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1.
Rev Saude Publica ; 53: 111, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31800908

RESUMO

OBJECTIVE: To describe the four types of horizon scanning (HS) outputs developed by the National Committee for Health Technology Incorporation (CONITEC) and show their main repercussions on the decision-making processes of the Brazilian Ministry of Health (MH). METHODS: Descriptive study based on participant observation and document analysis of HS outputs (internal reports, alert reports, briefs and sections for CONITEC recommendation reports) developed between January 2014 and July 2018. RESULTS: Fifteen internal reports, six alert reports, two briefs and 57 HS sections were produced. Each output has a specific structure according to its purpose. The methodological approach adopted for developing HS outputs in Brazil is described by EuroScan International Network. The outputs had institutional and international repercussions. The activities resulted in the inclusion of HS as a tool for reducing health lawsuits in the legal framework of the MH. One of the internal reports on a high-cost drug not approved in Brazil for a rare disease was requested by the Health Technology Assessments Network for the Americas (RedETSA), showing the international relevance of the outputs. The HS sections in recommendation reports influenced discussions about incorporating technologies into the Unified Health System. CONCLUSIONS: The developed outputs have purposes ranging from helping build arguments for defense of the MH in cases of health judicialization to inform decision-making processes. In addition, HS sections in recommendation reports have grown in importance recently. CONITEC's HS system has been structured, and its role as a tool to inform health managers has shown to be been relevant.


Assuntos
Tecnologia Biomédica/tendências , Tomada de Decisões , Avaliação da Tecnologia Biomédica/tendências , Brasil , Sistemas de Informação em Saúde/tendências , Humanos , Relatório de Pesquisa , Fatores de Tempo
2.
Cuad. bioét ; 30(100): 303-313, sept.-dic. 2019.
Artigo em Espanhol | IBECS | ID: ibc-185243

RESUMO

El derecho a la información clínica y el consentimiento informado como expresión práctica del principio de autonomía, son conquistas legales en España de finales del siglo XX que se han trasladado a la normativa deontológica médica. Se estudia el ritmo de ese traslado. Revisión histórica de los diferentes códigos de deontología médica desde la Guerra Civil, buscando la presencia de estas ideas en ella. Hasta el código de 1979 la idea de información clínica no aparece en la normativa deontológica vigente y el consentimiento lo hace en casos muy restringidos. A partir de esa fecha su aparición es progresiva en los sucesivos códigos. Actualmente ambas ideas están completamente desarrolladas en la normativa deontológica española. La Deontología médica ha asumido como suyas las ideas de información al paciente y consentimiento in-formado. Este ha sido un proceso largo en el tiempo que ha cambiado en buena medida la orientación deontológica para las relaciones médico-enfermo. En estos aspectos, la Deontología médica pasa, de hacer hincapié en la prudencia del médico, a subrayar el deber de informar y de dar amplio espacio a las decisiones del paciente, al que reconoce como un agente moral autónomo y reflexivo, capaz de tomar sus propias decisiones sobre su salud


In Spain, the right to clinical information and informed consent as a practical expression of the principle of autonomy, are legal conquests achieved in the late twentieth century. From the law they have been transferred to the codes of medical deontology. The aim of this work is to study the pace of this transfer. Historical review of the different codes of medical deontology in Spain since the Civil War, see-king the presence of these ideas in them. Until code of medical deontology of 1979, the idea of clinical information did not appear in the contemporary deontological norm, and the rules on consent did so in very restricted cases. As of that date, their appearance is progressive in the successive codes. Currently, both concepts are fully developed in Spanish deontological regulations. Medical Deontology has take on the ideas of patient information and informed consent. This has been a long process which have brought considerable changes the deontological orientations of the traditional form of doctor-patient relationship. In these aspects, medical deontology has drifted, from emphasizing the prudence of the doctor, to emphasize the duty to inform and give ample space to the patient’s decisions, which he recognizes as an autonomous and reflective moral agent, capable of taking his own decisions about your health


Assuntos
Humanos , História do Século XX , Sistemas de Informação em Saúde/ética , Sistemas de Informação em Saúde/legislação & jurisprudência , Consentimento Livre e Esclarecido/ética , Teoria Ética , Sociedades Médicas/ética , Ética Clínica , Consentimento Livre e Esclarecido/legislação & jurisprudência , Códigos de Ética/legislação & jurisprudência , Códigos de Ética/tendências , Sociedades Médicas/legislação & jurisprudência
3.
Global Health ; 15(1): 67, 2019 12 18.
Artigo em Inglês | MEDLINE | ID: mdl-31847863

RESUMO

BACKGROUND: Countries must be able to describe and monitor their populations health and well-being needs in an attempt to understand and address them. The Sustainable Development Goals (SDGs) have re-emphasized the need to invest in comprehensive health information systems to monitor progress towards health equity; however, knowledge on the capacity of health information systems to be able do this, particularly in low-income countries, remains very limited. As a case study, we aimed to evaluate the current capacity of the national health information systems in Mozambique, and the available indicators to monitor health inequalities, in line with SDG 3 (Good Health and Well Being for All at All Ages). METHODS: A data source mapping of the health information system in Mozambique was conducted. We followed the World Health Organization's methodology of assessing data sources to evaluate the information available for every equity stratifier using a three-point scale: 1 - information is available, 2 - need for more information, and 3 - an information gap. Also, for each indicator we estimated the national average inequality score. RESULTS: Eight data sources contain health information to measure and monitor progress towards health equity in line with the 27 SDG3 indicators. Seven indicators bear information with nationally funded data sources, ten with data sources externally funded, and ten indicators either lack information or it does not applicable for the matter of the study. None of the 27 indicators associated with SDG3 can be fully disaggregated by equity stratifiers; they either lack some information (15 indicators) or do not have information at all (nine indicators). The indicators that contain more information are related to maternal and child health. CONCLUSIONS: There are important information gaps in Mozambique's current national health information system which prevents it from being able to comprehensively measure and monitor health equity. Comprehensive national health information systems are an essential public health need. Significant policy and political challenges must also be addressed to ensure effective interventions and action towards health equity in the country.


Assuntos
Equidade em Saúde/organização & administração , Sistemas de Informação em Saúde , Indicadores Básicos de Saúde , Saúde Pública , Disparidades nos Níveis de Saúde , Humanos , Moçambique , Desenvolvimento Sustentável , Organização Mundial da Saúde
4.
RECIIS (Online) ; 13(4): 831-842, out.-dez. 2019. tab, ilus
Artigo em Inglês | LILACS | ID: biblio-1047577

RESUMO

The objective of this study was to compare intra-domiciliary contacts (IDCs) in the Health Information System (SIS) with records of people diagnosed with leprosy. This was a cross-sectional, retrospective, and quantitative study based on the physical information collected in medical records and the SIS records in 2015 and 2016, in a municipality in the countryside of the State of São Paulo. We used an instrument with variables related to IDCs such as gender, age, relationship, disease, BCG-ID vaccine, SIS records, and descriptive analysis. Out of the 81 IDCs from 40 diagnosed patients, 72 were evaluated, and 71 were included in the SIS. One IDC became ill after the end of treatment of the index case. The prevalent gender among IDCs was female, young adults, and children. A difference of 12.4% as observed between the physical and SIS records; a difference of 11.1% was observed when correlating 81 records with the frequency of the 72 evaluated IDCs. It is concluded that the IDC and SIS records are in disagreement.


O objetivo deste estudo foi comparar os contatos intradomiciliares (CIs) do Sistema de Informação em Saúde (SIS) com os registros de pessoas diagnosticadas com hanseníase. Estudo transversal, retrospectivo e quantitativo, baseado nas informações coletadas em registros físicos e do SIS em 2015 e 2016, em um município do interior do Estado de São Paulo. Foi utilizado um instrumento com variáveis relacionadas aos CIs: sexo, idade, relacionamento, doença, vacina BCG-ID, registros SIS e análise descritiva. Dos 81 CIs de 40 pacientes diagnosticados, 72 foram avaliados e 71 foram incluídos no SIS. 01 CIs adoeceu após o término do tratamento do caso índice. O sexo prevalente dos CIs é feminino, adulto jovem e filho. Entre os registros físicos e do SIS, houve uma diferença de 12,4%; e correlacionando os mesmos registros (81) com a frequência dos CIs avaliados (72), há uma diferença de 11,1%. Conclui-se que existe discordância entre os registos de CIs nos registos com o SIS.


El estudio tiene el objetivo de comparar las anotaciones de comunicantes intradomiciliares (CI) del Sistema de Información en Salud (SIS), con las de los prontuarios de las personas diagnosticadas con leprae. En el presente trabajo se analizaron los resultados obtenidos en el análisis de los resultados obtenidos en el análisis de los resultados obtenidos, evaluados en los registros del SIS. De los 81 CI de 40 pacientes diagnosticados, 72 fueron evaluados y 71 fueron incluidos en el SIS. Y en el caso de las mujeres, El grado de parentesco frecuente fue infantil, mujeres y adultos jóvenes. Entre las anotaciones del SIS y los prontuarios, hay diferencia del 12,4%; y correlacionando los mismos registros (81) con la frecuencia de los CI evaluados (72), hay una diferencia del 11,1%. Se concluye que hay discordancia entre los registros de CI en los prontuarios con el SIS.


Assuntos
Humanos , Epidemiologia , Comunicação em Saúde , Vigilância em Saúde Pública , Sistemas de Informação em Saúde , Hanseníase , Sistema Único de Saúde , Registros Médicos , Epidemiologia Descritiva , Estudos Transversais , Hanseníase/diagnóstico
5.
RECIIS (Online) ; 13(4): 854-862, out.-dez. 2019. ilus, tab
Artigo em Português | LILACS | ID: biblio-1047588

RESUMO

A avaliação do estado nutricional dos idosos possibilita uma intervenção adequada, a fim de evitar ou minimizar agravos à saúde que comprometam a capacidade funcional dessas pessoas. Nessa perspectiva, o trabalho apresentado neste artigo teve como objetivo verificar o estado nutricional e hábitos alimentares da população idosa do estado do Piauí. Foram utilizados dados de acesso público disponíveis no SISVAN Web referentes à avaliação nutricional realizada nos anos de 2014 a 2018. Observou-se aumento da prevalência de sobrepeso naquela população e uma diminuição do número de pessoas com baixo peso. Quando avaliados por sexo, as mulheres apresentaram maiores percentuais de excesso de peso em todos aqueles anos. O perfil do consumo alimentar mostrou que a maioria dos idosos consome alimentos in natura como frutas, verduras e feijão, e que, entre os que participaram da amostra, poucos fizeram uso de alimentos ultraprocessados. Por fim, cabe ressaltar a importância da avaliação do quadro de saúde da população como forma de subsídio para o planejamento de ações de saúde, dessa forma alocando melhor os recursos e possibilitando uma atuação eficaz dos que trabalham na área da saúde.


The evaluation of the nutritional status of the elderly allows the appropriate nutritional intervention avoiding or minimizing health problems that cause damage on their functional capacity. From this perspective, the study presented in this article aimed to verify the nutritional status and eating habits of the elderly population of the state of Piauí, Brazil. We used public access data available in the SISVAN Web regarding the nutritional evaluation carried out from 2014 to 2018. The data revealed an increase in the prevalence of overweight in that population and a reduction of the number of elderly with low weight. When evaluated by sex, women presented higher percentages of overweight in all those years. The food consumption profile showed that the majority of the eldery population consumes fresh foods such as fruits, vegetables and beans and only a few of participants of the sample consumed ultra-processed foods. Finally, the importance of the evaluation of the health of the population as a form of incentive to plan health actions is highlighted, so that the resources can be more competently allocated and the health care workers can act efficiently and effectively.


La evaluación del estado nutricional de las personas mayores permite una intervención nutricional adecuada evitando o minimizando los problemas de salud que comprometen su capacidad funcional. Desde esta perspectiva, el estudio presentado en este artículo tuvo como objetivo verificar el estado nutricional y los hábitos alimenticios de la población anciana del estado de Piauí, Brasil. Utilizamos los datos de acceso público disponibles en el SISVAN Web con respecto a la evaluación nutricional realizada desde los años 2014 hasta 2018. Se observó un aumento en la prevalencia del sobrepeso en laquella población y una disminución en el número de personas que tenían bajo peso. Cuando fueron evaluados por sexo, las mujeres presentaron porcentajes más altos de sobrepeso en todos aquellos años. El perfil del consumo de alimentos mostró que la mayoría de los ancianos consumía alimentos frescos como frutas, verduras y frijol, y pocos participantes de la muestra habían consumido alimentos ultraprocesados. Por fin, debe ser destacada la importancia de la evaluación de la salud de la población como una forma de incentivo para la planificación de acciones de salud, asignando así mejores recursos y posibilitando una actuación de los trabajadores de la salud eficiente y eficaz.


Assuntos
Humanos , Vigilância Nutricional , Envelhecimento , Saúde Pública , Fatores de Risco , Sistemas de Informação em Saúde , Qualidade de Vida , Idoso , Consumo de Alimentos , Índice de Massa Corporal , Estado Nutricional , Estudos Retrospectivos , Desnutrição , Sobrepeso , Obesidade
6.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 31(9): 1072-1077, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31657327

RESUMO

OBJECTIVE: To describe and compare the epidemiology of Sepsis-1 and Sepsis-3 in Yuetan Subdistrict of Beijing, and to estimate the incidence of Sepsis-3 in China. METHODS: A population-based cohort study was conducted. Through the database of Beijing Public Health Information System, the medical records of all adult residents hospitalized from July 1st, 2012 to June 30th, 2014 in Yuetan Subdistrict were reviewed. According to the clinical data of these patients, patients with Sepsis-1 and Sepsis-3 were enrolled in this analysis and the demographic characteristics of them were compared. Incidence and in-hospital mortality was calculated. Logistic regression method was used to analyze the risk factors of sepsis. RESULTS: Compared with non-septic patients with infections, patients with Sepsis-1 or Sepsis-3 were more likely to be male, older, had more comorbidities and lower body mass index (BMI), had more lower respiratory tract infections, more intra-abdominal infections and more blood flow infections, but had fewer urogenital tract infections, fewer upper respiratory tract infections, fewer gastrointestinal infections and fewer skin and soft tissue infections, and had pure prognosis with longer length of hospital stay [days, Sepsis-1 compared with non-Sepsis-1: 18 (10, 34) vs. 14 (9, 22), Sepsis-3 compared with non-Sepsis-3: 20 (11, 39) vs. 14 (9, 25)] and higher mortality [Sepsis-1 compared with non-Sepsis-1: 20.6% (353/1 716) vs. 2.5% (44/1 733), Sepsis-3 compared with non-Sepsis-3: 32.0% (299/935) vs. 3.9% (98/2 514), all P < 0.01]. Logistic regression analysis showed that male, elder (age ≥ 65 years old), low BMI, bed-rest state, and combined with cerebrovascular disease and hematological malignancies were risk factors for Sepsis-1 [all odds ratio (OR) > 1, all P < 0.05], while the male, elder (age ≥ 65 years old), low BMI, bed-rest state, and combined with cerebrovascular disease, rheumatic immune disease, malignant diseases of blood system and dementia were risk factors for Sepsis-3 (all OR > 1, all P < 0.05). Sepsis-3 was more common in males [OR = 1.19, 95% confidence interval (95%CI) was 1.01-1.40, P < 0.05] and elderly patients (age 65-84 years old: OR = 1.60, 95%CI was 1.28-1.99, P < 0.01; age ≥ 85 years old: OR = 1.76, 95%CI was 1.39-2.23, P < 0.01) as compared with Sepsis-1. After adjusted for gender and age, the standardized incidence of Sepsis-1 was 461 per 100 000 person-year, and that of Sepsis-3 was 236 per 100 000 person-year, with the standardized mortality of 79 per 100 000 person-year and 67 per 100 000 person-year, respectively, in Yuetan Subdistrict of Beijing. Corresponding to a speculative extrapolation of 4 856 532 new cases for Sepsis-1 and 2 487 949 new cases for Sepsis-3, there were 831 674 deaths and 700 437 deaths per year in China, respectively. CONCLUSIONS: Male, elder, more comorbidities and low BMI were risk factors for sepsis. The standardized incidence of Sepsis-3 in Yuetan Subdistrict of Beijing was 236 per 100 000 person-year, and speculated there were 2.5 million new cases of Sepsis-3 per year, resulting in more than 700 000 deaths in China. According to the diagnostic criterion of Sepsis-3, 2.36 million new cases per year were reduced, and the mortality was increased by 11.4%, as compared with the criterion of Sepsis-1.


Assuntos
Sistemas de Informação em Saúde , Sepse/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Pequim/epidemiologia , China , Estudos de Coortes , Humanos , Masculino , Estudos Retrospectivos , Sepse/epidemiologia
7.
Rev Bras Epidemiol ; 22: e190045, 2019 Sep 02.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31482984

RESUMO

INTRODUCTION: The study assessed interobserver reliability in the classification of record pairs formed during probabilistic linkage of health-related databases, a key step in the methodology validation to be used in a larger on-going study on inequalities in the access to breast and cervical cancer control activities in Brazil (DAAC-SIS). METHODOLOGY: The RecLink software was used to link two databases of the Breast Cancer Control Information System (SISMAMA) in the state of Minas Gerais, Brazil: a reference database, which included 301 screening mammograms with probable benign diagnosis (BI-RADS 3 category) recorded in October 2010, and a database comprising 158,517 mammograms registered in 2011. Subsequently, the 215 pairs of records that were not assigned the maximum RecLink score were independently classified as being true or false by ten independent evaluators from four participating centers. RESULTS: The Kappa coefficient ranged from 0.87 to 1.00. Six evaluators were in perfect agreement with one or more evaluators from the other centers. The global Kappa was 0.96 (95% confidence interval - 95%CI 0.94 - 0.99). DISCUSSION: Assessment of interobserver reliability is key to ensuring the quality of the record linkage, and it should be routine practice in studies of this nature. The disclosure of such results contributes to transparency in the conduct of such studies and in the reporting of their findings. CONCLUSION: Interobserver reliability in this study was excellent, indicating satisfactory team consistency in the classification of record pairs.


Assuntos
Neoplasias da Mama/prevenção & controle , Sistemas de Informação em Saúde , Registro Médico Coordenado , Brasil , Bases de Dados Factuais , Feminino , Humanos , Mamografia , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Integração de Sistemas
8.
Stud Health Technol Inform ; 267: 289-296, 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31483284

RESUMO

BACKGROUND: Assessing Mental Workload related to Health Information Systems can help to analyze weak points of the use of Health Information Systems and in health care work processes. Our objectives were to give an overview of current research and applied measurement methods as well as gaining insights into influencing factors of mental workload on the use of health information systems and vice versa. METHODS: We applied a structured literature research by searching for "mental workload" on PubMed. Studies were included into our review if they assessed related to Health Information Systems. RESULTS: The research in PubMed led to 124 articles, resulting in 17 papers taken into in-depth analyses. We identified three categories referring to different study design types. Additionally, articles showed that mental workload was influenced by using health information systems and vice versa. DISCUSSION: The review was limited to only one database but revealed that future research with sociotechnical focus including mental workload is necessary. CONCLUSION: In contrast to the high relevance only a few articles address mental workload in Health Information systems. The quality of the studies in terms of evidence and external validity appears to be largely in need of development and should be improved in ongoing research.


Assuntos
Sistemas de Informação em Saúde , Assistência à Saúde , Projetos de Pesquisa , Carga de Trabalho
9.
Surg Infect (Larchmt) ; 20(7): 571-576, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31397635

RESUMO

Background: The patient's history of present illness provides an important part of the data with which clinicians diagnose and treat. Once surgical patients are discharged, the ability to incorporate direct observation requires coordinating patient and provider for a clinical visit. Mobile technologies offer the ability to gather and organize the patient's history, supplement that history with photographs and other clinical observations, and convey those data accurately and rapidly to the entire clinical team. Methods: We review our experience with patient-generated health data in surgical site infection, draw parallels with similar work in other domains, and identify principles we have found useful. Results: Health information system implementations require substantial changes in provider workflow. Shared expectations between the patient and the surgical team, an incremental approach to change in clinical processes, and an emphasis on clinical utility all support successful implementation. Conclusions: The data collection and rapid information exchange afforded by monitoring post-operative, post-discharge patients using mobile technologies can support the expectations of both patients and providers and may provide a novel data source for public health surveillance of surgical site infection. Both uses of these data require careful attention to introducing changes in clinical workflow.


Assuntos
Gerenciamento Clínico , Sistemas de Informação em Saúde/tendências , Disseminação de Informação/métodos , Dados de Saúde Gerados pelo Paciente , Infecção da Ferida Cirúrgica/diagnóstico por imagem , Fluxo de Trabalho , Humanos
10.
Stud Health Technol Inform ; 265: 3-11, 2019 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-31431570

RESUMO

The digital transformation of health care delivery remains an elusive work in progress. Contextual variation continues to be a significant barrier to the development of sustainable health information systems. In this paper we characterize health informaticians as modern alchemists and use this characterization to describe informatics progress in addressing four key healthcare challenges. We highlight the need for informaticians to be diligent and loyal to basic methodological principles while also appreciating the role that contextual variation plays in informatics research. We also emphasize that meaningful health systems transformation takes time. The insight presented in this paper helps informaticians in our quest to develop sustainable health information systems.


Assuntos
Sistemas de Informação em Saúde , Informática Médica , Assistência à Saúde , Pesquisa
11.
Stud Health Technol Inform ; 264: 649-653, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438004

RESUMO

Usability of health information technology (HIT) remains a predominant concern - one often exacerbated by clinicians' need to access information created by many different professionals in different settings, often using very dissimilar EHRs or even different configurations of the same EHR. Because of these variations, we argue that we must no longer think of usability as anchored in one setting, one EHR, one data standard, or one type of clinician. Rather, usability must be understood as a collective and constantly evolving process. This paper seeks to address that reality by 1) substantially expanding our previously-developed conceptual matrix of the wide range of settings and interfaces comprising modern HIT and 2) presenting actual examples of EHR usability issues with similar data but very different displays or processes.


Assuntos
Sistemas de Informação em Saúde , Informática Médica , Assistência à Saúde , Registros Eletrônicos de Saúde , Interface Usuário-Computador
12.
Stud Health Technol Inform ; 264: 659-663, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438006

RESUMO

Enterprise Architecture allows addressing technologies and processes in a holistic way and mirrors choices related to process standardization and data integration. It has the potential to address long-standing problems in health information systems related to fragmented IT portfolios, immature IT infrastructures, and silo-structured organizing. Nevertheless, uptake of Enterprise Architecture in hospitals has been slow. To understand the issues related to this slow uptake we have undertaken an interview study with architects and managers. The issues identified reveal a level of incongruence between healthcare as a domain and the practice of EA. Specifically, by analyzing the experiences of architects and managers we identified four different areas of such incongruence that create the need to reconcile a) Bottom-up vs. Top-down Planning b) Clinical vs. Systems' Knowledge, c) Local vs. Global Arrangements and d) Patient Safety vs. Patient Privacy. Building on prior related research we propose ways for resolving the incongruence issues identified.


Assuntos
Sistemas de Informação em Saúde , Hospitais , Assistência à Saúde , Humanos
13.
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
14.
Stud Health Technol Inform ; 264: 1690-1691, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438295

RESUMO

The learning health system depends on a cycle of evidence generation, translation to practice, and continuous practice-based data collection. Clinical practice guidelines (CPGs) represent medical evidence, translated into recommendations on appropriate clinical care. The FAIR guiding principles offer a framework for publishing the extensive knowledge work of CPGs and their resources. In this narrative literature review, we propose that FAIR CPGs would lead to more efficient production and dissemination of CPG knowledge to practice.


Assuntos
Programas Governamentais , Sistemas de Informação em Saúde , Guias de Prática Clínica como Assunto , Confiabilidade dos Dados
15.
Stud Health Technol Inform ; 264: 1692-1693, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438296

RESUMO

CONTEXT: Arden Syntax is a standard that encodes knowledge as Medical Logic Modules (MLMs) but lacks a standard query data model and terminology. OBJECTIVE: Assess to what extent FHIR can represent MLMs. METHOD: A convenience sample of 340 MLMs were examined and tabulated for representation using the PlanDefinition resource. RESULT: While alignment between structured subsections is uneven, the PlanDefinition resource adequately represents procedural medical knowledge encoded as MLMs. CONCLUSION: FHIR adequately represents Arden Syntax MLMs.


Assuntos
Sistemas de Informação em Saúde , Bases de Conhecimento , Projetos de Pesquisa , Sistemas de Informação em Saúde/normas , Armazenamento e Recuperação da Informação , Linguagens de Programação
16.
Stud Health Technol Inform ; 264: 1694-1695, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438297

RESUMO

We developed a comprehensive health and social-need assessment system to evaluate the diverse needs of elders with chronic illnesses in the community and to enhance the connection of their needs to health and social services. A comprehensive needs-assessment tool and profiles were integrated into the ICT system. We found that care managers could assess elders' needs comprehensively and connect those needs to suitable health and social services systematically.


Assuntos
Determinação de Necessidades de Cuidados de Saúde , Autocuidado , Idoso , Doença Crônica , Sistemas de Informação em Saúde , Humanos
17.
Stud Health Technol Inform ; 264: 1905-1906, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438400

RESUMO

One of the challenges of implementing health information and communication technology is the need for a skilled workforce that understands health care and ITC. There are also people and organizational challenges involved. This work describes the strategies to create such a workforce for the public network of healthcare facilities in the City of Buenos Aires, which include promoting the adoption of technologies and providing lines of contention for continuous training.


Assuntos
Sistemas de Informação em Saúde , Saúde Pública , Argentina , Cidades , Desenvolvimento de Pessoal , Recursos Humanos
18.
Yearb Med Inform ; 28(1): 83-94, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31419820

RESUMO

OBJECTIVES: This survey aims at reviewing the literature related to Clinical Information Systems (CIS), Hospital Information Systems (HIS), Electronic Health Record (EHR) systems, and how collected data can be analyzed by Artificial Intelligence (AI) techniques. METHODS: We selected the major journals (11 journals) collecting papers (more than 7,000) over the last five years from the top members of the research community, and read and analyzed the papers (more than 200) covering the topics. Then, we completed the analysis using search engines to also include papers from major conferences over the same five years. RESULTS: We defined a taxonomy of major features and research areas of CIS, HIS, EHR systems. We also defined a taxonomy for the use of Artificial Intelligence (AI) techniques on healthcare data. In the light of these taxonomies, we report on the most relevant papers from the literature. CONCLUSIONS: We highlighted some major research directions and issues which seem to be promising and to need further investigations over a medium- or long-term period.


Assuntos
Inteligência Artificial , Sistemas de Informação , Sistemas de Apoio a Decisões Clínicas , Registros Eletrônicos de Saúde , Sistemas de Informação em Saúde , Sistemas de Informação Hospitalar
19.
Rev Soc Bras Med Trop ; 52: e20180532, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31340359

RESUMO

INTRODUCTION: Although congenital syphilis is preventable, its incidence has increased in Brazil. METHODS: In this ecological study, a Bayesian spatio-temporal model was used to estimate the attributable fraction of congenital syphilis cases due to the lack of prenatal care recorded between 2010 and 2015 in the state of São Paulo, Southeast Brazil. RESULTS: For the year 2016, it was estimated that between 79.4% and 95.3% of the congenital syphilis cases among women who did not have prenatal care could have been prevented. CONCLUSIONS: A significant proportion of congenital syphilis cases can be prevented if prenatal care coverage is expanded.


Assuntos
Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Complicações Infecciosas na Gravidez/epidemiologia , Cuidado Pré-Natal , Sífilis Congênita/epidemiologia , Teorema de Bayes , Brasil/epidemiologia , Notificação de Doenças , Feminino , Sistemas de Informação em Saúde , Humanos , Incidência , Gravidez , Características de Residência
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