Organizational and Implementation Factors Associated with Cirrhosis Care in the Veterans Health Administration.

BACKGROUND: The Veterans Health Administration provides care to more than 100,000 Veterans with cirrhosis. AIMS: This implementation evaluation aimed to understand organizational resources and barriers associated with cirrhosis care. METHODS: Clinicians across 145 Department of Veterans Affairs (VA) medical centers (VAMCs) were surveyed in 2022 about implementing guideline-concordant cirrhosis care. VA Corporate Data Warehouse data were used to assess VAMC performance on two national cirrhosis quality measures: HCC surveillance and esophageal variceal surveillance or treatment (EVST). Organizational factors associated with higher performance were identified using linear regression models. RESULTS: Responding VAMCs (n = 124, 86%) ranged in resource availability, perceived barriers, and care processes. In multivariable models, factors independently associated with HCC surveillance included on-site interventional radiology and identifying patients overdue for surveillance using a national cirrhosis population management tool ("dashboard"). EVST was significantly associated with dashboard use and on-site gastroenterology services. For larger VAMCs, the average HCC surveillance rate was similar between VAMCs using vs. not using the dashboard (47% vs. 41%), while for smaller and less resourced VAMCs, dashboard use resulted in a 13% rate difference (46% vs. 33%). Likewise, higher EVST rates were more strongly associated with dashboard use in smaller (55% vs. 50%) compared to larger (57% vs. 55%) VAMCs. CONCLUSIONS: Resources, barriers, and care processes varied across diverse VAMCs. Smaller VAMCs without specialty care achieved HCC and EVST surveillance rates nearly as high as more complex and resourced VAMCs if they used a population management tool to identify the patients due for cirrhosis care.

Digital dashboards for direct oral anticoagulant surveillance, intervention and operational efficiency: uptake, obstacles, and opportunities.

Direct oral anticoagulants (DOAC) are the most widely prescribed oral anticoagulants in the United States. Despite advantages over warfarin, system-level improvements are needed to optimize outcomes. While Veterans Health Administration and others have described successful DOAC management dashboard implementation, the extent of use nationally is unknown. A survey of Anticoagulation Forum's members was conducted to assess access to digital tools available within a dashboard and to describe implementation models. An Expert Forum was subsequently convened to identify barriers to dashboard development and adoption. Responses were received from 340 targeted recipients (8.5% of invitees). Only a minority of inpatient (25/52, 48.1%) and outpatient (47/133, 35.3%) respondents outside of Veterans Health Administration were able to generate rosters of DOAC users on-demand, and fewer had the ability to digitally display key clinical data elements, identify drug-related problems, document interventions, or generate reports. The lack of regulatory requirements regarding Anticoagulation Stewardship was identified by the Expert Forum as the major barrier to widespread development of digital tools for improved anticoagulation management. While some health systems have demonstrated the feasibility of DOAC dashboards and described their impact on quality and efficiency, these tools do not appear to be widely available in the United States apart from Veterans Health Administration. The lack of regulatory requirements for Anticoagulation Stewardship may be the primary barrier to the development of digital resources to better manage anticoagulants. Efforts to secure regulatory requirements for Anticoagulation Stewardship are needed, and evidence of improvements in clinical and financial outcomes through DOAC dashboard use will likely bolster such efforts.

Developing public health surveillance dashboards: a scoping review on the design principles.

BACKGROUND: Public Health Dashboards (PHDs) facilitate the monitoring and prediction of disease outbreaks by continuously monitoring the health status of the community. This study aimed to identify design principles and determinants for developing public health surveillance dashboards. METHODOLOGY: This scoping review is based on Arksey and O'Malley's framework as included in JBI guidance. Four databases were used to review and present the proposed principles of designing PHDs: IEEE, PubMed, Web of Science, and Scopus. We considered articles published between January 1, 2010 and November 30, 2022. The final search of articles was done on November 30, 2022. Only articles in the English language were included. Qualitative synthesis and trend analysis were conducted. RESULTS: Findings from sixty-seven articles out of 543 retrieved articles, which were eligible for analysis, indicate that most of the dashboards designed from 2020 onwards were at the national level for managing and monitoring COVID-19. Design principles for the public health dashboard were presented in five groups, i.e., considering aim and target users, appropriate content, interface, data analysis and presentation types, and infrastructure. CONCLUSION: Effective and efficient use of dashboards in public health surveillance requires implementing design principles to improve the functionality of these systems in monitoring and decision-making. Considering user requirements, developing a robust infrastructure for improving data accessibility, developing, and applying Key Performance Indicators (KPIs) for data processing and reporting purposes, and designing interactive and intuitive interfaces are key for successful design and development.

A mixed methods evaluation assessing the feasibility of implementing a PrEP data dashboard in the Southeastern United States.

BACKGROUND: Alabama is one of seven priority states for the National Ending the HIV Epidemic Initiative due to a disproportionate burden of rural infections. To reverse growing infection rates, the state must increase its focus on prevention efforts, including novel strategies. One such approach is to utilize dashboards that visualize real-time data on the pre-exposure prophylaxis (PrEP) care continuum to assist in prioritizing evidence-based preventative care for those most vulnerable for HIV infection. METHODS: We conducted a mixed methods evaluation to ascertain stakeholders' perceptions on the acceptability, feasibility, appropriateness, and usability of a PrEP care continuum dashboard, as well as gain insight on ways to improve the activities necessary to sustain it. Clinicians, administrators, and data personnel from participating sites in Alabama completed surveys (n = 9) and participated in key informant interviews (n = 10) to better understand their experiences with the prototype data dashboard and to share feedback on how it can be modified to best fit their needs. RESULTS: Surveys and interviews revealed that all participants find the pilot data dashboard to be an acceptable, feasible, and appropriate intervention for clinic use. Overall, stakeholders find the pilot dashboard to be usable and helpful in administrative efforts, such as report and grant writing; however, additional refining is needed in order to reduce burden and optimize usefulness. Participants voiced concerns about their site's abilities to sustain the dashboard, including the lack of systematized PrEP protocols and limited funds and staff time dedicated to PrEP data collection, cleaning, and upload. CONCLUSION: Study participants from clinics providing HIV prevention services, including PrEP, in Alabama voiced interest in sustaining and refining a data dashboard that tracks clients across the PrEP care continuum. Despite viewing the platform itself as an acceptable, feasible, and appropriate intervention, participants agreed that efforts need to be focused on standardizing PrEP data collection protocols in order to ensure consistent, accurate data capture and that limited funds and staff time are barriers to the sustained implementation of the dashboard in practice.

Using the technology acceptance model to assess clinician perceptions and experiences with a rheumatoid arthritis outcomes dashboard: qualitative study.

BACKGROUND: Improving shared decision-making using a treat-to-target approach, including the use of clinical outcome measures, is important to providing high quality care for rheumatoid arthritis (RA). We developed an Electronic Health Record (EHR) integrated, patient-facing sidecar dashboard application that displays RA outcomes, medications, and lab results for use during clinical visits ("RA PRO dashboard"). The purpose of this study was to assess clinician perceptions and experiences using the dashboard in a university rheumatology clinic. METHODS: We conducted focus group (FG) discussions with clinicians who had access to the dashboard as part of a randomized, stepped-wedge pragmatic trial. FGs explored clinician perceptions towards the usability, acceptability, and usefulness of the dashboard. FG data were analyzed thematically using deductive and inductive techniques; generated themes were categorized into the domains of the Technology Acceptance Model (TAM). RESULTS: 3 FG discussions were conducted with a total of 13 clinicians. Overall, clinicians were enthusiastic about the dashboard and expressed the usefulness of visualizing RA outcome trajectories in a graphical format for motivating patients, enhancing patient understanding of their RA outcomes, and improving communication about medications. Major themes that emerged from the FG analysis as barriers to using the dashboard included inconsistent collection of RA outcomes leading to sparse data in the dashboard and concerns about explaining RA outcomes, especially to patients with fibromyalgia. Other challenges included time constraints and technical difficulties refreshing the dashboard to display real-time data. Methods for integrating the dashboard into the visit varied: some clinicians used the dashboard at the beginning of the visit as they documented RA outcomes; others used it at the end to justify changes to therapy; and a few shared it only with stable patients. CONCLUSIONS: The study provides valuable insights into clinicians' perceptions and experiences with the RA PRO dashboard. The dashboard showed promise in enhancing patient-clinician communication, shared decision-making, and overall acceptance among clinicians. Addressing challenges related to data collection, education, and tailoring dashboard use to specific patient populations will be crucial for maximizing its potential impact on RA care. Further research and ongoing improvements in dashboard design and implementation are warranted to ensure its successful integration into routine clinical practice.

Smart City Scenario Editor for General What-If Analysis.

Due to increasing urbanization, nowadays, cities are facing challenges spanning multiple domains such as mobility, energy, environment, etc. For example, to reduce traffic congestion, energy consumption, and excessive pollution, big data gathered from legacy systems (e.g., sensors not conformant with modern standards), geographic information systems, gateways of public administrations, and Internet of Things technologies can be exploited to provide insights to assess the current status of a city. Moreover, the possibility to perform what-if analyses is fundamental to analyzing the impact of possible changes in the urban environment. The few available solutions for scenario definitions and analyses are limited to addressing a single domain and providing proprietary formats and tools, with scarce flexibility. Therefore, in this paper, we present a novel scenario model and editor integrated into the open-source Snap4City.org platform to enable several processing and what-if analyses in multiple domains. Different from state-of-the-art software, the proposed solution responds to a series of identified requirements, implements NGSIv2-compliant data models with formal descriptions of the urban context, and a scenario versioning method. Moreover, it allows us to carry out analyses on different domains, as shown with some examples. As a case study, a traffic congestion analysis is provided, confirming the validity and usefulness of the proposed solution. This work was developed in the context of CN MOST, the National Center on Sustainable Mobility in Italy, and for the Tourismo EC project.

Development of a Web-Based Oxygenation Dashboard for Preterm Neonates: A Quality Improvement Initiative.

BACKGROUND: Preterm neonates are extensively monitored to require strict oxygen target attainment for optimal outcomes. In daily practice, detailed oxygenation data are hardly used and crucial patterns may be missed due to the snapshot presentations and subjective observations. This study aimed to develop a web-based dashboard with both detailed and summarized oxygenation data in real-time and to test its feasibility to support clinical decision making. METHODS: Data from pulse oximeters and ventilators were synchronized and stored to enable real-time and retrospective trend visualizations in a web-based viewer. The dashboard was designed based on interviews with clinicians. A preliminary version was evaluated during daily clinical rounds. The routine evaluation of the respiratory condition of neonates (gestational age < 32 weeks) with respiratory support at the NICU was compared to an assessment with the assistance of the dashboard. RESULTS: The web-based dashboard included data on the oxygen saturation (SpO2), fraction of inspired oxygen (FiO2), SpO2/FiO2 ratio, and area < 80% and > 95% SpO2 curve during time intervals that could be varied. The distribution of SpO2 values was visualized as histograms. In 65% of the patient evaluations (n = 86) the level of hypoxia was assessed differently with the use of the dashboard. In 75% of the patients the dashboard was judged to provide added value for the clinicians in supporting clinical decisions. CONCLUSIONS: A web-based customized oxygenation dashboard for preterm neonates at the NICU was developed and found feasible during evaluation. More clear and objective information was found supportive for clinicians during the daily rounds in tailoring treatment strategies.

Web-based Dashboard on ECMO Utilization in Germany: An Interactive Visualization, Analyses, and Prediction Based on Real-life Data.

In Germany, a comprehensive reimbursement policy for extracorporeal membrane oxygenation (ECMO) results in the highest per capita use worldwide, although benefits remain controversial. Public ECMO data is unstructured and poorly accessible to healthcare professionals, researchers, and policymakers. In addition, there are no uniform policies for ECMO allocation which confronts medical personnel with ethical considerations during health crises such as respiratory virus outbreaks.Retrospective information on adult and pediatric ECMO support performed in German hospitals was extracted from publicly available reimbursement data and hospital quality reports and processed to create the web-based ECMO Dashboard built on Open-Source software. Patient-level and hospital-level data were merged resulting in a solid base for ECMO use analysis and ECMO demand forecasting with high spatial granularity at the level of 413 county and city districts in Germany.The ECMO Dashboard ( https://www.ecmo-dash.de/ ), an innovative visual platform, presents the retrospective utilization patterns of ECMO support in Germany. It features interactive maps, comprehensive charts, and tables, providing insights at the hospital, district, and national levels. This tool also highlights the high prevalence of ECMO support in Germany and emphasizes districts with ECMO surplus - where patients from other regions are treated, or deficit - origins from which ECMO patients are transferred to other regions. The dashboard will evolve iteratively to provide stakeholders with vital information for informed and transparent resource allocation and decision-making.Accessible public routine data could support evidence-informed, forward-looking resource management policies, which are urgently needed to increase the quality and prepare the critical care infrastructure for future pandemics.

A new rolling forecasting framework using Microsoft Power BI for data visualization: A case study in a pharmaceutical industry.

CONTEXT AND OBJECTIVES: Demand forecasting is a vital step for production planning and consequently, for supply chain efficiency, especially for the pharmaceutical (pharma) supply chain due to its unique characteristics. Numerous models and techniques that are proposed in the literature but little in concrete and generic framework to forecasting process, mainly for pharmaceutical supply chain. Unlike studies in the literature, this study not only perfectly predict the sales of a pharma manufacturer, but also visualize the results via a developed dashboard using modern information technology and business intelligence. MATERIAL AND METHODS: In this research, a rolling forecasting framework comprising of different steps and specialized tools is proposed that can assist supply chain managers to perform an accurate sales forecasting and consequently a better performance and specifically patient satisfaction. The proposed generic framework combines the use of Visual studio C++ software to extract optimal forecasting and the Power BI software to monitor the accuracy of the obtained sales forecasts. Three exponential smoothing methods are integrated in the proposed framework, which is open to adding more new forecasting methods. RESULTS: The proposed framework is tested for many data sets from a pharmaceutical manufacturer company, and the results obtained show superior performance, especially a clear decline in both forecast errors, which can reach 75% and a drop of stock level to 50%. Therefore, the company is currently using it and a future integration with their ERP is being carried out. CONCLUSION: The proposed rolling forecasting framework contributes to insightful decision-making through the visualization of accurate future sales and turnover, and consequently, an efficient stock management and effective production planning.

Assessment of Population-Based Approach to Direct Oral Anticoagulant Management.

Background: As preferences for oral anticoagulation shift from warfarin to direct oral anticoagulants (DOACs), a new care management model is needed. A population approach leveraging a DOAC Dashboard was implemented to track all patients on a DOAC followed by a physician at an academic medical center. The DOAC Dashboard is a real-time report within the electronic health record (EHR) that identifies patients who require evaluation for DOAC dose/therapy adjustment due to changing renal function, age, weight, indication, and/or significant drug-drug interaction (DDI). Objective: This study aims to describe the initial phase of DOAC Dashboard implementation, to evaluate the effectiveness of interventions, and to assess a multidisciplinary approach to management. Method: Retrospective descriptive study of the DOAC Dashboard from August 22, 2019, to January 20, 2022. Primary outcomes include total number of alerts addressed and interventions needed. Secondary outcome is the proportion of interventions implemented by the prescribing clinician. Result: A total of 10 912 patients were identified by the DOAC Dashboard at baseline. A total of 5038 alerts were identified, with 668 critical alerts, 3337 possible critical alerts, and 1033 other alerts. Pharmacists addressed 1796 alerts during the study period (762 critical alerts and 1034 possible critical). Critical alerts included 62 significant DDI, 379 inappropriate dosing, and 321 others. Of the critical alerts, intervention was needed in 291 cases (38%), with 255 (88%) of proposed interventions implemented. Critical alerts and possible critical alerts not requiring intervention were resolved by data entry. Conclusion: The DOAC Dashboard provides an efficient method of identifying patients on DOACs that require dose adjustments or therapeutic modifications.

Development of a risk-tailored approach and dashboard for efficient management and monitoring of investigator-initiated trials.

BACKGROUND: Most randomized controlled trials (RCTs) in the academic setting have limited resources for clinical trial management and monitoring. Inefficient conduct of trials was identified as an important source of waste even in well-designed studies. Thoroughly identifying trial-specific risks to enable focussing of monitoring and management efforts on these critical areas during trial conduct may allow for the timely initiation of corrective action and to improve the efficiency of trial conduct. We developed a risk-tailored approach with an initial risk assessment of an individual trial that informs the compilation of monitoring and management procedures in a trial dashboard. METHODS: We performed a literature review to identify risk indicators and trial monitoring approaches followed by a contextual analysis involving local, national and international stakeholders. Based on this work we developed a risk-tailored management approach with integrated monitoring for RCTs and including a visualizing trial dashboard. We piloted the approach and refined it in an iterative process based on feedback from stakeholders and performed formal user testing with investigators and staff of two clinical trials. RESULTS: The developed risk assessment comprises four domains (patient safety and rights, overall trial management, intervention management, trial data). An accompanying manual provides rationales and detailed instructions for the risk assessment. We programmed two trial dashboards tailored to one medical and one surgical RCT to manage identified trial risks based on daily exports of accumulating trial data. We made the code for a generic dashboard available on GitHub that can be adapted to individual trials. CONCLUSIONS: The presented trial management approach with integrated monitoring enables user-friendly, continuous checking of critical elements of trial conduct to support trial teams in the academic setting. Further work is needed in order to show effectiveness of the dashboard in terms of safe trial conduct and successful completion of clinical trials.

The laboratory journey to become a decision engine: a roadmap for diagnostic transformation.

Laboratories and diagnostic departments are presiding over a massive amount of data they are failing to fully leverage it. Data is the new black gold of healthcare organizations and by extracting insights from it, laboratories could become true decision engines, able to drive action across healthcare. This opinion paper responds three fundamental questions: (1) Where are we (diagnostic parties)? Taking a look at the most significant trends and challenges in healthcare and shedding some light upon the status of diagnostics. (2) Where do we want to be? Reviewing the opportunities for digital health, its role in the healthcare of the future and providing inspiration about what success looks like. (3) What do we need to do? Explaining what Digital Health Solutions (DHS) from Abbott is doing in this regard. This will include information about how DHS can impact the Diagnosis Cycle and how to set a roadmap for laboratories and diagnostic organizations. Diagnosis Cycle means the different steps in the diagnosis process, from the beginning when a patient is seen by a clinician and some tests are ordered, until the results are reviewed by the clinician and the treatment, follow up or discharge is decided.

Development of a prospective biliary dashboard to compare performance and surgical cost.

BACKGROUND: Transparency around surgeon level data may align healthcare delivery with quality care for patients. Biliary surgery includes numerous procedures performed by both general surgeons and subspecialists alike. Cholecystectomy is a common surgical procedure and an optimal cohort to measure quality outcomes within a healthcare system. METHODS: Data were collected for 5084 biliary operations performed by 68 surgeons in 11 surgical divisions in a health system including a tertiary academic hospital, two regional community hospitals, and two ambulatory surgery centers. A privacy protected dashboard was developed to compare surgeon performance and cost between July 2018 and June 2022. A sample cohort of patients ≥ 18 years who underwent cholecystectomy were compared by operative time, cost, and 30-day outcomes. RESULTS: Over 4 years, 4568 cholecystectomy procedures were performed by 57 surgeons. Operations were done by 57 surgeons in four divisions and included 3846 (84.2%) laparoscopic cholecystectomies, 601 (13.2%) laparoscopic cholecystectomies with cholangiogram, and 121 (2.6%) open cholecystectomies. Patients were admitted from the emergency room in 2179 (47.7%) cases while 2389 (52.3%) cases were performed in the ambulatory setting. Individual surgeons were compared to peers for volume, intraoperative data, cost, and outcomes. Cost was lowest at ambulatory surgery centers, yet only 4.2% of elective procedures were performed at these facilities. Prepackaged kits with indocyanine green were more expensive than cholangiograms that used iodinated contrast. The rate of emergency department visits was lowest when cases were performed at ambulatory surgery centers. CONCLUSION: Data generated from clinical dashboards can inform surgeons as to how they compare to peers regarding quality metrics such as cost, time, and complications. In turn, this may guide strategies to standardize care, optimize efficiency, provide cost savings, and improve outcomes for cholecystectomy procedures. Future application of clinical dashboards can assist surgeons and administrators to define value-based care.

Novel device for automating exchange transfusions through umbilical venous route in neonates.

Manually performed double-volume exchange transfusion (DVET) is tedious, error-prone, and may incur the risk of embolism. We aimed to develop a device that automates the DVET procedure performed through the umbilical venous route. We evaluated changes in blood passing through the device during DVET. We developed an electro-mechanical device with accessories (tubing and valve assembly) to perform a complete DVET. It comprises two syringes driven by a common pump that moves back and forth to withdraw aliquots of the patient's blood and infuse equal volumes of donor blood. In tandem, it draws donor blood from a blood bank bag and pushes the patient blood drawn from the previous cycle into a waste bag, respectively. One-way duckbill valves and a two-way pinch valve ensure the separation of the donor and patient blood. A sensor detects bubbles and clots. A dashboard displays set and measured parameters. We tested the accuracy of the delivered flow rate and volume, electrical safety, embolus detection, and changes in hematological and biochemical values. The delivered flow and volume were within 5% of the set parameters. All electrical safety parameters were within normal limits. The sensor consistently detected microbubbles and clots. There were no clinically significant differences in laboratory parameters between samples drawn directly from the blood bank bag and drawn from the exit port at 80, 100, 120, and 160 s with a fixed aliquot volume. CONCLUSIONS: Our prototype of a novel device can safely automate a DVET. Further trials of this device are warranted. WHAT IS KNOWN: • Double volume exchange transfusion is often performed manually, but this is time-consuming and error-prone. • Previous attempts at automation were not widely adopted because they involved inserting two catheters and did not have mechanisms to prevent embolism. WHAT IS NEW: • This novel device fully automates double volume exchange transfusions through a single-lumen umbilical venous catheter. • It prevents air and clot embolism and has a screen for input and output parameters and alarms.

Digital dashboards for oral anticoagulation management: a literature scoping review.

This scoping review summarizes the extent and characteristics of the published literature describing digital population management dashboards implemented to improve the quality of anticoagulant management. A standardized search protocol was executed to identify relevant manuscripts published between January 1, 2015 and May 31, 2022. The resulting records were systematically evaluated by multiple blinded reviewers and the findings from selected papers were evaluated and summarized. Twelve manuscripts were identified, originating from 5 organizations within the US and 2 from other countries. The majority (75%) described implementation in the outpatient setting. The identified papers described a variety of positive results of dashboard use, including a 24.5% reduction of questionable direct oral anticoagulant dosing in one organization, a 33.3% relative improvement in no-show appointments in an ambulatory care clinic, and a 75% improvement in intervention efficiency. One medical center achieved a 98.4% risk-appropriate venous thromboembolism risk prophylaxis prescribing rate and 40.6% reduction in anticoagulation-related adverse event rates. The manuscripts primarily described retrospective findings from single-center dashboard implementation experiences. Digital dashboards have been successfully implemented to support the anticoagulation of acute and ambulatory patients and available manuscripts suggest a positive impact on care-related processes and relevant patient outcomes. Prospective studies are needed to better characterize the implementation and impact of dashboards for anticoagulation management. Published reports suggest that digital dashboards may improve the quality, safety, and efficiency of anticoagulation management. Additional research is needed to validate these findings and to understand how best to implement these tools.

Global mosquito observations dashboard (GMOD): creating a user-friendly web interface fueled by citizen science to monitor invasive and vector mosquitoes.

BACKGROUND: Mosquitoes and the diseases they transmit pose a significant public health threat worldwide, causing more fatalities than any other animal. To effectively combat this issue, there is a need for increased public awareness and mosquito control. However, traditional surveillance programs are time-consuming, expensive, and lack scalability. Fortunately, the widespread availability of mobile devices with high-resolution cameras presents a unique opportunity for mosquito surveillance. In response to this, the Global Mosquito Observations Dashboard (GMOD) was developed as a free, public platform to improve the detection and monitoring of invasive and vector mosquitoes through citizen science participation worldwide. METHODS: GMOD is an interactive web interface that collects and displays mosquito observation and habitat data supplied by four datastreams with data generated by citizen scientists worldwide. By providing information on the locations and times of observations, the platform enables the visualization of mosquito population trends and ranges. It also serves as an educational resource, encouraging collaboration and data sharing. The data acquired and displayed on GMOD is freely available in multiple formats and can be accessed from any device with an internet connection. RESULTS: Since its launch less than a year ago, GMOD has already proven its value. It has successfully integrated and processed large volumes of real-time data (~ 300,000 observations), offering valuable and actionable insights into mosquito species prevalence, abundance, and potential distributions, as well as engaging citizens in community-based surveillance programs. CONCLUSIONS: GMOD is a cloud-based platform that provides open access to mosquito vector data obtained from citizen science programs. Its user-friendly interface and data filters make it valuable for researchers, mosquito control personnel, and other stakeholders. With its expanding data resources and the potential for machine learning integration, GMOD is poised to support public health initiatives aimed at reducing the spread of mosquito-borne diseases in a cost-effective manner, particularly in regions where traditional surveillance methods are limited. GMOD is continually evolving, with ongoing development of powerful artificial intelligence algorithms to identify mosquito species and other features from submitted data. The future of citizen science holds great promise, and GMOD stands as an exciting initiative in this field.

Involving Health Professionals in the Development of Quality and Safety Dashboards: Qualitative Study.

BACKGROUND: Dashboards are an important tool for hospitals to improve quality and safety performance. However, implementing quality and safety dashboards often does not increase performance due to a lack of use by health professionals. Including health professionals in the development process of quality and safety dashboards can improve their use in practice. Yet, it remains unclear how a development process involving health professionals can be executed successfully. OBJECTIVE: The aim of this study is twofold: (1) to delineate how a process whereby health professionals are included in the development of quality and safety dashboards can be facilitated and (2) to identify the factors that are important to consider in order to make that process successful. METHODS: We conducted a qualitative, in-depth exploratory case study in which we analyzed 150 pages of internal documents and interviewed 13 staff members regarding the development of quality and safety dashboards within 2 care pathways of a hospital that has experience in such development. The data were analyzed inductively using the constant comparative method. RESULTS: We found that the development of quality and safety dashboards in collaboration with health professionals was facilitated through a five-stage process: (1) familiarizing participants with dashboards and the development process; (2) brainstorming about potential indicators to be included in the dashboard; (3) prioritizing, defining, and selecting indicators to be included in the dashboard; (4) examining how the indicators can be visualized; and (5) implementing the dashboard and following up on its use. To enhance the success of the process, 3 factors were deemed important. The first is to create and maintain broad involvement, ensuring that various professions are represented and take ownership of the dashboard. Here, potential barriers include gaining engagement from peers not directly involved in the process and maintaining involvement after the initial implementation of the dashboard. Second, unburdening, whereby quality and safety staff facilitate a structured process that has little additional burden for professionals. For this, time management and a lack of collaboration with departments responsible for delivering the data might be an issue. Lastly, focusing on relevance for health professionals, which refers to the inclusion of indicators with value for health professionals. For this factor, a lack of consensus on how indicators should be defined and registered might be a barrier. CONCLUSIONS: Health care organizations seeking to develop quality and safety dashboards in collaboration with health professionals can use a 5-stage process. To enhance the success of the process, organizations are advised to focus on 3 key factors. For each of the key factors, potential barriers should be taken into account. Engaging in this process and attaining the key factors could increase the likelihood that the dashboards are used in practice.

Twelve tips for developing a systematic acute care curriculum for medical students.

There are inadequacies in the practice-readiness of junior doctors for providing acute care in areas of clinical deterioration. In addition, the existing undergraduate curricula are fragmented in how acute care is taught in medical schools. We propose twelve tips for developing a systematic acute care curriculum, including what to teach, how to teach it and, how to assess. Furthermore, we propose and incorporate an acute care learning dashboard as an assessment tool which collates and demonstrates the occurrence of learning, faculty feedback, and students' reflection. We also summarise the existing online resources available for acute care training. We hope to address the existing issues and improve acute care training to prepare the graduates to become practice-ready professionals.

Real-Time Estimation and Monitoring of COVID-19 Aerosol Transmission Risk in Office Buildings.

A healthy and safe indoor environment is an important part of containing the coronavirus disease 2019 (COVID-19) pandemic. Therefore, this work presents a real-time Internet of things (IoT) software architecture to automatically calculate and visualize a COVID-19 aerosol transmission risk estimation. This risk estimation is based on indoor climate sensor data, such as carbon dioxide (CO2) and temperature, which is fed into Streaming MASSIF, a semantic stream processing platform, to perform the computations. The results are visualized on a dynamic dashboard that automatically suggests appropriate visualizations based on the semantics of the data. To evaluate the complete architecture, the indoor climate during the student examination periods of January 2020 (pre-COVID) and January 2021 (mid-COVID) was analyzed. When compared to each other, we observe that the COVID-19 measures in 2021 resulted in a safer indoor environment.

A Real-Time Learning Analytics Dashboard for Automatic Detection of Online Learners' Affective States.

Students' affective states describe their engagement, concentration, attitude, motivation, happiness, sadness, frustration, off-task behavior, and confusion level in learning. In online learning, students' affective states are determinative of the learning quality. However, measuring various affective states and what influences them is exceedingly challenging for the lecturer without having real interaction with the students. Existing studies primarily use self-reported data to understand students' affective states, while this paper presents a novel learning analytics system called MOEMO (Motion and Emotion) that could measure online learners' affective states of engagement and concentration using emotion data. Therefore, the novelty of this research is to visualize online learners' affective states on lecturers' screens in real-time using an automated emotion detection process. In real-time and offline, the system extracts emotion data by analyzing facial features from the lecture videos captured by the typical built-in web camera of a laptop computer. The system determines online learners' five types of engagement ("strong engagement", "high engagement", "medium engagement", "low engagement", and "disengagement") and two types of concentration levels ("focused" and "distracted"). Furthermore, the dashboard is designed to provide insight into students' emotional states, the clusters of engaged and disengaged students', assistance with intervention, create an after-class summary report, and configure the automation parameters to adapt to the study environment.