analysis of how the implementation of national electronic health records affected different stakeholders, organizations and technology.


Assuntos
Registros Eletrônicos de Saúde , Informática Médica , Inglaterra , Modelos Teóricos
20.
Stud Health Technol Inform ; 263: 98-108, 2019 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-31411156

RESUMO

High reliability organisations operate safely in situations of high risk by organising for collective mindfulness. They do so through five ongoing processes geared towards anticipating, containing, and making sense of the unexpected. The five processes are: preoccupation with failure, reluctance to simplify interpretations, sensitivity to operations, commitment to resilience, and deference to expertise. The theory of collective mindfulness builds on Hutchins's theory of distributed cognition (the 'collective mind' of ship navigation teams) and on Langer's theory of mindfulness about individuals' interpreting information in context. However, in the theory of collective mindfulness, attention is paid not to individual cognition or decision making, but to collective processes of sensemaking emerging from individuals' interactions in dealing with an equivocal environment. In health informatics, the theory of collective mindfulness can be used to explain health information technology (IT) development and implementation, across its life cycle, and inform guidance towards mindful management of IT projects. For example, applied to a case of electronic health record implementation in a hospital context, the theory explains how mindful management of the sense-making challenges of post-roll out adaptation processes contributes to a 'successful' IT project. Further, the theory challenges a static and linear understanding of success (or failure) of health IT initiatives, supporting instead an argument for outcomes - be it reliability and safety, or IT project success - as collective, complex and dynamic achievements of mindful organising practices.


Assuntos
Informática Médica , Atenção Plena , Assistência à Saúde , Humanos , Transtornos Mentais , Reprodutibilidade dos Testes
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