Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.185
Filtrar
1.
Perspect Health Inf Manag ; 19(4): 1b, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36348729

RESUMO

Despite the cooperative sharing of health information exchange (HIE), various distinct limitations and barriers are found (i.e., substantial time and resources are being used to achieve health information). This paper investigates the limits of healthcare information sharing policy implementation for patient referral systems in Thailand. Mixed-methods research methodology, both quantitative and qualitative mechanisms, are conducted. The study results present the correlation between the current HIE among the hospitals in patient referral systems and the limitations of implementing the HIE policy, composed of technical, economic, political, and legal barriers. The statistical test reveals that these four main barriers could limit information sharing or impede Thailand's standard healthcare information-sharing policy and practice development. Predominantly, it is further found that there is no standard for data collection and data archiving systems; unclear guidelines, practices, and procedures; and a lack of standard practice due to fragmented administration. Foremost of all, the data ownership of any competent authorities or related regulators could cause any constraints in information sharing (e.g., complexity and processing time). This paper's findings will be beneficial to stakeholders, such as policymakers interested in achieving meaningful use, facilitating the adoption and implementation of HIE at a national level to ensure patients' safety and enhance healthcare quality.


Assuntos
Registros Eletrônicos de Saúde , Troca de Informação em Saúde , Humanos , Atenção à Saúde , Disseminação de Informação/métodos , Encaminhamento e Consulta , Tailândia , Pessoal de Saúde , Pacientes
2.
Front Public Health ; 10: 907141, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36388302

RESUMO

Introduction: Health information exchange (HIE) exhibits tremendous benefits in improving the quality of healthcare and reducing healthcare costs. However, it also poses challenges related to data security, data privacy, patient engagement, etc. Objective: This study aimed to explore the factors affecting patients' opt-in intention to HIE by using an empirical study based on the theory of planned behavior. Methods: A Web-based survey was conducted involving 501 valid participants in China (69% validity rate). Results: Information sensitivity and perceived HIE transparency affected the patients' opt-in intention to HIE through the mediation of perceived behavior control and trust in HIE. Information sensitivity negatively influenced perceived behavior control (-0.551, P < 0.001) and trust in HIE (-0.489, P < 0.001). Perceived transparency of HIE positively influenced perceived behavior control (0.396, P < 0.001) and trust in HIE (0.471, P < 0.001). Moreover, patients' opt-in intention to HIE can be positively affected by perceived HIE transparency (0.195, P < 0.001) and trust in HIE (0.294, P < 0.001). In addition, the moderating effect of health status was positive and significant between trust in HIE and opt-in intention to HIE but not between the perceived behavior control and opt-in intention to HIE. Conclusion: This study contributes to the theory of planned behavior and enriches the literature on HIE efforts. HIE administrators should design personalized health services on the basis of these different health statuses to successfully achieve patients' opt-in intention to HIE.


Assuntos
Troca de Informação em Saúde , Intenção , Humanos , Confiança , Participação do Paciente , Nível de Saúde
3.
J Med Internet Res ; 24(11): e41750, 2022 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-36331535

RESUMO

The federal Trusted Exchange Framework and Common Agreement (TEFCA) aims to reduce fragmentation of patient records by expanding query-based health information exchange with nationwide connectivity for diverse purposes. TEFCA provides a common agreement and security framework allowing clinicians, and possibly insurance company staff, public health officials, and other authorized users, to query for health information about hundreds of millions of patients. TEFCA presents an opportunity to weave information exchange into the fabric of our national health information economy. We define 3 principles to promote patient autonomy and control within TEFCA: (1) patients can query for data about themselves, (2) patients can know when their data are queried and shared, and (3) patients can configure what is shared about them. We believe TEFCA should address these principles by the time it launches. While health information exchange already occurs on a large scale today, the launch of TEFCA introduces a major, new, and cohesive component of 21st-century US health care information infrastructure. We strongly advocate for a substantive role for the patient in TEFCA, one that will be a model for other systems and policies.


Assuntos
Troca de Informação em Saúde , Health Insurance Portability and Accountability Act , Estados Unidos , Humanos , Privacidade , Confidencialidade , Segurança Computacional
4.
J Biomed Inform ; 134: 104199, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36100164

RESUMO

Despite the availability of secure electronic data transfers, most medical information is still stored on paper, and it is usually shared by mail, fax or the patients themselves. Today's technologies aim to the challenge of sharing healthcare information, since exchanging inaccurate data leads to inefficiency and errors. Currently, there exist numerous techniques for exchanging data, which however require continuous internet connection, thus lacking generic applicability in healthcare, in the cases where no internet connection is available. In this paper, a new Device-to-Device (D2D) protocol is proposed, specifying a series of Bluetooth messages regarding the healthcare information that is being exchanged in short-range distances, between a healthcare-practitioner and a citizen. This information refers to structured and unstructured data, which can be directly exchanged through a globally used communication protocol, extending it for the permission of exchanging HL7 FHIR Bluetooth structured messages. Moreover, for high volume data, the D2D protocol can support lossless compression and decompression, improving its overall efficiency. The protocol is firstly evaluated through exchanging sample data in a real-world scenario, whereas an overall comparison of exchanging multiple sized data either using lossless compression or not is being provided. According to the evaluation results, the D2D protocol specification was strictly followed, successfully providing the ability to exchange healthcare-related data, with Bluetooth being considered the most suitable technology for current needs. For small-sized data, the D2D protocol performs better without the provided lossless compression mechanism, whereas in the case of large-sized data lossless compression is considered as the only option.


Assuntos
Compressão de Dados , Troca de Informação em Saúde , Atenção à Saúde , Humanos
5.
J Med Internet Res ; 24(9): e33775, 2022 09 29.
Artigo em Inglês | MEDLINE | ID: mdl-36173664

RESUMO

BACKGROUND: Quality patient care requires comprehensive health care data from a broad set of sources. However, missing data in medical records and matching field selection are 2 real-world challenges in patient-record linkage. OBJECTIVE: In this study, we aimed to evaluate the extent to which incorporating the missing at random (MAR)-assumption in the Fellegi-Sunter model and using data-driven selected fields improve patient-matching accuracy using real-world use cases. METHODS: We adapted the Fellegi-Sunter model to accommodate missing data using the MAR assumption and compared the adaptation to the common strategy of treating missing values as disagreement with matching fields specified by experts or selected by data-driven methods. We used 4 use cases, each containing a random sample of record pairs with match statuses ascertained by manual reviews. Use cases included health information exchange (HIE) record deduplication, linkage of public health registry records to HIE, linkage of Social Security Death Master File records to HIE, and deduplication of newborn screening records, which represent real-world clinical and public health scenarios. Matching performance was evaluated using the sensitivity, specificity, positive predictive value, negative predictive value, and F1-score. RESULTS: Incorporating the MAR assumption in the Fellegi-Sunter model maintained or improved F1-scores, regardless of whether matching fields were expert-specified or selected by data-driven methods. Combining the MAR assumption and data-driven fields optimized the F1-scores in the 4 use cases. CONCLUSIONS: MAR is a reasonable assumption in real-world record linkage applications: it maintains or improves F1-scores regardless of whether matching fields are expert-specified or data-driven. Data-driven selection of fields coupled with MAR achieves the best overall performance, which can be especially useful in privacy-preserving record linkage.


Assuntos
Troca de Informação em Saúde , Registro Médico Coordenado , Algoritmos , Humanos , Recém-Nascido , Registro Médico Coordenado/métodos , Sistema de Registros , Projetos de Pesquisa
6.
J Am Med Inform Assoc ; 29(12): 2201-2205, 2022 11 14.
Artigo em Inglês | MEDLINE | ID: mdl-36164822

RESUMO

The foundational role of health information exchanges (HIEs) is to facilitate communication between clinical partners in real time. Once this infrastructure for the secure and immediate flow of patient information is built, however, HIEs can benefit community public health and clinical care in myriad other ways that are in line with their mission, goals, patient privacy, and funding structures. We encourage the development of community-integrated HIEs and list specific steps that can be taken toward community integration. We give three examples of those steps in action from a community HIE in El Paso, TX. Each local partnership, in combination with technology innovation, resulted in the development of informatics tools to address community health needs and generated long-term benefits, especially for the most vulnerable patients. Two examples relate to different aspects of the COVID-19 pandemic and a third to the Afghan refugee evacuation.


Assuntos
COVID-19 , Troca de Informação em Saúde , Humanos , Texas , Pandemias , Confidencialidade
7.
Med Care ; 60(12): 880-887, 2022 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-36049157

RESUMO

BACKGROUND: Increasing electronic health information exchange (HIE) between provider organizations is a top policy priority that has been pursued by establishing varied types of networks. OBJECTIVES: To measure electronic connectivity enabled by these networks, including community, electronic health record vendor, and national HIE networks, across US hospitals weighted by the volume of shared patients and identify characteristics that predict connectivity. RESEARCH DESIGN: Cross-sectional analysis of 1721 hospitals comprising 16,344 hospital pairs and 6,492,232 shared patients from 2018 CareSet Labs HOP data and national hospital surveys. SUBJECTS: Pairs of US acute care hospitals that delivered care to 11 or more of the same fee-for-service Medicare beneficiaries in 2018. MEASURES: Whether a patient was treated by a pair of hospitals connected through participation in the same HIE network ("connected hospitals") or not connected because the hospitals participated in different networks, only 1 participated, or both did not participate. RESULTS: Sixty-four percent of shared patients were treated by connected hospitals. Of the remaining shared patients, 14% were treated by hospital pairs that participated in different HIE networks, 21% by pairs in which only 1 hospital participated in an HIE network, and 2% by pairs in which neither participated. Patients treated by pairs with at least 1 for-profit hospital, and by pairs located in competitive markets, were less likely to be treated by connected hospitals. CONCLUSIONS: While the majority of shared patients received care from connected hospitals, remaining gaps could be filled by connecting HIE networks to each other and by incentivizing certain types of hospitals that may not participate because of competitive concerns.


Assuntos
Troca de Informação em Saúde , Medicare , Idoso , Humanos , Estados Unidos , Estudos Transversais , Hospitais , Registros Eletrônicos de Saúde , Eletrônica
8.
Appl Clin Inform ; 13(4): 803-810, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35858639

RESUMO

BACKGROUND AND OBJECTIVES: School-aged children with chronic conditions require care coordination for health needs at school. Access to the student's accurate, real-time medical information is essential for school nurses to maximize their care of students. We aim to analyze school nurse access to medical records in a hospital-based electronic health record (EHR) and the effect on patient outcomes. We hypothesized that EHR access would decrease emergency department (ED) visits and inpatient hospitalizations. METHODS: This retrospective secondary data analysis was conducted using EHR data 6 months pre- and post-school nurse access to students' hospital-based EHR. The main outcome measures were the ED visits and inpatient hospitalizations. RESULTS: For the sample of 336 students in the study, there was a 34% decrease in ED visits from 190 visits before access to 126 ED visits after access (p <0.01). Inpatient hospitalizations decreased by 44% from 176 before access to 99 after access (p <0.001). The incident rate of ED visits decreased (IRR: 0.66; 95% CI: 0.53-0.83; p = 0.00035), and hospitalizations decreased (IRR: 0.56; 95% CI: 0.44-0.72; p <0.0001) from pre to post access. These findings suggest school nurse access to medical records is a positive factor in improving school-aged patient outcomes. CONCLUSION: School nurse access to medical records through the hospital-based EHR may be a factor to improve patient outcomes by utilizing health information technology for more efficient and effective communication and care coordination for school-aged children with chronic medical conditions.


Assuntos
Troca de Informação em Saúde , Criança , Doença Crônica , Registros Eletrônicos de Saúde , Serviço Hospitalar de Emergência , Hospitalização , Humanos , Avaliação de Resultados em Cuidados de Saúde , Estudos Retrospectivos
9.
RECIIS (Online) ; 16(2): 404-426, abr.-jun. 2022. ilus, tab
Artigo em Português | LILACS | ID: biblio-1378408

RESUMO

As mídias sociais são importantes canais de difusão de informações em saúde. O objetivo deste artigo é apresentar um modelo de estudo métrico de informações para minerar temáticas relacionadas à covid-19 no Facebook, intitulado AC-Redes semânticas de hashtags. O modelo é composto pelos métodos de análise de redes semânticas e de análise de coocorrência. As métricas aplicadas no período de maio de 2020 a janeiro de 2021 foram: as frequências de hashtags, as centralidades de grau e de intermediação e o índice incidência-fidelidade; e o estudo de ilhas. As temáticas identificadas foram: 'Educação na pandemia'; 'Trabalho e pandemia'; 'Ciência, saúde e pandemia'; 'Isolamento social na pandemia'; e 'Política e pandemia'. Por meio desse modelo, foi possível identificar as temáticas mais relevantes sobre a covid-19 para os usuários do Facebook.


Social media are important channels for the dissemination of information on public health. The goal of this paper is to present a model of quantitative analysis of information from the hashtags with respect to covid-19 on Facebook, called CA-Hashtag semantic networks. This model consists of the methods of semantic network analysis and co-occurrence analysis.The metrics used from May 2020 to January 2021 were: hashtag's frequency, degree and betweenness centralities and incidence-fidelity index; and study of islands. The themes identified have been: 'Education in the pandemic'; 'Work and pandemic'; 'Science, health and pandemic'; 'Social isolation in the pandemic'; and 'Politics and pandemic'. Applying the proposed model, it has been possible to identify the most relevant themes about covid-19 for Facebook users.


Las redes sociales son canales importantes para la difusión de información sobre salud pública. El objetivo del artículo es presentar un modelo de análisis cuantitativo de información a partir de los contenidos de hashtags relacionadas con covid-19 en Facebook, llamado de AC-Redes semánticas de hashtags. Este modelo es compuesto por los métodos de análisis de redes semánticas y análisis de co-ocurrencia. Las métricas utilizadas desde mayo de 2020 hasta enero de 2021 han sido: la frecuencia de hashtags, las centralidades de grado e intermediación y el índice incidencia-fidelidad; e el estudio de islas. Los temas identificados han sido: 'Educación en la pandemia'; 'Trabajo y pandemia'; 'Ciencia, salud y pandemia'; 'Aislamiento social en la pandemia'; y 'Política y pandemia'. Con basis en el modelo propuesto, ha sido posible identificar los temas más relevantes sobre covid-19 para los usuarios de Facebook.


Assuntos
Humanos , Troca de Informação em Saúde , Web Semântica , COVID-19 , Isolamento Social , Disseminação de Informação , Educação , Pandemias , Mídias Sociais
10.
RECIIS (Online) ; 16(2): 266-280, abr.-jun. 2022. ilus
Artigo em Português | LILACS | ID: biblio-1378355

RESUMO

Este trabalho tem como objetivo relatar estratégias para coleta de um conjunto de dados em português para treinamento de modelos de Inteligência Artificial com vistas a identificar de forma automática fake news sobre covid-19 disseminadas durante a pandemia, a partir de código Python. Analisamos um método de detecção de fake news baseado em uma Rede Neural Recorrente e de aprendizagem supervisionada. Selecionamos um corpus com 7,2 mil textos coletados em websites e agências de notícias por Monteiro et al. (2018) com cada um previamente catalogado como verdadeiro ou falso como conjunto de dados de treino e validação. O modelo foi usado para detecção de fake news sobre covid-19 em um conjunto de notícias coletadas e classificadas pelos autores deste trabalho. O índice de acerto foi de 70%, ou seja, essa foi a taxa de sucesso da detecção dos itens catalogados.


This work aims to report strategies for collecting a dataset in Portuguese for training Artificial Intelligence models to automatically identify fake news about covid-19 disseminated during the pandemic, using Python code. We analyze a fake news detection method based on a Recurrent Neural Network and supervised learning. We selected a corpus with 7,200 texts collected on websites and news agencies by Monteiro et al. (2018), each one of them previously cataloged as true or false as a training and validation dataset. This model was used to detect fake news about covid-19 in a set of news collected and classified by the authors of this work. The hit rate was 70%.


Este trabajo tiene como objetivo informar estrategias para recopilar un conjunto de datos en portugués para entrenar modelos de Inteligencia Artificial para identificar automáticamente noticias falsas sobre covid-19 difundidas durante la pandemia, utilizando el código Python. Analizamos un método de detección de noticias falsas basado en una Red Neuronal Recurrente y de aprendizaje supervisado. Seleccionamos un corpus de 7.200 textos recogidos en webs y agencias de noticias por Monteiro et al. (2018) con cada uno catalogado previamente como verdadero o falso como un conjunto de datos de entrenamiento y validación. El modelo se utilizó para detectar noticias falsas sobre covid-19 en un conjunto de noticias recopiladas y clasificadas por los autores de este trabajo. La tasa de acierto fue del 70%, es decir, esta fue la tasa de éxito de detección de los artículos catalogados.


Assuntos
Humanos , Linguagens de Programação , Inteligência Artificial , Comunicação , COVID-19 , Desinformação , Coleta de Dados , Notícias , Troca de Informação em Saúde
11.
Recurso educacional aberto em Espanhol | CVSP - Regional | ID: oer-4059

RESUMO

Conocer y aplicar modelos de acrónimo específicas para definir la pregunta de investigación Tipos de estudios clínicos Funciones de búsqueda y navegación, Localización de descriptores (DeCS/MeSH) Búsqueda


Assuntos
Bibliotecas Digitais , Nicarágua , Métodos , Troca de Informação em Saúde
12.
Health Informatics J ; 28(2): 14604582221105444, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35676746

RESUMO

Stratification modeling in health services is useful to identify differential patient risk groups, or latent classes. Given the frequency and costs, repeated emergency department (ED) may be an appropriate candidate for risk stratification modeling. We applied a method called group-based trajectory modeling (GBTM) to a sample of 37,416 patients who visited an urban, safety-net ED between 2006 and 2016. Patients had up to 10 ED visits during the study period. Data sources included the hospital's electronic health record (EHR), the state-wide health information exchange system, and area-level social determinants of health factors. Results revealed three distinct trajectory groups. Trajectories with a higher risk of revisit were marked by more patients with behavioral diagnoses, injuries, alcohol & substance abuse, stroke, diabetes, and other factors. The application of advanced computational techniques, like GBTM, provides opportunities for health care organizations to better understand the underlying risks of their large patient populations. Identifying those patients who are likely to be members of high-risk trajectories allows healthcare organizations to stratify patients by level of risk and develop early targeted interventions.


Assuntos
Serviço Hospitalar de Emergência , Troca de Informação em Saúde , Registros Eletrônicos de Saúde , Humanos , Estudos Retrospectivos
13.
J Med Syst ; 46(7): 51, 2022 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-35678939

RESUMO

Excessive amounts of resources in healthcare are wasted due to duplicated or unnecessary health screenings, especially in the diagnosis of low back pain (LBP). Research shows that two-thirds of people will present with LBP at some point throughout their lifetime, but 20-50% of high-tech imaging procedures fail to provide information that improves the patient's condition, representing unnecessary services. The purpose of this study was to evaluate the existence of unnecessary imaging for low back pain throughout healthcare systems in Nebraska based on what was documented in the electronic health record. This study was a retrospective electronic health record analysis of a limited data set focused on procedures related to imaging for LBP extracted from Nebraska Health Information Exchange (HIE) managed by CyncHealth. The sample included 937 patient records with a diagnosis of LBP who received imaging in the state of Nebraska and whose health record was recorded in the Nebraska HIE. To determine necessity, records were categorized in three areas including necessary imaging, likely wasteful imaging, or wasteful imaging based on the criteria from the "First, Do No Harm" study conducted by the Washington Health Alliance. Results revealed a total of 51% of low back pain imaging considered wasteful, 35% likely wasteful, and 14% necessary. Based on these results, further research is warranted to determine specific demographics related to necessary, likely wasteful, and wasteful imaging and the purpose for performing these expensive imaging procedures.


Assuntos
Troca de Informação em Saúde , Dor Lombar , Registros Eletrônicos de Saúde , Humanos , Dor Lombar/diagnóstico por imagem , Nebraska , Estudos Retrospectivos
14.
Stud Health Technol Inform ; 290: 3-6, 2022 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-35672959

RESUMO

Clinical researchers hold high expectations for the utility of health data sourced from hospital information systems. In Japan, the standardized structured medical information eXchange version 2 (SS-MIX2) storage is a common resource for obtaining clinical data from different medical databases. However, little is known about the coverage of the data types derived from the SS-MIX2 storage. In this regard, we calculated the proportions of a dataset that could be extracted via SS-MIX2 for various clinical study categories listed in various articles published in the New England Journal of Medicine. In the 95 articles reviewed, the proportions varied from 13.3% ± 13.3% (mean ± SD) for dementia to 61.8% ± 13.7% for diabetes. For cardiology, the proportion of data accessed in a unique format (SEAMAT) increased significantly. We further noted that there was room for improvement in the coverage of SS-MIX2 data.


Assuntos
Cardiologia , Troca de Informação em Saúde , Sistemas de Informação Hospitalar , Bases de Dados Factuais , Japão
15.
J Am Pharm Assoc (2003) ; 62(5): 1615-1622, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35718713

RESUMO

BACKGROUND: Community pharmacists are one of the most accessible health professionals and provide many different services. However, lack of access to complete patient information is a barrier to making meaningful patient interventions. OBJECTIVES: To determine (1) current and desired health information access among community pharmacists in the Community Pharmacy Enhanced Services Network (CPESN) of Indiana and (2) design considerations for a health information exchange tool for use by community pharmacists. METHODS: This voluntary study was conducted over an 8-day survey period in which 40 pharmacies within the CPESN Indiana network were contacted during regular business hours and asked to take part in a 15-minute telephone survey. Questions asked were informed by the following Consolidated Framework for Implementation Research intervention characteristics domain constructs: relative advantage, evidence strength and quality, adaptability, trialability, complexity, costs, and design quality and packaging. RESULTS: Of the 40 contacted pharmacies, 32 (80%) completed the survey. Most pharmacies reported access to immunization registry data; no other routine access was reported by any pharmacy. In questions assessing the relative advantage of Health Information Exchange (HIE) access compared with their current information access, at least 84.4% said that they agreed or strongly agreed with all statements. When choosing the data element most desirable to have access to via HIE in a community pharmacy, the most frequently selected choices were updated medication orders (n = 18, 56.3%), progress notes (n = 5, 15.6%), and laboratory tests (n = 4, 12.5%). Suggestions to improve ease of implementation included integration within dispensing software and clinical decision-making support features, such as alerts for pertinent lab values. CONCLUSION: Integrating HIE data into community pharmacies would provide community pharmacists with access to important patient data, and pharmacists believed that this would improve their practice. Future research should explore whether implementation of this type of tool leads to better patient outcomes and improved pharmacist job satisfaction.


Assuntos
Serviços Comunitários de Farmácia , Troca de Informação em Saúde , Farmácias , Humanos , Indiana , Farmacêuticos
16.
Appl Clin Inform ; 13(3): 592-601, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35732191

RESUMO

BACKGROUND: Health information exchange (HIE) allows healthcare providers to access a patient's medical information to improve patient care continuity. The standardized data realize the HIE values. Since the Health Level 7 Clinical Document Architecture (CDA) is flexible, implementation guides (IG) are needed for use cases. Although many CDA IGs have been developed, they did not describe how these CDA IGs were developed. A national CDA IG that meets the local requirements is demanded since the data differs according to the digital divide and social-cultural background of the country that wants to establish HIE. Due to their localized contents, other countries cannot directly adopt the published CDA IGs. OBJECTIVES: We developed the national CDA IG, namely, Korean (K)-CDA IG that meets the local requirement, including reusable structured templates, value sets, and object identifiers (OIDs). We present a detailed description of the development process and the technical methods of the national CDA IG in the Korean context. METHODS: The K-CDA IG was developed in the following stages: analysis, development, and evaluation. First, we investigated the health information environment and electronic health record (EHR) systems and conducted a gap analysis with published CDA IGs. Second, a templated CDA approach was taken for designing modular. Lastly, we consulted a technical advisory group for comments on the validity of the K-CDA IG. RESULTS: A total of 35 CDA templates were developed. We improved 28 value sets of which 13 were Korea specific and 15 were based on the ones used in other IGs, and made a set of rules to establish the OID structure. CONCLUSION: We presented the development process and the technical specifications of K-CDA IG. We explored how the results can be used as interoperability criteria in the national EHR systems certification program. Finally, we provided recommendations that could guide other entities planning their HIE programs.


Assuntos
Troca de Informação em Saúde , Continuidade da Assistência ao Paciente , Registros Eletrônicos de Saúde , Nível Sete de Saúde , Humanos , Software
17.
J Am Med Inform Assoc ; 29(9): 1489-1496, 2022 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-35652172

RESUMO

OBJECTIVE: Hospitals have multiple methods available to engage in health information exchange (HIE); however, it is not well understood whether these methods are complements or substitutes. We sought to characterize patterns of adoption of HIE methods and examine the association between these methods and increased availability and use of patient information. MATERIALS AND METHODS: Cross-sectional analysis of 3208 nonfederal acute care hospitals in the 2019 American Hospital Association Information Technology Supplement. RESULTS: The median hospital obtained outside information through 4 methods. Hospitals that obtained data through a regional HIE organization were 2.2 times more likely to also obtain data via Direct using a health information service provider (HISP) than hospitals that did not (P < .001). Hospitals in a single electronic health record (EHR) vendor network were no more or less likely to participate in a HISP or HIE. Six of 7 methods were associated with greater information availability. Only 4 of 7 methods (portals, interfaces, single vendor networks and multi-vendor networks but not access to outside EHR, regional exchange or Direct using a HISP) were associated with more frequent use of information, and single vendor networks were most strongly associated with more frequent use (odds ratio = 4.7, P < .001). DISCUSSION: Adoption of some methods was correlated, indicating complementary use. Few methods were negatively correlated, indicating limited competition. Although information availability was common, low correlation with use indicated that challenges related to integration may be slowing use of information. CONCLUSION: Complementarities between methods, and the role of integration in supporting information use, indicate the potential value of efforts aimed at ensuring exchange methods work well together, such as the Trusted Exchange Framework and Common Agreement.


Assuntos
Troca de Informação em Saúde , Comércio , Estudos Transversais , Registros Eletrônicos de Saúde , Hospitais , Humanos , Estados Unidos
18.
Stud Health Technol Inform ; 292: 9-14, 2022 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-35575842

RESUMO

Healthcare processes have many particularities captured and described within standards for medical information exchange such as HL7 FHIR. BPMN is a widely used standard to create readily understandable processes models. We show an approach to integrate both these standards via an automated transformation mechanism. This will allow us to use the various tools available for BPMN to visualize and automate processes in the healthcare domain. In the future we plan to extend this approach to enable mining and analyzing executed processes.


Assuntos
Registros Eletrônicos de Saúde , Troca de Informação em Saúde , Procedimentos Clínicos , Atenção à Saúde , Instalações de Saúde , Nível Sete de Saúde
19.
JMIR Public Health Surveill ; 8(9): e35973, 2022 09 27.
Artigo em Inglês | MEDLINE | ID: mdl-35544440

RESUMO

BACKGROUND: Disease surveillance is a critical function of public health, provides essential information about the disease burden and the clinical and epidemiologic parameters of disease, and is an important element of effective and timely case and contact tracing. The COVID-19 pandemic demonstrates the essential role of disease surveillance in preserving public health. In theory, the standard data formats and exchange methods provided by electronic health record (EHR) meaningful use should enable rapid health care data exchange in the setting of disruptive health care events, such as a pandemic. In reality, access to data remains challenging and, even if available, often lacks conformity to regulated standards. OBJECTIVE: We sought to use regulated interoperability standards already in production to generate awareness of regional bed capacity and enhance the capture of epidemiological risk factors and clinical variables among patients tested for SARS-CoV-2. We described the technical and operational components, governance model, and timelines required to implement the public health order that mandated electronic reporting of data from EHRs among hospitals in the Chicago jurisdiction. We also evaluated the data sources, infrastructure requirements, and the completeness of data supplied to the platform and the capacity to link these sources. METHODS: Following a public health order mandating data submission by all acute care hospitals in Chicago, we developed the technical infrastructure to combine multiple data feeds from those EHR systems-a regional data hub to enhance public health surveillance. A cloud-based environment was created that received ELR, consolidated clinical data architecture, and bed capacity data feeds from sites. Data governance was planned from the project initiation to aid in consensus and principles for data use. We measured the completeness of each feed and the match rate between feeds. RESULTS: Data from 88,906 persons from CCDA records among 14 facilities and 408,741 persons from ELR records among 88 facilities were submitted. Most (n=448,380, 90.1%) records could be matched between CCDA and ELR feeds. Data fields absent from ELR feeds included travel histories, clinical symptoms, and comorbidities. Less than 5% of CCDA data fields were empty. Merging CCDA with ELR data improved race, ethnicity, comorbidity, and hospitalization information data availability. CONCLUSIONS: We described the development of a citywide public health data hub for the surveillance of SARS-CoV-2 infection. We were able to assess the completeness of existing ELR feeds, augment those feeds with CCDA documents, establish secure transfer methods for data exchange, develop a cloud-based architecture to enable secure data storage and analytics, and produce dashboards for monitoring of capacity and the disease burden. We consider this public health and clinical data registry as an informative example of the power of common standards across EHRs and a potential template for future use of standards to improve public health surveillance.


Assuntos
COVID-19 , Troca de Informação em Saúde , COVID-19/epidemiologia , Humanos , Pandemias/prevenção & controle , Saúde Pública , SARS-CoV-2
20.
Clin Chim Acta ; 532: 10-12, 2022 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-35594920

RESUMO

Laboratory tests, especially point-of-care testing (POCT), and related health information exchange (HIE) are necessary for patient management in the home care setting, where clinic-hospital cooperation and interprofessional collaboration are important. We raised the issues ahead of HIE in relation to POCT in home care in Japan, including issues in electronic medical record use, localized interprofessional collaboration networks with information and communication technology, personal health record use and open connectivity. HIE system may depend on the initiatives of expert communities with non-expert partnership, as well as national healthcare policies. We promote future challenges in this growing area.


Assuntos
Troca de Informação em Saúde , Serviços de Assistência Domiciliar , Registros Eletrônicos de Saúde , Humanos , Japão , Testes Imediatos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...